Pensacola Healthcare Fraud Defense Lawyers

If you or your healthcare practice is under federal investigation in Pensacola, you need the experienced Pensacola healthcare fraud defense lawyers at Oberheiden, P.C. on your side.

Federal law enforcement makes major efforts to reduce fraud, waste, and abuse in the healthcare system. To achieve this, they investigate healthcare providers and businesses in Pensacola as well as in major cities across Florida.

Many of these actions are led by the United States Department of Justice (DOJ) and the Department of Health and Human Services’ Office of Inspector General (DHHS – OIG).

These organizations investigate everything from phantom billing and false claims to physician self-referrals and unlawful kickbacks.

Healthcare providers in Pensacola might also find themselves investigated by the DEA for alleged misuse of prescription drugs. There are also a number of white-collar crimes that can affect business entities in any field. IRS inquiries into tax fraud, for example.

Oberheiden, P.C., is a federal criminal defense law firm with a national presence. Our attorneys bring exceptional experience to the table. In fact, several are former federal prosecutors who worked in the DOJ or in other prosecutorial roles.

We mount an aggressive criminal defense for healthcare professionals, corporate officers, and business owners accused of committing federal crimes. In most of our cases, our healthcare fraud defense lawyers have been able to avoid the filing of criminal charges against our clients. While we cannot promise specific results in advance, we fight to get the optimal outcome, every time.

What Is Healthcare Fraud?

Generally defined, healthcare fraud refers to intentional falsehoods devised to wrongfully deprive a healthcare program, such as Medicare, Medicaid, Tricare, the Department of Labor, or even a private insurance company, of money or other assets.

There are many kinds of healthcare fraud. Some common examples include:

• Billing fraud (phantom billing, upcoding, false claims, etc.)
• Department of Labor (DOL) fraud
• Anti-Kickback Statute violations
• Stark Law violations (physician self-referral)
• Prescription drug fraud and other Controlled Substances Act (CSA) / DEA registration violations
• Billing for services that are not medically necessary
• Billing for services you never actually provided
• Falsifying patient records, prescriptions, physician certifications, or election statements

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)

Federal Healthcare Statutes and Other Sources of Law You Need to Know

When prosecutors want to charge healthcare fraud in Pensacola, they have numerous federal statutes to choose from. These statutes also form the basis for most federal investigations into suspicious healthcare practices.

1. The False Claims Act

The False Claims Act (FCA) makes it a crime to submit “false or fraudulent” claims for payment to any federal healthcare program. The most serious penalty under the FCA is a five-year federal prison sentence. But, the civil and criminal fines can become a crippling penalty on their own, even without prison time. That’s because these fines can mean tens or hundreds of thousands of dollars for each false claim. And because an FCA conviction can mean program exclusion, an FCA charge threatens your business’s very existence. Learn more about the penalties for FCA violations for individuals and for corporations, here.

2. The Anti-Kickback Statute

The Anti-Kickback Statute (AKS) is one of the most complex and challenging pieces of federal healthcare legislation. Under the AKS, it’s a crime to intentionally offer, pay, solicit, or receive remuneration in exchange for patient referrals. The question of intent is key. “Remuneration,” meanwhile, is broadly defined. An AKS investigation can be civil or criminal in nature. Our office can help in either scenario.

3. The Stark Law

The Stark Law applies narrowly to “physician self-referrals,” which are illegal and can result in significant civil penalties. We urge Pensacola physicians who treat Medicare or Medicaid beneficiaries and who worry about facing an investigation for self-referrals to contact Oberheiden, P.C., right away.

4. The Federal Healthcare Fraud Statute

Federal prosecutors often seek charges under multiple statutes at once. 18 U.S.C. 1347, better known as the “healthcare fraud statute,” is something of a go-to statute, owing to its broad language and application. It reads (in part) as follows:

5. The Controlled Substances Act (CSA)

The Controlled Substances Act makes it illegal to:

• Write unnecessary prescriptions,
• Sell prescriptions or medications,
• Dispense medications without proper DEA registration,
• Engage in pharmaceutical fraud,
• Misappropriate opioids or other controlled substances, or
• Possess or distribute certain illegal drugs, among other things.

6. Other Fraud Statutes

Healthcare fraud charges rarely appear on an indictment alone. With the criminal statutes above, healthcare providers in Pensacola may face allegations of related charges. These can include:

• Mail fraud
• Wire fraud
• Bank fraud
• Forgery
• Making false statements
• Federal conspiracy
• Wrongful use of health information

7. Program Billing Regulations

Agencies, like the CMS, announce their own billing regulations. Violating these regulations, even unwittingly, can result in prosecution. Healthcare providers in Pensacola must maintain a proactive compliance program to reduce the risk of unwittingly violating a federal billing regulation.

8. DOJ Mandates

You might think that the Department of Justice’s only interest is, well, justice. But the officers and leaders at the DOJ are extremely interested in media coverage too; they maintain an active press department. From time to time, the department issues new departmental mandates. These mandates tell DOJ agents how to allocate their resources and which law enforcement actions to prioritize. The DOJ can also work with other federal agencies to launch task forces. These efforts are typically geared at making high-profile arrests en masse, with the aim of getting maximal media coverage. Paying attention to DOJ mandates can help you get a sense of where the DOJ is likely to strike next. We have seen a large amount of federal law enforcement activity in the Florida healthcare industry in recent years.

5 Reasons to Choose the Pensacola Federal Healthcare Fraud Defense Lawyers at Oberheiden, P.C.

Here are five reasons why healthcare professionals and businesses in the Pensacola area should trust Oberheiden, P.C., as their federal healthcare fraud defense attorneys:

• Our Extensive Experience in Healthcare Fraud Investigations – Healthcare fraud is a highly complex and specific area of law. There is simply no substitute for years of experience handling these cases. From negotiations with federal agents and prosecutors to advocacy at trial, our Pensacola healthcare fraud defense attorneys have handled thousands of federal healthcare fraud matters.
• Our Record of Avoiding Charges – While every case is unique, and we can’t promise specific results, we have proudly avoided criminal charges in the majority of cases. Avoiding charges is the most effective way to resolve a criminal investigation. That’s why we do everything we can to achieve that goal every time.
• Our Focus on Federal Healthcare Fraud Defense – If you’re facing federal criminal healthcare charges, you want defense lawyers with real experience in the field. Healthcare fraud defense has long been one of our primary areas of focus at Oberheiden, P.C. Our Pensacola federal healthcare defense lawyers are available to represent:
  • Doctors,
  • Pharmacists,
  • Physician’s groups,
  • Medical clinics,
  • Hospitals,
  • Hospices,
  • Medical labs,
  • Mobile labs,
  • Ambulance providers,
  • Diagnostic companies, and
  • Virtually any other healthcare provider in Pensacola.
• Our Experience on Both Sides – Several of the lawyers at Oberheiden, P.C. are former federal prosecutors. They’ve worked on the other side of the same kinds of cases. This allows them to bring unique perspectives to our clients’ defense.
• Our Aggressive Defense Strategies – When the stakes are high, you need attorneys who will fight for you with tenacity. The Pensacola healthcare fraud defense lawyers believe in taking an aggressive approach for every client.

Discuss Your Federal Healthcare Fraud Investigation in Confidence

If your Pensacola healthcare practice or company is a target in a federal healthcare fraud probe, we urge you to contact our Pensacola healthcare fraud defense attorney for a free and confidential case assessment. To speak with a member of our Pensacola healthcare fraud defense attorneys, right away, call 888-680-1745 or inquire online as soon as possible.

Additional Pages for Pensacola, Florida

• Pensacola federal criminal defense
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