Detroit Anti-Kickback Defense Attorneys
Litigation Counsel
220 West Congress St. 2nd Floor
Detroit, MI 48226
313-462-7972
Leading our nationally recognized Healthcare Fraud Defense Group at Oberheiden, P.C., is Dr. Nick Oberheiden. He is also one of the firm’s top Detroit anti-kickback defense attorneys. He has significant experience in defending medical professionals and business owners against accusations of Anti-Kickback violations.
Detroit Anti-Kickback Investigations
Federal anti-kickback statute applies to healthcare providers and non-licensed individuals like business owners, marketers, and healthcare executives. It prohibits offering, paying, soliciting, or receiving kickbacks, bribes, or rebates, in cash or otherwise, directly or indirectly for referring patients to providers in return for:
- An item or service covered by Medicare, Medicaid, or other federal healthcare programs such as Tricare, or patients covered by the Department of Labor;
- Buying, leasing, or ordering any item, service, or facility covered by Medicare and other federal healthcare programs such as Medicaid, Department of Labor patients, and Tricare.
Physicians and business owners in Detroit are at the forefront of healthcare fraud cases. Today, Detroit is one of nine U.S. areas where the federal government has special task forces monitoring, investigating, and prosecuting healthcare fraud. Physicians and healthcare business owners in Detroit must be aware that prosecutions are more aggressive and frequent than elsewhere. Leading cases is the elite Healthcare Fraud Prevention and Enforcement Action Team (HEAT). HEAT is a coordinated federal task force of federal prosecutors from the DOJ, HHS, OIG, FBI, and other federal agencies. Considering the scope and resources of the federal government, you need Detroit anti-kickback defense attorneys on your side.
In Detroit, the U.S. government currently investigates:
- physicians,
- physician-owned entities,
- pharmacies,
- compound pharmacies,
- medical device companies,
- imaging centers,
- labs,
- home health, and
- hospice care centers.
Are you the target of a federal healthcare investigation? Call our Detroit anti-kickback defense counsel team now to avoid criminal healthcare fraud prosecution.
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 Are the Penalties?
The federal Anti-Kickback Statute is a hybrid statute and violation of 42 U.S.C. § 1320a-7b. Prosecutions can be for a civil matter or a criminal offense.
- recoupment requests,
- non-payment of future claims,
- civil fines of up to $ 50,000 per violation,
- exclusion from federal healthcare programs,
- treble damages, and
- attorney fees.
- may be prosecuted as federal felonies,
- up to 5 years in prison per count,
- up to $ 25,000 in fines per occurrence, and
- exclusion from federal government programs.
- excluded from all federal healthcare programs,
- prohibited from receiving reimbursement from any federal healthcare program, and
- may face loss of medical license and hospital privileges.
- Why is the government investigating you?
- What law enforcement agencies are involved?
- Is the government planning to file criminal charges?
- What is the government’s ultimate goal in the case?
- What is a possible resolution to this case?
- Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges. - Healthcare Fraud
Result: No criminal charges.
CIVIL PENALTIES:
CRIMINAL PENALTIES:
PROGRAM EXCLUSION:
What the Government Must Prove
In each federal Anti-Kickback inquiry, the government has to prove an illegal remuneration. Payments in exchange for inducing or rewarding referrals, to purchase, lease, order, or arrange for, or recommend the purchase, lease, or order of any good, facility, or service that may be paid for by a government program.
Remuneration
In this context, virtually anything of value amounts to illegal remuneration. The Anti-Kickback law goes into effect when goods like gifts, rebates, durable medical equipment, cash, donations, or consulting fees are on offer between parties. Broad in scope, the statute may be violated if only one purpose of a payment is to induce referrals. Hiring the right legal counsel is one of the most important decisions you may make for your livelihood and future. Contact Oberheiden, P.C. to speak to a proven Detroit anti-kickback defense lawyer.
Intent
Before the Patient Protection and Affordable Care Act (PPACA), there was a high burden of proof for illegal kickbacks. The government is no longer required to prove that a defendant intended to violate the Anti-Kickback statute. Positive knowledge and specific intent to violate kickback laws has been replaced with the finding that a defendant’s intent was to violate the law by paying for Medicare or Medicaid business. Whether intent existed is left to judge or jury, as is reasonable doubt.
Health care fraud encompasses various fraudulent activities such as billing for unnecessary or non-existent medical services. Violations of the Anti-Kickback Statute can lead to criminal charges under the federal False Claims Act.
The Stark Law also plays a critical role in regulating physician referrals and financial relationships within the healthcare industry, working alongside the Anti-Kickback Statute to ensure compliance and prevent improper referral activities.
How to Defeat the Allegations?
Our Detroit anti-kickback defense lawyers have handled over 2,000 civil and criminal healthcare investigations and led more than two hundred criminal trials. Many of our attorneys come from senior positions within the Department of Justice. They share the experience, insights, and contacts as former federal prosecutors to fight for you in court. Every case presents its own challenges. Our defense strategies are successful time after time in Anti-Kickback cases.
Avoiding Criminal Charges. Our top priority in each case is to avoid criminal charges for our clients. We work to get the case dismissed, to secure your professional license, to turn a felony into a misdemeanor, and to avoid jail time.
Early Intervention. The importance of early case intervention by experienced defense counsel cannot be over-emphasized. An experienced anti-kickback attorney with the talent to carry out an effective defense strategy can halt an inquiry. A Detroit anti-kickback defense attorney can open dialogue with government officials and find a suitable solution. All this before the case gets out of control. Knowing what is on the line for our clients, we find answers to the following most pressing questions:
We strive to provide our clients these answers immediately upon being hired.
Safe Harbor Defenses. We remind the government that not every violation of the Anti-Kickback statute is unlawful. The law contains several safe harbor exceptions that make legal otherwise prohibited arrangements. Strict compliance with Safe Harbor regulations provide comfort that an arrangement will not violate the law. Failure to fit within a safe harbor does not always make an arrangement illegal. Among the most applied safe harbors are professional service agreements, space rental arrangements, equipment rental, personal services and management contracts, and the small investor safe harbor, see 42 C.F.R. § 1001.952(a)(2).
Fair Market Value. When exchanging goods between referral sources and businesses, we have experts to demonstrate the business relationship meets fair market value and is reasonable for services provided. For example, we defended a business relationship where a referring physician received large amounts of monthly stipends. A Detroit anti-kickback defense lawyer on our team showed that the amounts paid were valid under fair market value analysis. Our presentation turned the supposed illegal act into a perfectly legal arrangement.
Oberheiden, P.C.
The following summaries are outcomes accomplished for our clients.
Our Detroit anti-kickback defense attorneys are available every day of the year. You can call, complete our contact form, or email us directly.
