Portland Healthcare Attorneys

Oberheiden, P.C. is a remarkable a healthcare law defense firm with experience in the areas of regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. On our team are talented Portland healthcare lawyers with years of relevant experience and education from the country’s leading schools such as Harvard and Yale Law Schools. Our attorneys serve clients in Portland as well as throughout Oregon.

If you are a healthcare provider or own a healthcare entity, business, or facility in Portland, Oregon facing allegations of healthcare fraud, call Oberheiden, P.C. today. Our firm has substantive legal experience in:

• Healthcare fraud defense,
• Medicare and Tricare audits,
• OIG and grand jury subpoenas,
• Compliance programs,

• Internal health data investigations,

• Fraud allegation defense,
• Qui tam defense,
• Protection of assets,
• Criminal defense, and
• Jury trials.

Do you want to learn how Oberheiden, P.C. can help you during this stressful time? Call us now to speak with a member of our Healthcare Fraud Defense Team. Initial consultations are free and confidential.

Portland, Oregon Is Closely Watched for Healthcare Fraud

Portland, Oregon, is closely monitored by the Medicare Fraud Strike Force for healthcare fraud. This is because a large number of residents are enrolled in a federal healthcare program, which causes more claims to be filed with the federal government for payment. The Medicare Fraud Strike Force diligently watches areas with an increased number of claims.

The Medicare Fraud Strike Force is an elite team composed of select prosecutors and investigators from a variety of federal agencies. In FY 2022, the Department of Justice (DOJ) opened more than 809 new criminal health care fraud investigations. Federal prosecutors filed criminal charges in over 419 cases involving at least 680 health care industry defendants. More than 477 defendants were convicted of health care fraud related crimes during the year. Also, in FY 2022, DOJ opened more than 774 new civil health care fraud investigations and had over 1,288 civil health care fraud matters pending at the end of the fiscal year. OIG, HHS

What Is Healthcare Fraud?

It’s important to understand what constitutes healthcare fraud. Healthcare fraud is defined as an attempt to receive payment from a federal government healthcare program for medical services or equipment from incorrect or misleading claims. Federal healthcare programs include Medicare, Medicaid, Tricare, or federal workers’ compensation. It incorporates at least one of the following elements:

• Anti-Kickback Statute. Federal law restricts the exchange of money or other valuables for patient referrals. Anyone may face prosecution for violating this act if they offer or provide payment or other valuables in exchange for referrals.
• Stark Law. Stark Law is more commonly known as the Self-Referral Law. It bars physicians from referring patients to other healthcare providers if the physician or an immediate family member has an ownership or investment interest in the entity. Or, if there is a compensation arrangement between the providers. There are statutory exceptions to this law.
• False Claims Act. If you submit a claim to a federal healthcare program, you must ensure that your claim is accurate. Otherwise, it is a violation of the False Claims Act. The federal government may begin an inquiry into your billing practices under the criminal provisions of the act.
• Prescription Fraud. Prescribing a high volume of narcotics is closely monitored by the federal government. If you’re suspected of operating a “pill mill,” you may be targeted for insurance fraud or violating DEA dispensing rules.
• Billing Fraud. One of the most common occurrences of billing fraud is upcoding. This occurs when a higher, and more costly, code is used on claims made to federal healthcare programs. The federal government also investigates:
  • Allegations of phantom billing (services not provided),
  • Ghost patients (patients who do not exist), and
  • Billing for medically unnecessary services or equipment.
• Certification Errors. The federal government pays close attention to the home healthcare and hospice industry. The most common allegation is fraudulent certification for care.

Oberheiden, P.C. has a history of success in helping clients avoid criminal charges. If you or your healthcare practice or business are under investigation for healthcare fraud in Portland, Oregon or the surrounding area, call Oberheiden, P.C. Initial calls with our Portland healthcare attorneys are free of charge 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)

Civil and Criminal Penalties of Healthcare Fraud

Healthcare fraud is extremely serious and can result in civil or criminal penalties. Civil penalties may include repayment of claims, non-payment of future claims, and exclusion from federal healthcare programs entirely. You could be called before the state disciplinary board, lose your license, and/or lose your hospital privileges.

If you are found guilty of criminal healthcare fraud, you may receive one of the following prison sentences:

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

Often, we’re asked about the worst-case scenario for fraud for health care providers, entities, and businesses in Portland, Oregon. Whether or not you’ll face criminal charges or a prison sentence depends on several factors. These are: the severity of injury suffered by a patient, whether the prosecutor sees an advantage in pursuing criminal charges, and the reason why the federal government began the case. If you’re under investigation for healthcare fraud, contact Oberheiden, P.C. Your initial call is confidential and free.

