Oberheiden P.C.’s Healthcare Lawyers and Consultants Bring Centuries of Combined Experience To The Table
While access to healthcare is vital for our society, healthcare providers face some of the most stringent oversight across all industries. State and federal authorities regulate virtually all aspects of health care providers’ operations, from their billing and recordkeeping practices to their prescription protocols and patient services.
As a result, providers in all segments of the health care industry need to prioritize compliance. They also need to be prepared to defend themselves during audits, investigations, and both civil and criminal litigation. In short, medical practices and providers face numerous legal risks, and they need to manage these risks effectively.
About Our Healthcare Law Practice
At Oberheiden P.C., our healthcare attorneys work to represent providers in all legal matters. This includes all aspects of compliance as well as both civil and criminal defense. From developing and revamping Medicare billing compliance programs to defending providers during U.S. Drug Enforcement Administration (DEA) investigations and representing providers in business-to-business disputes, our comprehensive practice ensures that our healthcare clients have access to the information, guidance and legal counsel they need when they need it.
Our Healthcare Team
Our healthcare law practice is led by Founding Attorney Nick Oberheiden, PhD. With well over a decade of health law experience, Dr. Oberheiden is a skilled advisor and relentless advocate for his clients. As Oberheiden P.C.’s Founding Attorney, Dr. Oberheiden has built the firm into a nationwide network of senior-level compliance lawyers, defense lawyers, and expert consultants who offer centuries of combined experience in the healthcare realm.
Many of our firm’s senior attorneys are former healthcare fraud prosecutors who spent decades at the U.S. Department of Justice (DOJ) before entering private practice. Several of our attorneys have enforcement experience at the state level as well. The healthcare compliance consultants on our team include former Special Agents-in-Charge, Supervisory Special Agents, and other high-ranking employees within the DEA, Department of Health and Human Services Office of Inspector General (DHHS OIG), and other federal agencies.
Part of the reason why so many healthcare clients have trusted Oberheiden P.C. for well over a decade as their healthcare attorney is that our results speak for themselves. Through our compliance representation, we have helped numerous clients avoid substantial recoupments and other liabilities in healthcare audits and investigations. We have also successfully defended providers across the country in these audits and investigations, in many cases helping our clients completely avoid all forms of liability.
When necessary, we have also successfully defended healthcare businesses and professionals in civil and criminal litigation. From avoiding and dismissing indictments to securing favorable rulings at trial and on appeal, we have helped clients emerge victorious at all stages of the litigation process. Of course, we seek to resolve every case as quickly as possible—not only helping our clients avoid liability, but helping them mitigate their litigation costs as well.
Our Healthcare Practice Areas
We divide our health care practice into four key areas: (i) compliance, (ii) audits and investigations, (iii) healthcare fraud defense, and (iv) civil litigation. While we represent some clients in just one area, many of our healthcare clients prefer to work with our team in all aspects of compliance and risk management on an ongoing basis.
Our services for U.S. health care providers and the healthcare industry include:
Healthcare Law Compliance
There are numerous aspects to healthcare law compliance. To maintain compliance effectively, providers and facilities cannot rely on off-the-shelf compliance programs. They need to adopt policies and procedures that are custom-tailored to their operations, and they need to ensure that these policies and procedures fully address all of their compliance needs. We advise our clients on all aspects of health law compliance, including (but not limited to):
- DEA and prescription drug compliance (including electronic prescription compliance)
- Medicare and Medicaid billing compliance
- Tricare billing compliance
- U.S. Department of Labor (DOL) billing compliance
- Private health insurance compliance
- Anti-Kickback Statute (AKS) and Eliminating Kickbacks in Recovery Act (EKRA) compliance
- Stark Law (Physician Self-Referral Law) compliance
- False Claims Act compliance
- Health Insurance Portability and Accountability Act (HIPAA) compliance
- Emergency Medical Treatment and Active Labor Act (EMTALA) compliance
- Telehealth and telemedicine compliance
Compliance Audits and Investigations
Auditing is a key aspect of health care law compliance management for health care providers. This includes both conducting internal audits to assess compliance and defending against external audits conducted by the DEA, Medicare audit contractors, private insurers, and other entities. Suspected compliance violations can lead to state and federal investigations as well, and providers need experienced counsel to come out of these investigations unscathed.
State and Federal Healthcare Fraud Defense
In some cases, facing civil or criminal allegations is unavoidable. Most often, this is the case when healthcare professionals and providers fail to timely engage counsel during federal healthcare audits and investigations. But, providers can face charges under other circumstances as well—at both the state and federal levels—and sometimes prosecutors will be intent on pursuing charges based on mandates or other priorities.
For providers that are facing civil or criminal charges, we provide strategic and cost-effective healthcare fraud defense. Our experience as health care lawyers includes representing providers nationwide in grand jury proceedings, pre-trial proceedings, and state and federal trials and appeals.
