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McAllen, TX False Claims Act & Qui Tam Defense Lawyers

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Qui Tam and False Claims Act Legal Defense for McAllen and the Surrounding Areas

Are you facing criminal or civil charges involving the False Claims Act in McAllen, Texas? The Oberheiden, P.C. can help. Our nationally experienced Health Care Fraud Defense Team utilizes strategic defense strategies to assist medical professionals, health care businesses, and others involved in the health care field facing an investigation. Our defense attorneys can help you get answers to your questions and we’re available 7 days a week.

False Claims Act Investigations

In 2016, more than 300 cases of medical fraud were brought forward by the Department of Justice. This is the largest number of people charged in the history of the Medicare Fraud Strike Force. This number included more than 60 doctors, nurses, and other licensed medical professionals. The Strike Force stated in a press release that more than $900 million was at stake because of false billing.

Although every state is monitored for False Claims Act investigations, Texas is particularly watched. The federal government uses a special task force, in addition to the Medicare Fraud Strike Force, to monitor, investigate, and prosecute individuals and businesses that they allege have violated the False Claims Act. In McAllen, Texas, health care professionals, facilities, and related businesses must be aware that federal authorities are particularly aggressive. The Health Care Fraud Prevention and Enforcement Action Team HEAT) is comprised of prosecutors and investigators from the Federal Bureau of Investigations, the Office of Inspector General, Department of Health and Human Services, and the Department of Defense.

Allegations that you, your facility, or your business is in violation of the False Claims Act are a very serious matter.

What Is the False Claims Act?

The False Claims Act is a federal law that is directed toward any person or business that has either direct or indirect contracts with and is paid by the United States government. It presents a legal liability for any person, organization, corporation, or government contractor who knowingly submits or is the cause of a submittal of a bogus or fraudulent claim for payment by the government. In this instance, ‘knowingly’ means that there was either actual knowledge that the claim being submitted was bogus, or the person, organization, corporation, or contractor failed to conduct due diligence for the claim.

This creates what is often referred to as a “known or should have known” scenario. As an example for medical care, we can use billing codes. If a claim is submitted using an obsolete code, that can be considered a violation of the False Claims Act, because it was expected of you or your organization to perform due diligence research to use the correct code.

Criminal & Civil Liabilities for False Claims Act Violations

Allegations of False Claims Act violations are extremely serious. Despite their serious nature, it may be hard for you to determine if the investigation against you is civil, or if the government intends to pursue felony criminal charges. These allegations can present both civil and criminal liability.

Civil liability is assessed if you are taken to trial by the government in civil court. You may be forced to pay treble damages and a fine of up to $11,000 per claim. Criminal liability is under the control of the criminal court system. Under 18 USC § 287, you could receive a five-year prison sentence and fines based on whether you’re charged with a misdemeanor or a felony. These fines are per claim.

  • For misdemeanor convictions, individuals could be fined $100,000 per claim and companies could be fined $200,000 per claim.
  • For felony convictions, individuals could be fined $250,000 per claim. Companies could be fined up to $500,000 per claim.

What You Need to Know About Qui Tam Lawsuits

In McAllen, Texas, most investigations related to False Claims Act violations are not actually instigated by the federal government. They usually start because an unhappy former employee or a competitor lodges a complaint against you, your health care facility, or your business. There is a provision of the False Claims Act that enables private individuals to file a qui tam lawsuit. Qui tam is part of a Latin expression that means “he who sues for the king and himself.” Of course, the goal is supposed to be to assist the government in recovering money that it paid out for false claims. Yet, when the allegation of fraud comes from an unhappy former employee or a competitor, the goal generally isn’t to help the government.

The plaintiff, known as the qui tam relator, files a complaint with the Southern District of Texas. These complaints are sealed to protect the identity of the plaintiff. Non-public copies are given only to the judge and certain government officials. Extensions can be granted until the government finishes its investigation.

The government does have the option to totally reject an unsubstantiated complaint. However, if the government believes that there may be a violation of the False Claims Act, it will begin an investigation. You may come into contact with the FBI, DEA, OIG, HHS, DOJ, and other government agencies. They usually perform their investigations by subpoenaing corporate, financial, billing, business, and communication records from you or your facility.

After reviewing your records and speaking with your attorney, the government will determine if it will support the plaintiff’s qui tam case or if it will drop out. If the government drops out, the plaintiff has the option of continuing the case on his or her own. This process, known as intervention, requires approval that includes the Department of Justice (DOJ). The DOJ can include additional causes of action, including violations of the Anti-Kickback Act and the Truth in Negotiation Act.

