Experienced Legal Defense for False Claims Act Violations in the Laredo Area
Doctors, hospitals, pharmacies, nursing homes, and other healt care related businesses can be turned upside down with an allegation of a False Claims Act violation. Oberheiden, P.C. works to resolve these allegations using strategic, custom defenses for Laredo, Texas healthcare professionals and businesses. Our Healthcare Fraud Defense Team provides guidance and legal experience to our clients facing both civil and criminal allegations. If you’ve received notice of a False Claims Act violation, call Oberheiden, P.C. right away. We can help you get the answers that you need and put these allegations to rest.
False Claims Act Investigations in Laredo, Texas
Healthcare professionals and facilities in Laredo, Texas face a greater risk of investigation for False Claims Act violations. Texas is one of nine areas in the United States that the federal government believes has a higher instance of medical fraud. Because of this, the federal government has assigned two special task forces to investigate and prosecute False Claims Act violations.
The two task forces that investigate claims in Texas are the Medicare Fraud Strike Force and Healthcare Fraud Prevention and Enforcement Action Team (HEAT). These two teams are comprised of prosecutors and investigators from several federal agencies. You may come into contact with members of the FBI, Office of the Inspector General, Department of Health and Human Services (HHS), Department of Defense (DOD), Department of Justice (DOJ), the IRS, and other agencies.
Allegations of False Claims Act violations are extremely serious. It’s important that you retain a healthcare fraud defense attorney as soon as possible.
What Is the False Claims Act?
The False Claims Act is a federal statute that brings accountability to people or businesses that have direct or indirect contact with, and who receive payment from, the federal government. It assigns legal liability to any person, organization, business, or government contractor who knowingly submits or is the cause of the submission of a fraudulent or fictitious claim for payment by the government.
It’s important to note that the use of the word “knowingly” in the description above likely isn’t what you think. It’s not a matter of having actual knowledge of the submission of a false claim. Rather, it means that you were expected to know or that you should have known that whatever occurred during the filing of the claim was a violation of the False Claims Act. It’s a matter of due diligence research.
For example, if you work in a business that files Medicare/Medicaid or other federal claims that involve the payment by the government for medical devices, you must use the appropriate codes. Recently, medical codes were updated. Even if you accidentally use an obsolete medical code, it can be seen as a violation. This is because it is expected that medical professionals will do the research necessary to have the appropriate information they need to file a federal claim.
The Possibility of Civil and Criminal Liability
The majority of allegations in Laredo, Texas don’t arise because of criminal intent. Human error plays a large part in the violations. However, even though an honest mistake is made, you may be held liable in the civil or criminal court. During the beginning of the investigation, you may not be aware of whether the investigation against you is civil or criminal in nature. Oberheiden, P.C. can contact the investigating federal task force and can usually find out within a couple of days.
Civil and criminal liability are two separate matters. You could face only civil liability, criminal liability, or you could even face both. Civil liability is determined within the civil court system. With civil liability, you could be ordered to pay treble damages. This is three times the amount that the government lost on each claim. You could also face a fine of up to $11,000 per false claim.
Criminal liability is determined by the criminal court system. It can result in a five-year prison sentence and a steep fine. The amount is dependent upon two factors: Whether you’re charged with a misdemeanor or felony; and whether you are an individual or a business organization. Misdemeanors can carry charges of up to $100,000 per claim for an individual and up to $200,000 per claim for businesses. Felonies can leave you with charges of up to $250,000 per claim for individuals and up to $500,000 per claim for companies. In addition to facing fines and a prison sentence, you could also be stripped of your professional license.
Facing a Qui Tam Lawsuit in Laredo, Texas
In Laredo, Texas most False Claims Act investigations don’t start because the federal government randomly chooses to do one. What usually causes these investigations is when a former employee or a competitor tries to get back at you by filing a qui tam lawsuit. Private citizens have the right to file a claim on behalf of the federal government through the False Claims Act. This causes the beginning of a qui tam lawsuit.
Qui tam is Latin for “he who sues for the king and himself.” The use of the word “king” in this phrase is a reference to the federal government. The original motive behind a qui tam lawsuit was to assist the federal government in recovering money that it paid out in false claims. Private citizens who are successful in their cases will be eligible to receive a percentage of the money that is recovered.
