Detroit False Claims Act Defense Attorney - Oberheiden, P.C.

Detroit, MI False Claims Act & Qui Tam Defense Lawyers

Michigan Office
500 Griswold St #2450
Detroit, MI 48226
(Meeting location by appointment only)
The Oberheiden, P.C. has significant experience in advising and defending clients in False Claims Act cases. Our nationally recognized Healthcare Fraud Defense Group is headed by Dr. Nick Oberheiden, a healthcare fraud defense attorney and managing principal of Oberheiden, P.C..

Detroit Medicare Fraud Investigations

Detroit is one of only nine U.S. cities in which the federal government has established special task forces to monitor, investigate, and prosecute Medicare Fraud. Healthcare practitioners and businesses in Detroit must be aware that government prosecutions in Detroit are more aggressive and significantly more frequent than in other communities and spearheaded by the elite Healthcare Fraud Prevention and Enforcement Action Team (HEAT). HEAT is a coordinated federal task force composed of prosecutors from the Department of Justice (DOJ), Department of Health and Human Services (HHS), the Office of Inspector General (OIG), the Federal Bureau of Investigation (FBI), and others.

False Claims Act Explained

The federal False Claims Act applies to any individual or business that directly or indirectly contracts with and is paid for services by the United States government. The False Claims Act creates liability against any person, organization, corporation, or prime contractor that knowingly submits or causes to be submitted a false or fraudulent claim to procure payment or approval from the government. The submission of an inaccurate claim occurs knowingly if it was submitted with actual knowledge or even when the person or entity failed to conduct due diligence. In other words, liability under the False Claims Act already arises if an actor should-have-known that, for example, a billing code had changed, but lacking diligence, nonetheless submitted an obsolete (false) code.

Civil & Criminal Liability

False Claims Act investigations present severe challenges to any business because the statute contains both civil and criminal penalties and it is often not clear at the beginning of a case whether the government investigates the matter civilly or intends to press felony charges against the business owners.
  • Civil Liability: Triple damages and a penalty of up to $ 11,000 per claim for anyone who knowingly submits or causes submission of a false or fraudulent claim to the United States.
  • Criminal Liability (18 U.S.C. § 287): Healthcare providers who intentionally present false claims to the government for reimbursement with the knowledge that such claims were false, fictitious, or fraudulent are exposed to five year imprisonment and a fine of $ 250,000 (individuals) or $ 500,000 (companies) for federal felony convictions and $ 100,000 (individuals) or $ 200,000 (companies) for misdemeanor convictions— for each

What Is a Qui Tam Lawsuit?

Most Detroit False Claims Act investigations are not initiated by the government but instigated by disgruntled former employees or competitors. The False Claims Act contains a provision that allows private citizens (“relator”) to file so-called qui tam lawsuits (short for the Latin expression: “he who sues for the king and himself”) to recover monies on behalf of the United States by simply alleging that an individual or a business defrauded the federal government, see 31 U.S.C. § 3729. This is how a qui tam lawsuit works in practice. Complaint. The qui tam relator (the plaintiff) files a complaint against an individual, a business, or both (the defendants) with the U.S. District Court for the Eastern District of Michigan. To protect the anonymity of the plaintiffs, qui tams are filed under seal and the court’s clerk will provide a copy of the non-public complaint only to the assigned judge and certain government officials. Extensions to keep the case sealed are regularly granted for segments of six months and can be renewed until the government had a chance to investigate the matter. Evidence. Upon learning of the filed qui tam, the government screen the case and will immediately reject entirely unsubstantiated complaints. If the complaint appears persuasive, the government may investigate the facts with the help of federal law enforcement agencies such as the FBI, the DEA, the OIG, and other agencies. This factual investigation is typically done through subpoenas that require the accused targets to produce specified corporate, financial, billing, business, and communications records. Government Intervention. Upon review of those records and negotiations with the defense attorneys, the government must decide if it will support the plaintiff and intervene in the case or whether it will drop out and let the realtor continue on its own. Interventions require an approval process that involve the Department of Justice’s Washington D.C. headquarters. If the government does intervene, the Department of Justice will typically amend the complaint to include additional causes of actions such as the Anti-Kickback Act and the Truth in Negotiation Act. Case Settlement. Parallel to the government serving subpoenas and thereby notifying the defendants about the pending investigation, negotiations between the government and defendants’ called upon defense lawyers take place. Depending on the complexity of the case and the difficulty of the analysis, it may take several months before the government starts evaluating a qui tam and even longer before a matter is fully resolved. Liability and Rewards. If found liable, the individuals and companies accused of fraud in the qui tam lawsuit may be ordered to pay as much as three times the government’s losses plus penalties of up to $ 11,000, per claim, which can quickly amount to great financial exposure. The law incentivizes qui tam plaintiffs by allowing them keep up to 25 percent of any amount collected if the government participates in the litigation and up to 30 percent if the plaintiffs collect on their own without the government’s intervention.

