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Oberheiden Attorneys

Health Care Fraud Defense Lawyers serving theLakeland, Florida Area

Health care providers, entities, and businesses in Lakeland, Florida and the surrounding areas are at risk of being accused of health care fraud. The Oberheiden & McMurrey, LLP is here to help. Oberheiden & McMurrey, LLP has substantive experience in health care fraud defense, Medicare and Tricare audits, protection of assets, compliance programs, jury trials, fraud allegation defense, qui tam defense, OIG and grand jury subpoenas, criminal defense, and internal investigations. Our Health Care Fraud Defense Team includes such talent as a former Chief Health Care Fraud Coordinator for the U.S. Attorney’s Office, several former health care fraud prosecutors, and elite former lead prosecutors of the Medicare Fraud Strike Force. We proudly offer our services to clients in Lakeland as well as throughout Florida State.

If you’re under investigation for health care fraud in Lakeland, Florida or the surrounding areas, call us right away. Ask to speak with a member of our Health Care Fraud Defense Team. Initial calls are free and confidential.

Lakeland, Florida Is Diligently Watched for Health Care Fraud

Lakeland, Florida is one of nine areas in the United States that is diligently monitored for health care fraud. The area is directly monitored by the Medicare Fraud Strike Force. This is a federal investigative body that is comprised of prosecutors and investigators from the Department of Justice, Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. Other federal agencies often have members who are part of this team.

Lakeland, Florida and the surrounding areas are constantly monitored for health care fraud because of the number of citizens who rely on a federal health care program. Since there are more beneficiaries in the area, there are more claims filed with the federal government for reimbursement. The government believes that this large number of claims means an increase in health care fraud.

In 2016, the Department of Justice released a statement that revealed that they had investigated around 300 cases of health care fraud. Individual health care providers were the center of 80 of those investigations. The rest of the cases centered on a health care entity or business. The agency stated that they recovered more than $900 million in fraudulently paid out claims.

What Is Federal Health Care Fraud?

Federal health care fraud is when at least one claim is fraudulently filed for reimbursement for medical services or equipment with a federal health care 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 health care law outright prohibits kickbacks in exchange for referrals. Any individual (including doctors, marketing representatives, and business owners) is subject to prosecution for violating the Anti-Kickback statute for offering or providing payment or other valuables in exchange for patient referrals.
  • Stark Law. Stark Law, also known as the Self-Referral Law, prohibits doctors from referring patients to specific health care 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 health care program, you are required by law to abide by the False Claims Act. If the 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.
  • Prescription Fraud. The federal government pays special attention to health care practices that have 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.
  • Billing Fraud. 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.
  • Certification Errors. The home health care and hospice industry is frequently a practice that the federal government chooses to maintain a close eye on. The most common accusations include fraudulent certification for home health care and hospice care.

Oberheiden & McMurrey, LLP’s main objective is to help clients avoid criminal charges. If you’re being investigated for federal health care fraud in Lakeland, Florida or the surrounding areas, call us right away. The call is free and confidential.

What Are the Civil and Criminal Penalties of Health Care Fraud?

Federal health care fraud has civil and criminal penalties associated with it. If you’re tried in civil court, you could be ordered to repay the federal claims, lose the ability to be reimbursed for future claims, and you could be barred from participating in federal health care programs.

If you’re tried in criminal court, you could end up with a criminal records, fines that cost you hundreds of thousands of dollars, and you could even be sentenced to federal prison:

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

One of the most common questions that we’re asked is what the worst-case scenario is for health care fraud allegations in Lakeland, Florida. The answer is criminal charges or receiving a sentence for federal prison. There are factors that determine whether you will face either of those penalties. Factors include the severity of any injury suffered by the patient, whether the prosecutor is interested in pursuing criminal charges against you or your business, and the reason why the investigation against you was started.

Oberheiden & McMurrey, LLP provides legal defense for health care professionals, businesses, and entities in Lakeland, Florida and the surrounding areas that are accused of health care fraud. Our experience as previous health care prosecutors for the federal government, along with our experience as defense attorneys, has enabled us to provide excellent insight for our clients.

Is the Investigation Against You Civil or Criminal?

Health care fraud investigations that occur in Lakeland, Florida and the surrounding areas can be civil or criminal. Often, these investigations can start as civil and then turn into a criminal matter. This is why you should contact Oberheiden & McMurrey, LLP when you find out that you’re being investigated.