Oberheiden, P.C. is ready to help Portland, Oregon healthcare clients based on our dual experience as former federal prosecutors and healthcare fraud defense attorneys. If you’re contacted and told you’re under investigation for healthcare fraud, call us today. Learn more about your legal options and how we can help. Initial consultations are confidential and free of charge.

Indicators of a Criminal Investigation

Healthcare fraud cases can be either civil or criminal. With early intervention and compelling defense strategies, Oberheiden, P.C. has an excellent reputation for helping clients avoid criminal charges. Call us today if you’re under investigation for healthcare fraud in Portland, Oregon or the surrounding area. Let us begin our process to develop your custom defense strategies.

It’s not always easy to know if you are facing civil or criminal charges. The U.S. Attorney’s Office and other federal agencies have both a civil and a criminal division. So, being contacted by a federal prosecutor doesn’t always mean a criminal charge is imminent. However, civil cases can become criminal in nature. Oberheiden, P.C. can help by contacting federal prosecutors on your behalf. If you’re contacted by a federal prosecutor, call us right away for legal services.

Determining health law charges depends on the legal reading of many factors including OIG subpoenas, and how the inquiry or allegations are made. Expect criminal charges if you receive a(n):

• Search warrant,
• Seizure warrant,
• Arrest warrant,
• Target letter,
• IRS involvement,
• Grand jury subpoena, or
• There is involvement of a federal criminal prosecutor.

If you have questions about whether you are facing criminal or civil charges, call Oberheiden, P.C. as soon as possible. We represent physician groups, skilled nursing facilities, managed care organizations, living facilities, pharmaceutical companies, medical device manufacturers, entire health systems, and other related businesses. Our health care lawyers also provide healthcare defense services to healthcare providers, businesses, and entities in and around Portland, Oregon, that are under investigation by the federal government for healthcare fraud.

Healthcare Fraud Defenses

Oberheiden, P.C. is a health care law firm offering services in Portland, Oregon and the surrounding area. Several of our Portland healthcare lawyers have previous experience as healthcare auditors and fraud prosecutors with the Department of Justice. We provide this remarkable insight directly to our clients.

Legal advocacy begins right away. The main objective for our health care clients is to help them reduce the prospect of criminal charges. Our experience has taught us that the best way we can help our clients is to quickly contact federal authorities. We get answers to important questions, and stop the government from having unlimited time to investigate you. We work to protect your freedom and your career. We typically get answers to these most important questions within a few hours:

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

Addressing the fact that mistakes are not crimes. The federal government must prove beyond a reasonable doubt that you committed a crime. They must also show that you acted with criminal intent. When criminal charges look certain, we test if the government will be able to meet Constitutional standards. The government will try to use billing inaccuracies to prove you had criminal intent. Oberheiden, P.C. knows this most often happens as the result of an organizational or human error. These mistakes should not be held to criminal standards. We have provided successful legal defense for clients across the United States by proving that inaccuracies are a result of human or organizational error and not criminal intent. Some factors leading to such mistakes are:

• Unqualified workers,
• Delegation errors,
• Outsourcing errors,
• Lack of oversight,
• Insufficient supervision, and
• Constantly changing laws and rules in healthcare billing.

Although these issues should be corrected, they should not lead to a criminal conviction.

Developing strategic defenses for each case. Oberheiden, P.C. develops strategic healthcare fraud defenses for each client. Many of the cases we’ve successfully defended were won because of statutory loopholes and exceptions. For example, in the context of Stark Law which involves medical necessity certifications, we’ve been able to use exceptions to either ease or entirely resolve a healthcare fraud case.

Defending your reputation as a professional. We are committed to doing more than providing healthcare fraud defense. We are determined to defend your image. Allegations of healthcare fraud can be damaging. Many healthcare professionals express concern about how these allegations will affect their careers and future. The media has a lot of power and your reputation could be destroyed by their rumors. Our attorneys address instances of slander, and seek instances to correct misinformation about our clients. Call our Portland healthcare attorneys today to learn more about your legal options. The call is confidential and there is no charge for your initial call.

Contact Oberheiden, P.C. immediately if you’re facing allegations of healthcare fraud in Portland, Oregon or the surrounding area. Initial calls are confidential and free of charge.

Frequently Asked Questions

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