Midland / Odessa, TX Healthcare Fraud Defense Attorneys

The Oberheiden, P.C. is a healthcare 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 Healthcare 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. Our attorneys serve clients in Midland and Odessa as well as throughout Texas State.

If you’re accused of committing healthcare fraud in the Midland / Odessa Texas area, you should call Oberheiden, P.C.. We are a Texas firm working on healthcare fraud defense. We have extensive legal experience in OIG and grand jury subpoenas, Medicare and Tricare audits, fraud allegation defense, internal investigations, compliance programs, qui tam defense, protection of assets, criminal defense, and in jury trials. Our Healthcare Fraud Defense Team includes lawyers with extensive and impressive backgrounds, including a former Chief Healthcare Fraud Coordinator for the U.S. Attorney’s Office, several former healthcare fraud prosecutors, elite former lead prosecutors of the Medicare Fraud Strike Force, and accomplished lawyers with leading education from the leading law schools in the United States.

Dr. Nick Oberheiden is a Harvard-trained lawyer and negotiator. Dr. Oberheiden provides legal assistance to clients in West Texas. Dr. Oberheiden is a healthcare fraud defense attorney and is the managing partner of Oberheiden, P.C..

If you’re ready to discuss the legal options related to your case, call Oberheiden, P.C. right away and ask to speak with a member of our Healthcare Fraud Defense Team. Initial consultations are free and confidential.

Midland / Odessa, Texas Is Strictly Monitored for Healthcare Fraud

Midland / Odessa, Texas is strictly monitored for healthcare fraud by the Medicare Fraud Strike Force. The Medicare Fraud Strike Force is an exclusive team of prosecutors and investigators made up of members of multiple federal agencies, including representatives from 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 prosecutors and investigators can be involved in the Medicare Fraud Strike Force.

Midland / Odessa, Texas and its surrounding areas are closely monitored because many of the residents in the area are beneficiaries of a federal healthcare program. The increased reliance means that more claims are filed in the area than in cities of similar size throughout the United States. In areas where more claims are filed, the federal government pays closer attention to look for an increase in healthcare fraud. In fact, the Department of Justice released a statement in 2016 that it had investigated more than 300 cases of healthcare fraud. Close to 80 of those cases involved individual healthcare practitioners. The other cases involved a healthcare entity or business. The Department of Justice reported that it recovered more than $900 million in fraudulently paid out claims.

Defining Healthcare Fraud

Healthcare fraud is the attempt to receive reimbursement from a federal government healthcare program for medical services or equipment. Federal healthcare programs include Medicare, Medicaid, Tricare, or federal workers’ compensation. Healthcare fraud includes at least one of the following elements:

  • Violation of the Anti-Kickback Statute – Federal healthcare law prohibits receiving money or other valuables in exchange for patient referrals. Any person (including doctors, marketing professionals, and business owners) may be prosecuted for violating the Anti-Kickback statute, or for offering or providing payment or other valuables in exchange for patient referrals.
  • Violation of Stark Law – This is also referred to as the Self-Referral Law. It prohibits doctors from referring patients to certain healthcare service entities if the doctor or a member of the doctor’s immediate family has an ownership or investment interest in it, or if there is some compensation arrangement. There are statutory exceptions to this law.
  • Violation of the False Claims Act – If you submit a claim to a federal healthcare program, you must ensure that your claim is accurate. Otherwise, it is a violation of the False Claims Act. The federal government may begin an investigation into your billing practices under the criminal provisions of this act.
  • Prescription Fraud – The federal government watches healthcare practices who prescribe an unusually high number of narcotics. If you’re suspected of running a “pill mill,” you may be investigated for insurance fraud and for violating DEA dispensing rules.
  • Billing Fraud – One of the most common instances of billing fraud is when claims are upcoded. Upcoding means that the next higher code is used when the federal government is billed. The federal government also investigates phantom billing (billing for services that were not provided), ghost patients (billing for patients who don’t exist), and billing for services or equipment that aren’t medically necessary.
  • Certification Errors – The federal government pays close attention to the home healthcare and hospice industry. One of the most common allegations includes fraudulent certifications for care.

Oberheiden, P.C. has a distinguished track record of helping our clients avoid criminal charges. If you or your healthcare practice or business are being investigated for healthcare fraud in Midland / Odessa, Texas, call us right away. Initial consultations are free and confidential.

Penalties of Healthcare Fraud

Healthcare fraud is an extremely serious allegation. You could face civil or criminal repercussions. Civil penalties include repayment of claims, non-payment of future claims, and possible exclusion from federal healthcare programs. You may also face your state disciplinary board and lose your license or hospital privileges.

Criminal penalties are also serious. You could be subject to fines that cost you hundreds of thousands of dollars, prosecution, and prison time.

