Former federal prosecutors
offering unparalleled knowledge and a proven track record


Meet the Team
Oberheiden Attorneys

Texas Medicare Fraud Defense for the Rio Grande City Region

Medicare fraud allegations in Texas can devastate your business. If you’re facing an allegation of Medicare fraud in Rio Grande City, Texas or the surrounding areas, call the Oberheiden & McMurrey, LLP. We are a Texas law firm providing representation for those accused of Medicare fraud, involved in a Tricare or Medicare audit, involved in a jury trial, qui tam defense, and other legal matters. We also assist Texas clients with implementing a federal compliance program and responding to an OIG or grand jury subpoena. Our legal team is managed by a former Chief Health Care Fraud Coordinator from the Dallas U.S. Attorney’s Office.

Clarifying Medicare Fraud

Medicare fraud is a federal offense that can result in civil or criminal penalties. Medicare fraud involves the filing of one or more inaccurate claims with a federal health care program. The health care program can be Medicare, Medicaid, Tricare, or federal worker’ compensation. These claims are filed by medical professionals, entities, and businesses to receive reimbursement for their equipment and medical services that were provided to a program beneficiary. If you’re accused of Medicare fraud, it means that the federal government believes that you violated at least one of the following:

  • Violating the Anti-Kickback Statute;
  • Violating the False Claims Act;
  • Violating Stark Law (the Physician Self-Referral Law);
  • Violating the Social Security Act;
  • Violating U.S. Criminal Code.

Health care providers, labs, pharmacies, facilities, and businesses are investigated for Medicare fraud in Rio Grande City, Texas more often than in similar sized cities in the nation. Rio Grande City, Texas is one of nine areas in the nation with a substantial number of federal health care program recipients. This causes more claims to be filed in the area. The increase in claims causes the Medicare Fraud Strike Force to constantly monitor the area for occurrences of Medicare fraud.

The Medicare Fraud Strike Force is a federal team made up of investigators and prosecutors from several federal agencies including the DOJ, DEA, DOD, Department of Human Services, the Office of Inspector General, the FBI, and the IRS. This list isn’t all-inclusive. In fact, the Medicare Fraud Strike Force often includes members of other federal agencies. If you’re contacted by a representative of a federal agency, immediately contact Oberheiden & McMurrey, LLP.

Medicare Fraud Investigations in Rio Grande City, Texas

Medicare fraud investigations in Rio Grande City, Texas and the surrounding areas often begin because of a claim that is filed with a federal health care program that is deemed inaccurate in some way. The claim often includes a charge for unauthorized services or medical equipment, includes an excessive charge, or has an incorrect amount listed. The most common billing inaccuracies in Rio Grande City, Texas include:

  • Phantom billing – billing for services that were never performed;
  • Double billing for medical equipment or services;
  • Submitting a claim for medically unnecessary medical services or equipment;
  • Submitting a claim for medically unnecessary medical supplies;
  • Submitting a claim for a medically unnecessary certification (including a claim for hospice or home health care );
  • Inflating charges;
  • Up-coding;
  • The overuse of medical equipment of services;
  • Providing or accepting kickbacks.

Doctors, nurses, physician-owned entities, nursing and registered care facilities, clinics, pharmacies, labs, DME providers, and cancer centers are common targets of Medicare fraud investigations in Rio Grande City, Texas.

Civil and Criminal Penalties of Medicare Fraud in Rio Grande City, Texas

An allegation of Medicare fraud in Rio Grande City, Texas can cause you to face civil or criminal penalties. Civil penalties often include:

  • Repayment of claims in questions;
  • Future claims aren’t paid;
  • A fine of up to $11,000 per false claim;
  • Exclusion from federal health care programs;
  • Assignment of treble damages;
  • Attorney fees.

Additionally, you could be called in front of the state disciplinary or licensing board. You could lose your professional license or your hospital privileges.

Criminal penalties for Medicare fraud could result in:

  • Fines that cost you hundreds of thousands of dollars, even for a misdemeanor;
  • A criminal record;
  • A federal prison sentence of up to 10 years for each count of Medicare fraud for which you are convicted;
  • Federal prison sentence of up to 20 years for each count of Medicare fraud that resulted in serious bodily harm to the patient or patients;
  • A life sentence in federal prison for Medicare fraud that results in the death of a patient.

Choosing a Medicare Fraud Lawyer in Rio Grande City, Texas

Medicare fraud is a federal offense that requires you to have the assistance of a Medicare fraud lawyer in Rio Grande City, Texas. Medicare fraud allegations may also include a wire fraud, money laundering, tax fraud, or mail fraud allegation. Those are federal criminal offenses. It’s important that you choose the right health care fraud defense lawyer to help defend you. Watch for these characteristics:

  1. A successful record when handling Medicare fraud cases;
  2. Knowledge of the Medicare fraud and health care fraud laws and regulations;
  3. Knowledge of statutory exceptions;
  4. Both litigation and jury trial practices.

