Avoyelles Parish Healthcare Fraud Defense Lawyers

If you’re being investigated for healthcare fraud in Avoyelles Parish, Louisiana, call Oberheiden, P.C. today. Ask to speak with our Avoyelles Parish healthcare fraud defense lawyers. Initial calls are free and confidential.

Healthcare providers, entities, and businesses in Avoyelles Parish, Louisiana now have an expert legal advocate if accused of healthcare fraud. Oberheiden, P.C. has extensive legal representation 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.

Avoyelles Parish, Louisiana Is Continually Monitored for Healthcare Fraud

Avoyelles Parish is one of nine regions in the nation under near constant surveillance by the Medicare Fraud Strike Force. This federal body is made of prosecutors and investigators from several federal agencies.

Avoyelles Parish, Louisiana receives this attention based on the large population who rely on federal healthcare programs. The high number of recipients increases the number of claims filed by healthcare providers for payment. The government believes a high number of claims, means a higher instance of healthcare fraud.

The federal government is quite active in pursuing fraud cases. 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 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 based on incorrect or misleading claims. Federal healthcare programs include Medicare, Medicaid, Tricare, and federal workers’ compensation. It incorporates at least one of the following laws:

• The Anti-Kickback Statute. Federal law restricts the exchange of money or other valuables for patient referrals. You may face criminal prosecution if you offer or receive referrals in exchange for payment, or valuables.
• Stark Law. Stark Law is more commonly known as the Self-Referral Law. It bars doctors from referring patients to certain healthcare entities if the physician or an immediate family member has an ownership, investment, or financial 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 question your billing practices under the criminal provisions of the Act if there is an indication of such claims being filed.
• Prescription Fraud. Prescribing a high volume of narcotics is closely monitored by the federal government. If suspected of operating a “pill mill,” you may find yourself targeted for insurance fraud or violating DEA dispensing rules.
• Billing Fraud. One of the most common occurrences of fraudulent billing 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 medical equipment.
• Certification Errors. The federal government pays close attention to the home healthcare and hospice industry. The most common allegation is fraudulent certification for medical care.

Oberheiden, P.C. has a successful record of helping clients avoid criminal charges when they are being investigated for healthcare fraud. If you’re under investigation by the federal government for healthcare fraud in Avoyelles Parish Louisiana or the surrounding area, contact our Avoyelles Parish healthcare fraud defense attorneys. Your initial call is free and confidential.

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)

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, you could be ordered to repay claims, and you may lose payment for future claims. You could also face exclusion from federal healthcare programs all together.

Criminal penalties include more than an indictment. It also includes hefty fines that can cost you hundreds of thousands of dollars and 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.

Having a skilled Avoyelles Parish healthcare fraud defense lawyer can make a significant difference in the outcome of your case, potentially reducing or avoiding severe penalties.

Avoyelles Parish, Louisiana clients always ask one question during their initial call: What is the worst-case scenario when it comes to healthcare fraud? Whether you’ll face criminal charges or a prison sentence depends on several factors. These are: the severity of injury suffered by a patient, whether the prosecutor sees an advantage in pursuing criminal charges, and the reason the federal government began the case. If you’re under investigation for healthcare fraud, contact Oberheiden, P.C. Your initial call is confidential and free.

Oberheiden, P.C. provides legal advocacy for Avoyelles Parish, Louisiana medical professionals, entities, and businesses facing healthcare fraud charges.

Is the Investigation Against You Criminal?

Healthcare fraud investigations can be civil or criminal in nature. They often start off as civil and then become criminal as the federal government continues to investigate. That’s why it is extremely important for you to immediately contact the Avoyelles Parish healthcare fraud defense lawyer at Oberheiden, P.C. if you are being investigated.

Healthcare fraud investigations in Avoyelles Parish can be civil or criminal. Cases can start as civil and then become criminal as the investigation progresses. Being contacted by a prosecutor is not an indicator that the investigation 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.

Healthcare Fraud Defenses

Oberheiden, P.C. is a healthcare fraud defense firm. We provide legal advocacy to providers, entire healthcare systems, and businesses in Avoyelles Parish, Louisiana, and the surrounding areas. We’ve managed hundreds of cases during our time as a law firm. Several members of our team of Avoyelles Parish healthcare fraud defense lawyers have prior experience as healthcare auditors and healthcare fraud prosecutors with both the Department of Justice and the Medicare Fraud Strike Force. We use this experience to develop strategic defenses for each of our clients.

Advocacy begins right away. 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. 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 prove 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. 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. Some 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.

Researching and using strategic legal defenses. Oberheiden, P.C. 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. Healthcare fraud allegations can damage your professional reputation. An Avoyelles Parish healthcare fraud defense attorney will defend your professional reputation by correcting misinformation about you and the case, and addressing slanderous comments.

If you’re being investigated for healthcare fraud in Avoyelles Parish, Louisiana or the surrounding areas, call Oberheiden, P.C. We offer a free initial consultation.

Contact Oberheiden, P.C. today to speak to an Avoyelles Parish healthcare fraud defense attorney. We are available every day of the year. Call, complete our contact form, or email us directly.