Tampa, Florida Medicare/Medicaid Fraud Defense Attorneys

Experienced Legal Counsel Serving those Charged with Medicare/Medicaid Fraud in the Tampa Area

If you’re in Tampa, Florida or the surrounding areas and you’re being accused of Medicare/Medicaid fraud, call Oberheiden, P.C. We are a Medicare/Medicaid fraud defense law firm with extensive experience. Our legal team is led by a former Chief Healthcare Fraud Coordinator from the U.S. Attorney’s Office. Members of our legal team have experience as former federal prosecutors and as former senior trial attorneys. The Oberheiden, P.C. assists clients with Medicare/Medicaid fraud defense, government investigations, and in other legal matters in Tampa, Florida and in the surrounding areas.

Individual healthcare practitioners, entities, facilities, and businesses in Tampa, Florida are more likely to be investigated for Medicare/Medicaid fraud than their peers in most other locations within the United States. If you’re a healthcare practitioner, hospice provider, hospital, clinic, physician-owned entity, or a healthcare business accused of Medicare/Medicaid fraud in Tampa, Florida or the surrounding area, you can now retain of the nation’s most well-known Medicare/Medicaid fraud defense law firms: Oberheiden, P.C. Oberheiden, P.C. provides Medicare/Medicaid fraud defense for individual practitioners, entire hospital conglomerates, clinics, businesses, lawyers, executives, and anyone involved in the healthcare industry facing this devastating allegation. Dr. Nick Oberheiden is a Harvard-trained healthcare fraud defense attorney and negotiator. He is recognized for his experience in healthcare fraud defense. Dr. Oberheiden is the managing partner of Oberheiden, P.C.

Medicare/Medicaid Fraud Basics

Medicare/Medicaid fraud arises when there is a submission of one or more false claims to a federal healthcare program. The claims are filed by providers, businesses or entities to be reimbursed for services or equipment provided to the patient. Medicare/Medicaid fraud is a federal offense with civil and criminal penalties. It doesn’t just include Medicare and Medicaid, either. It covers false claims filed with any federal healthcare program: Medicare, Medicaid, Tricare, or federal workers’ compensation are all included under the term. If you’re accused of Medicare/Medicaid fraud, you’re being investigated for violating at least one of these statutes:

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

Individual practitioners, businesses, pharmacies and other related healthcare entities in Tampa are investigated for Medicare/Medicaid fraud more frequently than in other locations. Tampa, Florida has a high number of citizens who receive benefits from a federal healthcare program. This causes more claims to be filed with federal healthcare programs. It is one of nine locations expressly monitored by the Medicare Fraud Strike Force. The federal government believes that there is a correlation between the number of claims filed in Tampa and an increase in Medicare/Medicaid fraud.

The Medicare Fraud Strike Force monitors, investigates, and prosecutes Medicare/Medicaid fraud. This is a unit comprised of investigators and prosecutors from multiple federal agencies including the DOJ, DEA, DOD, Department of Human Services, the Office of Inspector General, the FBI, the IRS, and other federal agencies. If you’re contacted by the Medicare Fraud Strike Force, you should contact Oberheiden, P.C. immediately to learn about your defense options.

Medicare/Medicaid Fraud Investigations in Tampa, Florida

Medicare/Medicaid fraud investigations in Tampa and the surrounding area materialize when an individual practitioner, business, or other healthcare entity files an inaccurate claim with the federal healthcare program. The federal government reviews the claim and determines that it is a fraudulent billing matter or reimbursement request. These inaccurate claims often include charges that are unauthorized by the federal government, false charges, or excessive charges. In Tampa, Florida the most common inaccuracies result from:

• 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
• Inflating charges
• Overusing medical equipment or services
• Providing or accepting kickbacks

In Tampa, most Medicare/Medicaid fraud investigations are initiated against doctors, nurses, healthcare service providers, physician-owned entities, nursing and registered care facilities, hospitals, clinics, pharmacies, laboratories, cancer centers, DNA centers, and DME providers. Yet, it’s important for you to recognize that, if you submit claims to any federal healthcare program for reimbursement, you could eventually be charged with Medicare/Medicaid fraud.

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

Medicare/Medicaid fraud brings with it both civil and criminal penalties. You may be charged in civil or criminal court. Civil penalties for Medicare/Medicaid fraud in Tampa, Florida 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

You may also be subject to appearing before the state disciplinary or licensing board. You could lose your professional license and your hospital privileges.

