Miami Healthcare Fraud Defense Attorneys
Miami Healthcare Fraud Defense Team Lead
Former Deputy Chief, Appellate Division
2250 Southwest 3rd Ave, 4th Floor
Miami, FL 33129
Miami healthcare providers are often the target of high-stakes healthcare fraud investigations. These charges can jeopardize a practice and potentially ruin careers. Are you under investigation? Contact the experienced Miami defense attorneys of Oberheiden, P.C. today.
Miami is home to one of nine areas with an established federal healthcare fraud task force. When confronting charges brought by this task force or other federal agencies, it is critical to consult a lawyer experienced in healthcare fraud defense.
Oberheiden, P.C. offers healthcare fraud defense for medical providers, businesses, and entities that find themselves targeted by federal agencies. Our Miami, Florida lawyers have over 100 years of combined legal experience. We can design a legal defense customized to your situation.
What Is Healthcare Fraud?
Health care fraud is a crime involving false information, hiding information, or misleading a person or entity in order to gain benefits or financial advantage. Healthcare fraud appears under a variety of federal and state statutes.
Federal Healthcare Fraud Charges
One common statute that federal prosecutors use in healthcare fraud cases is 18 U.S.C. § 1347. For conviction, federal prosecutors must prove the following legal elements beyond a reasonable doubt:
- The defendant knowingly and willfully enacts or attempts to enact a scheme to defraud a healthcare benefit program.
- The defendant falsely obtains a benefit from a healthcare program.
- The defendant makes false statements related to a material fact.
- The defendant acted in a willful manner intended to defraud the healthcare benefit program.
- The defendant’s actions were in connection with the delivery of healthcare benefits, items, services, or payment.
There are many laws federal prosecutors can use to charge practitioners and entities with healthcare fraud:
- The False Claims Act protects the federal government from overcharged goods or services. The Act allows federal authorities to charge violations for each false claim. Violations can result in huge penalties and possible exclusion from further billing to the program. In addition, it provides rewards for whistleblowers, motivating reports from anonymous sources.The Act allows federal authorities to charge violations per each false claim that can result in significant penalties to healthcare providers and possible exclusion from further billing to the program. Additionally, it provides rewards for whistleblowers, which may motivate reports from anonymous sources.
- The Anti-Kickback Statute makes it illegal to pay or receive anything of value for referrals to government healthcare programs.
- The Stark Law prohibits doctors from referring Medicare patients to entities in which the doctor or an immediate family member has an ownership or investment interest.
- The Controlled Substances Act investigates potential criminal violations of drug laws. It includes monitoring physicians selling prescriptions or writing them for unnecessary medication.
State Healthcare Fraud Charges
Many instances of healthcare fraud may be prosecuted at both the state and federal levels. For example, Medicaid is a program managed by both state and federal governments. Therefore, a person may be responsible at both levels for Medicaid violations.
Florida law defines healthcare fraud as false presentation or intentional deception of a healthcare program resulting in unauthorized benefit to the individual or a third party. Most forms of healthcare fraud in Florida are third-degree felonies.
Types of Healthcare Fraud
There are several activities that can rise to the level of healthcare fraud, including the following:
- Billing for services not rendered
- Fraudulent billing for a non-patient
- Billing for more hours than those rendered
- Duplicate billing
- Illegal fee sharing
- Billing for unnecessary services
- Falsification of credentials
- False cost reports
- Accepting kickbacks
- Illegal prescribing of medications
- Nurses ordering medications without the approval of the physician
- Counterfeit prescriptions
- Theft or sale of patient medications
- Forging prescriptions
If charged with one of these offenses, it is vital to retain a skilled Miami healthcare fraud defense lawyer. Oberheiden, P.C., is available 24/7. Our Miami team can schedule a free and confidential consultation. One of our experienced lawyers will consider your situation and explain how we can help.
Why You Should Choose the Miami Healthcare Fraud Defense Attorney at Oberheiden, P.C., for Your Defense
Serious penalties are at risk in healthcare fraud cases. Possible imprisonment, loss of medical license, and exorbitant fines are possible. Therefore, it is important to hire a defense attorney immediately. Clients throughout Florida and the rest of the country choose the services of Oberheiden P.C. for the following reasons:
- Experience – Experience – Our firm has handled thousands of cases involving healthcare fraud defense. Members of our team are former federal prosecutors. They know how government agencies build a prosecution and what deficits may exist in the case.
