Mobile X-Ray Companies: The New Targets of Federal Investigations
Attorney Dr. Nick Oberheiden Has a Track Record of Successfully Defending Healthcare Business Owners
For years, the federal government has scrutinized home health, hospice agencies, and nursing home facilities for alleged Medicare fraud. Recently, the scope of those investigations has broadened to also include vendors and service providers to those agencies, in particular mobile radiology groups.
Providers of mobile x-ray services contact healthcare fraud defense attorney Dr. Nick Oberheiden when they become aware of an investigation against their business, either because they were subject to a search warrant or because investigators stopped by their offices in an attempt to interview the business owners or managers.
If this has happened to you, please read this article.
Following instructions from the Department of Justice, the Federal Bureau of Investigation (FBI), the Office of Inspector General (OIG), the Attorney General’s Office, the Medicaid Fraud Control Unit (MFCU), and the Department of Health and Human Services (HHS) have begun to systematically scrutinize the owners and operators of mobile x-ray companies in an effort to prosecute waste and abuse of Medicare and Medicaid funds.
From his defense of mobile radiology groups in various parts of the country, attorney Nick Oberheiden knows first hand what the government is looking for and how federal agents are building their cases. All cases have in common that current or former employees have served the government as confidential informants and have provided damaging, albeit untrue information that have led to FBI raids and arrests against the business owners. A successful defense in such a delicate situation must be based on experience; looming federal felony charges prohibit any experiment when it comes to selecting the right attorney.
Dr. Nick Oberheiden has the experience and the track record to avoid criminal charges in healthcare fraud investigations. If your business got raided or is subject to audit or expected investigation, please call federal criminal defense attorney Nick Oberheiden right away. The sooner you team up, the more likely you will escape the investigation just like so many of Nick’s previous clients with: No Civil, No Criminal Liability.
Meet Healthcare Fraud Defense Attorney: Dr. Nick Oberheiden
Attorney Nick Oberheiden has been featured by the media across the country and he has been interviewed by TV and radio stations on federal litigation and federal law in all 50 states.
What distinguishes Nick from many other attorneys is his ability to actually persuade decision-makers, be it prosecutors, federal agents, or judges by way of highly analytical but concise presentations. Liked and respected by government officials and clients alike, Nick’s approach is not characterized by rude aggressiveness but by lucid arguments.
With hundreds of healthcare audits and investigations successfully resolved, the following are recent examples of Medicare fraud cases, in which clients trusted Nick with their case. Nick and his team convinced the U.S. Attorney’s Office in each of these cases to not bring any charges against his clients.
- Representation of Medicare Business: Nick and his team represented the provider of mobile Medicare services in a criminal healthcare fraud investigation that involved the U.S. Attorney’s Office, the Department of Justice, the FBI, the Office of Inspector General, and a number of other federal law enforcement agencies. Although there was an active grand jury investigation tasked to indict our client, we were able to turn the case around by engaging into high-level negotiations and discussions with the prosecutors in charge. A series of zealous and determined presentations in front of government lawyers and agents allowed our team of attorneys to end the investigation and to share the good news with our clients: no civil and no criminal liability. The company continues its operations to this day.
- Representation of Medicare Business Owner: This case began with a grand jury subpoena asking for our client to produce documents and records that had the potential to jeopardize our client’s freedom. When Nick took on this matter he knew that he had to convince the government to limit the scope of the requested production and to ultimately work out a cooperation and non-prosecution agreement with the Department of Justice. After a number of painstaking negotiations with the prosecutor, Nick was able to meet all of his client’s goals and to conclude the investigation without any civil or criminal liability for his (very pleased) client.
- Representation of Medicare Provider: It happens quite often that everyone in the pool of potential government targets ends up being indicted—except for Nick’s client. This case is no exception. Nick entered the case in a seemingly hopeless situation with criminal charges about to be pending. The allegation: billing for services not actually performed. Time was of the essence to identify and analyze the source of potential mistakes before the government would bring criminal charges. Nick and his team conducted a rapid internal investigation that involved interviews of employees and managers. During this factual investigation, it became more and more clear that, while the set up was some standard, there were no signs of systematic and deliberate fraud. We presented the findings in a comprehensive and well structured meeting with the government and were able to save our client from what would otherwise have looked like years of jail.
Common Issues in Criminal Mobile X-Ray Cases
From his defense of various mobile healthcare businesses, Nick knows how quickly even well spirited companies may find themselves under investigation or subject to a search warrant. Most mobile x-ray companies service Medicare patients located in nursing homes or privately at the patient’s residence. Because this sector of the healthcare industry is already under the strictest government scrutiny, mobile x-ray companies need to understand that their mere home health/nursing home affiliation alone may put them on the government radar.
