Las Vegas, Nevada Medicare Fraud Defense Attorneys

Medicare fraud allegations can ruin your Las Vegas medical practice or business. If you’re facing these allegations in Las Vegas or the surrounding areas, call the Oberheiden, P.C.. We are knowledgeable in Tricare audits, Medicare audits, development and implementation of Medicare fraud strategies, asset protection, programs for compliance, jury trial knowledge, fraud defense, qui tam defense strategies, subpoenas from the OIG or a grand jury, federal criminal defense, and internal investigations. Oberheiden’s legal team includes a former Chief Health Care Fraud Coordinator from a U.S. Attorney’s office, several former federal health care prosecutors from the Medicare Fraud Strike Force, former senior trial attorneys from the Department of Justice, and highly skilled and educated attorneys.

What Is the Definition of Medicare Fraud?

Medicare fraud is a federal offense with both civil and criminal consequences. It involves the filing of one or more claims with a federal health care program. These claims are filed by health care providers, businesses, or entities in order to receive reimbursement for medical services or equipment that was provided to a federal health care program beneficiary. Despite the name, Medicare fraud includes more than just Medicare. It also includes Medicaid, Tricare, and federal workers’ compensation. If you’re accused of Medicare fraud, you will be investigated for at least one of the following:

  • Violating the Anti-Kickback Statute;
  • Violating the False Claims Act
  • Violating Stark Law (the Physician Self-Referral Law)
  • Violating the Social Security Act
  • Violating U.S. Criminal Code

Las Vegas medical providers, pharmacies, businesses, and other medical entities are investigated for Medicare fraud more often when compared with similar businesses and facilities in other areas of the nation. This occurs because Las Vegas is one of nine areas in the United States with a large number of federal health care program beneficiaries. This causes the area to be under constant scrutiny by the Medicare Fraud Strike Force. The federal government believes that, in areas like Las Vegas that have more claims filed, there is a higher probability that they will pay out on false claims.

The Medicare Fraud Strike Force is a combined agency of federal investigators and prosecutors. They monitor the area for Medicare fraud. They investigate potential cases. Ultimately, their job is to prosecute people and entities that they believe are committing Medicare Fraud. The federal agencies involved with the Medicare Fraud Strike Force come from the DOJ, DEA, DOD, Department of Human Services, the Office of Inspector General, the FBI, and the IRS. However, other federal agencies can be involved. If you’re contacted by the Medicare Fraud Strike Force or a member of a federal agency, immediately contact Oberheiden, P.C. to learn more about your options.

Medicare Fraud Investigations in Las Vegas, Nevada

In Las Vegas and the surrounding areas, Medicare fraud investigations usually begin because a provider, business, or an entity files a claim with a federal government health care program. That claim is deemed inaccurate or fraudulent by the federal health care program. These claims usually include some sort of unauthorized service or medical equipment, have an incorrect charge, or have an excessive charge. The most common billing inaccuracies for Las Vegas and the surrounding areas include:

  • Phantom billing – billing for services that were never performed;
  • Double billing for medical equipment or services;
  • Submitting a claim for medically unnecessary medical services or equipment;
  • Submitting a claim for medically unnecessary medical supplies;
  • Submitting a claim for a medically unnecessary certification (including a claim for hospice or home health care);
  • Inflating charges;
  • Up-coding;
  • The overuse of medical equipment of services;
  • Providing or accepting kickbacks.

Doctors, nurses, other individual medical providers, businesses owned by physicians, nursing homes, registered care providers and facilities, hospitals, pharmacies, labs, cancer centers, DME providers, and DNA providers are some of the most common targets of Medicare fraud investigations in Las Vegas, Nevada and the surrounding areas.

What Are the Civil and Criminal Consequences of Medicare Fraud?

Medicare fraud can result in civil or criminal consequences. Civil penalties for Medicare fraud in Las Vegas may include:

  • Repayment of claims in questions;
  • Future claims aren’t paid;
  • A fine of up to $11,000 per false claim;
  • Exclusion from federal health care programs;
  • Assignment of treble damages;
  • Attorney fees.

You could also be called before the state disciplinary or licensing board. This may result in the loss of your professional license or the loss of your hospital privileges.

Criminal consequences for Medicare fraud in Las Vegas may include:

  • Fines that cost you hundreds of thousands of dollars, even for a misdemeanor;
  • A criminal record;
  • A federal prison sentence of up to 10 years for each count of Medicare fraud for which you are convicted;
  • Federal prison sentence of up to 20 years for each count of Medicare fraud that resulted in serious bodily harm to the patient or patients;
  • A life sentence in federal prison for Medicare fraud that results in the death of a patient.

