Urine Drug Testing Fraud Investigations
5 Signs That You Are Under Investigation For Urine Drug Testing Fraud
Oberheiden, P.C. is a healthcare fraud defense law firm that consists of former Department of Justice healthcare fraud prosecutors and experienced federal defense attorneys. We represent clients that are under federal investigation for the relationship between sober living facilities and toxicology testing laboratories. The purpose of this article is to explain the scope and nature of these investigations as well as the potential exposure for individuals that do not obtain sound advice from experienced healthcare fraud defense attorneys.
Current Urine Drug Test Investigations
In recent years, the government has intensified its investigations of improper kickbacks in a variety of industries, including both sober living facilities and urine drug testing labs.
The federal government is particularly scrutinizing the relationships between sober living facilities and toxicology laboratories to determine whether improper kickbacks are being paid to the sober living homes. Such kickbacks may serve to incentivize the sober living facilities to choose one laboratory over others and/or to order more urine tests than necessary. Because sober living homes order a large volume of drug tests, toxicology laboratories value them as important and lucrative clients. So far, investigations have shown 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 various middlemen.
In the most common schemes, the government argues that 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 and to send those tests to the laboratories that pay the kickbacks instead of other law-abiding labs.
Are You Under Healthcare Fraud Investigation?
If you are under investigation for healthcare fraud associated with sober living facilities and/or toxicology laboratories, it is vital that you hire an experienced attorney immediately. But how do you know if you are under investigation? Among others, these are the five most common signs that an investigation involving your business is underway:
- Insurance Letter. Because more and more (federal) healthcare fraud investigations originate at and through private insurance companies like Blue Cross Blue Shield, Cigna, or United Healthcare, one first indication that a business or business owners are under investigation is when they receive suspicious letters from the insurance company. For example, the letter may suddenly inform the business that a fraud and abuse investigation has been initiated or that all claims are under payment suspension. Sometimes, insurance companies are even more blunt and contact a business directly in writing through one of their senior healthcare fraud investigators seeking information or asking for a meeting.
- Grand Jury. Purpose of the Grand Jury is to determine whether or not to formally charge someone with a crime. Before a Grand Jury makes that decision, the Grand Jury often sends out subpoenas to potential subjects and witnesses of the investigation and orders them to produce information in form of documents or testimony. If you or someone you are affiliated with or had a business arrangement with received a grand jury subpoena, you should be on alert. The existence of a grand jury investigation means that prosecutors are preparing criminal charges against one or more individuals. The closer you are to those individuals, the more you need to be concerned.
- Investigators. A common approach in healthcare audits and investigations is to send out fraud investigators or federal agents from the Federal Bureau of Investigation or the Office of Inspector General tasked to interview potential witnesses or targets of healthcare offenses. If you are being contacted by fraud investigators or by federal law enforcement, you should immediately call an attorney. Do not provide any information other than your name. Do not lie, but also do not engage in a conversation. If you do, you may turn yourself into a criminal target. Similarly, if you hear that investigators or agents have contacted business partners or affiliates such as employees, you should assume that you may be next. Call experienced attorneys immediately.
- Involved in Payment Schemes. You probably know best if you participated in a kickback scheme involving urine drug tests in the years 2014, 2015, 2016, or 2017. If you were and if you paid or received, yourself or through others, kickbacks in connection with sober living home patients and toxicology laboratories, then you are exposed. Investigations by private insurance companies and state and federal law enforcement are at an advanced level. Instead of betting or guessing that everyone except for you are on the government’s radar, you should consult with experienced healthcare fraud defense attorneys while there is a window of opportunity to mitigate or avoid criminal charges.
- Arrest Warrant. At the very end of an investigation could stand an arrest warrant. If the government is convinced and if a grand jury found probable cause that you committed a crime, a magistrate judge will sign a warrant for your arrest. If you are aware of an arrest warrant or if you think that one is possible (e.g. because people you know were already arrested or because you noticed law enforcement personnel looking for you), you must not hesitate and you must immediately consult with an experienced defense attorney to avoid being perceived as fugitive from justice.
In addition, you should ask yourself the following questions: Are you engaged in a business relationship that involves referrals? Have you signed a healthcare 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? Have you obtained reliable legal advice and a cohesive defensive strategy?
