Determined Legal Representation for Health Care Professionals in Southern California

Few things can turn your medical practice upside down like a subpoena or a notice of inspection from the federal government. It’s a nightmare scenario for most doctors and business owners, but it’s one you might never expect could actually happen to you.

The truth, though, is that the federal government has invested considerable amounts of money into combating health care fraud over the last decade. The Departments of Justice (DOJ) and Health and Human Services (HHS) are actively beefing up their fraud prevention efforts, and they’ve made a public show of “cracking down” on perceived waste and abuse in recent years.

That is especially true in Los Angeles, one of just nine cities around the country where the United States has established a Medicare Fraud Strike Force office.

The Strike Force searches aggressively for any activity that might signal health care fraud, adopting a “where there’s smoke, there’s fire” mentality.

In the health care industry, however, the “smoke” doesn’t always lead where the feds think it will.

That’s because much of what federal agents identify as “red flag” behavior is actually nothing more than an innocent clerical error. And in most cases (though certainly not all), the government will ultimately need to prove intent to defraud before it can successfully convict a health care professional on fraud-related charges.

Unfortunately, by the time the government’s case falls apart, the damage has already been done. Pharmacists’ reputations are ruined. Nurses lose their jobs. Doctors’ practices fall apart. Business owners lose more money in the interim than they can hope to recover.

That’s why it is so important, when facing a federal investigation related to health care fraud, to hire experienced legal counsel as early in the process as possible.

In many cases, a federal health care fraud defense lawyer can help you negotiate an early end to the investigation, sparing you undue embarrassment and business losses while also keeping your licenses intact and avoiding federal felony charges.

That’s what we do at Oberheiden, P.C. Having spent years as former prosecutors for the federal government – where we assisted the U.S. in these same kinds of health care fraud investigations – we now defend the doctors, nurses, pharmacists, and business owners instead.

We know from first-hand experience just how aggressive the government can get when it suspects fraudulent activity – even if you haven’t actually done anything wrong. You deserve an advocate who can be equally determined in protecting your interests.

Don’t face the Los Angeles Strike Force or any other federal agency on your own. Call Oberheiden, P.C. today.

Types of Health Care Fraud Cases in Los Angeles, California

If you work in the Los Angeles health care community, you are at a heightened risk of being investigated or accused of a health care fraud offense. The L.A. metro area has one of the highest numbers of federal health care program beneficiaries in the country, so agents are constantly looking for opportunities to cut down on payouts and potential waste.

The most commonly charged health care fraud offenses in California are:

  • False Claims Act violations. The False Claims Act is a federal statute that punishes anyone who enters into a contract with the U.S. government and then submits bogus claims for payments under that contract. More often than not, False Claims Act cases begin when a third party (often a competitor or an angry former employee) files what’s known as a qui tam lawsuit, meaning it’s filed on the government’s behalf. Don’t let a disgruntled acquaintance’s lawsuit derail your career. False Claims Act cases require proof of intent. An experienced team of federal law defense attorneys can help.
  • Anti-kickback statute violations. The Anti-kickback law applies when doctors give (or receive) a gift, kickback, or bribe in exchange for having patients or business opportunities referred to them. Here again, the government must be able to approve that the alleged “kickback referral” was made willfully and knowingly.
  • Stark Law violations. Stark Law provisions make it illegal to bill Medicare or Medicaid for services when there’s a “self-referral” involved. In other words, doctors cannot refer patients to service providers if the doctor has a commercial relationship with that provider. Unlike charges under the False Claims Act and Anti-kickback statute, the Stark Law does not require proof of knowledge or intent, meaning even accidental self-referrals can subject health care professionals to liability. Certain exceptions exist, however, and a federal law defense attorney can help you understand whether they might apply in your case.
  • Medicaid fraud. Most Medicaid fraud cases arise from everyday billing errors. Even if they are entirely unintentional, the Los Angeles Medicare Fraud Strike Force may try to take action against them. Our office takes an aggressive stand against these overzealous enforcement actions, and we are dedicated to protecting doctors, nurses, pharmacists, and business owners who are unfairly targeted.

The Los Angeles Strike Force Targets Individual Professionals

The most commonly targeted parties in Los Angeles health care fraud investigations are:

  • Doctors
  • Dentists
  • Surgeons
  • Nurses
  • Nursing homes / registered care facilities
  • HMOs
  • Hospitals
  • Clinics
  • Pharmacists / pharmacies
  • Labs and DNA centers
  • Cancer treatment centers
  • Medical device companies / equipment vendors
  • Business owners, directors, or executives
  • Other health care service providers

Examples of Los Angeles Medicare Fraud Strike Force Takedowns

  • In 2009, the federal government prosecuted 20 individual defendants, most of them living in the Los Angeles area, in seven different cases involving more than $26 million in allegedly fraudulent Medicare bills.
  • In 2011, the Los Angeles Medicare Strike Force brought charges against five L.A. defendants for scheming to defraud the federal government of more than $28 million. The charges were coordinated with similar arrests in the other Strike Force districts across the country.
  • In 2013, three defendants in the Los Angeles area were charged with paying illicit kickbacks to patient recruiters to bribe beneficiaries so they would participate in the alleged fraud scheme. Ten other defendants in the area were arrested on similar allegations as part of the same takedown.

Our Track Record in Medicare & Health Care Fraud Defense Cases

Below, we present just a few examples of our successes in defending health care organizations and practitioners against accusations of fraud:

  • Defended a health care management organization against an investigation by the OIG, the DOJ, and HHS for alleged Medicare fraud
    Result: No civil or criminal liability.
  • Defended a health care services company against an investigation by the Office of Inspector General, the DOJ, and HHS for alleged False Claims Act and Stark Law violations
    Result: No civil or criminal liability.
  • Defended a Medicare laboratory against investigations by HHS and the OIG for alleged health care fraud
    Result: No civil or criminal liability.
  • Defended 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.
  • Defended a different physician-owned entity against an investigation by the OIG for alleged fraud
    Result: No civil or criminal liability.
  • Defended another physician-owned entity against an HHS investigation for alleged Stark Law violations
    Result: No civil or criminal liability.
  • Defended a laboratory (operating nationally) against an investigation by the OIG for allegations of fraud
    Result: No civil or criminal liability.

Our Los Angeles Health Care Fraud Federal Law 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 (Los Angeles). 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.

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 Los Angeles 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 Strike Force and other federal offices.

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.

Contact the Aggressive Federal Law Defense Lawyers 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. Please contact Oberheiden, P.C. as soon as possible.

Our law firm will fight to achieve our goal to bring your investigation to an expedient end, protecting your reputation and your license along the way. You can count on us to explore every avenue for defending you against criminal charges and clearing your good name.

Please reach out to our office as soon as possible to request a free and confidential consultation. To speak with a federal health care law defense attorney for Los Angeles, simply dial (888) 727-0472 or contact us online as soon as possible.