Jacksonville Healthcare Fraud Defense Lawyers
Oberheiden, P.C.’s defense attorneys represent physicians, pharmacists, company executives and other clients in federal healthcare fraud investigations in Jacksonville, FL. If your healthcare business or medical practice is under investigation, call us at 888-680-1745. Your initial call is free and confidential. Our experienced Jacksonville healthcare fraud defense lawyers are here to help.
Jacksonville Healthcare Fraud Defense Team Lead
Former Deputy Chief, Appellate Division
Jacksonville Healthcare Fraud Defense Team Lead
Contact Nick13475 Atlantic Blvd. Unit 8
Jacksonville, FL 32225
888-680-1745
What is at stake if your Jacksonville healthcare business or medical practice is under investigation by the federal government? At Oberheiden, P.C., our Jacksonville healthcare fraud defense lawyers represent healthcare providers in Jacksonville and nationwide in federal matters. While providers who have nothing to hide often assume that these investigations will go away quietly on their own, the reality is often quite the opposite. If you are aware that federal authorities are looking into your business or practice, there is a good chance that the investigating agency or task force has already uncovered evidence against you. To avoid civil or criminal charges, you will need to mount a swift, proactive, and strategic defense.
The attorneys on our team have handled thousands of federal investigations. We have helped the majority of our clients avoid charges entirely. This involves a greater than 90% success rate in avoiding criminal indictments. When we have been involved, not a single client of ours has been forced to cease operations due to an investigation. If you are targeted by the:
- Department of Justice (DOJ),
- Drug Enforcement Administration (DEA),
- Federal Bureau of Investigation (FBI),
- Office of Inspector General (OIG),
- Opioid Fraud and Abuse Detection Unit,
- Prescription Interdiction & Litigation Task Force, or
- Other federal law enforcement authorities, you need to take your situation very seriously.
If you are suspected of healthcare fraud, you’re at risk of facing charges. Civil or criminal charges can mean business-threatening outcomes are on the table. Our team of highly experienced fraud defense attorneys can help. To begin a strategic defense today, we encourage you to call our Jacksonville healthcare fraud defense lawyers at 888-680-1745 for a confidential and free consultation.
What Is Healthcare Fraud?
For providers or business owners in the healthcare industry, facing a federal investigation typically involves allegations of healthcare fraud. So, what is “healthcare fraud”? The term can mean different things under different conditions. There is not one single act or omission that constitutes healthcare fraud. Broadly defined, healthcare fraud involves any activity that results in filing an invalid claim for payment to a federal healthcare benefit program. In a federal healthcare fraud case, specific allegations could include any or all of the following:
- Intentional or unintentional billing and coding errors
- Billing for medically-unnecessary services or for services that were not actually rendered
- Offering, soliciting, paying, or accepting any illegal “kickback” or referral fee
- Diverting prescription opioid medications
- Engaging in other forms of prescription drug fraud
- Falsifying patient records, physician certifications, or election statements
- Using any other “scheme or artifice” to obtain payment from Medicare, Medicaid, Tricare, or the Department of Labor (DOL)
To learn of allegations against you, it is necessary to intervene in the government’s investigation. Contact must be made with the agencies involved to quickly discern the scope and nature of the government’s inquiry. Answering these questions is important in beginning the process:
- Which agency or task force initiated the investigation?
- What other agencies or task forces are involved?
- Is the DOJ considering civil or criminal charges?
These are just some of the questions you need to have answered as soon as possible.
Our Jacksonville healthcare fraud defense lawyers are dedicated to protecting your rights and ensuring a robust defense.
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)
With a team of skilled Jacksonville healthcare fraud defense lawyers, we are committed to providing effective legal representation.
1. False Claims Act (FCA)
The False Claims Act (FCA) bars filing any “false or fraudulent” claim for payment by a federal healthcare program. If an investigation reveals evidence of intent, FCA charges can be civil or criminal in nature. Potential penalties include civil monetary penalties, criminal fines, and federal imprisonment.
2. Anti-Kickback Statute (AKS)
The Anti-Kickback Statute (AKS) bans offering, paying, soliciting, and receiving referral fees or other forms of payment for federally funded medical services and equipment. Like the False Claims Act, the AKS includes both civil and criminal enforcement provisions. The AKS’s broad prohibitions are subject to several statutory safe harbors. These safe harbors provide complete defenses to liability in many cases.
3. Stark Law
The Stark Law prohibits physicians from referring others to entities in which they or a close family member has a financial interest. These physician “self-referrals” can lead to civil penalties, including fines, recoupments, and treble damages. The Stark Law includes various safe harbor provisions. A Jacksonville healthcare fraud defense lawyer is skilled at using these safe harbors to protect clients.
4. Controlled Substances Act (CSA)
The Controlled Substances Act (CSA) imposes criminal penalties for assorted prescription drug-related offenses, including various forms of prescription drug fraud. The CSA also provides authority for the DEA’s registration enforcement program. Registered healthcare providers can face both routine and unannounced inquiries targeting their prescription practices.
