Anaheim Federal Healthcare Fraud Defense Lawyer

Federal authorities are targeting Anaheim healthcare providers in fraud investigations. Fraud can lead to civil monetary penalties, criminal fines, treble damages, healthcare benefit program exclusion, and even years in federal prison. Providers should seek to lower the risk of a disastrous judgment in civil or criminal court. Experienced legal counsel can help in these matters.

Oberheiden, P.C., is a federal defense law office. Our Anaheim federal healthcare fraud defense lawyers represent a great variety of medical professionals with federal benefit fraud allegations. Our firm has a national presence. Our attorneys are available to meet with new clients in Anaheim, CA. If your business or practice is targeted by:

• U.S. Department of Justice (DOJ),
• Drug Enforcement Administration (DEA),
• Internal Revenue Service (IRS),
• Office of Inspector General (OIG), or any other federal agency, you need experienced attorneys to represent you.

We can help with alleged billing violations, illegal kickbacks, prescription drug diversion, or any other form of federal fraud in the health industry. Our firm is available to take action in your federal case immediately.

Examples of our track record and our experience include:

• Representation of a healthcare provider and its principals in a federal fraud investigation involving the DOJ and FBI. Outcome: No civil or criminal liability.
• Representation of a healthcare provider and its principals in a federal fraud investigation involving the DOJ and OIG. Outcome: No civil or criminal liability.
• Representation of a healthcare provider and its principals in a federal fraud investigation involving the FBI and OIG. Outcome: No civil or criminal liability.
• Representation of a healthcare provider and its principals in a DOJ investigation following the issuance of a Medicare fraud subpoena by the OIG. Outcome: No civil or criminal liability.
• Representation of a healthcare provider and its principals in a large-scale criminal investigation involving numerous federal law enforcement agencies. Outcome: No civil or criminal liability.

What Is Healthcare Fraud?

If all you know is that you are under investigation for this offense, you only know part of the story. If your practice or business gains the government’s attention, federal agents and prosecutors are looking into very specific allegations against you. Each case is unique, but typical allegations of medical fraud include:

• Billing for medically-unnecessary services, supplies, or equipment
• Billing for services or supplies not actually rendered to patients
• Controlled Substances Act and DEA registration violations (e.g., prescription drug fraud or opioid diversion)
• Falsifying patient records, prescriptions, physician certifications, or election statements
• Double-billing the government and/or a private insurance company
• Upcoding or unbundling services or supplies in order to secure a higher reimbursement rate
• Other billing or coding violations
• Anti-Kickback Statute violations (unlawful kickbacks or referral fees)
• Stark Law violations (physician “self-referrals”)

To determine allegations against you, the first step is to intervene in the probe. When you engage Oberheiden, P.C., we will promptly make contact with the federal authorities handling your case in order to uncover:

• Which federal agencies are involved in the investigation?
• What triggered government interest (eg., automated comparative analysis of billing data or a “whistleblower” complaint)?
• How long has the investigation been ongoing?
• What types of information are the federal agencies seeking to collect?
• Is the investigation civil or criminal in nature?
• How close are federal prosecutors to filing civil charges or seeking an indictment?

The sooner we gather this information, the sooner we can start protecting you. This will also give us a greater chance to resolve your case before federal fraud charges are filed. To get started with a free and confidential case assessment, call 888-680-1745 or contact us about your investigation online now.

Put our highly experienced team on your side

Dr. Nick Oberheiden

Founder

Attorney-at-Law

Lynette S. Byrd

Former DOJ Trial Attorney

Partner

Brian J. Kuester

Former U.S. Attorney

Hon. Kevin McCarthy

55th Speaker, U.S. House of Representatives (ret.)

Government Consultant

Mike Pompeo

Of Counsel

Former U.S. Secretary of State

John W. Sellers

Former Senior DOJ Trial Attorney

Linda Julin McNamara

Federal Appeals Attorney

Nicholas B. Johnson

Former Prosecutor

Roger Bach

Former Special Agent (DOJ)

Chris J. Quick

Former Special Agent (FBI & IRS-CI)

Michael S. Koslow

Former Supervisory Special Agent (DOD-OIG)

Ray Yuen

Former Supervisory Special Agent (FBI)

What Statutes Do Federal Authorities Use to Investigate and Prosecute Healthcare Fraud?

1. The False Claims Act

Under the False Claims Act (FCA), providers can be prosecuted for both intentional and unintentional submission of “false or fraudulent” claims. Unintentional violations carry the potential for substantial monetary fines and program exclusion. Criminal violations carry fines and a lengthy prison sentence of up to five years for each offense. Financial penalties apply on a “per-claim” basis. Total liability in an FCA case can easily reach six or seven figures.

