Duval County, Texas Medicare Fraud Defense Attorneys

Medicare fraud allegations in Texas can destroy your livelihood and your reputation. If you’re in Duval County, Texas or in the surrounding areas, call the Oberheiden, P.C. if you’re under investigation. We are a Texas law firm with practices in Medicare fraud, Tricare and Medicare audits, developing and implementing Medicare compliance programs, asset protection, federal compliance matters, jury trials, qui tam defense, and we also assist clients who are in receipt of an OIG or a grand jury subpoena. Our Texas Medicare fraud law firm team is managed by a former Chief Healthcare Fraud Coordinator from the Dallas U.S. Attorney’s Office. Lawyers on our team have skills as former federal prosecutors and former senior trial attorneys.

Explaining Medicare Fraud

Medicare fraud is a federal offense. It includes both civil and criminal penalties. Medicare fraud is the filing of one or more inaccurate or false claims with a federal healthcare program. Claims are filed by medical providers and entities in order to be reimbursed for their medical services or the equipment that was used or needed by a federal healthcare program beneficiary. Medicare fraud doesn’t just include Medicare. It also includes federal workers’ compensation, Medicaid, and Tricare. If you’re being accused of Medicare fraud, that means that you’re being accused of violating at least one of the following statutes or laws:

• Violating the Anti-Kickback Statute;
• Violating the False Claims Act;
• Violating Stark Law (the Physician Self-Referral Law);
• Violating the Social Security Act;
• Violating U.S. Criminal Code.

Medical providers, labs, pharmacies, medical facilities, and businesses are investigated for Medicare fraud in Duval County, Texas with more frequency than in most areas in the United States. This is because Duval County, Texas is one of nine regions in the nation that has a substantial number of federal healthcare program beneficiaries. More claims are filed since more services are provided to beneficiaries. This increase in claims calls attention to the area. The federal government believes that there is a correlation between the number of claims filed and an increase in Medicare fraud.

The Medicare Fraud Strike Force constantly monitors the claims in Duval County, Texas and the surrounding areas. Their job is to watch for, investigate, and prosecute Medicare fraud. This team is comprised of representatives from several agencies including the DOJ, DEA, DOD, Department of Human Services, the Office of Inspector General, the FBI, and the IRS. This list isn’t all-inclusive. In fact, the Medicare Fraud Strike Force often includes members of other federal agencies. If you are contacted by the Medicare Fraud Strike Force or by a representative of a federal agency, call Oberheiden, P.C. right away.

Put our highly experienced team on your side

Dr. Nick Oberheiden

Founder

Attorney-at-Law

Lynette S. Byrd

Former Department of Justice

Brian J. Kuester

Former U.S. Attorney
Former DA

John W. Sellers

Former Senior Trial Attorney
U.S. Department of Justice

Local Counsel

Joanne Fine DeLena

Former Assistant U.S. Attorney

Local Counsel

Joe Brown

Former U.S. Attorney & Former District Attorney

Local Trial & Defense Counsel

Amanda Marshall

Former U.S. Attorney

Local Counsel

Aaron L. Wiley

Former Federal Prosecutor

Local Counsel

Roger Bach

Former Special Agent (OIG)

Michael Koslow

Former Supervisory Special Agent (FBI)

Chris Quick

Former Special Agent (FBI & IRS-CI)

Ray Yuen

Former Supervisory Special Agent (FBI)

Medicare Fraud Investigations in Duval County, Texas

Duval County, Texas and its surrounding areas often have Medicare fraud investigations begin because an inaccurate claim is filed with a federal healthcare program. Usually, the claim includes an unauthorized service or use of medical equipment, has an excessive charge, or has an incorrect charge. The most common billing mistakes in Duval County, Texas that start these investigations include:

• Phantom billing – billing for services that were never performed;
• Double billing for medical equipment or services;
• Submitting a claim for medically unnecessary medical services or equipment;
• Submitting a claim for medically unnecessary medical supplies;
• Submitting a claim for a medically unnecessary certification (including a claim for hospice or home healthcare );
• Inflating charges;
• Up-coding;
• The overuse of medical equipment of services;
• Providing or accepting kickbacks.

Individual medical providers, such as doctors and nurses, physician-owned companies, nursing facilities, registered care facilities, clinics, labs, pharmacies, cancer centers, DNA centers, and DME providers are the most common targets of Medicare fraud investigations in Duval County, Texas.

The Civil and Criminal Penalties of Medicare Fraud in Duval County, Texas

Allegations of Medicare fraud in Duval County, Texas can lead to civil or criminal penalties. Civil penalties may include:

• Repayment of claims in questions;
• Future claims aren’t paid;
• A fine of up to $11,000 per false claim;
• Exclusion from federal healthcare programs;
• Assignment of treble damages;
• Attorney fees.

You could be called before the disciplinary or licensing board where you may be forced to hand over your professional license and you may lose your hospital privileges.

