Portland, Oregon 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 and education from the country’s leading schools such as Harvard Law School and Yale Law School. Our attorneys serve clients in Portland as well as throughout Oregon State.

If you are a healthcare provider or own a healthcare entity, business, or facility in Portland, Oregon and you’re facing an allegation of healthcare fraud, call Oberheiden, P.C. right away. Oberheiden, P.C. possesses substantive legal experience in healthcare fraud defense, Medicare and Tricare audits, OIG and grand jury subpoenas, compliance programs, internal investigations, fraud allegation defense, qui tam defense, protection of assets, criminal defense, and jury trials. Our Healthcare Fraud Defense Team includes 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 superb education..

If you are ready to learn how Oberheiden, P.C. can help you during this stressful time, call us now and ask to speak with a member of our Healthcare Fraud Defense Team. Initial consultations are free and confidential.

Portland, Oregon Is Closely Watched for Healthcare Fraud

Portland, Oregon is closely monitored by the Medicare Fraud Strike Force for healthcare fraud. This is because there are a large number of residents who are enrolled in a federal healthcare program of some kind. This causes a larger number of claims to be filed with the federal government for reimbursement. The Medicare Fraud Strike Force watches areas with an increased number of claims.

The Medicare Fraud Strike Force is an elite team comprised of select prosecutors and investigators from a variety of federal agencies, including the Department of Justice, Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. However, this list is not exhaustive. Other agencies may have a presence in the Medicare Fraud Strike Force. The Department of Justice investigated over 300 cases in 2016 alone. Around 80 of those investigations centered on individual healthcare providers. The rest involved a healthcare entity or business. The agency reported that it recovered more than $900 million in fraudulently paid out claims.

What Is Healthcare Fraud?

Federal healthcare fraud is defined as an attempt to secure reimbursement for medical services or equipment through government healthcare programs, such as Medicare, Medicaid, Tricare, or federal workers’ compensation by filing one or more fraudulent claims. It generally includes a violation of at least one of the following:

  • The Anti-Kickback Statute. Federal healthcare law strictly prohibits kickbacks in exchange for referrals. Any individual (including doctors, marketing representatives, and business owners) is subject to prosecution for violating the Anti-Kickback statute for offering or providing payment or other valuables in return for patient referrals.
  • Stark Law. Stark Law is also known as the Self-Referral Law. The law prohibits doctors from referring patients to specific healthcare service entities if the doctor (or a member of the doctor’s immediate family) has an ownership or investment interest, or if there is a compensation arrangement. Note, however, that there are statutory exceptions to this law.
  • False Claims Act. If you submit a claim to Medicare or any other federal healthcare program, you are required to abide by the False Claims Act. If the claim submitted to the federal government is found to be inaccurate, the federal government is likely to launch an investigation into your billing practices under the criminal provisions of the False Claims Act.
  • Prescription Fraud. The federal government maintains a close eye on healthcare practices that have an unusually high number of narcotic prescriptions. If you are suspected of running a “pill mill,” you are at risk of being investigated for insurance fraud and for violating DEA dispensing rules.
  • Billing Fraud. The federal government actively investigates the upcoding of claims. Upcoding means that the next higher code is used for a service when the billing is done. The federal government will also investigate phantom billing (billing for services that were not provided), billing for patients who do not exist (referred to as ghost patients), and billing for equipment or services that are deemed not medically necessary.
  • Certification Errors. The federal government keeps a close eye on the home healthcare and hospice industry. The most common allegation includes fraudulent certification for home healthcare and hospice care.

Oberheiden, P.C. has a track record of success helping clients avoid criminal charges. If you or your healthcare practice or business are under investigation for healthcare fraud in Portland, Oregon or the surrounding area, call Oberheiden, P.C.. Calls are free of charge and confidential.

Civil and Criminal Penalties of Healthcare Fraud

Healthcare fraud is a grave matter that may present civil or criminal penalties. Civil penalties may include civil repayment of claims, non-payment of future claims, and you may be excluded from federal healthcare programs. You are also at risk of facing the state disciplinary board, losing your license, and being stripped of your hospital privileges. Criminal penalties include prosecution, prison time, and fines in the hundreds of thousands of dollars.

If you are found guilty of criminal healthcare fraud, you may receive one of the following prison sentences:

  • 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.

