Our Experience
Our Lawyers Have Extensive Experience in All Aspects of Healthcare Compliance and Healthcare Fraud Defense
When you need healthcare compliance or defense counsel, experience matters. You need a team of lawyers and consultants who understand the complex web of laws and regulations that apply to healthcare providers and other businesses in the healthcare industry. You need to have unwavering confidence in the advice and representation you receive, and you need to know that additional advice is just a phone call away.
At Oberheiden P.C., we provide healthcare compliance and healthcare fraud defense representation backed by extensive experience on both sides. Along with senior lawyers who have spent their entire careers representing healthcare providers and other clients, our team also includes former federal government attorneys and special agents who previously focused on uncovering and prosecuting high-level healthcare fraud. As a result, we understand the federal healthcare system inside and out, and we know exactly what it takes for providers and other businesses to avoid compliance-related liability.
A National Healthcare Compliance and Defense Law Firm
The healthcare compliance and defense lawyers at the national law firm Oberheiden P.C. have extensive experience advising healthcare providers regarding compliance and defending healthcare providers against civil and criminal allegations of healthcare fraud. Our thorough and intimate understanding of healthcare law and the complicated maze that is the United States healthcare system gives us the ability to provide unparalleled legal advice that helps to insulate our clients from civil and criminal liability due to compliance-related failures.
Put our highly experienced team on your side
Dr. Nick Oberheiden
Founder
Attorney-at-Law
Lynette S. Byrd
Former Department of Justice
Brian J. Kuester
Former U.S. Attorney
Former DA
John W. Sellers
Former Senior Trial Attorney
U.S. Department of Justice
Local Counsel
Joanne Fine DeLena
Former Assistant U.S. Attorney
Local Counsel
Joe Brown
Former U.S. Attorney & Former District Attorney
Local Trial & Defense Counsel
Amanda Marshall
Former U.S. Attorney
Local Counsel
Aaron L. Wiley
Former Federal Prosecutor
Local Counsel
Roger Bach
Former Special Agent (OIG)
Michael Koslow
Former Supervisory Special Agent (FBI)
Chris Quick
Former Special Agent (FBI & IRS-CI)
Ray Yuen
Former Supervisory Special Agent (FBI)
Countless clients have benefited from our comprehensive and custom-tailored approach to healthcare compliance and healthcare fraud defense. We work with hospitals, clinics, pharmacies, laboratories, durable medical equipment (DME) companies, physician-owned practices, and other clients nationwide. We advise these clients regarding all aspects of compliance, and we defend them when they face scrutiny from Medicare and Medicaid auditors and federal authorities such as the U.S. Drug Enforcement Administration (DEA) and the U.S. Department of Health and Human Services Office of Inspector General (DHHS OIG).
Our Experience in the Area of Healthcare Compliance
There are numerous aspects to healthcare compliance. While not all areas apply to all providers and businesses, most entities in the healthcare field will need to address several areas of compliance in order to mitigate their risk effectively.
At Oberheiden P.C., we provide proactive healthcare compliance representation focused on helping our clients implement custom-tailored compliance solutions. We have worked with providers and other businesses across the country, helping them manage compliance through steps including:
- Conducting comprehensive needs assessments focused on identifying our clients’ specific compliance obligations
- Developing compliance policies and procedures that reflect our clients’ specific compliance obligations and address the unique aspects of their operations
- Implementing our clients’ custom-tailored policies and procedures through training, software, contracting, and other means
- Conducting periodic internal compliance audits focused on assessing the efficacy of our clients’ compliance efforts and identifying areas for improvement
- Conducting internal investigations as necessary to respond to employees’ compliance failures and remedy issues before they lead to federal scrutiny
- Providing proactive advice regarding necessary compliance program updates in light of changes to our clients’ operations or changes in the government laws and regulations
- Assisting with the documentation of our clients’ ongoing compliance efforts to ensure that they are fully prepared to withstand scrutiny from federal auditors or agencies when necessary
Our healthcare lawyers and consultants are experienced in all areas of compliance; and, as a result of this experience, we are able to efficiently and comprehensively identify our clients’ areas of need. This means that we provide all of the compliance advice our clients need, and none of the advice they don’t—ensuring that we streamline the processes of establishing and maintaining compliance to the fullest extent possible.
For many healthcare providers, understanding their compliance obligations is one of the biggest hurdles standing in the way of managing their compliance obligations effectively. As a result, it is also one of their greatest risks. With our lawyers’ and consultants’ experience working both for the federal government and in the private sector, we are intimately aware of providers and other businesses’ compliance duties. This includes (but not limited to) their duties in the areas of:
- Medicare and Medicaid billing
- Tricare and U.S. Department of Labor (DOL) billing
- Durable medical equipment (DME)
- Prescription medications (including electronic prescriptions)
- Ordering, inspecting, storing, dispensing, and disposing of prescription medications
- Patient recordkeeping and privacy (HIPAA compliance)
- Anti-Kickback Statute and Stark Law
- Telehealth and telemedicine
- Healthcare marketing
- Hospital, clinic, and laboratory compliance
When it comes to compliance, healthcare providers and other businesses in the healthcare industry cannot afford to take chances. They need to make informed decisions, and they need to rely on the advice of experienced counsel. At Oberheiden P.C., our lawyers and consultants have the experience needed not only to establish and maintain compliance, but also to help our clients make informed decisions with confidence.
