Experienced Attorneys for Healthcare Providers and Business Owners Facing Fraud Investigations in Cleveland, Ohio
Has your healthcare business or practice been contacted by a federal agency? If so, you are not alone. Healthcare providers in Cleveland, Ohio and surrounding communities are targeted in audits, investigations, and criminal prosecutions. Taking steps to protect your license, livelihood, and freedom then becomes a critical business decision. Our experience includes:
- More than 2,000 healthcare fraud investigations
- Dismissal of state and federal indictments
- More than 70 combined years of Department of Justice experience
5900 Detroit Avenue
Cleveland, OH 44102
Who Will Handle My Case At Oberheiden, P.C.?
Oberheiden, P.C. is a team of healthcare fraud defense attorneys and former federal prosecutors. We represent Cleveland medical providers and business owners in federal healthcare fraud cases. With such experience, our attorneys offer clients unparalleled insights and knowledge. Our skills and knowledge allow us to determine effective defense strategies for our clients. Our firm does not assign paralegals or inexperienced attorneys to any cases.
If your practice is exposed, immediate intervention is required. With experience in more than 2,000 healthcare audits and prosecutions, Oberheiden, P.C. offers competent and efficient legal advice. We know how to protect you and your business. Our team of Cleveland healthcare fraud attorneys will develop a proven defense strategy.
Federal Prosecutors are Targeting Cleveland, Ohio Healthcare Providers and Businesses
No day goes by without new horror stories of hard-working doctors being arrested and prosecuted. Healthcare fraud enforcement is a federal priority. The war against opioid misuse has led to increased scrutiny in Cleveland and throughout Ohio.
The fraud accusations against Cleveland providers and healthcare entities include Medicare Fraud (18 U.S.C. 1347), Medicaid Fraud, as well as violations of the Controlled Substances Act (21 U.S.C. 841), the Anti-Kickback Statute (42 U.S.C. 1320a-7b), the Stark Law Statute (42 U.S.C. 1395nn), and the federal False Claims Act (31 U.S.C. 3729-3733).
Two things have changed in recent times. First, human errors are more and more seen as intentional fraud. Due to the complexity and changing rules of the healthcare industry, every healthcare practice is prone to errors. However, even unintended errors are subject to audit and referral to civil or criminal prosecution.
Second, investigations that used to be civil in nature, are now pursued as criminal prosecutions. Raids, arrests, and search warrants against providers in Ohio reflect the overall trend across the country. Fighting healthcare fraud is a top priority for the Department of Justice. Allegations target all areas of healthcare.
If your healthcare business or practice is under investigation, contact us for a free case assessment. Oberheiden, P.C. can quickly review your case, intervene in the investigation, and implement a complete defense strategy.
We Are Ready to Fight Healthcare Fraud Allegations in Cleveland, Ohio
Oberheiden, P.C.’s attorneys have successfully represented various professionals against alleged violations of the Controlled Substances Act and the Anti-Kickback Statute. We appear before agencies such as the Office of Inspector General, the Drug Enforcement Administration, the Federal Bureau of Investigation, and U.S. Attorney’s Offices around the country. Our team resolves cases of:
- Medicare fraud,
- Medicaid fraud,
- Stark Law,
- Anti-Kickback claims,
- False Claims Act,
- Prescription fraud, and similar issues on behalf of our clients.
- Medicare Audits. There are several types of Medicare audits. In general, Medicare Administrative Contractors (MACs) and Recovery Audit Contractors (RACs) work to identify improper payments by analyzing claims data and medical records. Many times this involves a statistical sampling of files in order to establish an error rate. Another type of Medicare audit is conducted by Zone Program Integrity Contractors (ZPICs). ZPIC audits identify potential fraud and refer cases to the Department of Health and Human Services (HHS) and the Office of Inspector General (OIG). The risk with Medicare audits is that if mishandled, they can lead to referrals to the U.S. Attorney’s Office. Oberheiden, P.C. knows how to avoid such a referral. Former Department of Justice healthcare prosecutors with first-hand knowledge of the process lead our clients through the audit. They make sure clients can continue their business and not worry about their license or government intervention.
- Medicare Fraud, Medicaid Fraud. There are a high number of Medicare and Medicaid beneficiaries in Ohio. With that comes a higher number of claims filed to the federal government. Healthcare providers, business owners, and healthcare entities can be accused of fraud based on the number of claims. The offenses can have serious outcomes and caution is in order. If you are accused of fraud, experienced attorneys carefully analyze the nature of the allegations to determine your exposure. In general, Medicare fraud covers a variety of conduct such as:
- Coding and billing fraud,
- Fraudulent physician certifications for home health and hospice care,
- Billing for services not provided,
- DME fraud.
Oberheiden, P.C. has a history of resolving Medicare and Medicaid fraud cases. Often, with neither civil, nor criminal liability for many of our clients. The sooner we oppose the government’s case, the higher the chance of a favorable outcome. Call to speak to one of our experienced healthcare fraud attorneys today. Find out how we can protect your license, livelihood, and freedom in Medicare and Medicaid fraud cases. Call us today and speak to an experienced healthcare fraud attorney on how we can protect your license, livelihood, and your freedom in Medicare and Medicaid cases.
