Louisiana Medicare Fraud Defense Lawyers

9655 Perkins Rd, Suite C-203
Baton Rouge, LA 70810
225-269-8749
(Meeting location by appointment only)

Experienced Legal Defense for Health Care and Medicare Fraud Cases throughout Louisiana

The Criminal Defense Firm is a health care law defense firm based out of Dallas, Texas. With significant experience in the areas of regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense, our attorneys are capable and well-tested. The firm’s attorneys include the former Chief Health Care Fraud Coordinator at the U.S. Attorney’s Office, former senior Department of Justice trial attorneys, and many other talented lawyers with years of relevant experience and law degrees from institutions like Harvard Law School and Yale Law School. We serve clients in Louisiana and surrounding areas.

What Is Medicare Fraud?

Medicare fraud is the submission of a false or fictitious claim to the federal government for payment on a claim that originated from a government health care program. Louisiana is one of nine areas in the United States that the government closely watches for Medicare fraud because of the large number of claims filed each year. Medicare fraud allegations usually state that you violated one of the following laws:

• False Claims Act
• Anti-Kickback Statute
• Stark Law
• Social Security Act
• U.S. Criminal Code

The commonality of all Medicare fraud allegations is that health care providers, facilities, and businesses profited from an illegal payment that came as a result of filing a false federal health care claim.

Since Louisiana is one of the nine most-watched areas for this type of fraud, there are two specialized teams put into place to investigate and prosecute Medicare fraud. One of the task forces, Health Care Fraud Prevention and Enforcement Action Team (HEAT), is made up of a team of prosecutors and investigators from many different federal agencies including the Department of Defense, the Department of Health and Human Services, the IRS, the Office of Inspector General, the FBI, and other agencies.

Medicare claims are processed through the Centers for Medicare and Medicaid Services (CMS). In Louisiana, there are a large number of individuals who are on Medicare. This means that more claims are processed. The higher the number of claims processed by a health care provider, business, or facility, the higher the risk of you being charged with Medicare fraud.

Billing Issues Commonly Trigger Medicare Fraud Allegations

There are many things that can cause you to face an allegation of Medicare fraud. Yet, In Louisiana, it is commonly issues with billing that triggers an investigation. This commonly involves false, excessive, or billing for unauthorized services, supplies, or equipment. The most common triggering billing practices are:

• Billing for services that weren’t performed (phantom billing)
• Billing for medically unnecessary services or supplies
• Billing for equipment or supplies that were never ordered
• Certification for medically unnecessary services (such as health or hospice)
• Certification for medically unnecessary supplies (such as DME)
• Double billing
• Upcoding
• Bill inflation
• Overuse of services or equipment
• Offering or accepting kickbacks

Louisiana doctors, nurses, health care businesses, hospice care, nursing homes, registered care centers, physician syndications, DNA centers, cancer treatment facilities, DME businesses, and other health care providers, services, or businesses are at risk of being investigated for Medicare fraud.

Severe Civil and Criminal Penalties for Medicare Fraud

Medicare fraud allegations come with severe civil and criminal penalties. Civil penalties include being forced to pay back the government, future claims are denied, civil fines up to $11,000 per false claim, exclusion from federal health care programs, ordered to pay treble damages, and pay attorney fees.

Criminal charges can result in huge fines, a criminal record, and even time in federal prison. For each count of Medicare fraud, you could face 10 years in prison. If the fraud resulted in serious bodily harm (as often seen in counterfeit or excessive medication), you could be sentenced to 20 years per count. If the Medicare fraud resulted in the death of a patient, you could be sentenced to life.

Choosing the Right Lawyer

As you’ve learned, Medicare fraud allegations in Louisiana are extremely serious. You must choose the right lawyer so that you can minimize the risk of facing those penalties. You should choose a lawyer who has the right skills and experience to defend you against the federal government. These cases involve more than health care. They involve more than potential criminal charges. Yet, many people facing these charges think that they should choose either a health care lawyer or a criminal lawyer.

Choosing a health care lawyer may seem ideal, but Medicare fraud is often charged concurrently with federal criminal charges such as tax evasion, money laundering, and wire fraud. Although a health care lawyer may understand the health care laws, he or she may not have any criminal experience. This can also leave the lawyer unable to negotiate with the federal government on your behalf. If your case goes to trial, he or she may not have the needed experience to be successful against federal prosecutors.

If you’re facing criminal charges, your first instinct may be to retain a criminal defense lawyer. However, a criminal defense lawyer may not have the experience that you need. The majority of criminal defense attorneys target their practice on the more common and classic criminal defenses, such as drugs, assault, etc. They likely don’t understand the nuances involved in health care law, either.

You Need a Health Care Fraud Defense Lawyer

The ideal attorney for Louisiana Medicare fraud defense is a health care fraud defense lawyer. Health care fraud defense lawyers understand health care laws and they also have experience dealing with federal criminal charges. As you speak with attorneys, ask the following four questions:

1. Do they have a verifiable track record of success?
2. Do they have experience in the health care industry and do they have criminal law knowledge?
3. How well do they understand health care law?
4. Do they have litigation experience?

If the answer is yes to those questions, then you must address their actual experience in handling Medicare fraud cases. Ask these three questions:

1. Throughout your legal career, how many Medicare fraud cases have you handled?
2. Out of those cases, how many resulted in no civil charges, no criminal charges, or total dismissals?
3. How many of those cases did you try in court?

Proven Defense Strategies Used by The Criminal Defense Firm

The Criminal Defense Firm has decades of experience in defending clients from Medicare fraud allegations. Some of our Health Care Fraud Defense Team members formerly held senior positions with the Department of Justice. Between the cases that we’ve handled and our collective past experience as prosecutors and defense attorneys, we’ve learned just how valuable proven defense strategies can be. It’s important to note that each case is different, but good defense strategies can help protect you and minimize your risk of facing criminal prosecution.

