Laredo, Texas Healthcare Fraud Defense Attorneys

Oberheiden, P.C. is a healthcare law defense firm. Among our Texas healthcare fraud defense team are Laredo, Texas healthcare fraud defense attorneys with years of relevant experience and education from the country’s best schools such as Harvard and Yale Law Schools. Our lawyers serve clients in Texas as well as surrounding areas. Our attorneys have experience in the areas of:

• regulatory compliance,
• corporate structuring,
• litigation,
• government investigations, and
• criminal defense.

Accusations of healthcare fraud in Laredo, Texas and the surrounding areas are a serious matter. If you’re under investigation by the federal government for healthcare fraud, contact Oberheiden, P.C. right away. We are a Texas law firm providing healthcare fraud defense. While general criminal defense attorneys focus on typical criminal cases, a specialized Laredo, Texas healthcare fraud defense lawyer understands both the legal implications and the potential impact on your career and license. It is crucial to hire specialized criminal defense attorneys who have expertise in federal law, particularly in relation to medical healthcare fraud and the False Claims Act. A regular criminal defense lawyer may not fully grasp the unique implications such cases have on a physician’s career, underscoring the importance of specialized legal knowledge in this field. Hiring a specialized defense lawyer is essential when facing audits or investigations related to healthcare and Medicaid fraud. We also have extensive legal experience in:

• OIG and grand jury subpoenas,
• Medicare and Tricare audits,
• internal investigations,
• compliance programs,
• qui tam defense,
• protection of assets,
• criminal defense, and
• jury trials.

Dr. Nick Oberheiden is a Harvard-trained lawyer and negotiator. Dr. Oberheiden provides legal assistance to clients in Laredo and throughout Texas. He is a healthcare fraud attorney and is the managing partner of Oberheiden, P.C.

If you’re under investigation for healthcare fraud defense in Laredo, Texas or the surrounding area, call Oberheiden, P.C. immediately to speak with a member of our Healthcare Fraud Defense Team. The call is free and the conversation is confidential.

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)

Laredo, Texas Is Directly Monitored by the Federal Government

The federal government oversees Laredo, Texas by way of the Medicare Fraud Strike Force. The Medicare Fraud Strike Force is a team of prosecutors and investigators made of members of various federal agencies. The Federal Bureau of Investigation (FBI) plays a critical role in fraud investigations. Federal investigators scrutinize healthcare fraud cases to ensure compliance with the Federal False Claims Act. Multiple federal agencies, including the DOJ, DOD, IRS, and others, collaborate in investigating Medicare and Medicaid fraud in Laredo, Texas.

Inspection by the federal government is caused by the number of people in the area who rely on federal healthcare programs. This causes more claims to be filed for payment to healthcare professionals, entities, and businesses. In areas like Laredo, Texas where more claims are filed, the federal government pays closer attention to possible healthcare fraud. This fraudulent activity is alive and well in the United States. In FY 2022, the Department of Justice (DOJ) opened more than 809 new criminal health care fraud investigations. Federal prosecutors filed criminal charges in over 419 cases involving at least 680 defendants. More than 477 defendants were convicted of health care fraud related crimes during the year. Also, in FY 2022, DOJ opened more than 774 new civil health care fraud investigations and had over 1,288 civil health care fraud matters pending at the end of the fiscal year.
OIG,HHS

Defining Healthcare Fraud

It’s important to understand what constitutes healthcare fraud. It is defined as an attempt to receive payment from a federal government healthcare program for medical services or equipment with false, fradulent, or misleading claims. Federal healthcare programs include Medicare, Medicaid, Tricare, or federal workers’ compensation. It includes at least one of the following elements:

• Anti-Kickback Statute – Federal law restricts the exchange of money or other valuables for patient referrals. Anyone may face prosecution for violating this act if they offer or provide payment or other valuables in exchange for referrals.
• 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.
• False Claims Act – 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 begin an inquiry into your billing practices under the criminal provisions of the act.
• Prescription Fraud – Prescribing a high volume of narcotics is closely watched by the federal government. If you’re suspected of operating a “pill mill,” you may be targeted for insurance fraud or violating DEA dispensing rules.
• Billing Fraud – One of the most common occurrences of billing fraud is upcoding. This occurs when a higher, and more costly, code is used on claims made to federal healthcare programs. The federal government also investigates:
  • allegations of phantom billing (services not provided),
  • ghost patients (patients who do not exist), and
  • medically unnecessary services billing
• Certification Errors – The federal government pays close attention to the home healthcare and hospice industry. The most common allegation is fraudulent certification for care.

Laredo fraud defense lawyers at Oberheiden, P.C. have a history of success helping clients avoid criminal charges. If you, your healthcare practice, or your business are under investigation for healthcare fraud in Laredo, TX or surrounding areas, call us today. Initial calls are free and confidential.

