Puerto Rico Healthcare Fraud Defense Lawyers
Healthcare providers in Puerto Rico face the same federal oversight as providers on the U.S. mainland. Audits and investigations can lead to substantial penalties; and, in order to avoid these penalties, providers need to know how to defend themselves effectively.
Fraud, waste, and abuse are pervasive in our modern healthcare system. Each year, Medicare, Medicaid, Tricare, and Veterans Affairs (VA) lose billions of taxpayer dollars due to fraudulent overbillings, and the federal government has attributed much of the nation’s current opioid problem to over-prescription and medication diversion by healthcare providers. As a result, despite the critical role providers play in our healthcare system, they are now squarely within the federal government’s crosshairs. Audits, investigations, takedowns, and prosecutions are the norm, and providers across Puerto Rico are suddenly finding themselves fighting to stay out of prison.
Are you facing a federal healthcare fraud audit or investigation in Puerto Rico? If so, our federal healthcare fraud defense lawyers can help you avoid life-altering and practice-threatening consequences due to being charged with criminal fraud. We have protected the majority of our clients against federal charges, and we also have a proven track record of helping our clients avoid fines and prison time post-indictment. While we cannot guarantee what the federal government will do, what we can guarantee is this: We will rely on our attorneys’ centuries of combined experience on both sides of federal healthcare fraud cases to protect you to the fullest extent possible.
15 Keys to Success When Facing a Federal Healthcare Fraud Audit or Investigation in Puerto Rico
5 Key Facts about Facing a Healthcare Fraud Audit or Investigation
1. Providers Can Be Charged for Intentional and Unintentional Billing Fraud
In federal healthcare fraud matters, ignorance is not a defense. Even if you (or one of your employees) unknowingly overbilled Medicare, Medicaid, Tricare, or the VA, you can still be charged with civil violations of the False Claims Act and the Anti-Kickback Statute. The Stark Law also imposes civil penalties for physicians who engage in prohibited referral transactions related to designated health services regardless of whether they were aware their actions violated federal law.
2. Audits and Investigations Can Ultimately Lead to the Same Outcomes
While audits and investigations are very different inquiries that involve very different standards and procedures, the end result can ultimately be the same. If an auditor concludes that a practice or business has overbilled the government, it can (and may be obligated to) refer the provider to the U.S. Department of Justice (DOJ) for civil or criminal prosecution. As a result, Puerto Rico healthcare providers must treat audits and investigations with equal care, and they must execute comprehensive defense strategies focused on fighting all of the allegations against them.
3. Trying to Be “Helpful” to Auditors or Investigators
While you may have an obligation to produce your practice’s billing records or provide other information in response to a subpoena or civil investigative demand (CID), handing over evidence when you are not legally required to do so is a mistake. There are certain circumstances in which it can make sense to voluntarily disclose information; however, the decision to do so needs to be made strategically and with the advice of legal counsel.
4. Ignoring the Audit or Investigation
Ignoring the audit or investigation, assuming it will “go away,” and waiting to see how the inquiry progresses before seeking legal representation are all common mistakes as well. If your Puerto Rico healthcare practice or medical business is facing scrutiny from federal authorities, protecting your practice – and yourself – needs to be your top priority.
5. Trying to Defend Your Practice Without Legal Advice
As a result of the complexity of the issues involved, the risks of facing civil or criminal charges, and the experience of the auditors or investigators who are looking into your practice or business, it is imperative that you seek legal representation immediately. In order to defend yourself to the fullest extent possible, you need to put experience on your side.
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5 Key Reasons Why Healthcare Providers in Puerto Rico and Nationwide Choose Oberheiden, P.C.
1. We are a Team of Senior Defense Attorneys and Former Federal Prosecutors
Our federal defense team is comprised entirely of senior defense attorneys and former federal prosecutors. Our practice is focused on federal defense with particular emphasis on healthcare fraud and related offenses, and we do not have junior associates or paralegals working on our clients’ cases. Throughout your case, you will work exclusively with our senior attorneys.
2. We have a Nationwide Presence
Our firm has a nationwide presence, and this allows us to effectively and efficiently represent clients in Puerto Rico. We have successfully defended healthcare providers and medical businesses across the country, and we use this vast experience to our clients’ advantage.
3. We have a Substantial Track Record of Securing Favorable Results for Our Clients
Our track record in federal healthcare fraud audits and investigations is substantial. We have secured favorable results in thousands of cases, with the majority of our clients never facing civil or criminal charges. In cases in which it has not been feasible to avoid charges (whether due to the provider’s delay in seeking legal representation or other factors), we have achieved favorable results both prior to and during trial.
4. We Focus on Securing Efficient and Discrete Pre-Charge Resolutions
While it is possible to successfully defend against charges of federal healthcare fraud (as our record shows), it is far less disruptive to resolve a federal inquiry before charges get filed. For this reason, we focus our efforts on securing favorable pre-charge resolutions for our clients. By getting involved in the process early and inserting ourselves into the audit or investigation, we are able to gain control of the process and work to steer it toward an efficient, positive, and discrete outcome.
5. We are Available When and Where Our Clients Need Us
Serving our clients is our top priority, and it shows in how we run our practice. Our clients have access to our senior attorneys 24/7, and we speak with our clients regularly during the stages at which their involvement is required. Whether we need to be on the ground in Puerto Rico or in any city across the United States, our attorneys will be there fully prepared to protect you and your practice or business.
Request a Free Assessment of Your Federal Healthcare Fraud Case in Puerto Rico
If you need legal representation for a federal healthcare fraud audit or investigation in Puerto Rico, we urge you to contact us promptly to discuss your case. To speak with one of our senior federal defense attorneys in confidence, call 888-680-1745 or tell us how we can reach you online now.