New Mexico Home Health Fraud Defense Team - Oberheiden, P.C.
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Defending Home Health Fraud in New Mexico

New Mexico address – by appointment only:
6300 Riverside Plaza Ln. NW Suite 100
Albuquerque, NM 87120
888-680-1745
Federal healthcare programs rules are complicated. It’s common for many home health providers and business owners to be confused dealing with the government’s changing regulations. Sadly, despite their best efforts, these companies and providers are finding themselves accused of fraudulent conduct. Some common reasons for these investigations include:
  • Overly-complicated rules and regulations
  • Untrained or unmotivated staff
  • Unreliable billing personnel
  • Fast-growing practice
  • Lack of effective compliance program
The government and federal healthcare statutes make clear that these are not excuses for violating the law. Therefore, if under investigation for home health fraud in New Mexico, you need legal counsel right away.

What Is Medicare Fraud?

Most home healthcare investigations allege that a home health provider has committed Medicare fraud. Specifically, what home healthcare providers are typically accused of are things like:
  • Billing fraud – Charging for services that were not provided, or billing Medicare for the same service more than once.
  • Preparing improper cost reports – Billing Medicare for durable medical equipment (DME) and other medical devices that are never actually provided to patients.
  • Coding fraud – One of the most common forms of coding fraud is called, “up-coding.” This involves billing a service under an incorrect code that provides a higher reimbursement rate.
  • Billing for services that are not medically necessary – Home health providers can only seek Medicare reimbursement for services that are medically necessary. Billing for unnecessary services is a common form of healthcare fraud.

When Is an Investigation Civil? When Is It Criminal?

Medicare and Medicaid fraud are serious federal offenses that can either be charged as civil violations or criminal misconduct. One of the most important questions to ask your attorney is whether your case is civil or criminal. There are certain factors that may indicate an investigation is criminal. But, it’s not always possible to know for certain until your attorney contacts the investigating agency. The fact that a federal agent shows up at your office does not always mean the case is criminal. This is a critical moment when proper decisions need to be made with your counsel. If there is an investigation involving you or your business, call a federal defense attorney now. In many cases, our experienced attorneys have been able to keep the government from bringing criminal charges against our clients. But, in order to do this, we need to get involved as early as possible.

What Happens in a Home Healthcare Case?

The Three Stages of a Federal Healthcare Fraud Case

All home healthcare investigations have three stages. In the first stage, the government investigates alleged wrongdoing. If there is belief you committed healthcare fraud, it will issue a subpoena or ask the court to execute a search warrant. If you are subpoenaed or a search warrant is served, it is critical to call experienced defense counsel promptly. With counsel retained, the case enters its second stage. At this stage, your attorney negotiates with government officials regarding your case. The object is to end the case favorably for our client. The third stage is the resolution of your case. The results depend on if your attorney can keep the case civil, or if you will face criminal charges in court.

At What Point Should You Hire an Attorney?

The importance of hiring experienced defense counsel at the earliest time possible can’t be overstated. When facing a federal investigation, you need experienced lawyers. Lawyers who can protect your business, your good name, and keep you from facing criminal charges. At Oberheiden, P.C., our former federal healthcare prosecutors and experienced defense counsel have handled numerous healthcare investigations in New Mexico and nationwide. We are prepared to take immediate action to enforce your legal rights. The sooner you call us, the greater the chances we can protect you, your business, and your family.

What is the “Emergency Defense Package”?

Our attorneys have developed an “Emergency Defense Package” to provide clients under investigation with an immediate action plan. The “Emergency Defense Package” has been featured on news stations and in the media. It includes protocols, instructions, and defense strategies for those facing charges of healthcare fraud. The “Emergency Defense Package” Contains:
  • General Protocols: What to Do
  • Instructions for Management: How to Deal with Agents
  • Instructions for Management: How to Deal with Employees
  • Instructions for Employees
  • Document Retention Forms
  • Compliance Examination Instructions
  • Important Contact Information
You can call 888-680-1745 at any time to request more information about Oberheiden, P.C.’s “Emergency Defense Package.”

The Four Goals of Our Defense at Oberheiden, P.C.

In each healthcare fraud case, we have four goals to protect our clients:
  • Avoiding a Criminal Investigation
  • Avoiding Media Coverage
  • Protecting Our Client’s Good Name Keeping the Entire Case Confidential
  • Protecting Our Client’s Financial Future

Schedule a Free Consultation with an Experienced Attorney at Oberheiden, P.C. Today

As a result of our experience-based and results-driven approach, at Oberheiden, P.C., we have a long, successful history of defending clients in healthcare fraud investigations. If you would like to speak with Dr. Nick Oberheiden or any of the other experienced defense attorneys at Oberheiden, P.C. about your case, contact us to request a free consultation today.

Success Stories

Oberheiden, P.C. represents clients in governmental investigations in New Mexico and across the country. Our attorneys have been able to avoid civil and criminal responsibility for the firm’s clients in healthcare fraud investigations involving the following government agencies, among many others:
  • Successful defense of a healthcare services company against an investigation by the Office of Inspector General for Medicare Fraud
  • Successful defense of healthcare company against investigations by the Department of Justice for alleged Healthcare Fraud
  • Successful defense of healthcare company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations
  • Successful defense of a healthcare company against an investigation by the Office of Inspector General and Department of Health and Human Services
  • Successful defense of a healthcare company against an investigation by the Office of Inspector General and the Department of Justice for alleged Medicare Fraud
  • Successful defense of a physician owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations
  • Successful defense of a physician owned entity against an investigation by the Office of Inspector General for alleged fraud
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