St. Louis Healthcare Attorneys

Oberheiden, P.C. is a health care law defense firm with experience in the areas of regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. On our team are talented St. Louis healthcare attorneys 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 St. Louis as well as throughout Missouri.

If you’re under investigation for healthcare fraud in St. Louis, call the healthcare fraud defense attorneys at Oberheiden, P.C. today. We provide healthcare fraud defense strategies and have extensive legal experience with:

• OIG and grand jury subpoenas,
• Medicare and Tricare audits,
• Fraud allegation defense,
• Internal investigations,
• Compliance programs,
• Qui tam defense,
• Protection of assets,
• Criminal defense, and
• Federal jury trials.

If you’re being investigated for healthcare fraud in St. Louis or the surrounding areas, call Oberheiden, P.C. and ask to speak with our St. Louis healthcare attorney. Initial calls are confidential and free of charge.

St. Louis Is Watched Closely for Healthcare Fraud

St. Louis is one of nine areas in the nation heavily monitored for healthcare fraud by the federal Medicare Fraud Strike Force. The Medicare Fraud Strike Force is an elite team comprised of select prosecutors and investigators.

St. Louis and its surrounding areas receive such attention because a large number of its health care clients rely on a federal healthcare program. This increases the number of claims filed with the federal government for reimbursement. The government aggressively monitors, investigates, and prosecutes allegations of healthcare fraud. 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 entities. 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)

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)

Defining Healthcare Fraud

Healthcare fraud is an attempt to receive payment from a federal healthcare program for medical equipment or services from an incorrect or misleading claim. Federal healthcare programs include Tricare, Medicare, Medicaid, and federal workers’ compensation. Healthcare fraud relates to at least one of the following laws:

• The Anti-Kickback Statute. Federal healthcare law restricts the exchange of money or other valuables for patient referrals. Physician groups and other health care providers, including ambulatory surgery centers, 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 certain health care entities if health professionals 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 Medicaid reimbursement 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 watched by the federal government. If you’re suspected of operating a “pill mill,” you may face allegations of 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. invites you to review our history of success which demonstrates a commitment to helping clients around the nation avoid federal criminal charges. If you or your healthcare practice or business is being investigated for healthcare fraud in St. Louis or the surrounding area, call our St. Louis healthcare fraud defense attorneys right away. The first call is free and confidential.

Healthcare Fraud Has Civil and Criminal Penalties

Healthcare fraud allegations may result in civil or criminal charges and penalties. Civil penalties may include civil repayment and non-payment of future claims, and you may be excluded from federal healthcare programs. Criminal penalties may include criminal prosecution, federal prison time, and fines that cost you hundreds and thousands of dollars.

If found guilty of criminal healthcare fraud, you may receive a 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
• Life sentence if the healthcare fraud resulted in death

Physician groups and other health professionals ask our St. Louis healthcare lawyers about worst-case scenarios for healthcare fraud allegations in St. Louis. Criminal prosecution can depend on many factors. The severity of the injury received by a patient, if the prosecutor has interest in pursuing criminal charges, and the reason the case began, are a few. If you’re being investigated for healthcare fraud in Saint Louis, call Oberheiden, P.C. today to speak to an experienced St. Louis healthcare attorney from our firm to learn about your options. Initial consultations are confidential and free of charge.

Signs That You’re Facing Criminal Charges

Healthcare fraud cases can be either civil or criminal. With early intervention and compelling defense strategies, Oberheiden, P.C. helps clients avoid criminal charges. Call our law firm today if you’re being investigated for healthcare fraud in St. Louis or the surrounding area. We can begin the process of developing your custom defense strategy right away.

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, reach out to law firms right away.

Determining health care industry charges depends on the legal reading of many factors including OIG subpoenas, and the manner in which the inquiry or allegations are made. Expect criminal prosecution 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 the charges you may face, call Oberheiden, P.C. now. We provide counsel for providers, entire health systems, and other related healthcare businesses. If you need help determining whether you’re facing civil or criminal charges, contact Oberheiden, P.C. now. We represent individual providers, entire healthcare systems, and other related businesses. We provide healthcare defense services to individuals, businesses, and entities in and around St. Louis that are under investigation by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, the Drug Enforcement Administration, the Office of Inspector General, Medicare Fraud Control Unit, St. Louis or state law enforcement, or the Internal Revenue Service.

Healthcare Fraud Defenses for St. Louis Clients

Oberheiden, P.C. works on behalf of St. Louis healthcare fraud defense clients. Many of the members on our St. Louis healthcare lawyers have previous experience as healthcare auditors and healthcare fraud prosecutors with the Department of Justice. This health law experience gives our St. Louis clients valuable insight and legal defense for their healthcare fraud cases.

Immediate government intervention. Our main goal is to help our clients avoid criminal indictment. We know that the best way in which we can advocate for our clients is to quickly contact the federal government. This immediate contact limits the amount of time the federal government has to pursue its case against you. We work to protect your career and your freedom. We can get answers to some important questions typically within a few hours after you retain us. Here are a few initial questions we will ask on your behalf:

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

Challenging the government’s allegations. 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 errors 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 company error and not criminal intent. Some factors leading to such mistakes are:

• Unqualified staff,
• 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 criminal charges.

Protecting your reputation. 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 of our clients express concern about how these allegations will affect their career 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 opportunities to correct misinformation about our clients.

Oberheiden, P.C. has provided legal advocacy for clients across the nation. Call us right away if you’re being investigated for healthcare fraud defense. The initial call is free and confidential.

Frequently Asked Questions

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