Medicare & Medicaid Fraud Attorney in Houston
Has the AG or OIG Contacted Your Health Care Organization?
Large and small health-care providers across the country-and particularly
in Texas-are under increasing levels of scrutiny in every area of their
businesses. Nowhere is this truer than in regard to billing practices.
Your organization could easily be the target of a government investigation,
even if you had no intent to commit fraud.
If the Office of Inspector General (OIG) or State Attorney General (AG)
has contacted you about a
healthcare fraud investigation, speak with an experienced health and medical law attaorney at Hendershot,
Cannon, Martin & Hisey before you respond. Even if investigators say
you are not the target of the investigation, you may inadvertently make
an admission that jeopardizes your practice or organization. Our job is
to protect your interests from the time you suspect a problem through
the conclusion of your case.
Have you been contacted by the Attorney General or Office of Inspector
General? Contact us right away at (713) 909-7323. We serve clients throughout Texas.
Common violations include:
- 60-Day rule
- Billing for services that a health-care professional did not provide
- Double-billing Medicare or Medicaid and a private company for the same treatment
- Upcoding, or exaggerating the service performed
- Certifying patients for unneeded services
- Accepting or providing anything of value for referrals for Medicare or
- Inducing referrals by making payments
- Business relationships where compensation is not set at a fair market value
The result of a Medicare and Medicaid fraud investigation can have serious
consequences and/or penalties. The earlier you contact us, the sooner we will begin investigating and
preparing your case.
Complex Health Care Regulations
Billing issues happen. We advise defendants on the most complex health
care regulations in Texas, including:
Fraud & Abuse Violations: The federal government has enacted an anti-kickback law called the Fraud
and Abuse Statute, and Texas has the Patient Solicitation Act. These laws
make it illegal to knowingly and willfully receive or offer payment to
influence referrals of state or federal healthcare program business.
The Stark Law, known as the self-referral law, governs medical professionals' conduct regarding the referral of Medicare
or Medicaid patients to another provider. Doctors are prohibited from
referring a patient for designated health services to a provider in which
there is financial interest.
False Claims Act Violations: The OIG and Texas AG are conducting an increasing number of investigations
violations of the federal False Claims Act by healthcare professionals and facilities. If the OIG or AG has requested
information or an interview or has served a notice or subpoena, contact
our legal team today.
Recovery Audit Contractor (RAC) Program: The RAC program detects and recovers improper payments to medical care
providers. Private contractors assess health-care records for signs of
wrongdoing. Investigators may look for things like improperly coded or
duplicate services, billing for services uncovered, and incorrect payments.
ZPIC Audits: Zone Program Integrity Contractors oversee the Medicare Benefit Integrity
program, including Parts A and B, home health care services, hospice care
and durable medical equipment (DME).
ZPIC audits are typically initiated based on rate analysis or information provided
by a whistleblower.
Novitas Audits: Novitas Solutions Inc. is an administrative services processing company
which serves as the Medicare Administrative Contractor (MAC) for Jurisdiction
H. If it finds patterns of coding errors or overbilling, it can initiate
an audit. If audit findings warrant it, Novitas can recommend additional
TDI Audits: The Texas Department of Insurance oversees the insurance industry in order
to protect patients from unethical or unfair behavior. The TDI has a law
enforcement arm (the Fraud Unit) with full police powers to conduct criminal
investigations and make arrests. Contact us, so we can help you prepare
for an audit and affirm your rights while remaining compliant throughout
Strategic Representation to Prevent or Resolve any
Healthcare Fraud Matter
Contact us so we can advise you on the creation, implementation, and maintenance
of compliance plans designed to prevent and resolve problems before they
Our Houston Medicare & Medicaid Fraud attorneys advise healthcare clients
on matters such as:
- Medical practice startups, mergers & acquisitions
- Regulatory compliance
- Risk management
- Contracts and agreements
- Transactions, such as purchase of equipment, lease agreements, billing
arrangements and more
Contact Our Houston Medicare & Medicaid Fraud Attorneys Today.
Accused of Medicare or Medicaid fraud? Contact Hendershot, Cannon, Martin
& Hisey, P.C, to discuss your case with a dedicated Houston health
law attorney. Fill out a simple
online consultation form or call (713) 909-7323 to get started with us today.