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Home Health Agency Compliance Lawyer

government investigations

What Home Health Agencies Should Do to Avoid a Government Investigation

Oberheiden, P.C.
Attorneys-at-Law
As a home health agency compliance law firm, Oberheiden, P.C. represents healthcare business owners, physicians, and companies using our experience to avoid and defend against healthcare fraud investigations. Undoubtedly, home health investigations and hospice care are two particularly strong areas of our practice. Our firm has created a team including former Department of Justice trial attorneys, the former Chief Health Care Fraud Coordinator at the U.S. Attorney’s Office, and former lead prosecutors of the Medicare Fraud Strike Force, as well as other experienced attorneys. Clients from across the United States call us when their reputation or livelihood are under attack.

Investigations of Agencies

The federal government has made combating waste fraud and abuse in the healthcare industry a significant priority.  HHS OIG and the FBI partner with other federal agencies such as the Food and Drug Administration (FDA), the Drug Enforcement Administration (DEA), and the Internal Revenue Service (IRS) in pursuing and prosecuting health care fraud.  Additionally, various state Medicaid Fraud Control Units (MFCU) contribute heavily to the investigation and regulation of the health care industry.  Many of these groups work throughout the United States on federal healthcare task forces investigating fraud allegations.

Home health agencies and practitioners could easily fall victim to a number of pitfalls in the context of regulation and compliance.  The government investigates all aspects of the home health business for potential areas of fraud, waste, or abuse, including:

  • Certification & Re-Certification Errors
  • Unsubstantiated Doctor-Patient Relationships
  • Lack of Appropriate Supervision
  • Questionable Homebound Status
  • Billing Problems and Errors
  • Physician Kickbacks

Oberheiden, P.C. assists clients with:

Put our highly experienced team on your side

Dr. Nick Oberheiden
Dr. Nick Oberheiden

Attorney-at-Law & Founder

Amanda Marshall
Amanda Marshall

Former U.S. Attorney

Local Counsel (Beaverton, OR)

Lynette S. Byrd
Lynette S. Byrd

Former Federal Prosecutor

Partner

Aaron L. Wiley
Aaron L. Wiley

Former Federal Prosecutor

Local Counsel (Dallas, TX)

Subodh Chandra
Subodh Chandra

Former Federal Prosecutor

Local Counsel (Cleveland, OH)

R. Brandon Johnson
R. Brandon Johnson

Former Federal Prosecutor

Local Counsel (Charleston, WV)

Roger Bach
Roger Bach
(Non-Lawyer)

Former Special Agent, OIG

Dennis A. Wichern
Dennis A. Wichern
(Non-Lawyer)

Former Special Agent-in-Charge

Chris Anderson
Chris Anderson
(Non-Lawyer)

Compliance Consultant

Beverly Gibson
Beverly Gibson
(Non-Lawyer)

Compliance Auditor

Joe Lewis
Joe Lewis
(Non-Lawyer)

Pharmacy Compliance

Valerie Rivera
Valerie Rivera
(Non-Lawyer)

Private Investigator

  • Medicare & Medicaid Fraud
  • Anti-Kickback Violations
  • OIG Subpoenas
  • Grand Jury Subpoenas
  • False Claims Act & Qui Tam Defense
  • Stark Law (Self-Referrals)
  • HIPAA Compliance
  • Certifications of Medical Necessity
  • Billing Errors and Overbilling
  • RAC & ZPIC Audits
  • IRS Investigations

Most home health care and hospice care prosecutions are pursued pursuant the general healthcare fraud statute at 18 U.S.C. 1347. This statute defines healthcare fraud as the knowing and willful execution, or attempt thereof, of a scheme or artifice to defraud a health care benefit program. Penalties may include:

  • Up to 10 years in prison for each count of fraud;
  • Up to 20 years in prison if the fraud resulted in serious bodily injury;
  • A life sentence if the fraud resulted in the patient’s death;
  • Exclusion from federal healthcare programs;
  • Criminal fines; and
  • License revocations.

The former federal prosecutors and attorneys of Oberheiden, P.C. are available to discuss your case. Don’t let the situation get out of control. Without proper attention and legal assistance it is possible that the government may attempt to build a criminal case against you. Call us today and let us identify your options.

