5 Things You Should Do If You Are Under Investigation for Urine Toxicology Kickbacks
Oberheiden, P.C. represents business owners and health care executives affiliated with sober living homes and toxicology laboratories. Our team of former Department of Justice Trial Attorneys, former Assistant and Special Assistant United States Attorneys and former federal health care prosecutors handle both civil (i.e. False Claims Act) and criminal (pre-indictment and post-indictment) health care fraud investigations throughout the United States.
Why Do Sober Living Homes Trust Oberheiden, P.C.?
Oberheiden, P.C. is not your average health care fraud defense firm. Our team of former federal health care prosecutors and veteran health care fraud defense attorneys have handled hundreds of civil and criminal health care investigations on both sides of the courtroom. We use our experience, insights, and contacts to achieve successful outcomes for our clients.
- Experience: More than 1,000 health care fraud investigations
- Experience: More than 1,000 grand jury investigations
- Experience: Former Department of Justice health care fraud prosecutors
Sober living homes trust Oberheiden, P.C. because they know that our attorneys will provide reliable and proven advice regarding the correct course of action for Medicare audits, appeals, and civil and criminal investigations, and criminal charges. We have helped hundreds of clients including sober living facilities, rehabilitation clinics, toxicology laboratories, business owners, physicians, marketing groups, hospitals, and other participants in the health care industry facing all varieties of health care fraud cases, including alleged violations of the Anti-Kickback Statute, Stark law violations, and False Claims Act suits.
Who Are the Targets of Anti-Kickback Cases in the Addiction Industry?
Within the past several years, federal investigations into the addiction industry have increased nationwide. Some of the current hot spots for anti-kickback investigations are the Southern District of California (Orange County, San Diego), the Central District of California (Los Angeles), the Southern District of Florida (Miami), the Middle District of Florida (Tampa), the Northern District of Texas (Dallas), and the Southern District of Texas (Houston).
Federal investigators target sober living homes and toxicology laboratories for their respective roles in overbilling and improper business practices to the detriment of private health insurance companies. The government holds the position that sober living homes and toxicology laboratories criminally conspire to defraud private insurers by exchanging kickbacks for referrals for urine sample analysis and ordering more urine samples than are medically necessary for the patients. With the growing media coverage of federal prosecutions against the addiction recovery industry, many of our clients come to us with the following pressing questions:
- Who investigates?
- Are fraud investigations civil or criminal?
- Can I go to prison for my role in the alleged health care fraud conspiracy?
- How will the government assess my level of culpability within the alleged conspiracy?
- Why is my business under investigation when so many others are not?
While the answers to each of these questions depend on the particular facts of the case at hand, the government has caught on to popular kickback schemes within the addiction recovery industry. According to public indictments, the toxicology laboratory will use a middleman to deposit kickbacks into a bank account owned by the principals of the sober living home. The toxicology laboratories will use the kickbacks to solicit business from sober living homes, which produce a high volume of urine toxicology samples. In some cases, the toxicology laboratories will pay kickbacks to sober living homes for each urine sample the facility sends to the laboratory. In this manner, the laboratory encourages the sober living home to order more urine tests than are medically necessary for its patients.
Kickback schemes within the addiction recovery industry predominantly involves the beneficiaries of private insurance companies. Therefore, private insurance investigators may be used to investigate suspected conspiracies between sober living homes and toxicology laboratories. Once the private insurance investigators uncover improper kickback schemes, they often share their finding with the federal government, which then launches its own investigation into the fraud.
Oberheiden, P.C. has repeatedly demonstrated its ability defeat federal health care fraud allegations. If you have been contacted by federal agents, received a government subpoena, or learned of a possible criminal investigation into your company, call us today to speak with one of our former prosecutors and experienced defense attorneys. All consultation calls are free and confidential.
Are Sober Living Home Investigations Civil or Criminal?
Before you can start building an effective defense, you must first determine whether the investigation is civil or criminal in nature. For the untrained eye, the distinction may not be obvious. For example, not every case that involves the U.S. Attorney’s is criminal in nature. In practice, around one third of health care prosecutions are civil in nature. Relying on our years of experience on both sides of health care fraud cases, the attorneys of Oberheiden, P.C. are able to discern the government’s investigative goals in relation to our clients. Once we have an idea of the government’s intentions, we can develop and implement a defensive strategy for our clients early on in the investigation. The sooner our experienced attorneys are retained, the better our chances of helping our clients avoid criminal charges.
What Are the Potential Penalties for Health Care Fraud?
Kickback and health care fraud allegations in the context of sober living homes and toxicology laboratories are investigated by several different federal agencies, including the Department of Health and Human Services (HHS), the Office of Inspector General (OIG), the Department of Justice (DOJ), and the Federal Bureau of Investigation (FBI). Additional state or federal agencies are currently being formed to add resources to specimen related kickback investigations.
The Anti-Kickback Statute, the Social Security Act, and the False Claims Act each authorize both civil and criminal penalties, including prison sentences of up to 5 years in federal prison. All of the aforementioned statutes call for civil monetary penalties and reimbursement to the government for its damages in addition to any criminal penalties that may be leveled against a defendant.
To limit your exposure to penalties for health care fraud, as soon as you have reason to believe you are under investigation, you should: 1) halt or extract yourself from the criminal scheme; 2) refrain from destroying existing evidence; 3) politely refuse to speak with any federal investigators that approach you; 4) appreciate the seriousness of the investigation and potential charges; and 5) immediately hire a defense attorney with specific experience and a presentable track record.
Who Will Handle My Case At Oberheiden, P.C.?
Oberheiden, P.C. only employs senior attorneys with years of experience in health care fraud proceedings. Our attorneys represent practitioners, business owners, laboratories, sober living homes, and other medical service providers who suspect they are being investigated by federal agents or have already received criminal or civil charges. At Oberheiden, P.C., you will not be walled off by junior lawyers, paralegals, or support staff. All of our attorneys have years, if not decades, of experience in health care cases, and we work as “One Team” to provide the best defense for our clients.
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