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False Claims Act & Qui Tam Lawsuit Defense in Ohio

Qui tam lawsuits are routinely abused in Ohio. This causes many innocent health care providers and businesses to be investigated for violating the False Claims Act. If you’re named in a qui tam lawsuit or if you are being investigated by the federal government, call Oberheiden & McMurrey, LLP. We also assist clients with federal criminal defense. To help our client lessen the likelihood of being investigated, we provide assistance with both corporate structuring and in developing and implementing a federal regulatory compliance program. Our experienced legal defense team is led by a former Chief Health Care Fraud Coordinator from the U.S. Attorney’s Office. Oberheiden lawyers have impressive legal educations and former experience. Many of our team members have former experience as federal prosecutors and senior trial lawyers. The Oberheiden & McMurrey, LLP represents clients throughout the entire State of Ohio.

Ohio health care providers, entities, businesses, and facilities are at higher risk of being accused of violating the False Claims Act than in the majority of the United States. If the federal government investigates you, your practice, or your business, you may be charged civilly or criminally. Oberheiden & McMurrey, LLP provides legal advocacy to Ohio health care providers, health care systems, businesses, and other related organizations that need assistance during the False Claims Act investigation. Our Health Care Fraud Defense Team is led by Dr. Nick Oberheiden. He is a Harvard-trained negotiator and renowned health care fraud defense attorney. Dr. Oberheiden is the principal managing partner of the Oberheiden & McMurrey, LLP.

False Claims Act Violations in Ohio

Individual providers (such as doctors and nurses), health care facilities, businesses, and other entities located or providing care in Ohio bear an exceptionally higher risk of investigation for violating the False Claims Act. Ohio is one of nine areas that is home to a large number of individuals who rely on a federal health care program of some type. Because of this, more claims are filed by providers just like you. In areas where more claims are filed, such as Ohio, the Medicare Fraud Strike Force pays close attention, because the federal government believes that there is more of a risk of violations of the law.

The Medicare Fraud Strike Force is an agency that monitors, investigates, and prosecutes False Claims Act violations. It is an investigative unit of combined investigators and prosecutors from several federal agencies including the Department of Justice, the Department of Health and Human Services, the Office of Inspector General, the DEA, the FBI, and the IRS. Other agencies can also be involved.

If you’re being investigated by the Medicare Fraud Strike Force, you should contact us right away. Initial consultations are free of charge, and they are confidential.

False Claims Act Basics

The False Claims Act is a federal law. It is applicable to any individual, business, or organization that has a direct or an indirect contract with and that will be paid by the federal government for equipment or services. Any individual, business, contractor, or organization that knowingly submits or causes the submission of a false claim for approval and payment by the federal government is subject to civil and criminal penalties.

The False Claims Act doesn’t have a legal requirement of actual knowledge that the claim itself was false. Civil and criminal liability exists because, as a professional, you knew or should have known whether or not the claim was illegal. Think about your need for medical coding. Recently, ICD-10 was released and implemented. Regardless of whether you hire someone to work in your office or if you outsource, an obsolete or inaccurate code that is used can be reason for a False Claims Act investigation launched against your practice or business. It is because you have the professional responsibility to ensure that people working on your behalf are using the appropriate and most up-to-date codes available.

Civil and Criminal Penalties Under the False Claims Act

If you’re investigated for violating the False Claims Act, you could be tried in civil or criminal court. If you’re not sure about the charges that you may be facing, call Oberheiden & McMurrey, LLP right now. Once retained, we can help you get the answers that you need.

Civil penalties are ordered by the civil court. They can have a major impact on your life. Other civil penalties may come from the disciplinary board or the state licensing board. You may be subject to one or more of the following:

  • Treble damages (damages that are three times more than the amount that the claim is worth)
  • A fine of up to $11,000 per false claim
  • State disciplinary proceedings
  • Loss of your professional license
  • Loss of hospital privileges
  • You could be ordered to pay attorneys’ fees for the federal government

Criminal penalties are imposed by the criminal court. You may face one or more of the following:

  • Criminal indictment
  • Prison time
  • A fine of $250,000 per claim for individuals for federal felony convictions
  • A fine of $500,000 per claim for businesses for federal felony convictions
  • A fine of $100,000 per claim for individuals for a misdemeanor conviction
  • A fine of $200,000 per claim for businesses for a misdemeanor conviction

Qui Tam Lawsuits in Ohio

Ohio False Claims Act investigations are often caused by a qui tam lawsuit filed against you or your organization. Initially, these lawsuits were meant to be utilized as a mechanism that protected the federal government from being defrauded. Private citizens file the lawsuit on behalf of the federal government to help it recover money that it paid out in false claims. If the lawsuit is successful, the plaintiff receives a portion of the recovered funds. Qui tam is Latin. It means ‘he who sues for the king and himself.’ Yet, what was meant to be a legal tool to assist legitimate whistleblowers is now abused by vindictive former employees and nervous competitors to take you and your business out of the health care industry.