This is Why You Are in Good Hands

I found Dr. Nick Oberheiden online and the moment I spoke with him, I knew he is a true federal law expert. Nick outlined a defense strategy that was so thought through and so out of this world--and he executed and delivered like I would never have imagined. Nick is unbelievably good!! Nick is the very best of the best lawyers. Hire Nick if you want a classy, smart, and extremely successful lawyer.read more
David Lo
David L.
Nick is extremely professional and knows what he is doing. He is also very kind as a person (unless he is in court!) I would recommend him to just about anyone if they need an amazing lawyer that is top notch and would frankly be scary to face in the court room. He will always do a great job representing his clients. Thank you very much.read more
Anna Pham
Anna P.
Nick is the absolute top expert in any federal case
Jeff Crilley
Jeff C.
Extremely successful attorney with brilliant litigation skills.
Shannon Faulk
Shannon F.
Smart. Smarter. Nick. As a healthcare executive, I once ran into a litigation issue. I hired Nick and, literally, before I knew it the case was resolved in my favor. Nick has an incredible presence and every lawyer in the room knows that Nick will do exactly what he says. It was a mesmerizing experience to see Nick in action! Very calm and determined, Nick is the absolute top litigator.read more
Whitney Bryant Milam
Whitney Bryant M.
Nick has been a friend and trusted advisor for almost 10 years. As anyone just looking at his bio can tell, Nick is an outstanding attorney in highest demand across the country. All healthcare providers should hire attorney Nick Oberheiden!! You will not be disappointed.
Pamela mulrooney
Pamela M.
I have never witnessed a lawyer with such uncompromising client commitment, integrity, and dedication. On weekends, at night, in the morning— Nick is always there for his clients, constantly identifying solutions, no matter how complex the situation. The only question I have after all these years of knowing Nick: Does he ever sleep?read more
Laura Driscoll
Laura D.
Dr. Oberheiden has served as council and represented our company on several occasions, even during depositions, contract reviews and providing invaluable advice on multiple occasions that transpired into multilevel success in our business. He and his teams knowledge of both local, state and federal statues, accompanied by their areas of expertise law regarding best asset protection, estate planning and wealth management solutions have provided both professional and personal growth for my companies, safeguarding them and protection my family’s name and legacy. I would recommend this firm and Dr. Nick Oberheiden without hesitation. I have no doubt that you will experience success with his council.read more
Corban Milam
Corban M.
I have worked with Nick Oberheiden for over ten years on various litigation matters in and around New York City. Nick is an accomplished and seasoned lawyer and litigator---efficient, reliable, practical and, at the same time, highly academic. Nick will take the time necessary to understand a client's short- and long-term goals, and tailor his representation and advice to work toward and achieve those ends. Nick is a zealous advocate for his client, and will never sacrifice his client's interests for a quick or easy resolution to a case. At the end of the day, Nick is a great person to know if you or your business is in need of a top litigator or defense attorney.read more
Brendan Carosi
Brendan C.
When I was faced with one of the most terrifying and unexpected situations in my life, I called Dr. Oberheiden. I had vetted other attorneys and came right back to him. His knowledge, expertise, and reassuring presence made the decision easy. Throughout my case, his level of communication was what I needed and expected. He constantly updated me on the status and progress of my case and was able to “talk me off the ledge” when the stress of it all would set in. He is simply the best of the best...there’s not a question about it.read more
Angela Lee
Angela L.
Nick is a superb lawyer with exceptional skills and a formidable personality. Nick works harder, he thinks smarter, and he delivers faster than any lawyer you will ever find. Good, better, Nick!
Jacqueline Singleton
Jacqueline S.
1st class service. Atty. Iberheiden and Atty. Lynette Byrd were always available for us during the whole process of our Home Health Audit. Thank you so much!
Ed Orosa
Ed O.
I am a healthcare compliance consultant with almost 25 years of experience. The one advice I have for anyone seeking a lawyer with unbeatable healthcare law experience is to hire attorney Nick Oberheiden. For the past 8 years, I have worked with Nick on a variety of healthcare matters—from DEA compliance to DOL supervisory rules to setting up PT and pain management clinics. I have never once seen a client not being 100% intrigued by Nick’s proven expertise in the field of healthcare structuring and compliance. Dr. S.T.read more
Raft Consultants
Raft C.
Nick Oberheiden is a spectacular lawyer, a true life saver. Nick is simply the very best!
Michael P
Michael P
Nick Oberheiden is the absolute best federal litigation attorney. Nick gives you the immediate comfort of feeling 100% protected. He is polite, respectful— and extremely compelling. His legal strategy turned out to be brilliant.
Marshall M
Marshall M
Great firm, with a great firm record of experienced healthcare and litigation attorneys.
Chris Anderson
Chris A.
Great attorney who will fight to protect your rights. I would recommend Nick to any friend or family member.
Gerrid Smith
Gerrid S.

