Phoenix Healthcare Fraud Defense Attorneys

If you’re a healthcare provider or you own a healthcare practice or business in Phoenix, Arizona or the surrounding areas, our attorneys can defend you against allegations of healthcare fraud. We have extensive experience in healthcare fraud matters, including Medicare and Medicaid audits, qui tam defense, OIG and grand jury subpoenas, criminal defense, and internal investigations. Our team of Phoenix healthcare fraud defense lawyers includes a former Chief Healthcare Fraud Coordinator for the U.S. Attorney’s Office, several former healthcare fraud prosecutors, and former lead prosecutors of the federal government’s Medicare Fraud Strike Force. We serve clients in Phoenix as well as the rest of the Arizona.

Regardless of the situation at hand, you have legal options. Call Oberheiden, P.C. and ask to speak with a Phoenix healthcare fraud defense lawyer. The call is free and confidential.

Healthcare Providers in Phoenix Are Constantly Monitored by the Federal Government

The Phoenix Metropolitan Area is one of nine regions in the United States that are constantly monitored by the Medicare Fraud Strike Force. The Medicare Fraud Strike Force is a team of prosecutors and investigators from multiple federal agencies. Often, members of this team work with the Department of Justice, Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. However, other federal agencies often have representatives who are part of this team as well.

Phoenix and the surrounding areas are constantly monitored because of the number of citizens in the area who rely on federal healthcare programs. The large number of recipients increases the number of claims filed with the federal government by healthcare providers and businesses for reimbursement. This increase in claims causes the federal government to watch the area closer because they believe that there will be an increase in the number of fraudulent claims filed.

What Is Healthcare Fraud?

Federal healthcare fraud is the attempt to receive reimbursement for medical equipment or services from a federal healthcare program such as Medicaid, Medicare, Tricare, or federal workers’ compensation. It is the filing of one or more false claims and includes a violation of at least one of the following laws:

• The Anti-Kickback Statute. Federal healthcare law prohibits kickbacks in exchange for referrals involving program beneficiaries. Any individual (including doctors, marketing representatives, and business owners) is subject to prosecution for violating the Anti-Kickback Statute by offering or providing payment or other valuables in exchange for prohibited patient referrals.
• The Stark Law. The Stark Law, also known as the Physician Self-Referral Law, prohibits doctors from referring patients to specific service entities if the doctor (or a member of the doctor’s immediate family) has an ownership or investment interest or if there is a compensation arrangement. Note, however, that there are statutory exceptions to this law.
• False Claims Act. If you submit a claim to Medicare or any other federal healthcare program, you are required by law to abide by the False Claims Act. If a claim submitted to the federal government is discovered to be inaccurate, the federal government will likely launch an investigation into your billing practices under the criminal provisions of the False Claims Act.
• Controlled Substances Act. The federal government pays special attention to practices with an unusually high number of narcotic prescriptions. If you are suspected of running a “pill mill,” you are at a high risk of being investigated for insurance fraud and for violating DEA dispensing rules.
• Healthcare Fraud Statute. The federal government is persistent about investigating the up-coding of claims. Up-coding means that the next higher code is used for a service when the billing is done. The federal government is also prone to investigating phantom billing (billing for services that were not provided), billing for patients who do not exist (referred to as ghost patients), and billing for equipment or services that are deemed not medically necessary.

Our Phoenix healthcare fraud defense attorneys have a successful track record in helping our clients avoid criminal charges. If you’re being investigated by the federal government for healthcare fraud in Phoenix, Arizona or the surrounding areas, call Oberheiden, P.C. now. Your initial call is free and confidential.

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)

This is Why You Are in Good Hands

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Denver F.

Fantastic lawyer - so dependable. We've worked with Nick for over 4 years and he is the best at what he does.

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Attorney Lynette Byrd was so kind and helpful with my case. I would highly recommend her legal services.

Chris Q.

Nick Oberheiden is an excellent attorney. He is hardworking, smart and intelligent.He takes a proactive approah on cases. He has dedicated team of former federal lawyers and investigators that are available to get results on cases. I recommend him highly.

M R.

Dr. Nick is acutely aware of the intricacies and subtleties of the relevant legal issues, and he is also gifted at explaining the issues in simple, easy-to-understand language. He has an outstanding rapport with the prosecutors - a critical talent for an Attorney trying to prevent prosecution or minimize criminal exposure of his clients. He is a master of multi-tasking, so you can be rest assured that he is always up-to-date with your representation. I believe that his European background allows him to view the totality of your case from an extra “dimension,” which allows him to craft exceedingly effective strategies and proffers. His caring and empathetic attitude goes a long way in helping you to keep up your spirits through the process. I could not have hoped for a better outcome. I unreservedly recommend him - he is a true Master of the trade!

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When your freedom, family, or fortune are at stake - it's best you meet Nick Oberheiden. Respected by the judges, his peers, colleagues, and clients - Nick is known to get results. Putting his keen intellect aside, one cannot help but appreciate his genuine desire to protect his clients and prevail. His cell number is in my phone for good reason. And if I ever need him, I know he'll be there - ready to win.

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I've had the pleasure of working with Nick over the last few years. Without a doubt, Nick is the best federal criminal defense attorney I've ever worked with. I wouldn't hesitate to recommend Nick and his team to any friend or family member. Keep up the great work.

