Florida Medicare Fraud Defense Lawyer

If you have been accused of Medicare fraud, your first move should be to contact an experienced Florida Medicare fraud defense lawyer. Oberheiden, P.C. is a healthcare law defense firm with experience in regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. Our attorneys serve clients throughout Florida.

There is a serious risk to Florida healthcare providers and businesses. Being involved in healthcare in Florida brings with it an increased probability that you’ll be investigated for Medicare fraud. If you’re under investigation for Medicare fraud in Florida, you need a Medicare fraud defense law firm. Oberheiden, P.C. is a healthcare fraud defense law firm serving the State of Florida. It is managed by Dr. Nick Oberheiden, a Harvard-trained defense attorney and negotiator.

Medicare Fraud in the State of Florida

Medicare fraud allegations mean a violation of federal law. It means that a false claim was submitted for payment to the federal government. Despite the name, it includes all federal healthcare programs. This means that it may originate through Medicaid, Tricare, or even federal workers’ compensation. Medicare fraud is an allegation that you’ve violated one or more of these laws:

• Physician Self-Referral Law (also known as Stark Law)
• False Claims Act
• Anti-Kickback Statute
• U.S. Criminal Code
• Social Security Act

Florida has a higher probability of Medicare fraud investigations than most states. In fact, it is one of nine areas subject to increased scrutiny by the Medicare Fraud Strike Force. The reason behind this is that Florida has a large population that relies on federal programs. This equates to more claims filed. The large volume of claims makes the government believe there is more potential for Medicare fraud. The Medicare Fraud Strike Force identifies, investigates, and prosecutes Medicare fraud.

How Do Most Medicare Fraud Allegations Start in Florida?

Medicare fraud investigations in the State of Florida often begin with billing mistakes. The federal government may judge such billing practices or reimbursement requests as fraudulent. Included are excessive charges, fraudulent charges, and unauthorized charges. The most common billing issues include:

• Phantom billing (billing for services that weren’t performed)
• Billing for medically unnecessary services or equipment
• Billing for equipment or services that weren’t ordered
• Certifications for medically unnecessary supplies or services (such as medical devices or hospice care)
• Charge inflation
• Double billing for equipment, services, or treatment
• Upcoding for equipment, services, disorders, or treatment
• Overuse of services or equipment
• Providing or accepting kickbacks

In Florida, any provider or company can be accused of committing healthcare fraud. If you’re under investigation for Medicare fraud, call Oberheiden, P.C. now to schedule a consultation. Initial consultations are free of charge and confidential.

Civil and Criminal Liability for Medicare Fraud in Florida

Medicare fraud in Florida can result in civil or criminal liability. In some instances, you may face both. Civil penalties can include one or more of the following:

• Assessment of treble damages
• Civil fines of up to $11,000 per false claim
• Recoupment requests
• Non-payment of future claims
• Exclusion from federal healthcare programs
• Assessment of attorney fees
• State disciplinary action
• Loss of professional license
• Loss of hospital privileges

Criminal penalties may include one or more of the following:

• A criminal record
• Fines that cost you hundreds of thousands of dollars
• 10 years in federal prison for each count of Medicare fraud for which you are convicted
• 20 years for each count of Medicare fraud if it resulted in serious bodily injury to the patient
• A life sentence if the Medicare fraud resulted in the death of the patient

Choosing the Right Florida Medicare Fraud Defense Attorney

Medicare fraud allegations require an experienced Florida medicare fraud defense attorney to strategize and execute the best defense for the facts of your case. The attorney should be prepared to help you with both civil and criminal charges. An experienced attorney can help navigate complex issues such as Stark Law violations, which involve legal restrictions on medical providers referring patients to entities with financial relationships or interests.

Medicare fraud investigations lead many to hire a Florida Medicare fraud defense lawyer. While a healthcare lawyer understands healthcare law, that’s only half the battle. It is likely that you’ll also face various federal criminal charges, such as wire fraud and money laundering. A healthcare lawyer may not have experience handling federal criminal matters. They may not have the needed negotiation and defense skills to face federal prosecutors.

