New York City Physicians and Health Care Business
Knowledgeable Former DOJ-Prosecutors Represent New York Physicians and Health Care Business Owners in NYC
Cardiologists, Medicare and Medicaid providers, home health and hospice agencies, DME companies, pharmacies, and toxicology laboratories in New York are declared targets of new government audits and investigations. At stake for everyone are their reputation, livelihood, and in some cases even their professional license and freedom. To avoid these results, practitioners must implement a carefully structured strategy, which starts with engaging experienced legal representation.
Experienced Health Care Fraud Attorneys to Defend Clients in New York City, New York
Oberheiden, P.C. is known for its forceful health care fraud defense practice. Our attorneys represent, advise, and defend physicians and health businesses in a broad spectrum of government health fraud investigations and criminal trials—utilizing decades of first-hand experience gathered from previously held positions at the Department of Justice.
All New York clients are represented by experienced health defense attorneys and former federal prosecutors. Oberheiden, P.C. does not use junior lawyers or associates. We recognize the importance of your case and we will not allow any experiments. Call us today to speak to former DOJ officials and attorneys with specific experience in health care defense cases.
Current Health Care Fraud Investigations in New York City, New York
The United States government is aggressively targeting providers including physicians, hospitals, pharmacists, toxicology labs, hospices, and other providers in New York City and surrounding communities. If you are a New Yorker physician, practice administrator, or health executive and know or believe that your company, practice or business is under audit or investigation, you should not hesitate to contact experienced attorneys for professional guidance. Current health investigations in New York include:
- Prescription Drug Fraud. Federal allegations of fraudulent prescriptions, drug diversion, issuing medically unnecessary prescriptions, and failure to adhere to prescription requirements are all common. Providers targeted in these cases often face the maximum penalties available to the Federal Government. Nonetheless, in October 2017, President Trump declared the nation’s opioid crisis a public health emergency. Since then, the DOJ, DEA and other government agencies’ prosecutors have been relentless in their pursuit of criminal prosecutions and enforcement actions against health providers suspected of prescription drug fraud.
- Anti-Kickback Statute (AKS). The AKS is a federal law that has both civil and criminal penalties. If you or your company, practice or business is under an AKS investigation, this means that the relevant federal government agency conducting the investigation has at least some basis to conclude that you, your subordinates or company has contrary to the AKS solicited, paid, offered or received an illegal payment for the referral of health business including for patients.
- Fraud in Hospice and Home Health Patient Certification. Physicians who certify hospice or home health patients must at all times ensure that their certification practices are compliant and precisely documented. Similar to other health fraud forms, physician certification fraud constitutes a significant federal offense attendant harsh civil and criminal penalties. Moreover, hospice and home health agencies relying on such certifications should be careful in ensuring that these patients satisfy all certification standards and requirements and further, that such patients are properly recertified as required or advisable. Physician and hospice and home health agency owners and employees must continuously be aware that even small issues with compliance or documentation have the potential to become certification fraud allegations.
- Medicare and Medicaid Fraud. The Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services and the Office of Inspector General (OIG) have significantly increased their audit and enforcement activity against medical providers and health care business owners (e.g. hospice, home health, DME, toxicology laboratory, cardiologists, pharmacies) that accept Medicare and New York Medicaid covered patients.
- The Federal False Claims Act. As applicable to the False Claims Act, severe consequences follow a physician or other services or products providers’ billing Tricare, Medicare, Medicaid, or any other health care benefit program in non-compliance with relevant billing regulations. Indeed, a provider’s “false or fraudulent” submission of reimbursement claims can lead to civil fines and recoupments, and, in criminal cases, severe penalties like long-term incarceration. False Claims Act investigations can stem from billing and illegal coding acts (and sometimes plain errors) such as double billing, up-coding, unbundling, phantom billing, and billing for medically unnecessary services.
- Stark Law. The Stark Law and the AKS are similar in that they both are concerned with illegal referral payments. The Stark Law, however, is different in that: (i) it applies only to physicians and affiliated entities that they or their immediate family members own, and (ii) it does not have criminal penalties, only civil penalties. Nonetheless, the Stark Law provides for civil penalties of up to $15,000 for each referred service that violates the law and the potential exclusion from health benefit programs (in addition to other penalties). Physicians under Stark Law violation investigation should actively protect themselves by securing representation as fast as possible when they learn they are under investigation.
You can contact Oberheiden, P.C. to schedule a free initial case assessment. If you conclude that our health fraud defense team has the experience you need, our attorneys will take immediate action to intercede in your investigation.
Call Today for a Free Case Assessment from Former DOJ-Prosecutors
If you or your practice is under government audit or investigation, you should immediately reach out to experienced attorneys with a proven track record. Experience matters when it comes to health fraud investigations. The difference between prosecution and no charges rests on the experience of hundreds of health care fraud cases handled.
