Portland Medicare/Medicaid Fraud Defense Attorneys

Experienced Team of Defense Attorneys Protecting Clients from Medicare/Medicaid Fraud Charges throughout Portland

If you’re under investigation for Medicare/Medicaid fraud in Portland, Oregon or the surrounding areas, you need to call Oberheiden, P.C.. We are a healthcare fraud defense law firm with extensive experience. We also provide representation of clients who are involved in federal investigations or who are in need of assistance with federal compliance matters. Oberheiden’s defense team is highly educated and experienced. Many on our team of defense lawyers have experience as former federal prosecutors and senior trial attorneys. The team is managed by a former Chief Healthcare Fraud Coordinator for the U.S. Attorney’s Office. Oberheiden, P.C. provides representation for clients in Portland, Oregon and the surrounding areas.

Doctors, nurses, other individual healthcare providers, entities, and facilities in or surrounding Portland, Oregon that are under investigation for Medicare/Medicaid fraud can now rely on one of the nation’s most powerful legal advocates: Oberheiden, P.C.. Oberheiden, P.C. are legal advocates for Medicare/Medicaid fraud defense. We represent individuals, entire hospital networks, healthcare businesses, clinics, physician-owned entities, and other healthcare businesses. Dr. Nick Oberheiden, managing principal partner, is a Harvard-trained lawyer and a healthcare fraud defense attorney.

Defining Medicare/Medicaid Fraud

Medicare/Medicaid fraud is a federal offense. It can result in serious civil and criminal consequences. Medicare/Medicaid fraud occurs when there is a submission of one or more false claims to a government healthcare program in order to receive money from the program. Despite the name, it covers false claims to any federal healthcare program. This means false claims submitted to Medicaid, Tricare, or federal workers compensation are also included under Medicare/Medicaid fraud. If you’re accused of Medicare/Medicaid fraud, you’re being accused of violating at least one of the following statutes:

• False Claims Act
• Anti-Kickback Statute
• Stark Law (Physician Self-Referral Law)
• Social Security Act
• U.S. Criminal Code

Portland, Oregon healthcare providers, businesses, and entities have a higher risk of being investigated for Medicare/Medicaid fraud than most other areas in the nation. In fact, it is one of the nine locations in the United States that the Medicare/Medicaid Fraud Strike Force specifically watches. This team monitors the healthcare industry for instances of Medicare/Medicaid fraud. They investigate and prosecute it, as well.

The Medicare Fraud Strike Force is a federal hybrid agency. It includes investigators and prosecutors from the DOJ, DEA, DOD, Department of Human Services, the Office of Inspector General, the FBI, the IRS, and other federal agencies. In addition to being investigated and the possibility of civil and criminal charges, you could also lose your license to practice, face state disciplinary charges, and lose your hospital privileges.

What Causes Allegations of Medicare/Medicaid Fraud?

In Portland, Oregon, Medicare/Medicaid fraud investigations are commonly started because the federal government notices certain issues involving the claims that they receive from providers, businesses, and entities. These issues are labeled fraudulent billing practices and reimbursement requests. The government spots what they consider false charges, excessive charges, or unauthorized charges. In Portland, Oregon, the most common billing errors that instigate a Medicare/Medicaid fraud investigation include:

• Phantom billing (billing for services that were never performed)
• Submitting a claim for medically unnecessary services or equipment
• Submitting a claim for medical supplies, equipment, or services that were never ordered
• Submitting a claim of certification for medically unnecessary supplies (such as DME)
• Submitting a claim of certification for medically unnecessary services (such as hospice or home healthcare)
• Double billing
• Upcoding
• Charge inflation
• Overuse of equipment or services
• Providing or accepting kickbacks

Common investigated Portland, Oregon providers and entities include doctors, nurses, healthcare services, physician-owned entities, nursing homes, registered care providers and facilities, hospitals, clinics, pharmacies, laboratories, DME providers, DNA centers, and cancer centers. It is important to note that any healthcare provider, entity, or business that submits claims to the federal government for reimbursement can be the subject of a Medicare/Medicaid fraud investigation.

A Look at Civil and Criminal Penalties Associated with Medicare/Medicaid Fraud

Medicare/Medicaid fraud investigations may result in serious civil and criminal penalties. You may have charges brought against you in civil court, criminal court, or both courts. Civil penalties may include one or more of the following:

• Recoupment requests
• Non-payment of claims
• Up to $11,000 in fines for each false claim
• Future exclusion from federal healthcare programs
• Treble damages
• Attorney fees

In addition, you may also be subject to a hearing over your professional license, state disciplinary proceedings, and you may lose your hospital privileges.

Criminal penalties may include one or more of the following:

• Hundreds of thousands of dollars in fines
• Criminal charges
• Prison sentence of up to ten years for each count of Medicare/Medicaid fraud
• Prison sentence of up to 20 years for each count of Medicare/Medicaid fraud that resulted in serious bodily harm
• Life sentence if the Medicare/Medicaid fraud results in the death of the patient.

Do You Know How to Choose the Right Portland Defense Lawyer?

By now, your mind is probably turning around the fact that you have to find the right Portland defense lawyer. Yet, who should you choose? Should you choose a healthcare attorney? Should you choose a criminal defense attorney? Is there a better option?

If you’re considering a Portland healthcare attorney, there are some things you should know and understand. You want an attorney who will understand the applicable healthcare laws. Also, they should be prepared for additional charges. Medicare/Medicaid fraud is often charged along with federal criminal charges, including tax evasion, wire fraud, mail fraud, and money laundering.