When you find a lawyer with those qualifications, ask these questions:

  1. How many Medicare fraud cases have you handled throughout your career?
  2. How many of those resulted in no civil or criminal charges or in dismissals for your clients?
  3. How many of those cases were tried in court?

Medicare Fraud Defense Strategies in Rio Grande City, Texas

Oberheiden & McMurrey, LLP has developed strategies that we use in each Medicare fraud case in Rio Grande City, Texas and in the surrounding areas. We do try to settle cases when it is an option, but we are also skilled federal trial lawyers who are ready to go to court on your behalf. We have represented hundreds of clients and we’re ready to represent you.

Contacting the federal investigator. Our goal is to successfully resolve the accusations against you or your business and to help you avoid criminal charges. Following our engagement, we immediately contact the involved federal investigator to get answers to the most important questions regarding your case:

  • What is the investigation about?
  • What prompted the investigation?
  • Is the investigation civil or criminal?
  • Which federal agencies are involved?
  • What is the ultimate goal of the government?
  • How can this matter be resolved?

We are usually able to get answers to these questions within just a few hours after we are retained.

Analyzing evidence presented by the federal government. The federal government will attempt to present evidence to prove that you committed a crime. However, the evidence must meet a high burden of proof known as “beyond a reasonable doubt.” Our team will analyze the evidence to determine if it reaches that standard. This one strategy has given our clients the following results on a regular basis:

  • Dismissal of charges;
  • No criminal charges;
  • Client retains professional license;
  • Civil fine with no criminal plea;
  • Reducing a felony to a misdemeanor;
  • No federal prison sentence.

Lack of criminal intent. In addition to proving that you committed a crime, the federal government must also be able to prove that you acted with criminal intent. This means that you decided to file an inaccurate claim in order to be illegally reimbursed. In Rio Grande City, Texas most of the Medicare fraud cases that occur don’t start because of intentional fraud. They start because someone made a mistake. The most common mistakes include:

  • Using unqualified staff;
  • Inadequate supervision;
  • Inappropriate delegation and outsourcing;
  • Structural errors;
  • Human errors;
  • Oversight;
  • Employees who are overwhelmed;
  • No Medicare compliance program in place;
  • The changing health care laws and rules.

These mistakes should be addressed and corrected by our clients, but they shouldn’t be held to criminal standards. Oberheiden & McMurrey, LLP works to prove that you made a mistake and that you did not act with criminal intent.

Using individual Medicare fraud defenses. Medicare fraud cases may have similar allegations, but they’re all different because of the involved facts and statutes. This is why we take the time to evaluate each case to determine the most appropriate Medicare fraud defenses to use. Recently, one of our clients was accused of providing fraudulent certifications for home health care services. We were able to prove that our client was legally protected by a delegation exception and that the certification was compliant with the law. In a separate case, we did not admit liability on behalf of our client. Rather, we proved to the federal prosecutor that our client acted within a safe harbor exception.

Oberheiden & McMurrey, LLP

Oberheiden & McMurrey, LLP provides legal advocacy for those accused of Medicare fraud in Rio Grande City, Texas and in the surrounding areas. We represent doctors, nurses, business owners, entities, business executives, attorneys, hospitals, clinics, pharmacies, labs, and other medical businesses under investigation for matters related to fraudulent billing, illegal kickbacks, and allegations of medically unnecessary services, services not rendered, or unlawful joint ventures. We can help you in many areas, including:

  • Health care fraud defense
  • Compliance program creation and implementation
  • Internal investigations
  • Asset protection
  • Licensure or disciplinary proceedings
  • Jury trials

If you’re under investigation by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, Rio Grande City or Texas law enforcement, call us right away. There is no charge for confidential first time consultations.

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.

Medicare Fraud Defense Lawyers Serving Rio Grande City, Texas

Nick OberheidenNick Oberheiden is a Harvard-trained and internationally educated health care fraud defense attorney. Dr. Oberheiden has successfully represented health care executives, business owners, public officials, physicians, and lawyers in high profile prosecutions, during accusations of political corruption, government investigations, and directed media campaigns, including 60 Minutes. He is most known for 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 knowledge from the Department of Justice, where she prosecuted health care fraud, Anti-Kickback violations, False Claims Act, and Stark violations on behalf of the United States. Ms. Byrd has skills with health care law enforcement, and she regularly argues federal matters for her clients.

We are available every day of the year. You can call us directly or complete our contact form or by emailing us directly.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving Rio Grande City, Texas 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
×