While the government looks at a variety of factors before opening a formal investigation, mobile x-ray company need to make extra certain that there is no discrepancy between claims billed to CMS on the one hand and radiology reviews and reports on the other hand. In other words, the government will compare whether the number of billed X-ray services and the number of radiology billing statements are identical and mirror each other. Further, given the nature of the patient population and the mortality rate in nursing homes, no mistakes should be made when it comes to billing for services of actually deceased patients, a problem that routinely leads to claims of services billed for but not provided. Also, carefulness is warranted when it comes to excessive x-ray images that were necessitated by a patient’s unwillingness or inability to allow the x-ray technician to complete the x-ray at the first attempt; five billed attempts to image a broken foot may raise red flags.
As it is true in every healthcare case, the financial relationship between healthcare providers and healthcare businesses is of significant importance to the government in light of the restrictions contained in the federal anti-kickback statute. There should be no implicit or explicit arrangement involving remuneration in exchange for referrals. This is particularly important when it comes to compensating healthcare marketers in the context of federally funded patients such as Medicare and Medicaid.
In terms of company control and corporate compliance, business owners in the healthcare industry may be civilly or criminally liable for wrongful acts committed by their employees. For example, if the technician submits suspicious or excessive X-ray reports to the billing department or the business owners, be it because the employee is financially incentivized by extra payments for the volume of x-ray performed, or be it to secure and protect his or her employment by demonstrating frequent imaging, criminal liability may arise for submitting medically unnecessary tests or for billing for services never performed.
A Different Level of Client Commitment
If there’s one thing that is completely different about Nick Oberheiden, it is his personal attention and client commitment. Nick’s clients all have direct and immediate and ongoing access to him. Nick does not delegate your case to junior lawyers or secretaries. Call him today to enjoy a different level of client commitment.
FAQs: What Happens in Mobile X-Ray Investigations?
Q: How Do I Know that My Company Is Under Investigation?
There are different ways to become aware of an investigation against your business. The more obvious way is to have a direct encounter with law enforcement, be it through a search warrant that is being executed against your business or by way of federal agents trying to interview you or business affiliates. However, in many instances, the first indication that something is not right is either receiving a ZPIC audit request or by being suddenly suspended by Medicare. Finally, if your mobile x-ray company provides services to, for example, a nursing home and that nursing home itself is subject to an investigation, there is a realistic chance that your business may become an offspring of the main investigation against your business partner.
Q: How Do I Know Whether the Investigation Against My Mobile X-Ray Company Is Civil or Criminal?
One of the most important questions to determine at the beginning of a case is whether the investigation is civil or criminal. While that assessment is not always easy to make right away, there are some signs that would suggest a criminal rather than a civil nature of the investigation. Among these indications are search warrants, the involvement of FBI agents, and the issuance of a criminal grand jury subpoena. It is important to understand that experienced lawyers have the ability to turn the criminal case into a civil payment matter depending on the circumstances of the investigation and the timing of the lawyer’s involvement in the case. Without a doubt, the sooner a respected and qualified lawyer interjects into the case, the more likely it is that the case will result in no charges.
Q: Can the Company Owners Be Criminally Liable?
Yes, although most investigations begin against the mobile x-ray company as a corporate entity, the company structure will ultimately offer no protection for the owners and managers behind the corporate veil. If the company fails to engage experienced counsel and thus allows the government to continue and expand its investigation, sooner than later the prosecutor in charge will shift the focus of the investigation to the individuals running the company. Further, should the case result in criminal prosecution and criminal charges, those charges would be brought not against the company but the allegedly responsible managers.
Q: When Is the Right Time to Hire Nick Oberheiden and His Team?
As stated earlier, the sooner an attorney with the required skillset engages into a dialogue with the investigators, the higher the chances of avoiding a criminal prosecution. That said, you can’t do anything wrong by getting a free and confidential consultation with Nick from the earliest moment you are aware of a potential problem. In this consultation, Nick will assess your situation and determine with you whether you or your business is in need of counsel.
Why Do Healthcare Business Owners and Providers Trust Dr. Nick Oberheiden, Esq.?
Healthcare business owners and providers trust federal defense attorney Dr. Nick Oberheiden because Nick delivers results. Nick has avoided criminal charges in hundreds of federal healthcare fraud investigations, many of which included prosecutable crimes known and identified by the government. Contact Nick today and find out for yourself if what you hear from Nick is articulate, helpful, and convincing. All calls are free and confidential.
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