As noted above, the federal government is currently putting an increased and specific focus on sober living homes and urine toxicology laboratories. In particular, federal investigators are closely examining all relationships between sober living homes and the toxicology laboratories they use for urine drug testing of their patients in order to determine whether violations of the federal Anti-Kickback Statute or other healthcare 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 are no signs that this trend will decrease any time soon. Given the harsh and unforgiving penalties associated with criminal healthcare fraud, if you believe you are under investigation, you should hire an experienced healthcare defense attorney immediately.
Call Oberheiden, P.C. today. If you have questions, please call us directly. Our clients range from individual providers to entire healthcare systems. We represent clients who are under investigation by the Department of Justice (DOJ), the Federal Bureau of Investigation (FBI), the Office of Inspector General (OIG), the Internal Revenue Service (IRS), and other federal agencies.
Our Healthcare Fraud Defense Track Record
The Oberheiden, P.C. track record of successful healthcare defense case outcomes is impeccable. The profound understanding of the healthcare industry and the negotiation skills of our attorneys have resulted in a number of appreciated outcomes. For example, our attorneys have avoided criminal charges against our clients by pursuing a determined and proactive negotiation approach with the government. Similarly, we were able to convince the government why the Anti-Kickback Statute does not apply in light of one of its numerous defense exceptions. We are glad to share more examples.
- Anti-Kickback Investigation Against A Toxicology Laboratory. Our Client Was Contacted by the Department of Health and Human Services and the Office of Inspector General as Part of a Federal Anti-Kickback Investigation. Our Attorneys Carefully Advised the Client and Its Officers and Directors and Navigated the Client Through the Complexity of Applicable Healthcare and Criminal Laws. Our Attorneys Convinced Federal Agents and Federal Prosecutors that The Toxicology Laboratory Did Not Violate Any Laws and We Were Able to Persuade the Government to Conclude the Fraud Investigation with No Civil and No Criminal Liability for Our Client and Any of Its Principals, Directors, Employees, and Otherwise Affiliated Individuals.
- Anti-Kickback Investigation Against A Healthcare Marketer. The Federal Government Was Prepared to Bring Criminal Charges Against Our Client for Alleged Violations of the Anti-Kickback Statute. Our Attorneys Decided it to Be Best to Open a Dialogue With Federal Prosecutors to Provide Factual Clarification and to Negotiate the Applicability of Any Fraud and Abuse Statute. Ultimately, We Were Able to Get Our Client Out of a Delicate Situation and the Case Ended with No Civil and No Criminal Liability for Our Client.
- Anti-Kickback Investigation Against A Healthcare Business Owned By One Individual. The Federal Government Was Prepared to Bring Criminal Charges Against Our Client for Alleged Violations of the Anti-Kickback Statute. Our Attorneys Pursued a Proactive Approach with the Lead Assistant United States Attorney (AUSA) With the Goal to Present Factual Explanations and Legal Arguments As to Why Our Client Was Not Involved in Alleged Conduct. We Met with the Prosecutors at Several Occasions and Our Healthcare Law Knowledge Allowed Us to Persuade the Government to Conclude the Fraud Investigation with No Civil and No Criminal Liability for Our Client and Any of Its Principals, Directors, Employees, and Otherwise Affiliated Individuals.
- Anti-Kickback Investigation Against Our Client, A Healthcare Marketing Company. The United States Was Planning to Charge Our Client with Various Counts of Healthcare Fraud, Including Violations of the Anti-Kickback Statute. We Took on the Case From Another Law Firm and Had to Undo What We Considered Strategic Mistakes. Our Attorneys Formed a Team With Our Client, Listened to Our Client’s Side of the Story, and Then Reached Out to the Federal Bureau of Investigation and the U.S. Attorney’s Office. Long Story Short, We Avoided Criminal Charges By Pointing Out that Our Client Was Simply the Wrong Guy. The Case Ended With No Civil and No Criminal Liability for Our Client and Any of Its Principals, Directors, Employees, and Otherwise Affiliated Individuals.
- Grand Jury Investigation Against Our Client, a Healthcare Entrepreneur. Our Attorneys Were Hired to Represent a Savvy Healthcare Business Owner Who Was Served a Federal Grand Jury Subpoena. After Conducting a Factual and Legal Analysis We Reached Our to the Prosecutors To Explore Our Client’s Best Options. After a Series of Discussions and Meetings with the Government, Our Attorneys Convinced the Prosecutors that Our Client Did not Have Alleged Involvement. Our Attorneys Were Able to Resolve the Matter With No Civil and No Criminal Liability for Our Client.
We are available to discuss your situation in a free and confidential consultation, including on weekends. Contact us now.