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Expert Panel Eyes Continued Push for Health Care Fraud Enforcement

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As we have previously discussed, federal agencies – including the Department of Justice (DOJ) – have recently been devoting substantial resources to pursuing civil and criminal cases against providers suspected of various forms of healthcare fraud. These cases often result in substantial prison time and significant financial liabilities for providers, with the government recovering nearly $2 billion as a result of healthcare fraud investigations in 2015 alone.

According to the DOJ and the Department of Health and Human Services’ Office of the Inspector General (OIG), these efforts are well worth the investment. These agencies report that the government is recovering eight dollars for every one dollar spent on enforcement. That is a significant return, and it is one of the main reasons why we don’t see the government scaling back its healthcare fraud enforcement efforts any time soon. Whistleblowers also received nearly $600 million in qui tam actions in 2015 – the most ever in a single year.

Increased Enforcement Continues Six Years after the Patient Protection and Affordable Care Act

Recently, an expert panel discussion that took place in North Texas confirmed the general expectation that the DOJ, OIG, and other federal agencies will continue to aggressively investigate and prosecute those suspected of healthcare fraud. This includes:

  • Compound pharmacies
  • Doctors
  • Durable medical equipment (DME) providers
  • Hospices
  • Hospitals
  • Marketers
  • Pharmacies

Many healthcare fraud investigations focus on entities – such as compound pharmacies and hospices – that are in growth industries, and also bill federal programs like Medicare and Tricare for medications and services delivered to their patients.

When Congress passed the Patient Protection and Affordable Care Act (widely known as “ObamaCare”) in 2010, our attorneys and others expected to see an increase in federal healthcare fraud enforcement. This proved to be true, and with the government’s success in enforcement, the rate of prosecution has only increased in the ensuing timeframe. Those facing criminal investigations often end up spending years behind bars, and in civil cases, as the panel’s moderator commented, “the price tag to settle with the government is rising.”

Defending Yourself in a Federal Healthcare Fraud Investigation

However, this assumes that you do not have an experienced legal defense team on your side. While the government’s methods are becoming more sophisticated, they are also becoming exposed, and at the Oberheiden, P.C., we have extensive experience representing clients in federal healthcare fraud investigations. This includes numerous recent cases in which we were able to secure outcomes of no civil or criminal liability for our clients.

Are You Being Investigated for Federal Healthcare Fraud?

Defending against a federal investigation requires substantial legal and industry knowledge, and our experienced defense attorneys and former federal prosecutors have spent decades on the front lines of the government’s war against healthcare fraud. If you are under investigation or are facing healthcare fraud charges, put our knowledge and experience on your side. Call (800) 701-7249 or request a free consultation online to meet with our team of senior healthcare fraud attorneys about your case today.

This information has been prepared for informational purposes only and does not constitute legal advice. This information may constitute attorney advertising in some jurisdictions. Reading of this information does not create an attorney-client relationship. Prior results do not guarantee similar future outcomes. Oberheiden, P.C. is a Texas LLP with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.
Orange County 714-294-2000
Los Angeles 310-873-8140
Detroit 313-888-8807
Nationwide 888-452-2503