Oberheiden, P.C. will dedicate all resources to your success. Call us today to discuss your situation or concerns in a free and confidential consultation, including on weekends.
Important Questions Regarding Health Care Fraud Investigations in New York City, New York
Oberheiden, P.C. is proud of its track record when it comes to achieving spectacular outcomes for its clients. As a team, we offer profound familiarity with the health industry and, specifically, with government investigations and federal trials. Our experience is based on hundreds of cases handled as federal health fraud prosecutors at various U.S. Attorneys’ Offices as well as during the course of long and distinct criminal defense careers. Oberheiden, P.C. combines compelling negotiation and trial advocacy to present effective defensive strategies to each of our valued clients.
Q: Which Government Agencies Conduct Health Care Fraud Investigations?
A significant number of health fraud investigations in New York City involve prosecutors and agents from the DEA, the DOJ, the Medicare Fraud Strike Force and the Office of Inspector General. These government agencies have been tasked with enforcing the country’s federal health laws. They have a clear mandate: to actively pursue civil enforcement and criminal charges against New York health providers suspected of defrauding the nation’s federal health benefit programs. Our firm routinely appears before the following federal agencies in health care matters.
- Department of Justice, headquarters, Washington D.C.
- Department of Health and Human Services, headquarters, Washington D.C.
- Office of Inspector General, headquarters, Washington D.C.
- Centers for Medicare and Medicaid (CMS), headquarters, Washington D.C.
- Department of Justice, Various Cities Across the United States
- Department of Defense, Various Cities Across the United States
- Department of Labor, Various Cities Across the United States
- DEA, Various Cities Across the United States
- IRS, Various Cities Across the United States
- S. Secret Service, Various Cities Across the United States
- Federal Bureau of Investigation (FBI)
- Medicaid Fraud Control Units (MFCUs)
- U.S. Department of Defense (DOD)
- U.S. Department of Labor (DOL), and,
- Other agencies and task forces
Q: Am I Required to Cooperate with Federal Agents Conducting the Investigation?
Knowing your obligations to a government agent conducting a federal health care fraud investigation requires your understanding of specific information. For example, which government agency or agencies are involved? Have you previously received a civil investigative demand or subpoena? Have you been served with a warrant? If the law does not require you to cooperate with a government agency, is it in your best interests to do so (and moreover, if so, to what extent)? Our attorneys can help you answer these critical questions. The goal you should keep in mind is that, during an investigation, you must make informed and helpful decisions all of may help you in the end.
Q: If I Know that My Practice Has Overbilled Medicare, Do I Have to Disclose this Fact to the Government?
Health providers are subject to various self-reporting obligations. If you discover a problem in your practice or business’s compliance program, which has resulted in overbilling Tricare, Medicaid, Medicare or other health care benefit program, you may be required to disclose this to the government. Nonetheless, there are specific procedures that must be followed for self-reporting billing violations. Also, keep in mind that only experienced attorneys can advise you whether your contemplated self-disclosure could result in criminal charges. To mitigate your liability as much as possible, contact our health care fraud defense team as soon as you can.
Q: How Far Back Can the Government Review Our Billing Records?
The breadth of the “Look-Back” period will depend on the specific statute(s) under which your business or practice is being investigated. Nonetheless and generally speaking, you should expect that several years of health program billings will be subjected to close scrutiny by the government. For example, under Section 3731(b) of the False Claims Act, federal investigators may review up to 10 years of billing records.
More questions? To schedule a free case assessment at Oberheiden, P.C., please call (888) 519-4897 or contact us online. We are available to talk to you seven days a week, and if we cannot respond immediately we will be in touch as soon as possible.
Whom Should I Call?
The federal law defense attorneys at Oberheiden, P.C. have decades of government and federal fraud investigation experience. The Firm’s federal law health care fraud defense team includes former fraud prosecutors with the U.S. Attorney’s Office and the U.S. Department of Justice (DOJ). Using these decades of government and prosecutorial experience, we design and execute defense strategies as measured to our clients’ unique circumstances and when we know are the federal government’s priorities. Nonetheless, our attorneys always take a comprehensive team approach focusing the full weight of our attorneys’ experience for the benefit of our clients.
Experience in All Federal Law and Government Health Care Fraud Matters
Our health fraud defense team is ready to provide reliable and effective legal representation for New York City health providers facing investigations by the federal government. If your practice or business is being investigated, or if you have concerns regarding potential billing violations, our attorney’s can take quick action to mitigate adverse consequences. In short, we will pursue all available courses of action to help you address any civil or criminal investigations or charges.
Free Consultation With Trusted Health Care Fraud Attorneys In New York City
If you are or if you think you are under investigation, you should immediately seek professional guidance. Oberheiden, P.C. offers free and confidential consultations, including on weekends, to discuss your situation and to find a way to avoid or fight criminal charges. Call us today.
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