Civil and Criminal Penalties for Federal Healthcare Fraud

Healthcare fraud in Phoenix can result in civil or criminal charges. Both courts have their own set of penalties that they may levy against you if you are found guilty. In civil court, you could be ordered to repay the claims, you could be denied reimbursement on future claims, and you could be excluded from filing claims with federal healthcare programs in the future. You may also be called in front of the state disciplinary board. You could lose your license and your hospital privileges.

Criminal penalties include more than a criminal record. You could be ordered to pay hefty fines that cost you hundreds of thousands of dollars, even if you’re only found guilty of a misdemeanor. You could receive a federal prison sentence:

• Up to 10 years for each count of healthcare fraud
• Up to 20 years for each count of fraud that resulted in serious bodily injury to the patient
• Life sentence if the healthcare fraud resulted in the death of a patient.

Phoenix clients often ask us about the worst-case scenario for fraud allegations. The worst-case scenario involves criminal charges or getting a prison sentence. Whether you will face either of those depends on factors such as the severity of any injury suffered by the patient, whether the prosecutor is interested in pursuing criminal charges, and the reason why the investigation was started.

Oberheiden, P.C. provides legal defense strategies for Phoenix area providers, entities, and businesses in fraud defense cases. Our Phoenix healthcare fraud defense lawyers use their experience as former healthcare prosecutors and as defense lawyers to develop strategic legal defenses for clients. If you’re being investigated, call us right away. The call is free and confidential.

How to Tell If the Investigation Against You Is Criminal

Healthcare fraud investigations in Phoenix, Arizona and the surrounding areas can be civil or criminal. They can even start off as civil and become criminal. This is why it is important to immediately contact Oberheiden, P.C. right away if you are being investigated.

Being contacted by a prosecutor isn’t a good indicator that the investigation against you is criminal. Federal agencies that have prosecutors have civil and criminal branches. That’s why you cannot rely on this. Signs of a criminal investigation into healthcare fraud include search warrants, seizure warrants, arrest warrants, target letters, contact from a federal criminal prosecutor, involvement from the IRS, or the receipt of a grand jury subpoena.

Developing Healthcare Fraud Defenses in Phoenix

Oberheiden, P.C. is a healthcare fraud defense firm providing legal advocacy to individual providers, entire healthcare systems, and healthcare businesses in Phoenix, Arizona and the surrounding areas. We’ve handled hundreds of cases during our time as a firm. Several of our Phoenix healthcare fraud defense attorneys have previous experience as healthcare auditors and fraud prosecutors with the Department of Justice and with the Medicare Fraud Strike Force. We use our combined experience to benefit our clients. This combined experience has led us to develop strategic healthcare fraud defenses that we use with our Phoenix clients.

Immediate contact with federal investigators. Our main priority is to help you avoid criminal charges. From our experience, we’ve learned that one of the most efficient ways that we can do this is to immediately contact federal investigators on behalf of clients. This reduces the amount of time that the federal government has to investigate you without an interruption. Immediately after we are retained, we contact federal investigators to get answers to the most important questions:

• What is the investigation about?
• What is the purpose of it?
• How long will the investigation take?
• What is the most likely outcome?

We are often able to get the answers to those questions within just hours after we are retained.

Evaluating the legal standards. The federal government must meet a high legal standard to show that you committed a crime and that you also acted with criminal intent. We evaluate the evidence and the legal standards in each case. Often, the federal government will point to billing inaccuracies to say that you committed a crime. Yet, we’ve found that these inaccuracies occur not because of fraud, but because of a mistake. While these mistakes should certainly be addressed and corrected, they shouldn’t cause you to face criminal penalties. Mistakes often occur when health practices or businesses grow quickly or because someone makes a mistake. The most common mistakes that cause these allegations include the use of unqualified workers, delegation errors, outsourcing errors, lack of oversight, insufficient supervision, and frequently changing laws and rules.

Developing strategic defenses for each case. Oberheiden, P.C. reviews each case and develops strategic legal defenses for our Phoenix clients. This may also include reviewing and utilizing the applicable statutory loopholes and exceptions. For example, the Stark Law involves medical necessity certifications. Where applicable, we will point to these exceptions to either mitigate or entirely resolve a healthcare fraud case.

Preserving your professional reputation. Fraud allegations can hurt your professional reputation. It’s one of the main concerns of our clients. Our lawyers will look for the right opportunities to correct any misinformation given to the public by the media. We also address slanderous comments.

If you’re under investigation for healthcare fraud in Phoenix, Arizona or the surrounding area, call our Phoenix healthcare fraud defense lawyers at Oberheiden, P.C. now. The call is free and confidential.

A Phoenix Healthcare Fraud Defense Attorney Answers Your Questions

Healthcare Fraud Defense Lawyers Serving Phoenix, Arizona

Nick Oberheiden is a highly experienced healthcare fraud defense attorney. Dr. Oberheiden has successfully represented healthcare executives, business owners, public officials, physicians, and lawyers in high-profile prosecutions, during accusations of political corruption, government investigations, and directed media campaigns, including 60 Minutes. He is most known for stopping federal investigations before criminal charges can be filed. In addition to his healthcare defense practice, Dr. Oberheiden leads internal investigations, implements corporate compliance programs, and teaches U.S. criminal law and federal litigation in the United States and abroad.

Our Phoenix healthcare fraud defense attorneys are available every day of the year. You can call us directly or complete our contact form to schedule a free and confidential consultation today.