Ada, Oklahoma Healthcare Fraud Defense Lawyers

Healthcare fraud entities, providers, and businesses in Ada, Oklahoma and the surrounding areas that are accused of healthcare fraud have Oberheiden, P.C. on their side. Oberheiden, P.C. has extensive legal experience in:

• Healthcare fraud defense,
• Medicare and Tricare audits,
• Protection of assets,
• Compliance programs,
• Jury trials,
• Fraud allegation defense,
• Qui tam defense,
• OIG and grand jury subpoenas,
• Criminal defense, and
• Internal investigations.

Our defense team includes a former Chief Healthcare Fraud Coordinator for the U.S. Attorney’s Office, several former healthcare fraud prosecutors, and elite former lead prosecutors of the Medicare Fraud Strike Force. Our Ada, Oklahoma healthcare fraud defense lawyers serve clients throughout the state and country. Our practice features lawyers with superior education and years of defense experience.

If you’re being investigated for healthcare fraud in Ada, Oklahoma or the surrounding areas, call Oberheiden, P.C. Ask to speak with a member of our Healthcare Fraud Defense Team. The call is free and confidential.

Ada, Oklahoma Is Watched for Healthcare Fraud

Ada, Oklahoma is one of nine areas in the nation that is intently monitored for instances of healthcare fraud. The area is overseen by the Medicare Fraud Strike Force. The Medicare Fraud Strike Force is a federal investigative body made of prosecutors and investigators from a number of federal agencies.

Ada, Oklahoma and the surrounding areas are surveilled for healthcare fraud because the area has a large number of people who rely on federal healthcare programs. The number of recipients means that more claims are filed with the federal government for payment to providers, entities, and businesses. The government believes that when there is a large number of claims filed, there must also be an increase in healthcare fraud.

In FY 2022, the Department of Justice (DOJ) opened more than 809 new criminal health care fraud investigations. Federal prosecutors filed criminal charges in over 419 cases involving at least 680 defendants. More than 477 defendants were convicted of health care fraud related crimes during the year. Also, in FY 2022, DOJ opened more than 774 new civil health care fraud investigations and had over 1,288 civil health care fraud matters pending at the end of the fiscal year. OIG, HHS

Defining Federal Healthcare Fraud

It’s important to understand what constitutes healthcare fraud. Healthcare fraud is defined as an attempt to receive payment from a federal government healthcare program for medical services or equipment from incorrect or misleading claims. Federal healthcare programs include Medicare, Medicaid, Tricare, or federal workers’ compensation. It incorporates at least one of the following elements:

• The Anti-Kickback Statute. Federal law restricts the exchange of money or other valuables for patient referrals. Anyone may face prosecution for violating this act if they offer or provide payment or other valuables in exchange for referrals.
• Stark Law. Stark Law is more commonly known as the Self-Referral Law. It bars physicians from referring patients to certain healthcare entities if the physician or an immediate family member has an ownership or investment interest in the entity. Or, if there is a compensation arrangement between the providers. There are statutory exceptions to this law.
• False Claims Act. If you submit a claim to a federal healthcare program, you must ensure that your claim is accurate. Otherwise, it is a violation of the False Claims Act. The federal government may begin an inquiry into your billing practices under the criminal provisions of the Act.
• Prescription Fraud. Prescribing a high volume of narcotics is closely monitored by the federal government. If you’re suspected of operating a “pill mill,” you may be targeted for insurance fraud or violating DEA dispensing rules.
• Billing Fraud. One of the most common occurrences of billing fraud is upcoding. This occurs when a higher, and more costly, code is used on claims made to federal healthcare programs. The federal government also investigates:
  • Allegations of phantom billing (services not provided),
  • Ghost patients (patients who do not exist), and
  • Billing for medically unnecessary services or equipment.
• Certification Errors. The federal government pays close attention to the home healthcare and hospice industry. The most common allegation is fraudulent certification for care.

Oberheiden, P.C. has the main objective of helping clients avoid criminal charges. Ada, Oklahoma healthcare fraud defense attorneys are available to assist you. If you’re being investigated by the federal government for healthcare fraud in Ada, Oklahoma or the surrounding areas, call us now. Initial calls are free and confidential.

Healthcare Fraud Has Civil and Criminal Penalties

Federal healthcare fraud can result in civil or criminal charges against you or your business. In civil court, a judge can order you to repay the amount of the federal claims, you may lose reimbursement for future claims, and you could be barred from future participation in federal healthcare programs.

Criminal penalties may include a criminal record, huge fines, and you could even receive a federal prison sentence of:

• Up to 10 years for each count of healthcare fraud,
• Up to 20 years for each count of fraud that resulted in serious bodily injury,
• Life sentence if the healthcare fraud resulted in death.

