Defending Medicare Fraud In Detroit

Oberheiden, P.C.
Former Medicare Prosecutors & Defense Counsel

The state of Michigan is experiencing a surge in Medicare fraud audits, investigations, and prosecutions. Over the last few years, the federal government has installed a Medicare Fraud Task Force in Detroit to work with state and other federal agencies in detecting and enforcing Medicare fraud violations. If faced with an investigation for Medicare fraud, individuals and businesses risk steep financial penalties, exclusion from federal healthcare programs, and criminal penalties.

While financial penalties can be debilitating for a provider’s business, criminal penalties are the government’s strongest weapon in punishing providers who are convicted of committed Medicare fraud. These penalties are harsh and can result in significant jail time, and monetary damages. The specific criminal penalties for Medicare fraud are: (1) Maximum 10-year prison term for each count of Medicare fraud; (2) Maximum 20-year prison term for each count of Medicare fraud resulting in serious bodily injury to a patient; and (3) Maximum of life in prison for each count of Medicare fraud resulting in the death of a patient.

Given the severity of these criminal penalties, our top priority at Oberheiden, P.C. is helping our clients avoid criminal charges and penalties as the result of a Medicare fraud investigation. Our former federal healthcare prosecutors and veteran healthcare defense attorneys rely on their government experience, healthcare industry knowledge, and national reputation to achieve successful outcomes for clients.

Defense Strategy

Early Intervention

We know that the earlier a target of an investigation has a defensive strategy in place, the more likely the target will avoid charges, because the longer a target waits to actively defend against an investigation, the longer federal prosecutors must freely develop their case. Therefore, at Oberheiden, P.C., we get to work on a defensive strategy the minute we are hired. We treat every client’s case as an emergency. We start by answering our client’s most pressing questions: Is the investigation civil or criminal? What charges are at issue? What is our client’s potential exposure to liability? How can we prove our client’s innocence and lack of intent? It is our mission to answer these and other questions within days of being hired.

No Criminal Charges

Our number one priority in any representation is to avoid criminal charges against our clients. To prevail on criminal charges of Medicare fraud against a defendant, a prosecutor must prove that the defendant had criminal intent to commit Medicare fraud. Prosecutors know their burden, and they are much less likely to bring criminal charges against a client if they are unsure, they can prove criminal intent at trial. At Oberheiden, P.C., we make clear to the prosecutors pursuing our clients that we will hold them to the full extent of their burden of proof of our clients’ intent at trial. When we see that our clients made a mistake but did not intend to commit fraud, we strive to establish that to investigators and prosecutors early in the investigation so that no criminal charges are ever brought. Borrowing from our experience working as federal prosecutors, we communicate our clients’ innocent intent in a way that prosecutors understand.

Depth of Understanding

After years of practice and hundreds of healthcare cases, Oberheiden, P.C. has determined that there are two key elements to a successful defense against Medicare fraud claims: 1) extensive federal trial experience and well-honed negotiation skills, which allow us to effectively advocate for our clients to judges and prosecutors; and 2) a well-rounded understanding of the healthcare industry and the intricacies of healthcare laws and regulations – including billing codes, certifications, and federal rules. Our strong grasp of the ever-changing legislation that governs the healthcare industry allows us to explore unique and creative defensive strategies for our clients.

Our Success Stories

Oberheiden, P.C. represents Detroit business owners and healthcare professionals. We regularly represent Detroit healthcare industry participants facing investigation by the Department of Justice, the Department of Health and Human Services, the Department of Defense, and various federal task forces. Our experienced team of former U.S. prosecutors and effective defense counsel has had significant success mitigating or avoiding criminal exposure for our clients. Oberheiden, P.C. has recently obtained these results for its clients:

  • Successful Defense of a Healthcare Business against an Investigation by the Department of Justice and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No Civil or Criminal Liability.
  • Successful Defense of a Healthcare Business against an Investigation by the Department of Health and Human Services for Alleged Medicare Fraud.
    Result: No Civil or Criminal Liability.
  • Successful Defense of a Healthcare Business against an Investigation by the Office of Inspector General and the FBI for Alleged Medicare Fraud.
    Result: No Civil or Criminal Liability.
  • Successful Defense of a Marketing Company against an Investigation by the Office of Inspector General and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No Civil or Criminal Liability.
  • Successful Defense of Physician Syndication against an Investigation by the Office of Inspector General and the FBI for Alleged Medicare Fraud.
    Result: No Civil or Criminal Liability.
  • Successful Defense of a Toxicology Laboratory against an Investigation by the Office of Inspector General for Alleged Medicare Fraud.
    Result: No Civil or Criminal Liability.
  • Successful Defense of a Toxicology Laboratory against an Investigation by the Office of Inspector General and the FBI for Alleged Medicare Fraud.
    Result: No Civil or Criminal Liability.
  • Successful Defense of a Physician against an Investigation by the Office of Inspector General for Alleged Medicare Fraud.
    Result: No Civil or Criminal Liability.
  • Successful Defense of a Physician against an Investigation by the Office of Inspector General for Alleged Medicaid Fraud.
    Result: No Civil or Criminal Liability.

Free Consultation

Oberheiden, P.C. is available for a free and confidential consultation seven days a week, including weekends. You will speak directly with one of our senior attorneys about your case and how we can help you. Call us today.

Oberheiden, P.C. combines the government experience of former federal healthcare prosecutors and the industry experience of veteran healthcare defense attorneys to assist clients throughout Michigan and Detroit undergoing investigation or prosecution for Medicare fraud. Our representations include cases involving Medicare/Medicaid fraud as well as other healthcare cases including Tricare fraud, Department of Labor fraud, Stark Law violations, Anti-Kickback Statute violations, and False Claims Act violations

Oberheiden, P.C.
Compliance – Litigation – Defense
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