The Health Law Blog

Latest Posts

Waiving patient fees, violating antitrust laws, healthcare fraud allegations, anti-competitive efforts, blocking patient referrals, legal representation for health care fraud allegations, Colorado Consumer and Protection Act, Colorado’s Abuse-of-health in

By Carole C. Schriefer, R.N., J.D., The Health Law Firm On July 14, 2016, a Colorado federal judge partly dismissed allegations against several surgical centers in claims filed by insurance companies Aetna and UnitedHealthcare. The judge disagreed that the two surgical centers committed fraud by waiving patient fees or violated antitrust laws by sending hefty bills to the insurers. The dismissals applied to counterclaims filed by Aetna and UnitedHealthcare against four out-of-network surgical ce...

Read More
7/22/2016 Comments(0)

Fourth Circuit U.S. Court of Appeals Dismisses Virginia Whistle Blower Action

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 7, 2016, the U.S. Fourth Circuit Court of Appeals dismissed a lower court judgment and remanded to state court a qui tam action alleging certain medical laboratories defrauded Virginia’s Medicaid program. The whistle blower action was brought under the Virginia Fraud Against Taxpayers Act VFATA . Our firm has experience with this state law, having defended other healthcare providers sued ...

Read More
7/20/2016 Comments(0)

Holding off a Professional License Revocation or Suspension During Appeal

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law If you are a physician, dentist, nurse, psychologist, pharmacist, physician assistant, nurse practitioner, massage therapist or other licensed health professional whose license has been recently revoked or suspended, there may still be hope. As a matter of course, you would be required to immediately stop practicing or risk being prosecuted for unlicensed practice, which is a felony. Although this blog...

Read More
7/16/2016 Comments(0)

X-Ray Company Owner Receives 10 Years in Prison For $8M Medicare and Medicaid Fraud Which Lead to the Death of Two Patients

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 15, 2016, A medical diagnostics company owner found guilty of Medicare and Medicaid fraud for billing $8 million for X-rays whose botched analysis by amateurs led to the death of two patients was sentenced in Maryland federal court to 10 years in prison, the U.S. Department of Justice said. The diagnostics company, Alpha Diagnostics, LLC Alpha , operated in Maryland, Delaware, Pennsylvania, Vir...

Read More
7/15/2016 Comments(0)

Government Agencies To Scrutinize Noncompetition Agreements in Employee Contracts

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Regulatory authorities in the United States are increasingly scrutinizing noncompetition provisions sometimes called restrictive covenants included as part of employment agreements. The main focus is close examination of provisions restricting junior-level and low-wage employees. Noncompetition agreements are becoming more common in other industries and increasingly appear in agreements with lower-leve...

Read More
7/15/2016 Comments(0)

Florida Heart Doctor Reaches Agreement in FCA Suit, Will Pay $2 Million to Settle

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 30, 2016, a Florida heart surgeon agreed to pay $2 million and release any claims to $5.3 million in suspended funds allegedly owed to him because of allegations of improperly billing Medicare, Medicaid and TRICARE. He is doing this to resolve a False Claims Act FCA suit, sometimes called a "whistle blowers" or "qui tam" suit. Dr. Asad Qamar of the Institute of Cardiovascular Excellence Institu...

Read More
7/14/2016 Comments(0)

Nationwide Health Care Fraud Takedown Results in Charges against 301 Medical Professionals for Approximately $900 Million in False Medicare Billings

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 22, 2016, Federal officials completed a three-day nationwide takedown announcing charges against 301 medical professionals who allegedly defrauded Medicare of more than $900 million in fraudulent billings. U.S. Attorney General Loretta Lynch and U.S. Health and Human Services HHS Secretary Sylvia Mathews Burwell said the three-day takedown represents the largest number of arrests, spread over t...

Read More
7/13/2016 Comments(0)

DOJ Claims Systematic Scheme to Defraud for Prime Healthcare Services's Patient Admissions

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 24, 2016, Prime Healthcare Services, Inc. Prime , a California-based company whose mission was stated to be turning around struggling hospitals, is alleged to have run a systematic scheme to defraud the federal government. Prime was allegedly able to defraud the federal government by forcing doctors to provide medically unnecessary services in order to maximize Medicare reimbursements, the U.S....

Read More
7/12/2016 Comments(0)

AMA Approves New Telemedicine Guidance for Ethical Practice of Health Care Professionals

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 13, 2016, the American Medical Association AMA implemented new guidance for the ethical practice of telemedicine. These new guidelines are aimed to help physicians understand how their fundamental responsibilities may play out differently when patient interactions occur through telemedicine, compared to traditional patient interactions at a medical office or hospital. New Ethical Guidelines for...

Read More
7/11/2016 Comments(0)

The Effect of OIG Exclusion On Health Care Professionals: The Effects of Exclusion: Payment Prohibition & Civil Monetary Penalties Part 2 of 2

By Michelle Bedoya, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This is part two of two in a blog series in which the effects and scope of OIG exclusion on health care professionals will be discussed. Click here to read part one of this blog series. Pursuant to Sections 1128 and 1156 of the Social Security Act, the U.S. Department of Health and Human Services Office of Inspector General "OIG" has the authority to exclude individuals and e...

Read More
7/6/2016 Comments(0)