Dearborn Federal Healthcare Fraud Defense Law Firm
Dearborn Healthcare Defense
Team Lead
Contact Nick3200 Greenfield Road
Suite 300
Dearborn, MI 48120
888-680-1745
Healthcare providers are at a high risk of facing fraud investigations that can severely affect their reputation and practice. Federal agencies, including the Department of Justice, Federal Bureau of Investigation, Health and Human Services Office of Inspector General, Medicare Fraud Strike Force, and Healthcare Fraud Unit, often lead these federal investigations. They may investigate providers for healthcare law violations, including everything from violating the False Claims Act to committing prescription fraud.
Federal investigators are actively looking for potential healthcare regulation and law violations throughout Dearborn and the United States. With any allegation of healthcare fraud, these providers need to seek legal assistance from an experienced healthcare fraud defense attorney at Oberheiden, P.C.
We have a distinguished track record of successfully defending healthcare providers against these charges. Our experienced Dearborn federal healthcare fraud defense attorneys can provide the representation you need to navigate the legal landscape of the federal court system. If you suspect you are under government investigation or facing charges, we encourage you to contact our law firm as soon as possible.
Federal Healthcare Fraud at the Criminal and Civil Level
Healthcare fraud cases can include civil and criminal allegations. Often, the distinction between the two is not always clear. At Oberheiden, P.C., we have successfully avoided criminal charges in a significant number of federal healthcare investigations through early intervention and effective defense strategies. If you suspect your practice is under investigation, you must speak with our experienced attorneys as soon as possible to discuss your case and develop a comprehensive and proper defense plan.
Some clients often do not know whether they face a criminal or civil charge. To complicate the matter, the U.S. Attorney’s Office is divided into criminal and civil divisions, with prosecutors handling both types of federal cases. Knowing that a federal prosecutor is working on the case doesn’t mean you will be charged with a criminal offense.
It is important to understand that the distinction between civil and criminal investigations applies to government attorneys and federal agents. It is a common misconception that if an individual is contacted by an agent from the Office of Inspector General (OIG) or the Federal Bureau of Investigation (FBI), it must be related to a criminal offense. However, this is not always the case. Many federal agents also investigate civil matters. It is important to be aware of this distinction and seek legal advice regarding your legal options.
As former federal healthcare prosecutors and investigators, we have firsthand experience in how cases that start as civil investigations can quickly escalate into criminal matters when not handled effectively by a defense team. Determining whether a case is civil or criminal depends on a few factors, such as the type of requests made in an OIG subpoena, the tone of the inquiry, or the underlying allegations. In any situation, specific indications can suggest a case may be leaning towards criminal prosecution instead of civil litigation. These signs can include:
- Execution of search and seizure warrants
- Involvement of criminal prosecutors
- Target letter issuance
- Issuance of grand jury subpoenas
You will want to be aware of these indicators in your legal matter. For these reasons, you will want to seek the advice of an experienced an experienced Dearborn federal healthcare fraud defense attorney at Oberheiden, P.C. Our legal team will determine the nature of the case and develop an appropriate defense strategy for you.
Healthcare Fraud Charges
Federal healthcare fraud charges are serious and can lead to severe penalties, including imprisonment and severe fines. One of the key statutes used by federal prosecutors in healthcare fraud cases is 18 U.S.C. § 1347, which defines healthcare fraud as the knowing and willful execution or attempt to execute a scheme to defraud any healthcare benefit program or to falsely obtain any benefit of a healthcare program. The potential penalty for a healthcare fraud conviction under this statute is up to 10 years imprisonment and potentially steep fines.
Other federal statutes that prosecutors may use to charge individuals and entities with healthcare fraud include the False Claims Act, the Anti-Kickback Statute, the Stark Law, and the Controlled Substances Act. These laws are intended to protect the government from being overcharged for goods and services, prohibit illegal referral payments, prevent doctors from referring patients to entities in which they have a financial interest, and prevent the unlawful distribution of controlled substances.
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)
Defending Against Healthcare Fraud Charges
Oberheiden P.C. is a law firm that focuses on defending clients in healthcare fraud cases. With extensive experience in the field, our attorneys have successfully handled over 2,000 healthcare matters and tried over 200 criminal cases in court. We focus on four areas of defense for your case.
1. Immediate Defense
We prioritize preventing criminal charges in all investigations. By intervening early, we are able to influence the investigation and increase the chances of avoiding prosecution. Each Dearborn federal healthcare fraud defense attorney works tirelessly to protect our clients’ freedom and livelihood from the moment we are retained. We will quickly assess the case and provide answers to you regarding the nature of the investigation, its duration, and potential outcome.
