The Health Law Blog

Concierge Medical Services Bring Cash With Few Hassles to Physicians

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law What is concierge medical services? A concierge medical service or practice is a similar to having a primary care provider such as a family practice physician. However, concierge practices are marked by a promise, explicit or implied, that they provide appointments quickly and give a greater degree of personal attention to patients and their problems. The physician works directly with a f...

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9/21/2017 Comments(0)

Embezzling Administrator of Pediatric Clinic Faces Health Care Fraud Sentencing

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An administrator of a Louisiana pediatric clinic has recently pleaded guilty in a health care fraud case. She faces up to 10 years in prison and over $200,000 in fines. The charges allege embezzling more than $500,000 of the clinic's money and diverting it to her personal account, from approximately August through September of 2014.  She allegedly used this massive amount of money to pur...

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9/18/2017 Comments(0)

Recommendations For Physicians Who Receive Notice of Investigation From the ABIM

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In 2010, the American Board of Internal Medicine (ABIM) sanctioned 139 physicians for seeking out and sharing board examination questions with a testing preparation company. For the physicians involved in that cheating scandal, disciplinary action taken by the ABIM included revocation of board certification or suspension of certification for one to five years, depending on the severity of the...

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9/7/2017 Comments(0)

Florida Department of Health and Law Enforcement Investigate School Providing Nurse Practitioner Courses

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A subpoena purportedly issued by the Clerk of Court for Seminole County, Florida, recently requested academic records on advanced registered nurse practitioner (ARNP) students, including preceptorship agreements for clinical courses they had taken. A follow-up inquiry revealed that the Florida Department of Health was behind the subpoena, seeking evidence concerning possible fraudulent practi...

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9/6/2017 Comments(0)

First Medical Marijuana Dispensary in Hawaii Gets Green Light From DOH

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 8, 2017, after waiting 17 years, Hawaii will begin dispensary sales of medical marijuana to patients. Maui Grown Therapies got the green light from the Hawaii Department of Health (DOH) to begin selling medical cannabis.  I know (from reliable sources, that is) that Hawaiian grown marijuana has always been a favorite with the connoisseur. Maui Grown Therapies. The Maui d...

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8/31/2017 Comments(0)

OIG Report Reveals VHA Improperly Billed For Service Conditions

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 9, 2017, the U.S. Department of Veterans Affairs (VA) Office of Inspector General (OIG) reported that the Veterans Health Administration (VHA) improperly issued close to 1.7 million bills to veterans and third-party payers. Of the estimated 15.4 million bills issued by the VHA’s Consolidated Patient Account Centers in  2015, an estimated 1.66 million were improper bills for t...

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8/23/2017 Comments(0)

CONTRACTS: Breach-of-Contract Claims in Medical Malpractice Cases Require Breach of Additional Promise

Our guest author of this is article is Emily Abel , a legal research attorney with National Legal Research Group in Charlottesville, Virginia. This article was originally published in The Lawletter Vol 42 No 6 . On March 17, 2017, in Heneberry v. Pharoan , 232 Md. App. 468, 158 A.3d 1087 (2017), the Maryland Court of Special Appeals addressed the issue of what is required to prevail on a breach-of-contract claim in a medical malpractice action. The plaintiff, Valerie Henebe...

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8/15/2017 Comments(0)

CMS Approves Five Year Extension of Florida Medicaid Managed Care Demonstration

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 3, 2017, the Centers for Medicare & Medicaid Services (CMS) approved a five-year extension of Florida’s Managed Medical Assistance (MMA) section 1115 demonstration. It allows the state to operate a capitated Medicaid managed care program and a low-income pool (LIP) to provide continuing support for the safety net providers that furnish charity care to the uninsured. CM...

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8/14/2017 Comments(0)

The 20 Major Mistakes Physicians Make After Being Notified of a Department of Health Investigation

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The investigation of a complaint which could lead to the revocation of a physician's license to practice, usually starts with a simple letter from the Department of Health (DOH). This is a very serious legal matter and it should be treated as such by the physician who receives it. Yet, in many cases, attorneys are consulted by physicians after the entire investigation is over and the damage ...

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8/10/2017 Comments(0)

Inmates Family Sues Jail After Improper Care

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Orange Country Jail Sued. A wrongful death suit has been filed against Orange County Jail due to what some are saying was a preventable death.  The suit was filed directly against Robert Buck, the head of the jails health services department, along with four nurses that cared for the late inmate. Dog Bites Leads to Death In Jail. In 2015, Max Gracia was arrested. During h...

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8/9/2017 Comments(0)

Florida Government Officer Charged in Billion Dollar Medicare Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Health Care Administrator Accepts Bribes. An alleged $1 billion health care scheme has lead to the first known prosecution against a Florida Agency for Health Care Administration official.  Bertha Blanco faces a wide range of charges including accepting bribes to tip off individuals when state wide investigations were to begin. The Ring Alleged Ring Leader. It is reported tha...

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8/8/2017 Comments(0)

Avoid Being Labeled as a "Disruptive Physician" at All Costs

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Although "old news" at this point, on July 9, 2008, the Joint Commission (TJC) published the following alert to health care organizations: Sentinel Event Alert;  Issue 40, July 9, 2008 Behaviors That Undermine a Culture of Safety Intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and to preventable adverse outcomes, increase t...

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8/2/2017 Comments(0)

What You Need to Know About Preparing and Responding to an Initial Medicaid Audit Request

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Health care providers in Florida who service Medicaid patients are at a higher risk for audits than anywhere else in the country.  The unfortunate truth is that Florida has become synonymous with health care fraud.  As a result, auditing and subsequent overpayment demands are very real possibilities. The Health Law Firm and its legal professionals represent health care providers...

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7/24/2017 Comments(0)

Responding to a Medicaid Audit: Important Tips You Should Know

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), Bureau of Medicaid Program Integrity, is the Florida agency responsible for routine audits of Medicaid health care providers. Each state has a similar state agency, though it may have a different name.  The agency’s job is to ensure that the Medicaid Program was properly billed for services. Health...

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7/14/2017 Comments(0)

Florida-Based Compounding Pharmacy Violated False Claims Act by Overcharging Tricare, Feds Claim

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 3, 2017, a compounding pharmacy based in Tampa, Florida, charged Tricare at least 2,000 percent more for drugs than it charged cash payers, according to the government. The government claimed that the Florida pharmacy acted in violation of the False Claims Act (FCA), as it intervened in a whistleblower’s suit. The government claimed that RS Compounding LLC and its owner, Reni...

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7/14/2017 Comments(0)

Florida Woman Who Performed Illegal Silicone Injections Sentenced After "Patient's" Death

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 26, 2017, a Sanford, Florida, woman who performed illegal cosmetic silicone injections was sentenced to 11 years in federal prison. According to prosecutors, the illegal procedures done by Deanna Roberts, led to serious health problems and the death of a prominent night club performer. Illegal Injections. From reports, Deanna Roberts bought about 178 gallons of non-medical gra...

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7/10/2017 Comments(0)

Health Care Fraud Puts Miami Man in Jail

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law 4.5 Year Sentence for Role in Fraud. A Miami Man voluntarily returned to Miami from Cuba and was immediately met with a 4.5-year long prison sentence.  Jose Gerardo Gonzalez, played a role in a scheme to defraud public schools and private health care insurers of $126 million. Gonzalez allegedly created shell companies that submitted false health care claims. The private insurer...

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7/10/2017 Comments(0)

Florida Substance Abuse Center Owner Gets 27 Years for Multi-Million Dollar Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 17, 2017, a Florida man who pled guilty to running a health care fraud scheme out of substance abuse treatment facilities he owned was sentenced to 27 years in prison. U.S. District Judge Donald M. Middlebrooks, handed down the sentence to Kenneth Chatman who pled guilty in March 2017 to conspiracy to commit health care fraud, conspiracy to commit money laundering and one count of sex...

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6/26/2017 Comments(0)

Think Three Times Before Signing an Exclusion Agreement with the OIG; the Consequences Are Career Killing

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are often consulted by licensed health professionals, doctors, dentists, nurses, physical therapists, pharmacists, chiropractors and others, after they have signed an Exclusion Agreement with the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS).  Such Exclusion Agreements are in the nature of a settlement agreement or plea bargain agreemen...

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6/23/2017 Comments(0)

Jury Awards $4.4 Million To Chicago Anesthesiologist Defrauded By Business Associate

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 9, 2017, a jury in Illinois awarded a Chicago-area anesthesiologist nearly $4.4 million. The jury unanimously agreed that his business associate defrauded him on a revenue sharing agreement and fraudulently reported his earnings to the Internal Revenue Service (IRS). The jury found that Dr. Martin R. Hall, owner of Keystone Orthopedic Specialists SC (Keystone), stuck Dr. Nicholas ...

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6/19/2017 Comments(0)

Florida Gov. Rick Scott Makes Changes to Florida Impaired Practitioners Program

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 31, 2017, Florida Governor, Rick Scott, signed into law House Bill 229 ( Ch. 2017-41, Laws of Florida ), which made changes to the statutory basis for Florida's impaired practitioner programs.  The impaired practitioner program for nurses in Florida is the Intervention Project for Nurses (IPN), which is a for-profit corporation,  The impaired practitioner program for doctor...

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6/19/2017 Comments(0)

Jury Convicts Doctor and Medical Billing Company Owner for $28 Million Medicare Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 1, 2017, a federal jury in Michigan found a Detroit-area doctor and owner of a medical billing company guilty of perpetrating a $28 million health care fraud scheme. The scheme  involved billing Medicare for pain treatments that weren’t actually provided, the U.S. Department of Justice (DOJ) said. Health Care Fraud Scheme. Dr. Johnny Trotter and Elaine Lovett were b...

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6/13/2017 Comments(0)

What is the corporate practice of optometry and what does it prohibit?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The legal doctrine called the "corporate practice of medicine or optometry" actually refers to the legal prohibition that prevents a doctor or an optometrist from working for a corporation (or other business entity) that is owned, operated or controlled by non-physicians or, in the case of optometrists, non-optometrists. In the context of such laws, the term "non-physician" or "non-optome...

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6/10/2017 Comments(0)

Florida Department of Health Urges Caution to Avoid Reported Medical Marijuana Scams

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 20, 2017, the Orange County Medical Society (OCMS) Board of Directors was alerted to a scam involving medical marijuana.  The scammers attempt to steal credit card information from patients.  Patients are requested to provide their credit card numbers in exchange for a bogus offer of free or reduced-cost medical marijuana. The DOH reports all incidents of potential frau...

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6/8/2017 Comments(0)

Rutgers University Faces Lawsuit Over Anesthesia Residency Program Head's Alleged Sexual Harassment

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 8, 2017, Rutgers University was hit with a lawsuit in New Jersey state court from former and current school employees. The suit alleges that the university failed to prevent, stop and remedy sexual harassment and retaliation by the director of its anesthesia residency program. Additionally, the suit also alleges that Rutgers “fostered a harassing and discriminatory atmosphere....

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5/31/2017 Comments(0)

Accused of Irregular Behavior on the USMLE? Here’s What You Need to Know

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law At The Health Law Firm, we frequently receive calls for consultations from medical students and medical school graduates who receive a letter from the National Board of Medical Examiners (NBME), concerning the United States Medical Licensing Examination (USMLE). The letter may accuse the student or medical resident of "Irregular Behavior" concerning one or more of the USMLE Step examinations....

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5/29/2017 Comments(0)

Florida's Baker Act: What You Need to Know - Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Our firm is frequently retained to act to obtain the release of individuals erroneously confined and held involuntarily under the Baker Act.  We hope to share some of the lessons we have learned in representing such individuals and obtaining their release. This is Part 2 of our blog on Florida's Baker Act.  To read Part 1 of this blog, click here . Selected Examples of Some...

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5/25/2017 Comments(0)

Medical Students, Interns & Residents Beware: A Finding of “Irregular Behavior” Can Ruin Your Medical Career Before it Starts

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A medical student, intern or resident may receive a letter from the National Board of Medical Examiners (NBME), United States Medical Licensee Examination (USMLE) Secretariat advising them that they are suspected of "irregular behavior" on a Step examination.  In the case of graduates of foreign medical schools, this will be a letter from the Educational Commission for Foreign Medical Gr...

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5/24/2017 Comments(0)

If You Are a Health Professional Facing Legal Challenges, Choose a Board Certified Attorney

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Doctors, nurses, dentists, pharmacists, health professionals, and health facilities often face legal challenges from many different sources. These challenges can come from federal and state regulators, medical malpractice trial lawyers, hospitals, clinics and colleagues. If you find yourself faced with a legal problem, the first person you should contact is an attorney who is Board Certified b...

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5/23/2017 Comments(0)

Florida’s Baker Act: What You Need to Know - Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law At The Health Law Firm, we are frequently consulted by family members of individuals who are erroneously held under Florida's Baker Act. An erroneous confinement under the Baker Act can occur for a number of different reasons.  However, the result is that an independent citizen is confined in violation of his/her constitutional rights to liberty, privacy and the pursuit of happiness. ...

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5/18/2017 Comments(0)

20 Tips Plus a Bonus for Physicians Negotiating Their Own Employment Contracts

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law At The Health Law Firm, we often receive calls from physicians and health professionals about reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, voiding contracts, getting out of contracts and litigating various contract provisions. Physicians and other health professionals should understand the common language and terms found in emplo...

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5/16/2017 Comments(0)

Jury Finds Four New Orleans Doctors and Others Guilty for Participation in $13.6 Million Medicare Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 9, 2017, a federal jury found four New Orleans doctors and two others guilty for their  participation in a Medicare fraud scheme. According to prosecutors the defendants netted more than $13.6 million in fraudulent Medicare reimbursements. Details of the Scheme. The six defendants worked for or with Abide Home Care Services (Abide) in New Orleans.  Federal prosecut...