Oberheiden, P.C. is regularly asked about the worst-case scenario related to healthcare fraud in Portland, Oregon and the surrounding area. The risk of facing criminal prosecution or receiving a federal prison sentence may depend on several factors, including the severity of any injury suffered by the patients, whether the prosecutor is interested in criminal prosecution, and the reason that started the investigation.

Oberheiden, P.C. is ready to help Portland, Oregon healthcare fraud defense clients thanks in part to our dual experience as former federal healthcare prosecutors and healthcare fraud defense attorneys. If you’re contacted and told that you’re being investigated for healthcare fraud and you’d like to learn more about your legal options, call us immediately. Initial consultations are confidential and free of charge.

Indicators of a Criminal Investigation

Healthcare fraud cases can be either civil or criminal. With early intervention and compelling defense strategies, Oberheiden, P.C. has an excellent reputation of helping clients avoid criminal charges. Call us right away if you’re being investigated for healthcare fraud in Portland, Oregon or the surrounding area so that we may begin our process to develop your custom defense strategies.

Being contacted by a prosecutor is not a certain sign that you are being investigated for criminal charges. All federal agencies that have prosecutors have both a civil and a criminal division. This is why you cannot accurately ascertain the nature of the charges based on the fact that a prosecutor has contacted you. Determining whether the investigation is criminal in nature can depend on the legal interpretation of many different elements, such as 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 signaled by search warrants, seizure warrants, arrest warrants, target letters, involvement of federal criminal prosecutors, IRS involvement, or grand jury subpoenas.

If you have questions about whether you are facing criminal or civil charges, call Oberheiden, P.C. as soon as possible. We represent individual providers, entire healthcare systems, and other related businesses. We provide healthcare defense services to individuals, businesses, and entities in and around Portland, Oregon that are under investigation 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, Portland or Oregon state law enforcement, or the Internal Revenue Service.

Healthcare Fraud Defenses

Oberheiden, P.C. is a healthcare fraud defense law firm offering services in Portland, Oregon and the surrounding area.. Several of our attorneys have previous experience as healthcare auditors and healthcare fraud prosecutors with the Department of Justice. We provide their extraordinary insight directly to our clients.

Legal advocacy begins right away. In every case, our primary objective is to assist our clients in avoiding criminal charges. Our experience and track record prove that the best way to defend against criminal prosecution is to intervene early and not allow the government much uninterrupted time to compile its case against you. We continuously work to protect your freedom and your professional aspirations. We begin to advocate for you immediately by getting into contact with federal prosecutors. Usually, we can 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?

Addressing the fact that mistakes are not crimes. The Constitution requires the federal government to prove beyond a reasonable doubt that you committed a crime and performed your actions with criminal intent. We test this high standard in each case where the federal government indicates that there may be criminal charges in the future. Prosecutors often use billing inaccuracies as an example to attempt to prove criminal intent. Despite this, we know from experience that mistakes happen and that those mistakes do not and should not equate to fraudulent activity. Oberheiden, P.C. has provided successful legal defense for clients across the United States by proving that the inaccuracies in billing are results of organization or human error and did not happen because of an intent to defraud the government. In our experience, we’ve learned that the use of unqualified workers, delegation errors, outsourcing errors, lack of oversight, insufficient supervision, and the frequently 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.

Developing strategic defenses for each case. Oberheiden, P.C. will help you to develop strategic defenses, including locating applicable defenses and statutory loopholes. Many of our cases have been successful because of our use of legal exceptions. For example, in the context of Stark Law, which involves medical necessity certifications, we have been able to point to exceptions to either mitigate or entirely resolve a healthcare fraud case.

Defending your reputation as a professional. We are committed to our clients both inside and outside of the courtroom. Allegations of healthcare fraud can be extremely harmful to your career. Rightfully, many of our clients are very concerned about how these allegations will affect their future. The media holds the power to ruin someone’s image or spread vicious rumors. Reports are often biased and averse to including the whole story. Our attorneys routinely address concerns about slander, and book news spots and other opportunities to correct misinformation about our clients.

Contact Oberheiden, P.C. immediately if you’re facing allegations of healthcare fraud in Portland, Oregon or the surrounding area. Initial calls are confidential and free of 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 Portland, Oregon 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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