Our Experience Defending Clients Against Allegations of Healthcare Fraud
If you or your healthcare company is facing allegations of fraud, you need an experienced law firm to represent you during these troubling and crucial moments. Not only are the sanctions for committing healthcare fraud extremely steep – even civil cases can impose treble damages, or three times what was allegedly defrauded – but the process of defending against the accusations is often far from simple.
The lawyers at Oberheiden P.C. are highly experienced with defending clients across the country from a wide variety of allegations related to healthcare fraud. Just a few of the most common have been for:
- Billing fraud
- Drug diversion
- Home health agency (HHA) fraud
- Hospice care fraud
- Laboratory fraud
- Medicare fraud
- Pharmaceutical fraud
- Psychologist and psychiatrist fraud
- Tricare fraud
Depending on the facts of the case, these allegations can be pursued as a civil allegation or as a criminal charge. Some of the most common federal laws that get invoked in healthcare fraud allegations are:
- 18 U.S.C. § 1347, which covers healthcare fraud in general
- 18 U.S.C. § 1349, which forbids conspiring to commit healthcare fraud
- 31 U.S.C. § 3729 et seq., also known as the False Claims Act (FCA), which makes it unlawful to submit false claims for reimbursement against a government source of funding, like Medicare or Medicaid
- 42 U.S.C. § 1395nn or the Physician Self-Referral Law, also known as the Stark Law, which forbids healthcare professionals from referring patients to other healthcare providers in which the referring professional has a financial stake or interest
- 42 U.S.C. § 1320a-7b, or the Anti-Kickback Law, which prohibits taking kickbacks for referrals or business
- 18 U.S.C. § 1028 and 18 U.S.C. § 1028A, which cover identity theft and aggravated identity theft, respectively
These are serious federal laws that come with huge penalties, regardless of whether they come in the form of a criminal conviction or a civil judgment. Worse, cases that invoke these laws frequently start out as something far smaller. Over the course of representing defendants against healthcare fraud allegations, we have frequently dealt with cases that escalated from the following seemingly innocuous scenarios:
- Medicaid audits
- Laboratory audits
- Medicare audits, including:
- Medical malpractice lawsuits
- Qui tam lawsuits
- Wrongful death lawsuits
- Civil investigative demands (CIDs)
- Drug diversion investigations
- Investigations by the Department of Labor (DOL)
- Investigations by the Food and Drug Administration (FDA)
- Subpoenas from the Office of Inspector General (OIG)
- Recovery audit contractor (RAC) audits
- Qlarant investigations and audits
- Zone program integrity contractor (ZPIC) audits
Getting effective legal representation at the earliest stage possible is essential for overcoming preliminary suspicions of healthcare fraud before they can grow into something that jeopardizes you or your company.
Oberheiden P.C.’s Attorneys are All Senior Status
At Oberheiden P.C., we strongly believe that the best way to help our clients during these fraught investigations and cases is to provide them with legal representation from only the most experienced attorneys available. That is why we do not employ junior associates, paralegals, or legal secretaries at our firm.
When you call Oberheiden P.C. to handle your legal defense against allegations of healthcare fraud, the first person that you will speak with is a defense lawyer who has years of experience handling cases just like your own. Throughout your legal representation, that will not change. You will only deal with senior attorneys at our law firm.
Over years in the healthcare fraud defense field, we have found that this is the best way to vigorously advocate for our clients, fully understand their needs and concerns, and give them the peace of mind that comes with knowing that everything is being done to protect them from legal liability.
A National Law Firm With Local Counsel You Can Trust
Even better, you have access to those senior lawyers wherever you are. Oberheiden P.C. is a national law firm that is headquartered in Texas, but that relies on local counsel that we use and fully trust in nearly all states and jurisdictions in the United States. We have extensively vetted the senior lawyers in our office closest to you and they have our complete confidence.
Investigators With Backgrounds in Healthcare Fraud Cases
To help our senior lawyers gather the facts in your particular case, we have tapped into the extensive experience of a roster of senior investigators, the vast majority of whom have remarkable experience of their own in the very same law enforcement agencies that are likely to be prosecuting your case. Many of them are retired agents, with long and impressive track records, from the following government agencies:
- Federal Bureau of Investigation (FBI)
- Department of Justice (DOJ)
- Department of Health and Human Services Office of Inspector General (HHS-OIG)
- Centers for Medicare and Medicaid Services (CMS)
Their insider experience prosecuting these cases makes them an invaluable resource in defending against them. Our senior lawyers and experienced investigators have been called on to represent healthcare fraud defendants and suspects at all junctures of a case. In many instances, we have been called on to craft compliance policies for healthcare providers so they never come under the scrutiny of law enforcement agents. In others, we have inherited cases where fraud defendants have been tried and convicted and want to either appeal their conviction or want more effective legal representation for the sentencing process.
Contact Us to Speak with a Senior Healthcare Lawyer at Oberheiden P.C.
Whether you have questions about compliance or concerns about facing an external audit or investigation, it is never too early and never too late to contact the healthcare fraud defense lawyers at Oberheiden P.C. Call us at (888) 680-1745 or contact us online and get started with a complimentary initial consultation.