However, because qui tam lawsuits are often filed by angry former employees or competitors, the true objective is often lost. Many people use qui tam suits as a way to punish or sabotage successful medical professionals and companies.
The plaintiff is referred to as a “qui tam relator.” Plaintiffs file qui tam suits against Laredo medical professionals and businesses in the Southern District of Texas. The complaints are sealed by the court clerk. This is to protect plaintiffs who truly are whistleblowers. Unsealed copies of the complaint are only provided to the presiding judge and to involved government officials.
Investigations can last for months. Extensions are generally filed in the qui tam lawsuit and granted by the judge. During the investigation, you will receive subpoenas for your financial, communication, billing, and business records. These subpoenas can come from different government agencies, including the FBI, the DEA, OIG, DOJ, DOD, and HHS.
During the investigation, your records will be reviewed. Your fraud defense attorney can stay in contact with the federal government. The federal government can either decline to support the qui tam lawsuit or it can intervene. If the government decides to decline support, the qui tam lawsuit won’t necessarily end. The plaintiff can choose to pursue the case on his or her own. If the government decides to intervene, you may face additional charges involving violations of the Truth in Negotiation Act or the Anti-Kickback Act.
Working with a healthcare fraud defense lawyer beginning in the early stages of the investigation can help you ultimately avoid the most severe consequences: Criminal charges and losing your professional license. Keep in mind that if the qui tam plaintiff wins, he or she will receive a percentage of the money that is recovered. If the government intervenes, the plaintiff will be entitled to 25 percent. If the government declines, he or she will be eligible to receive 30 percent.
Oberheiden, P.C.’s Guiding Defense Principles
Oberheiden, P.C.’s Healthcare Fraud Defense Team has a history of effectively negotiating with the federal government and defending clients in False Claims Act cases within the United States. We use a core set of guiding defense principles to help our clients.
- Early involvement with the investigating bodies. When you first find out that you’re being investigated, you may not know whether you’re facing civil or criminal charges. Our aim from the beginning is to help you avoid criminal charges that could destroy your career. We will contact the investigating bodies to ask the right questions: What are they looking to find, what charges might you face, and how these issues can be resolved.
- Vigorous qui tam defense. Most qui tam lawsuits originate from former employees and competitors. We will provide a vigorous qui tam defense that challenges the provided evidence and brings the plaintiff’s credibility into question. This strategy is extremely valuable because it can show the federal government that the claims against you are unfounded. When the federal government realizes that qui tam claims are unfounded or corrupt, it is less likely to provide support.
- Settling with the government. In most of our former civil liability cases, we’ve successfully negotiated damage amounts to small fractions of the government’s initial demand. To this day, none of our former clients had to stop practicing or shut down their business as a result of a False Claims Act violation.
False Claims Act investigations can be time-consuming and stressful. Oberheiden, P.C. can help you find a successful resolution. Call us today to discuss the specifics of your case. We provide free initial consultations that are confidential. You can call us at any time. We are available 24 hours a day, 7 days a week. You can also use our contact form or send us an email in order to learn more about how we can help.
Oberheiden, P.C.
The defense 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. today and speak with former federal prosecutors and established defense counsel about your case. All initial consultations are free and confidential.
False Claims Act Defense Attorneys in Laredo, Texas
Dr. Nick Oberheiden has represented clients in Qui Tam, False Claims Act, Medicare/Medicaid Fraud, Tricare Fraud, Stark Law, and anti-kickback proceedings before virtually all federal agencies including but not limited to the Office of Inspector General (OIG), the Department of Health and Human Services (HHS), the Department of Defense (DOD), the Department of Justice (DOJ), and the Department of Labor (DOL). Dr. Oberheiden is trained in negotiations by Harvard Law School and holds a Juris Doctor from the University of California, Los Angeles, as well as a Ph.D. in law.
Lynette S. Byrd is a former Assistant United States Attorney (AUSA). Clients greatly benefit from Lynette’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. Lynette has immense experience with healthcare law enforcement, and she regularly argues federal matters for her clients.
We are available to discuss your case. You can call us directly or complete our contact form or by sending us an email.
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