Sherman Healthcare Fraud Defense Attorney
Aggressive Federal Healthcare Lawyers Defending Providers and Healthcare Businesses
Federal authorities are aggressively targeting healthcare providers throughout Texas, including in Sherman, in high-stakes fraud investigations. If your business or practice is under federal investigation, you need the experienced federal defense team at Oberheiden, P.C.
As a healthcare provider, one of the most significant risks you face is a federal investigation. Even if you attempt to follow all the rules, you may still find yourself or your practice at the center of a federal healthcare fraud investigation. In part, this is due to the very complex labyrinth of laws and regulations governing referrals, billing and coding, especially for providers who bill Medicare or Medicaid. While most Sherman healthcare fraud cases involve civil liability, the government has a handful of options to pursue criminal charges against practitioners they believe intentionally defrauded the government.
If you recently learned that the FBI, DOJ, OIG, or DEA is investigating your practice, it is imperative that you reach out to a Sherman federal healthcare fraud defense attorney. If skillfully handled, there may be quick resolutions in fraud investigations. However, if you wait too long or make even a small mistake in how you handle the situation, it can spiral out of control. At Oberheiden, P.C., we’ve assembled a team of veteran healthcare fraud attorneys from across the country. Many of our senior-level attorneys spent years prosecuting these very crimes on behalf of the federal government, giving us a unique and valuable perspective on how to best defend against these claims.
What Are the Most Common Healthcare Fraud Statutes?
Federal prosecutors can pursue healthcare fraud charges under many different laws. In some cases, a single violation can implicate several different statutes. However, federal authorities rarely make the extent of their investigation known, making it challenging to mount an effective defense.
At Oberheiden, P.C., our Sherman healthcare fraud defense attorneys have extensive experience handling a wide range of fraud cases on behalf of doctors, pharmacists, dentists, hospitals, hospice-care providers, and others in the healthcare industry. While we handle all types of healthcare fraud matters, in our experience, the most commonly used statutes include the following:
The False Claims Act
The False Claims Act is a federal healthcare fraud law prohibiting the submission of any “false or fraudulent” claim for payment by the federal government. In most cases, allegations under the False Claims Act related to bills submitted to Medicare or Medicaid. Liability under the False Claims Act can be civil or criminal, depending on whether prosecutors believe your conduct was intentional.
The Anti-Kickback Statute
The Anti-Kickback Statute is a criminal healthcare fraud law preventing anyone from paying or receiving a referral when the federal government is footing the bill. The Anti-Kickback Statute not only makes it illegal to pay or receive cash in exchange for a referral, but anything of value. This may include fancy meals, expensive vacations, or even a prestigious job within a company. Violations of the Anti-Kickback Statute carry a potential jail sentence of up to five years as well as a fine of up to $50,000 per violation.
The Stark Law
The Stark Law imposes strict limits on physician self-referrals. In this context, a self-referral occurs when a physician refers a patient to a practice that they have a financial stake in. Unlike the Anti-Kickback Statute, a violation of the Stark Law carries only civil liability and applies only to physicians.
The Controlled Substances Act
The Controlled Substances Act is one of the primary federal statutes used by federal authorities to prosecute healthcare providers suspected of engaging in pharmaceutical fraud. For example, the following all fall under the Controlled Substances Act:
- Writing prescriptions for unnecessary medications;
- Providing drugs to dependent patients,
- Diverting prescription medications; and
- Selling prescriptions.
The Drug Enforcement Administration is the federal agency primarily responsible for enforcing the Controlled Substances Act. DEA investigations are unique because as long as the DEA is not acting in concert with other federal law enforcement agencies, it may conduct an inspection without a probable cause warrant. This means that DEA investigations often come up without warning, catching providers by surprise.
The Healthcare Fraud Statute
Whenever possible, federal prosecutors prefer to bring charges under 18 USC 1347, which is the general healthcare fraud statute. Section 1347 makes it illegal to “knowingly and willfully executes, or attempts to execute, a scheme or artifice to defraud any health care benefit program; or to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program.”
A violation of the healthcare fraud statute carries extremely strict punishments, including up to ten years in jail in addition to a fine. Notably, however, because the healthcare fraud statute is criminal in nature, prosecutors must establish you knew you were making false representations to defraud the government.