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5/12/2017 Comments(0)

Judge Refuses to Dismiss Whistleblower's False Research Data Suit Against Duke University and Two Faculty Members

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 27, 2017, a federal judge in North Carolina refused to dismiss a False Claims Act (FCA) lawsuit against Duke University and some of its faculty. The suit alleges that Duke knowingly falsified medical research data in order to get federal grants. According to the judge, the whistleblower in the suit had adequately stated his case against the defendants. The case was originally filed...

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5/11/2017 Comments(0)

Florida Doctors and Pharmacists Beware: Gov. Scott Declares State of Emergency for Opioid Abuse Crisis

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 3, 2017, Florida Gov. Rick Scott declared a state of emergency to combat Florida's opioid-addiction epidemic. According to the governor, the number of overdose deaths has reached epidemic proportions. This declaration will allow nearly $30 million in federal funding to be spent for treatment and prevention services. Given past state actions taken to attempt to eliminate prescription...

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5/4/2017 Comments(0)

Accused Dental Supply Manufacturers Argue Antitrust Suit Belongs In Arbitration

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 21, 2017, accused dental suppliers in an antitrust suit told the U.S. Fifth Circuit Court of Appeals that a Texas federal judge was wrong to override an arbitration agreement. The antitrust suit involves a dental supply manufacturer as a plaintiff.  It accused six others of unfairly pushing it out of the market. U.S. District Judge Rodney Gilstrap overturned a magistrate's decis...

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4/28/2017 Comments(0)

Did I Miss Something, or Is the Nation's Highest Doctor Now a Nurse? Trump Fires Vivek H. Murthy, M.D., as Surgeon General; Replaces with Sylvia Trent-Adams, R.N.

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law President Trump fired Vivek H. Murthy, M.D., as the U.S. Surgeon General on April 21, 2017, and replaced the nation's top doctor with a nurse.  Dr. Murthy was replaced with Sylvia Trent-Adams, a nurse who is a career Public Health Service officer. For more details on the education and credentials of each, see:  https://en.wikipedia.org/wiki/Vivek_Murthy   and   http...

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4/25/2017 Comments(2)

Medical Students, Residents and Fellows Need to Properly Disclose Medical Disabilities in advance of problems

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are often retained to provide legal representation to medical school students, residents and fellows who run into difficulties and have disputes with their medical schools or programs.  This may be after they are required to repeat a year, terminated from the program, or have other adverse action taken against them.  When this occurs and we investigate the details, occasionally w...

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4/24/2017 Comments(0)

Licensed Health Professionals Should Have No Trouble Locating an Attorney/Legal Counsel Who Takes CPH & Associates (CPH&A) Insurance To Represent Them in Licensing Actions and Hearings

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We often hear from licensed health professionals who call and retain us to represent them in complaints against their professional licenses in investigations and formal licensure complaints.  Often these professionals retain us after adverse disciplinary action has already been taken.  In many cases they had good insurance coverage with CPH & Associates (CPH&A) Insurance, or...

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4/17/2017 Comments(0)

Houston Heart Surgeon Wins $6.4 Million Defamation Case Regarding Peer Review

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 29, 2017, a Houston heart surgeon was awarded $6.4 million in damages after a jury found that Memorial Hermann Health System (Memorial) defamed his reputation. The suit arose out of a peer review proceeding against Dr. Miguel Gomez.  He claimed that the peer review was not about the quality of health care, but was to retaliate against him for moving his lucrative practice to a c...

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4/13/2017 Comments(0)

Orlando To Be Site for Opening of First Florida Medical Marijuana Dispensary

By Shannon McDonough, Legal and Marketing Intern Central Florida Making Strides Toward Medical Marijuana Acceptance. Central Florida has jumped on the bandwagon with the acceptance of the alternative medicine, medical marijuana. The first medical marijuana dispensary in Florida is opening within the next few weeks in Orlando. It will offer patients the option of medical marijuana to help treat pain and other symptoms. The dispensary, being opened by Knox Medical, is to be located ...

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4/10/2017 Comments(0)

3 Sentenced in Florida for $175 Million Drug Compounding Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 24, 2017, three participants were sentenced in Florida federal court, for a scheme that used call centers and kickbacks to generate fake prescriptions for compounding pharmacies. The scheme was able to scam the government and private insurers for $175 million. U.S. District Judge Daniel T.K. Hurley, sentenced one of the defendants, Todd Stephens, to ten years.  He sentenced T...

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4/10/2017 Comments(0)

Home Health Provider Sues Medicare Contractor and HHS Over Unfair Audit and Denied Medicare Reimbursement Payments

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 2, 2017, an Illinois home health care provider launched a class action law suit against Medicare reimbursement auditor AdvanceMed and the U.S. Department of Health and Human Services (HHS) Secretary Tom Price. MedPro Health Providers LLC (MedPro) filed the complaint in an effort to collect $300,000 it says it is owed in Medicare payments.  The complaint was filed in the U.S. Dis...

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4/7/2017 Comments(0)

Virginia Medical Board Wins Appeal Concerning Doctor’s Revoked Medical License

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 21, 2017, a Virginia appellate court ruled that a doctor's state medical license was properly revoked for various reasons including allowing medical students to perform unauthorized medical procedures. The appellate court said the doctor's due process rights weren't violated because he had three months to prepare for an administrative hearing before the Virginia Board of Medicine. ...

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4/3/2017 Comments(0)

Former Pharmaceutical Sales Rep to Serve 70 Months in Prison for Part in $13M Oxycodone Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 24, 2017, a federal judge in the U.S. Southern District of Florida in Miami sentenced a former pharmaceutical salesman to nearly six years in prison for his part in a $13 million money laundering scheme. The scheme involved more than two million oxycodone pills, which the salesperson allegedly helped supply to pain clinics by falsely telling pharmaceutical wholesalers that the clinic...

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3/28/2017 Comments(0)

It is Always a Bad Idea for a Doctor, Nurse or Health Professional to . . . .

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law My experience in representing doctors, nurses and other licensed health professionals in disciplinary cases has lead me to conclude, us to conclude, its is always a bad idea for them to: 1.    Write a prescription for any medication for yourself. 2.    Start a romantic relationship with a patient. 3.    Take someone else's prescripti...

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3/27/2017 Comments(0)

Florida Federal Judge Triples Award to $347 Million in Rare Whistleblower Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 1, 2017, a Florida federal judge tripled a $115 million damages award for the government to $347 million after a jury found that the operators of 53 nursing facilities submitted false claims to Medicare and Medicaid. U.S. District Judge, Steven D. Merryday, upheld the jury’s $115 award affirming that the operators of the 53 nursing facilities had violated the False Claims Act ...

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3/24/2017 Comments(0)

Florida Supreme Court Upholds Amendment 7, Right of Patients to Documents on Adverse Events

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Supreme Court in Charles v. Southern Baptist Hospital, on January 31, 2017, issued a decision dealing with the relationship of Florida’s Constitution Amendment 7, allowing patient access to documents on adverse medical incidents, and the Federal Patient Safety Quality Improvement Act (PSQIA). The Florida Supreme Court disagreed with the lower court's interpretation of the PS...

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3/23/2017 Comments(0)

Finding an Attorney/Lawyer Who Takes Healthcare Providers Service Organization (HPSO) Insurance

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We often hear from callers and clients in professional licensing complaints, Department of Health investigations and Board of Medicine cases, that they had good insurance coverage with Healthcare Providers Service Organization (HPSO) Insurance, but could not find an attorney that would accept it.  Often these professionals retain us after action has been taken to appeal or attempt to r...

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3/22/2017 Comments(0)

Louisiana Based Health Care Company To Pay Nearly $7 Million for Medicaid Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 20, 2016, the owner of Millennium Health Care Services (Millennium) must pay the state nearly $7 million in restitution and will spend 10 years behind bars for his role in a scheme to defraud the Medicaid system, according to Louisiana Attorney General Jeff Landry. Millennium’s owner, Dwaine Woods, was ordered to pay $6,985,249 in restitution after his wife and the compan...

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3/13/2017 Comments(0)

Florida Proposed Amendment: Telemedicine Exams Not Allowed for Medical Marijuana Doctor Order

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 8, 2016, The Florida Board of Medicine issued a proposed amendment to its telemedicine regulations to clarify that physicians cannot order medical cannabis or low-THC cannabis through telemedicine.  The regulation is in the preliminary stages and awaits further review It’s been proposed that Florida residents seeking medical marijuana prescriptions will need to have an...

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3/9/2017 Comments(0)

Texas Appeals Court Affirms$1.37 Million in Sanctions Against Doctor who Sued Hospital Former Employers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 16, 2016, an appeals court in Texas affirmed a $1.37 million sanction against a doctor. The physician was ordered to pay the fine after the dismissal of a defamation lawsuit he filed against his former employers. The decision affirmed that the actions of his former employers, Baylor College of Medicine (Baylor) and Texas Children's Hospital, did not cause the litigation fees which...

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3/7/2017 Comments(0)

CMS Issues Final Rule to Revise Home Health Conditions of Participation

By Michelle Bedoya, J.D., The Health Law Firm On January 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that revises the conditions of participation (CoPs) that home health agencies (HHAs) must meet to participate in the Medicare and Medicaid. The requirements focus on the care delivered to patients by HHAs, reflect an interdisciplinary view of patient care, allow HHAs greater flexibility in meeting quality care standards and eliminate unnecessary pro...

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3/6/2017 Comments(0)

Court Rules That Florida Doctors Can Talk to Patients About Guns

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 16, 2017, a federal appeals court ruled that a controversial Florida law that restricted doctors from asking patients about firearm ownership violates medical professionals' constitutional right to free speech. The opinion, striking down key provisions of the Florida law, was the latest ruling in a legal challenge to the so-called "Docs vs. Glocks" law. The law quickly became a he...

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3/1/2017 Comments(0)

U.S. District Court in Texas Orders Hospital to Void Report to National Practitioner Data Bank

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 8, 2017, the U.S. District Court for the Eastern District of Texas, issued a Memorandum Opinion and Order directing Memorial Health System of East Texas (Memorial Health) to submit a Void Report to the National Practitioner Data Bank (NPDB). In the case Walker v. Memorial Health System, the court found the initial report, submitted after 30 days of an uncompleted proctoring requi...

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2/28/2017 Comments(0)

The City of Fort Myers, Florida Agrees to Pay $149,000 to Settle Dispute With Mental Health Facility

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 3, 2017, the city of Fort Myers, Florida, agreed to pay $149,000 to settle a discrimination-related real estate zoning and licensing dispute with Sovereign Health of Florida Inc., a rehabilitative mental health and addiction treatment provider. Sovereign Health, which opened January 2015, filed a federal lawsuit alleging that the city of Fort Myers violated discrimination and d...

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2/9/2017 Comments(0)

Florida High Court Drops Hospital Negligence Lawsuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Supreme Court made the decision on November 30, 2016, to dismiss a negligence suit filed against a hospital over the death of a patient Ashley Lawson.  Lawson escaped from Shands Teaching Hospital and Clinic, Inc.  The Shands psychiatric hospital was renamed and is now known as the UF Health Shands Psychiatric Hospital and is located in Gainesville, Florida. The main legal iss...

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1/24/2017 Comments(0)

Florida High Court Drops Hospital Negligence Lawsuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Supreme Court made the decision on November 30, 2016, to dismiss a negligence suit filed against a hospital over the death of a patient Ashley Lawson.  Lawson escaped from Shands Teaching Hospital and Clinic, Inc.  The Shands psychiatric hospital was renamed and is now known as the UF Health Shands Psychiatric Hospital and is located in Gainesville, Florida. The main legal iss...

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1/24/2017 Comments(0)

Orlando City Council Vote to Extend Temporary Ban on Medical Marijuana Dispensaries

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 14, 2016, Orlando's City Council voted to extend its temporary ban on new marijuana dispensaries, less than a week after Florida voters backed a constitutional amendment to expand medical use of the drug. Back in July 2016, city commissioners voted to approve the temporary pause on marijuana dispensaries.  The current ban is set to expire December 2016, but the city is pursuin...

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1/14/2017 Comments(0)

Wisconsin Supermarket Violated FCA With Illegal Kickbacks, Pharmacist Claims

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 20, 2016, a pharmacist and whistle blower told an Illinois federal court that Wisconsin and Chicago-area chain of grocery stores, Roundy’s Supermarket, Inc. (Roundy’s),  knew gift cards it was providing Medicare and Medicaid beneficiaries were actually illegal kickbacks. In defense of his False Claims Act (FCA) Suit, the whistle blower claims the chain proceeded t...

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1/11/2017 Comments(0)

Arizona Appeals Court Affirms Dentist's Suspension Over Questionable Prescriptions

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 13, 2016, an Arizona appeals court affirmed the suspension of a dentist who allegedly had a history of opioid addiction and who also allegedly wrote dozens of questionable prescriptions. The Arizona appeals court held that the state dental board didn't violate his due process rights and had substantial evidence backing its decision that it wasn't safe for him to practice. The A...

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1/10/2017 Comments(0)

Safeway Pharmacy Settles Medical Negligence and Wrongful Death Suit Over Woman's Death

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 5, 2016, a Nebraska magistrate judge signed off on an agreement resolving a widower’s wrongful death suit. The medical negligence suit contends that Safeway pharmacists negligently dispensed methadone and another medication to the plaintiff’s now-dead wife even though using the drugs together is risky, ultimately leading to her death. Medical Negligence. U.S. ...

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1/9/2017 Comments(0)

Appeals Court Affirms $1.37 Million in Sanctions Against Doctor for Dismissed Defamation Suit Against Former Employers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 16, 2016, an appeals court in Texas affirmed a $1.37 million sanction assessed against a doctor.  The doctor was ordered to pay the sanction after the dismissal of a defamation lawsuit he filed against his former employers. The doctor's former employers were Baylor College of Medicine (Baylor) and Texas Children's Hospital. The case had previously been appealed to the Texas ...