5. Federal Healthcare Fraud Statute
The healthcare fraud statute, 18 U.S.C. 1347, makes it a federal offense to “knowingly and willfully execute[], or attempt[] to execute, a scheme or artifice – (1) to defraud any healthcare benefit program; or (2) 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.” Potential prison sentences under 18 U.S.C. 1347 start at up to 10 years. However, in healthcare fraud cases involving serious bodily injury or death, healthcare providers can face 20 years and life imprisonment, respectively.
6. Program Billing Regulations
Providers filing claims to federal healthcare benefit programs are subject to a host of strict billing and coding regulations. Both intentional and unintentional violations can trigger government scrutiny. Sadly, these regulations frequently change. This forces providers to maintain up to date compliance programs in order to mitigate their risk of severe outcomes.
7. Other Federal Criminal Statutes
Healthcare-specific statutory and regulatory violations are the force behind most federal investigations. But, in criminal cases, federal prosecutors often pursue a variety of other charges such as:
- Conspiracy,
- Bank fraud,
- Mail fraud,
- Wire fraud, and
- Money laundering.
These charges can put healthcare providers at risk for hundreds of thousands or millions of dollars in fines and decades in prison.
5 Reasons Why Healthcare Providers in FL Trust the Jacksonville Healthcare Fraud Defense Lawyers at Oberheiden, P.C.
Your choice of legal counsel matters. Here are five reasons why healthcare providers across Florida, and nationwide trust the federal healthcare fraud defense team at Oberheiden, P.C.:
Remarkable Federal Experience – Each Jacksonville healthcare fraud defense attorney combined experience in federal court matters on both the prosecution and defense side of a case. Members of our team have experience working as healthcare fraud prosecutors for the DOJ. Others are expert in defending healthcare providers in federal districts across the country.- Commitment to Federal Healthcare Fraud Protection – Our practice is devoted to representing healthcare providers, companies, and other entities in federal fraud cases. Our attorneys have handled thousands of cases and hundreds of trials. We have a national reputation for superior healthcare fraud defense.
- A Significant Pretrial Record – We can’t guarantee the outcome of any particular case, but we have helped a majority of our clients avoid federal prosecution. When involved during the investigative process, we have a better than 90% success rate in helping our clients avoid criminal charges.
- Comprehensive, Strategic, and Personalized Defense – We have achieved this superb record by providing a complete, strategic, and personalized defense strategy for each case. We focus on the details to build strategies designed to protect our clients as effectively as possible.
- Devotion to Our Clients – Our Jacksonville healthcare fraud defense lawyer is committed to protecting our clients’ interests. We are often able to avoid charges during the government’s investigation. But, sometimes, it becomes necessary to go to trial. Our attorneys fight to secure the best possible outcome for our clients in light of the facts at hand.
Frequently Asked Questions
I am innocent; do I still need a Jacksonville, Florida federal healthcare fraud defense attorney?
Absolutely, yes. Federal healthcare fraud laws don't require the government to prove that you knowingly engaged in fraud to find you liable. The fact that errors occurred can serve as the basis for a healthcare fraud prosecution in most cases. However, showing that the errors were isolated incidents can result in charges being withdrawn. An attorney can help decrease the chances of the government pursuing charges by putting any errors in context. A Jacksonville federal healthcare fraud defense attorney can also help limit the scope of the government’s case. This can reduce the burden of complying with their demands and free up valuable resources. To learn more about how we can help, contact our firm today.
Which healthcare providers are most frequently targeted in Jacksonville federal healthcare fraud cases?
The federal government can pursue healthcare fraud charges against any type of provider. Speak to a Jacksonville, FL federal healthcare fraud defense attorney if you operate any of the following facilities and think you may be under investigation for fraud:
- Pharmacies;
- DNA testing facilities;
- Drug rehabilitation facilities
- Healthcare marketing agencies;
- Home healthcare agencies;
- Hospice providers;
- Hospitals;
- Mobile healthcare clinics;
- Outpatient surgical centers; and
- Toxicologists and toxicology labs
Careless bookkeeping or a simple mistake can force a provider to the center of a fraud investigation. If you believe the federal government is looking at your business practices, contact us right away.
What is the Stark Law?
The Stark Law is a federal statute that limits when a physician can make a referral for certain services paid by Medicare. The law bars a healthcare provider from referring patients to another provider with whom the referring physician has a “financial relationship.” For example, a doctor who is a co-owner of a lab needs to be careful when referring patients to the lab. However, not all of these referrals are prohibited under the Stark Law. Some important exceptions apply. To learn more about creating a legitimate referral program, contact a Jacksonville, Florida federal healthcare fraud defense attorney today.
Contact the Jacksonville Federal Healthcare Fraud Defense Lawyers at Oberheiden, P.C.
To discuss your federal healthcare fraud investigation in Jacksonville, FL, with a member of Oberheiden, P.C.’s federal healthcare fraud defense team, please call 888-680-1745 or contact us online. You can reach our attorneys at Oberheiden, P.C. 24/7, and we will schedule your free and confidential initial case assessment as soon as possible.
- Jacksonville federal criminal defense
- Jacksonville federal appeals
- Jacksonville white collar crime
- Jacksonville Medicare fraud defense