Why Choose the Sherman Healthcare Fraud Defense Attorneys at Oberheiden, P.C.?
Healthcare fraud investigations present incredibly high stakes for providers. Not only can a violation put your career in jeopardy, but it can also put your freedom on the line. At Oberheiden, P.C., our dedicated team of healthcare fraud defense lawyers enjoy a national reputation for excellence based on the following:
Oberheiden, P.C, is a healthcare fraud defense law firm. We are not general practitioners who dabble in healthcare matters when we come across them. This is all we do. We have handled more than 500 federal jury trials and more than 1,000 other cases. Our attorneys have centuries of experience handling some of the most complex and high-stakes healthcare fraud investigations across the country.
Former Federal Prosecutors
Unlike many other Sherman healthcare fraud defense law firms, we have a large staff of former federal prosecutors who joined Oberheiden, P.C. after leaving their position with the federal government. This provides us with a keen ability to understand how the government will build its case and which defenses may be the most successful.
At Oberheiden, P.C., we do not wait to see what federal investigators uncover to get involved. Why sit back and allow investigators to conduct an uninterrupted of your practice? Instead, we immediately reach out to federal prosecutors to clear up any misconceptions and limit the scope of the investigation. Often, we can resolve our clients’ cases without the government ever formally filing charges.
Frequently Asked Questions:
Should I speak with FBI agents if they inquire about my practice?
No. If FBI agents approach you with questions about your healthcare practice or business, nothing can be gained by speaking to them. In fact, doing so only opens the door to more problems. Whenever possible, the FBI will not inform a subject that they are under investigation. If the FBI starts asking questions, it likely means they suspect you of wrongdoing but do not have enough evidence to pursue an indictment. The last thing you want to do is give them the information they are looking for. When you speak to the FBI, it is the equivalent of testifying in court, as anything you tell them can later be used against you. So, for example, if you make a vague or ambiguous statement, the FBI may assume the worst. This immediately puts you on the defensive, trying to clarify what you previously said. Rather than voluntarily take these risks, politely tell the FBI you are not interested in speaking with them and contact the Sherman healthcare fraud defense attorneys at Oberheiden, P.C.
What is at stake in a Sherman healthcare fraud investigation?
All healthcare fraud investigations can carry very serious consequences. Most fraud cases involve civil liability, meaning you could face astronomical fines, exclusion from federal programs, and other professional sanctions. However, when federal prosecutors believe that your intent was to defraud the government, they will pursue criminal healthcare fraud charges. For example, a violation of the False Claims Act or the Anti-Kickback Statute is a criminal offense. In these cases, you could face time in federal prison if you are convicted. However, federal authorities do not always make it clear what’s at stake in an investigation, making it hard to know the best way to approach the case. At Oberheiden, P.C., one of the first things we do is to reach out to federal investigators to gain a full understand of your perceived role in the investigation. From there, we will develop a custom-tailored defense strategy to take on whatever charges the government is pursuing.
What should I look for in a Sherman healthcare fraud defense lawyer?
Perhaps the most important trait to look for in a Sherman healthcare fraud defense attorney is experience. However, not all experience is created equal. You want an attorney who has specific, hands-on experience handling complex fraud cases from beginning to end. Undoubtedly, there are dozens of defense attorneys in and around Sherman who can competently handle a healthcare fraud case. However, when your practice, your freedom, and your life is on the line, you want more than mere competence; you want an attorney who excels at what they do. At Oberheiden, P.C., we have a national reputation for providing aggressive representation to healthcare providers. With centuries of experience handling complex healthcare fraud cases in Sherman and throughout the United States, Oberheiden, P.C. has what it takes to provide you with the representation you need and deserve.
Contact Oberheiden. P.C. to Schedule a Free Consultation with an Experienced Sherman Healthcare Fraud Defense Attorney
If you face federal healthcare fraud charges in Sherman or elsewhere in Texas, contact Oberheiden, P.C. Our attorneys are standing by to discuss your case, answer your questions, and offer whatever assistance we can. You can reach our Sherman healthcare fraud defense lawyers at 888-680-1745 or reach us online through our contact form.