Experienced Attorneys for Medical Disability Fraud Defense in Virginia

VirginiaMedical disability fraud costs the federal government billions of dollars every year. Medicare, Social Security Disability (SSD or SSDI), and other state and federal benefit programs are under constant attack by fraud artists seeking to collect payments to which they are not entitled. Unfortunately, state and federal authorities simply do not have the resources needed to put an end to medical disability benefit program waste and abuse.

But, this doesn’t mean that they aren’t trying. In Virginia and other states around the country, federal authorities are aggressively pursuing civil and criminal cases against individuals and entities suspected of engaging in medical disability fraud. In addition, while some of these cases are targeting fraudulent scams, far more are targeting legitimate health care providers who are alleged to have submitted unqualified claims for disability benefit program reimbursement. Although some of these providers may have billed Medicare, SSD, SSDI, or another benefit program improperly, many more are innocent of the severe allegations against them.

If your health care business or practice is being targeted in a medical disability fraud investigation, it is critical not to assume that the government’s allegations are correct. We have decades of experience representing health care providers in government investigations, and we have resolved a significant number of our cases without our clients facing civil or criminal charges. Our nation’s health care laws are extraordinarily complex; and, from revised Medicare billing regulations to safe harbors under the Anti-Kickback Statute, we are frequently able to assert a variety of defenses to protect our clients from prosecution.

Health Care Fraud Defense Attorneys for Providers and Medical Facilities in Virginia

Oberheiden, P.C. is has a nation-wide reaching law practice that represents physicians, pharmacists, medical facilities, durable medical equipment (DME) companies, and other health care providers in health care fraud investigations. We have particular experience in cases involving allegations of medical disability fraud, including fraudulent billing of Medicare, SSD, SSDI, the Veterans Benefits Administration, and other federal benefit programs.  Our attorneys are available to represent professionals, executives, and health care entities throughout Virginia. This includes providers in Northern Virginia cities such as Fairfax, Alexandria, Richmond, and Chesapeake-area health care providers – as well as providers throughout central and southwestern Virginia.

Medical Disability Fraud Defense Lawyers

We provide full-service legal representation for health care providers in disability fraud investigations and prosecutions. From pre-investigation internal assessments to Medicare fraud trials and appeals, we work closely with our clients at every stage. We also engage investigators and prosecutors to explore all available opportunities for securing a favorable resolution without putting our client’s fate in the hands of a jury. We routinely represent health care providers, medical facilities, and other individuals and entities in matters involving allegations of:

  • Medicare fraud
  • Social Security Disability (SSD or SSDI) fraud
  • Supplemental Security Income (SSI) and Medicaid fraud
  • U.S. Department of Veterans Affairs (VA) fraud
  • Other forms of medical disability fraud

Our attorneys are intimately familiar with the federal health care billing regulations as well as the requirements (and protections) of federal statutes such as the False Claims Act, the Anti-Kickback Statute, and the Stark Law. We understand your compliance obligations, we know what is at stake in medical disability fraud investigations. We use our extensive experience to make sure that you do not unjustly face civil or criminal penalties for legitimate billing practices.

Frequently-Asked Questions (FAQs): Medical Disability Fraud

Q: Why is my business or practice being investigated for medical disability fraud?



If your business or practice is being targeted in a disability fraud investigation, there are a number of reasons why this could be the case. First, federal authorities such as the Centers for Medicare and Medicaid Services (CMS), the Medicare Fraud Strike Force, the Social Security Administration’s Office of Inspector General (OIG), and others routinely conduct reviews of health care providers’ billing practices. If an algorithm in one of these agencies’ computer programs suggests that your billing records fall too far outside of the norm, this alone can trigger a federal investigation.


Second, many medical disability fraud and other health care fraud investigations result from “whistleblower” claims. The OIG’s website encourages citizens to report instances of suspected fraud and abuse, and the False Claims Act provides a significant financial incentive for individuals and competitors to allege that providers are engaged in fraudulent billing practices. Whistleblower (or “qui tam“) actions can cause huge disruptions for health care providers, and defending against qui tam litigation requires a comprehensive understanding of the unique rules and procedures involved.


Medical disability fraud investigations can be triggered by a number of other factors as well. From anonymous tips – to grand jury testimony and unfavorable Medicare audit determinations – all providers that serve disabled patients can be exposed to civil or criminal prosecution from a variety of sources.

Q: What are some defense strategies for fighting medical disability fraud accusations?



The list of potential defenses to medical disability fraud is long. The best defense strategy in any particular case will depend upon the unique facts involved, the specific disability benefit program(s) involved, the federal authorities involved, and the federal statute(s) under which the provider is being investigated. Broadly speaking, however, the types of defense strategies available in disability fraud investigations and prosecutions include:



  • Demonstrating that apparent anomalies or seemingly-fraudulent billings simply reflect the unique characteristics of a provider’s geographic region, or scope of practice.

  • Challenging investigators’ interpretation of a provider’s billing records or patient files.

  • Asserting statutory safe harbors and exceptions that authorize specific billing practices and compensation arrangements.

  • Relying on established common law and recent case results to present exculpatory defenses.

  • Utilizing Constitutional protections and other sources of legal authority to prevent the use of evidence obtained through illegal or improper means.


Q: What factors should I consider when choosing legal counsel for a medical disability fraud investigation?



When facing an investigation for disability fraud, your choice of legal representation can mean the difference between going to trial and resolving the investigation without charges ever being filed. Relevant experience is critical, not just in health care law or federal investigations, but specifically in the area of health care fraud defense.


At Oberheiden, P.C., we are a team of defense attorneys and former federal prosecutors whose careers have been devoted to cases involving allegations of benefit program fraud. We have been on both sides of thousands of federal investigations, and we have a significant track record of resolving our clients’ investigations without civil or criminal charges. If you need a medical disability fraud defense lawyer in Virginia, we can come to you; and if necessary, we can take action immediately to begin building your defense.

Why Virginia Health Care Providers Choose Oberheiden, P.C.

At Oberheiden, P.C., our team is led by highly experienced and recognized defense attorney Nick Oberheiden, PhD, firm partner and former health care fraud prosecutor William (Bill) C. McMurrey, and other former prosecutors who all held senior positions within the DOJ prior to entering private practice. It is this in-depth experience – coupled with our exclusive focus – that helps to set us apart from other firms.

Schedule Your Free Case Assessment Now

If you are facing a Virginia medical disability fraud investigation, we urge you to contact us promptly to schedule your free case assessment. To speak with the attorneys on our health care fraud defense team in confidence, please call (888) 356-4634 or submit your case online now.

This information has been prepared for informational purposes only and does not constitute legal advice. While this information may constitute attorney advertising in some jurisdictions, merely reading this information does not create an attorney-client relationship. Every case is different, any prior result described or referred to herein cannot guarantee similar outcomes in the future. Oberheiden, P.C. is a Texas firm with its headquarters in Dallas, Texas. Mr. Oberheiden limits his practice to federal law.