Indianapolis Healthcare Fraud Defense Lawyers
Aggressive Healthcare Fraud Defense Attorneys for Indianapolis, Indiana
Medical providers in Indianapolis and surrounding communities must expect increased scrutiny and prosecutions from federal law enforcement agencies. In late 2017, Attorney General of the United States, Jeff Sessions, announced a national effort against healthcare fraud and abuse. He instructed federal prosecutors to aggressively pursue Medicare and Medicaid fraud, and violations of the Controlled Substances Act. It is no secret that Indianapolis is one of the epicenters of this new wave of prosecution. FBI, DEA, and DOJ prosecutors throughout Indiana have noticeably expanded their inquiries. This is leading to additional arrests and prosecutions of healthcare providers and business owners. In this climate, experienced legal advice is a fundamental decision directing your success or failure.
735 Shelby St.
Indianapolis, IN 46203
About Oberheiden, P.C.
Oberheiden, P.C. is a team of healthcare fraud defense attorneys who represent medical providers in federal health audits, fraud investigations, and federal criminal defense cases. As former Department of Justice officials, federal health fraud prosecutors, and federal criminal defense lawyers, our firm offers clients real-life experience for audits and investigations.
This is who we are:
- Former Department of Justice Trial Attorneys
- Former Assistant United States Attorneys
- Former Federal Healthcare Fraud Prosecutors
- Experience of More than 2,000 Federal Healthcare Fraud Cases
- Dismissed Federal Indictments
- Avoided Criminal Charges in the Majority of Cases
- Handled More than 2,000 Grand Jury Subpoenas
- 70 Years of Department of Justice Experience
We have successfully represented:
- Pain management specialists,
- Toxicology labs,
- DME companies,
- Home health and hospice agencies, and many more.
We defend against alleged violations of the Controlled Substances Act, Medicare and Medicaid fraud, the Anti-Kickback Statute, and fraud of private insurance plans. Call now to speak with a former federal prosecutor about your situation. The initial assessment is free and confidential.
“Our companies have worked with firms all over the country within various specialties and now use [Oberheiden, P.C.] almost exclusively. Nick represented our companies in some federal law investigations. His guidance and expertise allowed us to continue to concentrate on our core business as he dealt with the complex legal issues.” – Satisfied Client
“I hired Nick Oberheiden and Oberheiden, P.C. to defend me in a criminal healthcare matter. From the first moment I met with Nick[,] my wife and I knew that he [would provide] the help I need[ed]. And yes, Nick got me out of trouble. No charges. Case Dismissed.” – Satisfied Client
Indianapolis, and Indiana Healthcare Companies are Being Targeted in Federal Fraud Investigations
Various federal agencies such as the U.S. Department of Health & Human Services’ (HHS), the Office of Inspector General (OIG), the Drug Enforcement Administration (DEA), and the Federal Bureau of Investigation (FBI) have elevated Indianapolis to one of the centers of Medicare fraud enforcement. Local providers and healthcare entities must remain vigilant to stay off the government’s radar.
Here is the real news. In previous years, government agents investigated companies and practices when they had fairly concrete information something was wrong or at least suspicious enough to look into.
Today, computers do that work. Healthcare investigations have become data games. If your practice bills more than the practice next door, you may find yourself on the target list. Data analysts compare billing records and payment reports of different providers, often from different specialties and regions. From this, they conclude that the DME provider or pain management physician billing Medicare the most is likely committing fraud.
This “outlier” approach routinely fails in practice. Experienced Indianapolis healthcare fraud defense attorneys can often show there are important reasons why one provider sees more patients, and files more claims, than another. The lump sum approach of comparing different specialties (with complete ignorance of applicable subspecialties) also leads to uneven judgements. Nonetheless, this data approach still exists, so providers must take necessary precautions. Hiring lawyers to conduct a professional compliance review is one of several options. Fighting charges is another.
Current Fraud Investigations in Indianapolis, Indiana
Our Indianapolis healthcare fraud defense attorneys are prepared to represent physicians and executives in cases involving allegations, or violations of:
- Medicare and Medicaid fraud (18 U.S.C. 1347),
- Controlled Substances Act (21 U.S.C. 841),
- Anti-Kickback Statute (42 U.S.C. 1320a-7b),
- Stark Law Statute (42 U.S.C. 1395nn), and
- Federal False Claims Act (31 U.S.C. 3729-3733).
