Hospice Fraud Defense Attorneys
Hospice Care Fraud Defense Lawyers Serving Healthcare Professionals Across the US
Healthcare Fraud Team Lead
Former DOJ Attorney
Healthcare Fraud Team
Healthcare Fraud Team
Former FBI Special Agent
Healthcare Fraud Team
Former HHS-OIG Assistant Special Agent-in-Charge
Hospice providers may be accused of criminal misconduct or exposed to civil liabilities. The government believes that many hospice providers are committing healthcare fraud by billing for unnecessary services. Because hospice fraud is prosecuted as a federal felony, the mere accusation of someone’s involvement in a fraud scheme means the threat of years in prison. Axios reported in August 2023, “After a year of scrutinizing fraud in the hospice industry, Medicare dropped the hammer this week: The agency warned nearly 400 hospices are at risk of being bounced from the program if they can’t prove they’re a legitimate enterprise.”
The last thing you want is the government branding you as a criminal or imposing a civil liability. You could lose the business you created. Our team of former federal prosecutors and hospice care fraud defense lawyers want to fight for your innocence. Call us today at 888-680-1745 today and speak with a former federal prosecutor at no charge to you.
Our “Emergency Defense Package”
Clients in need have no time to waste. Our “Emergency Defense Package” is a tool providing immediate help to clients under government inspection. The package contains proven steps to take control and not be rattled by government investigators. Developed by experienced counsel and former government officials, it will address your most pressing questions, such as:
- Is the investigation civil or criminal?
- Should I talk to the government?
- Do I have a duty to talk to federal agents?
- What should I tell my employees?
- Can I continue my business?
- What happens next in my case?
Put our highly experienced team on your side
Free Consultation
Oberheiden, P.C. successfully assists clients in healthcare fraud cases across the country. we have practice centers in San Francisco, Washington D.C., San Antonio, Austin, Dallas, Houston, Georgia, New Mexico, and Oklahoma. Contact us online today for a free and confidential consultation.
What Constitutes Hospice Fraud?
Hospice Fraud exposes both providers and business owners. Laws apply when directly or indirectly contracting with and paid for services by the government. Nearly every for-profit hospice company in the country has been or will be accused of fraud at some point.
- Booming Business. The government routinely executes criminal search warrants in connection with hospice care. As more than half of all Medicare patients die under hospice care, prosecution is fierce.
- Example: In August 2022, a hospice provider in Texas agreed to repay nearly $1 million for filing false claims for patients not qualifying for the service.
- Certification Errors. Falsified records and kickbacks are reasons for indictments in all types of healthcare fraud. The most common fraud charges relating to hospice care involve a significant Medicare rule. That is, hospice care is only available if a physician certifies the patient has six months or less to live. Lacking certifications, or falsifying them define many fraud charges. Failure to discharge patients if their condition and life expectancy improves also qualifies as fraud.
- Unnecessary Services. The federal government can file fraud charges when medication orders are not for pain or symptom relief, but to treat the underlying condition. To receive hospice care, a patient must agree to stop treating the condition and accept only palliative care. The government may seek charges based on claims the provider ordered unneeded medical equipment. An unusual number of cap repayments, live discharges, elevated levels of care, length of stay, or use of particular diagnostic codes can also draw attention.
What Are the Penalties?
That you can be accountable for hospice fraud should prompt you to invest time and resources in a strategic and thoughtful defense plan.
Hospice fraud is investigated by the Office of Inspector General (OIG), the Department for Health and Human Services (HHS), the Department of Justice (DOJ), the Federal Bureau of Investigation (FBI), Medicaid Fraud Control Units (MFCUs), and State Medicaid Agencies in cooperation with the Healthcare Fraud Prevention and Enforcement Action Team (HEAT), the General Services Administration (GSA), and the Centers for Medicare and Medicaid Services (CMS).
If found guilty, targets of investigations may be exposed to recoupment requests, non-payment of future claims, civil fines of up to $ 11,000 per false claim, exclusion from federal healthcare programs, treble damages, attorney fees, criminal fines, criminal indictment, or incarceration in a federal prison.