Criminal penalties for Medicare/Medicaid fraud are also very serious. You may receive one or more of the following penalties:

• 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.

Finding the Right Tampa, Florida Defense Attorney

As you’ve learned from reviewing the civil and criminal penalties associated with Medicare/Medicaid fraud, these allegations can affect you for the rest of your life. You’re likely considering which type of law firm you should hire to assist you. Should you choose a healthcare attorney serving the Tampa, Florida area? Should you choose a criminal defense lawyer? Is there a better choice to handle the complexities of a Medicare/Medicaid fraud case?

If you’re considering a healthcare law attorney who serves the Tampa, Florida area, there are some things you should consider. You need one that understands the laws associated with healthcare, so that you are not left vulnerable to federal criminal charges. Medicare/Medicaid fraud often includes additional charges like mail fraud, wire fraud, money laundering, or tax fraud. A lawyer you choose should be experienced in these matters, or have the negotiation skills or federal trial experience that you truly need.

Criminal defense lawyers in Tampa, Florida are another common consideration. However, you need one with the training in healthcare law, billing, coding, and medical utilization rules.

There is another option for Medicare/Medicaid fraud defense in Tampa and the surround areas: A healthcare fraud defense lawyer. A healthcare fraud defense attorney has experience in healthcare law and federal criminal law. This type of attorney has experience negotiating with the federal government and has federal trial experience. As you research your options, look for these 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

Next, you’ll want to ask your potential attorney these three important questions to ascertain their experience:

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?

Assertive Medicare/Medicaid Fraud Defense Strategies

Oberheiden, P.C. analyzes each Medicare/Medicaid fraud case and uses assertive defense strategies on behalf of our Tampa, Florida clients. While we look to settle cases with the federal government where possible, we also have federal trial experience. We’ve taken more than 200 cases to trial. Many of our Healthcare Fraud Defense Team attorneys have experience as senior-level federal healthcare fraud prosecutors and with the Medicare Fraud Strike Force. We use the following assertive and strategic Medicare/Medicaid fraud defense strategies:

Immediate contact with investigators. Our primary goal is to resolve this matter for our clients, while also protecting our clients from federal criminal charges. We immediately get into contact with federal investigators. This strategy is key to a successful resolution of your case. It gives us the opportunity to get answers to important questions and to advocate on your behalf. Within hours of our engagement, we can usually get the answers to the following 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?

If you’re being investigated, it’s imperative that you call us right away. Do not give the federal government too much time to investigate you without interruption.

Evaluating federal evidence. The federal government must present evidence that you committed Medicare/Medicaid fraud. Their evidence must meet a Constitutional standard that is known as “beyond a reasonable doubt.” We evaluate the evidence presented by prosecutors to determine whether it meets this standard. By doing this, we’ve seen 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

No criminal intent. The federal government must also prove that you acted with criminal intent. This means that you planned to defraud the government. This is difficult for them to prove because intentional Medicare/Medicaid fraud in Tampa, Florida is rare. Medicare/Medicaid fraud investigations in this area start because a provider, facilities, or business made a serious mistake in their billing or coding. The most common issues that result in mistakes that are flagged as Medicare/Medicaid fraud include:

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

Of course, these mistakes should certainly be addressed and corrected. However, as mistakes, they should not be subject to criminal penalties. We work to prove to the government that you did not commit a crime, but that you do want to correct your mistakes.

Appropriate and strategic Medicare/Medicaid fraud defenses. Medicare/Medicaid fraud cases have some similarities since they all involve the same basic problem. Yet, not every case can have the same defense. This is because each case has its own set of facts. This is why Oberheiden, P.C. analyzes each case to develop appropriate and strategic Medicare/Medicaid fraud defenses. One of our recent clients was accused of fraudulently certifying home healthcare services. We proved to the federal government that our client was legally protected by a recognized delegation exception that made their certification fully compliant within the law. In another recent case, we would not admit liability on behalf of our client. We were able to prove to prosecutors that our client acted within a safe harbor exception.

Oberheiden, P.C.

Oberheiden, P.C. provides legal advocacy for Tampa, Florida healthcare providers, entities, and related businesses accused of Medicare/Medicaid fraud. 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. represents individual providers and entire healthcare systems in the State of Florida. 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, Tampa or Florida state law enforcement, contact us immediately. Initial consultations are confidential and free.

Medicare/Medicaid Fraud Defense Lawyers Serving Tampa, Florida

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.