The Health Law Blog

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New Jersey Pharmacy Agrees to Pay $1.9 Millions to Settle Allegations of Medicaid Overbilling

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A pharmacy in New Jersey, Cross Roads Pharmacy, agreed to pay over $1.9 million to resolve allegations of its overbillling the Medicaid Program. According to the Office of the State Comptroller, more than 3,800 claims were submitted by the pharmacy without records to back up the claims. A Three Year Investigation. After a three-year investigation by the office’s Medicaid Fraud Division, it reveal...

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4/28/2016 Comments(0)

HITECH Violations Do Not Support FCA Liability, Affirms Sixth Circuit Court of Appeals

By Miles Indest, J.D./M.B.A candidate at Tulane University, Law Clerk, The Health Law Firm On March 7, 2016, the United States Court of Appeals for the Sixth Circuit confirmed that individual Health Information Technology for Economic and Clinical Health Act HITECH violations do not support allegations under the False Claims Act FCA . U.S. ex rel. Sheldon v. Kettering Health Network, 2016 WL 861399 6th Cir. Mar. 7, 2016 . A qui tam relator claimed that her ex-husband had improperly retrieved ele...

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4/27/2016 Comments(0)

Aetna Wins $37.4 Million Verdict In Case Against Fraudulent Overbillings and Payment of Kickbacks

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 14, 2016, a jury in California awarded Aetna Inc. more than $37.4 million in damages after finding a network of Northern California surgical centers overbilled the insurer for out-of-network procedures. The verdict comes from a complex scheme in which referring physicians received substantial kickbacks for services over a three-year period from 2008 to 2011. Details of the Complex Fraud Scheme...

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4/20/2016 Comments(0)

FDA Issues Warnings About Research Participant Protections and Inadequate Sterilization of Medical Equipment to Mayo Clinic Care Network Hospital

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 12, 2016, the U.S. Food and Drug Administration FDA issued warnings that targeted the allegedly substandard protection of research participants at a hospital in the Mayo Clinic Care Network. It also addressed shortcomings involving the sterilization of medical devices used to harvest fat during plastic surgery. Below are the enforcement actions taken by the FDA. Hospital Allegedly Fell Short o...

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4/19/2016 Comments(0)

State Lawmakers in Missouri Move to Hold Planned Parenthood President in Contempt

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 5, 2016, republican lawmakers in Missouri threatened to hold the president of a St. Louis-area Planned Parenthood affiliate in contempt of court – under threat of jail time – for refusing to submit private medical documents. The contempt charge is related to a November subpoena issued to Mary Kogut, President and Chief Executive Officer CEO of Planned Parenthood of the St. Louis Re...

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4/12/2016 Comments(0)

Federal Regulators Launch New Round of HIPAA Audits

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 21, 2016, the Office for Civil Rights OCR of the U.S. Department of Health and Human Services HHS launched a new round of audits to help ensure compliance with the Health Insurance Portability and Accountability Act HIPAA , especially its Privacy Rule and Security Rule. The new HIPAA Audit Program will review the policies and procedures adopted and employed by covered entities and their busine...

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3/31/2016 Comments(0)

Florida Health Care Providers and Insurers Take Step Forward with Passage of New Telehealth Bill Focusing on Reimbursement

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 11, 2016, the Florida Legislature passed a new bill designed to set the stage for telemedicine commercial insurance coverage. This is a giant step forward as the Florida Legislature has had several unsuccessful attempts in the past. The current bill benefits providers of telehealth services, focusing on commercial insurance coverage and reimbursement. Key Elements in the New Telehealth Bill. T...

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3/30/2016 Comments(0)

WHAT TO DO IF THE DEA OR OTHER LAW ENFORCEMENT ARRIVES WITH A SEARCH WARRANT

By George F. Indest III, J.D., M.P.A., LL.M., President The Health Law Firm First , know the difference between a search warrant and a subpoena or a civil investigative demand, which is similar to a subpoena . For a subpoena , you must be given a reasonable period of time to respond. Take the time, call your attorney and have your attorney respond or assist you in responding. "Right now" is not a reasonable response time for a subpoena. For a search warrant , this is issued by a court and you ar...

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3/23/2016 Comments(0)

U.S. Court in Michigan Denies Motion to Suppress Evidence in Medicare Fraud Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health On February 3, 2016, the U.S. District Court for the Eastern District of Michigan denied a motion to suppress all evidence of health care fraud seized by the government pursuant to a search warrant of Naseem Minhas’s home health care agency. The Federal Bureau of Investigations FBI conducted the search warrant at Minhas’s business, Tricounty Home Care Services, Inc., in December 2013. The Michi...

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3/21/2016 Comments(0)

Florida Couple Accused of Medicaid Fraud For False Mammograms

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 9, 2016, authorities in Florida arrested a Kissimmee couple accused of Medicaid fraud. Oscar Alzate and Alba Garcia, owners of Digital Radiology Center, Inc. and Medisound, Inc., are accused of fraudulently billing Medicaid for more than $180,000 worth of mammography services never rendered. The couple, neither who are physicians, allegedly operated a clinic without the appropriate Agency for ...

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3/18/2016 Comments(0)