- Prescription Drug Fraud. Pain management physicians in Indiana and medical providers who prescribe drugs under Schedules I, II, or III need a team of experienced healthcare law defense attorneys. Oberheiden, P.C. offers a wealth of experience from members of our team who served as federal healthcare fraud prosecutors. Our defense attorneys have also managed hundreds of cases on behalf of clients across the United States. The Drug Enforcement Administration (DEA) has intensified its investigations in the metropolitan Indianapolis area. Oberheiden, P.C. offers competent help to those that are already targeted as well as to those physicians that have concerns and are seeking compliance advice. Don’t tackle DEA agents or FBI investigators on your own. Call us today and speak to competent legal counsel to get the advice that can save your career.
- Medicare Fraud, Medicaid Fraud. Medicare Fraud and Medicaid Fraud have always been top enforcement priorities in Indianapolis. New, however, is that prosecutors in Indiana can request more support and resources from Washington D.C. Medicare Fraud represents any intentional violation of federal health laws, in particular 18 U.S.C. 1347 and 18 USC 1349 (conspiracy to commit healthcare fraud). Fraud encompasses billing and coding fraud (e.g. upcoding, getting paid for services not actually provided), home health and hospice certifications, and many more. Oberheiden, P.C. has handled Medicare and Medicaid cases across the country with success. Key in each of our defense cases is to understand the nuances of the Medicare rules to find exceptions and turn allegedly illegal conduct into lawful behavior. If you or your business are under Medicare Fraud suspicion, you should speak to a former Medicare Fraud prosecutor, someone who understands the process and regulations.
- ZPIC Audits. There are several types of Medicare audits. In general, Medicare Administrative Contractors (MACs) and Recovery Audit Contractors (RACs) work to identify improper payments through a process of reviewing and analyzing claims data in addition to medical documentation that is obtained from the member/provider. Many times this involves a statistical sampling of files in order to establish an error rate. Another type of Medicare audit is conducted by the Zone Program Integrity Contractors (ZPICs). ZPIC audits identify potential fraud and refer cases to the Department of Health and Human Services (HHS) and the Office of Inspector General (OIG). The risk with Medicare audits is that if mishandled, they can lead to referrals to the U.S. Attorney’s Office. Oberheiden, P.C. knows how to avoid such a referral. Former DOJ healthcare prosecutors with first-hand knowledge of the process lead our clients through the audit. They make sure they can continue their business and not worry about their license or government interruptions.
- Kickbacks & Bribery Accusations. The Anti-Kickback Statute (AKS) prohibits the offer, solicitation, payment, or receipt of any form of compensation for a patient referral. The Anti-Kickback Statute is broad and covers any person, not just physicians, and any form of payment. Indirect schemes like “consulting arrangements” are also covered. Oberheiden, P.C. intervenes in Anti-Kickback violations by explaining that alleged payments fall under a statute exception. AKS investigations can quickly turn into criminal felony cases. Our case work shows it’s critical to contact experienced attorneys the moment you think your business is in jeopardy. We offer a forceful defense to Indianapolis businesses based on vast experience in Anti-Kickback cases. Call today to hear how we can turn your case around.
- The False Claims Act. Why is the False Claims Act (FCA) the most heavily enforced healthcare fraud statute? The False Claims Act does not require intent, and does not require actual knowledge. Government prosecutors need only show that a business or a provider should have known that the submission of a certain claim was false and therefore, fraudulent. This “should-have-known” standard means that there is less room to defend an FCA case. The argument that the client did not know a certain code was wrong, doesn’t really matter. Nonetheless, Oberheiden, P.C. has resolved False Claims Act cases against toxicology labs, hospitals, pharmacies, billing providers, medical offices, and many more with no civil and no criminal liability for our clients. To find out how, call our attorneys today for a free and confidential consultation.
