Experienced Legal Counsel Serving those Charged with Medicare Fraud in the Tampa Area

If you’re in Tampa, Florida or the surrounding areas and you’re being accused of Medicare fraud, call Oberheiden & McMurrey, LLP. We are a Medicare fraud defense law firm with extensive experience. Our legal team is led by a former Chief Health Care Fraud Coordinator from the U.S. Attorney’s Office. Members of our legal team have experience as former federal prosecutors and as former senior trial attorneys. The Oberheiden & McMurrey, LLP assists clients with Medicare fraud defense, government investigations, and in other legal matters in Tampa, Florida and in the surrounding areas.

Individual health care practitioners, entities, facilities, and businesses in Tampa, Florida are more likely to be investigated for Medicare fraud than their peers in most other locations within the United States. If you’re a health care practitioner, hospice provider, hospital, clinic, physician-owned entity, or a health care business accused of Medicare fraud in Tampa, Florida or the surrounding area, you can now retain of the nation’s most well-known Medicare fraud defense law firms: Oberheiden & McMurrey, LLP. Oberheiden & McMurrey, LLP provides Medicare fraud defense for individual practitioners, entire hospital conglomerates, clinics, businesses, lawyers, executives, and anyone involved in the health care industry facing this devastating allegation. Dr. Nick Oberheiden is a Harvard-trained health care fraud defense attorney and negotiator. He is recognized for his experience in health care fraud defense. Dr. Oberheiden is the managing partner of Oberheiden & McMurrey, LLP.

Medicare Fraud Basics

Medicare fraud arises when there is a submission of one or more false claims to a federal health care program. The claims are filed by providers, businesses or entities to be reimbursed for services or equipment provided to the patient. Medicare fraud is a federal offense with civil and criminal penalties. It doesn’t just include Medicare, either. It covers false claims filed with any federal health care program: Medicare, Medicaid, Tricare, or federal workers’ compensation are all included under the term. If you’re accused of Medicare fraud, you’re being investigated for violating at least one of these statutes:

  • False Claims Act
  • Anti-Kickback Statute
  • Stark Law (Physician Self-Referral Law)
  • Social Security Act
  • U.S. Criminal Code

Individual practitioners, businesses, pharmacies and other related health care entities in Tampa are investigated for Medicare fraud more frequently than in other locations. Tampa, Florida has a high number of citizens who receive benefits from a federal health care program. This causes more claims to be filed with federal health care programs. It is one of nine locations expressly monitored by the Medicare Fraud Strike Force. The federal government believes that there is a correlation between the number of claims filed in Tampa and an increase in Medicare fraud.

The Medicare Fraud Strike Force monitors, investigates, and prosecutes Medicare fraud. This is a unit comprised of investigators and prosecutors from multiple federal agencies including the DOJ, DEA, DOD, Department of Human Services, the Office of Inspector General, the FBI, the IRS, and other federal agencies. If you’re contacted by the Medicare Fraud Strike Force, you should contact Oberheiden & McMurrey, LLP immediately to learn about your defense options.

Medicare Fraud Investigations in Tampa, Florida

Medicare fraud investigations in Tampa and the surrounding area materialize when an individual practitioner, business, or other health care entity files an inaccurate claim with the federal health care program. The federal government reviews the claim and determines that it is a fraudulent billing matter or reimbursement request. These inaccurate claims often include charges that are unauthorized by the federal government, false charges, or excessive charges. In Tampa, Florida the most common inaccuracies result from:

  • Phantom billing (billing for services that were never performed)
  • Submitting a claim for medically unnecessary services or equipment
  • Submitting a claim for medical supplies, equipment, or services that were never ordered
  • Submitting a claim of certification for medically unnecessary supplies (such as DME)
  • Submitting a claim of certification for medically unnecessary services (such as hospice or home health care)
  • Double billing
  • Upcoding
  • Inflating charges
  • Overusing medical equipment or services
  • Providing or accepting kickbacks

In Tampa, most Medicare fraud investigations are initiated against doctors, nurses, health care service providers, physician-owned entities, nursing and registered care facilities, hospitals, clinics, pharmacies, laboratories, cancer centers, DNA centers, and DME providers. Yet, it’s important for you to recognize that, if you submit claims to any federal health care program for reimbursement, you could eventually be charged with Medicare fraud.