Hiring the Right Las Vegas Attorney for Medicare Fraud

Medicare fraud is extremely serious. You must hire the right Las Vegas attorney to help protect you against this federal allegation. Medicare fraud allegations often include federal criminal charges such as mail fraud, wire fraud, money laundering, or tax fraud. You must do your research to make sure that you hire a Las Vegas attorney who is well-suited to deal with the unique needs of this type of case.

A Las Vegas health care fraud defense attorney understands both the minute details of health care law and the requirements to mount a federal criminal defense on your behalf. Look for these four key traits:

  • A successful record when handling Medicare fraud cases;
  • Knowledge of the Medicare fraud and health care fraud laws and regulations;
  • Knowledge of statutory exceptions;
  • Both litigation and jury trial practices.

You should also ask these three questions to better understand the skills held by the health care fraud defense attorney:

  • How many Medicare fraud cases have you handled throughout your career?
  • How many of those resulted in no civil or criminal charges or in dismissals for your clients?
  • How many of those cases were tried in court?

Defense Strategies for Medicare Fraud in Las Vegas

Oberheiden, P.C. analyzes each case on its own facts and merits to determine the right defense strategies. We do look to settle cases with the federal government when possible, but we also have   as federal trial lawyers. We have assisted hundreds of clients. Members of our Health Care Fraud Defense Team have former skills as federal health care prosecutors and federal trial lawyers. We’ve used this knowledge to develop strategies that we use for each of our Las Vegas Medicare fraud clients.

Immediate contact. The main priority of Oberheiden, P.C. is to resolve the accusation and help our clients avoid criminal charges. This is why we immediately contact the federal investigator involved after we are retained. We’ve learned that this gives us the opportunity to get answers to the most important questions:

  • What is the investigation about?
  • What prompted the investigation?
  • Is the investigation civil or criminal?
  • Which federal agencies are involved?
  • What is the ultimate goal of the government?
  • How can this matter be resolved?

Usually, we are able to get answers to those questions within just a few hours after we are retained by our client. If you’re being investigated, call Oberheiden, P.C. now. Do not give the federal government time to investigate you without first securing legal representation.

Weighing the evidence. The federal government collects evidence that determines if you committed a crime and if you acted with criminal intent. They must be able to meet a legal standard known as “beyond a reasonable doubt.” Our legal team analyzes the evidence presented by the federal government to determine if they are able to reach this high standard. This one strategy has given the following results on a regular basis:

  • Dismissal of charges;
  • No criminal charges;
  • Client retains professional license;
  • Civil fine with no criminal plea;
  • Reducing a felony to a misdemeanor;
  • No federal prison sentence.

Showing lack of intent. The federal government tries to prove that you made a decision to attempt to defraud the government. This is hard for the federal government to prove because most Las Vegas Medicare fraud investigations start because of a mistake that is made. Usually, a health care provider, facility, or business makes a mistake during the billing and coding process. The most common errors that cause an investigation include:

  • Using unqualified staff;
  • Inadequate supervision;
  • Inappropriate delegation and outsourcing;
  • Structural errors;
  • Human errors;
  • Oversight;
  • Employees who are overwhelmed;
  • No Medicare compliance program in place;
  • The changing health care laws and rules.

While these mistakes should be corrected, they aren’t crimes. Oberheiden, P.C. works to prove that you made a mistake that you are willing to address and correct.

Appropriate Medicare fraud defenses for each case. Medicare fraud cases are similar because they all have the same basic allegation. However, they can’t all have the same defense because each case has its own facts. We analyze each case to determine the appropriate Medicare fraud defenses. One of our clients was recently accused of providing fraudulent certification for home health care services. We proved that our client was legally protected by a recognized delegation exception and that the certification was compliant within the law. In another recent case, we refused to admit liability on behalf of our client. Instead, we proved to the federal prosecutor that our client acted within a safe harbor exception.

Oberheiden, P.C.

Oberheiden, P.C. provides legal advocacy for Medicare fraud defense for Las Vegas, Nevada and the surrounding areas. We serve individual medical providers, entities, business owners and executives, attorneys, hospitals, clinics, pharmacies, labs, and other related medical businesses being investigated for fraudulent billing, illegal kickbacks, and allegations of medically unnecessary services, services not rendered, or unlawful joint ventures. We can help you in many areas, including:

  • Health care fraud defense
  • Compliance program creation and implementation
  • Internal investigations
  • Asset protection for physicians
  • Licensure or disciplinary proceedings
  • Jury trials

Oberheiden, P.C. represents both individuals and entire health care systems or businesses in Las Vegas, Nevada and the surrounding areas. If you’re being investigated by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, Las Vegas or Nevada state law enforcement, contact Oberheiden, P.C.. Initial phone consultations are free of charge and confidential.

Our Track Record

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

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.

If you are under
you should contact us today

Contact the Experienced Attorneys of Oberheiden, P.C. Now for a Confidential Consultation

Contact Us Now