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1/5/2017 Comments(0)

Whistleblowing Doctor Agrees To Split Fees In $785M Pfizer FCA Deal

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 29, 2016, Dr. William LaCorte, M.D., a whistleblowing physician in Metairie, Louisiana, helped win a $785 million False Claims Act settlement with Pfizer, Inc., one of the World's largest pharmaceutical companies.  Dr. LaCorte agreed with his former lawyers on a split of attorney's fees, which resolves one of the several disputes about paying multiple attorneys. An Agreement Was ...

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12/29/2016 Comments(0)

Florida Court Denies Motion to End Patient Wrongful Death Suit Despite Settlement

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 15, 2016, The Florida Supreme Court refused to dismiss a lawsuit over the death of an escaped psychiatric hospital patient for the second time. The suit questions the thin line between medical and ordinary negligence, even though the parties settled their dispute several months ago. The justices offered no explanation when they denied a motion from defendant-appellee Shands Te...

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12/29/2016 Comments(0)

U.S. Enforcing Law For Equal Insurance Coverage For Mental and Physical Illnesses

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 27, 2016, President Obama made one more major health care initiative as his presidency comes to an end. The administration is stepping up enforcement of laws that require equal insurance coverage for mental and physical illnesses. Officials are hoping this decision will help combat an opioid overdose epidemic. Drug Addiction Equal to Mental Illness. The White House Mental ...

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12/28/2016 Comments(0)

21 Charged In Extensive Bribery Scheme At Dallas' Forest Park Medical Center

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 1, 2016, founders and investors of a physician-owned health care facility in Dallas, Texas, known as the Forest Park Medical Center, were charged in a bribery and kickback scheme. The range of felony offenses stem from their payment or receipt of roughly $40 million in bribes and kickbacks for referring patients to Forest Park Medical Center (FPMC), according to a federal indictment in T...

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12/28/2016 Comments(0)

DOJ Releases 2016 False Claims Act Recovery Statistics: Third Highest Annual Recovery Ever

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 14, 2016, the U. S. Department of Justice (DOJ) released its annual False Claims Act (FCA) recovery statistics. It revealed that the DOJ obtained more than $4.7 billion in settlements and judgments from civil cases involving fraud and false claims against the government in fiscal year 2016.  What this indicates to me is that, if all of these cases had been brought by individua...

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12/28/2016 Comments(0)

New York Optometrist Malpractice Suit for Patient's Brain Tumor Dismissed

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 23, 2016, a New York appeals court freed a Madison Avenue Eye Care Ltd.  optometrist Paul Kantrowich from a malpractice suit.  It was alleged in the suit that Kantrowich negligently failed to diagnose a patient's partial blindness caused by a brain tumor.  The brain tumor was found and diagnosed by a different doctor.  The patient, Neil Flaherty, filed the suit too la...

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12/27/2016 Comments(0)

Doctor Indicted In Home Health Medicaid Fraud Suit Hit With 3-Year Prison Sentence

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 7, 2016, Banio Koroma was convicted in a northern Illinois court of falsely certifying elderly patients for in-home care will spend the next three years in prison and be forced to reimburse the government for the $1.5 million in losses he caused, an Illinois federal judge ruled. Paying For His Crimes. In June 2016, Banio Koroma, 67, appeared in court in an orange jumpsuit...

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12/24/2016 Comments(0)

Florida Orthopedic Center Pays Out Millions To End FCA Claims

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 7, 2016, Southeast Orthopedic Specialists (SOS), located in Jacksonville, Florida, agreed to pay $4,488 million to settle allegations that it violated the False Claims Act (FCA) by allegedly billing federal health care programs for millions of dollars in unnecessary services. Protection of Federal Health Care Programs. An announcement was made by U.S. Attorney A. Lee Bentley III of ...

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12/23/2016 Comments(0)

Are Caribbean Medical Schools Under Investigation for USMLE Irregularities?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Based on recent potential client consultations we are asking whether the National Board of Medical Examiners (NBME), perhaps acting through the Educational Commission for Foreign Medical Graduates (ECFMG), is investigating Caribbean medical schools such as Atlantic University School of Medicine, St. Lucia (AUSOM);  Aureus University School of Medicine, Aruba (AUSM); American University o...

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12/22/2016 Comments(0)

South Florida Hospital Agrees To Pay $12 Million To Settle FCA Claims

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 7, 2016, a Miami-area hospital will pay the federal government about $12 million to resolve allegations that it violated the False Claims Act (FCA) by submitting false claims to federal health care programs for medically unnecessary cardiac procedures, the U.S. Department of Justice (DOJ) said. The Allegations. The allegations against South Miami Hospital stem from proce...

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12/22/2016 Comments(0)

Medicare Administrative Contractor and Other Contractors Continue to Penalize Medicare Providers Who Do Not Have Correct, Current Address Information on File; This Is One Thing You Absolutely Want to Check up On!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We continue to receive calls from physicians and other Medicare providers who have had their Medicare billing privileges revoked or terminated because their address information is not up to date or is incomplete.  You must include a physical address at which your business operates so that if the Medicare Administrative Contractor (MAC), the Zone Program Integrity Contractor (ZPIC), or the Recov...

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12/21/2016 Comments(0)

Forest Labs Agree to Pay $38 Million Settlement to End Whistle Blower’s FCA Suit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 15, 2016, Forest Laboratories agreed to pay $38 million to resolve a whistle blower’s False Claims Act (FCA) suit involving allegations that it paid kickbacks to doctors who prescribed three of the company’s drugs, the U.S. Department of Justice (DOJ) announced. The lawsuit contends that Pharmaceuticals Inc. (Forest), targeted physicians who had a high prescription ...

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12/21/2016 Comments(0)

East Texas Lab Agrees to Pay $3.75 Million to Settle False Claims Suit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 14, 2016, owners of an East Texas clinical laboratory who overcharged Medicare for falsified driving mileage bills have agreed to pay the U.S. government $3.75 million to settle a whistle blower's False Claims Act (FCA) lawsuit. The suit was brought by a former employee, the U.S. attorney’s office announced. Submitting False Claims. Texas-based Elite Lab Services LL...

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12/20/2016 Comments(0)

MetroHealth Medical Center's Former COO Charged In Dental Intricate Program Bribery Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 25, 2016, previous MetroHealth Medical Center Chief Operating Officer (COO) and Dental Director Edward Hills was charged for running a complex bribery and kickback scheme selling positions in the medical center's residency program. MetroHealth Medical Center is located in Cleveland, Ohio and is an integrated health system that sees around one million patients a year.According to ...

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12/19/2016 Comments(0)

New Report Reveals Massive $2.4 Billion Marijuana Impact on Colorado Economy

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 27, 2016, the Marijuana Policy Project issued a report for 2015 stating that the state-legal medical marijuana industry had a $2.4 billion economic impact on the Colorado economy.  The cannabis industry, the fastest-growing business sector in Colorado, is credited with funding 18,005 direct and ancillary full-time jobs in 2015, according to the report. The Marijuana Policy Gro...

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12/16/2016 Comments(0)

News For Nursing Homes: Federal Government’s Attempt to Ban Nursing Home Arbitration Blocked

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 7, 2016, a Mississippi federal judge temporarily blocked enforcement of the federal government’s proposed ban on mandatory arbitration in cases involving nursing homes. The order from U.S. District Judge Michael P. Mills granted a preliminary injunction sought by the American Health Care Association (AHCA) and prevents the ban from taking effect on Nov. 28. The proposed ...

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12/12/2016 Comments(0)

Guilty Pharmacist Admitted To $2.4 Million Prescription Fraud Scheme, Including Using Foreign Drugs

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Walter Beich, an Illinois pharmacist, pled guilty on November 17, 2016 to defrauding Medicare, Medicaid and several private insurers out of $2.4 million by submitting false reimbursement requests for prescriptions he had filled with counterfeit drugs or did not fill at all. Beich faces up to 12 years in prison. Beich is the owner of Corwin Pharmacy in Lockport, Illinois.  On Thursday, Nov...

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12/12/2016 Comments(0)

New Jersey Woman Pleas Guilty to $1 Million DNA Testing Medicare Fraud Scheme.

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 1, 2016, Sheila Kahl pled guilty in a New Jersey federal court that she took part in a $1 million Medicare fraud scheme.  Kahl admitted to two conspiracy charges deriving from a scheme involving a nonprofit organization that appeared to help seniors navigate through federal benefit programs. In reality, the organization served as a front to subject elderly victims into taking unnece...

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12/6/2016 Comments(0)

Legal Access to Marijuana Expands: California Legalizes Recreational Pot & Florida Legalizes Medical Marijuana

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law After looking at the red and blue map of America from the recent presidential election, it may be time to add some green. On November 9, 2016, the movement to legalize marijuana, which has been in the public eye for some time now, took a giant step forward. Voters in California voted to legalize the recreational use of marijuana. Voters in Florida, the third most populous state, overwhelming...

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12/5/2016 Comments(0)

Types of Cases a General Health Law Firm Works On

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are often asked by doctors and lawyers alike what types of cases our firm takes.  They often mistake the practice of health law as medical malpractice defense.  However, this is an incorrect assumption.  Asa general health law practice, we concentrate on legal issues and clients involved in the health care industry.  To a certain extent the firm does practically everyth...

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11/29/2016 Comments(0)

What is a Compromised Physician or Health Care Provider?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Do you know what a "compromised physician" or "compromised health provider" is?  It may not be what you think it is. This is a rarely seen term used to refer to physicians, health professionals and health facilities whose identities and billing numbers have been stolen and have been or are being used by crooks to falsely bill Medicare, Medicaid, Tricare and health insurance programs f...

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11/21/2016 Comments(0)

Don't Detract From Your Professional Reputations. Always Ensure Your Correspondence Looks Professional: 30 Tips (Part 3 of 3)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This is Part 3 of a 3 part series on this issue.  To see my past blogs on this topic click here for Part 1 and click here for Part 2. I continue with my tips for preparing good, professional correspondence. 19. In longer correspondence, use section headings (in bold or underlined) or headings for each issue, to better organize it. Think of these as road signs on a long road.  They...

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11/21/2016 Comments(0)

What To Do When Notified Of A ZPIC or Medicare Audit and Site Visit: Checklist

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law   When a physician, medical group or other healthcare provider receives a notice of an audit and site visit from Medicare, the Medicare Administrative Carrier (MAC) or the Zone Program Integrity Contractor (ZPIC), things happen fast with little opportunity to prepare.  Hopefully this checklist will help you to prepare for the on-site visit that will shortly follow. Many items on th...

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11/18/2016 Comments(0)

Don't Detract From Your Professional Reputations. Always Ensure Your Correspondence Looks Professional: 30 Tips (Part 2 of 3)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This is Part 2 of a 3 part series on this issue.  To see my past blogs on this topic click here for Part 1. I continue with my tips for preparing good, professional correspondence: 5. Use titles or honorifics .  In the "business address" of your correspondence, always use the complete name of the person to whom you are writing (if known) together with that person's honorific or profe...

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11/17/2016 Comments(0)

Cuban Lung Cancer Vaccine To Be Followed Up In Clinical Trials In The U.S.

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A lung cancer vaccine that was developed in Havana, Cuba, will be the first such clinical trial to be approved by The Food and Drug Administration (FDA) for testing in the United States.  The approval was announced October 26, 2016, by New York Governor Andrew Cuomo with other officials at the Roswell Park Cancer Institute in Buffalo.  The trial could start as soon as November 2016 an...

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11/16/2016 Comments(0)

Prime Healthcare In the Spotlight Again: Hit With Age Discrimination Suit From New Jersey Nurses

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 10, 2016, California-based hospital chain Prime Healthcare Services Inc. (Prime) was slapped with a discrimination lawsuit in New Jersey state court. Three nurses formerlt employed by the company are alleging that they were discriminated against and fired at a New Jersey hospital earlier this year because of their ages. Alleged Termination Based on Age. The three plainti...

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11/14/2016 Comments(0)

Don't Detract From Your Professional Reputations. Always Ensure Your Correspondence Looks Professional: 30 Tips (Part 1 of 3)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I review many letters, e-mails, memoranda, and other types of correspondence prepared by my physician and nurse clients during the course of my legal representation of them.  Often this is the result of a dispute with a hospital, a dispute with their peers or the medical staff, a dispute with an insurance company, a law suit filed by a patient, a complaint being investigated by the licensing ag...

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11/14/2016 Comments(0)

What is a Compromised Physician or Health Care Provider?

 By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Do you know what a "compromised physician" or "compromised health provider" is?  It may not be what you think it is. This is a rarely seen term used to refer to physicians, health professionals and health facilities whose identities and billing numbers have been stolen and have been or are being used by crooks to falsely bill Medicare, Medicaid, Tricare and health insurance programs for ...

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11/9/2016 Comments(0)

Ex-Warner Chilcott Manager Sentenced to Probation and $10,000 Fine for Health Care Fraud & HIPAA Violations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 4, 2016, a federal judge sentenced Landon Eckles, a former manager at Warner Chilcott, to one year of probation and a $10,000 fine after he pled guilty to wrongful disclosure of protected health information (PHI).  According to U.S. Attorney for the District of Massachusetts Carmen M. Oritiz, his sentence could have been much worse as he pled guilty to a criminal violation o...

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11/7/2016 Comments(0)

Will Normalization of Business Relations with Cuba Benefit U.S. Patients with Lower Drug Prices?

  By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 14, 2016, the Obama administration announced its decision to lift a long-standing ban on importing Cuban pharmaceuticals into the U.S.  If the policy change is approved by the Food and Drug Administration (FDA), this could bring Cuba's cheaper, creditable medicines to the United States.  This presents an interesting side effect for the normalization of business relationshi...

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11/1/2016 Comments(0)

Nursing Home Chain Reaches Record High False Claims Act Settlement With DOJ

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 24, 2016, the U.S. Department of Justice (DOJ) announced that Life Care Centers of America will be paying $145 million to end False Claims Act (FCA) litigation that alleged the company submitted false claims to Medicare for rehabilitation therapy services that were not necessary.  This settlement is a FCA record for the nursing industry and DOJ claims it is the largest in the ...