2. The Anti-Kickback Statute

The Anti-Kickback Statute (AKS) prohibits offering, paying, soliciting, or receiving referral fees or other goods and services in connection with federal healthcare benefit program referrals. This includes referrals for beneficiaries of Medicare, Medicaid, Tricare, and the DOL. The Anti-Kickback Statute also includes provisions for both civil and criminal prosecution. It carries penalties similar to those imposed under the False Claims Act.

3. The Stark Law

The Stark Law prohibits physicians who participate in Medicare and Medicaid from engaging in so-called “self-referrals.” A self-referral is a referral for program-reimbursed business provided to (or received from) a related entity, including immediate family members. It involves any of the following designated health services:

• Clinical laboratory services
• Physical therapy services
• Occupational therapy services
• Outpatient speech-language pathology services
• Radiology and certain other imaging services
• Radiation therapy services and supplies
• Durable medical equipment and supplies
• Parenteral and enteral nutrients, equipment, and supplies
• Prosthetics, orthotics, and prosthetic devices and supplies
• Home health services
• Outpatient prescription drugs
• Inpatient and outpatient hospital services

The Stark Law is a civil statute. Potential penalties include recoupments, civil monetary penalties, treble damages, and permanent loss of Medicare or Medicaid participation.

4. The Controlled Substances Act

In the criminal justice system, the Controlled Substances Act carries penalties for fraudulent prescription practices, drug diversion, improper filling of prescriptions, and other forms of pharmaceutical fraud. Providers who violate the Controlled Substances Act can have their DEA registrations revoked. They can also face criminal prosecution in federal district court.

5. The Federal Healthcare Fraud Statute

The healthcare fraud statute, 18 U.S.C. 1347, makes it a crime to “knowingly and willfully . . . (1) . . . defraud [or attempt to defraud] any healthcare benefit program; or (2) . . . obtain [or attempt to obtain] by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any healthcare benefit program.” While this language echoes the prohibitions of the False Claims Act and the other statutes listed above, 18 U.S.C. 1347 imposes possible prison sentences of 10 years, 20 years, or life behind bars, depending upon the existence and extent of any harm to patients resulting from a provider’s violations.

6. Other Federal Criminal Statutes

In addition to these statutes, in criminal fraud cases, prosecutors with the U.S. District Attorney’s Office will often file criminal charges for a number of other offenses as well. These include:

• 18 U.S.C. 371 (criminal conspiracy)
• 18 U.S.C. 1028A (identity theft)
• 18 U.S.C. 1341 (mail fraud)
• 18 U.S.C. 1343 (wire fraud)
• 18 U.S.C. 1344 (bank fraud)
• 18 U.S.C. 1357 (money laundering)
• 21 U.S.C. 841 (distribution of controlled substances)
• 26 U.S.C. 7206 (tax fraud/tax evasion)

Why Choose Oberheiden, P.C., for Your Federal Healthcare Fraud Case in Anaheim, CA?

The success or failure of your defense depends heavily on your choice of legal counsel. Why do healthcare providers in Anaheim, throughout California, and nationwide choose an Anaheim federal healthcare fraud defense lawyer at Oberheiden, P.C.?

• Thousands of Federal Investigations Handled. Collectively, our firm has represented clients in thousands of inquiries and hundreds of trials. We know what worked well in the past, and we use our experience to our clients’ advantage.
• Personal Attention by Senior Attorneys. All clients work directly with senior attorneys on our federal fraud defense team. We do not employ paralegals or junior associates.
• Available 24/7. When your future is on the line, you don’t have time to wait around. We make ourselves available to our clients 24/7.
• Focus on Pre-Charge Resolution. Whenever possible, we focus on resolving our clients’ cases prior to charges being filed. This keeps you in control and protects you against the inherent uncertainty of a trial.
• Legal Representation at Trial. Sometimes, you must fight for your right to practice at trial. If that is the situation, our attorneys will use their extensive trial backgrounds to develop an agressive defense strategy.

Frequently Asked Questions

Contact Oberheiden, P.C.

If you would like to speak with an Anaheim federal healthcare fraud defense lawyer about your investigation, please call 888-680-1745 or request a free initial case assessment online. We will arrange for you to discuss your case with an attorney, in confidence, as soon as possible.

Additional Pages for Anaheim, California

• Anaheim federal criminal defense

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The only Firm attorneys admitted in California are Nicholas Johnson and Paul Strickland. Local counsel James Bell is also admitted in California. Any other lawyer displayed or mentioned in connection with matters in California are either attorneys admitted in jurisdictions other than California or non-lawyer consultants. Firm attorneys not admitted in California do not advise on California law and they do not practice California law. Upon special request by an informed client, Firm attorneys not admitted in California may assist California licensed attorneys on federal law matters within the confines detailed in our Disclaimer and FTC Disclaimer. Importantly, Firm does not have offices in California.  

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