If you bill the workplace of workers’ Compensation audit Program or the other U.S. Department of Labor (DOL) workers’ compensation audit program, you wish to be cautious of the risks concerned in facing Associate in Nursing audit or investigation. Our federal health care fraud defense lawyers and workers’ compensation audit consultants have the expertise and insights you wish to avoid practice-threatening penalties.
When you bill the U.S. Department of Labor (DOL) workers’ compensation audit program, you would like to be cautious of the risks concerned in facing associate degree audit or investigation. Our federal health care fraud defense lawyers and workers’ compensation audit programs, as well as those administered by the workplace of staff Compensation audit Program (OWCP), square measure subject to strict rules and rules, and there square measure numerous federal laws that impose civil and criminal penalties for health care suppliers that over-bill the DOL.
This means one thing: For aid suppliers that bill DOL workers’ compensation audit programs, compliance is essential. With an efficient DOL compliance program, not solely are you able to considerably cut back your risk of being targeted in an exceedingly workers’ comp audit or workplace of military officer (OIG) investigation; however, within the event that you just area unit audited or investigated, you’ll clearly establish that you just aren’t worth of apply throughout an audit or investigation are often more difficult, however you may still have variety of effective compliance program in situ, defensive your apply throughout an audit or investigation are often more difficult, however you may still have variety of effective defense methods on the market.
About Oberheiden, P.C. | Federal Healthcare Fraud Defense Lawyers and Workers’ Comp Consultants for DOL Healthcare Providers Nationwide
At Oberheiden, P.C., our apply is targeted on representing attention suppliers that bill the DOL’s workers’ compensation audit programs and alternative federal attention profit programs. Additionally to representing suppliers with relation to proactive compliance, we have a tendency to conjointly often advise purchasers relating to audits and investigations. Our lawyers and consultants, several of whom antecedently worked for the national investigation and prosecuting suppliers suspected of defrauding these programs, provide centuries of combined expertise and a tested chronicle of serving to suppliers avoid the substantial penalties that may result from DOL fraud liability.
While we have a tendency to represent tending suppliers that bill all federal tending advantages programs – and a major portion of our apply is dedicated to health care and health care fraud defense – we have a tendency to habitually counsel suppliers World Health Organization treat gashed federal and private-sector staff beneath the four main DOL programs:
- Federal Employees’ Compensation Program (FECP)
- Energy Employees Occupational Illness Compensation Program (EEOICP)
- Longshore and Harbor Workers’ Compensation Program (LHWCP)
- Coal Mine Workers Compensation Program (Black Lung)
We know the rules governing these programs just like the backs of our hands; and, with our defense attorneys’ previous prosecutorial expertise, we tend to square measure able to provide economical, strategic, and effective consulting services for shoppers that square measure either involved concerning or actively facing a DOL workers’ compensation program audit or investigation.
How Our Lawyers and Consultants Help with Federal Workers’ Comp Audits and Investigations
As lawyers and consultants, we have a tendency to square measure able to offer comprehensive, full-service recommendation and illustration for federal workers’ comp audits and investigations. This includes conducting internal audits to spot potential areas of exposure, interfacing with the DOL and federal prosecutors on behalf of our shoppers, corporal punishment defense ways targeted on avoiding federal charges, and helping with the event and implementation of adequate DOL compliance policies and procedures. relying upon your clinic’s or care practice’s specific desires, we will offer you with services including:
1. Confidential and Attorney-Client Privileged Internal Compliance Audit
When facing a federal workers’ comp audit or investigation, you would like to understand what – if something – the DOL goes to seek out. However, within the method of uncovering any potential violations, you furthermore may ought to avoid generating records or revealing info which may be subject to a warrant or subpoena. We will work with you and your key personnel to confidentially and discretely conduct an indoor audit that avoids raising issues among your workers and patients, and that we will make sure that all communications, notes, and alternative records made throughout the interior audit ar protected by the privilege.
