Experienced Federal Law Defense Attorneys for Chicago Health Care Professionals
If you are a doctor, pharmacist, nurse, or business owner in the medical field, you’ve worked hard to get where you are. Years of diligent study have earned you respect in your community, and a career for which you can be proud.
But when the federal government targets you for a criminal investigation pertaining to alleged health care fraud, those achievements can come crashing down around you.
Health care providers in Chicago know this all too well. Chicago is one of just nine cities in the United States where the federal government operates a designated Medicare Fraud Strike Force. The government chose Chicago because there are so many Medicare beneficiaries living in the Windy City metro, and because the city is one of the largest in the country.
The Strike Force is part of a larger initiative known as the Health Care Fraud and Prevention and Enforcement Action Team, or HEAT, a joint effort by the U.S. Department of Justice (DOJ), Office of the Inspector General (OIG), and Department of Health and Human Services (HHS).
The HEAT strike force closely collaborates with numerous state, local, and federal agencies, which means it can take rapid action against clinics or individual owners and providers who violate health care laws. And because HEAT switched its emphasis from enforcement to prevention in 2010, that rapid action can affect you long before the government has actually proved you’ve done something wrong.
For instance, if you practice in a small medical clinic in Illinois, and you make a small billing error involving a Medicare patient (accidentally coding for the wrong services, for example), the Chicago Medicare Fraud Strike Force could refer the activity to the Centers for Medicare & Medicaid Services (CMS) as a “credible suspicion” of fraudulent billing. CMS would then have authority to immediately cease all payments to your practice, which could have a potentially debilitating impact on your ability to do business. The strike force would then likely move in with an investigation or a raid, further impacting your business and casting a pall over your professional reputation in the community.
Medicare fraud isn’t the only allegation you have to worry about either. The health care industry is heavily regulated, so simple clerical errors can trigger a whole host of legal problems, including alleged violations of the:
- Anti-kickback statute
- Stark Law
- False Claims Act
- Controlled Substances Act
- Internal Revenue Code (federal tax)
- And more
Because Chicago is home to one of the principal HEAT Strike Force offices, practitioners in the Windy City are under heightened scrutiny. While the federal Strike Forces are technically national watchdogs, in reality, most of their takedown efforts happen in the cities where they’re headquartered.
If you are currently under audit, investigation, or suspicion for violating health care laws in the Chicago area, please take immediate action to protect your legal interests. The government takes these cases seriously and approaches them aggressively. You should too. There’s a lot on the line.
At Oberheiden, P.C., we fight for the rights of health care providers and business owners targeted by HEAT Strike Forces, the DOJ, HHS, DEA, IRS, FBI, and other federal agencies.
We are a national law firm with a focus on health care fraud cases in the nine Strike Force cities, including Chicago. Our lawyers are former federal prosecutors who now leverage their experience on behalf of hard working medical professionals who deserve strong, strategic legal representation.
Don’t risk your reputation and career by facing the federal government alone. Contact Oberheiden, P.C. right away.
The Federal Government Will Try to Prosecute Small Errors
Medicare Fraud Strike Forces have already arrested and charged more than 2,000 people around the country in connection with alleged health care fraud, many of them in Chicago and Illinois.
While most of the arrests are individual in nature, the Strike Forces coordinate them in highly publicized “takedown sweeps,” which the agencies then tout as major federal achievements in taxpayer protection.
In reality, however, many of these arrests spring from overblown accusations. Often, they boil down to innocent mistakes or minor clerical errors. That’s why you must take every audit, every investigation, and every conversation with a federal agent extremely seriously.
The government will use your records, filings, invoices, statements, and any other available evidence against you.
Examples of Health Care Fraud Takedowns in Chicago
- In 2011, the HEAT Strike Force expanded to Chicago and promptly charged 14 defendants in the greater Chicago area with health care fraud. The arrests were part of a larger sweep involving 111 individuals across the country, totaling some $225 million in alleged fraud.
- In 2013, the Chicago Medicare Fraud Strike Force simultaneously announced the arrest of seven people in five separate, unrelated “health care fraud schemes” worth millions of dollars combined. The defendants included two doctors and three co-owners of a local health clinic.
- A nationwide Strike Force sweep in 2016 saw 301 people charged, including two high-profile arrests of Chicago-area doctors: a physician in Buffalo Grove and another practitioner in Skokie.
The federal agents in Chicago are relentless. These are only a few examples of the federal government’s continuous prevention and enforcement efforts. They demonstrate the need to pay careful attention to your office’s billing and filing patterns.
Still, even those who are careful can end up on the wrong side of a federal investigation.
While health care fraud is unquestionably a problem, the government’s eagerness to “crack down” on crime frequently leads to overreach. Innocent health care professionals end up targeted unfairly.
What Triggers a Health Care Fraud Audit or Investigation?
