Home Health Agency Fraud Defense - Oberheiden, P.C.
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Home Health Agency (HHA) Fraud Defense

Federal Defense Attorneys Serving Healthcare Professionals Charged with Home Health Fraud

Lynette Byrd
Attorney Lynette Byrd
Home Health Agency (HHA) Fraud Team Lead
Former DOJ Attorney envelope icon Contact Lynette
Nick Oberheiden
Attorney Nick Oberheiden
Home Health Agency (HHA) Fraud Team Lead envelope icon Contact Nick
Wade McFaul
Wade McFaul
Home Health Agency (HHA) Fraud Consultant
Former HHS-OIG Assistant Special Agent-in-Charge

The rules for federal healthcare programs are complex. Home health providers and business owners can become overwhelmed in attempts to deal with difficult and changing regulations. Business owners may then find themselves in the middle of a government investigation. These are common reasons for investigations:

  • Overly Complicated Rules
  • Untrained or Unmotivated Staff
  • Unreliable Billing Personnel
  • Fast Growing Practice
  • Lack of Compliance Program

What is Medicare Fraud?

Most investigations allege that a home health provider committed Medicare Fraud. Typically, the accusations are billing fraud, improper cost reports, coding fraud, and billing for unnecessary services.

Services charged, but not provided, or billing for the same service more than once, is billing fraud. Improper cost reports include billing for needless procedures and charges for equipment that was never provided.

Finally, one of the most common forms of coding fraud is called up-coding. This term means a service is billed under a code that allows for higher reimbursement than the proper code.

Criminal Penalty

Medicare and Medicaid fraud can result in charges as criminal felonies. Federal prosecutors will attempt to indict the home healthcare company’s responsible owners and staff with fraud under 18 U.S.C. § 1347. Other criminal statutes may also apply.

Civil Penalty

The government will ask for the difference between services charged by and paid to the provider vs. what should have been charged and paid. In addition to repayment, the government can impose a fine based on a percentage of total damage caused by the billing error.

Put our highly experienced team on your side

Dr. Nick Oberheiden
Dr. Nick Oberheiden

Founder

Attorney-at-Law

Lynette S. Byrd
Lynette S. Byrd

Former DOJ Trial Attorney

Partner

Brian J. Kuester
Brian J. Kuester

Former U.S. Attorney

Amanda Marshall
Amanda Marshall

Former U.S. Attorney

Local Counsel

Joe Brown
Joe Brown

Former U.S. Attorney

Local Counsel

John W. Sellers
John W. Sellers

Former Senior DOJ Trial Attorney

Linda Julin McNamara
Linda Julin McNamara

Federal Appeals Attorney

Aaron L. Wiley
Aaron L. Wiley

Former DOJ attorney

Local Counsel

Roger Bach
Roger Bach

Former Special Agent (DOJ)

Chris Quick
Chris J. Quick

Former Special Agent (FBI & IRS-CI)

Michael S. Koslow
Michael S. Koslow

Former Supervisory Special Agent (DOD-OIG)

Ray Yuen
Ray Yuen

Former Supervisory Special Agent (FBI)

What Are the Penalties?

Medicare and Medicaid fraud are serious federal felonies that can be charged in one of two ways.

When is the Investigation Civil? When is It Criminal?

Among the most important questions clients ask us is whether an investigation is civil or criminal. It takes an experienced attorney to open communication with investigating agencies to assess the nature of the case. The FBI showing up at your clinic or office does not always mean the case is criminal. At this critical moment, you must make the proper decisions regarding your counsel.

If you become aware of a healthcare investigation against you, there’s no time to lose. Experienced defense attorneys may be able to keep a case non-criminal from the start.

Contact Oberheiden, P.C. online today.

What Happens in a Home Healthcare Case?

All home healthcare investigations have three stages. First, the government investigates alleged wrongdoings. If convinced of fraud, a subpoena and request for records follows or, the court is asked to execute a search warrant. If you receive a subpoena, or you are handed a search warrant, promptly call experienced defense counsel. In the second stage, your attorney s begin negotiations with government officials. The third stage is resolution of the case. This stage depends on whether your attorneys are able to keep the case civil. If criminal, a court order will resolve the case.

The Five Goals of Our Defense

In each healthcare fraud case, we have five goals to protect our clients:

  • Avoid a Criminal Investigation
  • Avoid Media News Coverage
  • Protect Your Good Name by Keeping the Entire Case Confidential
  • Protect Your Financial Future

Our team is adept at handling healthcare investigations.

At What Point Should You Hire an Attorney?

Never overstated is the importance of hiring experienced defense counsel as soon as possible. You need a experienced defense that can protect your business and good name. One that will keep the investigation civil, not criminal. The more quickly you call us, the higher your chances that we can protect you, your business, and your family.

What is the Emergency Defense Package?

Dr. Nick Oberheiden developed an Emergency Defense Package to provide clients an immediate action plan. It has been featured on news stations and in the media. The Package contains protocols, instructions, and defense strategies. Our main goal is to keep your case non-criminal.

The Emergency Defense Package Contains:

  • General Protocols: What to Do
  • Instructions for Management: How to Deal with Agents
  • Instructions for Management: How to Deal with Employees
  • Instructions for Employees
  • Document Retention Forms
  • Compliance Examination Instructions
  • Important Contact Information

Success Stories

Oberheiden, P.C. appears in governmental investigations across the country. Our healthcare fraud defense attorneys help service providers and businesses in alleged Qui Tam Lawsuits, Stark Law, False Claims Act, or Anti-Kickback violations.

Our attorneys have obtained many successful outcomes for their clients and were able to dismiss healthcare fraud investigations involving the following government agencies:

  • Successful defense of a healthcare services company against an investigation by the Office of Inspector General for Medicare Fraud
  • Successful defense of healthcare company against investigations by the Department of Justice for alleged Healthcare Fraud
  • Successful defense of healthcare company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations
  • Successful defense of a healthcare company against an investigation by the Office of Inspector General and Department of Health and Human Services
  • Successful defense of a healthcare company against an investigation by the Office of Inspector General and the Department of Justice for alleged Medicare Fraud
  • Successful defense of a physician owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations
  • Successful defense of a physician owned entity against an investigation by the Office of Inspector General for alleged fraud

Contact our offices today to discuss your situation with our experienced home health agency fraud defense lawyers. We are here to help you.

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