Ft. Lauderdale Healthcare Fraud Defense Lawyers
Healthcare providers in Ft. Lauderdale and throughout South Florida are being targeted in federal healthcare fraud investigations. Fort Lauderdale is a notable hub for such illegal activities, particularly involving Medicaid and Medicare fraud. At Oberheiden, P.C., our Ft. Lauderdale healthcare fraud defense lawyers represent providers nationwide in serious federal matters. To discuss your case with a member of our federal healthcare fraud defense team in confidence, call 888-680-1745 now.
Ft. Lauderdale Healthcare Fraud Defense Team Lead
Former Deputy Chief, Appellate Division
For healthcare providers in the Ft. Lauderdale area, the risk of being targeted in a federal investigation is very real. The federal agencies most likely involved are the Department of Justice (DOJ), Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), Office of Inspector General (OIG), Internal Revenue Service, and Department of Labor. All aggressively pursue providers suspected of improperly billing Medicare, Medicaid, and Tricare. These probes often lead to civil or criminal charges. If your healthcare business or practice is under federal inquiry, you need to protect yourself. The government may have been looking into your billing practices or business contacts for weeks – if not months. If you fail to defend yourself, you could end up facing charges needlessly.
While some federal healthcare fraud cases target real violations, the reality is that many are misguided. In order to convince officials they don’t have a case to prosecute, you must present a proactive defense. This means hiring experienced and strategic legal counsel. At Oberheiden, P.C., our skilled attorneys have notable experience on both sides of federal matters. With career defense attorneys, several members of our team are former prosecutors who spent years with the DOJ. As a result, our highly experienced Ft. Lauderdale healthcare fraud defense lawyers know what to expect at all stages of the case. We know what strategies have proven effective in shielding healthcare providers from the risk of conviction at trial.
What Is Healthcare Fraud?
If under investigation for healthcare fraud, what do federal authorities think you did wrong? There is no single answer. This presents one of the first challenges in defending against such allegations. Many investigations target healthcare providers’ billing practices (e.g., overbilling or double-billing). But, a review could also indicate illegal “kickbacks” or making unlawful “self-referrals.” In order to identify specific allegations against you, our team will promptly intervene to determine:
- Why your business or practice is being targeted;
- Whether any other businesses or practices are being targeted in related investigations;
- Which federal agencies and/or task forces are handling the investigation;
- Whether the investigation is civil or criminal in nature; and
- What information federal authorities have gathered to support the allegations against you.
Once our Ft. Lauderdale healthcare fraud defense lawyer has secured this information, we can then use our experience in thousands of federal fraud investigations to develop and execute a defense strategy that is specifically tailored to the unique circumstances of your case. In most cases, this will involve defending against allegations of:
- Medicare, Medicaid, or Tricare coding violations (commonly referred to as “billing fraud”)
- Department of Labor (DOL) fraud
- Improper payments under the Anti-Kickback Statute or Stark Law
- Prescription drug fraud (including opioid medication diversion)
- DEA registration violations
- Providing and billing for medically-unnecessary services or medications
- Billing for services not actually rendered to patients
- Falsifying patient records, prescriptions, physician certifications, and election statements
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)
1. The False Claims Act (FCA)
If you submit a claim to a federal healthcare program, you must ensure that your claim is accurate. Otherwise, it is a violation of the False Claims Act. The federal government may look into your billing practices under the criminal provisions of the Act.
2. The Anti-Kickback Statute (AKS)
The Anti-Kickback Statute restricts the exchange of money or other valuables for patient referrals. Anyone may face prosecution for violating this act if they offer or accept payment or other valuables in exchange for referrals.
3. The Stark Law
Stark Law is more commonly known as the Self-Referral Law. It bars physicians from referring patients to certain healthcare entities if the physician or an immediate family member has an ownership or investment interest in the entity. Or, if there is a compensation arrangement between the providers. There are statutory exceptions to this law.
4. The Controlled Substances Act (CSA)
The Controlled Substances Act is one of the primary federal statutes used to prosecute providers suspected of prescription drug-related offenses. This includes various forms of pharmaceutical fraud. A CSA investigation can result in criminal charges. Providers who go to trial for alleged CSA violations can face years or decades in prison and huge fines.
5. The Federal Healthcare Fraud Statute
The healthcare fraud statute, 18 U.S.C. 1347, makes it a federal offense to “knowingly and willfully . . . (1) . . . defraud [or attempt to defraud] any healthcare benefit program; or (2) . . . obtain [or attempt to obtain], by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any healthcare benefit program.” These violations often give rise to allegations under the False Claims Act and other statutes.
6. Program Billing Regulations
With the statutes listed above, healthcare providers are subject to many regulations under Medicare, Medicaid, Tricare, and DOL government programs. Regulatory violations can lead to statutory charges. Not having an effective compliance program is among the most common factors leading to dangerous federal investigations.