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10/31/2016 Comments(0)

Florida Federal Judge Grants Government's Request to Refile $320 Million FCA Suit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 21, 2016, a Florida federal judge clarified that the dismissal of a whistleblower’s $320 million False Claims Act (FCA) (or qui tam) suit against a hospice care provider does not affect the government’s ability to file its own lawsuit.  The case was filed in the U.S. District Court for the Middle District of Florida. U.S. District Judge James S. Moody, Jr., had d...

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10/27/2016 Comments(0)

Florida Compounding Pharmacy Owner Agrees to Pay $4 Million To Settle TRICARE False Claims Allegations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law   On October 21, 2016, the part owner of a Florida compounding pharmacy reportedly agreed to pay $4.25 million to settle claims that he knowingly billed federal health care programs for services that were not eligible for reimbursement. The settlement of alleged False Claims Act (FCA) violations with the part owner of Maitland-based QMedRx, follows a similar deal authorities reached with...

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10/26/2016 Comments(0)

Medical Group Sued by EEOC for ADA Violations for Terminating Doctor on Pain Medications

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In July 2013, Dr. Alunda Hunt M.D., was employed by the Georgia Hospitalists Group to treat acutely ill patients at the Spaulding Regional Medical Center.  Exactly one month after hire, Hunt provided a doctor's note explaining that he had a chronic medical condition and was being treated with back injections and a combination of prescribed narcotics.  Shortly after Hunt presented th...

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10/25/2016 Comments(0)

Baker Act: Get Back To The Basics

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are continuously consulted by family members of individuals who are mistakenly confined under The Florida Baker Act or who believe their family member is being held without a valid reason. The Baker Act, also known as the Florida Mental Health Act, was passed in order to establish programs that are designed to "reduce the occurrence, severity, duration, and disabling aspects of mental, emo...

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10/20/2016 Comments(0)

Study Finds States That Allow Medical Marijuana May Have Less Opioid Use

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 15, 2016, a new study was released from Columbia University Mailman School of Public Health, that suggests people in states that allow medical marijuana may be using fewer opioid painkillers. Researchers analyzed crash data in 18 states from 1999 to 2013 and revealed that states that allow medical marijuana use saw a reduction in opioid involvement in fatal car accidents. T...

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10/18/2016 Comments(0)

Feds Reach Deal With Florida Compounding Pharmacy Owners, Agree to Pay Almost $7.8 Million to Settle FCA Suit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 14, 2016, co-owners of a Maitland, Florida, compounding pharmacy agreed to pay $7.75 million to the federal government to resolve False Claims Act (FCA) allegations. QMedRx reached the settlement in connection with alleged fraudulent billing practices for services that weren’t eligible for reimbursement through federal health care programs, prosecutors said. The U.S. att...

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10/12/2016 Comments(0)

Decision Paves the Way for Graduate Student Unionization

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 24, 2016, the National Labor Relation's Board (NLRB) ruled that graduate students who teach at private universities are employees with full rights to join unions. In a sweeping decision for Columbia University graduate students, the labor board's decision paves the way for student unionization on campuses nationwide. The same rule may very well apply to medical residents and fellow...

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10/11/2016 Comments(0)

Community Health Exploring Options Including the Possible Sale of Its Business

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 16, 2016, Community Health System Inc. (CHS), one of the largest U.S. hospital chains, announced that it is exploring the possibility of a deal to sell the company. The struggling Tennessee-based company announced "very preliminary" discussions with advisers to consider all of its options. A Tough Sell. Since its acquisition of 71 hospitals from Florida-based Health Mana...

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9/26/2016 Comments(0)

HHS Announces Hefty Increase in Civil Monetary Penalties

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 16, 2016, the U.S. Health and Human Services (HHS) announced new updates that would require health care organizations to pay heftier penalties if they violate federal regulations. HHS is seeking maximum penalties and adjustments reflects multiple years of inflation. HHS is required to publish “catch-up adjustments” under Section 4(b) of the Federal Civil Penalties...

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9/23/2016 Comments(0)

CMS's Pre-Claim Review Project for Home Health Agencies Delayed Indefinitely For Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Centers for Medicare & Medicaid Services (CMS) is implementing a three-year Medicare Pre-Claim Review Demonstration for Home Health Services in the states of Illinois, Florida, and Texas Michigan and Massachusetts. The CMS Pre-Claim Review Demonstration officially began in Illinois on August 3, 2016, however, early information received from Illinois, has caused a change of plans. C...

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9/22/2016 Comments(0)

Judge Rules Against Wal-Mart For a New Trial in $16 Million Gender Bias Suit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 16, 2016, a New Hampshire federal judge ruled against Wal-Mart’s request for a new trial after a fired store pharmacist won about $16.2 million in a gender discrimination case. The judge did however, request clarification from a state court on the company's request to limit enhanced compensatory damages to $15 million and reduce the front-pay award. The Gender Bias La...

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9/21/2016 Comments(0)

New Florida Rules Shorten Required Hours For Community Pharmacies and Change Start of Business Requirements

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Board of Pharmacy (BOP) amended its rules regarding community pharmacies following a request for relief by industry health care professionals. The amended rules include shortening community pharmacy hours of operation from 40 to 20 hours per week, pharmacy delays to open business after the receipt of a permit and changes regarding ownership. Rules promulgated by The Florida BOP are pu...

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9/20/2016 Comments(0)

Big Surprise! California Doctors And Hospitals Can’t Agree Over Role Of Nurse-Midwives

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 8, 2016, a California bill was announced that would allow certified nurse-midwives (CNMs) to practice in hospitals independently. It is apparently upsetting many of teh state's physicians.  The California Hospital Association and the California Medical Association (which represents doctors), agree that nurse-midwives have the training and qualifications to practice without phy...

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9/20/2016 Comments(0)

Dentists File Class Action Lawsuit Against 3M over Faulty Dental Crown Materials

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In April and May 2016, dentists from Florida, Georgia and Texas filed a class action lawsuits.  Six suits have been filed in federal court in Minnesota against the Minneapolis-based 3M Co. (http://www.3m.com/).  These have been consolidated by the federal court.  Each of the complaints in these six cases alleges that 3M's Lava Ultimate restorative material used to make dental ...

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9/19/2016 Comments(0)

Former Connecticut Dentist Ordered To Pay $700k For Medicaid Billing Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 11, 2016, a former dentist in Connecticut and his practice were ordered to pay more than $700,000 in restitution and civil penalties for improperly billing the state Medicaid program for pediatric dental cleanings and fluoride treatments. Connecticut Attorney General George Jepsen says a Superior Court judge ruled that Dr. Douglas Macko and his practice violated the Connecticut U...

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9/19/2016 Comments(0)

DOJ and FTC Ask Fifth Circuit To Dismiss Antitrust Appeal

By Miles O. Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm On September 14, 2016, the Department of Justice (DOJ) and Federal Trade Commission (FTC) filed a joint amicus brief before the United States Court of Appeals for the Fifth Circuit, arguing that the court lacks jurisdiction to hear a medical board’s appeal of an antitrust case.  The central issue of the Fifth Circuit’s jurisdiction is whether it can hear an immediate appeal of a lower court’s refusal...

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9/19/2016 Comments(0)

It is Always a Bad Idea For a Doctor To...

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In my 30 plus years of practice representing physicians, dentists, nurses and psychotherapists, I have defended clients involved in many different situations. Several of these seem to be problem  areas which we see repeatedly. Following is a list of those problems which it would seem to be common sense for a physician or other health care professional to avoid doing. If you do any of the...

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9/16/2016 Comments(0)

DOJ and OIG Use Complex Data Analysis To Find Medicare Fraudsters

By Miles O. Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm Since the 1990s, the credit-card industry has successfully used predictive analytics to find suspicious patterns and protect consumers from fraudulent charges. The health care industry has found a similar success in recent years, as federal agents use data mining, predictive analytics, and other modeling approaches to catch Medicare fraud. Medicare Strike Force Enhanced to Reduce Billion-Dollar Losses. In 2015, th...

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9/12/2016 Comments(0)

Does This Drug Make People Irresponsible Zombies?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The smoking-cessation drug Chantix has come into the spotlight and allegedly played a crucial role in a second violent crime. On August 8, 2016, a Maryland man was reported to have been found not criminally responsible for shooting his wife in their home in 2014 because he was found to be suffering from “involuntary intoxication” due to the drug Chantix. His wife survived. In 2...

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9/8/2016 Comments(0)

Early Bird Whistleblowers May Block Third Whistleblower From $18M FCA Deal

By Miles O. Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm On August 16, 2016, two whistleblowers asked a Colorado federal court to disqualify a third whistleblower from sharing in a $18 million False Claims Act settlement award with OptumHealth. Evercare LLC (now known as OptumHealth) had allegedly submitted false Medicare claims for hospice care on behalf of patients who were not in fact terminally ill. Whistleblowers Use “First-To-File” Rule To Disqualify Later...

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9/2/2016 Comments(0)

Ninth Circuit Upholds Whistleblower Complaint Against Health Insurance Giants

By Miles O. Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm In a David and Goliath legal battle, a whistleblower recently won a small victory against several large insurance companies accused of defrauding the Medicare Advantage Program. Ignorance Was Bliss: Medicare Payments for Over-Coded Diagnoses.   On August 10, 2016, the United States Court of Appeals for the Ninth Circuit unanimously ordered United Healthcare, WellPoint, Aetna, and other health insurance prov...

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9/1/2016 Comments(0)

Texas Jury Finds Doctor Responsible for Harassment of Nurse Despite Settlement Being Reached

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 9, 2016, a licensed vocational nurse in Texas who alleged she was bullied and sexually harassed by a doctor at work was vindicated when a $440,000 settlement was reached between the parties.  Patricia Hahn alleged the harassment she received from Dr. Scott Davidson started soon after beginning work at North DFW Urology Associates (North DFW) in 2007. The Alleged Harassment. Hah...

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9/1/2016 Comments(0)

SEC Fines Health Net $340,000 for Anti-Whistleblower Agreements

By Miles Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm On August 16, 2016, Health Net Inc. agreed to pay a $340,000 penalty to the United States Securities and Exchange Commission (SEC) for allegedly using severance agreements to restrict the rights of whistleblowers. The health insurance company paid the penalty without admitting or denying the SEC’s allegations. The Dodd-Frank Whistleblower Program. After the 2008 financial crisis, the U.S. Congress passed the Do...

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8/31/2016 Comments(0)

Maryland’s Approval of Thirty Medical Marijuana Businesses Shadows Florida’s Efforts

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Three years ago, Maryland regulators first legalized marijuana for medical use. Maryland has recently nurtured its commitment to the medical cannabis movement, awarding thirty businesses with licenses to grow and process medical marijuana. Maryland Regulators Balance Economic Growth with Consumer Safety. Twenty-five states and the District of Columbia have legalized the medical use o...

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8/30/2016 Comments(0)

Florida Organization Maintains False Claims Suit Against Anesthesiology Companies and Others

By Miles O. Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm The Florida Society of Anesthesiologists (FSA) is unwavering as a qui tam relator, maintaining that more than 50 physicians, anesthesiology companies, and ambulatory surgical centers (ASCs) engaged in illegal kickback schemes. The suit involves claims under the False Claims Act, the Anti-Kickback Statute, and the Florida Medicaid False Claims Act. Companies Abused Their Power and Patients, FSA Alleges. On August 2...

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8/29/2016 Comments(0)

CMS Asks Federal Officials to Enforce Penalties on Nursing Home Employees Using Social Media to Violate the Privacy of Nursing Home Residents

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 8, 2016, federal health regulators announced plans to crack down on nursing home employees who take "demeaning" photographs and videos of residents and post them on social media. Patient advocates want the federal agency to more explicitly outline the penalties for the growing number of nursing home employees who are abusing patients in this extremely public way. "Patient Abus...

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8/24/2016 Comments(0)

Appeals Court Rules Against Nursing Home: Bankruptcy Cannot Affect Prevent Cancellation of Medicare or Medicaid Contacts

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 11, 2016, a federal appeals court stated that a bankruptcy judge did not have the authority to block government health officials from cutting off Medicare and Medicaid payments to a Florida nursing home that was alleged to have violated patient-care regulations. A three-judge panel of the 11th U.S. Circuit Court of Appeals sided with the U.S. Department of Health and Human Services (H...

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8/22/2016 Comments(0)

Spoiled Eggs: Eighth Circuit Imposes Prison Time on Negligent Executives

By Miles Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm On July 6, 2016, the United States Court of Appeals for the Eighth Circuit upheld prison sentences for two executives who had pled guilty to misdemeanor violations of the Food, Drug and Cosmetic Act (FDCA). United States v. Decoster, No. 15-1890 (8th Cir. July 6, 2016). The decision raises issues concerning the “responsible corporate official” (RCO) doctrine and the imposition of criminal penalties for negligence ...

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8/18/2016 Comments(0)

Rising Executive Compensation May Impact Long Term Sustainability of Health Care Organizations

By Miles Indest, J.D./M.B.A; Law Clerk, The Health Law Firm Health care executive compensation has increased over the past few years, raising several questions regarding its potential effect on the long term sustainability of these organizations. Modern Healthcare Releases Annual Executive Compensation Survey. This month, Modern Healthcare released its 36th annual Executive Compensation Survey, highlighting that the median increase in cash compensation for health care executive...

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8/17/2016 Comments(0)

Medical Director's Failure to Perform Duties Makes Florida Health Care Clinic Liable; All Insurance Charges Voided

By Michael L. Smith, J.D., R.R.T., Board Certified by The Florida Bar in Health Law     A recent  U.S. Eleventh Circuit Court of Appeals decision, upheld a federal district courts decision which found a Florida Health Care Clinic liable for fraud and other torts. Because of violations of Florida's Health Care Clinics Leave Act, section 400.990, Florida Statutes, it also declared all claims submitted to the insurer for payments were voided.      ...