Criminal penalties for Medicare fraud may include:

• Fines that cost you hundreds of thousands of dollars, even for a misdemeanor;
• A criminal record;
• A federal prison sentence of up to 10 years for each count of Medicare fraud for which you are convicted;
• Federal prison sentence of up to 20 years for each count of Medicare fraud that resulted in serious bodily harm to the patient or patients;
• A life sentence in federal prison for Medicare fraud that results in the death of a patient.

Medicare Fraud Lawyers That Serve All of Texas, Including Duval County

Medicare fraud is a serious federal offense. You need the right Medicare fraud lawyer in Duval County, Texas to help defend you. Medicare fraud allegations often include federal criminal charges like wire fraud, money laundering, tax fraud, and mail fraud. It’s important that you do your research to choose the right Medicare fraud lawyer to help you with your needs.

A Duval County, Texas healthcare fraud defense lawyer understands the intricate healthcare statutes and also has knowledge in handling federal criminal charges. Watch for:

• A successful record when handling Medicare fraud cases;
• Knowledge of the Medicare fraud and healthcare fraud laws and regulations;
• Knowledge of statutory exceptions;
• Both litigation and jury trial practices.

When you find a lawyer with those qualifications, ask these questions:

• How many Medicare fraud cases have you handled throughout your career?
• How many of those resulted in no civil or criminal charges or in dismissals for your clients?
• How many of those cases were tried in court?

Medicare Fraud Defense Strategies for Duval County, Texas

Oberheiden, P.C. takes the time to evaluate each case to determine the most effective Medicare fraud defense strategies. Where possible, we do look to settle with the federal government. However, as federal trial lawyers, we are fully prepared to go to court on your behalf. We have represented hundreds of clients in Texas and in the entire nation. We’ve used our skills to develop strategies that we use with each client.

Contacting the federal government. Our main priority is to resolve the accusation of Medicare fraud and help clients avoid criminal charges. Immediately after being retained, we reach out and contact the federal government. This gives us an opportunity to get answers to the most important questions:

• What is the investigation about?
• What prompted the investigation?
• Is the investigation civil or criminal?
• Which federal agencies are involved?
• What is the ultimate goal of the government?
• How can this matter be resolved?

We are usually able to get answers to these questions within just a few hours after we are retained.

Evaluating the evidence. Evidence must be presented to show that you committed a crime. The federal government must present evidence that means a legal standard known as “beyond a reasonable doubt.” Our lawyers will evaluate the evidence presented by the federal government to determine if it reaches the necessary legal standard. Using this strategy has given the following results on a routine basis:

• Dismissal of charges;
• No criminal charges;
• Client retains professional license;
• Civil fine with no criminal plea;
• Reducing a felony to a misdemeanor;
• No federal prison sentence.

No criminal intent. The federal government must also show that you made an active decision to try and receive an illegal reimbursement from the government. That would be acting with criminal intent. In Duval County, Texas, most Medicare fraud cases that start aren’t intentional. They start because of a mistake. The most common mistakes that begin these investigations include:

• Using unqualified staff;
• Inadequate supervision;
• Inappropriate delegation and outsourcing;
• Structural errors;
• Human errors;
• Oversight;
• Employees who are overwhelmed;
• No Medicare compliance program in place;
• The changing healthcare laws and rules.

These issues should certainly be corrected by our clients, but they aren’t crimes. Oberheiden, P.C. works to prove that you made a mistake and that you are ready and willing to correct and prevent future mistakes of this nature.

Individualized Medicare fraud defenses. Medicare fraud cases are similar in nature because of the basis of the allegation, but they can include different facts and violations of various statutes. This is why our legal team takes the time necessary to evaluate each case on its own and determine the right Medicare fraud defenses. Recently, one of our clients was accused of providing fraudulent certifications for home healthcare services. We were able to prove that our client was legally protected by a delegation exception and that the certification was compliant with the law. In a separate case, we did not admit liability on behalf of our client. Rather, we proved to the federal prosecutor that our client acted within a safe harbor exception.

Oberheiden, P.C.

Oberheiden, P.C. provides legal representation for Medicare fraud defense in Duval County, Texas and in the surrounding areas. We represent individual medical providers, entities, business owners and executives, attorneys, hospitals, clinics, pharmacies, labs, and other related medical businesses being investigated for fraudulent billing, illegal kickbacks, and allegations of medically unnecessary services, services not rendered, or unlawful joint ventures. We can help you in many areas, including:

• Healthcare fraud defense
• Compliance program creation and implementation
• Internal investigations
• Asset protection
• Licensure or disciplinary proceedings
• Jury trials

If you’re under investigation by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, Duval County or Texas law enforcement, call Oberheiden, P.C. now. The call is free and confidential.

We are available every day of the year. You can call or email us directly, or complete our contact form.

Additional Pages for Duval County, Texas

• Duval County healthcare fraud defense