Healthcare Lawyer - Federal Lawyer
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Healthcare Lawyer

Consultants Bring Centuries of Combined Experience To The Table

Lynette Byrd

Attorney Lynette Byrd
Healthcare Compliance and Defense Team Lead
Former DOJ Attorney envelope icon Contact Lynette

Ellen Comley

Attorney Ellen Comley
Healthcare Compliance and Defense Team Lead
Litigation Counsel

Roger Bach

Roger Bach
Healthcare Compliance and Defense Team
Former Special Agent (DOJ)

While access to healthcare is vital for our society, healthcare industry providers face some of the most stringent oversight across all industries. State and federal authorities regulate virtually all aspects of operations of providers in the health care industry, from their billing and recordkeeping practices to their prescription protocols and patient services.

As a result, providers in all segments of the health care industry need to prioritize compliance. They also need to be prepared to defend themselves during audits, investigations, and both civil and criminal litigation. In short, medical practices and providers face numerous legal risks, and they need to manage these risks effectively.

About Our Healthcare Law Practice

At Oberheiden P.C., our healthcare attorneys work to represent providers in all legal matters. This includes all aspects of compliance as well as both civil and criminal defense. From developing and revamping Medicare billing compliance programs to defending providers during U.S. Drug Enforcement Administration (DEA) investigations and representing providers in business-to-business disputes, our comprehensive practice ensures that our healthcare clients have access to the information, guidance and legal counsel they need when they need it.

Our Healthcare Team

Our healthcare law practice is led by Founding Attorney Nick Oberheiden, PhD. With well over a decade of health law experience, Dr. Oberheiden is a skilled advisor and relentless advocate for his clients. As Oberheiden P.C.’s Founding Attorney, Dr. Oberheiden has built the firm into a nationwide network of senior-level compliance lawyers, defense lawyers, and expert consultants who offer centuries of combined experience in the healthcare realm.

Many of our firm’s senior attorneys are former healthcare fraud prosecutors who spent decades at the U.S. Department of Justice (DOJ) before entering private practice. Several of our attorneys have enforcement experience at the state level as well. The healthcare compliance consultants on our team include former Special Agents-in-Charge, Supervisory Special Agents, and other high-ranking employees within the DEA, Department of Health and Human Services Office of Inspector General (DHHS OIG), and other federal agencies.

Our Results

Part of the reason why so many healthcare clients have trusted Oberheiden P.C. for well over a decade as their healthcare attorney is that our results speak for themselves. Through our compliance representation, we have helped numerous clients avoid substantial recoupments and other liabilities in healthcare audits and investigations. We have also successfully defended providers across the country in these audits and investigations, in many cases helping our clients completely avoid all forms of liability.

When necessary, we have also successfully defended healthcare businesses and professionals in civil and criminal litigation. From avoiding and dismissing indictments to securing favorable rulings at trial and on appeal, we have helped clients emerge victorious at all stages of the litigation process. Of course, we seek to resolve every case as quickly as possible—not only helping our clients avoid liability, but helping them mitigate their litigation costs as well.

Our Healthcare Practice Areas

We divide our health care practice into four key areas: (i) compliance, (ii) audits and investigations, (iii) healthcare fraud defense, and (iv) civil litigation. While we represent some clients in just one area, many of our healthcare clients prefer to work with our team in all aspects of compliance and risk management on an ongoing basis.

Our services for U.S. healthcare industry providers and the healthcare industry include:

Healthcare Law Compliance

There are numerous aspects to healthcare law compliance. To maintain compliance effectively, providers and facilities cannot rely on off-the-shelf compliance programs. They need to adopt policies and procedures that are custom-tailored to their operations, and they need to ensure that these policies and procedures fully address all of their compliance needs. We advise our clients on all aspects of health law compliance, including (but not limited to):

  • DEA and prescription drug compliance (including electronic prescription compliance)
  • Medicare and Medicaid billing compliance
  • Tricare billing compliance
  • U.S. Department of Labor (DOL) billing compliance
  • Private health insurance compliance
  • Anti-Kickback Statute (AKS) and Eliminating Kickbacks in Recovery Act (EKRA) compliance
  • Stark Law (Physician Self-Referral Law) compliance
  • False Claims Act compliance
  • Health Insurance Portability and Accountability Act (HIPAA) compliance
  • Emergency Medical Treatment and Active Labor Act (EMTALA) compliance
  • Telehealth and telemedicine compliance

Compliance Audits and Investigations

Auditing is a key aspect of health care law compliance management for healthcare industry providers. This includes both conducting internal audits to assess compliance and defending against external audits conducted by the DEA, Medicare audit contractors, private insurers, and other entities. Suspected compliance violations can lead to state and federal investigations as well, and providers need experienced counsel to come out of these investigations unscathed.