If you are found guilty of criminal healthcare fraud, you may receive a prison sentence:

  • Up to 10 years for each count of healthcare fraud
  • Up to 20 years for each count of fraud that resulted in serious bodily injury to the patient
  • Life sentence if the healthcare fraud resulted in the death of a patient

We’re often asked about what the worst-case scenario is for healthcare fraud in Midland / Odessa, Texas. Whether you may face criminal prosecution or receive a prison sentence will depend on several factors. Some of the factors include the severity of an injury suffered by a patient, whether the prosecutor is interested in pursuing criminal charges, and the reason why the federal government initiated the investigation. If you’re alerted to the fact that you’re being investigated for healthcare fraud and you’d like to learn more about your options, call Oberheiden, P.C. now. Initial consultations are confidential and have no charge.

Determining If Healthcare Fraud Is Criminal

Healthcare fraud can be civil or criminal in nature. With the use of early intervention and strategic defense, Oberheiden, P.C. has an excellent record of helping our clients avoid criminal prosecution. Call us immediately if you’re being investigated. We can help by developing a custom defense.

At the start of most healthcare fraud investigations, most clients don’t know whether they are facing civil or criminal charges. The U.S. Attorney’s Office has a civil division and a criminal division. There are prosecutors who work for each division. So, being contacted by a prosecutor from the U.S. Attorney’s Office really isn’t an indicator of whether you’re going to face criminal charges. The same is true with other federal prosecutors. Most agencies have both a civil and criminal division. Yet, with that said, you should understand that a civil investigation can quickly become criminal. We can help by contacting the federal prosecutors right away to advocate on your behalf. Call Oberheiden, P.C. immediately if you’re contacted by a federal prosecutor.

Determining the charges can depend on the legal interpretation of many things including 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 imminent if you receive a search warrant, seizure warrant, arrest warrant, target letter, IRS involvement, grand jury subpoena, or if there is the involvement of a federal criminal prosecutor.

If you have questions about whether you’re facing criminal or civil charges, contact Oberheiden, P.C. immediately. We provide legal advocacy for individual practitioners, entire healthcare systems, and other related healthcare businesses. If you are a healthcare provider, business, or entity in the Midland / Odessa, Texas being investigated 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, Midland / Odessa or Texas state law enforcement, or the IRS, call us now.

Healthcare Fraud Defense

Oberheiden, P.C. is a Texas law firm providing healthcare fraud defense to clients in Midland / Odessa and the surrounding area. Many of our attorneys have previous experience as healthcare auditors and as healthcare fraud prosecutors with the Department of Justice. Our clients gain valuable insight for their healthcare fraud defense cases.

Legal advocacy. The main objective for each healthcare fraud case is to help our clients avoid criminal charges. Our experience has taught us that the best way to defend our clients against the possibility of criminal prosecution is to get into immediate contact with the federal government to begin legal advocacy for our clients. This gets answers to important questions and also stops the government from having a lot of uninterrupted time to investigate you. We work to protect your freedom and your career. Usually, we 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?

No criminal intent. The U.S. Constitution has a high standard that requires the federal government to prove beyond a reasonable doubt that you committed a crime. They must also prove that you acted with criminal intent. In cases where criminal charges may be levied, we test these standards. The federal government will often try to use billing inaccuracies to prove criminal intent. Oberheiden, P.C. has learned from experience that mistakes happen by our clients. Those mistakes should not equate to fraudulent activity. We have provided successful legal defense for clients across the United States by proving that the inaccuracies are a result of human or organizational error, and not a result of criminal intent. We’ve noted that the use of unqualified workers, delegation errors, outsourcing errors, lack of oversight, insufficient supervision, and the constantly changing laws and rules that are involved in healthcare are the most common errors that cause these investigations. Although these issues should be corrected, they should not lead to criminal liability.

Strategic healthcare fraud defense. Oberheiden, P.C. has substantial experience in developing strategic defenses. Many of our cases were successful because of statutory loopholes and exceptions. For instance, in the context of Stark Law which involves medical necessity certifications, we’ve been able to use exceptions to either mitigate or entirely resolve a healthcare fraud case.

Defending your reputation. We are committed to doing more than providing healthcare fraud defense. We are also committed to defending your image. Allegations of healthcare fraud can be extremely damaging. Many of our clients are concerned about how these allegations may affect their future. The media has a lot of power. Your reputation could be destroyed by rumors spread by the media. Our attorneys routinely address concerns about slander, and book news spots and other opportunities to correct misinformation about our clients.

Oberheiden, P.C. has helped clients across the country who were accused of healthcare fraud. Call us today to learn more about your legal options. The call is confidential and there is no charge.

Our Track Record

The commitment of Oberheiden, P.C. is to avoid criminal charges and to shield our client’s medical business from government intrusion. Our team of former healthcare prosecutors and experienced defense attorneys have a distinguished history of protecting business owners, executives, lawyers, physicians, hospitals, laboratories, pharmacies, home healthcare entities, and many other healthcare organizations against any form of alleged healthcare 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 Healthcare 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 Healthcare Marketing Group Against an Investigation by the Office of Inspector General for Alleged Healthcare 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 Healthcare 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.

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

888-680-1745
Including Weekends
Oberheiden, P.C.
Serving Midland / Odessa, Texas 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, P.C. is a Texas LLP with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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