False Claims Act and Qui Tam Lawsuit Defense Team Serving all of California

If you’re facing a qui tam lawsuit in California, call Oberheiden, P.C. We are experienced in qui tam defense strategies, criminal defense, healthcare fraud defense, and in other legal matters. Oberheiden, P.C. also assists clients in matters involving federal compliance and during federal investigations. Our defense team is led by a former Chief Healthcare Fraud Coordinator for the U.S. Attorney’s Office. California clients are represented by our team of former federal healthcare prosecutors and former federal senior trial attorneys. Oberheiden, P.C. serves clients in the entire State of California.

Oberheiden, P.C. is recognized as a False Claims Act defense and qui tam defense. Our law firm possesses significant legal experience in regulatory compliance, corporate structuring, litigation, federal government investigations, and in criminal defense. Our Healthcare Fraud Defense Team includes a former Chief Healthcare Fraud Coordinator for the U.S. Attorney’s Office, several former healthcare fraud prosecutors, elite former lead prosecutors of the Medicare Fraud Strike Force, and accomplished lawyers with leading education from the country’s best law schools, including Yale and Harvard. Oberheiden, P.C. provides healthcare fraud defense services in the State of California.

False Claims Act Investigations in California

California doctors, nurses, other practitioners, entities, facilities, and businesses have a higher than national average of being investigated for an alleged violation of the False Claims Act. The State of California is one of nine areas in the United States watched closer by the Medicare Fraud Strike Force than most of the nation. This is because more claims are filed in California for reimbursement by the federal government. The State of California has a large population that relies on federal healthcare programs for care. The federal government believes in a correlation between an increase of claims and an increase in violations of the False Claims Act.

The Medicare Fraud Strike Force is a joint federal team of investigators and prosecutors. It has members from the Department of Justice, the Department of Health and Human Services, the Office of Inspector General, the DEA, the FBI, the IRS, and can include other federal agencies. This team has the responsibility of detecting, investigating, and prosecuting violations of the False Claims Act. If you are notified of an investigation beginning against you by the Medicare Fraud Strike Force, it is imperative that you call Oberheiden, P.C. immediately. Initial consultations are free of charge and confidential.

The Basics of the False Claims Act

The False Claims Act is a federal regulation covering any person, business, or other organization with a direct or an indirect contract with and who will be reimbursed by the federal government. The False Claims Act establishes civil and criminal penalties for any individual, corporation, contractor, or business that knowingly submits or causes the submission of a false claim for approval and reimbursement by a federal healthcare program.

Actual knowledge of a false claim or of the intention to file a false claim isn’t a requirement for you to be charged. Legal liability occurs for you as a medical professional because the federal government believes that you had the obligation of due diligence. In short, it was your job to know what was happening in relation to your claims.

Medical coding offers us a clear example of how lack of actual knowledge can cause you to be investigated. Most healthcare professionals and business owners do not generally handle their own medical coding. They either hire a dedicated employee or they outsource it to a company. Although you may assume that the person or entity responsible for your medical coding uses up-to-date codes, that may not be the case. ICD-10 was recently adopted and instituted. It made many codes obsolete. If your employee or the entity uses an obsolete code and the government flags it, you could be investigated for violating the False Claims Act.

Civil and Criminal Penalties of Violating the False Claims Act

If you are accused of violating the False Claims Act, you may face civil or criminal charges and penalties. If you are notified of an investigation, call Oberheiden, P.C. immediately. We can help you find out which charges you may be facing, and we can begin to advocate on your behalf.

Civil penalties are imposed by the civil court. You may be subject to one or more of the following:

  • Treble damages (damages that are three times more than the amount that the claim is worth)
  • A fine of up to $11,000 per false claim
  • State disciplinary proceedings
  • Loss of your professional license
  • Loss of hospital privileges
  • You could be ordered to pay attorney’s fees for the federal government

Criminal penalties are imposed by the criminal court. You may be subject to one or more of the following criminal penalties:

  • Criminal record
  • Prison time
  • A fine of $250,000 per claim for individuals for federal felony convictions
  • A fine of $500,000 per claim for businesses for federal felony convictions
  • A fine of $100,000 per claim for individuals for a misdemeanor conviction
  • A fine of $200,000 per claim for businesses for a misdemeanor conviction

Qui Tam Lawsuits in California

Qui tam lawsuits that are filed in California federal court often cause False Claims Act investigations. Initially, qui tam lawsuits were used to provide a way for private citizens to protect the federal government from being defrauded by dishonest healthcare providers and entities. Qui tam is Latin. It means “he who sues for the king and himself.” Qui tam lawsuits are equipped with a monetary reward for successful lawsuits. Plaintiffs, known as “qui tam realtors”, receive a portion of the recovered money if the lawsuit is successful.