State and Federal Healthcare Fraud Defense

In some cases, facing civil or criminal allegations is unavoidable. Most often, this is the case when healthcare professionals and providers fail to timely engage counsel during federal healthcare audits and investigations. But, providers can face charges under other circumstances as well—at both the state and federal levels—and sometimes prosecutors will be intent on pursuing charges based on mandates or other priorities.

For providers that are facing civil or criminal charges, we provide strategic and cost-effective healthcare fraud defense. Our experience as health care lawyers includes representing providers nationwide in grand jury proceedings, pre-trial proceedings, and state and federal trials and appeals.

Business Disputes and Litigation

Along with representing health care providers in state and federal enforcement litigation, we represent clients in private civil litigation as well. This includes business disputes and litigation involving breach of contract claims, joint ventures, and other issues. While it will be necessary to take these cases to trial in some circumstances, our healthcare attorneys have had significant success securing favorable out-of-court resolutions for our clients in most cases.

Healthcare Businesses Served

At Oberheiden P.C., our health care clients range from individual physicians and other licensed medical professionals to large regional hospital chains and other healthcare organizations with multiple facilities and hundreds of employees. But, for all of our clients, we provide the same custom-tailored legal advice and personalized attention. Our healthcare attorneys regularly advise and represent health care clients including (but not limited to):

  • Clinics (Private and Government-Funded)
  • Durable Medical Equipment (DME) Companies
  • Laboratories (Clinical and Toxicology)
  • Healthcare Marketers
  • Healthcare Practitioners
  • Hospices, Nursing Homes, and Home Health Agencies and Providers
  • Hospitals, Hospital Systems, and Ambulatory Surgery Centers
  • Pharmacies, Compound Pharmacies, and Pharmacists
  • Physician Practices and Groups
  • Academic Medical Centers
  • Physician Practice Management Companies
  • Telehealth and Telemedicine Companies

10 Ways We Help Our Healthcare Clients

Within these four areas of our health law practice, we serve our clients in a variety of different ways. Here are 10 examples of what our healthcare attorneys at Oberheiden P.C. can do to help you, your business, or your healthcare practice:

piercing the veil in a commercial litigation dispute

1. Corporate Structuring and Governance

Whether you are starting a private healthcare practice, merging practices, or need to establish a new subsidiary or affiliate for ancillary business activities, our healthcare attorneys can help you choose the right corporate structure for your needs. We can assist with establishing ownership rights and managerial responsibilities, tax mitigation, liability limitation and other corporate governance matters as well.

piercing the veil in a commercial litigation dispute

2. Corporate Compliance Policies and Procedures

All companies should have a comprehensive set of corporate compliance policies and procedures. We help our health care clients adopt and implement policies and procedures regarding data security, employee rules and responsibilities, and other pertinent matters.

piercing the veil in a commercial litigation dispute

3. Healthcare Compliance Policies and Procedures

A robust healthcare compliance program is the center of any effective risk management program. We work closely with our clients to identify all pertinent areas of healthcare law compliance and develop policies and procedures that are well-suited to their specific risks and needs. We assist with healthcare compliance program training, implementation, and enforcement as well.

piercing the veil in a commercial litigation dispute

4. Internal Compliance Auditing

We help our clients conduct periodic internal compliance audits to test the efficacy of their healthcare compliance programs. Along with managing the internal audit process, we also thoroughly document our clients’ audits so that we can demonstrate our clients’ good-faith compliance efforts when necessary; and, when our clients’ internal audits reveal compliance deficiencies, we help them implement remedial measures promptly.

piercing the veil in a commercial litigation dispute

5. Internal Investigations

In addition to assisting our clients with internal compliance audits, we also assist our clients with internal investigations. If you are aware that an employee of your healthcare business or practice has engaged (or is actively engaging) in non-compliant conduct, our healthcare lawyers can conduct an investigation focused on gathering the documentation you need to take appropriate responsive action. Along with appropriate disciplinary action, this includes updating your business’s compliance protocols to mitigate the risk of recurrence.

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6. External Audit and Investigation Defense

We defend health care providers during external audits and investigations conducted by state authorities, federal agencies, and private health insurance companies. Our healthcare lawyers’ experience includes, but is by no means limited to, defending providers and other entities in matters involving the DEA, DHHS OIG, DOJ, Federal Bureau of Investigation (FBI), Internal Revenue Service (IRS), Medicaid Fraud Control Units (MFCUs), and all types of Medicare audit contractors (i.e., RACs, MACs, and UPICs).

piercing the veil in a commercial litigation dispute

7. Representation in Settlement Negotiations, Mediation, and Arbitration

Whether dealing with a government authority, competitor, vendor, or other business, it will typically be most advantageous to resolve the dispute by the most efficient means possible. The healthcare lawyers at Oberheiden P.C. have significant experience successfully representing clients in settlement negotiations, mediation and arbitration.

