Former federal prosecutors
offering unparalleled knowledge and a proven track record


Meet the Team
Oberheiden Attorneys

Health Care Fraud Defense Lawyer Serving Los Angeles, California

Los Angeles Office
12400 Wilshire Blvd #1180
Los Angeles, CA 90025
310-873-8140
(Meeting location by appointment only)

If your health care practice or business serves others in Los Angeles, California or the surrounding area and you’re facing an allegation of health care fraud, call the Oberheiden & McMurrey, LLP right away. Oberheiden & McMurrey, LLP has in-depth legal 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. Our attorneys serve clients in Los Angeles, California as well as the rest of the state.

To learn about your legal rights when you’re being accused of health care fraud, call Oberheiden & McMurrey, LLP now and request to speak with a member of our Health Care Fraud Defense Team. Initial consultations are free of charge and confidential.

Los Angeles Is Strictly Scrutinized for Health Care Fraud

Los Angeles is one of nine regions in the United States that is strictly scrutinized for instances of health care fraud. The area is watched by the Medicare Fraud Strike Force. The Medicare Fraud Strike Force is a select investigative team comprised of prosecutors and investigators from several federal agencies, including the Department of Justice, Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. This list isn’t all-inclusive. Other federal agencies may have a presence on the team for any given investigation.

Los Angeles and the surrounding areas are closely watched because of the number of citizens who rely on a federal health care program. This increases the number of claims filed with the federal government for reimbursement. Because of this, the federal government aggressively monitors investigates, and prosecutes allegations of health care fraud. In fact, in 2016, the Department of Justice investigated more than 300 cases involving health care fraud. Around 80 of those allegations involved individual health care providers. The other cases involved health care entities and businesses. The agency recovered more than $900 million in fraudulently paid out claims.

Defining Health Care Fraud

Federal health care fraud is defined as an attempt to receive reimbursement for medical services or equipment through a government health care program, including Medicaid, Medicare, Tricare, or federal workers’ compensation by filing one or more bogus claims. It likely includes a violation of at least one of the following:

  • 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 is proud of its track record of success. Our main objective is to help our clients avoid criminal charges. If you or your health care practice or business are being investigated for health care fraud in Los Angeles or the surrounding areas, call Oberheiden & McMurrey, LLP right away. The call is free and confidential.

Health Care Fraud Has Serious Civil and Criminal Penalties

Health care fraud is an extremely serious allegation. You can be charged in civil or criminal court. Both courts have serious penalties. In civil court, you may be relegated to civil repayment of claims, non-payment of your future claims, and you may be excluded from federal health care programs in the future. You may also be called before the state disciplinary board, lose your license, and be stripped of your hospital privileges.

Criminal penalties include more than a criminal record. You could also be ordered to pay fines that cost you hundreds of thousands of dollars or you could face federal prison time of up to:

  • 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

Oberheiden & McMurrey, LLP is often asked about the worst-case scenario for this type of allegation in Los Angeles. The likelihood of whether someone will face criminal charges or if he or she will receive a prison sentence depends on many factors including the severity of any injury suffered by the patients, whether the prosecutor is interested in pursuing criminal charges, and the reason why the investigation was started.

Oberheiden & McMurrey, LLP is ready to help with your Los Angeles health care fraud defense case. We have dual experience as former health care prosecutors and as defense attorneys. If you’re being investigated for health care fraud, you should call Oberheiden & McMurrey, LLP to learn about your legal options. Initial calls are free and confidential.

How Do You Know if the Investigation is Criminal?

Health care fraud investigations can be civil or criminal. We use proven methods of defense such as early intervention and custom defense strategies to help our clients avoid criminal charges. Call us right away if you’re being investigated.

Being contacted by a prosecutor is not an absolute indicator of a criminal investigation. All federal agencies that have prosecutors have both civil and criminal divisions. This is why you cannot use the fact that you were contacted by a prosecutor as an indicator of a criminal investigation. Determining whether the investigation is criminal can depend on the interpretation of many elements, including the receipt of OIG subpoenas, the way that an inquiry or the allegation is made, and other indicators such as a criminal search warrant, seizure warrants, arrest warrants, target letters, involvement of federal criminal prosecutors, IRS involvement, or grand jury subpoenas.

Call Oberheiden & McMurrey, LLP if you have questions about whether you are facing a civil or criminal investigation. We represent individual providers, entire health care systems, and related businesses. We provide our health care defense services to individuals, businesses, and entities in and around Los Angeles that are being investigated by the Department of Justice, the Department of Defense, Office of Inspector General, Drug Enforcement Administration, the Federal Bureau of Investigation, Medicare Fraud Control unit, Los Angeles or California law enforcement, or the IRS.

Health Care Fraud Defense

Oberheiden & McMurrey, LLP is a health care fraud defense law firm providing services to individual health care providers, health care systems, and businesses in Los Angeles, California and the surrounding areas. During our time as a law firm, we’ve handled hundreds of health care fraud cases. Several of our attorneys have previous experience as health care auditors and health care fraud prosecutors with the Department of Justice. We provide their invaluable insight directly to our clients.

