Health Care Fraud

Defending Against Health Care Fraud, Waste, and Abuse Charges

Allegations and/or charges of health care fraud, waste, or abuse, can and probably will have a major effect on any medical or health care provider, including physicians, nurses, home health care agencies, durable medical equipment companies, ambulance companies and others.

At Eyler Law Offices, we defend individuals and businesses in administrative, civil and criminal proceedings arising from allegations and charges of health care fraud. I have extensive experience and knowledge in health care fraud cases from my years of representing and defending health care providers and businesses. I have been both a state and federal prosecutor who represented the government in various types of health care fraud investigations and court cases. I also gained an immense amount of experience about the health care industry and about corporate health care issues from my employment as a corporate compliance manager for the Dallas County Hospital District (Parkland Hospital). From this vast amount of experience in representing health care providers and businesses and prosecuting health care fraud for the government, I have obtained the knowledge and experience necessary to effectively and aggressively represent anyone or any business who is under investigation or who has been indicted for health care fraud.

At Eyler Law Offices we know how to answer when the government comes knocking at your door and accuses you of any wrongdoing or illegal activity. We also know how to help you respond to any “over-payment” or “recoupment” issues that are alleged against you or your business by the state or federal government. We definitely understand the difference between a civil health care matter and a criminal health care matter. And in today’s health care world that is very important because the government has become very aggressive in its attempts to investigate fraud and recoup what it believes is an “overpayment”. The government often times escalates a case of civil health care fraud up to a criminal investigation. If this happens you need to understand there can be a fine line between a civil fraud case and a criminal fraud case, and we know how to make that determination. We can help you explain to the government why a case should not be considered criminal.

We understand that the government has the heavy burden of proving that you or your company has committed fraud. And we definitely understand that the government has the very heavy burden of establishing guilt beyond a reasonable doubt. And you can assure yourself that we will hold them to that heavy burden.

At Eyler Law Offices, we represent and defend individuals and business organizations if they have been accused of any type of wrongdoing or fraud by the government, e.g. Federal Bureau of Investigation (FBI), Health Human Services –Office of Inspector General (HHS-OIG), Medicaid Fraud Control Unit (MFCU), the Texas Attorney General, the Centers for Medicare and Medicaid Services (CMS), or any Texas Professional Regulatory Boards, e.g. Texas Medical Board, Texas Board of Nursing, Texas Dental Board, Texas Chiropractic Board, Texas Board of Physical and Occupational Therapists, Texas Podiatry Board, in the following matters:

  • False claims
  • Over-billing for payments
  • Rendering services not medically necessary
  • Billing for services not rendered
  • Credentials and peer review issues
  • Medicaid and Medicare compliance
  • Provider reimbursement and payment issues
  • STARK / Anti-Kickback issues and review
  • Investigations by the Texas Medical Board and the Texas Dental Board
  • HIPAA Violations- Health & Human Services - Office of Civil Rights investigations
  • HIPAA compliance, medical records, and patient confidentiality
  • Corporate Compliance with all local, state, and federal rules and regulations
  • Recruitment agreements, employment contracts, non-compete agreements and confidentiality clauses
  • Employment issues
  • Contract Review
  • Pharmaceutical issues
  • Retention of medical records and completion of death certificates
  • Disputes with third-party insurers
  • Audit and fraud defense
  • Facility and office lease agreements
  • Representation before professional licensing boards e.g. Texas Nursing Board, Texas Pharmacy board, Texas Dental Board, Texas Medical Board, Texas Chiropractic board, etc.
  • Day-to-day business issues with contracts, employment law, etc.

We pride ourselves on keeping on top of the very latest and critical information in the every-changing and complex healthcare industry. With the implementation of the American Recovery and Reinvestment Act of 2009 (ARRA), and the Patient Protection and Affordable Care Act (PPACA), businesses are facing a vast amount of new laws that they must be in compliance with or they face possible severe sanctions and/or prosecution. With this in mind, we use all available resources to communicate this information and to promptly and efficiently provide the very best legal representation to our clients, be it in state or federal court, administrative courts or forums, or in appeals.

Eyler Law Offices also handles any Medicare and Medicaid or private insurance companies billing and coding compliance issues. We will help you respond to any fraud or compliance allegations against you from any state or federal government agency or from any private insurance company. We will attend all hearings and appearances, ensuring that our clients have the opportunity to be heard and to clear up any allegations made against them. We also undertake negotiations to reduce the amount a client owes in fines or reimbursements for possible over-billing or over-payments. We handle all criminal and disciplinary matters so that each client receives a vigorous defense against health care fraud allegations and charges.

If you need an experienced health care attorney in the Dallas/ Fort-Worth metroplex, contact Eyler Law Offices at 214-540-7750 for any matter arising from health care fraud, waste, or abuse charges, or email us from our contact page to discuss your case.