Qui tam lawsuits are filed and heard in federal court. The federal court will depend on where your practice, facility, or business operates in Ohio. In the lawsuit, the plaintiff is called the ‘qui tam realtor.’ Qui tam lawsuits are sealed, with the exception of unsealed copies that are given to the assigned judge and the involved federal officials. Since False Claims Act investigations can be time-consuming, the court regularly grants six month extensions to give the government all of the time that it needs.

As soon as you learn that you’re the defendant of a qui tam lawsuit, you need to retain a health care fraud defense attorney. Your attorney can open the channels of communication with the federal government on your behalf. This can help determine what can be done to bring the investigation to a close. In some instances, there are settlements available. However, please keep in mind that these investigations and any potential settlement agreement can take time. The more complex your case is, the longer it can take.

The federal government will issue subpoenas for your financial, corporate, billing, communication, and other important records. You may receive subpoenas from the FBI, the IRS, OIG, DEA, DOJ, or other federal agencies. The federal government will receive the documents from you to make its determination on whether it will support the qui tam lawsuit or decline to get involved.

If the federal government elects to decline involvement, the qui tam lawsuit doesn’t necessarily die. The plaintiff still has the option to try to pursue the allegations against you. If they win the qui tam lawsuit, they will be rewarded with 30 percent of the recovered funds. In cases where the federal government gets involved, this is known as government intervention. The Department of Justice must grant permission to the investigators and prosecutors. If this happens, you will very likely face additional serious charges, such as violations of the Anti-Kickback Act, the Truth in Negotiation Act, or the Physician Self-Referral Law. If you lose the qui tam suit, the plaintiff will receive 25 percent of the recovered funds as a reward.

Imperative Defense Strategies

Oberheiden & McMurrey, LLP has an impressive combination of experience. Many of the lawyers who are part of our Health Care Fraud Defense Team formerly held senior positions as federal prosecutors of health care fraud. This experience, combined with our experience as health care fraud defense attorneys, has led us to develop imperative defense strategies that we use in False Claims Act investigations for our clients in Ohio and around the nation.

Addressing possible charges. Our first objective is to contact the government. It is important to do this for two reasons. First, we are able to ascertain the potential charges that our clients may face. Knowing this can help our Health Care Fraud Defense Team formulate a strategic defense. Second, we understand that most False Claims Act investigations in Ohio do not originate out of criminal intent. Rather, they happen because of a mistake. When we contact the government, we are able to determine how the investigation started, the possible exposure, and what mistakes our clients need to correct in order to resolve the investigation. This early intervention on behalf of our clients is integral. Generally, we can get into contact with the federal investigators and get the answers to these questions within just a few hours after we are retained.

Qui tam defense strategies. As you learned earlier, most qui tam lawsuits in Ohio are not true whistleblowing events. They are attempts at shutting you down. This is why we aggressively confront qui tam lawsuits involving our Ohio clients. The objective is to destroy the credibility and integrity of the case and the plaintiff. We closely analyze the facts and the evidence in order to prove to the federal government that the case has no merit and does not deserve its support.

Negotiations with the federal government. In civil liability cases, the government may inform us of a settlement demand. We work to lower this amount to something that is more favorable to our clients. None of our clients have ever been forced to shut down their businesses or stop practicing medicine.

Oberheiden & McMurrey, LLP

Oberheiden & McMurrey, LLP provides successful legal defenses nationwide for doctors; clinic owners; physician-owned entities; toxicology labs; DME companies; pharmacies; service management organizations; marketing companies that work in health care, clinics, hospitals; and many other health care related entities in relation to False Claims Act violations. We also assist defendants in qui tam lawsuits; Stark Law violations; Anti-Kickback statute violations; and with Medicare, Medicaid, Tricare, and Department of Labor investigations.

Our Track Record

The attorneys of Oberheiden & McMurrey, LLP have successfully defended physicians, practice owners, physician owned entities, toxicology laboratories, device companies, pharmacies, service management organizations, health care 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 (Health Care Service Provider)   Result: No Liability.

Call Oberheiden & McMurrey, LLP now and ask to speak with our Health Care Fraud Defense Team about your case. Initial consultations are confidential and free.

False Claims Act Defense Lawyers Serving Ohio

Nick OberheidenDr. Nick Oberheiden has represented clients in qui tam lawsuits, False Claims Act investigations, Medicare fraud investigations, Tricare fraud investigations, Stark Law violations, and anti-kickback proceedings before virtually all federal agencies including, but not limited to, the Office of Inspector General (OIG), the Department of Health and Human Services (HHS), the Department of Defense (DOD), the Department of Justice (DOJ), and the Department of Labor (DOL). Dr. Oberheiden is trained in negotiations by Harvard Law School and holds a Juris Doctor from the University of California, Los Angeles, as well as a Ph.D. in law.

Lynette ByrdLynette S. Byrd is a former Assistant United States Attorney (AUSA). Detroit clients greatly benefit from Ms. Byrd’s previous experience with the Department of Justice, where she prosecuted health care fraud, Anti-Kickback violations, violations of the False Claims Act, and Stark Law violations on behalf of the United States. Ms. Byrd has immense experience with health care law enforcement, and she regularly argues federal matters for her clients.

Don’t wait. We’re available now to discuss your case. Call us, email us, or use our contact form.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving the State of Ohio 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.

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