Immediate legal advocacy for our clients. In each case, our main objective is to help our clients avoid criminal charges. We’ve learned that the most effective way to defend our clients is to immediately contact the federal prosecutor. This minimizes the amount of time that the federal government has to investigate you without interruption. Generally, we can get answers to the most important questions within just a few hours after we are engaged:

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

Testing the legal standards. The federal government must meet high legal standards to show that you committed a crime with criminal intent. We test their evidence in every case. Prosecutors generally cite billing inaccuracies as an attempt to prove that you acted with criminal intent. We’ve learned from our experience that mistakes happen; those mistakes should not be the equivalent of criminal fraud. Oberheiden & McMurrey, LLP has provided successful legal defense for clients across the nation by proving that billing inaccuracies are the result of human or business mistakes and that they are not the outcome of intentional fraud. We know that unqualified workers, delegation errors, outsourcing errors, lack of oversight, insufficient supervision, and the frequently changing laws and rules that are involved in health care are the most frequent errors that cause these investigations. Although these issues should be corrected, they should not lead to criminal liability.

Strategic defenses for Los Angeles clients. Oberheiden & McMurrey, LLP develops strategic legal defenses for our Los Angeles clients. This often includes locating and using applicable statutory loopholes and exceptions. For example, in the context of Stark Law which involves medical necessity certifications, we have been able to point to exceptions to either attenuate or entirely resolve a health care fraud case.

Defending your professional reputation. Oberheiden & McMurrey, LLP is committed to defending your professional reputation in and out of court. Accusations of health care fraud can be extremely harmful to your career. Rightfully, many of our clients have grave concern about how these accusations will affect their future. The media has the ability to tarnish your image by spreading biased reports and rumors. Our lawyers look for opportunities to correct misinformation and to address slanderous comments made about our clients.

Contact Oberheiden & McMurrey, LLP immediately to discuss your case. The initial 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 Los Angeles

Nick OberheidenNick Oberheiden is 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.

310-873-8140
Including Weekends
Oberheiden & McMurrey, LLP

Serving: Diamond Bar, Valencia, Newhall, Santa Monica, Canyon Country, Saugus, Monterey park, Santa Clarita, Beverly Hills, Glendale, Pasadena, Long Beach, Bell Gardens, Bellflower, Alhambra, Arcadia, Azusa, Baldwin Park, Bell, Burbank, Carson, Cerritos, Claremont, Compton, Covina, Culver City, Downey, Elmonte

Zip Codes: 90040, 90058, 90059, 90066, 90096, 90201, 90239, 90240, 90241, 90242, 90248, 90291, 90292, 90401, 90402, 90403, 90623, 90638, 90640, 90701, 90703, 90706, 90707, 90710, 90715, 90740, 90755, 91001, 91010, 91011, 91020, 91046, 91066, 91077, 91182, 91201, 91202, 91321, 91321, 91322, 91322, 91350, 91351, 91351, 91354, 91526, 91702, 91706, 91711, 91722, 91723, 91724, 91732, 91732, 91741, 91746, 91754, 91755, 91756, 91765, 91776, 91780, 91789, 91896, 91899, 90201, 90230, 90231, 90233, 01905, 01906, 02151, 90744, 90745, 90746, 90747, 90748, 90749, 91006, 91007, 90801, 90202, 90802, 90803, 90804, 90805, 90806, 90807, 90808, 90809, 90810, 90811, 90812, 90813, 90814, 90815, 91101, 91102, 91103, 91104, 91105, 91106, 91107, 91108, 91109, 91110, 91111, 91112, 91113, 91114, 91115, 91116, 91117, 91118, 91119, 91120, 91121, 91122, 91123, 91124, 91125, 91126, 91801, 91802, 91803, 91804, 90209, 90210, 90211, 90212, 90213, 91501, 91502, 91503, 91504, 91505, 91506, 91507, 91508, 91509, 91510, 91521, 91522, 91523, 91731, 91732, 91733, 91734, 91735

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.

Who Will Handle Your Case

When you hire us, you will not work with paralegals or junior lawyers. Each lawyer in our Healthcare Practice Group has handled at least one hundred (100) matters in the healthcare industry. So, when you call, you can expect a lawyer that immediately connects with your concerns and who brings in a wealth of experience and competence. For example, you need someone like Lynette S. Byrd, a former federal prosecutor in healthcare matters, who recently left the government and who is now sharing the valuable insights she gained as a healthcare prosecutor with our clients.

Bill C. McMurrey

Bill C.
McMURREY

Dr. Nick Oberheiden

Dr. Nick
OBERHEIDEN

Lynette S. Byrd

Lynette S.
BYRD

Glenn A. Harrison

Glenn A.
HARRISON

IF YOUR FREEDOM IS AT STAKE

YOU SHOULD CONTACT US TODAY

Contact the Experienced Attorneys of Oberheiden & McMurrey, LLP Now for a Confidential Consultation

Contact Us Now
×