Chat with us, powered by LiveChat
90%+ SUCCESS RATE
AVOIDING CRIMINAL CHARGES

Dr. Nick Oberheiden
Founder

Aaron Wiley
Former State &
Federal Prosecutor

S. Amanda Marshall
Former U.S. Attorney

Bill McMurrey
Former DOJ-Trial Attorney

Lynette Byrd
Former Assistant
U.S. Attorney

  • Federal Criminal Defense
  • Federal Trial Lawyers
  • Search Warrant Defense
  • Grand Jury Subpoenas
  • OIG Subpoenas
  • Whistleblower Cases
  • FBI, DEA, IRS, OIG, HHS Cases
Los Angeles Hospice & Home Health Care Fraud Defense

Categories: Health Care Law

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

If you are a Los Angeles business owner or medical provider who has been charged with either home health care fraud or hospice fraud, you need a team of attorneys with years of expertise in representing clients in similar situations.  You need Oberheiden, P.C..  Our team includes several former Department of Justice trial attorneys, former federal health care fraud prosecutors, and renowned criminal defense attorneys.

Medicare Fraud Investigations in Los Angeles

In an effort to crack down on the perceived influx of health care fraud in the country, the United States government has recently established specialized task forces to detect, investigate, and prosecute Medicare fraud in nine cities across the country.  One of those nine task forces is located in Los Angeles.  If you own a health care business or are a medical provider in Los Angeles or Southern California, you should know that the presence of this task force in close proximity to you means that health care fraud prosecutions in your area will be more aggressive and more frequent than in other cities without the presence of such task forces.  The health care fraud investigations are overseen by the Health Care Fraud Prevention and Enforcement Action Team, or HEAT, an elite group of federal investigators and attorneys from agencies including the DOJ, HHS, FBI, and others.

Hospice & Home Health Care Fraud

At Oberheiden, P.C., we routinely represent hospice and home health care providers as well as business owners and other professionals in every aspect of health care law, from internal audits and investigations, corporate compliance programs, Medicare audits, and reimbursement or recoupment requests to defense of civil or criminal charges brought by federal prosecutors.  Among other matters, we provide services covering:

  • Medicare and Medicaid Fraud allegations
  • Violations of Anti-kickback laws
  • Issues with the DEA, including Prescription Fraud
  • Grand Jury Subpoenas
  • OIG Subpoenas
  • ZPIC & RAC Audits
  • IRS Audits
  • Accusations of False Claims Act Violations
  • Overutilization Claims, for Equipment and/or Services
  • Qui Tam cases
  • Stark Law Violations
  • Compliance Issues, including HIPAA
  • Accusations of Overbilling or Billing Errors
  • Fraudulent or Incorrect Certificates of Medical Necessity

Our attorneys have experience in all aspects of home health and hospice care including medical necessity, conditions of coverage, plan of care requirements, clinical status determinations, initial certification requirements, re-certification, homebound evaluations, and respite care.  We frequently work in conjunction with the National Association for Home Care & Hospice (NAHC), the National Center for Assisted Living (NCAL), and the National Hospice and Palliative Care Organization (NHPCO).

What Are the Penalties of Medicare Fraud?

If a health care fraud case is brought against you in relation to home health care or hospice, you could be facing recoupment or repayment requests, non-payment of any future claims, and exclusion from federal health care programs such as Medicare and Medicaid.  Moreover, you may be required to pay a fine of up to $21,916 per false claim, as well as treble damages and attorneys’ fees.  Even worse, criminal charges could bring additional fines, indictment, and/or imprisonment.

Criminal sentences for Medicare fraud may result in up to ten years in prison for each count, which may be increased up to twenty years per count if a patient suffered serious bodily injury as a result of the fraud or up to life in prison if the fraud caused a patient’s death.

If you are a medical professional, charges of incorrectly prescribing, certifying, or supervising medical care may also lead to your exclusion from participation in federal health care programs or suspension or revocation of your professional license.

Choosing the Right Medicare Defense Lawyer

Health care fraud allegations threaten your livelihood, your business, your reputation, and even your freedom.  With such dire consequences on the line, you must hire an experienced and knowledgeable attorney to represent your interests against the government. Your lawyer should be an expert in health care law as well as in the courtroom with the ability to convince the prosecutors, your patients, the public, and the media that you are not guilty of the fraud of which you have been accused.

