The Department of Health and Human Services (HHS) and the Office of the Inspector General (OIG) use subpoenas to investigate health care fraud allegations without the involvement of the federal courts. The underlying fraud allegations in OIG investigations typically involve violations of the False Claims Act, Medicare fraud, Medicaid fraud, Tricare fraud, or a violation of the Stark Law.
At Oberheiden & McMurrey, LLP, we regularly represent clients in OIG investigations in New Mexico and nationwide. In each case involving defense of an OIG subpoena, we center on five core goals:
- Avoiding a criminal investigation
- Keeping the investigation confidential
- Protecting your business and your good name
- Resolving the government’s requests through our channels of communication
- Negotiating a fair outcome
If you are being investigated by the OIG for health care fraud, you need to speak with an attorney as soon as possible. Your freedom, your business, and your family’s financial future may all be on the line. In OIG investigations, you can trust the experienced defense attorneys and former federal prosecutors at Oberheiden & McMurrey, LLP to take aggressive action to protect you.
What Prompts an OIG Subpoena?
For most people, receiving a subpoena from HHS or the OIG comes as a surprise. These subpoenas are typically triggered by one of two events.
The most likely reason that your business will receive an OIG subpoena is because a current or former (or someone else with inside information about your business) discloses information to the government that the government considers credible enough to launch an investigation. This often involves an employee filing a qui tam, or “whistleblower,” lawsuit against your company.
The second reason the government typically issues OIG subpoenas is because it has obtained information about a business in the course of an ongoing investigation.
Avoiding Criminal Charges After an OIG Subpoena
If you are being investigated by the OIG, the most important thing you can do is take immediate action to keep the investigation civil. OIG subpoenas do not explain whether the government is seeking civil penalties or criminal indictments. In order to keep the investigation civil and avoid facing criminal charges, you need to have experienced defense counsel, such as our former federal health care prosecutors, on your side.
As a result, the first thing you need to do when you receive an OIG subpoena is hire experienced defense counsel to assess the subpoena and evaluate the merits of the government’s case against you. Among the very first steps we take in OIG subpoena cases is to find out whether the case is civil or criminal in nature. When you engage us, we will provide you with our “Emergency Defense Package” – which gives you immediate action items to make sure you and your business are protected.
What is the “Emergency Defense Package”?
The ”Emergency Defense Package” is an action plan that we use to help our clients avoid criminal charges once the government launches an investigation into their business for Medicare or some other type of health care fraud. Years of experience have shown that too many business owners are making mistakes in the early stages of their investigations that have severe impacts on their cases. This is why we strongly encourage anyone who has received an OIG subpoena to seek legal representation right away.
How Can Oberheiden & McMurrey, LLP Protect Me?
When you engage us to represent you regarding your OIG subpoena, we will immediately take a number of steps to prepare you and your business to appropriately respond to the government’s investigation. These steps include:
- Having our former prosecutors conduct an analysis
- Executing on an immediate action plan
- Preparing appropriate document preservation notices
- Establishing channels of communication with the government
- Showing the government your “good intent” to avoid or defeat criminal charges
Answer to FAQs About OIG Subpoenas
What prompts an OIG subpoena?
In many cases, disgruntled former employees reported alleged misconduct leading the government to investigate the allegations. In other situations, you may receive a subpoena as part of the fallout from another investigation.
What documents do OIG subpoenas typically request?
OIG subpoenas typically request documents about business structure, billing records, financial statements, marketing materials, legal opinions, and email communications between senior company officials.
What happens if I don’t respond?
OIG subpoenas can be enforced by federal prosecutors at the Department of Justice (DOJ). If you do not respond, you could be held in contempt of court and face a criminal investigation.
How do I know if the subpoena is civil or criminal?
By its nature, OIG subpoenas are administrative, and it is not evident from the subpoena itself whether the underlying investigation is civil or criminal. Our experienced defense attorneys and former prosecutors can assess your subpoena and determine whether you are facing a civil or criminal investigation.
Do I have to produce everything requested in the subpoena?
It is not uncommon for OIG subpoenas to request huge amounts of documents and emails spanning several years of a company’s operations. Our experienced lawyers know how to work out a compromise with the government to limit your production obligations.
What are the most common fraud allegations in OIG subpoenas?
OIG subpoenas may focus on Medicare, Medicaid, or Tricare fraud; violations of the Stark Law; violations of Department of Labor rules; or, violations of the False Claims Act.
What is the False Claims Act?
The False Claims Act is a federal statute that makes it illegal to submit false or incorrect requests for reimbursement under programs such as Medicare and Medicaid.
What are the penalties under the False Claims Act?
The False Claims Act is a hybrid statute that allows the government to collect civil penalties or initiate a federal criminal investigation. Penalties can include, but are not limited to, fines, recoupment of fraudulent billings, federal prison time, and exclusion from future participation in federal programs.
Which federal agency investigates health care fraud?
Depending on the underlying allegations, agents of the U.S. Postal Service, the FBI, or the DEA may be involved in your OIG investigation.
Schedule a Free, Confidential Consultation about Your OIG Subpoena
To find out more about our “Emergency Defense Package” and get help from our experienced attorneys, we encourage you to contact us right away. When we take your case, we will seek to resolve the government’s claims by way of confidential negotiations and avoid exposing you to criminal prosecution in federal court. Call (888) 727-5159 or contact Oberheiden & McMurrey, LLP online and start protecting yourself today.
Oberheiden & McMurrey, LLP regularly represents clients in governmental investigations in New Mexico and across the country. The following are some examples of cases where we have helped our clients avoid civil and criminal responsibility. You can see more examples in our Success Stories.
- Successful defense of a health care services company against an investigation by the Office of Inspector General for Medicare Fraud
- Successful defense of health care company against investigations by the Department of Justice for alleged Health Care Fraud
- Successful defense of health care company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations
- Successful defense of a health care company against an investigation by the Office of Inspector General and Department of Health and Human Services
- Successful defense of a health care company against an investigation by the Office of Inspector General and the Department of Justice for alleged Medicare Fraud
- Successful defense of a physician owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations
- Successful defense of a physician owned entity against an investigation by the Office of Inspector General for alleged fraud