Liability does not require a specific intent to violate the law. The government does not even need to prove actual knowledge of the wrongfulness of the transaction.
A Team You Can Trust
The hospice care fraud defense attorneys of Oberheiden, P.C. successfully defend clients against Medicare Fraud, Medicaid Fraud, Tricare Fraud, Anti-Kickback, and False Claims Act accusations. We end quite a few healthcare fraud cases with no civil or criminal liability for our clients. See for yourself, our healthcare defense track record is impeccable.
We are a team of former federal prosecutors and experienced defense attorneys committed to assist you when you need help. We represent nurses, physicians, business owners, hospitals, laboratories, and pharmacies in healthcare probes across the country.
This Is How We Defend Hospice Fraud
When you hire Oberheiden, P.C., you realize that we understand your industry and we know precisely how the government will build its case.
- Industry Knowledge. Because hospice fraud charges often stem from billing and coding errors, a detailed sense of CMS protocols is critical. Don’t let lack of coding policy knowledge or missed updates to billing changes expose your business. You need attorneys who understand billing and coding violations. Our attorneys have analyzed, reviewed, and defended over 500,000 billed claims. Don’t let certifying a patient for hospice care confuse you. Knowing the legal requirements for certifications, our lawyers can work to get your case dismissed.
- Government Experience. The difference between liability and human error is a fine line requiring negotiation skills and attention to detail. The lawyers and former government officials of Oberheiden, P.C. have proven healthcare and law enforcement experience. Our attorneys have extensive knowledge and competence in handling fraud allegations in the healthcare industry. Just look at our track record.
- Civil, not Criminal. Civil, not Criminal. We want to keep investigations civil, not criminal. Many times, our attorneys can persuade the government that errors, if they exist, were not intentional or willful, but human error. Doing so is critical because the government has two choices. Investigate you to seek recoupments or prosecute and indict you to seek imprisonment. The law provides for both.
Government Investigation: Civil or Criminal?
Is the government seeking monetary remedies or criminal indictments and imprisonment? Healthcare fraud statutes offer both options. As of September 2022, the Medicare Fraud Task Force reported 2,688 criminal actions and 3,483 indictments accounting for $4.7 billion in investigative receivables
How can we tell? When first talking to our clients and hearing their side of the story, we develop a sense of how the case may proceed. Years of experience let us to see details and nuances that do not appear relevant to most people. Close attention to client notification, the government agency making contact, and which official is in charge tells a lot. The involvement of a prosecutor or a federal agency does not mean the case is a criminal matter.
Call us today to discuss your case with our attorneys. All initial consultations are free and confidential. Let us handle your case.
Our Track Record
- Investigations by the Department of Justice and the U.S. Attorney’s Office for alleged Medicare Fraud.
Result: No civil or criminal liability, case dismissed. - Investigation by the Department of Health and Human Services and the Office of Inspector General for alleged Healthcare Fraud.
Result: No civil or criminal liability, case dismissed. - Investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged False Claims Act violations.
Result: No civil or criminal liability, case dismissed. - Investigation by the Department of Defense for alleged Tricare fraud.
Result: No civil or criminal liability, case dismissed. - Investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations.
Result: No civil or criminal liability, case dismissed. - Investigation by the Department of Health and Human Services for alleged Medicare Fraud.
Result: No civil or criminal liability, case dismissed. - Investigation by the Office of Inspector General for alleged healthcare fraud.
Result: No civil or criminal liability, case dismissed. - Investigation by the Office of Inspector General for alleged False Claims Act violations.
Result: No civil or criminal liability, case dismissed. - Investigation by various branches of the federal government for alleged False Claims Act, Stark Law, and Medicare violations.
Result: No civil or criminal liability, case dismissed. - Investigation by the Department of Defense for alleged Tricare fraud.
Result: No civil or criminal liability, case dismissed. - Investigation by the Department of Justice for alleged Medicare Fraud.
Result: No civil or criminal liability, case dismissed. - Investigation by the Department of Health and Human Services for alleged Stark Law violations.
Result: No civil or criminal liability, case dismissed. - Investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged Medicare Fraud.
Result: No civil or criminal liability, case dismissed.
