Former federal prosecutors
offering unparalleled knowledge and a proven track record


Meet the Team
Oberheiden Attorneys

Providing Health Care Fraud Defense for the State of Louisiana

The Oberheiden & McMurrey, LLP is a health care law defense firm with significant experience in the areas of regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. Among our attorneys are the former Chief Health Care Fraud Coordinator at the U.S. Attorney’s Office, former senior Department of Justice trial attorneys, former lead prosecutors of the elite Medicare Fraud Strike Force, and other talented attorneys with years of relevant experience and education from the country’s best schools such as Harvard Law School and Yale Law School. Our attorneys serve clients in Louisiana as well as surrounding areas.

If you operate in the state of Louisiana and find yourself facing accusations of health care fraud, make a call to Oberheiden & McMurrey, LLP as soon as possible. Oberheiden & McMurrey, LLP commands comprehensive legal experience in health care fraud defense, Medicare and Tricare audits, OIG and grand jury subpoenas, compliance programs, internal investigations, fraud allegation defense, qui tam defense, protection of assets, criminal defense, and jury trials. Our Health Care Fraud Defense Team includes a former Chief Health Care Fraud Coordinator for the U.S. Attorney’s Office, several former health care fraud prosecutors, elite former lead prosecutors of the Medicare Fraud Strike Force, and accomplished lawyers with educations from the country’s leading law schools, including Yale and Harvard.

If you are interested in learning how we can help, call now and request to speak with a member of our Health Care Fraud Defense Team. Initial consultations are completely free and totally confidential.

The State of Louisiana Is Heavily Monitored for Health Care Fraud

Louisiana is one of nine areas in the nation heavily monitored for health care fraud by the Medicare Fraud Strike Force. The Medicare Fraud Strike Force is an elite team comprised of select prosecutors and investigators from a variety of federal agencies, including the Department of Justice, Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. However, this list is not exhaustive. Other agencies may have a presence in the Medicare Fraud Strike Force.

Louisiana and its surrounding areas are heavily monitored, as a noticeable amount of its citizens rely on a federal health care program. This increases the number of claims filed with the federal government for reimbursement. This leads the government to aggressively monitor, investigate, and prosecute allegations of health care fraud. The Department of Justice investigated over 300 cases in 2016 alone. Around 80 of those investigations centered on individual health care providers. The rest involved a health care entity or business. The agency reported that it recovered more than $900 million in fraudulently paid out claims.

Health Care Fraud: What Is It?

Federal health care fraud is defined as an attempt to secure reimbursement for medical services or equipment through government health care programs, such as Medicare, Medicaid, Tricare, or federal workers’ compensation by filing one or more fraudulent claims. It can include a violation of at least one of the following:

  • The Anti-Kickback Statute. Federal health care law strictly 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 by offering or providing payment or other valuables in return for patient referrals.
  • Stark Law. Stark Law is also known as the Self-Referral Law. The 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 to abide by the False Claims Act. If the claim submitted to the federal government is found to be inaccurate, the federal government is likely to launch an investigation into your billing practices under the criminal provisions of the False Claims Act.
  • Prescription Fraud. The federal government maintains a close eye on health care practices that have an unusually high number of narcotic prescriptions. If you are suspected of running a “pill mill,” you are at risk of being investigated for insurance fraud and for violating DEA dispensing rules.
  • Billing Fraud. The federal government actively investigates the upcoding of claims. Upcoding means that the next higher code is used for a service when the billing is done. The federal government will also investigate 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 federal government keeps a close eye on the home health care and hospice industry. The most common allegation includes fraudulent certification for home health care and hospice care.

Oberheiden & McMurrey, LLP has a sturdy track record of success in helping clients avoid criminal charges. If you or your health care practice or business are under investigation for health care fraud in Louisiana, call Oberheiden & McMurrey, LLP now. Initial consultations are free and confidential.

The Harsh Penalties of Health Care Fraud

Health care fraud is a very serious matter. You may be subject to civil repayment of claims, non-payment of future claims, and may be excluded from federal health care programs. You are also at risk of facing the state disciplinary board, losing your license, and being stripped of your hospital privileges. Criminal penalties include prosecution, prison time, and fines in the hundreds of thousands of dollars.

