find attorney who defends medical fraud

Why hire a healthcare fraud defense attorney?

Apr 02, 2022 · Speak with a Federal Healthcare Fraud Defense Lawyer at Oberheiden, P.C. If you are being targeted by federal authorities, contact us for your free and confidential initial case assessment. To speak with a member of Oberheiden P.C.’s federal health care fraud defense team as soon as possible, call 888-680-1745 or tell us how to reach you online now.

Where can I find information about Medi-Cal fraud in California?

Sep 03, 2017 · The federal public defender’s offices are wonderful in helping private counsel navigate their day to day world. One caveat, medical fraud cases are not frequently defended at the public defender level so they may lack some expertise in the narrow specialty of health care fraud defense practice. However, they are still a wonderful resource.

What agencies investigate healthcare frauds?

Apr 19, 2018 · Healthcare fraud is a federal criminal offense addressed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) with stiff penalties. Violators of this prohibition against healthcare fraud can end up in federal prison for white-collar offenses. If found guilty of healthcare fraud, penalties may include:

What should you do when facing a healthcare fraud investigation?

Apr 09, 2017 · Our firm has successfully defended people and businesses charged in health care fraud cases in federal district courts across the country. We have obtained dismissals, favorable plea deals, and “not guilty” verdicts for our clients in federal criminal trials. Attorney Page Pate explains health care fraud charges in this video.

What is the government's responsibility when accused of healthcare fraud?

When an individual is accused of healthcare fraud, the government has to prove that the defendant engaged in a scheme to steal from a healthcare program, such as Medicare, DOL, Medicaid, Tricare, another government insurance program or a private insurance program.

How do healthcare fraud and abuse investigations work?

Healthcare law and fraud and abuse investigations operate in a small circle of lawyers and government officials. Attorneys frequently run into the same FBI agents and work routinely with the same prosecutors and appear before the same judges. This experience may help the lawyer to better anticipate the government’s next step, and may ease settlement negotiations with the government. After all, if your lawyer kept his or her word in the last case, the prosecutor will remember and trust him or her in this case. People talk, and lawyers at the U.S. Attorney’s Office and healthcare fraud defense attorneys are no exception. Reputation and past interactions with the government can make a decisive difference, especially in areas like healthcare investigations where the line between mistake and criminal misconduct can be very thin at times.

How to contact Oberheiden P.C.?

To speak with a member of Oberheiden P.C.’s federal health care fraud defense team as soon as possible, call 888-519-4897 or tell us how to reach you online now.

What is FCA case?

That is, someone, often a former employee or a competitor, reports alleged fraud to the government by filing a lawsuit in an effort to later collect a reward. Targets of these whistleblower cases often find out about the existence of an investigation when they receive a Civil Investigative Demand (CID) or another form of a government subpoena (e.g. OIG subpoena) requesting documents and corporate information. The absolute priority in all of these defense cases is to make sure that the investigation does not turn into a criminal case—that is something Oberheiden P.C. has accomplished in every single whistleblower case. By the same token, Oberheiden P.C. is an asset protection specialist and protected the financial stability of its clients by dismissing or favorably settling these types of cases (e.g. in Los Angeles, in Florida, in Houston, in Philadelphia, in Dallas, in Portland, in Ohio etc.).

What is healthcare fraud?

As seen, healthcare fraud is a generic term that encompasses a variety of conduct designed to illegally obtain a financial benefit of a provider to the detriment of the state or federal government. The following list is not exclusive, but it summarizes some of the most common fraud examples.

How long can you be in jail for healthcare fraud?

Federal Imprisonment – In criminal healthcare fraud cases, practitioners and business owners can face the potential for years , or even decades , of federal imprisonment. Civil or Criminal Fines – Civil and criminal healthcare fraud offenses also carry steep fines, with fines often applying on a “per-claim” basis.

Is fraud a federal crime?

Regardless of your role within the healthcare industry, facing federal fraud allegations is an extremely serious matter. If federal agents are targeting your business or practice based upon allegations of Medicare, Medicaid, Tricare, or Department of Labor (DOL) fraud, failing to find the best healthcare defense could result in exposure to significant civil or criminal penalties.

What is the CPT code for medical fraud?

There are standard terms and phrases that apply to most medical fraud cases. CPT codes ICD-9, ICD-10, , Health Insurance Claim Form (HCFA, 1500), upcoding, unbundling are some that you should know.

Is medical fraud a murder case?

Medical fraud is unlike even a special circumstance murder case. The charges are very VERY broad and it is often difficult to relate the listed charges to specific files, billings or conduct. A typical case might charge the following:

Is medical fraud a battle of experts?

Medical fraud is often a battle of experts. Billing and medical practice involves a tension between patient care, profitability and masses of government and insurance company regulations. Reasonable people and hired guns can and will differ on interpretation.