Being contacted by a prosecutor is not an indicator to determine if the investigation against you is criminal. All federal agencies with prosecutors have both a civil and a criminal branch. That’s why you cannot use contact by a federal prosecutor as an indicator. Rather, signs of a criminal investigation may 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.

Using Health Care Fraud Defenses

Oberheiden & McMurrey, LLP is a health care fraud defense law firm. We provide legal defenses for individual health care providers, entire health care systems, and businesses in Lakeland, Florida and the surrounding areas. We’ve provided help in hundreds of cases. Several of the members of our health care Fraud Defense Team have experience as former health care auditors and as health care fraud prosecutors with both the Department of Justice and the Medicare Fraud Strike Force. We use this experience to develop strategic defenses for each of our clients.

Immediately reaching out to the federal government. The main priority of our firm is to help our clients avoid criminal charges. Once retained, we immediately contact the federal government. This shortens the amount of time that the federal government has to investigate you without interruption. If the federal government has a long period of time to investigate you, you could face federal charges. Our goal is to get answers to the most important questions within hours:

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

Showing our clients did not commit a crime. The federal government must meet a high burden of proof to show that you committed a crime and acted with criminal intent. We evaluate the evidence given by the federal government to determine if they are able to meet that burden of proof. 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 care 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 the frequently changing laws and rules that are involved in health care.

The use of strategic defenses for each client. Oberheiden & McMurrey, LLP analyzes each case in order to utilize the right strategic defenses. This may include using 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 entire resolve a health care fraud case.

Protecting your professional reputation. An allegation of health care fraud can damage your professional reputation. Oberheiden & McMurrey, LLP will work to protect your professional reputation. We look for opportunities to correct misinformation, and we also address slanderous comments made by the media.

If you’re in Lakeland, Florida or the surrounding areas and you’re being investigated for health care fraud, call Oberheiden & McMurrey, LLP now. The call is free and confidential.

Our Track Record

The commitment of Oberheiden & McMurrey, LLP is to avoid criminal charges and to shield our client’s medical business from government intrusion. Our team of former health care prosecutors and experienced defense attorneys have a distinguished history of protecting business owners, executives, lawyers, physicians, hospitals, laboratories, pharmacies, home health care entities, and many other health care organizations against any form of alleged health care fraud. Here are some recent examples of our case outcomes.

  • Representation of a Pharmacy Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of a Marketing Group Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Physicians Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the U.S. Attorney’s Office for alleged Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of a Health Care Services Company against an Investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for Alleged False Claims Act and Stark Law Violations.
    Result: No civil or criminal liability.
  • Representation of a Health Care Marketing Group Against an Investigation by the Office of Inspector General for Alleged Health Care Fraud.
    Result: No civil or criminal liability.
  • Representation of a Physician against an Investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare Fraud, Stark Law Violations, and Anti-Kickbacks.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the Office of Inspector General for Alleged False Claims Act and Medicare Violations.
    Result: No civil or criminal liability.
  • Representation of Physician Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud and False Claims Act Violations.
    Result: No civil or criminal liability.
  • Representation of Physician Investigated by the Office of Inspector General for Medicaid Fraud and Stark Law Violations.
    Result: No civil or criminal liability.
  • Representation of Health Care Organization Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.
  • Representation of Physician Group Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud, Stark Law Violations, and False Claims Act Violations.
    Result: No civil or criminal liability.
  • Representation of Physician Group Investigated by the Department of Health and Human Services and the Office of Inspector General for False Claims Act Violations.
    Result: No civil or criminal liability.
  • Representation of a Physician Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Pharmacy Investigated by the Department of Justice and the Office of Inspector General for Department of Labor Program Fraud.
    Result: No civil or criminal liability.

Health Care Fraud Defense Lawyers Serving Lakeland, Florida

Nick OberheidenNick Oberheidenis a health care fraud defense attorney. Dr. Oberheiden has successfully represented health care 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 health care 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.

Lynette ByrdLynette S. Byrd is a former Assistant United States Attorney (AUSA). Clients greatly benefit from Ms. Byrd’s experience from the Department of Justice, where she prosecuted health care fraud, Anti-Kickback violations, False Claims Act, and Stark violations on behalf of the United States. Ms. Byrd has immense experience with health care law enforcement, and she regularly argues federal matters for her clients.

We are available every day of the year. You can call us directly or complete our contact form or by emailing us directly.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving Lakeland, Florida and Surrounding Areas
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 & McMurrey, LLP is a Texas LLP with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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