In order to choose a lawyer to represent them against allegations of health care fraud, service providers and business owners in the home health care and hospice industries should judge the attorneys they are considering based on the following three criteria: 

  • First, the attorney you select should be extremely knowledgeable about the statutes and regulations governing the home health care and hospice industries. You do not want to waste time explaining billing, coding, and certification requirements to lawyers unfamiliar with these concepts when you are fighting against the federal government.
  • Second, you should determine whether or not the attorney you are considering hiring has a track record of successfully resolving health care fraud cases and health care audits. An attorney may claim that he is an aggressive, experienced trial lawyer, but having a criminal defense lawyer who specializes in drug cases, DWIs, or assaults will do you little good in the specialized arena of health care fraud.
  • Third, your attorney should be a talented litigator who is comfortable and experienced in front of federal judges and juries. Ask any potential attorneys how many trials they have conducted.  The government prosecutors are keenly aware of which defense attorneys are not afraid to go to trial.

Our Proven Defense Strategies

Oberheiden, P.C. is different from other law firms.  We are distinguished by our experience, our expertise, and our track record in health care fraud defense.  Together, our team has tried over 200 cases to a judge or a jury and has handled over one thousand health care fraud investigations.  Before joining our firm, many of our attorneys have headed fraud investigations and health care audits as Assistant United States Attorneys for the Department of Justice.  Our clients now benefit from their unique insights and unparalleled network of contacts.  Although we tailor each defense to the specific facts of the case and individual client, we follow the same general strategy that has achieved positive results on countless occasions.  Our unique defense strategy consists of the following steps:

  • Putting Pressure on the Government. Once you are named as a target in a government investigation, you can be sure that such investigation has been proceeding for a while.  Therefore, you must respond as soon as possible.  The more time the government has to investigate you without facing opposition from a skilled defense attorney, the easier it will be for them to build a strong case against you.  Don’t let that happen to you.  As soon as you become aware of your involvement in an investigation or audit, hire a strong and experienced defense attorney like those at Oberheiden, P.C..
  • Showing Lack of Intent. In our experience, many health care providers are investigated for fraud due to simple human error, as opposed to fraudulent or malicious intent. Maybe the staff at your business was overwhelmed, undertrained, or simply unfamiliar with the latest billing rules.  Maybe someone made a simple data entry error.  The hospice and home health care industries have expanded rapidly in recent years with the aging of the Baby Boomer generation, and such growth is likely to continue.  Such quick expansion can make it difficult for you and your staff to keep up with the business side of health care.  Fortunately, a criminal case of health care fraud requires the government to prove fraudulent intent beyond a reasonable doubt for each and every charge.  The government knows that our attorneys will insist that they meet this stringent standard in every single case we defend.
  • Demonstrating Appropriate Certifications. Commonly, in health care fraud cases involving home health care or hospice agencies, the government allegations center on the accusation that the certification or re-certification of medical necessity was incorrect and therefore in violation of federal law. At Oberheiden, P.C., our team understands that such claims are easy to make but difficult to prove.  We work with a network of qualified health care experts to disprove the prosecution’s claims about medical necessity and explain the certification exceptions and delegation rules that the government typically ignores in their criminal indictments.
  • Media Intervention. Our representation does not stop in the courtroom or the negotiating table.  We recognize that our clients’ reputations and the public perception of the charges brought against them are important considerations in our defensive strategy.  It is not uncommon for the media to present stories based on unfounded rumors or biased reporting that reflects only the government’s side of the story, thereby ruining someone’s reputation in the process.  Our lawyers know how to stop such media defamation, and we find opportunities to publicize our clients’ side of the story to educate the media and correct the public record.

Our Track Record

Our clients range from individual health care providers to entire medical systems.  We represent clients in Los Angeles, throughout California, and around the country in investigations by the FBI, the DEA, the OIG, the Department of Defense, the IRS, and Medicaid Fraud Control Units, among others.  Our recent successes include:

  • Defense of Health Care Service Business Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Justice and the FBI for Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Justice and the FBI for Medicare Fraud and False Claims Act Violations.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Defense and the FBI for Tricare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Defense and the OIG for Tricare Fraud.
    Result: No civil or criminal liability.
  • Defense of Physician Syndication Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud and Stark Law.
    Result: No civil or criminal liability.
  • Defense of Physician Investigated by the Department of Health and Human Services and the Office of Inspector General for Medicare Fraud and Stark Law Violations.
    Result: No civil or criminal liability.
  • Defense 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.
  • Defense of Health Care Service Business Investigated by the Office of Inspector General for Medicare Fraud and Stark Law Violations.
    Result: No civil or criminal liability.
  • Defense 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.
  • Defense of Health Care Marketing 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.
  • Defense of Health Care Service Business Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Health and Human Services and the Office of Inspector General for Medicare and Tricare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Conglomerate Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.

We are available every day of the week, including weekends. You can call us directly, complete our contact form, or send us an email.

1-800-810-0259
Including Weekends 
 
Oberheiden, P.C.
Serving Los Angeles, CA and Surrounding Areas
310-873-8140
Federal-Lawyer.com
Not all attorneys of Oberheiden, P.C. are licensed in California and nothing contained in here is meant to constitute the unauthorized practice of law.
×