Arlington / Grand Prairie Healthcare Fraud

What You Need to Know About FBI, DEA, and OIG Healthcare Fraud Defense in Grand Prairie & Arlington

Attorney Nick Oberheiden
Arlington / Grand Prairie Healthcare Defense
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Agents and prosecutors with the Federal Bureau of Investigation (FBI), the Drug Enforcement Administration (DEA), the U.S. Department of Justice (DOJ), and other law enforcement authorities have expanded their prosecutions of healthcare providers and businesses in Grand Prairie & Arlington. Nearly everyday new arrests, takedowns, and grand jury investigations occur involving alleged:

Medicare Fraud,
Commercial insurance fraud,
Anti-Kickback violations,
Department of Labor and Workers Compensation,
Opioid-related violations of the Controlled Substances Act, and
The federal False Claims Act.

You need Arlington and Grand Prairie healthcare fraud attorneys on your side if facing any of these allegations.

Former Justice Department Lawyers from Oberheiden, P.C. Can Handle Your Federal Case in Grand Prairie & Arlington

Dallas-based Oberheiden, P.C. has tremendous experience in complex health investigations and government prosecutions. These cases have included:

Medicare Fraud,
Medicaid Fraud,
Tricare Fraud,
False Claims Act,
Qui Tam Defense,
Stark Law Violations, and
Physician Self-Referral Prohibitions across the country, including in Grand Prairie & Arlington.

Our Accomplishments Include:

More than 2,000 healthcare fraud investigations
More than 2,000 grand jury investigations
Dismissal of state and federal indictments
70 combined years of Department of Justice experience

While there are many law firms in the Dallas Fort Worth area, there is no firm that focuses its practice on healthcare fraud defense like we do. We are lead counsel throughout Texas defending physicians, mental health providers, dentists, psychologists, psychiatrists, health marketers, and a variety of health-related businesses.

Many of our attorneys previously supervised FBI, DEA, and OIG healthcare investigations at the Department of Justice and understand the process and how to challenge and defend the government’s case. We are:

Former Department of Justice Attorneys
Former Healthcare Fraud Prosecutors, U.S. Attorney’s Office (Dallas)
Former Chief Prosecutor, Healthcare Fraud, U.S. Attorney’s Office
Former Assistant United States Attorneys
Federal Litigation & Trial Lawyers

Our Arlington and Grand Prairie healthcare fraud lawyers have successfully represented healthcare clients against alleged violations of the Controlled Substances Act, Medicaid and Medicare Fraud, the Anti-Kickback Statute, and fraud of private insurance plans. Call us if you are concerned about your role or if you are under investigation. As we have for others, we will find a way to help you.

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)

Healthcare Fraud Investigations in Grand Prairie & Arlington

Every Arlington and Grand Prairie healthcare fraud attorney has seen a significant increase in investigations involving the FBI, OIG, and DEA throughout Texas.

CMS Audits:

Medicare Audits & ZPIC Audit. Home healthcare, hospice agencies, cardiology providers and many other medical clinics with high numbers of Medicare beneficiaries contact us to handle their CMS audit. Former DOJ healthcare lawyers on our team will be able to walk you through the process of an audit. Most importantly, they will make sure the government will not gain interest in referring your case to the U.S. Attorney’s Office in Dallas Fort Worth.

Fraud Investigations:

False Claims Act (FCA) & Whistleblower Defense. Many Texas health providers are shocked to find that their former employee or business partner is behind allegations of violating the FCA. Under the FCA, any submission of a fraudulent claim (e.g. use of a wrong code or accidental billing for services not provided) is a federal violation. Intent is not needed. What makes the FCA appealing to former employees is that it contains a whistleblower provision. If a former employee reports fraud, and the government agrees with the allegations, they can force recoupment of their losses. The whistleblower can receive about 20% of that recovery as a reward for reporting. Oberheiden, P.C. routinely helps businesses in healthcare and other industries defend against such allegations. Attorney Nick Oberheiden has successfully defended False Claims Act and whistleblower cases at U.S. Attorney’s Offices across the nation, at the DOJ, before the DHHS, and at the OIG Washington D.C. Headquarters.

Illegal Physician “Self-Referrals”. Stark Law prohibits a physician from referring patients for certain types of services to entities where the physician has a financial interest. The most common application of Stark Law is a situation where a physician enters a joint venture with, for example, a toxicology lab, pharmacy, or MRI/radiology center. The provider then sends scripts and samples to that business not knowing if the relationship is covered by an exception. Oberheiden, P.C.’s lawyers have a proven track record of convincing agencies an alleged violation is really a protected arrangement. Nick Oberheiden has argued Stark Law cases across the country, including at the OIG and the DHHS headquarters. Not one of his clients had to admit any civil or criminal liability.

