Former federal prosecutors
offering unparalleled knowledge and a proven track record


Meet the Team
Oberheiden Attorneys

Providing Medicare Fraud Legal Defense for the New Orleans Area

The Oberheiden & McMurrey, LLP, PLLC is a health care fraud defense law firm comprised of a team of experienced defense attorneys and former federal prosecutors. Our Health Care Fraud Defense Group is headed by senior attorney Dr. Nick Oberheiden. Dr. Oberheiden is a health care fraud defense attorney and managing principal of Oberheiden & McMurrey, LLP. Oberheiden & McMurrey, LLP brings decades of experience to defending clients in Medicare fraud investigations in New Orleans, Louisiana.

This page is intended as a resource for individuals and health care companies facing Medicare fraud investigations in New Orleans, Louisiana. Here, you will find answers to the following questions:

  • Have I committed Medicare fraud?
  • What penalties can I face for Medicare fraud?
  • How can a lawyer help with my Medicare fraud investigation?
  • What type of lawyer do I need?
  • What distinguishes Oberheiden & McMurrey, LLP?

Medicare Fraud in New Orleans, Louisiana

Louisiana is one of only seven states in the country in which the federal government has placed a team from its elite Health Care Fraud Prevention and Enforcement Action Team (HEAT) task force. HEAT is composed of prosecutors from the Department of Justice (DOJ), the Department of Health and Human Services (HHS), the Office of Inspector General (OIG), the Federal Bureau of Investigation (FBI), and other federal agencies. Their specific task is to combat Medicare fraud in areas of the country where health care providers submit a high volume of Medicare reimbursement claims.

As a result, health care practitioners and businesses in New Orleans must be particularly diligent in seeking to avoid billing mistakes that the government may interpret as signs of fraud. Unfortunately, HEAT relies on data analysis as one of its primary tools for identifying targets of investigations. This leads to many innocent providers in New Orleans who submit a high volume of claims being scrutinized and who will have to defend themselves and their business against unwarranted investigations. In many cases, they may even face criminal charges.

Have I Committed Medicare Fraud?

Medicare fraud involves submitting false or fictitious claims for reimbursement. However, it’s really not just limited to Medicare. Programs like Medicaid, Tricare, and federal workers’ compensation are also included, Medicare is a federal benefit program that pays health care providers for services, supplies, and equipment provided to qualifying patient-beneficiaries. These programs make it possible for countless patients to receive treatment; unfortunately, federal health care programs are also ripe for abuse. HEAT and other federal law enforcement agencies pursue billions of dollars in fraudulent claims every year – in some cases, recovering hundreds of millions of dollars for individual schemes. In 2016 alone, the Department of Justice performed more than 300 investigations and listed the total amount of false claims at more than $900 million.

Some of the most common forms of Medicare fraud include the following:

  • “Phantom billing” (billing for services that were never performed);
  • Providing and billing for medically unnecessary services, supplies, and equipment;
  • Billing for supplies and equipment that were never purchased;
  • Obtaining fraudulent certifications for medically unnecessary services and supplies (a common allegation in home health and hospice fraud investigations);
  • Double-billing and submitting false patient records;
  • Upcoding;
  • Unbundling or other forms of coding fraud; and
  • Entering into illegal kickback arrangements with physicians or other providers;

Physicians, nurses, home health care centers, hospice care centers, nursing homes, registered care facilities, hospitals, pharmacies, toxicology laboratories, medical devices companies, physician syndications, DNA testing centers, cancer treatment centers, and other health care service providers in New Orleans, Louisiana are all potentially at risk for facing Medicare fraud investigations. These investigations can involve allegations of wrongdoing under the False Claims Act, the Anti-Kickback Statute, the Physician Self-Referral Laws (Stark Law), the Social Security Act, provisions of the U.S. Criminal Code, and other federal laws.

What Penalties Can I Face for Medicare Fraud?

If you are being investigated for Medicare fraud, you need to take your situation with utmost seriousness. The civil and criminal penalties for Medicare fraud can include recoupment requests, non-payment of future claims, civil fines of up to $11,000 per false claim, exclusion from future participation in federal health care programs, treble damages, government attorneys’ fees, criminal fines, and incarceration in a federal prison. The potential prison sentences for Medicare fraud include:

  • Up to 10 years for each count of fraud;
  • Up to 20 years if the fraud resulted in serious bodily injury; and,
  • A life sentence if the fraud resulted in a patient’s death.

In addition, as a medical professional, you could be at risk for a state disciplinary action which may result in loss of your license and loss of your hospital privileges, as well.

How Can a Lawyer Help with My Medicare Fraud Investigation?

While each case is different, there are three primary strategies for defeating a Medicare fraud investigation. The right attorney should be able to help you deploy these strategies quickly and effectively. This will, ideally, help you avoid civil or criminal prosecution:

  • Early intervention;
  • Attacking the government’s case; and
  • Making effective use of key defenses.