2. Showing No Intent
The U.S. Constitution demands that the government must prove every element of a crime beyond a reasonable doubt. At Oberheiden P.C., we challenge this standard whenever criminal charges are possible, particularly when the crime requires a specific showing of intent to defraud. Many times, inaccuracies in medical billing records are used as evidence of intent. We understand that innocent mistakes can happen and do not necessarily indicate criminal intent. Our law firm has successfully defended clients by showing that any inaccuracies in their billing records resulted from a human or organizational error, not criminal intent. As a result, these actions should not lead to criminal liability.
3. Legal Challenges
The healthcare fraud defense attorneys at Oberheiden, P.C. have the trial and negotiation skills necessary to defeat a government’s case. We use our knowledge of healthcare law to introduce statutory loopholes into a case. Our team has successfully defended many individuals by showing how exceptions can be applied to their situation, mitigating the government’s fraud case.
4. Protecting Your Rights and Reputation
We are committed to protecting our clients from unfounded allegations of fraud and wrongdoing by developing legal strategies and defense plans to defend their reputations in public. Our Dearborn federal healthcare fraud defense lawyers take proactive steps to address biased or misleading news reports and provide accurate information to the public to correct any errors that may have been made. We work tirelessly to protect our client’s reputations, both in court and in the public eye.
Federal Charges are Common
Most healthcare fraud allegations are levied by the federal government. The difference between state and federal charges are not small. State charges are prosecuted by local district attorneys or the Michigan Attorney General’s Office. Federal charges, on the other hand, are investigated and prosecuted by some of the largest and most powerful law enforcement agencies in the world.
It also means that your case will be heard by a federal judge in federal court. For charges filed in Dearborn, Michigan, that court will be the U.S. District Court for the Eastern District of Michigan. This court has five locations, with the closest being in downtown Detroit, in the Theodore Levin Courthouse at 231 West Lafayette Boulevard.
Should your case of healthcare fraud need to be appealed, your defense team can request that the Sixth Circuit Court of Appeals review the district court’s decision. The Sixth Circuit Court is located in Cincinnati, Ohio.
Frequently Asked Questions About Healthcare Fraud
What Are the Common Types of Healthcare Fraud Cases?
Healthcare fraud covers a wide range of conduct, including:
- Billing for medical services that were not performed or were not of medical necessity
- Billing for supplies or equipment that were never ordered
- Participating in illegal kickback arrangements
- Overutilization of services or equipment
The federal government does not have to prove intent to defraud to establish civil liability, meaning well-intentioned providers can find themselves under investigation. If you believe federal agencies are investigating you, seek the guidance of our skilled federal healthcare fraud defense attorneys as soon as possible.
Are Referral Fees Illegal?
While these benefits are prevalent in the medical industry, certain referrals and kickbacks can violate federal healthcare fraud laws. For example, the Eliminating Kickbacks in Recovery Act prohibits paying or accepting kickbacks for referrals to laboratories, recovery homes, or clinical treatment facilities. The Anti-Kickback Statute prohibits exchanging or rewarding referrals for services covered by Medicare, Medicaid, and other federal healthcare programs. Additionally, the Stark Law holds providers liable for civil penalties for referring patients to another practice in which they have a financial interest. With a fine line between legal and illegal activities, practitioners should consult with our federal healthcare fraud defense attorneys to ensure their referrals comply with the law.
Do I Have to Answer Questions From Federal Investigators?
It is highly recommended to decline any request for an interview by federal agents without an attorney present. This is your constitutional right and the best way to avoid getting caught up in an ongoing investigation. Those statements made to agents cannot be taken back, and agents may not always be forthcoming about the nature of the investigation or your role in it. You will want to consult with an experienced Dearborn federal healthcare fraud defense lawyer before making any statements to the government, even if you believe you have nothing to hide.
When Is the Best Time to Contact a Law Firm?
Retaining the services of our healthcare defense law firm as early as possible during a federal healthcare fraud investigation can significantly increase the chances of avoiding severe consequences. Our attorneys’ early involvement may help clear any misconceptions or prevent you from making incriminating statements during the investigation. Federal investigators often use statements made by the subject during the investigation as evidence. With that in mind, you will want to hire Oberheiden, P.C. as soon as possible to protect yourself throughout this legal process.
Contact a Dearborn Federal Healthcare Fraud Defense Attorney at Oberheiden, P.C.
If your healthcare practice or medical business is under a fraud investigation or has been charged with a criminal offense in Dearborn, Michigan, reach out to the experienced and skilled legal team at Oberheiden, P.C. immediately. We understand the complexities of these healthcare laws and will use our skills to build a case for you. If you want to discuss your legal situation with our knowledgeable healthcare fraud defense attorneys, contact us at 888-680-1745 for a free confidential consultation, or request a free online case evaluation.