Proven Defense Strategies

The Michigan attorneys and former federal prosecutors of Oberheiden, P.C. have in depth experience and have successfully resolved False Claims Act cases throughout the United States. From experience as prosecutors in charge of False Claims Act investigations as well as defense counsel we know that the difference between human error and liability is often a fine line that requires compelling negotiation skills, demonstrated industry competence, and attention to details. The following are our guiding principles.
  • No Criminal Charges. Our top priority in every False Claims Act case is to avoid criminal charges. Years of experience as former federal healthcare prosecutors in charge of False Claims Act investigations and a focused practice on healthcare fraud defense work allow us to quickly determine whether the investigation is civil or criminal, what the government’s objectives are, and how to efficiently resolve the matter. On average, we are able to tell our clients within the first day or two what the case is about, what exposure exists, and what the government wants to do moving forward.
  • No Government Intervention. Because False Claims Act cases are often initiated by whistle-blowing ex-employees or competitors with disingenuous agendas, we will aggressively confront these individuals, challenge their alleged evidence, demolish their story, and destroy their credibility. Doing so is critical in order to convince the government that the accusations lack merit and do not deserve government intervention and support.
  • Favorable Settlement. In instances, in which civil liability was indicated, we have negotiated the damages to fractions of the government’s demand. To date, not a single False Claims Act settlement that we achieved for our clients forced any of our clients to cease its operations or to close their business.
Call Oberheiden, P.C. today to discuss your situations with our attorneys. All initial consultations are free and confidential. You can call us directly or complete our contact form or contact us by sending an email.

Oberheiden, P.C.

The attorneys of Oberheiden, P.C. have successfully defended physicians, practice owners, physician owned entities, toxicology laboratories, device companies, pharmacies, service management organizations, healthcare marketing companies, hospitals, and many others in False Claims Act, qui tam lawsuits, Stark Law, Anti-Kickback, Medicare, Medicaid, Tricare, and DOL investigations.
  • False Claims Act Investigation (Pharmacy) Result: No Liability.
  • False Claims Act Investigation (Pharmacy) Result: No Liability.
  • False Claims Act Investigation (Laboratory Group) Result: No Liability.
  • False Claims Act Investigation (Laboratory Group) Result: No Liability.
  • False Claims Act Investigation (Laboratory Group) Result: No Liability.
  • False Claims Act Investigation (Physician) Result: No Liability.
  • False Claims Act Investigation (Physician) Result: No Liability.
  • False Claims Act Investigation (DME Company) Result: No Liability.
  • False Claims Act Investigation (MSO) Result: No Liability.
  • False Claims Act Investigation (MSO) Result: No Liability.
  • False Claims Act Investigation (Physician Syndication) Result: No Liability.
  • False Claims Act Investigation (Physician Syndication) Result: No Liability.
  • False Claims Act Investigation (Physician Syndication) Result: No Liability.
  • False Claims Act Investigation (Device Company) Result: No Liability.
  • False Claims Act Investigation (Healthcare Service Provider) Result: No Liability.
Call Oberheiden, P.C. today and speak with former federal prosecutors and established defense counsel about your case. All initial consultations are free and confidential.
We are available every day of the year. You can call us directly, complete our contact form, or email us directly.
313-462-7972 Including Weekends Oberheiden, P.C. Serving Detroit, Michigan and Surrounding Areas

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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 PC with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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