Business Disputes and Litigation
Along with representing health care providers in state and federal enforcement litigation, we represent clients in private civil litigation as well. This includes business disputes and litigation involving breach of contract claims, joint ventures, and other issues. While it will be necessary to take these cases to trial in some circumstances, our healthcare attorneys have had significant success securing favorable out-of-court resolutions for our clients in most cases.
Healthcare Businesses Served
At Oberheiden P.C., our health care clients range from individual physicians and other licensed medical professionals to large regional hospital chains and other healthcare organizations with multiple facilities and hundreds of employees. But, for all of our clients, we provide the same custom-tailored legal advice and personalized attention. Our healthcare attorneys regularly advise and represent health care clients including (but not limited to):
- Clinics (Private and Government-Funded)
- Durable Medical Equipment (DME) Companies
- Laboratories (Clinical and Toxicology)
- Healthcare Marketers
- Healthcare Practitioners
- Hospices, Nursing Homes, and Home Health Agencies and Providers
- Hospitals, Hospital Systems, and Ambulatory Surgery Centers
- Pharmacies, Compound Pharmacies, and Pharmacists
- Physician Practices and Groups
- Academic Medical Centers
- Physician Practice Management Companies
- Telehealth and Telemedicine Companies
10 Ways We Help Our Healthcare Clients
Within these four areas of our health law practice, we serve our clients in a variety of different ways. Here are 10 examples of what our healthcare attorneys at Oberheiden P.C. can do to help you, your business, or your healthcare practice:
1. Corporate Structuring and Governance
Whether you are starting a private healthcare practice, merging practices, or need to establish a new subsidiary or affiliate for ancillary business activities, our healthcare attorneys can help you choose the right corporate structure for your needs. We can assist with establishing ownership rights and managerial responsibilities, tax mitigation, liability limitation and other corporate governance matters as well.
2. Corporate Compliance Policies and Procedures
All companies should have a comprehensive set of corporate compliance policies and procedures. We help our health care clients adopt and implement policies and procedures regarding data security, employee rules and responsibilities, and other pertinent matters.
3. Healthcare Compliance Policies and Procedures
A robust healthcare compliance program is the center of any effective risk management program. We work closely with our clients to identify all pertinent areas of healthcare law compliance and develop policies and procedures that are well-suited to their specific risks and needs. We assist with healthcare compliance program training, implementation, and enforcement as well.
4. Internal Compliance Auditing
We help our clients conduct periodic internal compliance audits to test the efficacy of their healthcare compliance programs. Along with managing the internal audit process, we also thoroughly document our clients’ audits so that we can demonstrate our clients’ good-faith compliance efforts when necessary; and, when our clients’ internal audits reveal compliance deficiencies, we help them implement remedial measures promptly.
5. Internal Investigations
In addition to assisting our clients with internal compliance audits, we also assist our clients with internal investigations. If you are aware that an employee of your healthcare business or practice has engaged (or is actively engaging) in non-compliant conduct, our healthcare lawyers can conduct an investigation focused on gathering the documentation you need to take appropriate responsive action. Along with appropriate disciplinary action, this includes updating your business’s compliance protocols to mitigate the risk of recurrence.
6. External Audit and Investigation Defense
We defend health care providers during external audits and investigations conducted by state authorities, federal agencies, and private health insurance companies. Our healthcare lawyers’ experience includes, but is by no means limited to, defending providers and other entities in matters involving the DEA, DHHS OIG, DOJ, Federal Bureau of Investigation (FBI), Internal Revenue Service (IRS), Medicaid Fraud Control Units (MFCUs), and all types of Medicare audit contractors (i.e., RACs, MACs, and UPICs).
7. Representation in Settlement Negotiations, Mediation, and Arbitration
Whether dealing with a government authority, competitor, vendor, or other business, it will typically be most advantageous to resolve the dispute by the most efficient means possible. The healthcare lawyers at Oberheiden P.C. have significant experience successfully representing clients in settlement negotiations, mediation and arbitration.
8. Representation in State and Federal Courts
Each healthcare attorney at Oberheiden P.C. who handles dispute resolution also has significant experience in courtroom litigation. Our lawyers have successfully represented clients in the state and federal courts, and many of our lawyers have decades of relevant litigation experience. While we work to help our clients avoid litigation whenever possible, we do not hesitate to litigate on behalf of our clients when necessary.
9. Ongoing Compliance and Risk Management
For all types of health care providers, compliance and risk management are ongoing processes. We communicate with many of our health care clients on a day-to-day basis. If you have questions about compliance or concerns about risk management, you cannot afford to make uninformed decisions. We are here to help; and, as a client of the Oberheiden P.C. legal team, you can expect to get in touch with your healthcare lawyer whenever you need to.
10. Outside General Counsel
Many of our clients also use our firm as outside general counsel. For health care practices and businesses of all sizes, their legal needs extend far beyond the healthcare realm. Whether you need help dealing with employees, managing data security, or maintaining appropriate corporate books and records, we can offer an outside general counsel solution that is custom-tailored to your needs and budget.