7. DOJ Mandates
The DOJ routinely issues releases identifying new law enforcement priorities and task forces. Increasingly, these initiatives target providers and entities in the healthcare industry. Recent initiatives include the Opioid Fraud and Abuse Detection Unit and Prescription Interdiction & Litigation Task Force. These groups combine the DOJ’s resources with those of other federal law enforcement agencies. Such enforcement is in addition to numerous federal laws not specific to healthcare related offenses. When criminally charged for committing fraud, providers are frequently accused of offenses like:
- Conspiracy,
- Bank fraud,
- Mail fraud,
- Wire fraud, and
- Money laundering.
These charges carry the potential for decades behind bars.
5 Reasons to Choose the Winning Ft. Lauderdale Healthcare Fraud Defense Lawyers at Oberheiden, P.C., for Fraud Investigation
As a healthcare provider in Ft. Lauderdale, if you are at risk for:
- Fines,
- Program exclusion,
- Loss of licensure, and
- Possibly even federal imprisonment.
Your choice of legal representation matters. Here are five reasons why healthcare providers across Florida and nationwide trust the federal healthcare fraud defense team at Oberheiden, P.C.:
90%+ Success Rate Avoiding Criminal Charges – We have resolved the majority of our clients’ cases without charges being filed. Plus, more than 90% of our clients’ cases end with no criminal prosecution.- Broad Experience in Federal Healthcare Fraud Matters – Our Ft. Lauderdale healthcare fraud defense attorneys are highly experienced on both sides of fraud cases involving the DOJ, DEA, FBI, OIG, and other federal agencies.
- Exclusive Focus on Healthcare Fraud Defense – Our firm’s exclusive focus is on federal healthcare fraud defense. We have handled thousands of cases, and we have a nationwide reputation as effective client advocates.
- Aggressive Intervention and Pretrial Strategies – We want to do all we can to resolve your case quickly and quietly. This starts with intervening in the government’s probe to employ a pretrial strategy to keep your case out of court.
- Trial-Ready Litigators with a Proven Track Record – Our goal is always to secure a favorable pretrial resolution. However, if our Ft. Lauderdale healthcare fraud defense lawyers need to go to court to protect you, we will. Our team will be fully prepared to carry out a cohesive, broad, and strategic defense.
Frequently Asked Questions
What are the common types of healthcare fraud?
Healthcare fraud is a very broad term that can refer to a wide range of conduct. Below are some of the most common examples of healthcare fraud:
- Billing for services that were not performed
- Billing for services that were not medically necessary
- Billing for supplies or equipment that were never ordered
- Billing for supplies or equipment that were not medically necessary
- Participating in an illegal kickback arrangement
- Certification for services or supplies that were not medically necessary
- Double billing, up-coding, and inflating bills
- Overutilization of services or equipment
Typically, the federal government is not required to prove you planned to defraud the government to establish civil liability. Thus, even well-intentioned providers can find themselves in the middle of a healthcare fraud situation. If you think you’re under suspicion by the FBI, OIG, DEA, or any other federal agency, contact an experienced Ft. Lauderdale healthcare fraud defense attorney today.
What is the False Claims Act?
The False Claims Act is a federal statute that bans anyone from submitting a false or fraudulent claim for payment to a federal program. Although some cases under the False Claims Act are the result of government actions, many come from a whistleblower’s allegations. Depending on the violation, punishments can carry both civil and criminal penalties. It is critical to speak to a Ft. Lauderdale, FL federal healthcare fraud defense lawyer as soon as possible if you’re facing allegations of fraud under the False Claims Act.
What should I look for in a Ft. Lauderdale, Florida federal healthcare fraud defense attorney?
Because they are quite complex, healthcare fraud cases require a knowledge of both legal principles and the healthcare industry. When searching for an attorney to help against governmental allegations, it’s important to hire one who has experience successfully handling fraudulent insurance claims. Law firms with senior attorneys who worked as federal healthcare fraud prosecutors have the best insight into how the government will build and present its case. This can be a huge advantage.
Schedule a Free Case Assessment with Our Ft. Lauderdale Healthcare Fraud Defense Attorneys at Oberheiden, P.C.
Is your Ft. Lauderdale healthcare business or practice under investigation by the DOJ, DEA, FBI, OIG, or another federal agency or task force? If so, we encourage you to contact a Ft. Lauderdale healthcare fraud defense attorney at Oberheiden, P.C. today for a confidential and free consultation. To speak with a member of our federal healthcare fraud defense team, call 888-680-1745 or tell us how to reach you online.
- Ft. Lauderdale federal criminal defense
- Ft. Lauderdale Medicare fraud defense