Criminal Defense:

Prescription Drug Fraud & Opioid Investigations. Opioid cases continues to dominate the attention of federal prosecutors. Internal medicine, pain management, and family practitioners in Grand Prairie & Arlington should expect increased enforcement, aggressive tactics, search warrants, and even arrests. Dramatic results can ensue if their practice involves prescribing or dispensing of Schedules I-III drugs under the Controlled Substances Act. The government instructed the U.S. Attorney’s Office and all federal agencies to identify, monitor, and arrest anyone straying from the new government’s opioid policy standards. If you seek proactive compliance advice, or you were notified about a case against you, Oberheiden, P.C. can help. Several of our lawyers supervised DEA and FBI agents and our history involves a number of successful cases on behalf of pharmacies and physicians. Representing clients against opioid charges across the United States, we are at the forefront against this government policy. We are familiar with prosecutors’ strategies, and have the experts and experience to challenge and defend you. Call us as early as possible to make sure there is time to introduce strong defense strategies for your case.

Medicare Fraud, Medicaid Fraud. Medicaid and Medicare Fraud are among the most charged offenses in Grand Prairie & Arlington healthcare fraud cases. Of particular focus are:
- Mental health providers,
- Cardiologists,
- Home healthcare agencies,
- Hospice agencies,
- DME companies, and
- other Grand Prairie & Arlington medical providers with high numbers of federally funded program patients.
Medicare fraud covers any violation of Medicare program rules, in particular billing and kickbacks. Most Medicare fraud cases are criminal in nature and pursued under a federal felony statute (18 U.S.C. 1347). Felony status makes the offense all the more serious. If you or your business receive notice from the U.S. Attorney’s Office in North Texas, the Medicaid Fraud Control Unit, or agents from the FBI or OIG, contact an Arlington and Grand Prairie healthcare fraud defense attorney promptly. The sooner we intervene and clarify the situation, the more likely it is that we can stop the investigation before it’s out of control. Call Oberheiden, P.C. to let us assess your situation and find a way to navigate through this process.

Illegal Kickbacks, Bribes, and Referral Fees. North Texas is known for its aggressive enforcement of the federal Anti-Kickback Statute (“AKS”). The AKS prohibits the offering, solicitation, payment, or receipt of any form of compensation for patient referrals. An example of the statute is when a physician or healthcare entity enters into a business development/marketing contract with a percentage or commission payment structure. The AKS is clear that commissions, percentages, cash payments, and fee payments to recruit Medicare, Medicaid, or Tricare patients are prohibited. Attorney Nick Oberheiden has frequently defended medical professionals and health marketing groups against federal fraud allegations. He is available to explain how he avoided criminal charges in these cases.

Arlington/Grand Prairie Healthcare Fraud

The attorneys at Oberheiden, P.C. are open to discuss your situation in a free and confidential consultation, including on weekends. You will benefit from an assessment by lawyers previously in charge of DOJ, OIG, FBI, CMS, and DEA investigations. We await your call.

FAQs: What Providers in Grand Prairie & Arlington Need to Know about Healthcare Fraud Investigations

Q: What types of healthcare providers are being targeted in Texas?

The government’s policy on pain medication prescriptions, and healthcare fraud, makes members of the Grand Prairie & Arlington medical community wonder if they will be next. Taking effective measures now to avoid future problems is always prudent. Compliance is key, but thinking about compliance and meaning to be compliant is not enough. The main targets of current Grand Prairie & Arlington health fraud investigations are:

Pharmacies & Compound Pharmacies
Opioid Prescribing Physicians
Toxicology & DNA Laboratories
Home Health & Hospice Agencies
Hospitals & Surgery Centers
Drug Rehabilitation Centers

Q: What are some examples of billing and coding errors that can initiate federal healthcare fraud investigations in Grand Prairie & Arlington?

If your health practice is being accused of:

Submitting fradulent claims,
Billing for medically unnecessary services,
Up-coding,
Double-billing, or
Billing for services not actually rendered, you should immediately contact Oberheiden, P.C. to avoid civil or criminal prosecution.

Q: What should I do when I receive an OIG Subpoena?

The OIG and the HHS are the CMS and Medicare enforcement arms within the Department of Justice. If your business receives an OIG subpoena, either by mail or by service through agents, the government is investigating your practice for possible healthcare fraud. Sometimes the subpoena will note the nature of the investigation, but a skilled Arlington and Grand Prairie healthcare fraud lawyer can help determine if it’s a civil or criminal matter. They can then work to successfully defend your business. Oberheiden, P.C.’s attorneys have, in previous positions, issued and supervised OIG subpoenas and investigations as DOJ prosecutors. As criminal defense lawyers in private practice, they have resolved OIG cases across the United States. If you receive an OIG subpoena, don’t take chances. Don’t let untried lawyers simply produce the items that have been requested. Call us today and let us make sure your case doesn’t end up in the hands of a criminal prosecutor.

