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New Mexico Medicare Fraud Defense Lawyers

Are you under investigation for phantom billing or up-coding? Have you been accused of billing for services that were not medically necessary? If so, you have no time to waste. Your lawyer must be up to speed on all Medicare rules and regulations involved in your case. If facing charges for Medicare fraud in New Mexico, you need a team of experienced attorneys. Attorneys who know every nuance and detail of your business. That way, they can concentrate on developing a strategic defense right away.

Medicare fraud is a federal felony, and the monetary penalties can be enormous. The potential of being held accountable for Medicare fraud should motivate you to invest time and resources in a strategic defense plan. The last thing you want is the government branding you a criminal or imposing civil liability. The fines could easily cause you to lose your business. To avoid such outcomes, you need an experienced New Mexico Medicare fraud defense lawyer.

At Oberheiden, P.C., we are experienced fraud defense lawyers and former federal prosecutors. Our record speaks for itself. Call us today at 888-680-1745 to discuss next steps forward in your case.

A Team You Can Trust

The New Mexico Medicare fraud defense lawyers of Oberheiden, P.C. have successfully defendedhave successfully defended:

  • Physicians,
  • Practice owners,
  • Physician-owned entities,
  • Toxicology labs,
  • Pharmacies,
  • Service management organizations,
  • Healthcare marketing companies, and
  • Others in Medicare fraud investigations.

When you choose Oberheiden, P.C., Dr. Nick Oberheiden or an experienced New Mexico Medicare fraud defense attorney on our team will exclusively handle your defense. No junior lawyers or paralegals will work on your case. Each member of our Healthcare Practice Group has handled at least 100 healthcare matters.

What Constitutes Medicare Fraud?

Medicare fraud refers to the submission of false or fictitious claims to a governmental healthcare program. According to government statistics, about $50 billion worth of claims are investigated for potential Medicare fraud each year. The federal government has the power to investigate possible Medicare fraud under numerous federal statutes, including:

  • Anti-Kickback Statute
  • Civil Monetary Penalties Law
  • Criminal Fraud Statute
  • False Claims Act
  • Stark Law (Self-Referrals)

As a result, no matter how well you have organized your practice, the chances of being investigated are high. This is especially true if your business is successful and submits a high volume of claims to the Centers for Medicare and Medicaid Services (CMS).

What Are the Penalties for Medicare Fraud?

Medicare fraud is investigated by the:

  • Office of Inspector General (OIG),
  • Department of Justice (DOJ),
  • Centers for Medicare and Medicaid Services (CMS),
  • Department for Health and Human Services (HHS),
  • Federal Bureau of Investigation (FBI),
  • Medicaid Fraud Control Units (MFCUs),
  • State Medicaid Agencies in cooperation with the Healthcare Fraud Prevention and Enforcement Action Team (HEAT), and
  • General Services Administration (GSA).

If found guilty of Medicare fraud, you can face:

  • Recoupment requests,
  • Non-payment of future Medicare claims,
  • Exclusion from federal healthcare programs,
  • Civil fines of up to $11,000 per false claim,
  • Treble damages,
  • Attorneys’ fees,
  • Criminal fines, and
  • Years in federal prison.

Who Is Investigated?

Medicare fraud exposes providers and business owners alike. The statutes mentioned above apply to any individual or business that directly or indirectly contracts with CMS or is paid for services through Medicare. At Oberheiden, P.C., we represent clients in New Mexico in the following industries, with some examples of the specific types of cases we handle listed below:

Industries

  • Healthcare providers (e.g. physicians)
  • Hospitals
  • Home health centers
  • Laboratories (toxicology, biologics)
  • Medical device companies
  • Pharmacies (including compound pharmacies)
  • Physician-owned entities

Recent Examples

  • Medicare Fraud Strike Force charges 90 individuals
  • Medicare Fraud Strike Force charges 89 individuals
  • Doctor admits taking bribes in test-referral scheme with lab
  • Owner of nursing agency convicted of multi-million dollar fraud scheme
  • Principal in $28.3m Medicare fraud scheme sentenced to 11 years in prison

(Published by U.S. Department of Justice at http://www.stopmedicarefraud.gov/newsroom/)

Government Investigation: Civil or Criminal?

New Mexico Medicare Fraud Defense LawyersOne of the most important questions when facing an investigation for Medicare fraud is whether the investigation is civil or criminal in nature. Is the government seeking monetary remedies, making it a civil investigation? Or, is the government seeking criminal indictments and imprisonment? Healthcare fraud statutes provide for both, and about 1,400 individuals are indicted in federal court for healthcare fraud each year. Our experienced defense attorneys can determine if your investigation is civil or criminal. If it’s not too late, we can work with the investigating agency (or agencies) to try to avoid criminal charges.

How do we know if your case is civil or criminal? We can often get a good sense just from hearing our client’s side of the story. Years of experience combined with the insight and knowledge of our former government officials allow us to see details of the investigation most people wouldn’t notice. We pay attention to how our clients are notified, which government agency contacted them, and which government official is in charge. The involvement of a prosecutor or a federal agency doesn’t mean the case is a criminal matter.

How We Defend Medicare Fraud

When you hire Oberheiden, P.C. for your Medicare fraud investigation, you are not just hiring a law firm. We are a team of former federal prosecutors, government officials, and committed defense attorneys who have knowledge of both the healthcare and legal issues involved in your case. With us, you get:

Industry Knowledge

Our New Mexico Medicare fraud defense attorneys have a deep healthcare industry knowledge. Because Medicare fraud often stems from billing and coding errors, you need attorneys who understand billing and coding violations. Our attorneys have analyzed, reviewed, and defended close to 500,000 billed claims.

Government Experience

We have extensive government experience. The difference between liability and human error is often a fine line. Explaining the difference requires convincing negotiation skills and attention to detail. To succeed, you often need to know what the other side is thinking. The former government officials of Oberheiden, P.C. have years of healthcare and law enforcement experience from working inside the government.

Determination To Quell Criminal Charges

We want to keep investigations civil, and keep criminal charges off the table. In fact, we want to end your case before you ever face federal charges. Our attorneys can often persuade the government that errors, if they exist, were innocent mistakes and not grounds for federal prosecution.

Contact Oberheiden, P.C. for a Free Consultation

Oberheiden, P.C. represents clients in investigations throughout New Mexico and nationwide. When you call our New Mexico Medicare fraud defense lawyers, we will explain how our “Emergency Defense Package” can help you take action to protect yourself and your business. The “Emergency Defense Package” uses our experience on both sides of federal investigations. It condenses the information into clear steps that can provide instant relief for those facing Medicare fraud accusations.

Contact us today to discuss your case with our New Mexico Medicare fraud defense attorneys. All initial consultations are free and confidential. Let us show you how we can protect you, your family, and your future.

Our Track Record

  • Defense of Medicare laboratory against investigations by the Department of Justice and the U.S. Attorney’s Office for alleged Medicare Fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense 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, case dismissed.
  • Defense of Medicare laboratory against investigations by the Department of Health and Human Services and the Office of Inspector General for alleged Healthcare Fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of nationally operating healthcare company against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of healthcare marketing company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a laboratory against an investigation by various branches of the federal government for alleged fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of physician owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Department of Justice for alleged fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged Stark Law violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by various branches of the federal government for alleged False Claims Act, Stark Law, and Medicare violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Department of Justice for alleged Medicare Fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of physician owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of healthcare management organization against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged Medicare Fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of nationally operating laboratory against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability, case dismissed.

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