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Dr. Nick Oberheiden
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Aaron Wiley
Former State &
Federal Prosecutor

S. Amanda Marshall
Former U.S. Attorney

Bill McMurrey
Former DOJ-Trial Attorney

Lynette Byrd
Former Assistant
U.S. Attorney

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Sober Living Home & Toxicology Investigations: Important Questions You Should Ask Your Attorney

Categories: Health Care Law

Sober Living Home & Toxicology Investigations

Oberheiden, P.C. is comprised of former federal prosecutors and veteran health care fraud defense attorneys. Our clients include business owners and medical professionals facing health care investigations, including investigations into sober living homes and toxicology laboratories. Our attorneys rely on their experiences serving as Assistant United States Attorneys and Special Assistant United States Attorneys in the civil and criminal health care fraud sections at the U.S. Attorney’s Office to offer insightful advice to clients looking for reliable health care fraud defense services.

Are You Under Investigation?

Are you engaged in a business relationship that involves referrals? Have you signed a health care contract without legal representation? Are you confused about the parameters of the federal Anti-Kickback Statute? Have you been approached by fraud investigators? Have you been criminally indicted for violations of the Anti-Kickback Statute? Do you want reliable legal advice and a cohesive defensive strategy?

If you own or operate a sober living home or a toxicology laboratory and answered yes to one or more of these questions, you should call Oberheiden, P.C. today.

The federal government is placing an increasing focus on sober living homes and urine toxicology laboratories. In particular, federal investigators are scrutinizing the relationships between sober living homes and the toxicology laboratories they use to process the urine tests of their patients in order to determine whether violations of the federal Anti-Kickback Statute or other health care regulations are occurring.  Countless medical professionals and business owners have been arrested in connection with kickback schemes in recent times within the rehabilitation industry, and there is no sign that this trend will wane any time soon.  Given the harsh penalties associated with health care fraud crimes, if you believe you are under investigation, you should hire an experienced health care defense attorney immediately.

Why Are Sober Living Facilities Under Investigation?

Like many other industries, the federal government is susceptible to trends and cycles, which are often driven by the political atmosphere and current events.  For example, a decade ago, DME (Durable Medical Equipment) was a high priority of federal investigators and, as a result, DME companies faced much more scrutiny than other branches within the health care industry.  Similarly, with the growing opioid crisis in America, pain management clinics are receiving a noticeable amount of law enforcement attention. Most recently, perhaps as a reverberation of the opioid epidemic, the government has begun to target sober living facilities and the toxicology laboratories they use to process urine samples.

In particular, the government is scrutinizing the relationships between sober living facilities and toxicology laboratories to determine whether improper kickbacks are being paid to the sober living homes to incentivize them to choose one laboratory over others and/or to order unnecessary urine tests.  Since sober living facilities order a high volume of urine tests, they are lucrative clients for toxicology laboratories. What has transpired from investigations so far is that some toxicology laboratories felt tempted to provide sober living homes with cash, gifts, discounts, or other remuneration in return for their business—either directly or through middlemen.  In other common kickback schemes, toxicology laboratories pay sober living homes a kickback per urine sample submitted to them, which encourages sober living homes to order more urine samples than medically necessary for their patients in order to increase their kickback amounts. 

According to recent case filings, characteristic of a sober living/toxicology kickback arrangement is that the principles of the sober living home will set up an independent limited liability company to operate a bank account that will receive the kickbacks.  The toxicology laboratories will then utilize a seemingly unrelated middleman to deposit the kickbacks into the bank account.  While this sort of scheme appears to have several layers of protection to throw off investigators, experienced investigators are familiar with this type of set up and they know what signs to look for to uncloak it.

Why Does Federal Law Apply to Private Insurance Fraud?

Although sober living facilities generally service patients with private health insurance, they are not immune from federal prosecution. Federal fraud statutes encompass fraud committed against private companies. More so, the United States Department of Justice has taken the position that each invoice submission to a private insurance constitutes either mail fraud or wire fraud, two of the most severe federal fraud statutes with punishments ranging up to 20 years incarceration—per each fraudulent claim submission.

Ask These 10 Questions Before Hiring Your Attorney

Remember, the best DUI attorney in town may not know much about effective federal health care fraud defense strategies. Owners and contractors of sober living homes and affiliated toxicology laboratories that are (or could be) targets of health care fraud need attorneys with a proven track record and experience in complex health care defense matters. Before hiring an attorney, any providers and business executives under federal investigation should ask a combination of the following questions to test the attorney’s specific experience in this area of law.

  1. Does Your Practice Focus on Health Care Fraud Cases?
  2. How Regularly Do You Defend Clients Against the U.S. Attorney’s Office?
  3. How Many Times Have You Appeared before the Office of Inspector General of the Department of Health and Human Services?
  4. How Many Years of Combined Health Care Fraud Experience Do the Lawyers that Would Represent Me Have?
  5. How Many Health Care Fraud Investigations Has Your Firm Handled?
  6. How Many of Your Firm’s Health Care Fraud Investigations Have Resulted in No Civil or No Criminal Liability for Your Clients?
  7. How Many Cases Have You Handled that Involved Sober Living Homes?
  8. How Many Federal Jury Trials Have You Tried?
  9. How Many Federal Health Care Fraud Cases Have Brought to Trial?
  10. Will Your Attorneys Be Available to Answer Pressing Questions about My Case or Do You First Need to Research the Law?