Often, we’re asked about the worst-case scenario for healthcare fraud for providers, entities, and businesses in Ada, Oklahoma. Whether or not you’ll face criminal charges or a prison sentence depends on several legal matters. These are: the severity of personal injury suffered by a patient, whether the prosecutor sees an advantage in pursuing criminal charges, and the reason why the federal government began the case. If you’re under investigation for healthcare fraud, contact Oberheiden, P.C. An Ada, Oklahoma healthcare fraud defense lawyer is ready to answer your questions. Your initial call is confidential and free.

Oberheiden, P.C. is ready to help Ada, Oklahoma healthcare clients based on our dual experience as former federal prosecutors and healthcare fraud defense attorneys. If you’re contacted and told you’re under investigation for healthcare fraud, call us today. Learn more about your legal options and how we can help. Initial consultations are confidential and free of charge.

Is the Investigation Civil or Criminal?

Healthcare fraud investigations in Ada, Oklahoma can be civil or criminal. Investigations can start as civil and then become criminal as the investigation progresses. Being contacted by a prosecutor is not an indicator determining the investigation against you is criminal. All federal agencies with prosecutors have both a civil and a criminal branch. That’s why you cannot use contact by a federal prosecutor as an indicator. Rather, signs of a criminal investigation may include:

• Search warrants,
• Seizure warrants,
• Arrest warrants,
• Target letters,
• Contact from a federal criminal prosecutor,
• Involvement from the IRS, or
• Receipt of a grand jury subpoena.

Being investigated for a federal crime such as healthcare fraud can have severe consequences, including significant fines and imprisonment.

Healthcare Fraud Allegation Defenses

Oberheiden, P.C. is a healthcare fraud defense law firm offering services in Ada, Oklahoma and the surrounding area. Several of our attorneys have previous experience as healthcare auditors and fraud prosecutors with the Department of Justice. We provide this remarkable insight directly to our clients. We offer a free consultation to help you understand your legal issues and determine the best course of action for your defense.

Contacting the federal government. The main objective for our clients is to help them reduce the prospect of criminal charges. Our experience has taught us that the best way we can help our clients is to quickly contact federal authorities. We get answers to important questions, and stop the government from having unlimited time to investigate you. We work to protect your freedom and your career. An Ada, Oklahoma healthcare fraud defense attorney from our firm can get the information needed to plan your defense. We typically get answers to these most important questions within a few hours:

• What is the investigation about?
• What is the purpose of it?
• How long will the investigation take?
• What is the most likely outcome?

Showing our clients made a mistake. The federal government must evidence that proves beyond a reasonable doubt that you committed a crime. They must also show that you acted with criminal intent. When criminal charges look certain, we test if the government will be able to meet Constitutional standards. The government will try to use billing inaccuracies to prove you had criminal intent. Oberheiden, P.C. knows this most often happens as the result of an organizational or human error and not a provider who decides to commit a crime. These mistakes should not be held to criminal standards. We have provided successful legal defense for clients across the United States by proving that inaccuracies are a result of human or organizational error and not criminal intent. Several factors leading to such mistakes are:

• Unqualified workers,
• Delegation errors,
• Outsourcing errors,
• Lack of oversight,
• Insufficient supervision, and
• Constantly changing laws and rules in healthcare billing.

Although these issues should be corrected, they should not lead to a criminal conviction.

Using strategic healthcare fraud defenses. Your Ada, Oklahoma healthcare fraud defense attorney evaluates each case in order to research and utilize the right strategic legal defenses. This may include using statutory loopholes and exceptions. For example, the Stark Law involves medical necessity certifications. Where applicable, we will point to these exceptions to either mitigate or entirely resolve a healthcare fraud case.

Defending your professional reputation. We are committed to doing more than providing healthcare fraud defense. We are determined to defend your image and provide the assistance you deserve. Allegations of healthcare fraud can be damaging. Many of our clients express concern about how these allegations will affect their career and future. The media has a lot of power and your reputation could be destroyed by their rumors. Our attorneys address instances of slander, and seek opportunities to correct misinformation about our clients. Call our Ada, Oklahoma healthcare fraud defense attorneys today to learn more about your legal options. The call is confidential and there is no charge for your initial call.

If you’re under investigation in Oklahoma or the surrounding areas and you’re being investigated for healthcare fraud, call Oberheiden, P.C. right away. Our Ada, Oklahoma healthcare fraud defense lawyers are ready to provide their services. The initial call is free and confidential.

We are available every day of the year. You can call or email us directly, or complete our contact form.