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South Carolina Health Care Fraud Defense Lawyers

From Charleston in the Lowcountry to Greenville upstate, our federal defense lawyers represent health care providers across South Carolina in Medicare, Medicaid, Tricare, VA, and DOL audits and investigations.

Health care providers throughout South Carolina are being targeted in federal audits and investigations. While many of these audits and investigations are targeting providers’ federal health care program billing practices, various other allegations are putting providers’ businesses and practices in jeopardy as well. If your medical practice’s programs are being audited, or if your business is under investigation for Medicare, Medicaid, Tricare, VA, or DOL fraud, it is important that you speak with an attorney as soon as possible. 

Oberheiden, P.C. is your choice for federal health care fraud in South Carolina. Our attorneys have centuries of relevant experience, including prior experience as health care fraud prosecutors with the U.S. Attorney’s Office and the U.S. Department of Justice (DOJ). We have successfully handled health care fraud matters in 48 states and counting, with the  vast majority of our cases being resolved without charges, and with none of our clients facing liability under the False Claims Act (which is one of the primary federal statutes the DOJ uses to prosecute health care fraud). While no outcome is guaranteed, what we can guarantee is that we will fight vigorously on your behalf, and we will rely on our attorneys’ vast experience to protect you to the greatest extent possible. 

 

Why Choose Oberheiden, P.C. for Federal Health Care Fraud Defense in South Carolina?

 

When the future of your health care business or medical practice is on the line, you need to make an informed decision about your choice of legal representation. You only get one chance to defend yourself’; and, if your defense strategy is ineffective, you could face substantial financial penalties, loss of program eligibility, loss of professional licensure or Drug Enforcement Administration (DEA) registration, and even federal imprisonment. So, why do health care providers in South Carolina choose Oberheiden, P.C.? 

  • We are federal health care fraud defense lawyers. We aren’t just lawyers. We aren’t just defense lawyers. We are lawyers who focus our practice specifically on federal health care fraud defense. We are thoroughly knowledgeable about the laws and billing regulations that apply to your specific set of circumstances, and we have extensive experience on both sides of federal health care fraud investigations.
  • We are former federal health care fraud prosecutors. Several of our attorneys are former health care fraud prosecutors. This means that we have experience both working with and defending our clients against investigating agencies including the DOJ, the DEA, the Federal Bureau of Investigation (FBI), and the U.S. Department of Health and Human Services’ Office of Inspector General (OIG).
  • We are a team of highly-experienced senior attorneys. Unlike other law firms, all of our lawyers are highly-experienced senior attorneys. With Oberheiden, P.C., your case will never be in the hands of a junior associate or paralegal. 
  • We are passionate about protecting our clients. As licensed professionals ourselves, we appreciate what it means to have your ability to practice put in jeopardy. As a result, we believe strongly in protecting our clients against overreaching “fee-for-service” auditors and federal investigations that are driven by data “anomalies” rather than a real-world understanding of the practical circumstances at hand.
  • We have non-lawyer experts and consultants who are available to assist with compliance and defense. In addition to our senior attorneys, our team also includes several non-lawyer experts and consultants. These individuals specialize in specific areas (such as DEA and pharmacy compliance) and are available to lend their expertise on an as-needed basis. 

What Can You Expect When You Choose Oberheiden, P.C.?

 

As a result of our experience working with physicians, pharmacists, clinic owners, durable medical equipment (DME) distributors, testing laboratories, and other health care providers across the country, we are intimately familiar with the concerns practitioners and business owners have when it comes to facing a federal audit or investigation and choosing defense counsel to represent them. This is why we offer personalized, one-on-one legal counsel in all aspects of our representation, and it is why we offer free initial consultations to all prospective clients. It is important to us that you choose our firm not because you have already invested in a costly retainer; but, instead, because you feel confident that we can represent you effectively. 