- History – We have a proven record of securing favorable outcomes. We have often convinced prosecutors to drop criminal charges against our clients. Our team has helped many clients avoid federal indictments by providing early intervention in the case. We can often stop federal investigations in their tracks long before charges get filed. Additionally, we have prevented many defendants from serving a prison sentence. None of our False Claims Act clients have been held criminally or civilly liable. We have negotiated significant civil penalties to lower amounts. We implement proven strategies to win favorable outcomes for clients.
- Focus – Federal agencies devote extensive resources to healthcare fraud investigations and prosecutions. It is important to mount a strong defense against these charges. Your attorney will focus on your case and employ proven strategies to defend you. We have the knowledge and experience to present a strong defense on your behalf.
- Customized legal representation – Our experienced attorneys know that every case is unique. We will create a customized defense strategy that is effective and aggressive from the start. We will explore all options to resolve your case with a favorable outcome, including providing assistance to prosecutors in exchange for reducing or dropping charges in your case. Your attorney can try to negotiate a plea agreement that may help avoid prison time, such as seeking probation or other alternatives to incarceration. We understand that your future and your freedom are at stake and we will work tirelessly on your behalf.
- Ready for a courtroom battle – Our attorneys can advise you on whether early resolution is in your best interest or if a trial is a better option. Our Miami healthcare fraud defense lawyers are known for their aggressive trial practice.
Frequently Asked Questions
Which government agencies prosecute healthcare fraud?
There are several federal government agencies responsible for prosecuting healthcare fraud, including:
- Centers for Medicare and Medicaid Services (CMS)
- Department of Defense (DOD)
- Department of Health and Human Services (HHS)
- Department of Justice (DOJ)
- Department of Labor (DOL)
- Drug Enforcement Administration (DEA)
- Federal Bureau of Investigation (FBI)
- Office of Inspector General (OIG)
Some of these agencies specialize in healthcare fraud. Others maintain a focus on law enforcement in a more general sense. No matter which federal agency is involved, you must contact a dedicated Miami federal healthcare fraud defense attorney as soon as possible.
Can healthcare fraud result in criminal charges?
Yes, there are several statutes that allow federal prosecutors to pursue criminal charges for healthcare fraud. Some statutes, such as the False Claims Act, allow for both civil or criminal penalties. The general rule is that criminality does not attach to a provider’s negligent actions, but to intentional misconduct. Fraud must be willingly and knowingly committed to find guilt. However, there is often a fine line between the two. It is best to contact an experienced defense attorney to learn more about what the allegations mean.
When should I reach out to a Miami federal healthcare fraud defense attorney?
In a fraud probe, the sooner you reach out to an attorney, the better chance you have to avoid severe outcomes. Early attorney involvement can help clear up any confusion about the case. An attorney can also prevent a client from making errors when speaking with investigators. Federal investigators may rely on statements made by a subject during the course of the investigation. The last thing you want is to give the government the upper hand in prosecuting you for fraud. If you are under investigation for federal healthcare fraud, don’t wait to contact a lawyer. Contact Oberheiden, P.C. today for the help you need.
When are physician kickbacks not allowed?
Kickbacks and referral fees are common in the medical industry. There are several instances in which referral arrangements can run afoul of federal healthcare fraud laws. The Eliminating Kickbacks in Recovery Act forbids kickbacks for referrals to recovery homes, clinical treatment facilities, or labs. The Anti-Kickback Statute forbids giving or receiving anything of value for referring a patient covered by a federal program. Lastly, the Stark Law imposes civil liability on providers who refer patients to another practice in which they or an immediate family member have a financial interest. Not all referrals are illegal. Providers should consult with an experienced Miami fraud defense attorney to make sure that an arrangement is legal.
Speak with our Miami Healthcare Fraud Defense Lawyers Today
If your healthcare business, practice, or organization is under investigation, call Oberheiden, P.C., to schedule an initial consultation with one of our expert attorneys. Our team can immediately mount an aggressive defense or help you create a compliance program. We have over 100 years of combined experience in defending clients against charges that can result in imprisonment, significant monetary fines, and damage to their reputations. Call our Miami healthcare fraud defense lawyers today at 305-928-8505 or contact us online to schedule your confidential consultation. We offer free and confidential consultations.
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