A Look at the Civil and Criminal Penalties Associated with Medicare Fraud

Medicare fraud brings with it both civil and criminal penalties. You may be charged in civil or criminal court. Civil penalties for Medicare fraud in Tampa, Florida may include one or more of the following:

  • Recoupment requests
  • Non-payment of claims
  • Up to $11,000 in fines for each false claim
  • Future exclusion from federal health care programs
  • Treble damages
  • Attorney fees

You may also be subject to appearing before the state disciplinary or licensing board. You could lose your professional license and your hospital privileges.

Criminal penalties for Medicare fraud are also very serious. You may receive one or more of the following penalties:

  • Hundreds of thousands of dollars in fines
  • Criminal charges
  • Prison sentence of up to ten years for each count of Medicare fraud
  • Prison sentence of up to 20 years for each count of Medicare fraud that resulted in serious bodily harm
  • Life sentence if the Medicare fraud results in the death of the patient.

Finding the Right Tampa, Florida Defense Attorney

As you’ve learned from reviewing the civil and criminal penalties associated with Medicare fraud, these allegations can affect you for the rest of your life. You’re likely considering which type of law firm you should hire to assist you. Should you choose a health care attorney serving the Tampa, Florida area? Should you choose a criminal defense lawyer? Is there a better choice to handle the complexities of a Medicare fraud case?

If you’re considering a health care law attorney who serves the Tampa, Florida area, there are some things you should consider. You need one that understands the laws associated with health care, so that you are not left vulnerable to federal criminal charges.  Medicare fraud often includes additional charges like mail fraud, wire fraud, money laundering, or tax fraud. A lawyer you choose should be experienced in these matters, or have the negotiation skills or federal trial experience that you truly need.

Criminal defense lawyers in Tampa, Florida are another common consideration. However, you need one with the training in health care law, billing, coding, and medical utilization rules.

There is another option for Medicare fraud defense in Tampa and the surround areas: A health care fraud defense lawyer. A health care fraud defense attorney has experience in health care law and federal criminal law. This type of attorney has experience negotiating with the federal government and has federal trial experience. As you research your options, look for these four traits:

  1. A proven track record of success in Medicare fraud cases
  2. Industry knowledge
  3. Deep familiarity with health care laws and their exceptions
  4. Litigation and trial experience

Next, you’ll want to ask your potential attorney these three important questions to ascertain their experience:

  1. How many Medicare fraud cases have you handled during your career in law?
  2. How many of those cases resulted in no civil or criminal charges or in dismissals for your clients?
  3. How many Medicare fraud cases did you try in court?

Assertive Medicare Fraud Defense Strategies

Oberheiden & McMurrey, LLP analyzes each Medicare fraud case and uses assertive defense strategies on behalf of our Tampa, Florida clients. While we look to settle cases with the federal government where possible, we also have federal trial experience. We’ve taken more than 200 cases to trial. Many of our Health Care Fraud Defense Team attorneys have experience as senior-level federal health care fraud prosecutors and with the Medicare Fraud Strike Force. We use the following assertive and strategic Medicare fraud defense strategies:

Immediate contact with investigators. Our primary goal is to resolve this matter for our clients, while also protecting our clients from federal criminal charges. We immediately get into contact with federal investigators. This strategy is key to a successful resolution of your case. It gives us the opportunity to get answers to important questions and to advocate on your behalf. Within hours of our engagement, we can usually get the answers to the following questions:

  • What is the case about?
  • What prompted the investigation?
  • Is this a criminal or a civil matter?
  • Which federal agencies are involved?
  • Who all is under investigation?
  • What is the ultimate goal of the government?
  • How can the investigation be resolved?

If you’re being investigated, it’s imperative that you call us right away. Do not give the federal government too much time to investigate you without interruption.

