Orange County Healthcare Attorneys

Seasoned Orange County Healthcare Fraud Defense Lawyers

If you’re a healthcare provider in Orange County and nearby cities, chances are high that you are (or may soon be) the target of a federal investigation for legal disputes. High-stakes fraud investigations are being conducted by the Drug Enforcement Administration (DEA) and the Department of Health and Human Services (DHHS) with increasing frequency into matters ranging from employment to opioid diversion to payment of unlawful kickbacks and any number of alleged federal violations in between. If your business or practice is currently under such an investigation, you need the help of the experienced Orange County healthcare lawyers at Oberheiden, P.C.

Oberheiden, P.C., is a federal healthcare fraud defense law firm representing health care industry entities in both civil and criminal matters in California. Our proven Orange County healthcare attorneys have combined legal experience in healthcare and business law – including experience as senior federal prosecutors – to contribute to the most effective defense of your case. The health care law knowledge and skill offered by Oberheiden, P.C., are unequaled, and our passion is helping clients make smart decisions to avoid the unneeded effects of federal healthcare fraud investigations.

Health care providers may be investigated for allegedly filing “false” or “fraudulent” claims to federal healthcare programs. You may have been told that you’re contributing to the nation’s opioid epidemic. You may be the target of the federal government, and not know why. If you’re facing these difficulties, we’d like to help. It’s our goal to clear your name so that you can get back to the business you know best.

What Is Healthcare Fraud?

The first step in reacting to an inquiry from the federal government is to know what caused their interest in your practice. A number of agencies investigate alleged healthcare fraud, and can include a number of potential violations – both civil and criminal. The DEA, DHH/OIG or the DOJ may be just a few of the agencies involved.

To formulate the most effective defense possible, it’s important to answer two initial questions:

• Is this case civil or criminal; and
• What special task forces or agencies lead the investigation

To answer these questions, some knowledge of the regulations involved in healthcare fraud is helpful. Briefly, the laws for most healthcare fraud allegations are as follows:

1. The False Claims Act

If you submit a claim to a federal healthcare program, your claim must be accurate. Otherwise, it is a violation of the False Claims Act (FCA). The federal government may begin an investigation into your billing practices under the criminal provisions of the act.

2. The Anti-Kickback Statute

Federal law restricts the exchange of money or other valuables for patient referrals. Anyone can face prosecution for violating this act if they offer or provide goods or services in exchange for referrals.

3. The 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 have a financial interest in the entity. Or, if there is a compensation arrangement between the providers. There are statutory exceptions to this law.

4. The Controlled Substances Act

The CSA was created to control and regulate dangerous substances. It’s one of the primary federal statutes used to prosecute providers engaging in prescription drug fraud. Drug fraud can include:

• Knowingly selling prescription drugs,
• Reselling prescription medications,
• Trading counterfeit drugs,
• Receiving kickbacks from drugmakers to prescribe one medication over another, and a number of other unlawful practices.

Depending on its severity, a violation of the CSA can result not only in the loss of your practice, but in substantial civil and/or criminal penalties.

5. The Federal Healthcare Fraud Statute

The federal healthcare fraud statute, 18 U.S.C. 1347, makes knowingly and purposely defrauding any healthcare benefit program a federal offense. Obtaining money or property from a federal healthcare program by false statements or promises, is also restricted. Like the False Claims Act, this statute is broad. It gives federal prosecutors a range of options to target healthcare providers.

6. Program Billing Regulations

Along with the federal statutes above, healthcare providers who participate in Medicare, Medicaid, Tricare, DOL, or similar health benefit programs have strict billing rules. Willfully or unknowingly violating the regulations could result in losing your ability to work with the programs. There are a variety of other penalties that may stem from an audit or investigation. Maintaining an updated compliance plan can help lower your risk of prosecution.

DOJ Mandates

All medical professionals should also monitor the Department of Justice news releases issued on their website. This can help identify potential risks to your practice while tracking DOJ’s priorities for the healthcare industry. Currently, the DOJ is focusing efforts on their Opioid Fraud and Abuse Detection Unit and the Prescription Interdiction & Litigation (PIL) Task Force. These federal teams seek out physicians who have violated fraud laws.

Healthcare providers and related entities must know that DOJ prosecutors can seek evidence necessary to charge targets with:

• Mail fraud,
• Wire fraud,
• Tax fraud,
• Money laundering, and a variety of other federal offenses.

Being informed is the first step to being prepared. When informed, you can rely on counsel to help you structure a defense customized to your case. The highly experienced Orange County healthcare fraud and personal injury defense team at Oberheiden, P.C., should be that choice.

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)

Five Reasons to Choose Our Orange County Healthcare Attorneys at Oberheiden, P.C.

When targeted for federal investigation, you may feel overwhelmed. Providers facing such inquiries can turn to Oberheiden, P.C. You can rely on a firm with experience and knowledge of the various types of allegations you may face. Our highly skilled healthcare fraud defense lawyers have represented clients accused under the statutes and provisions mentioned above.

As a medical provider, you have too much at stake to not hire a firm with experience in these matters. Here are five reasons medical providers choose Oberheiden P.C.:

• Our Team Includes Former Federal Prosecutors – We have a team of seasoned litigators, and many of our attorneys are former federal prosecutors. They have devoted their careers to healthcare fraud cases.
• Our Extensive Knowledge of the Federal Healthcare Fraud System – Our highly skilled Orange County healthcare fraud defense team understands federal actions. We can help you identify the trigger for the investigation. Our attorneys have handled thousands of healthcare fraud audits, investigations, and prosecutions, including numerous cases in Orange County. We can put that knowledge and experience to work for you.
• Our Record – We get involved in the case as early as possible, and we have a history of stopping investigations before they reach a federal indictment.
• Our Customized Defense Strategies that Work – We have proven defense strategies and years of experience implementing them. We tailor our approach to the unique aspects of our clients’ cases to give them the aggressive, effective defense they need.
• Our Focus on Federal Healthcare Defense – Our firm focuses exclusively on federal cases. Our established Orange County defense lawyers have the experience required to defend clients representing all sectors of healthcare, including:
  • Hospice care,
  • Physicians,
  • Pharmacies,
  • Hospitals,
  • Home care services,
  • Emergency clinics, and more.

Frequently Asked Questions

Discuss Your Healthcare Fraud Defense Today in Confidence

As a medical professional working in Orange County, you know the damage that can be done by allegations of healthcare fraud, even if you are innocent. That is why our team suggests you speak with an attorney as quickly as possible after allegations come out. Contact one of our healthcare fraud defense attorneys for a risk-free, confidential consultation  888-680-1745 or inquire online now.  Our dedicated attorneys are available 24 hours a day, 7 days a week, to discuss your concerns.

Additional Pages for Orange County, California

• Orange County False Claims Act & Qui Tam defense
• Orange County federal criminal defense
• Orange County healthcare compliance
• Orange County hospice & home health fraud defense
• Orange County Medicare fraud defense