When criminal charges loom, people often look for a criminal defense attorney immediately to assist them. Most criminal defense attorneys in Florida aren’t prepared to handle federal criminal matters. They likely lack a deep understanding of healthcare law, billing, coding, or medical utilization rules. Medicare fraud is a serious charge. You do not have time to school an attorney on these key components.

You need an advocate with experience in healthcare law and federal criminal defense. You need a Florida medicare fraud defense attorney. As you look for legal counsel, check for these four necessary traits:

• A proven record of success in Medicare fraud cases
• Industry knowledge
• Superior knowledge of healthcare laws and their exceptions
• Litigation and trial experience

Once you’ve created a list of potential lawyers or firms, you should ask these three questions to learn more about their experience:

• How many Medicare fraud cases have you handled during your career?
• How many of those healthcare fraud cases resulted in neither civil, nor criminal charges, or in dismissals?
• How many Medicare fraud cases have you tried in court?

Florida Medicare Fraud Defenses

Oberheiden, P.C. uses proven strategic defenses for our Florida clients accused of Medicare fraud. We’ve developed three primary defense points that we use in each case. Their effectiveness has been proven time and again in Florida and across the nation.

Early government contact. Experience has shown that early contact with the federal government is one of the best ways we can help clients. Making early contact can reduce the risk of criminal charges. When investigators have time to investigate you without intervention from an attorney, you’re more likely to face criminal charges. Our goal is to lessen that risk. This is why we contact the federal government right away to get answers to important questions like:

• What is the investigation about?
• What prompted the investigation?
• Is this civil or criminal?
• Which federal agencies are involved in the investigation?
• Who is being investigated?
• How can the matter be resolved?

Many of our team members previously worked as federal healthcare fraud prosecutors. Those connections allow us to get questions answered within hours of our engagement. We also use these answers to begin planning a strategic defense for your case.

Addressing the lack of evidence. Evidence is essential to any lawsuit. The government must present evidence that proves beyond a reasonable doubt that you committed a crime. We test the evidence in each case to determine if the government is able to reach this Constitutional standard. Because of this one defense strategy, we routinely achieve the following results:

• Case dismissal
• No criminal charges
• Clients maintain their professional license
• Civil fine without a criminal plea
• Reducing a felony to a misdemeanor
• No prison time

Disputing intent. In addition to proving you committed a crime, the government must be able to prove you acted with criminal intent. Most federal fraud cases don’t involve someone deciding to defraud the government. We seek to demonstrate that our client made a simple mistake and did not intend to commit a serious crime. Most federal investigations occur because of a mistake. The most common that trigger a Medicare fraud investigation in Florida include:

• Relying on unqualified or untrained staff
• Inadequate supervision of staff
• Delegation and outsourcing of work to unqualified entities
• Business errors
• Human error
• Oversight
• Overwhelmed staff
• Lack of a Medicare compliance program
• Failure to keep up with the quickly changing healthcare laws and rules

Healthcare providers and businesses in Florida facing Medicare fraud allegations often accept severe penalties without question. They believe that if the government accuses them of something, they must be guilty. While the mistakes that caused the investigation should be corrected, they shouldn’t result in criminal charges. Our goal is to show the federal government that our clients had no criminal intent.

Developing and implementing strategic defenses. Each Florida Medicare fraud case has its own set of facts. By analyzing the facts surrounding a case, we can develop and put into action the best strategic defense. We recently handled a Medicare fraud case where the government accused our client of fraudulently certifying home healthcare services. We proved to the government that our client was protected by a delegation exception making the certification legal. In another case, we refused to admit liability. We proved to federal prosecutors that our client acted within a safe harbor exception.

Oberheiden, P.C. – Your Florida Medicare Fraud Defense Team

Oberheiden, P.C. serves the State of Florida by providing excellent Medicare fraud defense counsel. We’ve assisted Florida healthcare providers and businesses under investigation for illegal kickbacks and fraudulent billing practices. We can help you with:

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

Oberheiden, P.C. provides legal representation for providers, businesses, and facilities in the State of Florida. If you’re under investigation by a federal agency, or Florida State law enforcement, call us right away. We offer a free initial consultation that is completely confidential.

Our Florida Medicare fraud defense lawyers are available every day of the year. Call, complete our contact form, or email us directly.