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8/16/2016 Comments(0)

Columbia University Agrees to Pay $9.5 Million For Improper Billing in Connection With Medical Research Grants from NIH

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 14, 2016, Columbia University agreed to pay $9.5 million to the U.S. government in order to resolve a False Claims Act (FCA) suit. The suit alleges that the prominent New York university sought and received excessive cost repayments in connection with federal research grants, the Assistant U.S. Attorney who is prosecuting the case stated.  It is being brought in the Southern Dist...

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8/12/2016 Comments(0)

Florida Harvests It’s First Legal Medical Marijuana Crop

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 18, 2016, Florida harvested it’s first legal marijuana crop.  The new crop is being stored in multiple vacuum-packed, 441-gram bags in a freezer on the outskirts of Tallahassee. The harvest is the result of months of careful growing, monitoring, coaxing, and finally cultivating, scores of plants in a hidden farm overseen by horticulturalists and protected by armed guards.&...

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8/12/2016 Comments(0)

Gunman Accused of Killing Two at Titusville Hospital Was Waiting For Mental Health Evaluation

Gunman Accused of Killing Two at Titusville Hospital Was Waiting For Mental Health Evaluation By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The gunman accused of shooting and killing two women at a Titusville hospital on July 17, 2016, was awaiting a court-ordered mental evaluation, according to authorities. The gunman, David Owens, had a long history of mental health problems and it is believed that he sought help over eight times. T...

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8/11/2016 Comments(0)

Pennsylvania Hospital Agrees to Pay $325,000 to Settle Medicare Overbilling Allegations: Inpatient Codes Used for Outpatient Procedures

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 8, 2016, a Pennsylvania hospital accused of overbilling Medicare agreed to settle civil claims with the federal government for $325,000, the U.S. Attorney’s office in Philadelphia announced.  The case arose out of allegations that the hospital used inpatient diagnosis codes for routine outpatient procedures. Northampton Hospital Co. LLC (Northampton), which operates E...

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8/11/2016 Comments(0)

EPA Reveals That Copper Can Be Used to Combat Hospital Germs

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Copper producers have taken advantage of a new premise that the base metal is actually good for your health. Copper is used in a wide variety of tasks from construction to electrical wiring, but now it has also been found to have antimicrobial properties that kill 99.9% of germs. According to the Environmental Protection Agency (EPA), copper can kill bacteria on its surface within two hours. ...

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8/10/2016 Comments(0)

Illinois Hospital Chain Pays Record $5.5 Million HIPAA Settlement For Privacy Breaches

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 4, 2016, one of Illinois' largest hospital chains agreed to pay $5.5 million in settlement for lax data security and breaches of protected health information for millions of patients. This deal is a record payout under the Health Insurance Portability and Accountability Act (HIPAA), federal regulators said. Advocate Health Care Network (Advocate), which operates 12 hospitals and...

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8/9/2016 Comments(0)

Too Old For Sex: Are Nursing Home Residents Able to Consent to Sex?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Sexual relationships in long-term care facilities or nursing homes are not uncommon these days. But the long-term care industry is still grappling with the issue and the question of whether some residents are able to give consent. In some cases, these aging lovers have raised logistical and legal issues for their families, caretakers and the institutions where they live.  Complicating t...

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8/3/2016 Comments(0)

HHS Announces Proposal To Extend Discrimination Protections In Research Grants

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 14, 2016, the U.S. Department of Health and Human Services (HHS) floated a proposal  that would make several changes to its cost principles and administrative and audit requirements for grants, including a clarification for awards to Native American tribes and a broad bar on discrimination. The notice of proposed rule-making, which is published in the Federal Register, inclu...

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8/1/2016 Comments(0)

Florida Faces Yet Another Challenge for Medical Marijuana Licenses

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Despite a previous law change allowing more Florida growers to try and obtain medical marijuana licenses, the state faced another challenge on July 6, 2016.  A Florida nursery and families of those promised medical marijuana for chronic illnesses filed an administrative challenge. The state of Florida originally licensed five growers, but the entire process has been tangled in a web of l...

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8/1/2016 Comments(0)

Colorado Judge Reduces Fraud Conspiracy Claims Against Aetna, UnitedHealthcare

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-netw...

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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 healthca...

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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 ...

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7/16/2016 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 wit...

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7/15/2016 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, Pennsy...

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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 ...

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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 arre...

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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 reimbu...

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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. ...

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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...

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7/6/2016 Comments(0)

The Effect of OIG Exclusion On Health Care Professionals: Part 1 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 one of two in a blog series in which the effects and scope of OIG exclusion on health care professionals will be discussed.  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 entities from federally fun...

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6/29/2016 Comments(0)

Referral Sources Protected by Restrictive Covenants in Florida? Recent Case Decides

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Physician employees and other health care professionals who sign employment contracts are often confronted with restrictive covenants or covenants-not-to-compete.  Many states prohibit such clauses in contracts;  however, Florida has a law that specifically permits them.  In the case of physicians, given that patients may have a legal right to choose their own doctors, enforc...

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6/21/2016 Comments(0)

Court Rejects Arguments That Both Parents Need to Give Consent For Surgery

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 22, 2016, an appeals court in Florida ruled that only one parent is needed to consent to a child’s surgery. The ruling, by a three-judge panel of the Florida First District Court of Appeal, upheld an Escambia County circuit judge's decision in a case in which the parents had separated and only the mother gave consent for a 3-year-old child to have ear-tube surgery. What H...

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6/14/2016 Comments(0)

FDA Announces New Draft Guidance on Use of Electronic Health Record Data in Clinical Investigations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 17, 2016, the United States Food and Drug Administration (FDA) published a draft guidance titled “Use of Electronic Health Record Data in Clinical Investigations” (Draft Guidance) which emphasizes interoperability and outlines other best practices for effectively using EHR data in FDA-regulated studies. The Draft Guidance is intended to assist sponsors, clinical investiga...

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6/13/2016 Comments(0)

OIG Announces Projected Recoveries of More Than $2.77 Billion in First Half of Fiscal Year 2016 Alone

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has reported that it expects recoveries of more than $2.77 billion—nearly $554.7 million in audit receivables and about $2.22 billion in investigative receivables—from October 1, 2015 to March 31, 2016, the agency said in its Semiannual Report to Congress. Click here to view the report. This ...

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6/8/2016 Comments(0)

House Passes $81.6 Billion Veterans Affairs Bill: Includes Allowing Medical Marijuana

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 19, 2016, a new bill was passed that would allow U.S. Department of Veterans Affairs (VA) doctors to prescribe medical marijuana to patients.  As part of the $81.6 billion budget and policy bill for military construction and the department of Veterans Affairs, this new measure would allow VA doctors to prescribe medical marijuana to their patients in states where medical marijuana is c...

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6/2/2016 Comments(0)

Letter From Industry Group Claims OIG’s Audits Billing Contain Legal Defects

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 24, 2016, the American Hospital Association (AHA) released a letter claiming that Audits of hospital billing by the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) contain numerous legal defects. According to AHA, the defects result in wildly excessive repayment demands. Hospital Compliance Reviews. The letter from AHA relates to hospital com...

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6/1/2016 Comments(0)

Former Arizona Medicaid Official Sentenced to 10 Years for Medicaid Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 9, 2016,Michael John Veit, 64, the former chief procurement officer for Arizona's state Medicaid program, was sentenced to 10 years in prison for his role in the fraud scheme that resulted in the theft of 5.9 million dollars. The Original Fraud and Theft Charges. A briefcase containing old checks written from the agency to the vendor nearing 1.5 million dollars was discovered in August ...

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5/31/2016 Comments(0)

Stoel Rives Law Firm Allegedly Assisted Tri-Med’s $17M Ponzi Scheme

By Miles Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm On May 6, 2016, investors filed a securities class action lawsuit against law firm Stoel Rives, Charles Corces, CPA, and affiliated individuals for allegedly helping Tri-Med Corp operate a Ponzi scheme. According to the complaint, which was filed in a Florida federal court, the defendants helped Tri-Med raise over $17 million, most of which funded personal expenses and outside ventures of the company’s principal insiders. ...

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5/24/2016 Comments(0)

Walgreens Announces Expansion of Mental Health Services to Raise Awareness

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 10, 2016, Walgreens announced it will expand its mental health services, including access to behavioral health treatment via telemedicine, expand customer options for treatment, screenings and awareness. To improve overall mental health care for patients, Walgreens will offer access to 1,000 therapists and psychiatrists via Breakthrough, an MDLive telemedicine company. Walgreens recently bega...

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5/18/2016 Comments(0)

Quality of Care: New Study Finds That Medical Errors Are Third Leading Cause of Death in U.S.

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A new study by patient safety researchers revealed that common medical errors are now the third leading cause of death in the U.S., after heart disease and cancer.  Their analysis, published in the British Medical Journal (BMJ) on May 3, 2016, contends that “medical errors” in hospitals and other health care facilities are incredibly common and may now be the third-leading cau...

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5/12/2016 Comments(0)

New OIG Guidance Publishes on Permissive Exclusions from Federal Health Care Program Participation

By Miles Indest, J.D./M.B.A candidate at Tulane University: Law Clerk, The Health Law Firm On April 20, 2016, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released updated non-binding criteria that disclosed when a company or individual can be barred from participating in Medicare, Medicaid, and other federal health care programs. The OIG has permissive authority to exclude a person or company from participation in federal health care programs for ...

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5/9/2016 Comments(0)

Miami Doctor Gets Slapped With Nine Years in Prison for Complex $30 Million Medicare Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 18, 2016, Dr. Henry Lora, a doctor in Miami was sentenced to nine years in federal prison for his role in a scheme to defraud the Medicare system out of around $30 million in phony reimbursements. Dr. Lora is the latest of five individuals sentenced in the South Florida fraud ring, according to the Department of Justice. Dr. Lora was also ordered to pay $30.3 million in restitutio...

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5/1/2016 Comments(0)

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 ...

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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 improp...

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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 Compl...

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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...

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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 ...

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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 enti...

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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 Te...

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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 , thi...

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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. ...

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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 A...

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3/18/2016 Comments(0)

THE 33 BIGGEST MISTAKES FOR A NURSE TO AVOID AFTER BEING NOTIFIED OF A COMPLAINT AGAINST THE NURSE'S LICENSE PART 3 OF 3

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This is the final part in a three part blog series focusing on how the investigation of a complaint against your nursing license could lead to the revocation of the license, and the assessment of tens of thousands of dollars in fines, as well as a number of adverse collateral consequences.  Yet it usually starts usually with a simple letter from the state regulatory authority, in Flori...

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3/15/2016 Comments(1)

Cybersecurity Vulnerability in Healthcare Organizations: Consequences and Collaborative Solutions

By Miles Indest, J.D./M.B.A candidate at Tulane University A recent cyber-attack on a prominent hospital has drawn significant attention to cybersecurity vulnerability within the healthcare industry. Last month, Hollywood Presbyterian Medical Center was forced to pay hackers $17,000 in bitcoin in order to unlock its computer systems that were controlled by “ransomware.” Healthcare organizations with lax cybersecurity protocols have more to fear than disgruntled patients or p...

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3/14/2016 Comments(0)

Ex-Chesapeake Energy CEO Dies in Car Accident Shortly After DOJ Indictment

By Miles Indest, J.D./M.B.A candidate On March 2, 2016, Ex-Chesapeake Energy CEO Aubrey McClendon was killed in a car wreck—one day after he was indicted by the United States Department of Justice (DOJ) for allegations regarding antitrust and conspiracy violations. Police are still investigating how the crash occurred, and many are saddened to hear of the death of “one of the greatest oil and gas wildcatters of his generation,” stated Forbes. The DOJ indictment alleged that ...

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3/11/2016 Comments(0)

Wal-Mart Urges Federal Judge to Overturn Verdict in $31 Million Discrimination Lawsuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 2, 2016, Wal-Mart asked a New Hampshire federal judge to overturn a jury’s verdict against the company in a discrimination case, as well as a $31 million award. Maureen McPadden, a pharmacist formerly employed by Wal-Mart, accused the retail giant of gender bias and wrongful termination after she complained that her medical information had been disclosed by one of her colleague...

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3/11/2016 Comments(0)

Former Executive of Assisted Living Provider Challenges $4.2 Million SEC-Enforced Penalty for Falsifying Occupancy Data.

By Miles Indest, J.D./M.B.A candidate, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A former executive of a private equity-backed assisted living provider is aggressively protesting a $4.2 million penalty over an alleged healthcare-related fraud scheme, challenging the penalty in both administrative proceedings and the United States Supreme Court. Falsifying Occupancy Data Results in $4.2 Million SEC-Enforced Penalty. On Decem...

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3/10/2016 Comments(0)

RESTRICTIVE COVENANTS IN EMPLOYMENT CONTRACTS FOR RECRUITED PHYSICIANS

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law   Early versions of the Stark Regulations, Federal Regulations adopted by the U.S. Department of Health and Human Services (HHS) to implement the Stark Act, prohibited the inclusion of restrictive covenants (sometimes called noncompetition agreements, covenants not to compete or noncompetes), in physician employment agreements, when hospitals subsidized the hiring of a relocated ...

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3/10/2016 Comments(0)

Florida-Based Health Plan Suspended for “Serious Threat” to the Health and Safety of Medicare Beneficiaries

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 1, 2016, the Centers for Medicare and Medicaid Services (CMS) suspended a Florida insurer, Ultimate Health Plans Inc.(UHP), for posing a “serious threat” to Medicare beneficiaries. The sanction comes as a result of deficiencies including problems with compliance and coverage determinations involving Medicare Parts C and D. The insurer will no longer be able to enroll Medic...

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3/9/2016 Comments(0)

Application Deadline for Medicare EHR Incentive Hardship Exception Extended

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 26, 2016, The Centers for Medicare & Medicaid Services (CMS) extended the deadline for eligible hospitals/professionals and critical access hospitals to apply for a hardship exception from the 2015 Medicare Electronic Health Records Incentive Program. The previous deadline was March 15, 2016, but now has been extended to July 1, 2016. “CMS is extending the deadline so pro...