During the time when the government is issuing subpoenas and notifying you that you’re under investigation, negotiations can occur between the government and your defense lawyers. Of course, depending on the severity of the matter and the complexity of the analysis, it may take months before the government begins to evaluate the qui tam. It can take quite some time before the matter is totally resolved.

If you’re found civilly or criminally liable for violating the False Claims Act, you could be ordered to pay up to three times the total of loss by the government. You could also be fined up to $11,000.00 per claim. Qui tam plaintiffs are allowed by the government to keep up to 25 percent of the amount collected if the government participates in the lawsuit. If they proceed on their own and you are found liable, they may keep up to 30 percent.

Utilizing Proven Defense Strategies

Oberheiden, P.C.’s experienced Health Care Fraud Defense Team has successfully resolve False Claims Act cases throughout the nation. Our guiding principles have helped our clients accept responsibility for human error while negotiating away the risk of criminal liability.

  1. Avoiding criminal charges. Our first goal is to help you avoid criminal charges. We use our years of experience in federal health care cases and False Claims Act investigations to get answers to your questions. We will find out if the investigation is civil or criminal, what the government hopes to learn, and how we can help you resolve this issue. Usually, we are able to inform our clients within 48 business hours regarding what the case is about, the risks, and what the government wants. We know that your business and occupation are your livelihood, and just how much a criminal charge could affect that. Finding out this information as soon as possible is vital, so that we are able to assist you in resolving the complaints against you or your business.
  2. Avoiding government intervention. As stated earlier, many False Claims Act cases aren’t instigated by the government. They happen because of angry former employees or competitors who are out to jeopardize or ruin your business. Oberheiden, P.C. provides more than just an experienced, passionate defense. We will confront the qui tam plaintiff, challenge the evidence, and question his or her credibility. This is critical because it shows the investigating government body that the plaintiff’s accusations are without merit and should not have its support.
  3. Work toward a favorable settlement. In cases where civil liability was an issue, we’ve successfully negotiated the damages to a small portion of the original demand made by the government. To date, none of our clients were forced to stop practicing or close down their business because of a violation of the False Claims Act.

Call Oberheiden, P.C. now to discuss your situation. Each case is different and needs its own set of unique defense strategies. The sooner you call, the sooner we can help. Our initial consultations are free and confidential. We’re available 7 days a week. You can call, use our online contact form, or send us an email to learn more.

Oberheiden, P.C.

The attorneys of Oberheiden, P.C. have successfully defended physicians, practice owners, physician owned entities, toxicology laboratories, device companies, pharmacies, service management organizations, health care marketing companies, hospitals, and many others in False Claims Act, qui tam lawsuits, Stark Law, Anti-Kickback, Medicare, Medicaid, Tricare, and DOL investigations.

  • False Claims Act Investigation (Pharmacy)
    Result: No Liability.
  • False Claims Act Investigation (Pharmacy)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Physician)
    Result: No Liability.
  • False Claims Act Investigation (Physician)
    Result: No Liability.
  • False Claims Act Investigation (DME Company)
    Result: No Liability.
  • False Claims Act Investigation (MSO)
    Result: No Liability.
  • False Claims Act Investigation (MSO)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Device Company)
    Result: No Liability.
  • False Claims Act Investigation (Health Care Service Provider)
    Result: No Liability.

Call Oberheiden, P.C. today and speak with former federal prosecutors and established defense counsel about your case. All initial consultations are free and confidential.

False Claims Act Defense Attorneys Serving  McAllen, Texas

Nick OberheidenDr. Nick Oberheiden has represented clients in Qui Tam, False Claims Act, Medicare Fraud, Tricare Fraud, Stark Law, and anti-kickback proceedings before virtually all federal agencies including but not limited to the Office of Inspector General (OIG), the Department of Health and Human Services (HHS), the Department of Defense (DOD), the Department of Justice (DOJ), and the Department of Labor (DOL). Dr. Oberheiden is trained in negotiations by Harvard Law School and holds a Juris Doctor from the University of California, Los Angeles, as well as a Ph.D. in law.

Lynette ByrdLynette S. Byrd is a former Assistant United States Attorney (AUSA). Clients greatly benefit from Lynette’s experience from the Department of Justice, where she prosecuted health care fraud, Anti-Kickback violations, False Claims Act, and Stark violations on behalf of the United States. Lynette has immense experience with health care law enforcement, and she regularly argues federal matters for her clients.

We are available to discuss your case. You can call us directly or complete our contact form or by sending us an email.

1 (214) 469-9009
Including Weekends
Oberheiden, P.C.
(800) 810-0259
(214) 469-9009
www.criminaldefense.com
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 firm 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