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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

Defending Medicare Fraud in New Mexico

Whether you are under investigation for phantom billing or up-coding, or you have been accused of billing for services that were not medically necessary, you do not have time to waste getting your lawyer up to speed on the Medicare rules and regulations involved in your case. If you are facing possible charges for Medicare fraud in New Mexico, you need a team of experienced attorneys who already know every nuance and detail of your business so that they can immediately center on developing a strategic defense.

Medicare fraud is federal felony, and the monetary liabilities if you are found to have committed fraud can be enormous. The possibility of being held accountable for Medicare fraud should caution you to invest your time and resources in a strategic and thoughtful defense plan. Clearly, the last thing you want is for the government to brand you as a criminal or to impose civil liability that causes you to lose your business. To avoid these consequences, you need get a knowledgeable attorney on your side right away.

At Oberheiden, P.C., we are experienced fraud defense lawyers and former federal prosecutors. Our track record speaks for itself. Call us today at (888) 727-5159 to discuss how to keep your record clean.

A Team You Can Trust

The attorneys of Oberheiden, P.C. have successfully defended physicians, practice owners, physician-owned entities, toxicology labs, pharmacies, service management organizations, health care marketing companies, and many others in Medicare fraud investigations. Each member of our Health Care Practice Group has handled at least 100 health care matters.

When you choose Oberheiden, P.C., Dr. Nick Oberheiden or an experienced attorney on our team will exclusively handle your defense. No junior lawyers or paralegals will work on your case.

What Constitutes Medicare Fraud?

Medicare fraud refers to the submission of false or fictitious claims to a governmental health care program. According to government statistics, approximately $50 billion worth of claims are investigated for potential Medicare fraud every year. The federal government has the power to investigate possible Medicare fraud under numerous federal statutes, including:

  • Anti-Kickback Statute
  • Civil Monetary Penalties Law
  • Criminal Fraud Statute
  • False Claims Act
  • Stark Law (Self-Referrals)

As a result, no matter how well you think you have organized your practice, the chances of being investigated are high. This is especially true if your business is successful and submits a high volume of claims to the Centers for Medicare and Medicaid Services (CMS).

What Are the Penalties for Medicare Fraud?

Medicare fraud is investigated by the OIG, the DOJ, CMS, the Department for Health and Human Services (HHS), the Federal Bureau of Investigation (FBI), Medicaid Fraud Control Units (MFCUs), State Medicaid Agencies in cooperation with the Health Care Fraud Prevention and Enforcement Action Team (HEAT), and the General Services Administration (GSA).

If found guilty of Medicare fraud, you can face recoupment requests, non-payment of future Medicare claims, exclusion from federal health care programs, civil fines of up to $ 11,000 per false claim, treble damages, attorneys’ fees, criminal fines, and years in a federal prison.

Who Is Investigated?

Medicare fraud exposes providers and business owners alike. The statutes mentioned above apply to any individual or business that directly or indirectly contracts with CMS or is paid for services through Medicare. At Oberheiden, P.C., we regularly represent clients in New Mexico in the following industries, with some examples of the specific types of cases we handle listed below:

Industries

  • Health care providers (e.g. physicians)
  • Hospitals
  • Home health centers
  • Laboratories (toxicology, biologics)
  • Medical device companies
  • Pharmacies (including compound pharmacies)
  • Physician-owned entities

Recent Examples

  • Medicare Fraud Strike Force charges 90 individuals
  • Medicare Fraud Strike Force charges 89 individuals
  • Doctor admits taking bribes in test-referral scheme with lab
  • Owner of nursing agency convicted of multi-million dollar fraud scheme
  • Principal in $28.3m Medicare fraud scheme sentenced to 11 years in prison

(Published by U.S. Department of Justice at http://www.stopmedicarefraud.gov/newsroom/)

Government Investigation: Civil or Criminal?

One of the most important questions when you are facing an investigation for possible Medicare fraud is whether the investigation is civil or criminal in nature. That is, is the government seeking monetary remedies (which would make it a civil investigation); or, is the government seeking criminal indictments and imprisonment? Health care fraud statutes provide for both, and about 1,400 individuals are indicted in federal court for health care fraud each year. When you contact us, our experienced defense attorneys can determine if your investigation is civil or criminal, and if it is not too late we can work with the investigating agency (or agencies) to try to avoid criminal charges.

How do we know if your case is civil or criminal? We can often get a good sense just from hearing our client’s side of the story. Years of experience combined with the insight and knowledge of our former government officials allow us to catch certain details and nuances of the investigation that most people gloss over. For example, we pay close attention to how our clients are notified of the investigation, which government agency contacted them, and which government official is in charge of the investigation. The mere involvement of a prosecutor or a federal agency does not mean that the case is a criminal investigation.

This Is How We Defend Medicare Fraud

When you hire Oberheiden, P.C. for your Medicare fraud investigation, you are not just hiring a law firm. You are hiring a team of former federal prosecutors, government officials, and committed defense attorneys who have a deep understanding of both the health care and legal issues involved in your case. With us, you get:

Industry Knowledge

We have deep health care industry knowledge. Because Medicare fraud often stems from billing and coding errors, you need attorneys that understand billing and coding violations. Our attorneys have analyzed, reviewed, and defended close to 500,000 billed claims.

Government Experience

We have extensive government experience. The difference between liability and human error is often a fine line that requires convincing negotiation skills and attention to detail. To succeed, you often need to know what the other side is thinking. The former government officials of Oberheiden, P.C. have years of health care and law enforcement experience working inside the government.

Determination To Criminal Charges

We want to keep investigations civil, not criminal. In fact, we want to end your case before you ever face federal charges. Our attorneys are frequently able to persuade the government that errors, if they exist, were innocent mistakes and not grounds for a federal prosecution.

Contact Oberheiden, P.C. for a Free Consultation

Oberheiden, P.C. represents clients in investigations throughout New Mexico and nationwide. When you call us, we will explain how our “Emergency Defense Package” can help you take immediate action to protect yourself and your business. The “Emergency Defense Package” takes our extensive experience on both sides of federal investigations and boils it down to clear, proven steps that can provide instant relief for individuals and businesses facing Medicare fraud accusations.

Contact us today to discuss your case with our attorneys. All initial consultations are free and confidential. Let us show you how we can protect you, your family, and your future.

Our Track Record

  • Defense of Medicare laboratory against investigations by the Department of Justice and the U.S. Attorney’s Office for alleged Medicare Fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense 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, case dismissed.
  • Defense of Medicare laboratory against investigations by the Department of Health and Human Services and the Office of Inspector General for alleged Health Care Fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of nationally operating health care company against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of health care marketing company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a laboratory against an investigation by various branches of the federal government for alleged fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of physician owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Department of Justice for alleged fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged Stark Law violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by various branches of the federal government for alleged False Claims Act, Stark Law, and Medicare violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of a physician owned entity against an investigation by the Department of Justice for alleged Medicare Fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of physician owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
    Result: No civil or criminal liability, case dismissed.
  • Defense of health care management organization against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged Medicare Fraud.
    Result: No civil or criminal liability, case dismissed.
  • Defense of nationally operating laboratory against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability, case dismissed.

Who Will Handle Your Case

When you hire us, you will not work with paralegals or junior lawyers. Each lawyer in our Health Care Practice Group has handled at least one hundred (100) matters in the health care 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.

Bill C. McMurrey

Bill C.
McMURREY

Dr. Nick Oberheiden

Dr. Nick
OBERHEIDEN

Lynette S. Byrd

Lynette S.
BYRD

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