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3/8/2016 Comments(0)

Growing Publicity of Research Fraud and Misconduct Impacts the Innocent Majority of Scientific Researchers.

By Miles O. Indest, J.D./M.B.A candidate at Tulane University.   Medical and clinical researchers face increased attacks on their reputation and research validity, a trend brought about by a few “bad apples” within their own industry. Most researchers, whether in an academic community or in a practice setting, spend years on clinical trials and investigations in hopes of contributing to their respective fields. Unfortunately, a growing number of cases involv...

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3/7/2016 Comments(0)

Latest Cyber-Security Attack on Hospital Brings More Attention to the Threat of Health Care Hackers (Part 2 of 3)

By George F. Indest IV, Director of System Services, The Health Law Firm, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law (Part two of a three-part blog) You would think that health care professionals, who are saving lives every day at busy hospitals, wouldn’t have to worry about cyber-attacks or protecting network computers. However, recent events have put this security threat at the top of the list. Recent cyber-attacks such a...

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3/4/2016 Comments(0)

Department of Justice’s Focus On “Individual Accountability” Hits Healthcare Industry

By Miles Indest, J.D./M.B.A candidate, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 9, 2015, the Department of Justice (DOJ) Deputy Attorney General Sally Yates issued a memorandum emphasizing increased attention to individual criminal accountability for corporate wrongdoing. The Yates memo outlined six measures to strengthen the DOJ’s pursuit of individuals engaged in fraud, two of the most important being: (1)...

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3/4/2016 Comments(0)

THE 33 BIGGEST MISTAKES FOR A NURSE TO AVOID AFTER BEING NOTIFIED OF A COMPLAINT AGAINST THE NURSE'S LICENSE PART 2 OF 3

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This is part two in a three part blog series focusing on how the investigation of a complaint against your nursing license could lead to the revocation of the license, and the assessment of tens of thousands of dollars in fines, as well as a number of adverse collateral consequences.  Yet it usually starts usually with a simple letter from the state regulatory authority, in Florida, the Dep...

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3/3/2016 Comments(0)

Owner of X-Ray Company Facing Life in Prison for Health Care Fraud: Two Patient Deaths Involved

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The owner of a diagnostic imaging company in Maryland is facing life in prison after a federal jury found him guilty on February 17, 2016, of health care fraud. Rafael Chikvashvili, was found guilty of billing Medicare and Medicaid for more than $7.5 million for X-rays that were not analyzed by licensed physicians, which led to the death of two patients. Chikavashvili, who is a mathematician a...

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3/2/2016 Comments(0)

Federal Court to Decide APA's Claim of Copyright Infringement for Its Testing Standards: Are They Public Domain?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 18, 2016, six law professors urged a D.C. federal court to rule against the American Psychological Association Inc.(APA), and their motion for a summary judgment and permanent injunction over a copyright infringement. The APA and the other plaintiffs claim that the website Public.Resource.org (Public Resource), infringed a copyright for their “Standards for Educational and Ps...

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2/26/2016 Comments(0)

Florida Teenager Accused of Posing as a Doctor For the Second Time

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 16, 2016, a Florida teen was arrested and accused of posing as a doctor for the second time in less than a year. Malachi Love-Robinson, 18, was arrested for practicing medicine without a license and allegedly even running his own health facility called New Birth, New Life Alternative Medicine and Urgent Care Clinic in South Florida. Is it just me or does Florida really have so ...

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2/26/2016 Comments(0)

South Florida Set to Become Major Hub for Health Care as Medical Education Expands

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health   South Florida medical education has recently seen a boom by rapidly expanding and upgrading medical schools in the region. On February 4, 2016, the University of Miami (UM) announced that it has received a $50 million donation for a new state-of-the-art building to house its medical education program. Along with UM, Nova Southeastern University (NSU), Florida Atlantic University (FAU), and Fl...

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2/24/2016 Comments(0)

Pharmacists: Beware of the Adverse Effects of Discipline on Your License or Resignation of a License: Steps You Should Take to Protect Yourself

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Though pharmacists pursue a career hoping that they will never face disciplinary charges, any number of events can lead to an investigation or administrative action. Have you been notified that an investigation has been opened against you? Are you thinking about resigning your pharmacist license or voluntarily relinquishing your license? If So, You Should Be Aware of the Following. I...

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2/23/2016 Comments(0)

Qui Tam Cases: Tips for Whistleblowers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law At The Health Law Firm, we have represented many clients involved in qui tam cases brought because of false claims under the Medicare False Claims Act. If you are thinking about blowing the whistle on some sort of fraud or unlawful conduct by your current or former employer, there are important things that you should know. Filing a qui tam case can be very complicated.  It is importan...

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2/22/2016 Comments(0)

AHA Medicare Backlog Lawsuit Back on Track as D.C. Circuit Reverses Dismissal

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 9, 2016, the D.C. Circuit ordered the U.S. District Court for the District of Columbia to reconsider a lawsuit seeking to compel the Department of Health and Human Services (HHS) to meet statutory deadlines for reviewing Medicare claims denials. This order overturns the district court’s December 2014 decision in the American Hospital Association’s (AHA) lawsuit.  ...

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2/20/2016 Comments(0)

Florida Ophthalmologist Involved in Senate Bribery Case Defends Medicare Billings

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 12, 2016, a Florida ophthalmologist accused of bribing his friend, U.S. Sen. Robert Menendez, said that separate allegations against him for Medicare fraud should be dismissed. Dr. Salomen Melgen was accused of using one single-dose vial of the wet macular degeneration drug Lucentis on multiple patients at his clinic called Vitreo-Retinal Consultants. He then allegedly billed Medic...

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2/19/2016 Comments(0)

Hackers Demand Multi-Million Dollar Ransom From Hollywood Hospital Following Cyber-Attack: Hospital Record System Out of Commission for Over a Week (Part 1 of 2)

By George F. Indest IV, Director of System Services, The Health Law Firm, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law (Part 1 of a 2 part blog) For more than a week, the computer systems at Hollywood Presbyterian Medical Center have been offline following a cyber-attack. The hospital has, apparently, also been locked out of all access to patient electronic health records (EHR). The unknown hackers are demanding a $3.6 million ...

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2/18/2016 Comments(0)

Orlando Chiropractor Faces 50 Years in Prison for PIP Scam

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An Orlando health clinic owner and one other person were recently arrested on charges of defrauding multiple insurance companies and payers, according to the Florida Division of Insurance Fraud. Dr. Troy Godsey of Spine Health Solutions, P.A., allegedly provided treatments to”patients” involved in auto accidents. Three insurance companies received a $300,000 bill for reimbursements...

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2/18/2016 Comments(0)

THE 33 BIGGEST MISTAKES FOR A NURSE TO AVOID AFTER BEING NOTIFIED OF A COMPLAINT AGAINST THE NURSE'S LICENSE PART 1 OF 3

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In this three part blog series, I will focus on how the investigation of a complaint against your nursing license could lead to the revocation of the license, and the assessment of tens of thousands of dollars in fines, as well as a number of adverse collateral consequences.  Yet it usually starts usually with a simple letter from the state regulatory authority, in Florida, the Departme...

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2/17/2016 Comments(0)

Pill-Mill Crackdown Hurting Patients With Legitimate Pain

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida has been plagued for years with the reputation of being the "pill mill capital of the country." Lawmakers needed to do something about prescription painkiller abuse. But, the crackdown on pill mills has produced unintended consequences. Since 2011, there have been strict regulations on doctors and pharmacies when it comes to dispensing controlled substances. Click here to read about Atto...

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2/16/2016 Comments(0)

TRICARE Settles Large Case with Florida Pharmacies and Doctors for $10 Million

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 10, 2016, the U.S. Department of Justice (DOJ) announced it had reached a settlement agreement with two compounding pharmacies and four physicians in Florida for $10 million. The physicians, Manish Bansal, Mehul Parekh, Marisol Arcila, and Syed Asad allegedly profited from the military’s health care program called TRICARE. The settlement is to resolve allegations that they t...

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2/15/2016 Comments(0)

CMS To Relax Medicare 60-Day Overpayment Rule

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health On February 11, 2016, the Centers for Medicare and Medicaid Services (CMS) published a final rule which eased requirements for health care providers to return overpayments within 60 days to avoid False Claims Act (FCA) liability. Under the rule, overpayments must be reported and returned only if a person identifies the overpayment within six years of the date the overpayment was received. To rea...

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2/15/2016 Comments(0)

Pfizer’s Wyeth Pharmaceutical Inc. Claims Whistleblower Cannot Prove Alleged Promotion of Off-Label Prescribing in Federal Court Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Two whistleblowers brought suit against Pfizer’s Wyeth Pharmaceutical Inc. (Wyeth) alleging violations of the False Claims Act (FCA).  Relator Lauren Kieff alleged the company encouraged physicians to prescribe its acid reflux drug, Protonix, off-label.  This is in addition to allegations that Wyeth offered Protonix in oral and intravenous forms as a bundling deal to offer both...

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2/14/2016 Comments(0)

Denver Surgical Technologist Accused of Tampering with and Stealing Narcotics

By Carole C. Schriefer, R.N., J.D., The Health Law Firm A surgical technologist accused of stealing powerful drugs and putting thousands of Colorado patients at risk is now in federal custody. Rocky Allen was indicted on February 16, 2016, on charges of allegedly stealing and tampering with narcotics at the Swedish Medical Center in Denver, Colorado. Allen surrendered himself to federal agents in Denver, according to the Department of Justice. Following His Arrest, 3,000 Patients ...

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2/14/2016 Comments(0)

Eye Doctor Faces Maximum of 200 Years in Prison for Medicare Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A central Florida ophthalmologist with offices in Windermere and Leesburg, was found guilty of 20 counts of Medicare fraud on September 29th. He faces a maximum of ten years in prison for each count. David Ming Pon, M.D., was convicted of health care fraud this past Tuesday by a Jacksonville federal jury. Following trial, Dr. Pon was turned over to the United States Marshals Service. He will r...

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2/12/2016 Comments(1)

Helpful Tips For Avoiding HIPAA Violations on Social Media

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Digital mediums are a popular great way to connect, but they can also pose a great risk for Health Insurance Portability And Accountability (HIPAA) violations. When it comes to guarding against accidental revelations of patient identity and sensitive information, Ophthalmologists, Optometrists and all medical staff should adopt various measures to protect themselves. In this day and age, al...

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2/12/2016 Comments(0)

Dentists and Dental Hygienists Beware: Know Who Actually Owns Your Clinic

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida has long been a state that does not prohibit the corporate practice of medicine, unlike many other states. However, it does prohibit the corporate practice of dentistry. The key provision in Florida law that establishes this is Section 466.028, Florida Statutes, but the Florida Board of Dentistry has adopted administrative rules on this topic as well. What this means is that any cor...

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2/12/2016 Comments(0)

OIG Issues Favorable Advisory Opinion 15-14 Involving 501(c)(3) Charitable Organization Funded by Pharmaceutical Manufacturers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A nonprofit organization (Requestor) requested an advisory opinion from the Office of the Inspector General (OIG).  The organization is dedicated to helping financially needy patients, including those covered by Medicare and Medicaid, with a single disease state (Disease State) obtain magnetic resonance imaging (MRI) (altogether, "Arrangement").  Specifically, the Requestor sought th...

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2/11/2016 Comments(0)

COLORADO HEALTH OFFICIALS ‘JUST SAY NO’ TO MARIJUANA FOR PTSD TREATMENT

By Carole C. Schriefer, R.N., J.D., The Health Law Firm The Colorado Board of Health denied a motion to approve medical marijuana as a treatment for post-traumatic stress disorder (PTSD) on July 15, 2015. The rejection was made despite the recommendation of the state’s chief medical officer. This marks the third time that Colorado’s health officials have said ‘No’ to including PTSD on its medical marijuana approved uses list. Is Marijuana Medicine? The C...

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2/10/2016 Comments(0)

California Attorney Ordered By Court To Pay Donation to Women Lawyers’ Professional Group

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health A medical group defense attorney in California, Peter Bertling, was ordered on Tuesday, January 12, 2016, by U.S. Magistrate Judge Paul S. Grewal, to pay a $250 donation to the Women Lawyers' Association. The ruling was in response to a sexist comment made by Bertling to opposing counsel, Lori Rifkin, during a heated deposition. Additionally, Judge Grewal sanctioned Bertling's clients...

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2/9/2016 Comments(0)

Check Your Professional Liability Insurance to Make Sure You Are Covered for Professional License Defense Expenses

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar  in Health Law Most mental health counselors, psychologists, and social workers carry professional liability (malpractice) insurance policies to protect them against claims and suits for malpractice.  Yet the most likely legal problem you will encounter will be that a patient, former patient or patient's family files a complaint against your professional license.  You should closely examine your ins...

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2/8/2016 Comments(0)

It’s Official: Medical Marijuana Will Be on the Ballot For 2016 in Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A proposed constitutional amendment to allow medical use of marijuana in Florida will be back on the ballot in November of 2016. On Wednesday, the Florida Division of Elections said the proposed amendment to legalize medical marijuana has met requirements to appear on the state’s ballot. If passed, the amendment would allow doctors more freedom to prescribe marijuana for people with ...

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2/8/2016 Comments(0)

Dentists File Lawsuits Against Supply Distributors Alleging Violations of Antitrust Statues

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Several dentists have joined together to file suits against leading dental supply distributors in New York and Texas federal courts alleging the companies jointly conspired to keep prices artificially inflated. Five lawsuits have been filed since Wednesday, January 20, 2016, against Patterson Cos. Inc. (Patterson), Henry Schein Inc. (Henry Schein) and Benco Dental Supply Co. (Benco). These co...

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2/8/2016 Comments(0)

Kindred Healthcare Inc. To Pay $125 Million to Settle Allegations of False Claims

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Kindred Healthcare Inc. (Kindred), the largest skilled therapy provider in the nation, has agreed to pay $125 million to settle allegations that it violated the False Claims Act (FCA). Kindred is accused of billing Medicare for therapy services that were unnecessary or never occurred, the U.S. Department of Justice (DOJ) announced January 12, 2016. Knowingly Violating The False Claims Act Alleg...

