Midland / Odessa Healthcare Fraud Attorneys
Midland / Odessa Healthcare Defense Team Lead
Contact NickOberheiden, P.C. attorneys serve clients in Midland and Odessa as well as throughout Texas. Oberheiden, P.C. is a healthcare law defense firm with significant experience in the areas of regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. On our team are talented attorneys with years of relevant experience.
For healthcare providers accused of committing healthcare fraud in the Midland/Odessa, Texas area, you should call Oberheiden, P.C. We are a Texas firm working on healthcare fraud defense and False Claims Act cases. We have extensive legal experience in the following areas:
- OIG and grand jury subpoenas,
- Medicare and Tricare audits,
- Fraud allegation defense,
- 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 West Texas. He is a healthcare fraud attorney and is the managing partner of Oberheiden, P.C.
If you want to discuss the legal options related to your case, call Oberheiden, P.C. today. Ask to speak with a member of our Healthcare Fraud Defense Team. Initial calls are free and confidential.
Midland/Odessa, Texas Is Strictly Monitored for Healthcare Fraud
The Medicare Fraud Strike Force is an exclusive team of prosecutors and investigators made up of members of multiple federal law enforcement agencies.
Midland/Odessa, Texas, is monitored by the Medicare Fraud Strike Force because of the large number of citizens in the area who rely on federal healthcare programs. The number of beneficiaries means more claims filed with the federal government for payment. The large number of claims is a trigger for the federal government that fraud or False Claims Act violations may happen. In FY 2022, the Department of Justice (DOJ) and the Department of Health and Human Services opened more than 809 new criminal healthcare 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.
Defining Healthcare Fraud
Healthcare fraud is an attempt to receive payment from a federal healthcare program for medical equipment or services for an incorrect or misleading claim. Federal healthcare programs include Tricare, Medicare, Medicaid, and federal workers’ compensation. Healthcare fraud involves at least one of the following laws:
- Anti-Kickback Statute – Federal law restricts the exchange of money or other valuables for patient referrals. Anyone in the healthcare industry can face prosecution for violating this act if they offer or provide goods or services 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 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 investigation into your billing practices under the criminal provisions of this act.
- Prescription Fraud – Prescribing a high volume of narcotics gets attention from the federal government. If you’re suspected of operating a “pill mill,” you may be targeted for insurance fraud or violating Drug Enforcement Administration 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 billing for medically unnecessary services or equipment.
- Certification Errors – The federal government pays close attention to the home healthcare and hospice industry. The most common allegation is fraudulent certification for care.
Midland/Odessa healthcare 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 is under investigation for healthcare fraud in Midland/Odessa, Texas, call us today. Initial calls are free and confidential.
Founder Attorney-at-Law Former DOJ Trial Attorney Partner Former U.S. Attorney 55th Speaker, U.S. House of Representatives (ret.) Government Consultant Of Counsel Former U.S. Secretary of State Former Senior DOJ Trial Attorney Federal Appeals Attorney Former Prosecutor Former Special Agent (DOJ) Former Special Agent (FBI & IRS-CI) Former Supervisory Special Agent (DOD-OIG) Former Supervisory Special Agent (FBI)Put our highly experienced team on your side
Dr. Nick Oberheiden
Lynette S. Byrd
Brian J. Kuester
Hon. Kevin McCarthy
Mike Pompeo
John W. Sellers
Linda Julin McNamara
Nicholas B. Johnson
Roger Bach
Chris J. Quick
Michael S. Koslow
Ray Yuen
Penalties for Healthcare Fraud
Healthcare fraud is extremely serious and can result in civil and 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.
Criminal liability is also serious. You could be subject to fines that cost you hundreds of thousands of dollars, prosecution, and prison time.
If you are found guilty of criminal healthcare fraud, you may receive a prison sentence:
- 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
Clients ask us about worst-case scenarios for healthcare fraud in Midland and Odessa. Criminal prosecution can depend on many factors. The severity of the injury received by a patient, if the prosecutor has an interest in pursuing criminal charges, and the reason the inquiry began are a few. Suppose you’re under suspicion for healthcare fraud in Midland/Odessa. In that case, you should call Oberheiden, P.C. today to speak to an experienced Midland/Odessa healthcare fraud defense attorney from our firm to learn about your options. Initial calls are confidential and free of charge.
Determining If Healthcare Fraud Is Criminal
Healthcare fraud cases can be either civil or criminal. With early intervention and compelling defense strategies, Oberheiden, P.C. helps clients avoid criminal charges. Call us today if you’re being investigated for healthcare fraud in Midland/Odessa, TX, or the surrounding area. We can begin the process of developing your custom defense strategy right away.
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. Our Midland/Odessa healthcare fraud defense lawyers can help by negotiating with 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 the manner in which the inquiry or allegations are made. Expect criminal prosecution 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 the charges you may face, call Oberheiden, P.C. now. Our Midland/Odessa healthcare fraud lawyers provide counsel for providers, entire healthcare systems, and other related healthcare businesses.
Frequently Asked Questions
What is the Anti-Kickback Statute?