Evaluating federal evidence. The federal government must present evidence that you committed Medicare fraud. Their evidence must meet a Constitutional standard that is known as “beyond a reasonable doubt.” We evaluate the evidence presented by prosecutors to determine whether it meets this standard. By doing this, we’ve seen the following results on a regular basis:

  • Case dismissal
  • No criminal charges
  • Clients maintain their professional license
  • Civil fine without a criminal plea
  • Reduction of a felony to a misdemeanor
  • No prison sentence

No criminal intent. The federal government must also prove that you acted with criminal intent. This means that you planned to defraud the government. This is difficult for them to prove because intentional Medicare fraud in Tampa, Florida is rare. Medicare fraud investigations in this area start because a provider, facilities, or business made a serious mistake in their billing or coding. The most common issues that result in mistakes that are flagged as Medicare fraud include:

  • The use of unqualified staff
  • Lack of adequate supervision
  • Delegation and outsourcing
  • Structural or organizational mistakes
  • Human errors
  • Oversight
  • Overwhelmed employees
  • No Medicare compliance program
  • Quickly changing health care laws and rules

Of course, these mistakes should certainly be addressed and corrected. However, as mistakes, they should not be subject to criminal penalties. We work to prove to the government that you did not commit a crime, but that you do want to correct your mistakes.

Appropriate and strategic Medicare fraud defenses. Medicare fraud cases have some similarities since they all involve the same basic problem. Yet, not every case can have the same defense. This is because each case has its own set of facts. This is why Oberheiden & McMurrey, LLP analyzes each case to develop appropriate and strategic Medicare fraud defenses. One of our recent clients was accused of fraudulently certifying home health care services. We proved to the federal government that our client was legally protected by a recognized delegation exception that made their certification fully compliant within the law. In another recent case, we would not admit liability on behalf of our client. We were able to prove to prosecutors that our client acted within a safe harbor exception.

Oberheiden & McMurrey, LLP

Oberheiden & McMurrey, LLP provides legal advocacy for Tampa, Florida health care providers, entities, and related businesses accused of Medicare fraud. We’ve assisted health care businesses, owners, executives, lawyers, individual providers, hospitals, clinics, pharmacies, labs, and other health care entities under investigation for fraudulent billing and illegal kickbacks. We also assist with allegations of medically unnecessary services, services not rendered, or unlawful joint ventures. We can help you in many areas, including:

  • Health Care fraud defense
  • Compliance program creation and implementation
  • Internal investigations
  • Asset protection
  • Licensure or disciplinary proceedings
  • Jury trials

Oberheiden & McMurrey, LLP represents individual providers and entire health care systems in the State of Florida. If you’re being investigated by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, Tampa or Florida state law enforcement, contact us immediately. Initial consultations are confidential and free.

Our Track Record

  • Defense of Medicare laboratory against investigations by the Department of Justice and the U.S. Attorney’s Office for alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of a health care services company against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged False Claims Act and Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of Medicare laboratory against investigations by the Department of Health and Human Services and the Office of Inspector General for alleged Health Care Fraud.
    Result: No civil or criminal liability.
  • Defense of nationally operating health care company against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability.
  • Defense of health care marketing company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations.
    Result: No civil or criminal liability.
  • Defense of a laboratory against an investigation by various branches of the federal government for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of physician-owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Justice for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by various branches of the federal government for alleged False Claims Act, Stark Law, and Medicare violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Justice for alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of physician-owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of health care management organization against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of nationally operating laboratory against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.

Medicare Fraud Defense Lawyers Serving Tampa, Florida

Nick OberheidenDr. Nick Oberheiden has successfully represented health care executives, business owners, public officials, physicians, and lawyers in high profile prosecutions, during accusations of political corruption, government investigations, and directed media campaigns, including 60 Minutes. He is most known for stopping federal investigations before criminal charges can be filed. In addition to his health care defense practice, Dr. Oberheiden leads internal investigations, implements corporate compliance programs, and teaches U.S. criminal law and federal litigation in the United States and abroad.

Lynette ByrdLynette S. Byrd is a former Assistant United States Attorney (AUSA). Clients greatly benefit from Ms. Byrd’s experience from the Department of Justice, where she prosecuted health care fraud, Anti-Kickback violations, False Claims Act, and Stark violations on behalf of the United States. Ms. Byrd has immense experience with health care law enforcement, and she regularly argues federal matters for her clients.

We are available every day of the year. You can call us directly or complete our contact form or by emailing us directly.

888-997-2520
Including Weekends
Oberheiden & McMurrey, LLP
Serving Tampa, Florida and Surrounding Areas
www.medicare-lawyer.com
This information has been prepared for informational purposes only and does not constitute legal advice. This information may constitute attorney advertising in some jurisdictions. Reading of this information does not create an attorney-client relationship. Prior results do not guarantee similar future outcomes. Oberheiden & McMurrey, LLP is a Texas LLP with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.