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2/8/2016 Comments(0)

2015 Proved to Be a Good Year in Medicine as FDA Approvals of First-Of-A-Kind Drugs Continued to Escalate

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law It's been 19 years since anyone has seen the approval of more first-of-a-kind drugs by the U.S. Food and Drug Administration (FDA).  2015 proved to be a year of satisfactory innovation for medicine.  With the approval of 45 drugs formulated with never-before-sold ingredients, the FDA came close to surpassing its previous all-time record of 53 first-of-a-kind drug approvals in 1996. ...

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2/8/2016 Comments(0)

Windermere Eye Doctor Faces Eye Opening Prison Term in $7M Medicare Fraud Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Windermere ophthalmologist charged with intentionally misdiagnosing patients and performing unnecessary surgery headed for trial in Federal Court on Tuesday. According to prosecutors, Dr. David Ming Pon, with Advanced Retina Eye Institute in Leesburg and Orlando, is charged with 20 counts of Medicare fraud. This case is being tried in the U.S. District Court for the Middle District of Flo...

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2/8/2016 Comments(0)

Florida is Serious in Combating PIP Fraud: Don’t Land Yourself in Prison

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An Orlando health clinic owner and one other person were recently arrested on charges of defrauding multiple insurance companies and payers, according to the Florida Division of Insurance Fraud. Dr. Troy Godsey of Spine Health Solutions, P.A., allegedly provided treatments to”patients” involved in auto accidents. Three insurance companies received a $300,000 bill for reimbursements...

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2/5/2016 Comments(0)

FDA's Agenda for 2016: Biggest Issues on Agency’s Calendar for the New Year

By: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Food and Drug Administration (FDA) has great influence on a vast array of issues impacting the medical industry in the U.S. The decisions it makes in 2016 will have a significant impact for health care providers and on the lives of many Americans. Here is a look at the top issues on the agency’s agenda in 2016. Reigning in E-Cigarettes. The use and health of electronic ciga...

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2/5/2016 Comments(0)

Tallahassee Massage Therapist Arrested Twice in Massage Parlor Stings

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Tallahassee massage therapist, Gendi Li, has been arrested twice in two weeks for charges of prostitution and practicing without a license. The Florida Departments of Health and Law Enforcement had received several complaints from customers of the massage parlor where Li worked. It was reportedly called the “Health Center.” Ms. Li was first arrested on Jan. 22, 2016, after s...

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2/5/2016 Comments(0)

The Title of “Disruptive Physician” Can Ruin Your Professional Career

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Nobody likes dealing with a nuisance, and disruptive physicians are no exception. Disruptive physicians threaten the morale of medical staff, the safe and orderly operation of a medical practice, as well as a threat to the safety of patients. They can also become expensive liabilities.      The Behavior That May Cause One to Earn the Title of “Disruptive Physician.̶...

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2/5/2016 Comments(0)

COLORADO CREDIT UNION SPECIFICALLY FOR THE MARIJUANA INDUSTRY

By: Carole C. Schriefer, R.N., J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law While most banks are refusing to work with marijuana businesses, The Fourth Corner Credit Union is welcoming them with open arms. On November, 19, 2014, the credit union was granted a charter by Colorado’s banking regulators. However, it still awaits a master account number from the Federal Reserve, which will give it access to the country’s ele...

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2/5/2016 Comments(0)

OIG Flags Questionable Billing for Ophthalmology Services Totaling $171 Million in Medicare Pay-Outs to Various Providers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Department of Health and Human Services Office of Inspector General (OIG) flagged various Medicare providers as having questionable billing practices for ophthalmology services rendered in 2012. The services billed for and flagged as questionable include the diagnosis and treatment of wet age-related macular degeneration (wet AMD) and complex cataract surgery. Medicare paid a total of $171...

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2/4/2016 Comments(0)

Florida Compounding Pharmacy Pays $3.7 Million in Tricare False Claims Settlement

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In May of 2015, Tricare began screening all compound medication prescriptions to ensure approval of each ingredient with the Food and Drug Administration (FDA). This decision came after a finding of a significant increase in compound drug prescriptions reimbursed by Tricare over the last year. In April 2015, just four months into the fiscal year, it was already determined that total costs f...

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2/1/2016 Comments(0)

Miami Medicare Fraud Fugitive Returns After Hiding in Cuba

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On Friday, a Miami pharmacy owner charged in a Medicare fraud scheme, surrendered to U.S. authorities after hiding in Cuba for over two years. Sandy De La Fe, was charged in 2013 with unlawfully pocketing $2.8 million in taxpayer-funded Medicare payments through his former business Goldenway Pharmacy Discount. False Claims for Prescription Drugs. According to the indictment, De La Fe ...

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2/1/2016 Comments(0)

Florida Law Prohibits Optometrists from Practicing with Non-Licensed Corporations or Individuals

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida , unlike many other states, does not prohibit the corporate practice of medicine. This lack of prohibition, allows for a licensed physician or other health care provider to practice medicine as an employee or contractor of a corporation or other business entity owned and operated by a non-physician. This principle has been exhibited in a number of court cases and several declaratory st...

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2/1/2016 Comments(0)

MISSISSIPPI NURSE PRACTITIONER CHARGED WITH DEFRAUDING MEDICAID

By Carole C. Schriefer, R.N., J.D., The Health Law Firm A nurse practitioner from Corinth, Mississippi, turned herself over to the authorities on Friday, January 8, 2016.  Tami Bivens-Johnson was indicted on three counts of Medicaid fraud by an Alcorn County Grand Jury.  Bivens-Johnson’s charges constitute felonies and account for more than $3,200 in fraudulent claims for Medicaid benefits. Her Alleged Crimes Against Medicaid . The first of Bivens-Johnson’s...

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1/31/2016 Comments(0)

Dentists Targeted for Billing Medicaid for Dead Patients; Okay to Treat Dead Patients, You Just Can’t Bill for It

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Two South Florida dentists are at the center of a fraud investigation after, among other things, allegedly billing Medicaid for unnecessary dentures for their patients, according to the Florida Attorney General’s Office. Married couple Marino Vigna and Beth Reinstein operate Sunrise Dental Clinic in Fort Lauderdale. They have not yet been arrested or charged, however, their billing practice...

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1/31/2016 Comments(0)

Health Care Professionals: Are You A Target of Medicare Audits? Follow These Tips to Protect Yourself and Your Practice

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Health care professionals in Florida who serve Medicare patients are at a higher risk for audits than anywhere else in the country. Unfortunately, Florida seems to have become synonymous with health care fraud. At The Health Law Firm, we have been contacted and retained by many health care professionals that have become the subjects of Medicare audits. If you find yourself or your health car...

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1/27/2016 Comments(0)

Florida Physician Accused of Overprescribing Pain Meds is Permanently Barred from Treating Pain Patients by Board of Medicine

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health The Florida Department of Health (DOH) filed an administrative complaint against central Florida physician, Dr. Frances F. Cruz-Pacheco, M.D., on November 24, 2014.  The complaint alleged that Dr. Cruz-Pacheco provided care and treatment during a specified time period for a particular patient whose untimely death on April 28, 2012, was the result of multiple drug intoxication.  The DOH ...

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1/26/2016 Comments(0)

FTC Drills Dental Software Provider For Deceptive Encryption Promises

By: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A leading dental office management software provider has agreed to pay $250,000 to settle the Federal Trade Commission’s (FTC) claims that it falsely advertised its product as having industry-standard encryption. This encryption would help clients meet obligations under federal health privacy law to protect patient information. Protecting Patient Information. The Dentrix G5 sof...

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1/24/2016 Comments(0)

Florida Hospital Will Be First to Test So-Called “Smart” Prescription Bottle That May Offer a Solution to a Cost Issue in U.S. Health Care

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A burgeoning health care tech company, Smrxt, recently closed shop in New York to relocate its headquarters to Orlando, Florida.  It has designed a so-called “smart” prescription bottle that will alert physicians and health care companies to missed medication doses.  While it’s currently only been used in the prototype phase, Florida Hospital will be the health care pi...

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1/21/2016 Comments(0)

Fort Myers Doctor Convicted of Running Two"Pill Mills" Sentenced to 30 Years in Prison

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Former Fort Myers, Florida doctor, Jacinta Irene Gillis, was sentenced to 30 years in prison on Tuesday, January 12, 2016.  Gillis's sentencing was the result of a conviction for running two illegal "pill mill" operations in the Pinellas and Lee County areas.  Gillis was charged with one count of racketeering, two counts of money laundering and one count of conspiracy to traffic in...

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1/15/2016 Comments(0)

2015 Hospital Qui Tam Settlements Instruct Employers to Take Heed of Employee Compliance Concerns

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Two qui tam settlements taking place at the tail-end of 2015, were originally filed by former employees of the hospitals.  The first qui tam relator was a physician at Fairview Park Hospital in Dublin, Georgia.  He was the Executive Medical Director of Cardiovascular Services.  The second relator was a former president and chief executive officer of Memorial Health Inc. and Mem...

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1/15/2016 Comments(0)

Health Care Providers Should Be Aware of New Medicare Law Changes

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law President Obama executed a new law on December 28, 2015, which will significantly impact Medicare.  The recently enacted law, the Patient Access and Medicare Protection Act, includes a number of Medicare provisions not included in the Consolidated Appropriations Act.  The Act amended several parallel sections of the Social Security Act (SSA) and the United States Code pertaining to M...

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1/14/2016 Comments(0)

Professionals Resource Network Provides Intake Statistics for the 2014 Calendar Year

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law At a recent Executive Council meeting of the Health Law Section of the Florida Bar, leaders of the Professionals Resource Network (PRN) met to answer questions from attorneys representing health professionals.  Following the meeting, Robert C. Nuss M.D., Chair of the Board of Directors for PRN, provided statistics on PRN intakes for the 2014 calendar year.   The total intakes for ...

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1/5/2016 Comments(0)

20 Years for Ohio Cardiologist Sentenced in $29 Million Overbilling Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Assistant U.S. Attorney Carole S. Rendon, said of a Westlake, Ohio cardiologist sentenced to 20 years in prison on Friday, December 18, 2015, "This defendant used his medical license as a license to steal."  Dr. Harold Persaud was convicted earlier this year of one count of health care fraud, 13 counts of making false statements and one count of engaging in monetary transactions in proper...

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12/24/2015 Comments(0)

Employee Claims Wrongful Termination After Blowing the Whistle on New York Health Care Center

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On Monday, December 21, 2015, Debra Martin filed suit against former employer, Middletown Community Health Center Inc. (MCHC), in the U.S. District Court for the Southern District of New York, claiming she was wrongfully terminated after exposing alleged illegal activities of the health center to her superiors.  Martin claims she discovered MCHC's alleged misuse of federal funds and overb...

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12/24/2015 Comments(0)

Eleventh Circuit (Once Again) Upholds Florida's "Gun Gag" Law

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For the third time now, the Eleventh Circuit ruled on Monday, December 14, 2015, that a Florida law restricting physicians' questions about patients' gun ownership is constitutional.  The ruling eliminated an injunction against enforcement and again reversed a district court's grant of summary judgment in favor of a group of physicians challenging what has become known as the "gun gag" ...

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12/23/2015 Comments(0)

Court Finds Qui Tam Relators Failed to Satisfy Evidentiary Requirements for Alleged Kickback Scheme of Pharmaceutical Company in Texas Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 10, 2015, U.S. District Court for the Southern District of Texas granted defendant's partial motion for summary judgment in a qui tam case alleging violations of the Anti-Kickback Statute (AKS).  The case was originally filed on June 10, 2003, by relators John King and Tammy Drummond, naming several pharmaceutical companies as defendants including Solvay Pharmaceuticals Inc. (...

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12/22/2015 Comments(0)

Chicago Husband and Wife Sentenced to Prison Terms for Misappropriation of $3 Million in Grant Funds

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A husband and wife from Chicago, Illinois, were sentenced to prison terms by U.S. District Judge Richard Mills on Monday, December 14, 2015, for their roles in the misappropriation of $3 million in grant funds.  Leon Dingle Jr. and his wife, Karen Dingle, were convicted at a one-week long jury trial in December 2014 of conspiracy, mail fraud and money laundering.  To read the full pr...

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12/17/2015 Comments(0)

24-Year-Old May Spend Nearly a Decade Behind Bars as the Alleged Mastermind in a $21 Million Medicare Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On Thursday, December 10, 2015, 24-year-old, Daniel Suarez, was sentenced to nine years in prison and ordered to pay nearly $21 million in restitution by U.S. District Judge Donald Middlebrooks, for his alleged leading role in a Medicare fraud scheme in Miami, Florida.  Suarez was sentenced after pleading guilty in September 2015, as to one count of conspiracy to commit wire fraud and hea...

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12/15/2015 Comments(0)

Central Florida Medical Student Shot While Saving Woman in New Orleans

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On Friday, November 20, 2015, during the early morning hours in New Orleans (my home town), a Tulane University (my alma mater) medical student from Longwood, Florida, Peter Gold, was shot in the stomach as he attempted to assist a woman who was being assaulted in a botched robbery.  Officials say video footage shows the armed attacker attempting to shoot Gold a second time, aiming for th...

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12/14/2015 Comments(0)

Rare Occurrence: Dermatologist Acquitted of More Than 40 Counts of Health Care Fraud Following a 16-Day Trial: Part 2 of a 3-Part Series Part Two: Prosecutorial Overcharging

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Virginia dermatologist, revered by several publications as one of the top doctors in the nation for several years running, was recently acquitted of more than 40 counts of health care fraud following an unusually lengthy 16-day trial.  Dr. Amir Bajoghli was originally indicted in August 2014 on 60 counts; 53 counts of health care fraud, six counts of aggravated identity theft and one ...