Q: What are some examples of practices that can lead to allegations of prescription drug fraud?

As stated, drug diversion, prescription fraud, and pill mill operations are pillars of current DOJ investigations. The FBI, the DEA, and other agencies were instructed to identify doctors, patients, and pharmacies with high or unusual amounts of Schedules I-III prescriptions. The problem with this data-driven approach is that the analysis does not take enough into consideration. Such as the fact that some physicians are simply busier, and prescribe more, than others. Or, that some patients may have exhausted conventional and interventional medicine and can only be treated with pain medications to help their suffering. Further, DEA agents will examine compliance with prescription formalities. They will look for mistakes with respect to the doctor’s signature and authorization. They will also consider the level of medical review prior to approving a controlled substance.

Q: What healthcare fraud penalties are possible?

Healthcare fraud can result in civil and criminal fines, but also criminal convictions and prison. Anyone accused of healthcare fraud should know that there is no time for mistakes or inexperience when it comes to avoiding charges. If your practice receives a grand jury subpoena, or federal agents try to interview you, the sooner you have lawyers on board who understand this area of law, the greater the likelihood of a positive resolution. Oberheiden, P.C. is one of the few firms nationwide dedicating nearly its entire practice to defending health fraud allegations. No matter where you and your Texas business are in this process and no matter the status of the investigation, there is no hopeless case for us. Most healthcare fraud criminal violations involve the potential of felony charges and incarceration of up to 10 years per count. Our attorneys have proven again and again:

How to avoid charges,
How to completely defend charges,
How to favorably resolve investigations,
How to obtain probation, and
How to avoid jail or prison time.

Q: What steps can I take to protect my business or practice now that I am aware of the government’s investigation?

If your business or practice is targeted with civil or criminal healthcare fraud, or opioid investigation, you should contact Oberheiden, P.C. to discuss various compliance techniques proven to mitigate or eliminate criminal intent.

Why Grand Prairie & Arlington Clients Select Oberheiden, P.C.

Healthcare fraud charges, no matter how absurd they may be, are not the time to take chances. Too much is on the line and a simple mistake can turn a civil case into a criminal matter and a criminal matter into an indictment. Clients coming to our firm know they don’t need to worry about that.

Oberheiden, P.C. is local and experienced. Experience from healthcare enforcement positions at the DOJ and from establishing a record in private practice allows us to advise and guide individual and corporate clients through any healthcare law related audit, investigation, prosecution, or trial.

We have concluded many criminal fraud investigations resulting in no client liability.
We have avoided civil liability in numerous False Claims Act, Qui Tam, and whistleblower cases representing physicians, physician groups, toxicology labs, pharmacies, and hospitals.
We are one team and everyone on that team works towards one outcome: no civil and no criminal charges for our clients.

Are You Being Investigated for Healthcare Fraud in Grand Prairie or Arlington? Call Our Trusted Federal Defense Lawyers Today

When it comes to protecting and defending your license, livelihood, and freedom, you must be vigilant. If you are under investigation or have questions about healthcare fraud, Medicaid and Medicare fraud, prescription policies, drug probes, or the Anti-Kickback Statute, advice from the best DUI defense attorney in Grand Prairie & Arlington isn’t what you need. Call us today to speak to an Arlington and Grand Prairie healthcare fraud lawyer. Our approach to defending health providers in Grand Prairie & Arlington and Texas includes:

Making contact with the investigators and prosecutors involved in your case to intervene in the investigation and collect information needed to build a defense strategy.
Evaluating the legal standards based on the nature of the government’s investigation and the unique aspects of your business or practice.
Exploring all possible defenses to the government’s allegations, including statutory exceptions, safe harbors, factual arguments, and constitutional protections.
Doing everything possible to preserve your professional reputation and resolve the investigation without your business or practice being put in jeopardy.
Trial expertise. Where needed, we are ready to challenge the government in court. With many criminal cases handled, Oberheiden, P.C. will bring in former Department of Justice Trial Attorneys, and former state and federal prosecutors with significant courtroom expertise.

Our Grand Prairie/Arlington healthcare fraud defense team is available to begin working on your case today. To speak with our attorneys in confidence, please call 817-859-8549 or request a free case evaluation online now.

Oberheiden P.C.
500 E Front St Suite 160-71
Arlington, TX 76011
817-859-8549