- Controlled Substance Act and Prescription Drug Fraud. Federal authorities prosecute pain management physicians in Cleveland and throughout Ohio. New arrests and investigations are a near daily occurrence. Prescribers of Schedule II and III drugs should know that finding prescription fraud and closing “pill mills” is a priority of the Department of Justice. If you are under suspicion, contact attorneys who led and supervised FBI and DEA healthcare fraud cases before. Their experience will enhance the help we offer clients like you at Oberheiden, P.C. Given the aggressive nature of current investigations, your license and your freedom may be at risk.
- Illegal Kickbacks. Current Anti-Kickback Statute investigations in Cleveland and throughout Ohio focus on:
- Healthcare marketers,
- Toxicology labs, and
- Hospital Billing and Coding Violations. Cleveland is home to many hospitals and surgery centers. Their boards of directors, physicians, and related individuals can come under scrutiny for billing fraud. Much of this activity involves Medicare patients. If you are under investigation for any of the following, promptly seek legal counsel to avoid civil or criminal prosecution:
- Billing for medically-unnecessary services,
- Double-billing, or
- Billing for services not actually rendered.
- Physician “Self-Referrals.” The federal Stark Law imposes penalties for what are commonly known as physician “self-referrals.” Physicians are prohibited from referring certain federal healthcare program beneficiaries to entities in which these referring physicians have a financial interest. Liability costs under the Stark Law statute can be massive. Similar to the Anti-Kickback Statute, the Stark Law includes various exceptions, and Oberheiden, P.C. has a record of identifying these exceptions to protect our clients from liability.
Call us immediately if you are concerned about your role in a case or if you are under investigation. As we have for so many others, Oberheiden, P.C. will find a way to protect you.
FAQs: What Providers in Cleveland, Ohio Need to Know about Healthcare Fraud Investigations
Q: What Are Likely Outcomes If My Business is Under Investigation for Healthcare Fraud?
If your business or practice is being targeted for healthcare fraud, there are a number of potential outcomes. What happens depends on if the investigation is civil or criminal, when experienced attorneys intervene, the alleged misconduct, and other factors. Potential outcomes may include:
- The investigation being closed without charges or liability
- The investigation being resolved with a negotiated settlement prior to charges being filed
- Negotiating a plea deal once charges have been filed
- Going to trial on criminal charges with a guilty or not guilty finding
Again, the ultimate outcome depends on a number of factors. At Oberheiden, P.C., our goal is to keep our clients’ cases civil in nature and to resolve each case without charges filed. Our history shows that it is often possible to achieve this goal.
Q: What Is Prescription Fraud?
“Prescription drug fraud” is a generic term that includes the unlawful practice of dispensing and managing of scheduled medications. Some of the most common allegations in prescription drug fraud allegations include:
- Prescribing opioid or narcotic medications to a drug-dependent patient
- Prescribing outside of acceptable medical treatment principles
- Allowing unauthorized use of your DEA registration number
- Prescribing medications that are not medically necessary or without proper justification
- Failing to follow the rules for electronic and hard-copy prescriptions
Q: Are There Exceptions to Violations of the Anti-Kickback Statute and the Stark Law?
Yes, federal law recognizes a number of important exceptions. The exceptions can render alleged violations, including criminal offenses, lawful. We regularly identify these exceptions and make compelling arguments why it applies to the Anti-Kickback Statute or Stark Law applies. This occupies a significant amount of work Oberheiden, P.C. attorneys do on a daily basis for their clients. After all, if an exception applies, the government’s claim is meaningless. Common exceptions and safe harbors involve:
- Personal service arrangements
- Bona-fide employment relationships and incidental staff benefits
- Certain forms of non-monetary compensation
- Discounts and group purchasing arrangements
- In-office ancillary services
- Indirect compensation arrangements
- Isolated transactions
- Price reductions involving eligible managed care organizations
- Referral agreements for specialty services
- Waivers of coinsurance and deductibles
Why Choose Oberheiden, P.C. in Cleveland, Ohio?
When you need legal representation to protect you and your business, you cannot afford experiments. Oberheiden, P.C. offers you the experience, resources, and capabilities required to present the strongest possible defense. At Oberheiden, P.C., we offer:
- Commitment to client protection with many cases resulting in no civil and no criminal liability for our clients.
- A team approach in which clients benefit from notable prosecutorial and defense experience in the specific area of healthcare investigations.
- Highly experienced as fraud defense attorneys and former federal healthcare prosecutors.
- A practice with Ohio lawyers focused on healthcare fraud defense.
Schedule a Confidential Case Evaluation
Our healthcare fraud defense team is available to begin working on your case immediately. To speak with our attorneys in confidence, please call 888-680-1745 or request a free case evaluation online now.
Areas We Serve in Cleveland, Ohio
Subject to our terms and conditions and in accordance with the applicable local rules of United States District Courts and state professional boards, the attorneys of Oberheiden, P.C. may accept engagements in federal cases relating to the following geographical areas either as already admitted counsel, pro hac vice, or in combination with locally licensed counsel. The areas include: Cleveland, Parma, Lorain, Elyria, Lakewood, Euclid, Mentor, Cleveland Heights, Akron, Ashland, Ashtabula, Carroll, Columbiana, Cuyahoga, Geauga, Lake, Lorain, Mahoning, Medina, Portage, Richland, Stark, Summit, Trumbull, Wayne.
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Serving the State of Ohio and Surrounding Areas