If you are found guilty of criminal health care fraud, you may receive one of the following prison sentences:

  • 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

We are often asked about the worst-case scenario for health care fraud in Louisiana. Whether someone will face criminal prosecution or be sent to prison depends on several factors, such as the severity of any injury suffered by the patients, whether the prosecutor is interested in criminal prosecution, and the reason that started the investigation.

Oberheiden & McMurrey, LLP is ready to handle Louisiana health care fraud defense cases, thanks to our dual experience as former health care prosecutors and defense attorneys. If you have been notified that you’re being investigated for health care fraud or if you’d like to discuss your legal options, call us right away. Initial consultations are free of charge and confidential.

Indications That the Investigation May Be a Criminal Matter

Health care fraud cases can be either civil or criminal. With early intervention and compelling defense strategies, Oberheiden & McMurrey, LLP helps clients to avoid criminal charges. Call us immediately if you’re being investigated for health care fraud in Louisiana or the surrounding area so that we may begin our process to develop your custom defense strategies.

Being contacted by a prosecutor is not a certain sign that you are being investigated for criminal charges. All federal agencies that have prosecutors have both a civil and a criminal division. This is why you cannot accurately ascertain the nature of the charges based on the fact that a prosecutor has contacted you. Determining whether the investigation is criminal in nature can depend on the legal interpretation of many different elements, such as OIG subpoenas, the manner in which the inquiry is made or in the way in which the allegations are made, and other indicators of criminal prosecution. Criminal prosecution may be signaled by search warrants, seizure warrants, arrest warrants, target letters, involvement of federal criminal prosecutors, IRS involvement, or grand jury subpoenas.

If you have questions about whether you are facing criminal or civil charges, call Oberheiden & McMurrey, LLP as soon as possible. We represent individual providers, entire health care systems, and other related businesses. We provide health care defense services to individuals, businesses, and entities in Louisiana that are under investigation by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, Drug Enforcement Administration, Office of Inspector General, Medicare Fraud Control unit, Louisiana state law enforcement, or the IRS.

Health Care Fraud Defense

Oberheiden & McMurrey, LLP is a health care fraud defense law firm offering services in Louisiana. A multitude of our lawyers have previous experience as health care auditors and health care fraud prosecutors with the Department of Justice. We provide our extraordinary insight directly to our clients.

Advocacy begins immediately for our clients. In each case, our primary objective is to assist our clients in avoiding criminal charges. Our experience and track record prove that the best way to defend against criminal prosecution is to intervene early and not allow the government much uninterrupted time to compile its case against you. We continuously work to protect your freedom and your professional aspirations. We begin to advocate for you immediately by getting into contact with federal prosecutors. Usually, we can get answers to the most important questions within just a few hours:

  • 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 standards. The Constitution requires the federal government to prove beyond a reasonable doubt that you committed a crime and performed your actions with criminal intent. We test this high standard in each and every case where the federal government indicates that there may be criminal charges involved. Prosecutors often use billing inaccuracies as an example to attempt to prove criminal intent. Despite this, we know from experience that mistakes happen, and that those mistakes do not and should not equate to fraudulent activity. Oberheiden & McMurrey, LLP has provided successful legal defense for clients across the United States by proving that the inaccuracies in billing are results of organizational or human error and did not happen because of an intent to defraud the government. In our experience, we’ve learned that 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 are the most common errors that cause these investigations. Although these issues should be corrected, they should not lead to criminal liability.

The use of strategic defenses. Oberheiden & McMurrey, LLP will help you to develop strategic defenses, including locating applicable defenses and statutory loopholes. Many of our cases have been successful because of our use of legal exceptions. For example, in the context of Stark Law which involves medical necessity certifications, we have been able to point to exceptions to either mitigate or entirely resolve a health care fraud case.

Protecting your professional reputation. Not only are we devoted to defending you in court, but we are also committed to protecting your professional reputation. Allegations of health care fraud can be extremely harmful to your career. Rightfully, many of our clients are very concerned about how these allegations will affect their future. The media holds the power to besmirch someone’s image or spread vicious rumors. Reports are often biased and averse to including the whole story. Our attorneys routinely address concerns about slander, and book news spots and other opportunities to correct misinformation about our clients.

Contact Oberheiden & McMurrey, LLP right away to discuss the details of your case. Initial calls are free and confidential.

Our Track Record

  • 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 Attorneys Serving Louisiana
Nick OberheidenNick 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. 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 the State of Louisiana 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.

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
×