If you are facing an investigation for health care fraud, you need a lawyer with the following attributes:

  • Expertise in state and federal health care laws;
  • Experience defending clients against the Department of Defense, Department of Justice, the Department of Health and Human Services, and other agencies involved in health care investigations;
  • Well-honed negotiating skills;
  • Trial experience before federal judges and juries;
  • A track record of success in complex health care fraud cases.

Your lawyer should not merely be a “health care attorney” but a health care defense attorney.  Most health care attorneys focus on transactional matters, such as reviewing contracts and setting up business structures.  While these skills are very important to the health care industry, they are less useful on the backend of a criminal case when medical professionals or business owners are facing criminal health care fraud investigations. Instead, you need an attorney who is used to dealing with federal prosecutors and agents and who has experience in federal criminal health care law.

Health Care Fraud Defense Attorneys of Oberheiden, P.C.

Oberheiden, P.C. is known for its forceful health care fraud defense practice. Our attorneys represent, advise, and defend corporate and individual clients facing a wide variety of civil and criminal health care fraud investigations—applying decades of experience and insights as former federal health care fraud prosecutors with the Department of Justice.

Our team consists of former federal prosecutors and experienced health care fraud attorneys who understand how the government builds its case and what the best tactics are to fight against it. Our track record speaks for itself. We have helped clients throughout the country retain their freedom, their reputations, and their practices. Call us today to see how we can help you.

All of our clients are represented by veteran attorneys with the specific experience needed to navigate clients through sober living and toxicology investigations. When you call us you will not be represented by junior lawyers or paralegals. Your case is not an experiment. You will be represented by senior attorneys with significant experience.

What Should I Do Next?

The most important thing anyone under health care investigation can do is to act quickly. By the time you learn that the government is investigating you, their investigation has been proceeding for months or even years.  By dragging your feet before arranging for your defense, you are simply giving the government more time to investigate you, your business, your affiliates, and your family members.  The best way to achieve a successful outcome from a government investigation is to implement an effective defense strategy early on in the government’s investigation.

Call one of our senior attorneys today to discuss your case.  All calls are free and absolutely confidential.

The attorneys at Oberheiden, P.C. have experience appearing before all agencies and government entities involved in the health care industry.  Through our unique defense strategies and unparalleled experience, we have amassed an impeccable track record. Our lawyers regularly handle cases before the following agencies:

  • 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
  • FBI, 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

We have specific experience representing business executives, owners, staff, marketers, and physicians as follows:

  • Toxicology Laboratory, Health Care Fraud Investigation
  • Toxicology Laboratory, False Claims Act
  • Toxicology Laboratory, Regulatory Compliance
  • Toxicology Laboratory, Anti-Kickback Issues
  • Rehabilitation Center, Health Care Fraud Investigation
  • Rehabilitation Center, False Claims Act
  • Rehabilitation Center, Regulatory Compliance
  • Rehabilitation Center, Anti-Kickback Issues
  • Business Executives, Marketing Groups, Health Care Fraud Investigations
  • Business Executives, Marketing Groups, Anti-Kickback Issues
  • Physicians, Anti-Kickback Investigations
  • Physicians, Civil and Criminal Health Care Fraud
  • Owners & Staff, Rehabilitation Centers

Whom at Oberheiden, P.C. Should You Contact to Get a Free Consultation?

Oberheiden, P.C. has a nationwide practice defending medical providers and business owners. Our team of attorneys includes distinguished former federal health care fraud prosecutors from the Department of Justice and senior federal defense attorneys who have successfully completed hundreds of health care investigations.

If you or your business is under federal investigation for health care fraud, you need to contact one of our experience defense attorneys today for a free and confidential consultation. Experience matters when it comes to health care fraud investigations. In practice, experience often makes the difference between receiving criminal charges and walking away as a free person.

    Oberheiden, P.C. recognizes how important each of our matters are and we dedicate careful attention to each client. Contact us today to discuss your concerns in a free and confidential consultation, including on weekends.

    Oberheiden, P.C.
    Compliance – Litigation – Defense
    (800) 810-0259
    (214) 469-9009
    Federal-Lawyer.com

    Who Will Handle Your Case

    When you hire us, you will not work with paralegals or junior lawyers. Each lawyer in our Healthcare Practice Group has handled at least one hundred (100) matters in the healthcare industry. So, when you call, you can expect a lawyer that immediately connects with your concerns and who brings in a wealth of experience and competence.

    Bill C. McMurrey

    Bill C.
    McMURREY

    Dr. Nick Oberheiden

    Dr. Nick
    OBERHEIDEN

    Lynette S. Byrd

    Lynette S.
    BYRD

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