Tricare, the health care program for the U.S. Department of Defense Military Health System, provides coverage for the cost of active-duty, retired, and reserve service members’ medical care and prescriptions. It is a federal program similar to Medicare, which means that: (i) Tricare is subject to a complex web of rules and regulations; and, (ii) federal prosecutors are taking aggressive action against health care providers, pharmacies, and others who they believe are involved in Tricare fraud.
Committing Tricare fraud is an extremely serious offense. A federal investigation can disrupt your business and put you at risk for huge financial penalties, jail time, and a variety of other forms of civil and criminal punishment. To protect yourself from the consequences of a Tricare fraud investigation, you need to speak with an experienced defense lawyer as soon as you find out that you have the government’s attention.
National Tricare Fraud Lawyers Serving South Florida/Miami, Detroit, Houston, Louisiana, California, Texas, and the Entire United States
The Oberheiden, P.C. is a national criminal defense law firm that represents clients facing civil and criminal investigations for Tricare fraud. Our experienced team includes former federal prosecutors and renowned health care fraud defense lawyers who have a long record of success defending clients in federal court.
However, if at all possible, we want to keep you out of court altogether. This is why it is critical that you contact us as soon as possible. We have helped numerous clients facing Tricare and other health care fraud allegations avoid court proceedings and criminal charges. If you get us involved early, we can work with the prosecutors in order to protect you. There are many potential defenses to Tricare fraud, and understanding the nature of the investigation whether it is civil or criminal, and finding out what information the government has against you early in the process are both critical to presenting the strongest possible defense.
Civil, Criminal, and Administrative Penalties for Tricare Fraud
Like other forms of health care fraud, Tricare fraud can be charged as both a civil and a criminal offense. In addition, individuals and companies found to have been involved in Tricare fraud can also face administrative penalties under the Tricare program.
Civil Penalties for Tricare Fraud
In a civil investigation, the government’s focus is on seeking monetary recovery for the losses caused by the fraud, and on punishing the company (and in some cases, individuals) involved in order to deter future fraudulent conduct. This means that in a civil investigation, without the help of an experienced criminal defense law firm, you are likely to face:
- Recoupment of fraudulent claims,
- Treble (triple) damages,
- Fees payable to the government, and
- Fines of up to $11,000 per false claim.
In most cases, the government seeks civil liability for the companies involved in fraudulent Tricare billing practices. However, federal prosecutors have also been known to pursue civil actions against the company’s senior officers (including CEOs and CFOs) and other responsible individuals.
Criminal Penalties for Tricare Fraud
In a criminal case, the possible punishment for Tricare fraud includes federal imprisonment. Prosecutors can bring Tricare fraud charges under a number of different federal laws, with penalties in cases involving substantial fraud reaching decades behind bars. Due to the risks involved in a criminal investigation, we typically use an arsenal of proven strategies and defenses in order to try to keep our client’s cases civil.
Administrative Penalties for Tricare Fraud
In addition to civil or criminal punishment, companies and individuals accused of Tricare fraud can face a number of administrative penalties as well. These include temporary or permanent suspension from participation in Tricare. If you lose your status as a Tricare provider, you will no longer be able to seek reimbursements through the program.
Defending Tricare Fraud Allegations
The Department of Defense (DOD), the Office of Inspector General (OIG), the Department for Health and Human Services (HHS), the Department of Justice (DOJ), the Federal Bureau of Investigation (FBI), and other federal law enforcement agencies all prosecute cases of alleged Tricare fraud. In cases involving compound pharmacies, the Drug Enforcement Administration (DEA) frequently gets involved as well. Knowing what you are up against is the first step toward building a strong defense.
From the investigation to civil, criminal, and administrative appeals, there are many ways to fight Tricare fraud allegations. At Oberheiden, P.C., we have the experience and commitment you need to protect your business and preserve your future.
Request a Free Tricare Fraud Case Evaluation
If you are being investigated for Tricare fraud, we urge you to contact us for a free case evaluation. If you choose to work with us, we will use our decades of experience including time spent as federal prosecutors to help protect you from the government. To start building your Tricare fraud defense, call 866-603-4540 or contact us online now. Doing so could change your life.