However, what started out as an honest and noble intention to give citizens a way to protect the government eventually became an abusive practice. In California, these lawsuits are frequently filed by disgruntled former employees and jealous competitors in an attempt to hurt you. These lawsuits are filed in federal court. Where your healthcare entity or practice operates will be the determining factor of which California federal court will be used. Qui tam lawsuits are sealed to protect the plaintiff. Only the presiding judge and the involved federal officials will receive copies of the unsealed documents.

False Claims Act investigations can take a lot of time. The court grants six month extensions to give federal investigators the time that they need to complete the investigation. Your lawyer can be in contact with the federal government from the very beginning of the investigation. This can be beneficial, because your lawyer can advocate on your behalf and ask how the entire investigation can be involved. Complex cases can take much longer to settle.

You will receive subpoenas from the FBI, the DEA, the DOJ, or other federal agencies. You may be required to turn over financial, billing, communication, and corporate records. The government will review your records and decide if they will support or decline the qui tam lawsuit. If the federal government declines, the case isn’t over. The plaintiff can continue the case without the support of the federal government. If the qui tam lawsuit is successful, the plaintiff will receive a reward of 30 percent of the recovered claim amount.

If the federal government decides to support the qui tam lawsuit, this is known as government intervention. It is extremely serious and you may face additional charges such as violating the Anti-Kickback Act and the Truth in Negotiation Act. If the qui tam lawsuit is successful against you, the plaintiff will receive a reward of 25 percent of the recovered claim amount.

Compelling Defenses for California False Claims Act Investigations

Oberheiden, P.C. possesses unique experience because of our group of fraud defense attorneys. We’ve used our collective experience to create compelling defenses for California False Claims Act investigations. Most of these investigations that occur in California don’t start because of an intention to defraud the government. They start because of a mistake or because of a qui tam lawsuit. Here are the defense principles that we use to advocate for our California clients:

Criminal charges. If you’re investigated for violating the False Claims Act, you may be facing criminal charges. Our objective is to contact the federal government to find out and minimize this risk. We use our experience as former federal healthcare prosecutors and defense teams to determine the exposure that you face. We contact the federal government immediately to find out why the investigation started and what can be done to resolve it. We get answers to your questions and we can usually do it within hours of being retained by you.

Qui tam defense. Because California False Claims Act investigations are commonly triggered by qui tam lawsuits, we work hard to discredit the evidence and the allegations. We use aggressive defense techniques to show the federal government that the case is meritless and does not deserve its support.

Settlements. In cases where the federal government notifies us that our client will face civil liability, we work toward a favorable settlement on behalf of our clients. None of our false Claims Act clients have been forced by the federal government to close down their healthcare practice or their business.

Oberheiden, P.C.

Oberheiden, P.C. has provided successful legal advocacy for doctors, clinic owners, physician-owned entities, toxicology labs, DME companies, pharmacies, service management organizations, marketing companies that work in healthcare, clinics, hospitals, and many other healthcare related entities in relation to False Claims Act violations. We also assist defendants in qui tam lawsuits, Stark Law violations, Anti-Kickback statute violations, Medicare, Medicaid, Tricare, and Department of Labor investigations.

Our Track Record

The attorneys of Oberheiden, P.C. have successfully defended physicians, practice owners, physician owned entities, toxicology laboratories, device companies, pharmacies, service management organizations, healthcare marketing companies, hospitals, and many others in False Claims Act, qui tam lawsuits, Stark Law, Anti-Kickback, Medicare, Medicaid, Tricare, and DOL investigations.

  • False Claims Act Investigation (Pharmacy)
    Result: No Liability.
  • False Claims Act Investigation (Pharmacy)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Physician)
    Result: No Liability.
  • False Claims Act Investigation (Physician)
    Result: No Liability.
  • False Claims Act Investigation (DME Company)
    Result: No Liability.
  • False Claims Act Investigation (MSO)
    Result: No Liability.
  • False Claims Act Investigation (MSO)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Device Company)
    Result: No Liability.
  • False Claims Act Investigation (Healthcare Service Provider)
    Result: No Liability.

Call Oberheiden, P.C. now and ask to speak with our Healthcare Fraud Defense Team about your case. Initial consultations are confidential and free.

False Claims Act Violation Defense Attorneys Serving California

Nick OberheidenDr. Nick Oberheiden has successfully represented healthcare 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 healthcare 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 healthcare fraud, Anti-Kickback violations, False Claims Act, and Stark violations on behalf of the United States. Ms. Byrd has immense experience with healthcare 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.

Including Weekends
Oberheiden, P.C.
Serving the State of California 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, P.C. is a Texas firm with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.