What Should I Do in a CGX Investigation?
Oberheiden P.C. Has Defended Business Owners Across the United States Including Miami, Los Angeles, Houston, Dallas, New York, Newark/NJ, Philadelphia, Detroit, San Diego, Ohio, New Orleans, Pacific North West
The FBI currently investigates business owners of laboratories, billing companies, distributorships, lead generators, and telemedicine companies for alleged Medicare Fraud in connection with PGX and CGX testing. Current indictments in Newark, Miami, Los Angeles, and other cities demonstrate how seriously the Justice Department is prosecuting illegal kickback arrangements, commission payments, and fraudulent billing to Medicare. If you find yourself in the middle of an investigation or are concerned about the general scope of the investigations, please call us immediately, including on weekends.
- FBI Interview Requests
- Grand Jury Subpoenas
- Federal Search Warrants
- Arrests & Criminal Defense
You Found the Right Firm. Oberheiden P.C. is a team of former DOJ Trial Attorneys, former federal healthcare fraud prosecutors, and federal healthcare fraud defense attorneys located in all major metropolitan areas across the United States—including South Florida, Southern California, Texas, the Pacific North, and the East Coast. We offer clients real experience, not experiments!
- Former DOJ Officials and Trial Attorneys
- No Junior Lawyer Will Ever Touch Your Case
- Uncompromising Defense, Unmatched Outcomes
- Acquittals, Dismissals, and Probation in White-Collar Cases
Oberheiden P.C. is the first choice defense firm for owners of telemedicine companies, marketing and distributor companies, billing companies, physicians, and owners of laboratories.
If the FBI Wants to Speak to You, Politely Decline
FBI agents are not your friends. If you get approached by law enforcement, resist the temptation to volunteer information. You are not required to do so, and there is zero benefit for you to incriminate yourself—or to allow the agents to construe a criminal case against you based on misinterpreting what you told them. Don’t do it. That simple.
Consider this. Under 18 U.S.C. 1001, you risk up to five years in prison if you lie to a federal agent. Worse, if you are being asked a question and you are defensive (e.g. you withhold a piece of information)—you commit a federal crime. Anything you misrepresent, minimize, withhold, lie about, fail to disclose that is important to the investigators, constitutes a crime.
Hire Counsel. The only good way to handle a subpoena or an interview request is through an experienced attorney. That attorney, after knowing all the facts about your case and fully understanding the benefits of speaking with the government (e.g. agreed immunity), should make the decision for you.
How Do I Know If I Am A Witness, Subject, or a Target in a Medicare Fraud Investigation?
Federal criminal investigations distinguish between three categories of involvement: witness, target, and subject.
A person designated as a “target” faces the most substantial risk and potential for serious consequences. The definition of a “target” is specified in Section 9-11.151 of the United States Attorney Manual. The full text of the definition is as follows: “A “target” is a person as to whom the prosecutor or the grand jury has substantial evidence linking him or her to the commission of a crime and who, in the judgment of the prosecutor, is a putative defendant. An officer or employee of an organization which is a target is not automatically considered a target even if such officer’s or employee’s conduct contributed to the commission of the crime by the target organization. The same lack of automatic target status holds true for organizations which employ, or employed, an officer or employee who is a target.”
A “subject” of an investigation is a person whose conduct is within the scope of the grand jury’s investigation. In terms of criminal exposure, a “subject” falls on the spectrum somewhere between a “target” and a “witness.” The prosecutor may believe a “subject” has engaged in criminal activity but does not have the corroborating evidence yet to label this individual as a “target.”
A “witness” is an individual who may information that law enforcement believes might be relevant in a criminal investigation to help prove either the guilt or the innocence of another individual. The criminal exposure of a “witness” is low – the prosecutor generally believes a “witness” did not do anything wrong but has information to aid the pending investigation.
Identifying and understanding this status within a federal investigation is critically important in determining how to proceed and what decisions to make in the pending investigation. The only safe and reliable way for you to find out is through an experienced attorney. Why? Because federal agents are not allowed and won’t tell you what your status is. Only your attorney can find out when discussing your matter with the lead prosecutor. If you are not under formal investigation, but you are concerned and want to understand your status to prepare yourself, then the attorney becomes even more important. Oberheiden PC attorneys with decades at DOJ and hundreds of federal cases handled will be able to assess your exposure—to then position you in case the government ever contacts you. Give us a call today, tell us what concerns you, and we tell you what we think you should do next.
The Government Has the Burden of Proof in a Medicare Fraud Case
Healthcare fraud is regulated in numerous federal statutes, in particular at 18 U.S.C. 1347. Depending on the case allegations and whether or not a case is charged as a conspiracy to connect different people in one case, the government may try to proceed with one of the following statutes:
Under 18 U.S.C. 371 (Federal Conspiracy) the government must prove all of the following elements beyond a reasonable doubt:
- That the defendant and at least one other person made an agreement to pay or receive remuneration in return for referring Medicare patients or arranging for the furnishing of items or services paid for by Medicare;
- That the defendant knew the unlawful purpose of the agreement and joined in it willfully, that is, with the intent to further the unlawful purpose; and
- That one of the conspirators during the existence of the conspiracy knowingly committed at least one of the overt acts described in the indictment, in order to accomplish some object or purpose of the conspiracy.
Under 42 U.S.C. 1320a-7(b)(b) (Federal Kickbacks), the government must prove all of the following elements beyond a reasonable doubt:
- That the defendant solicited or received remuneration, including any kickback or bribe, directly or indirectly, overtly or covertly, in cash or in kind from any person;
- That the remuneration was offered or paid to induce the defendant to refer an individual to a person for the furnishing or arranging of an item or service;
- That the item or service was one for which payment may be made in whole or in part under a federal health care program; and
- That the defendant acted knowingly and willfully.
Importantly, the government has the burden of proof. The government must show that what you allegedly did wrong was done intentionally. That is a high burden. You should not simply surrender and give up your rights, run into a plea or decide to cooperate with the government, just because the FBI told you to do so. Consider your options more carefully. Call Dr. Nick Oberheiden and his team to carefully walk you through the investigation—and obtain the types of results you expect from us.
How Can Oberheiden P.C. Avoid Charges in CGX Investigations?
Most targets and lawyers in federal cases rush to judgment. Just because the FBI told you that you are under investigation or that you are a target does not mean you are in fact a target or actually end up indicted. The experience of hundreds and hundreds of federal healthcare fraud cases have taught us to first care and inquire about our client’s side of the story. Did you really sit at the kitchen table with your business partners and discussed how to best defraud Medicare? Doubtful. So, if that’s not the case, let’s explore together what your weaknesses might be—and how to overcome them. The earlier you call, the faster we can help.