Early involvement with federal investigators. The Criminal Defense Firm gets involved right away with federal investigators. It’s an integral part of minimizing your risk. The longer that the government has to investigate Louisiana Medicare fraud cases, the more likely it is that it will bring criminal charges. We get involved early so that we can get answers to pressing questions:

1. What is this investigation about?
2. Who all is under investigation?
3. Is the investigation civil or criminal?
4. Which agencies are involved in the investigation?
5. What started this investigation?
6. What is the government’s goal?
7. What can be done to resolve the investigation?

We can usually get answers to those questions within the first few hours after we are retained.

Assert a lack of evidence. Our justice system is unique because we presume that everyone is innocent until they are proven guilty. To prove that you’re guilty of Medicare fraud, the federal government must present evidence that meets a legal standard. This legal standard is “beyond a reasonable doubt.” We will test that standard in every case. We’ve used this successfully in many cases. Several of our clients either had the charges dismissed, only paid a civil fine, had a felony reduced to a misdemeanor, or served no prison time.

Lack of criminal intent. In addition to proving that you committed a crime, the federal government must also prove that you acted with criminal intent. In simple terms, this means that you knew what you were doing submitting a false claim was a crime and you did it anyway. It doesn’t have to just be you. It can be someone who works in your Louisiana health care business who makes a mistake. It is presumed that you knew or that you should have known what was going on in the business.

The Criminal Defense Firm knows that most Louisiana Medicare fraud investigations don’t happen because someone intended to commit fraud. They happen because someone makes a mistake. The most common areas of negligence that cause Medicare fraud investigations include:

• The hiring and use of unqualified staff
• Lack of proper supervision
• Improper delegation
• Overuse of outsourcing
• Organizational mistakes
• Human errors
• Lack of oversight
• Employees who feel overwhelmed by their workload
• Lack of a compliance program
• Constantly changing Medicare rules and laws

While these are errors that you certainly may need to address and correct, they’re far from criminal. Unfortunately, the federal government will try to treat your honest mistake like it’s a criminal offense. In many instances, Louisiana health care services, businesses, facilities, and providers just presume they’ve done something wrong when they’re under investigation. They accept the charges and penalties. Retaining The Criminal Defense Firm can increase your chances of showing the government that your mistakes weren’t criminal acts and you don’t deserve to suffer criminal penalties.

Applicable Medicare fraud defenses. The Criminal Defense Firm reviews and handles each case individually because this is the best way to examine the facts and ascertain applicable defenses. Recently, one of our Medicare fraud cases involved an allegation that our client provided fraudulent certification for the need for health care. We used a delegation exception to prove to the government that the certification in question was fully compliant with the law. In another case, we did not admit liability. Instead, we proved to the government that our client acted within a safe harbor exception.

The Criminal Defense Firm

The Criminal Defense Firm provides representation for Louisiana health care business owners, executives, attorneys, practitioners, hospitals, pharmacies, labs, and other health care related entities. We can help you:

• Identify and implement health care fraud defenses
• Implement a corporate compliance program
• Assist with internal investigations
• Provide qui tam defense
• Help protect your assets
• Represent you during licensure or disciplinary proceedings
• Represent you in a jury trial

If you’re in Louisiana and you’re being investigated by the Department of Justice, the Department of Defense, the DEA, the FBI, HEAT, the Office of the Inspector General, the Medicare Fraud Control Unit, Louisiana law enforcement, or the IRS, call us. We can help. We’re available 7 days a week.

Our Track Record

• Defense of Medicare laboratory against investigations by the Department of Justice and the U.S. Attorney’s Office for alleged Medicare fraud.
  Result: No civil or criminal liability.

• Defense of a health care services company against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged False Claims Act and Stark Law violations.
  Result: No civil or criminal liability.

• Defense of Medicare laboratory against investigations by the Department of Health and Human Services and the Office of Inspector General for alleged health care fraud.
  Result: No civil or criminal liability.

• Defense of nationally operating health care company against an investigation by the Department of Defense for alleged Tricare fraud.
  Result: No civil or criminal liability.

• Defense of health care marketing company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations.
  Result: No civil or criminal liability.

• Defense of a laboratory against an investigation by various branches of the federal government for alleged fraud.
  Result: No civil or criminal liability.

• Defense of physician-owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
  Result: No civil or criminal liability.

• Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
  Result: No civil or criminal liability.

• Defense of a physician-owned entity against an investigation by the Department of Justice for alleged fraud.
  Result: No civil or criminal liability.

• Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged Stark Law violations.
  Result: No civil or criminal liability.

• Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations.
  Result: No civil or criminal liability.

• Defense of a physician owned entity against an investigation by various branches of the federal government for alleged False Claims Act, Stark Law, and Medicare violations.
  Result: No civil or criminal liability.

• Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
  Result: No civil or criminal liability.

• Defense of a physician-owned entity against an investigation by the Department of Defense for alleged Tricare fraud.
  Result: No civil or criminal liability.

• Defense of a physician-owned entity against an investigation by the Department of Justice for alleged Medicare fraud.
  Result: No civil or criminal liability.

• Defense of physician-owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
  Result: No civil or criminal liability.

• Defense of health care management organization against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged Medicare fraud.
  Result: No civil or criminal liability.

• Defense of nationally operating laboratory against an investigation by the Office of Inspector General for alleged fraud.
  Result: No civil or criminal liability.

Medicare Fraud Defense Attorneys Serving Louisiana

We are available every day of the year. You can call us directly or complete our contact form or email us directly.

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. The Criminal Defense Firm is a Texas firm with headquarters in Dallas.