Texas Health Care Fraud Investigation Defense

Protecting the Rights of Health Businesses and Medical Professionals in Texas and Across the U.S. How We Can Help

Hendershot Cowart P.C. is a nationally recognized health care law firm with extensive experience protecting the rights and businesses of physicians and other health care providers, suppliers, and facilities.

Regulators, auditors, and others who initiate health care fraud actions are highly sensitive to spotting inconsistencies and unusual patterns, and aggressive in pursuing potential violations. They also work to stay a step ahead: When agencies come knocking on your door, chances are they have already invested significant time investigating your case.

As a firm trusted by clients and colleagues nationwide, we understand the importance of early intervention when it comes to resolving health care actions as quickly as possible, mitigating your exposure to penalties, and preventing audits or civil investigations from being referred for criminal prosecution.

Read Our blog: What Is Involved in a Health Care Fraud Investigation?

Because acting quickly is critical to establishing lines of communication with the investigating body and for devising a comprehensive defense strategy, we encourage you to speak with an attorney as soon as possible after receiving notice of any action, audit, or investigation.

Since 1987, our attorneys have represented thousands of individuals and companies in complex and high-stakes audits, investigations, and other civil and administrative proceedings at both the state and federal level – including those involving:

• STARK Law violations
• OIG investigations and OIG subpoenas
• Anti-Kickback Statute violations
• Telemedicine fraud
• False Claims Act violations
• Medical license defense
• Improper billing practices
• Medicare and Medicaid fraud
• Improper referral arrangements
• CMS exclusions
• Non-compliant billing agreements
• UPIC audits
• Billing for services not rendered
• CPOM violations
• Improper supervision for services rendered
• RAC audits
• Billing for services under improper credentials
• Prescription drug fraud
• Failure to properly document medical necessity
• Compounding pharmacy fraud
• Failure to timely pay an overpayment (60-Day rule)
• TRICARE audits and investigations
• Civil Investigative Demands
• EKRA (Eliminating Kickbacks in Recovery Act)

Who We Represent

Hendershot Cowart P.C. represents all types of individuals, professionals, and entities facing fraud-related health care actions, including:

• Individual physicians and corporate executives
• Ambulatory surgical centers
• Physician practices and medical groups
• Medical device manufacturers
• Hospitals, clinics, and health care systems
• Durable medical equipment (DME) companies
• Long-term care providers
• Diagnostic and testing facilities
• Pharmacies, pharmacists, and technicians
• Management service organizations (MSOs)

Our firm has successfully represented clients against audits, investigations, and enforcement actions involving a range of state and federal agencies and administrative entities, including the

• Department of Health and Human Services (HHS)
• Centers for Medicare and Medicaid Services (CMS)
• Office of Inspector General (OIG)
• Department of State Health Services
• Texas Medical Board (TMB) and Texas Board of Nursing (BON)
• And other contractors, agencies, and administrative licensing boards
• Texas Department of Insurance (TDI)

Responsive Representation in Medicare Fraud Defense

If you are facing any fraud allegation, audit, or investigation related to Medicaid or Medicare, our firm is prepared to immediately represent you. Our goals in these cases include:

1. Keeping cases civil, rather than criminal.
2. Maintaining confidentiality and protecting reputation.
3. Reaching good faith resolutions and negotiating fair outcomes.

Learn More About Our Medicare and Health Care Fraud Services

• Appealing a Medicare Enrollment Denial
• Novitas or Qlarant Audits
• Responding to Civil Investigative Demands (CID)
• OIG Investigations
• Medicare & Medicaid Fraud Investigations
• RAC Audits
• Medicare & Medicaid Recoupment
• TRICARE Fraud
• Medicare Billing Privilege Revocations & Appeals
• UPIC Audits
• Medicare Exclusions

Call to Speak With a Texas Health Care and Medicare Fraud Defense Lawyer Now

Based in Houston, our health care fraud defense attorneys serve clients across Texas and the U.S., and are available to discuss your case immediately.

In addition to defense representation, our firm also provides proactive counsel to help clients in the health care industry assess regulatory compliance, and create comprehensive training and compliance plans.

Proactive Compliance Services

Consequences associated with health care fraud investigations and Medicare enrollment or participation sanctions can be extreme, which is why building a medical business upon a compliant foundation is critical. Limiting risks also requires a front-footed approach, careful planning, and a focus on prevention.

We help safeguard clients from business disputes and ensure regulatory compliance to avoid violations of federal health care laws. Our services are also intended to help clients reduce their exposure to Medicare fraud and other enforcement actions.

• Medical practice set-up
• Licensure and credentialing
• Medical contract drafting
• Billing agreements and practices
• Compliance plans
• Compensation agreements

Let's Get Started

We handle reconsiderations, appeals, and health care fraud defense matters throughout Texas, and are available to discuss how we can immediately begin representing you.

Call or contact us to learn more about our services.