Here is what you can expect when you choose the attorneys and consultants at Oberheiden, P.C. for your federal health care audit or investigation in South Carolina:

  • You will have direct access to your legal team. As a client of our firm, you will have direct access to your legal team throughout the course of our engagement. 
  • You will be able to contact our lawyers and consultants 24/7. Our lawyers and consultants will be available to you when you need them by phone, text, and email. 
  • You will receive individualized legal advice and a custom-tailored defense strategy. All federal health care fraud matters involve unique aspects, and our legal services will be entirely customized to the unique circumstances of your audit or investigation. 
  • You will never have to wonder about the status of your case. We prioritize consistent, clear, and effective communication, and you will be fully aware of the status of your case at all times. 
  • You will feel confident moving forward once your case is over. From the outcome of your audit or investigation to your ongoing compliance efforts, if you allow us to do our job, you will feel entirely confident moving on from your run-in with the federal government. 

Proven Defense Representation for All Federal Health Care Fraud Matters

 

Our practice encompasses all aspects of federal health care fraud defense, from audit representation to federal criminal appeals. We also provide health care compliance representation as a preventive measure and in response to federal billing fraud allegations. 

In the area of federal health care fraud defense, our services include:

ZPIC, MAC, and RAC Audits

We have extensive experience representing health care providers in Medicare audits conducted by Zone Program Integrity Contractors (ZPICs), Medicare Administrative Contractors (MACs), and Recovery Audit Contractors (RACs). We also represent clients in Medicaid, Tricare, VA, DOL, and private insurance audits. If you have received an audit letter, we encourage you to contact us promptly, as prompt intervention can be critical to preventing unjustified demands for recoupments, prepayment review, and other penalties. 

Federal Program Billing Fraud Investigations

Our experience includes successfully defending clients in billing fraud investigations involving the DOJ, FBI, OIG, Medicare Fraud Strike Force, and all other major federal health care law enforcement agencies and task forces. Examples of allegations against which we have successfully defended our clients include:

  • Overbilling Medicare, Medicaid, Tricare, the VA, and the DOL
  • Double-billing the federal government and/or private insurance companies
  • Billing for services not provided (known as “phantom billing”)
  • Billing for services not considered “medically necessary” under the relevant program guidelines
  • Unbundling, upcoding, and other billing and coding violations
  • Falsifying patient records and test results
  • Conspiring with other providers and businesses to commit health care fraud

Anti-Kickback Statute and Stark Law Investigations 

The Anti-Kickback Statute and Stark Law contain broad prohibitions against the use of program-reimbursed fees to provide compensation for referrals. This includes referrals fees and other direct and indirect forms of remuneration, and each statute imposes penalties for parties on both sides of unlawful transactions. 

DEA Audits and Investigations 

The DEA holds primary responsibility for enforcing health care providers’ obligations under the federal Controlled Substances Act (CSA), including the CSA’s requirement that health care providers register with the DEA. We represent health care providers in routine and ad hoc DEA audits and investigations, and we have experience defending clients against allegations ranging from prescribing medically-unnecessary medications to opioid drug diversion. 

Federal Grand Jury Proceedings and Trials

While most of our clients are able to avoid prosecution, if it is too late or otherwise not possible to obtain a pre-charge resolution, we provide vigorous representation at all stages of the federal trial process. In criminal cases, this starts with federal grand jury proceedings. However, even once our clients have been charged, we continue to work toward securing a favorable result short of trial, and we have resolved numerous civil and criminal cases without our client facing the risk of an unfavorable verdict in court. 

Audit and Judicial Appeals

When necessary we also represent clients in appealing unfavorable audit determinations and federal judgments. We have experience at all stages of the audit appeals process, and our attorneys have taken cases as far as the U.S. Supreme Court

 

Speak with a Federal Health Care Fraud Defense Lawyer in Confidence 

If you need to speak with a federal health care fraud defense attorney in South Carolina, we encourage you to get in touch. A member of our firm will be happy to provide a complimentary assessment of the risks involved in your audit or investigation. You can reach us 24/7, so call 214-469-9009 or tell us how to contact you online now. 

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