Midland / Odessa Medicare Fraud Attorneys

Serving healthcare service providers in the Midland/Odessa area of Texas, our Healthcare Fraud Defense Group is headed by attorney Dr. Nick Oberheiden. Dr. Oberheiden is a nationally recognized healthcare fraud defense attorney with an extensive trial record. He is also the founder and managing principal of Oberheiden, P.C..

Are You Under Investigation for Medicare Fraud in Midland/Odessa, Texas?

Medicare fraud involves the submission of false or fictitious claims for Medicare reimbursement. Submitting false and fictitious claims to Medicare violates a number of federal statutes:

• False Claims Act,
• Anti-Kickback Statute,
• Physician Self-Referral Laws (Stark Law),
• Social Security Act,
• Various provisions of the U.S. Criminal Code.

The Midland/Odessa, Texas region is home to numerous healthcare facilities. False Claims Act violations are closely monitored in Texas. All healthcare practitioners and businesses in Midland and Odessa must be careful to avoid mistakes that lead to federal review. Texas is one of nine areas closely watched within the United States. Medicare fraud is one of the top priorities of the federal government in fighting fraud. Parts of four federal agencies combined to form a special task force to fight the rising costs of Medicare fraud. The Healthcare Fraud Prevention and Enforcement Action Team (HEAT) and Medicare Fraud Strike Force have a presence in nine areas around the country. Texas is one of only three states with two HEAT teams assigned to combat in-state Medicare fraud.

Common Forms of Medicare Fraud

Federal government law enforcement officers and prosecutors tend to allege that the healthcare provider has engaged in fraudulent billing. This typically involves submitting claims for excessive or unauthorized services or services not provided. Some specific allegations are:

• “Phantom billing” (billing for services that were never performed);
• Providing and billing for medically unnecessary services;
• Billing for supplies and equipment that were never purchased;
• Purchasing and billing for medically unnecessary supplies and equipment;
• Obtaining fraudulent certifications for medically unnecessary services (a common allegation in home health and hospice fraud investigations);
• Obtaining fraudulent certifications for medically unnecessary supplies (including durable medical equipment (DME));
• Double-billing;
• Upcoding, unbundling, and other forms of coding fraud; and
• Entering into illegal kickback arrangements with physicians or other providers.

Medicare enforcement efforts cover many providers; physicians, nurses, home healthcare centers, hospices, nursing homes, registered care facilities, hospitals, pharmacies, toxicology labs, medical devices companies, physician syndications, DNA testing centers, cancer treatment centers, and other healthcare service providers. They are more often becoming the targets of federal investigations.

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)

Understanding the Civil and Criminal Penalties for Medicare Fraud

The situation can be serious if targeted in a False Claims Act investigation. Providers in the Midland/Odessa, Texas area found civilly or criminally liable for federal law violations can face the following:

• Recoupment requests,
• Non-payment of future claims,
• Civil fines of up to $11,000 per false claim,
• Exclusion from future participation in federal healthcare programs,
• Treble damages,
• Attorney fees,
• Criminal fines, and
• Federal imprisonment.

The potential prison sentences for those facing criminal Medicare fraud investigations include:

• Up to 10 years in prison for each count of Medicare fraud;
• Up to 20 years in prison for fraud resulting in serious bodily injury (including billing for providing patients with counterfeit or excessive medication); and
• A life sentence if a fraudulent Medicare practice results in a patient’s death.

Physicians and other healthcare professionals charged with Medicare fraud will often face licensing actions and loss of hospital privileges in addition to possible prison time and expensive fines.

How to Choose the Right Defense Lawyer

The Right Choice: A Healthcare Fraud Defense Lawyer

The ideal lawyer for your Medicare fraud case in Midland or Odessa, Texas works in the practice area of healthcare fraud defense and will have four key traits:

• A proven track record;
• Industry knowledge;
• Intimate knowledge of federal healthcare laws and criminal procedure;
• Extensive litigation and trial experience;

Before paying any retainer fees, request a free consultation and ask the lawyer the follow important questions:

• How many healthcare fraud cases have you handled so far?

• How many of those cases resulted in no civil and no criminal charges for your clients?

• How many False Claims Act cases have you tried in court?

Proven Defense Strategies for Your Medicare Fraud Investigation

At Oberheiden, P.C., our experience and record set us apart from other defense firms serving the Midland/Odessa region. Our attorneys have handled healthcare proceedings and conducted over 200 criminal trials nationwide. As former federal prosecutors, our Midland/Odessa Medicare fraud attorneys provide the experience and insight few can match. We have developed several proven defense strategies for Medicare fraud investigations.

Early Intervention

Early intervention is critical in Medicare fraud investigations. This means hiring an attorney before your investigation leads to civil or criminal charges. Negotiating early with the government can change the entire outcome of your case. At Oberheiden, P.C., our Healthcare Fraud Defense Team has a successful history of communication with federal agencies. We can quickly get answers to the following questions:

• What is the case about?
• What prompted the investigation?
• Is the case civil or criminal?
• What agencies are involved?
• Who else is under investigation?
• How can the issue be resolved?

Getting answers to these questions early can be crucial to building a successful defense that avoids trial.

Arguing a Lack of Evidence

In order to convict you of Medicare fraud, the government must meet the burden of proof. They must prove beyond a reasonable doubt that you committed an illegal act and did so with “criminal intent”. We target the government’s lack of evidence on both elements to secure a fast and favorable resolution. In every case, the goal of our Midland / Odessa Medicare fraud lawyers is to achieve the following:

• Dismissal;
• No criminal charges;
• Keep professional licenses;
• Civil fines, but no criminal pleas;
• Misdemeanor, and no felony charges; and
• No prison time.

Demonstrating Lack of Intent

In our experience, most incidents that prompt Medicare investigations do not involve criminal intent. They are the result of organizational and human errors. Busy healthcare providers focused on caring for their patients may make mistakes the government misinterprets as fraud. Some of the more common issues we encounter, which do not rise to the level of criminal intent, include:

• Unqualified staff;
• Supervision errors;
• Delegation and outsourcing;
• Structural deficits;
• Organizational mistakes;
• Human error; and
• Lack of compliance program.

In addition, the ever-changing nature of federal Medicare rules can make even the most compliant practices susceptible to mistakes leading to allegations of fraud.

Intentional healthcare fraud is rare. Unfortunately, too many business owners are willing to accept penalties for simple oversights. Mistakes are common in a busy practice, and they should not result in fraud convictions or liabilities.

About Oberheiden, P.C.

The Midland / Odessa Medicare fraud attorneys of Oberheiden, P.C. represent business owners, healthcare executives, lawyers, healthcare providers, hospitals, pharmacies, labs, and other healthcare entities throughout the Midland and Odessa area in cases involving allegations of Medicare fraud. We have broad experience in healthcare fraud investigations and center our practice in the following areas:

• Healthcare fraud defense;
• Compliance programs;
• Internal investigations;
• Defense of qui tam lawsuits;
• Protect assets;
• Licensure & disciplinary hearings; and
• Trial by jury.

Our clients range from individual providers and healthcare company executives to entire healthcare systems. We are available to represent healthcare clients in Midland and Odessa, Texas under fraud investigation by state or federal agencies.

Our Midland / Odessa Medicare fraud lawyers are available every day of the year, 24 hours a day. You can call us directly or complete our contact form to request a free consultation.