Civil v. Criminal

Healthcare investigations take several different forms.  Some investigations are civil in nature.  Civil investigations mostly deal with False Claims Act allegations.  Many times a False Claims Act case stems from a whistleblower action or Qui Tam where an individual is reporting allegations of wrongdoing to the government.  The purpose of a civil fraud investigation is to identify provider overpayments in federal programs and to assess monetary damages.  The federal government has recouped billions of dollars through civil investigations and has increased its efforts in this area in recent years.

Criminal investigations are different from civil investigations in that the government’s goal is not only to recoup money from a provider, but to charge an individual or a group of individuals with a felony.  A felony conviction normally results in incarceration, significant monetary damages and the loss of the provider’s professional license.

Many times civil and criminal investigations intersect and overlap in what is known as a parallel investigation.  In a parallel investigation the government is working with several sets of agents who assess allegations of wrongdoing from the civil and criminal perspective.  It is important to note that the information that the government is evaluating in this parallel process is many times the same set of facts or circumstances.  The main element the government will be focusing on is the intent of the provider—meaning did the provider intentionally create a scheme to defraud the government or was the improper billing a mistake or oversight.  Clearly this is the most crucial part of an investigation and one that needs to be addressed by experienced counsel in order to move the investigation away from the criminal and toward the civil side.

Home Health Compliance Recommendations

Oberheiden, P.C. has successfully represented clients throughout the United States who were under investigation by the Department of Justice (DOJ), the Department of Defense (DOD), the Federal Bureau of Investigation (FBI), Drug Enforcement Administration (DEA), the Office of Inspector General (OIG), the Medicaid Fraud Control Unit (MFCU), and the Internal Revenue Service (IRS). Our clients benefit from the combined experience that our team of former federal healthcare prosecutors, former leaders of the Medicare Fraud Strike Force, and experienced defense attorneys bring to the table. We routinely advise healthcare clients in False Claims Act, Stark Law, Anti-Kickback, Medicare, Medicaid, Tricare, and DOL investigations.

Are you accused of a federal crime?

Don’t delay. Learn about your rights.

Text Dr. Nick Oberheiden now!

(310) 873-8140

Below is a list of preventative measures we have taken on behalf of clients:

  • Effective Compliance (establish, monitor, enforce OIG-approved compliance policies; appoint and train a compliance officer, compliance training re HIPAA, fraud and abuse laws, specific home health rules e.g. certification);
  • Corporate Structure (employment manual, make sure employment agreements, contractor agreement, operating agreement are consistent with state and federal regulations);
  • Voluntary Audit (vet all corporate documents and policies, take sample files and review billing codes and procedures, review all company policies, extensive compliance training);
  • Immediate Defense (if under investigation or audit, Emergency Defense Package—rushed and expedited compliance perfection, activate defense plan, board meetings, identify company weaknesses and rectify, bring in experts from relevant agencies- former FBI etc.); and
  • Media Protection (your name and reputation are key, nobody wants to be in the news, we work with the media and where needed oppose unjust reporting or sensational and biased stories).

Home Health Agency Compliance Lawyers

In light of heavy and aggressive government scrutiny against Medicare business owners and medical service providers, it is imperative to consult with knowledgeable and experienced counsel. All clients of Oberheiden, P.C. are represented by senior attorneys.

We recognize the importance of each matter and we dedicate our fullest attention to each client. Our home health agency complaince lawyers are available to discuss your concerns in a free and confidential consultation, including on weekends.

Oberheiden, P.C.
Compliance – Litigation – Defense
(800) 810-0259
(214) 469-9009
www.federal-lawyer.com
This information has been prepared for informational purposes only and does not constitute legal advice. This information may constitute attorney advertising in some jurisdictions. Reading of this information does not create an attorney-client relationship. Prior results do not guarantee similar future outcomes. Oberheiden, P.C. is a Texas LLP with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

Meet Nick

Impeccable Service

ratingratingratingratingrating

I found Dr. Nick Oberheiden online and the moment I spoke with him, I knew he is a true federal law expert. Nick outlined a defense strategy that was so thought through and so out of this world–and he executed and delivered like I would never have imagined. Nick is unbelievably good!! Nick is the very best of the best lawyers. Hire Nick if you want a classy, smart, and extremely successful lawyer.

– David Lo

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