1. Early Intervention

By the time when you find out that you are under investigation, the government will already be well on its way to building a case against you. As a result, once you find out about their Medicare fraud investigation, you need to retain an attorney as soon as possible. The more time the government has to investigate without interruption, the higher the chances of your investigation leading to a criminal trial. At Oberheiden & McMurrey, LLP, when a new client hires us, we immediately reach out to our government contacts to find out what is going on and gather the information that we need to start building a strategic defense.

2. Attacking the Government’s Case

In order to convict you of Medicare fraud, the government must prove its case “beyond a reasonable doubt.” This is an extremely high standard, and one that requires enough evidence to convince a jury without question that you are guilty of fraud.

As a result, a key defense strategy involves poking holes in the government’s case. We will seek to use the available evidence (or lack thereof) to prevent the government from proving two key elements: that you committed a fraudulent act and that you did so with criminal intent. Honest mistakes are common in a busy practice, and they should not result in fines and prison time.

3. Making Effective Use of Key Defenses

The third primary method we employ on behalf of our clients is to diligently research and assert all available and applicable legal defenses. In many cases, federal health care laws have special provisions that allow what might otherwise be considered fraudulent conduct.

For example, in one of the recent Medicare fraud cases we defended an allegation made that our client had fraudulently certified the need for health care services. We successfully argued that a delegation exception rendered the certification fully compliant with the law. In another Medicare fraud case, we refused to admit liability. We proved to prosecutors that our client was protected by a safe harbor provision.

What Type of Lawyer Do I Need?

When it comes to defending against a Medicare fraud investigation, it is crucial to have an attorney (or, preferably, a defense team) with extensive experience in the area of health care fraud defense. This is a complex area of the law. With so much at stake, now is not the time to test the waters with an inexperienced attorney.

The Right Choice: A Health Care Fraud Defense Lawyer

A health care fraud defense lawyer combines the best traits of health care lawyers and criminal lawyers, and will typically be the best choice your Medicare fraud investigation in New Orleans, Louisiana. When researching health care fraud defense lawyers, you want to center on four criteria:

  • Proven track record of success;
  • Health care industry knowledge;
  • Profound familiarity with health care laws; and
  • Experience in both litigation & going to trial.

You can test these criteria by asking the following questions during your initial consultation:

  • How many Medicare fraud cases have you handled during your career?
  • How many of the health care fraud cases that you have handled have resulted in no civil or criminal charges or dismissals for your clients?
  • How many health care fraud cases have you tried in court?

What Distinguishes Oberheiden & McMurrey, LLP?

What distinguishes Oberheiden & McMurrey, LLP from other health care fraud defense firms is our experience. Our defense team includes former federal prosecutors and experienced defense lawyers who have handled hundreds of health care proceedings and conducted several criminal trials nationwide. We center our practice on representing business owners, health care executives, health care providers, hospitals, pharmacies, laboratories, and others in the following core areas:

  • Asserting health care fraud defense strategies;
  • Implementing compliance programs;
  • Internal investigations;
  • Qui tam defense;
  • Asset protection;
  • Assistance with licensure & disciplinary proceedings; and
  • Jury trials.

At Oberheiden & McMurrey, LLP, we have broad experience within the area of health care fraud defense. Our health care clients range from individual providers to entire medical systems, and we regularly provide representation for clients involved in investigations conducted by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, the Drug Enforcement Administration, the Office of Inspector General, the Medicaid Fraud Control Unit, New Orleans and Louisiana law enforcement, the Internal Revenue Service, and other state and federal agencies.

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.
  • 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.
  • 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.
  • 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.
  • 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.
  • Defense of a laboratory against an investigation by various branches of the federal government for alleged fraud.
    Result: No civil or criminal liability.
  • 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.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Justice for alleged fraud.
    Result: No civil or criminal liability.
  • 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.
  • 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.
  • 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.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Justice for alleged Medicare fraud.
    Result: No civil or criminal liability.
  • 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.
  • 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.
  • Defense of nationally operating laboratory against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.

New Orleans, Louisiana Medicare Fraud Defense Attorneys

Nick OberheidenDr. Nick Oberheiden is a Harvard-trained and internationally educated health care fraud defense lawyer. Dr. Oberheiden has a track record of successfully representing health care executives, business owners, public officials, physicians, and lawyers in high profile prosecutions, political corruption allegations, governmental investigations, and in media campaigns, including 60 Minutes. Dr. Oberheiden’s experience includes stopping federal investigations before criminal charges can be filed. 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 of prosecuting health care fraud, Anti-Kickback violations, False Claims Act, and Stark violations on behalf of the United States. Ms. Byrd uses her immense experience with health care law enforcement to argue federal matters on behalf of her clients.

We are available every day of the year to discuss your case. You can call us directly or complete our contact form to request a free consultation.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving New Orleans, 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
×