Is Healthcare Fraud a Criminal Offense?

Healthcare fraud is a federal criminal offense addressed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) with stiff penalties. Violators of this prohibition against healthcare fraud can end up in federal prison for white-collar offenses. If found guilty of healthcare fraud, penalties may include:

What are Some Common Types of Healthcare Fraud?

Healthcare fraud can be committed both by the patient and the provider. Healthcare fraud may sometimes involve illegal conduct such as:

What are the Defenses to Healthcare Fraud Charges?

Healthcare fraud charges are sometimes associated with certain defenses. These include:

How Can Health Care Fraud Be Avoided?

Health care fraud can be prevented or avoided by the patient by doing the following:

Do I Need a Lawyer?

Healthcare fraud schemes can be very complex and may not be readily apparent. If you think that you have been the victim of healthcare fraud, an experienced personal injury attorney can help you figure out how to best pursue a remedy for the harm you suffered.

What is healthcare fraud?

Health care fraud involves intentionally trying to deceive or misrepresent medical claims to the government or receiving self-referrals. Health care law is complicated because there is no single law that governs healthcare fraud. Instead, medical providers must navigate numerous laws to avoid both criminal and civil charges for health care fraud, anti-kickbacks, referrals, and false claims. As a defendant you could be charged under any combination of these laws with severe consequences including prison, steep fines, and loss of your medical license.

Does the DOJ monitor health care?

While COVID-19 brought relaxation of some regulations to facilitate delivery of health care services like telehealth, with release of trillions in funding under the CARES Act, the DOJ and OIG will continue to diligently monitor health care for possible criminal abuse. The OIG and HHS have also expressed concerns that fraud could be on the rise particularly related to COVID-19 testing services.

Defenses to Healthcare Fraud Cases at the Federal Level

Probably the best defense obviously is that you’re not the person that took funds illegally, because when someone is receiving a benefit from the federal government and that benefit is received unlawfully, then the federal government will come with the full weight of their investigative power and the prosecutorial power.

Call Our Federal Criminal Lawyers for Help

Once we’re moving in the right direction, then there’s a number of different options that are available to you in a federal healthcare fraud case that’s filed pursuant to Section 1347.

What are the other crimes that can be charged with Medi-Cal fraud?

Other California offenses that may be charged along with or instead of Medi-Cal fraud include: 4.1. Elder abuse. Penal Code 368 PC, California’s elder abuse law, makes it a crime to willfully or negligently impose unjustifiable physical pain and/or mental suffering on a person who is 65 or older. 42.

What is Medi-Cal fraud?

Simply put, Medi-Cal fraud is any instance of California insurance fraud that has California’s Medi-Cal program as a “victim.”. Medi-Cal is a program of free or low-cost health coverage for Californians. Groups that may receive Medi-Cal benefits include:

How long is the prison sentence for Medi-Cal fraud?

This means that they may be charged as either misdemeanors or felonies in California law. 6. The potential felony prison sentence for most forms of Medi-Cal fraud is anywhere from sixteen (16) months to five (5) years.

Does the Attorney General investigate Medi-Cal fraud?

This explains why the California Office of the Attorney General is very motivated to investigate and prosecute Medi-Cal fraud cases. In fact, the Attorney General has established a specialized Bureau of Medi-Cal Fraud and Elder Abuse.

What is healthcare fraud?

In healthcare fraud billing investigations, experience matters. You may be up against investigators and prosecutors who focus 100 percent of their time and effort on healthcare fraud enforcement and by the time you find out you are under investigation the government is likely already building its case against you. The healthcare fraud defense team at Oberheiden, P.C. can level the playing field and we can help you take control of your situation. Contact us today to learn more about:

What is billing fraud?

“Billing fraud” is a broad term that encompasses a range of violations involving healthcare providers’ reimbursement requests submitted to Medicare, Medicaid, Tricare, and other benefit programs. Most of these violations are prosecuted as civil or criminal offenses under the False Claims Act, although federal authorities can pursue billing fraud charges under a variety of other statutes as well. This includes the Anti-Kickback Statute (which applies to all healthcare providers), and the Stark Law (which applies specifically to billings that include compensation for physician “self-referrals”). Some of the most common allegations in billing fraud investigations under these statutes include:

What are the consequences of billing fraud?

For physicians, pharmacists, hospice owners, and other healthcare providers, the consequences of billing violations can be substantial. From civil monetary penalties and program exclusion – to loss of licensure and even federal imprisonment – accusations of billing fraud can impact all aspects of providers’ professional and personal lives.

Can you be charged with billing fraud?

According to federal data, only a relatively small percentage of billing fraud investigations lead to indictments, with an even smaller percentage leading to convictions. However, those that avoid prosecution are often those who seek experienced legal representation. Ignoring your investigation is perhaps the best way to put yourself at risk for facing charges.