Conducting an enclosed audit throughout (or in anticipation of) a federal workers’ comp audit or OIG investigation is very important for variety of reasons. These reasons include:
- Federal auditors and agents won’t forever tell you what they’re investigating; and, as a result, you would like to try to to your own legwork to work out what allegations you will ought to defend against;
- By distinguishing any DOL charge violations before the govt., you’ll develop a proactive strategy for responding to the audit or investigation;
- As a aid supplier that bills the DOL, you will have Associate in Nursing obligation to affirmatively disclose charge violations, however you can’t do that with confidence till you recognize specifically what you would like to disclose; and,
- By distinguishing any workers’ comp code errors or alternative charge mistakes, you’ll proactively update your policies and procedures to demonstrate to the DOL that you just ar serious concerning compliance with the federal workers’ comp rules.
2. Intervention and Proactive Defense of the DOL’s Audit or Investigation
When facing a federal workers’ comp audit or investigation, one choice is to let the DOL conduct its inquiry at its own pace and in line with its own standards and protocols. an alternative choice is to intervene within the audit or investigation, take hold of the method, and actively steer the inquiry toward a good outcome.
At Oberheiden, P.C., we have a tendency to believe firmly within the latter approach, because it has protected the overwhelming majority of our purchasers not simply from facing criminal penalties, however from federal charges even being filed. With our defense lawyers’ and former prosecutors’ insights, and with our federal workers’ comp consultants’ expertise, we have a tendency to ar able to fleetly and strategically intervene in DOL audits and investigations and start operating promptly toward a positive outcome.
3. Assertion of DOL Billing Fraud Defenses and Legal Protections
When facing a federal workers’ comp audit or investigation, one choice is to let the DOL conduct its inquiry at its own pace and consistent with its own standards and protocols. another choice is to intervene within the audit or investigation, lead of the method, and actively steer the inquiry toward a positive outcome. At Oberheiden, P.C., we tend to believe firmly within the latter approach, because it has protected the overwhelming majority of our purchasers not simply from facing criminal penalties, however from federal charges even being filed. With our defense lawyers’ and former prosecutors’ insights, and with our federal workers’ comp consultants’ expertise, we tend to ar ready to fleetly and strategically intervene in DOL audits and investigations and start operating promptly toward a positive outcome.
- Compliance with all workers’ comp rules and regulations
- Protection under the Anti-Kickback Statute safe harbors
- Unconstitutional search or seizure
- Unconstitutional interrogation or “fruit of the poisonous tree”
- Lack of evidence to justify federal prosecution
4. Demonstrating Lack of Knowledge or Intent
In federal tending fraud cases, together with those involving allegations of fraud beneath DOL workers’ compensation programs, a key component of the government’s case is intent. If prosecutors will gift a case that you simply advisedly overbilled the DOL, then they’ll pursue jail time and different criminal penalties. If proof of intent is lacking, or if you’ll use your compliance program to affirmatively demonstrate that you simply totally meant to adjust to the federal workers’ comp rules, then prosecution is unwarranted.
Additionally to the defenses listed higher than, if it’s impractical to argue that you simply area unit 100 percent innocent (i.e. if request errors have clearly been made), then our lawyers Associate in Nursingd consultants will use their expertise to argue that the proof doesn’t support an logical thinking of intent.
Lack of information or intent may be a key defense strategy in cases wherever a provider’s alleged liability is predicated upon the conduct of a 3rd party – like a third-party charge company, marketer, or appurtenant service supplier. If federal prosecutors try to implicate your clinic or apply in an exceedingly DOL fraud conspiracy, then demonstrating not solely that you simply didn’t will violate the law, however that you simply weren’t even aware that a violation occurred, are often massively effective for partitioning associate audit or investigation while not negative ramifications.
5. Taking Corrective Action to Prevent Future Federal Workers’ Comp Violations
As we have a tendency to mentioned on top of, one in every of the explanations for conducting an interior audit once you’ve got been contacted by the DOL (or if you’ve got reason to believe that the DOL is also contacting you soon) is in order that you’ll be able to correct any in progress problems or general compliance deficiencies. However, overtly taking corrective action also can signal to the DOL that you just area unit aware that a drag exists. additionally to handling the DOL on your behalf, our lawyers and consultants also can assist you with creating any necessary changes to your clinic’s or practice’s request policies and procedures while not increasing your risk of prosecution for past violations.
Get Started with a Free Initial Consultation
If you’d wish to speak with a member of our federal workers’ compensation fraud consulting and assemblage, we have a tendency to encourage you to contact U.S.A. promptly. To schedule a free and confidential consultation as shortly as potential, call 1-800-813-1386
Workers Compensation 