piercing the veil in a commercial litigation dispute

8. Representation in State and Federal Courts

Each healthcare attorney at Oberheiden P.C. who handles dispute resolution also has significant experience in courtroom litigation. Our lawyers have successfully represented clients in the state and federal courts, and many of our lawyers have decades of relevant litigation experience. While we work to help our clients avoid litigation whenever possible, we do not hesitate to litigate on behalf of our clients when necessary.

piercing the veil in a commercial litigation dispute

9. Ongoing Compliance and Risk Management

For all types of health care providers, compliance and risk management are ongoing processes. We communicate with many of our health care clients on a day-to-day basis. If you have questions about compliance or concerns about risk management, you cannot afford to make uninformed decisions. We are here to help; and, as a client of the Oberheiden P.C. legal team, you can expect to get in touch with your healthcare lawyer whenever you need to.

piercing the veil in a commercial litigation dispute

10. Outside General Counsel

Many of our clients also use our firm as outside general counsel. For health care practices and businesses of all sizes, their legal needs extend far beyond the healthcare realm. Whether you need help dealing with employees, managing data security, or maintaining appropriate corporate books and records, we can offer an outside general counsel solution that is custom-tailored to your needs and budget.

Speak with a Senior Healthcare Attorney at Oberheiden P.C. in Confidence

We strongly encourage you to contact us for more information about our healthcare law practice. We can schedule a remote complimentary consultation at a time that is convenient for you. To discuss your business’s or practice’s legal needs with a senior lawyer or consultant at Oberheiden P.C. in confidence, please call 888-680-1745 or tell us how we can help online today.

Make The Right Choice

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Your Healthcare Law Team

FAQs: Maintaining Compliance In Today’s High-Stakes Healthcare Environment

How Important is Compliance for Healthcare Providers?

Compliance is extremely important for health care providers. Not only are many aspects of compliance essential for effective patient care and business management, but all aspects of compliance are essential for mitigating providers’ legal risk. Multiple state and federal government agencies enforce health care providers’ compliance obligations, and non-compliance uncovered during audits and investigations can lead to substantial penalties.

How Can Healthcare Providers Establish (and Maintain) Compliance at the Federal and State Levels?

Establishing (and maintaining) compliance starts with gaining a clear understanding of a provider’s compliance burden. While many compliance obligations apply across the board, there are certain aspects of compliance that are unique to certain types of healthcare businesses (and business relationships) as well. At Oberheiden P.C., we begin by thoroughly assessing our clients’ compliance obligations, and then we work with our clients to develop comprehensive and custom-tailored compliance programs.

How Can Healthcare Providers Assess the Efficacy of Their Compliance Programs?

As a provider, you do not want to wait until a state or federal authority assesses the efficacy of your compliance program for you. Instead, you should take a proactive approach to assessing and managing compliance. This starts with conducting an internal compliance audit focused not only on the current scope of your business’s or practice’s compliance program, but on any additional aspects of compliance that your current program may be overlooking as well.

What Are the Risks of Non-Compliance for U.S. Healthcare Providers?

For U.S. providers, the risks of non-compliance are substantial. Depending on the circumstances involved, allegations of non-compliance can lead to either civil or criminal allegations. When prosecuted civilly, healthcare compliance failures can lead to recoupments, fines, loss of program eligibility, and other financial consequences. In criminal healthcare fraud cases, not only are financial penalties on the table, but practitioners and business owners can potentially face federal prison time as well.

Do Healthcare Providers Need Outside Compliance Counsel, or Can They Manage Compliance In-House?

Due to the complexities of healthcare compliance (and the risks of non-compliance), providers generally should not try to manage compliance in-house. While providers should have an internal Chief Compliance Officer (CCO), their CCO should work with outside counsel to manage their compliance-related risk effectively. Along with helping CCOs assess providers’ compliance needs, our healthcare lawyers advise CCOs during internal compliance audits, and we provide full-scale defense representation for external audits, investigations, and litigation.

What Should I Do if I Have Been Contacted By the DHHS OIG, DEA, or a CMS Audit Contractor?

If you have been contacted by the DHHS OIG, DEA, a CMS audit contractor, or any other state or federal authority, you should speak with a healthcare lawyer at Oberheiden P.C. promptly. This may mean that your practice is the target of an audit or investigation. If this is the case, you will need to execute a proactive and strategic defense, and this starts with engaging healthcare defense counsel to advise you going forward. At Oberheiden P.C., we regularly represent providers in audits and investigations, and we can get to work immediately if necessary.

Why Should Healthcare Providers Choose Oberheiden P.C. for Compliance and Defense?

Oberheiden P.C. is a team of senior-level healthcare lawyers and consultants who bring centuries of combined relevant experience to the table. We advise providers on compliance matters daily, and we routinely defend providers during compliance audits and healthcare fraud investigations. With our nationwide network, we are able to provide efficient legal representation across the United States; and, with our lawyers’ and consultants’ federal law enforcement backgrounds, we have an intimate understanding of both why and how government authorities enforce compliance and target providers suspected of fraud.

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