Laredo False Claims Act Defense Attorneys

Oberheiden, P.C. is a healthcare law defense firm with expertise in regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. Our firm includes specialized criminal defense attorneys and is a team of talented attorneys with years of experience and education from the country’s best schools such as Harvard Law School and Yale Law School. Our Laredo False Claims Act defense attorneys serve clients in Laredo as well as throughout Texas.

The federal False Claims Act imposes severe civil and criminal liability for healthcare service providers and companies receiving reimbursements through Medicare, Medicaid, Tricare, and other federal benefit programs. If you are facing a False Claims Act investigation or a qui tam lawsuit, you must protect yourself. It is crucial to hire established counsel to navigate the complexities of federal inquiries. Headquartered in Texas, our nationally known Healthcare Fraud Defense Group provides an aggressive defense for clients facing allegations of False Claims Act violations in Laredo, TX and throughout the United States.

Oberheiden, P.C.’s Healthcare Fraud Defense Group is led by senior Laredo False Claims Act defense lawyers. They take an experience-based approach to False Claims Act cases using their combined talents to help clients avoid civil or criminal liability. If you know or suspect you are the target of a federal investigation, the advice of a Laredo False Claims Act defense attorney is vital.

This page serves as a resource for individuals and companies facing allegations of filing false claims in Laredo, TX. Here you will find:

• An Introduction to the False Claims Act
• What It Means to “Knowingly” Submit a False or Fraudulent Claim
• An Overview of Potential Penalties Under the False Claims Act
• An Overview of the Qui Tam Litigation Process
• Three Key Components of a Strategic False Claims Act 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)

Laredo Healthcare Companies Are Facing Strict Enforcement Under the False Claims Act

Due to the large number of federal program beneficiaries in Texas, cities throughout the state have long been key targets in the government’s fight against healthcare fraud. In fact, Texas is one of only two states nationwide hosting two of the federal government’s fifteen Healthcare Fraud Prevention and Enforcement Action Team (HEAT) task forces. These task forces are prosecutors from the Department of Justice (DOJ), the Department of Health and Human Services (HHS), the Office of Inspector General (OIG), the Federal Bureau of Investigation (FBI), and other federal agencies. Multiple federal agencies collaborate in investigating healthcare fraud. They target local providers suspected of violating the False Claims Act. The Medicare Fraud Strike Force plays a crucial role in scrutinizing healthcare providers in Laredo. Health care providers face serious consequences, such as civil or criminal liability. If you know or suspect you are the target of a federal investigation, the advice of a Laredo False Claims Act defense attorney is vital.

1. Introduction to the False Claims Act

The False Claims Act is a federal statute that prohibits “knowingly” submitting or causing the submission of false and untruthful claims under federal government contracts and federal benefit programs.

2. What It Means to “Knowingly” Submit a False or Fraudulent Claim

It is illegal to knowingly submit or cause the submission of false or fraudulent claims for payment. But, the word “knowingly” is misleading. To knowingly submit such a claim, you don’t have to know that it was false or fraudulent. The False Claims Act attributes knowledge when a party should have known that a claim for payment violates the law. Such complexities require the knowledge of a Laredo False Claims Act defense lawyer. These items all constitute potential violations of the False Claims Act:

• Mistakenly using an old (false) billing code
• Double-billing for services, supplies, medication, or use of equipment
• Unbundling and upcoding reimbursable services
• Billing for services, supplies, medication, or equipment that were not purchased/provided, or that were not medically necessary

3. Overview of Potential Penalties Under the False Claims Act

As noted above, the Act has both civil and criminal penalties for submitting false and fraudulent claims. These penalties include:

• Civil Penalties – Three times the government’s actual losses plus fines of up to $11,000 per false claim.
• Criminal Penalties 18 U.S.C. § 287) – Up to five years in federal prison and fines up to $250,000 (for individuals) or $500,000 (for companies) per false claim.

4. Overview of the Qui Tam Litigation Process

HEAT pursues healthcare providers and companies in Laredo suspected of federal program fraud. But, under the False Claims Act’s qui tam provision, private citizens referred to as relators, can file lawsuits on behalf of the United States federal government (see 31 U.S.C. § 3729). Qui tam does have a legitimate purpose in some cases. However, it is often used maliciously by competitors and angry ex-employees.

Here is an overview of the qui tam litigation process for claims filed in Laredo, TX:

• The Complaint. Litigation begins with the relator filing a complaint in the U.S. District Court for the Southern District of Texas. To protect the relator’s identity, the complaint is filed under seal. It is only made available to the assigned judge and select government officials.
• Initial Case Review. The government conducts an initial case review to determine if the relator’s allegations are valid. If they are not, the government will not intervene. However, if the allegations appear to be correct, federal investigators open a case. Typically, defendant(s) receive subpoenas requesting any records that may contain evidence of violations. It is crucial to consult with former federal prosecutors who possess firsthand experience in handling cases involving potential civil or criminal charges.
• Government Intervention. Based on the investigation and early negotiations with your Laredo False Claims Act defense attorney, the government will either, 1) intervene in the case, or 2) allow the relator to pursue the case without government support. If they intervene, they will likely amend the complaint to add charges under a variety of other anti-fraud laws like the Anti-Kickback Statute and the Truth in Negotiation Act.
• Settlement Negotiations Continue. At this stage, prosecutors and defense lawyers continue settlement negotiations. Based on the complexity of the case, it can take several months or longer before reaching a settlement.
• Resolution and Relator Compensation. If the case results in civil liability, defendant(s) can face penalties of three times the government’s losses plus fines of $11,000 per false claim. If the government intervenes, the relator will receive up to 25 percent of the amount recovered. with no intervention, this can increase to 30 percent.

5. Three Key Components of a Strategic False Claims Act Defense

In these investigations, our Healthcare Fraud Defense Group uses a proven strategy that involves three key components. The critical role of legal defense in addressing allegations under the Act cannot be overstated:

• Keeping the Case Civil. Our first priority is to keep our clients’ cases from becoming criminal. This keeps a prison sentence and criminal fines off the table.
• Preventing Government Intervention. In qui tam cases, we want to prevent government intervention. We will conduct our own investigation to expose flaws in the complaint and question the relator’s credibility.
• Negotiating a Favorable Settlement. If evidence supports civil liability, we seek to negotiate a minimal settlement letting our client remain in business.

If you are facing accusations or a federal investigation under the False Claims Act, the time to act is now. You don’t want to delay and risk criminal charges. At Oberheiden, P.C., we have successfully defended many kinds of healthcare providers and companies. A Laredo False Claims Act defense lawyer is prepared to act quickly to protect you. Request your free case evaluation today.

We are available to discuss your case. Call us directly or complete our contact form to schedule your free, confidential case evaluation today.