- Stark Law. The federal Stark Law imposes penalties for what are commonly known as physician “self-referrals.” Referring certain federal healthcare program recipients to entities in which the referring physicians have a financial interest is prohibited. Liability costs under the Stark Law can be massive. Similar to the Anti-Kickback Statute, the Stark Law includes various exceptions. Oberheiden, P.C. has extensive experience in Stark Law matters. On a national basis, we have resolved Stark Law cases by avoiding any fines or recoupments for our clients. Call us today to find out how.
Do you have concerns about healthcare fraud or are seeking advice regarding a defense matter? Call former Justice Department prosecutors for an initial case assessment. The call is free and confidential.
Important FAQs Regarding Healthcare Fraud Investigations in Indianapolis, Indiana
Q: What should I do if our practice is accused of fraud?
If your practice is under investigation, you should consult with lawyers who understand all pertinent healthcare laws. The lawyer of choice should have a history of resolving health fraud allegations. The government’s lawyers are sophisticated and trained. You cannot prevail in negotiations about misconduct if your counsel needs to research the rules first. Instead, experienced counsel will analyze the allegation, and present defenses. They will then contact the auditors, agents, or prosecutors to open a dialogue to resolve the matter. An Indianapolis healthcare fraud defense lawyer at Oberheiden, P.C. is known for getting clients out of trouble before they are actually in trouble. If you call our firm, you will speak to a senior healthcare fraud defense attorney right away. You will not be walled off by paralegals or secretaries. We immediately start working on each new case because we know that time is on the government’s side, not yours.
Q: What are the penalties for healthcare fraud?
The penalties for federal fraud depend on the underlying statute (or statutes). In civil cases (e.g. Stark Law), the government may ask for repayment. In criminal cases, the penalties can include:
- Asset forfeiture and seizure
- Up to 10 years of federal imprisonment for each count of healthcare fraud
- Up to 20 years of federal imprisonment for each count involving serious bodily injury to a patient
- A life sentence for fraud resulting in a patient fatality
Q: When should I reach out to an Indianapolis federal healthcare fraud defense attorney?
Without question, as soon as you know you are under investigation. By retaining an attorney early in the process, your advocate can get involved from the outset. This will give federal investigators less time to investigate the case and come to their own conclusions. In some cases, your attorney can convince investigators that their initial impressions were wrong and charges are not warranted. However, even if civil or criminal charges are filed, an Indianapolis federal healthcare fraud defense attorney is a valuable ally. If you are under investigation for healthcare fraud, do not trust just any local law firm to handle your case. Contact an experienced federal healthcare fraud defense attorney today./p>
Compelling Defenses and Creative Ideas for Healthcare Practices in Indianapolis, Indiana
When your license, your business, and potentially your freedom are at stake, nothing replaces a proven defense plan. Healthcare fraud defense is not a hobby. There is a reason why Oberheiden, P.C. almost exclusively focuses on:
- Federal health fraud,
- ZPIC audits,
- Civil and criminal healthcare fraud investigations, and
- Federal criminal trials in the healthcare industry.
The experience we bring to your case is very hard to match. Our record speaks for itself. Proven defense strategies and winning cases let you know you are in good hands. Our strategic approach to defending healthcare providers in Indianapolis and throughout Indiana includes:
- Making immediate contact investigators and prosecutors involved in your case. We intervene in the government’s investigation and collect key information to build a tailored defense strategy.
- Evaluating the legal standards that apply based on the nature of the government’s investigation and the unique aspects of your business or practice.
- Exploring all possible defenses to the government’s allegations, including statutory exceptions and safe harbors, factual arguments, and constitutional protections.
- Doing everything possible to preserve your professional reputation and resolve the investigation without putting your business or practice in jeopardy of federal charges.
- Trial expertise. When needed, we are ready to challenge the government in court. With many criminal cases handled, Oberheiden, P.C. can bring in former Department of Justice Trial Attorneys, and former state and federal prosecutors with significant courtroom expertise. All of our attorneys have superior courtroom expertise.
Find Out Why So Many Clients Trust The Dedicated Lawyers of Oberheiden, P.C. with Their Business and Their Livelihoods
Our Indianapolis healthcare fraud defense lawyers are available to begin working on your case immediately. To speak with our attorneys in confidence, please call 888-680-1745 or request a free case evaluation online now.