The Anti-Kickback Statute (AKS) is a federal law limiting a medical provider’s ability to participate in certain referral agreements. Specifically, the AKS forbids a provider from giving or receiving anything of value in exchange for patient referrals. This takes effect when the patient’s healthcare is under a federal program. Many cases of alleged violations of the AKS are in the form of cash for referrals. But, other common kickbacks include costly meals, hotel stays or vacations, and glamorous or high-paying positions within a company. The AKS is a criminal law, and a conviction carries the potential of prison time and other criminal sanctions. Civil liability may also be pursued under the False Claims Act. If you are facing a violation of the Anti-Kickback Statute, it is vital to contact a dedicated Texas federal healthcare fraud defense attorney as soon as possible.
Are whistleblower complaints taken seriously?
Absolutely. Although there is some level of suspicion when someone brings a qui tam claim under the False Claims Act. The complainant stands to receive a portion of the amount recovered. Thus, federal investigators take these claims very seriously. It is also important to keep in mind that even if the federal government does not intervene, the whistleblower can continue with the case against you on their own. Regardless of why you are being investigated, it is important to reach out to a Midland/Odessa federal healthcare fraud defense attorney as soon as possible.
How do I know whether my case is civil or criminal?
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.
Healthcare Fraud Defense
Oberheiden, P.C. is a Texas law firm providing healthcare fraud defense to clients in Midland/Odessa and the surrounding area. Many of our Midland/Odessa healthcare fraud attorneys are former federal prosecutors and have 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.
Legal advocacy. Our main goal is to help our clients avoid criminal indictment. We know that the best way in which we can advocate for our clients is to quickly contact the federal government. This immediate contact limits the amount of time the federal government has to pursue its case against you. We work to protect your career and your freedom. We can get answers to some important questions typically within a few hours after you retain us. Here are a few initial questions we will ask on your behalf:
- What is the investigation about?
- What is the purpose of it?
- How long will the investigation take?
- What is the most likely outcome?
No criminal intent. 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 errors 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. Our Midland/Odessa healthcare fraud attorneys have provided successful legal defense for clients across the United States by proving that inaccuracies are a result of human or company error and not criminal intent. Some factors leading to such mistakes are:
- Unqualified staff,
- Delegation errors,
- Outsourcing errors,
- Lack of oversight,
- Insufficient supervision, and
- Constantly changing laws and rules in healthcare billing.
Strategic healthcare fraud defense. 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. 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.
Defending your reputation. 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. Our attorneys address instances of slander, and seek opportunities to correct misinformation about our clients.
Oberheiden, P.C. has helped clients across the country who were accused of healthcare fraud. Call us today to learn more about your legal options. Your initial call with a Midland/Odessa healthcare fraud lawyer is confidential and free of charge.
Our Track Record
The commitment of Oberheiden, P.C. is to avoid criminal charges and to shield our client’s medical business from government intrusion. Our team of former healthcare prosecutors and experienced defense attorneys have a distinguished history of protecting business owners, executives, lawyers, physicians, hospitals, laboratories, pharmacies, home healthcare entities, and many other healthcare organizations against any form of alleged healthcare fraud. Here are some recent examples of our case outcomes.
- Representation of a Pharmacy Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
Result: No civil or criminal liability.
- Representation of a Marketing Group Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
Result: No civil or criminal liability.
- Representation of Physicians Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
Result: No civil or criminal liability.
- Representation of Laboratory against an Investigation by the Department of Justice and the U.S. Attorney’s Office for Alleged Medicare Fraud.
Result: No civil or criminal liability.
- Representation of Laboratory against an Investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare Fraud.
Result: No civil or criminal liability.
- Representation of Laboratory against an Investigation by the Department of Justice and the U.S. Attorney’s Office for alleged Tricare Fraud.
Result: No civil or criminal liability.
- Representation of a Healthcare Services Company against an Investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for Alleged False Claims Act and Stark Law Violations.
Result: No civil or criminal liability.
- Representation of a Healthcare Marketing Group Against an Investigation by the Office of Inspector General for Alleged Healthcare Fraud.
Result: No civil or criminal liability.
- Representation of a Physician against an Investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare Fraud, Stark Law Violations, and Anti-Kickbacks.
Result: No civil or criminal liability.
- Representation of Laboratory against an Investigation by the Department of Justice and the Office of Inspector General for Alleged False Claims Act and Medicare Violations.
Result: No civil or criminal liability.
- Representation of Physician Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud and False Claims Act Violations.
Result: No civil or criminal liability.
- Representation of Physician Investigated by the Office of Inspector General for Medicaid Fraud and Stark Law Violations.
Result: No civil or criminal liability.
- Representation of Healthcare Organization Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
Result: No civil or criminal liability.
- Representation of Physician Group Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud, Stark Law Violations, and False Claims Act Violations.
Result: No civil or criminal liability.
- Representation of Physician Group Investigated by the Department of Health and Human Services and the Office of Inspector General for False Claims Act Violations.
Result: No civil or criminal liability.
- Representation of a Physician Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
Result: No civil or criminal liability.
- Representation of Pharmacy Investigated by the Department of Justice and the Office of Inspector General for Department of Labor Program Fraud.
Result: No civil or criminal liability.
Defend Your Reputation – Call Our Midland/Odessa Healthcare Fraud Lawyers
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Oberheiden, P.C.
Serving Midland / Odessa, Texas and Surrounding Areas
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