You also need an attorney that can offer you criminal defense. Criminal defense attorneys may understand the criminal side of the law, but you also need an attorney that understands the nuances of billing, coding, or medical utilization rules or other necessary aspects of healthcare law. These charges are extremely serious. You do not have time to select the wrong attorney — so knowing what to look for is critical.

The good news is that there is a better choice. A healthcare fraud defense attorney serving Portland, Oregon has experience in both healthcare fraud defense and federal criminal charges. As you do your research, look for the following four traits:

1. A proven track record of success in Medicare/Medicaid fraud cases
2. Industry knowledge
3. Deep familiarity with healthcare laws and their exceptions
4. Litigation and trial experience

Once you’ve completed your initial research, you should contact your possible choices and ask the following three questions:

1. How many Medicare/Medicaid fraud cases have you handled during your career in law?
2. How many of those cases resulted in no civil or criminal charges or in dismissals for your clients?
3. How many Medicare/Medicaid fraud cases did you try in court?

Vital Medicare/Medicaid Fraud Defense Strategies

The Oregon and the surrounding areas. We’ve taken hundreds of Medicare/Medicaid fraud cases to trial. Our Medicare/Medicaid fraud defense attorneys have experience as former senior level federal healthcare fraud prosecutors with the Department of Justice and as part of the Medicare Fraud Strike Team. Combined with our experience as attorneys in healthcare fraud defense, we have incredible insight that we put to work for each and every Medicare/Medicaid fraud client.

Our objective is to resolve the investigation with minimal risk of criminal charges for our clients. To accomplish this, we rely on four specific strategies:

Early contact with federal investigators. Throughout our experience, we’ve learned that early contact with the federal government is key. Through this one task, we are able to get answers to your questions, and it also reduces the risk of criminal charges. If the government has too much uninterrupted time to investigate you, you have a higher risk of facing criminal charges. Our Healthcare Fraud Defense Team believes that opening the lines of communication with the federal government is one of the best ways that we can advocate for our clients. Within hours, we can usually get answers to the following important questions:

• What is the case about?
• What prompted the investigation?
• Is this a criminal or a civil matter?
• Which federal agencies are involved?
• Who all is under investigation?
• What is the ultimate goal of the government?
• How can the investigation be resolved?

Questioning federal evidence. In any lawsuit that alleges a crime, there must be evidence. The federal government’s evidence must meet a Constitutional standard known as beyond a reasonable doubt. By questioning the federal evidence and testing whether or not it meets this high standard, we see the following results on a regular basis:

• Case dismissal
• No criminal charges
• Clients maintain their professional license
• Civil fine without a criminal plea
• Reduction of a felony to a misdemeanor
• No prison sentence

Lack of criminal intent. In addition to presenting evidence of a crime, the federal government must also prove that you acted with criminal intent. Criminal intent means that you had the intention of committing a crime. This is a difficult standard for the federal government to meet. This is because very few legitimate cases of Medicare/Medicaid fraud occur. Most people simply do not wake up one day with the intent to defraud the government. Rather, the Medicare/Medicaid fraud that happens in Portland, Oregon is because of an honest mistake that was made. These mistakes occur because healthcare providers are busy helping patients and not paying attention to the specifics of the back office. Healthcare businesses often make mistakes because of how fast they’re growing. The most common errors include:

• The use of unqualified staff
• Lack of adequate supervision
• Delegation and outsourcing
• Structural or organizational mistakes
• Human errors
• Oversight
• Overwhelmed employees
• No compliance program
• Quickly changing healthcare laws and rules

While honest mistakes certainly may need to be corrected, they shouldn’t cause you to face criminal penalties. Yet, healthcare providers and businesses who make mistakes often just accept the penalties levied against them by the federal government instead of working to clear their name. Our objective is to prove to the federal government that our client made a mistake and should not be subject to criminal penalties.

Strategic Medicare/Medicaid fraud defenses. Oberheiden, P.C. analyzes each Medicare/Medicaid fraud case that we represent. By doing so, we are able to locate strategic and applicable Medicare/Medicaid fraud defenses at an individual level. Recently, we handled a Medicare/Medicaid fraud case where the government alleged fraudulent certification for home healthcare services by our client. We were able to prove to the government that our client was protected by a recognized delegation exception that rendered the certification fully compliant within the law. In another Medicare/Medicaid fraud case, we refused to admit liability. We were able to prove to prosecutors that our client acted within a safe harbor exception.

Oberheiden, P.C.

Oberheiden, P.C. advocates aggressively for our Portland, Oregon Medicare/Medicaid fraud clients. We’ve assisted healthcare businesses, owners, executives, lawyers, individual providers, hospitals, clinics, pharmacies, labs, and other healthcare entities under investigation for fraudulent billing and illegal kickbacks. We also assist with allegations of medically unnecessary services, services not rendered, or unlawful joint ventures. We can help you in many areas, including:

• Healthcare fraud defense
• Compliance program creation and implementation
• Internal investigations
• Asset protection
• Licensure or disciplinary proceedings
• Jury trials

Oberheiden, P.C. provides legal representation of individual providers and entire healthcare systems in Louisiana. If you’re being investigated by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, Portland, Oregon or Oregon state law enforcement, call us. Initial consultations are free and totally confidential.

Medicare/Medicaid Fraud Defense Attorneys Serving Portland, Oregon

Dr. 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 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.