McAllen, Texas healthcare providers and businesses that are being investigated by the federal government because of allegations of violating the False Claims Act now have a powerful healthcare fraud defense law firm on their side. The Oberheiden, P.C., PLLC is a Texas law firm that practices in strategic defenses for False Claims Act allegations. Harvard-trained Dr. Nick Oberheiden is the managing principal attorney. He assists clients throughout Texas who are involved in federal healthcare investigations. Lynette Byrd is a former federal prosecutor. She prosecuted healthcare fraud, False Claims Act violations, Stark Law violations, and Anti-Kickback violations on behalf of the federal government.
McAllen, Texas False Claims Act Violations
While the federal government monitors and investigates False Claims Act violations across the United States, there are nine specific areas that are more closely scrutinized. McAllen, Texas is one of those areas. This is because McAllen and the surrounding areas have a large number of federal healthcare program beneficiaries. This means that healthcare providers, entities, and businesses in McAllen file more claims. When a large number of claims are filed, the government pays more attention because they believe that there is a likely chance that a False Claims Act violation may occur. In fact, the Department of Justice investigated more than 300 cases in 2016 and recovered more than $900 million in fraudulent claims.
McAllen, Texas is closely monitored by the Medicare Fraud Strike Force. This federal team monitors, investigates, and prosecutes False Claims Act violations. It is comprised of investigators and prosecutors from multiple federal agencies such as the DEA, the Department of Justice, the Department of Health and Human Services, OIG, the FBI, and the IRS. Being investigated is an extremely serious matter. McAllen, Texas providers and entities under investigation should call Oberheiden, P.C. immediately.
What Is the False Claims Act?
The False Claims Act is a federal law that applies to any individual or entity that has direct or indirect contracts with and will be paid for services by the federal government. The law creates civil and criminal liability for contractors, individuals, businesses, or organizations who knowingly submit or cause the submission of a false claim for approval of payment from the United States government.
Legal liability in this context involves the word knowingly. It’s important that you understand this because it’s not just a matter of having actual knowledge. It means that you should have known. For instance, if you contract your billing and coding out to someone or to a business and they use an obsolete code, that can be a violation of the False Claims Act that can cause you to be investigated. You knew or you should have known whether or not the provider used the proper codes.
What About Criminal and Civil Liability?
McAllen, Texas healthcare practitioners and entities that are investigated may face serious civil and criminal penalties. When you receive notice of the investigation, you may not know whether you’re facing civil or criminal charges. Retaining Oberheiden, P.C. can help you get the answers to the questions that you need.
Civil liabilities can include one or more of the following:
- Treble damages
- Civil fines up to $11,000 per claim
- Recoupment requests
- Future exclusion from federal healthcare programs
- Disciplinary action
- Loss of license
- Loss of hospital privileges
- Future claims will not be paid
Criminal liabilities can include one or more of the following:
- Criminal record
- Fines that amount to hundreds of thousands of dollars
- Federal prison time
How Qui Tam Lawsuits Affect McAllen False Claims Act Investigations
Qui tam lawsuits are the cause of most of the False Claims Act investigations that occur in McAllen, Texas. Qui tam, Latin for he who sues for the king and for himself, was designed to enable private citizens to assist the government by acting as a whistleblower. The problem is that most qui tam lawsuits aren’t filed by whistleblowers. They’re filed by angry employees and competitors who simply want to hurt your business.
Qui tam plaintiffs are referred to as a “qui tam relator”. They are filed in the Southern District of Texas federal court. The information is sealed with the exception of the appointed judge and the appropriate federal investigators. This is meant to protect people who are whistleblowers. The qui tam plaintiff can receive a monetary reward if a judgment is levied against you. They can receive 25 or 30 percent of the recovered funds, depending on whether the government supports the qui tam lawsuit.
The associated investigations can take quite some time. It’s extremely common for extensions to be filed in the case and granted by the judge. This is to allow the government the time that it needs to finish its investigation. You will receive subpoenas from federal agencies such as the DOJ, DOD, DEA, FBI, and OIG (just to name a few) requesting that you turn over your corporate, billing, financial, and communication records. The government will review your documents and decide whether or not it will support or reject the case. Should it choose to reject the allegations, that doesn’t mean that the case is over. The plaintiff can continue the case. If they are successful, they will receive 30 percent of the recovered funds. If the government chooses to get involved, it is referred to as government intervention. You’ll likely face additional charges. If you lose the qui tam case, the plaintiff will receive 25 percent of the recovered funds.
If you receive a notification about a qui tam lawsuit, you need a False Claims Act defense attorney on your side. Your defense law team can get into contact with the federal investigating bodies and work to negotiate a settlement on your behalf as well as work to minimize the criminal repercussions that you may face. The amount of time each case takes is dependent upon the facts involved. Call us right away for a free and confidential initial consultation.
Proven Strategic Defenses
Oberheiden, P.C. uses proven strategic defenses based off of three main guiding principles. We developed these principles using our collective experience in the healthcare fraud prosecution and defense industries. We’ve used these core principles to help people throughout the United States.
- Our first goal is to minimize the risk of criminal charges for McAllen clients. When you retain our firm, we immediately get into contact with the investigators to determine whether you’re facing civil or criminal charges, to find out the objective of the investigation, and what can be done to resolve the matter. We can usually get the answers in the first few days after our engagement.
- For our McAllen, Texas clients who are defendants in a qui tam lawsuit, we develop a zealous defense to the allegations. Our goal is to cast doubt on the plaintiff’s allegations and destroy their credibility. This is key to proving to the government that the case has no merit, and that it should not support the claims.
- Where civil liability is indicated, we work to reach a favorable settlement that is a fraction of the original demand. To date, none of our clients facing a False Claims Act violation have been forced to stop practicing or shut down their business.
Call Oberheiden, P.C. immediately if you’re being investigated for violating the False Claims Act. Initial consultations are confidential and free. You can call us, email us, or use our contact form to get started.
Oberheiden, P.C.
Oberheiden, P.C. has successfully represented individual healthcare providers, clinics, physician owned entities, practice owners, laboratories, DME companies, pharmacies, healthcare marketing companies, hospitals, and other healthcare businesses facing False Claims Act violations, qui tam lawsuits, Stark Law violations, Anti-Kickback Statute violations, and Medicare, Medicaid, Tricare, and Department of Labor investigations.
Here’s a small look at our Track Record:
- 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. right away to speak with our Healthcare Fraud Defense Team about your case. Initial consultations are free and confidential.
False Claims Act Defense Attorneys Serving McAllen, Texas
Dr. Nick Oberheiden has represented clients in qui tam lawsuits, False Claims Act investigations, Medicare/Medicaid fraud investigations, Tricare fraud investigations, Stark Law violations, 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). Detroit clients greatly benefit from Ms. Byrd’s previous experience with the Department of Justice, where she prosecuted healthcare fraud, Anti-Kickback violations, violations of the False Claims Act, and Stark Law 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 to discuss your case. You can call us directly or complete our contact form or by sending us an email.
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