Data collection and analysis is a key part of federal investigators’ work. Often, an audit or investigation begins because of a perceived irregularity in data connected with your hospital, clinic, pharmacy, or practice. Tips from patients or community members might also raise a red flag. Some audits or inspections are routine (but even regularly scheduled federal prodding can lead to misunderstandings and overblown complications).
The most common mistakes that health care companies and their employees make involve simple billing errors.
For example, the government frequently targets Chicago clinics for:
- Phantom billing (i.e., billing for services that were not performed)
- Double billing for treatment services or medical equipment
- Inflating charges
- Upcoding for treatment, disorders, services, or equipment
- Certifying for medically unnecessary supplies (e.g., DME) or services (e.g., hospice care)
- Billing for equipment that was never ordered
- Billing for services that Medicare does not cover as covered services
- Inefficient billing
- Bending the Medicare rules
- Overusing certain services or equipment
- Providing (or accepting) kickbacks or bribes
Who Are the Most Common Defendants in Health Care Criminal Cases?
Many of the individuals investigated for alleged health care fraud are people who never imagined they would face criminal suspicion, or potential federal felony charges.
Nevertheless, the government is as aggressive against people in the medical field as it is against drug dealers in the streets. Common defendants in Chicago health care criminal cases include:
- Business owners / co-owners
- Nursing home employees
- Physician’s Assistants
- Registered Nurses
- Other health care service providers
- Cancer treatment centers
- DNA Centers
- Health care marketing companies
- Medical equipment vendors
- Nursing homes
- Registered care facilities
Meet Our Team of Health Care Defense Lawyers
Dr. Nick Oberheiden is an experienced attorney, author, and legal contributor to media outlets. He has significant experience on issues pertaining to federal health care law, including health care fraud, federal enforcement actions and the Medicare Fraud Strike Force (Chicago). He has successfully defended numerous individuals and corporate clients (including doctors and health care practices) against federal criminal charges and regulatory enforcement actions. Dr. Oberheiden holds a PhD in law, a Juris Doctorate from the UCLA School of Law, and has been trained in negotiation at Harvard Law School.
Glenn A. Harrison is a former Special Asst. U.S. Attorney, a former DOJ Trial Attorney, and a former federal prosecutor. His primary practice areas include health care law, financial offenses, commercial litigation, and unfair competition. He is well known for his skills as a litigator inside and outside the courtroom, and he has personally overseen numerous high-level, complex cases involving health care law, federal criminal matters, and accusations of corporate fraud.
Lynette S. Byrd defends both individual and corporate clients who are accused of federal crimes or under investigation by state / federal agencies, including by the Chicago Medicare Fraud Strike Force. Ms. Byrd is a former federal prosecutor, and she served for several years as an Assistant U.S. Attorney for the Northern District of Texas. While representing the federal government, she worked on a number of high-profile cases, including one of the largest health care fraud cases in her district, and collected millions of dollars for the government on behalf of taxpayers. Today, she puts her experience as a former prosecutor to work for health care providers and their organizations against enforcement actions brought on by the Chicago HEAT Strike Force and other federal offices.
Our Track Record in Medicare & Health Care Fraud Defense Cases
- Defended a health care management organization against an investigation by the OIG, DOJ, and HHS for alleged Medicare fraud
Result: No civil or criminal liability.
- Defended a health care marketing company against an investigation by the OIG for alleged Medicare and False Claims Act violations
Result: No civil or criminal liability.
- Defended a physician-owned entity against an investigation by the OIG for alleged fraud
Result: No civil or criminal liability.
- Defended a health care services company against an investigation by the OIG, DOJ, and HHS for alleged False Claims Act and Stark Law violations
Result: No civil or criminal liability.
This is only a small selection of the many victories we have achieved for private health care organizations and medical professionals across the country.
In case after case, the experienced federal defense lawyers at Oberheiden, P.C. have successfully taken on federal agencies and won, including the DOJ, HHS, OIG, U.S. Attorney’s Office, DEA, IRS, FBI, Federal Strike Force, and more.
Whether you are facing an alleged violation of the False Claims Act, Stark Law, Anti-kickback statute, Controlled Substances Act (CSA), Internal Revenue Code, or any other federal law, we can help.
You deserve the strongest legal defense possible. We are a national law firm, and we are here to fight for you in Chicago.
Call the Chicago Health Care Federal Law Defense Attorneys at Oberheiden, P.C.
If you or your practice is currently facing an audit or investigation involving an alleged violation of federal health care law, you should take immediate action to protect your legal interests.
At Oberheiden, P.C., we will fight tirelessly to achieve our goals to:
- End investigations
- Keep your license
- Save your business
- Protect your reputation
- Advise you strategically
- Get all the criminal charges against you dismissed.
We offer free consultations. To speak confidentially with a federal law experienced defense attorney for Chicago, please call Oberheiden, P.C. at (888) 727-0472 or contact us online right away.