Civil and Criminal Penalties of Healthcare Fraud

Healthcare fraud is extremely serious and can result in civil or criminal penalties. Civil penalties may include repayment of claims, non-payment of future claims, and exclusion from federal healthcare programs entirely. You could be called before the state disciplinary board, lose your license, and/or lose your hospital privileges.

Federal prison time can be sentenced as:

• Up to 10 years for each count of healthcare fraud
• Up to 20 years for each count of fraud that resulted in serious bodily injury
• Life sentence if the healthcare fraud resulted in death

Often, we’re asked about the worst-case scenario for fraud for health care providers, entities, and businesses in Laredo, Texas. Whether or not you’ll face criminal charges or a prison sentence will depend on several factors. These are, the severity of injury suffered by a patient, whether the prosecutor sees an advantage in pursuing criminal charges, and the reason why the federal government began the case. If you’re being investigated for healthcare fraud, contact Oberheiden, P.C. Your initial call is confidential and free.

Is the Investigation Against You Criminal?

Healthcare fraud charges can be civil or criminal in nature. Oberheiden, P.C. utilizes early intervention and a strategic defense to help our Laredo, TX clients. Many of our Laredo, Texas healthcare fraud defense lawyers have experience working at this federal office, providing a strong background in handling health care fraud cases. If you are being investigated, contact us promptly.

It’s not always easy to know if you are facing civil or criminal charges. The U.S. Attorney’s Office and other federal agencies have both a civil and a criminal division. So, being contacted by a federal prosecutor doesn’t always mean a criminal charge is imminent. However, civil cases can become criminal in nature. Oberheiden, P.C. can help by contacting federal prosecutors on your behalf. If you’re contacted by a federal prosecutor, call us right away.

Determining charges depends on the legal reading of many factors including OIG subpoenas, and how the inquiry or allegations are made. Understanding the process is crucial in the context of healthcare fraud investigations. Expect criminal charges if you receive a(n):

• search warrant,
• seizure warrant,
• arrest warrant,
• target letter,
• IRS involvement,
• grand jury subpoena, or
• there is involvement of a federal criminal prosecutor.

If you have questions about whether you’re facing criminal or civil charges, contact Oberheiden, P.C. today.

Frequently Asked Questions

Important Healthcare Fraud Defenses

Oberheiden, P.C. is a Texas law firm providing strategic healthcare fraud defense to clients in Laredo, Texas and the surrounding areas. Several of our attorneys have previous experience as healthcare auditors and as healthcare fraud prosecutors with the Department of Justice. Our clients gain valuable insight for their healthcare fraud defense cases.

Immediate contact with the federal government. The main objective for our clients is to help them reduce the prospect of criminal charges. Our experience has taught us that the best way we can help our clients is to quickly contact federal authorities. We get answers to important questions, and stop the government from having unlimited time to investigate you. We work to protect your freedom and your career. We typically get answers to these most important questions within a few hours:

• What is the investigation about?
• What is the purpose of it?
• How long will the investigation take?
• What is the most likely outcome?

Testing the federal government’s case. The federal government must prove beyond a reasonable doubt that you committed a crime. They must also show that you acted with criminal intent. When criminal charges look certain, we test if the government will be able to meet Constitutional standards. The government will try to use billing inaccuracies to prove you had criminal intent. Oberheiden, P.C. knows this most often happens as the result of an organizational or human error. These mistakes should not be held to criminal standards. We have provided successful legal defense for clients across the United States by proving that inaccuracies are a result of human or organizational error and not criminal intent. Some factors leading to such mistakes are:

• unqualified workers,
• delegation errors,
• outsourcing errors,
• lack of oversight,
• insufficient supervision, and
• constantly changing laws and rules in healthcare billing.

Developing strategic healthcare defenses. Oberheiden, P.C. develops strategic healthcare fraud defenses for each client. Many of the cases we’ve successfully defended were won because of statutory loopholes and exceptions. For example, in the context of Stark Law which involves medical necessity certifications, we’ve been able to use exceptions to either ease or entirely resolve a healthcare fraud case.

Protecting your reputation as a professional. We are committed to doing more than providing healthcare fraud defense. We are determined to defend your image. Allegations of healthcare fraud can be damaging. Many of our clients express concern about how these allegations will affect their career and future. The media has a lot of power and your reputation could be destroyed by their rumors. Each Laredo, Texas healthcare fraud defense lawyer will address instances of slander, and seek opportunities to correct misinformation about our clients. Call our Laredo, Texas healthcare fraud defense attorneys today to learn more about your legal options. The call is confidential and there is no charge for your initial call.

Oberheiden, P.C. has provided legal advocacy for clients across the country who faced allegations of healthcare fraud. Call us right away to learn more about your legal options. Initial calls are free of charge and confidential.

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