What Dallas, Texas Medical Providers Should Know About Medicare Fraud
The Oberheiden, P.C. is a team of former Department of Justice prosecutors from the U.S. Attorney’s Office in Dallas, Texas and experienced healthcare fraud defense attorneys. We assist medical providers, DME and device companies, hospitals, surgery centers, home health care centers, hospice care centers, pharmacies, toxicology laboratories, and physical and occupational rehabilitation groups accused of Medicare Fraud, kickbacks, and other allegations of healthcare fraud. Our Firm offers medical providers and business owners in Dallas the unique insights of several former federal prosecutors previously in charge of civil and criminal healthcare prosecutions in North Texas.
Medicare Fraud Investigations in Dallas
Dallas business owners must understand that healthcare prosecutions in the DFW area are more aggressive than elsewhere. The reason for this harsher approach is that the U.S. government and the Department of Justice declared Dallas and North Texas a hotspot for healthcare fraud and established highly specialized law enforcement agencies to combat fraud in the healthcare sector. Dallas is now one of few U.S. cities that are monitored by the Medicare Fraud Strike Force, a subdivision of the Department of Justice that investigates and prosecutes Medicare Fraud in combination with the Department of Health and Human Services (HHS) and the Office of Inspector General (OIG).
- In June 2016, following an investigation by the Medicare Strike Force for the Northern District of Texas, federal agents arrested twelve people in the Dallas area on allegations that they fraudulently billed Medicare for millions of dollars. https://www.justice.gov/usao-ndtx/pr/dallas-doctor-and-three-dallas-area-home-health-agency-owners-convicted-running-large.
- In April 2016, a Dallas doctor and three home health providers were found guilty of engaging in a $375 million Medicare fraud scheme. The conviction followed a large-scale multi-agency investigation spearheaded by the Medicare Fraud Strike Force for the Northern District of Texas. https://www.justice.gov/usao-ndtx/pr/dallas-doctor-and-three-dallas-area-home-health-agency-owners-convicted-running-large.
- In December 2015, a Medicare Fraud Strike Force investigation in Dallas led to the arrest of two nurses and two co-owners of a home health services agency on charges that they defrauded Medicare of $13.4 million by submitting fraudulent medical bills.
Not Every Mistakes Constitutes Medicare Fraud
With a heightened focus on weeding out Medicare fraud, practically any medical services provider that participates in the Medicare program is under the microscope of federal investigators. Merely experiencing an uptick in business may signal a red flag to investigators. Federal investigators are trained to view any inconsistency or abnormality with a skeptical eye; however, almost any activities or documents may appear suspicious to investigators even if they were errors and not fraudulent in nature. Human and organizational errors occur in every industry, and the medical industry is particularly prone to inadvertent mistakes given the complex and ever-changing nature of healthcare regulations. These mistakes do not equate to fraud. To commit fraud, one must knowingly engage in misleading or dishonest practices. As such, if you are the target of a Medicare audit, one of the primary goals of your defense will be to demonstrate to investigators that any mistakes were, in fact, mistakes and not fraudulent conduct.
Dallas Attorneys Are Available to Answer Your Questions
If you are concerned that you are being audited or investigated or if you simply want to ask questions in a free and confidential setting, you should contact the experienced attorneys at Oberheiden, P.C.. We are available seven days a week, including weekends. All calls are free and confidential.