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12/11/2015 Comments(0)

Speaking of Religious Discrimination: Second Appeal to Supreme Court on Former Nursing Home Employee's Termination for Refusal to Pray with Residents

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Former nursing home employee, Kelsey Nobach, a Jehovah's Witness, filed a discrimination suit against former employer, Woodland Village Nursing Center Inc. (Woodland), alleging her termination from the facility was the direct result of her religious beliefs.  The suit was originally filed in the U.S. District Court for the Southern District of Mississippi on September 16, 2011.  Noba...

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12/10/2015 Comments(0)

U.S. Department of Justice's Antitrust Division Has Yet to Weigh In on Anthem/Cigna Mega-Merger Given the Go-Ahead by Shareholders

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On Thursday, December 3, 2015, shareholders of Anthem Inc. (Anthem) and Cigna Corp. (Cigna) approved a previously announced $54 billion mega-merger in an overwhelming 99 percent favorable vote.  The pending acquisition of Cigna by Anthem would cover approximately 53 million medical members resulting in the formation of the nation's largest health insurance company.   The transacti...

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12/7/2015 Comments(0)

Baker Acts Are on the Rise Among Students at the University of Central Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law It's beginning to look a lot like Christmas; candy canes and toys, holly and trees, bells and carols, and... Baker Acts?  You read that right.  According to University of Central Florida (UCF) police Cpl. Peter Osterrieder, a rise in Baker Acts is to be expected among college students this time of year.   Not only do UCF police expect to see more Baker Acts around the holiday...

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12/7/2015 Comments(0)

Rare Occurrence: Dermatologist Acquitted of More Than 40 Counts of Health Care Fraud Following a 16-Day Trial: Part 1 of a 3-Part Series Part One: Reviewing the Charges

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Dr. Amir Bajoghli, of McLean, Virginia, was a dermatologist and owner of the Skin & Laser Surgery Center.  Dr. Bajoghli was recognized by former Washingtonian Magazine, Northern Virginia Magazine, U.S. News & World Report and Castle Connolly as "Top Doctor."  Washingtonian and Northern Virginia Magazines bestowed this honor over several consecutive years.   To read ...

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12/4/2015 Comments(0)

Former New York Assembly Speaker Convicted on Corruption Charges in Scheme for Referral Fees

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Former New York Assembly Speaker, Sheldon Silver, was convicted by a jury on Monday, November 30, 2015, on federal corruption charges.  Silver had spent nearly 40 years as an elected New York Assemblyman.  Prosecutors say Silver was using public money to fund an asbestos disease researcher in exchange for patient referrals to Silver's colleagues and personal injury law firm, Weitz &a...

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12/2/2015 Comments(0)

Pharmaceutical Company Says Former Employee is Not "Original Source" of False Claims Act Allegations and Cannot Bring Whistleblower Suit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Medco Health Solutions Inc. (Medco) asked a Delaware federal judge to dismiss a False Claims Act (FCA) lawsuit brought by former employee and vice president of the company's pharmaceutical contracting group.  Paul Denis brought the qui tam suit against Medco alleging the company defrauded state and federal insurance companies by hiding discounts it was receiving on drugs.   Medc...

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12/2/2015 Comments(0)

Oncologist Falsified Data on Research Once Described as "Holy Grail" of Cancer Treatment

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Back in 2006, Anil Potti, a cancer researcher at Duke University, claimed to identify genetic markers that would allow customized treatment for cancer patients based on the types of tumors they had. Several reports from Potti and his team claimed it could predict a patient's response to chemotherapy with up to 90 percent accuracy. His research captured worldwide attention until other scienti...

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12/1/2015 Comments(0)

Florida Court of Appeal Says Federal Law Preempts Florida's Amendment 7; The Peer Review Privilege May Still Be Alive

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Southern Baptist Hospital of Florida Inc. (Baptist) filed a Petition for Writ of Certiorari with the First District Court of Appeal in Florida following a Florida circuit court ruling on the compelled disclosure of certain documents.  The plaintiffs in a medical malpractice case were attempting to obtain peer review documents from the hospital on their claims.  Florida's Amendment 7 say...

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12/1/2015 Comments(0)

U.S. District Court Awards Costs to Prevailing Defendants in False Claims Act Case; Whistleblower Appeals to Second Circuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law U.S. District Judge Jed S. Rakoff, ordered relator, Associates Against Outlier Fraud (Associates), to pay $15,000 in costs to the prevailing defendants, Huron Consulting Group Inc. (Huron) and Empire HealthChoice Assurance Inc. (Empire), in a failed False Claims Act (FCA) suit.  Associates appealed from the Southern District of New York to the Second Circuit Court of Appeals arguing that ...

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11/25/2015 Comments(0)

University of Florida Agrees to Pay Nearly $20 Million to Settle False Claims Act Allegations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The University of Florida (UF) has agreed to pay nearly $20 million to the federal government to settle allegations brought under the False Claims Act. The U.S. Department of Justice (DOJ) announced the settlement Friday under allegations that it "improperly charged the U.S. Department of Health and Human Services (HHS) for salary and administrative costs on hundreds of federal grants." Ac...

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11/24/2015 Comments(0)

Florida HMO Owners File $1.2 Billion Lawsuit Against BankUnited for Alleged Racketeering and Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Former owners of a health maintenance organization (HMO), Haider Ali Khan and Sabiha Haider Khan, recently filed suit in Florida federal court against BankUnited Inc. and its acquired New York-based Herald National Bank.  The Khans formerly operated the Tampa-based HMO, Quality Health Plans Inc. (QHP), prior to the alleged misrepresentations made by Herald Bank that according to the Khan...

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11/23/2015 Comments(0)

OIG Annual Work Plan for 2016 Series: Spotlight on OIG Investigations and Affordable Care Act Review Part Two of Two

By Michelle Bedoya and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. The United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its 2016 Annual Work Plan (Work Plan) on November 2, 2015, with an effective date of October 1, 2015. The 2016 Work Plan identifies the new and ongoing investigative, enforcement and compliance activities that the OIG will undertake. Through the Work Plan, a broad r...

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11/20/2015 Comments(0)

Head of the DOJ's Antitrust Division Raises Concerns About Two Proposed Mega-Mergers Between Leading Health Insurers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Assistant Attorney General, Bill Baer, head of the Department of Justice's (DOJ) Antitrust Division, recently spoke at a Yale Law School conference about competition in the health care industry.  While not singling out any specific companies, Baer seemed to repeatedly reference two proposed "mega-mergers" that are currently in the balance.  The anticipated mergers between four leadin...

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11/18/2015 Comments(0)

Florida Man Sentenced to 30 Months in Prison; Four Defendants Previously Sentenced; Two Defendants Plead Guilty in $126 Million Health Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A federal judge decided that a Florida man convicted of conspiracy to commit health fraud will spend the next 30 months behind bars.  Humberto Martinez Rodriguez was the nominee owner of two clinics involved in an elaborate fraud scheme to submit $126 million in false health care claims to private insurers.  A "nominee owner" is someone who is given limited authority to act on behalf...

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11/17/2015 Comments(0)

Eight Tips to Speed Up the Medicare Prepayment Review Process

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Medicare providers generally recoil at the news of an impending audit.  However, being notified of a prepayment review is even worse.  In a prepayment review, health care providers are required to submit documentation to a contractor for the Centers for Medicare & Medicaid Services (CMS) before ever even receiving payment.  The health care provider subject to the review will...

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11/17/2015 Comments(0)

OIG Annual Work Plan for 2016 Series: Spotlight on Medicare and Medicaid Areas of Fraud Part One of Two

By Michelle Bedoya and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. The United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its 2016 Annual Work Plan (Work Plan) on November 2, 2015, with an effective date of October 1, 2015. The Work Plan describes more than 40 new investigations and strategic inquiries concerning pharmacy fraud and increased drug prices, among other topics. The Work P...

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11/17/2015 Comments(1)

Medical Licensing Exams to Include Questions on Military Medicine, Requiring Physicians to Know Their Veterans

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Just prior to Veteran's Day this year, an announcement was made by former U.S. Representative and licensed clinical psychologist, Brian Baird, and his colleague, Steven Haist.  Moving forward, examinations for medical students and new physicians seeking licensure will now include questions about military medicine issues.  Dr. Haist is a physician and associate vice president for test...

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11/16/2015 Comments(0)

HCA Settlement in Shareholder Class Action Suit Over Failure to Disclose False Claims Act Cases Will Cost the Company Another $215 Million

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Just days after settling with the U.S. Department of Justice (DOJ) agreeing to pay $16 million to resolve allegations of False Claims Act (FCA) violations, HCA Holdings, Inc. (HCA), a notable Tennessee-based health care company, announced yet another settlement, this time with its shareholders.  HCA reached a $215 million settlement on Wednesday, November 4, 2015, to conclude a class acti...

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11/13/2015 Comments(0)

450 Hospitals Pay $250 Million in One of Nation's Largest False Claims Act Cases for Number of Defendants

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In an investigation that has spanned several years and is still ongoing, the Department of Justice (DOJ) has reached False Claims Act (FCA) settlements with more than 450 hospitals totaling $250 million over alleged improper billing of Medicare for unnecessary cardiac implants.  Many of the hospitals comprising the settlements are among the nation's leading health care chains, including A...

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11/11/2015 Comments(0)

Federal Judge Denies Florida Cardiovascular Center's Motion to Dismiss Whistleblower Suit: Judge Rules that U.S. and Florida A.G. Did Not File "Shotgun Pleadings"

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law U.S. District Judge for the Middle District of Florida, Roy B. Dalton, Jr., denied a motion to dismiss filed by a cardiovascular center based in Ocala, Florida, and its top physician.  The case the defendants sought to dismiss is a False Claims Act (FCA) qui tam suit brought by two whistleblowers in which the United States and Florida have intervened.   Defendants, Institute of Ca...

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11/11/2015 Comments(0)

Peer Review Confidentiality in Florida: Does it Exist?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The confidentiality of peer review documents in Florida has been very questionable since a state constitutional amendment was passed in 2004.  Amendment 7, found in Section 25, Article X of the Florida Constitution, restricts Section 395.0193(7), Florida Statutes, which originally established peer review confidentiality.  To read the full law in Section 395.0193(7), click here .  ...

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11/9/2015 Comments(0)

Whistleblower Complaint Filed in Middle District of Florida Against Healogics, Inc. is Unsealed; Hundreds of Hospitals Also Sued

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The United States District Court for the Middle District of Florida recently unsealed a complaint filed by qui tam relators (whistleblowers) against Healogics, Inc. (Healogics) and hundreds of hospitals spanning the country alleging violations of the False Claims Act (FCA).  The lawsuit stems from allegations of a scheme to improperly bill Medicare for costly and unnecessary medical procedur...

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11/6/2015 Comments(0)

OIG Opinion States Health System May Legally Provide Free Shuttle Service for Patients

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A medical center, a community hospital and a multi-specialty clinic comprising an integrated health care system (System) (collectively known as Requestors), requested an advisory opinion from the Office of Inspector General (OIG) about a plan to offer free shuttle service to patients of the System (Proposed Arrangement).  The OIG issued its opinion on October 14, 2015, concluding that the Pr...

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11/5/2015 Comments(0)

Millennium Health Pays $256 Million in Settlement with DOJ Involving False Claims Act Allegations: Omni Healthcare of Melbourne, Florida, Receives Millions as One of Eight Whistleblowers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Millennium Health (Millennium), formerly Millennium Laboratories, Inc., entered into a settlement with the Department of Justice (DOJ) on Monday, October 19, 2015, agreeing to pay $256 million to resolve allegations of False Claims Act (FCA) violations.  The allegations include billing Medicare, Medicaid and other federal health care programs for medically unnecessary urine tests and for pro...

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11/4/2015 Comments(0)

Subsidiary of Global Healthcare Company Agrees to Pay $390 Million in Whistleblower's False Claims Act Suit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Novartis Pharmaceuticals Corp. (Novartis), a subsidiary of Novartis AG, an international pharmaceutical company headquartered in Switzerland, agreed to pay a whopping $390 million as a "settlement in principle" to resolve a False Claims Act (FCA) suit.  The lawsuit, brought by whistleblower David Kester, former Novartis sales manager, alleged improper kickbacks to pharmacies to boost the sal...

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11/3/2015 Comments(0)

D.O.J. Announces $72.4 Million Settlement in False Claims Act/Stark Law Case Resolving a Decade of Litigation

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In a qui tam False Claims Act (FCA) case based on Stark Law violations, the United States Department of Justice (DOJ) and Tuomey Healthcare Systems, Inc. (Tuomey), reached a settlement of $72.4 million on October 16, 2015.  This settlement put to rest a decade of litigation, including two trials and two U.S. Fourth Circuit appellate decisions.  Tuomey's liability for FCA and Stark Law v...

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10/30/2015 Comments(0)

Medicare Paid $171 Million for Ophthalmology Services Flagged by OIG for Questionable Billing

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law According to the Department of Health and Human Services Office of Inspector General (OIG), Medicare paid a total of $171 million for ophthalmology services that now warrant further scrutiny.  OIG flagged various providers as maintaining questionable billing practices for services rendered in 2012.  The services billed for and flagged as questionable include the diagnosis and treatment ...

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10/27/2015 Comments(0)

Florida Board of Medicine Declares Arizona Homeopathic Doctor "Very, Very Dangerous"

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A doctor practicing homeopathic medicine was accused of administering a lethal dose of an unapproved drug to a toddler in Arizona.  She was required to appear before the Florida Board of Medicine last Friday, October 9, 2015.  It may seem odd that a doctor licensed and practicing medicine in Arizona would have to answer to the Florida Board of Medicine.  However, even though sh...

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10/26/2015 Comments(0)

Medicare Fraud Scheme Results in a Five-Year Prison Term for Owner of Orlando Health Care Clinic

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An Orlando health care clinic owner who engaged in a $2.4 million scheme to defraud Medicare will spend the next five years behind bars.  Juan Carlos Delgado and his wife, Nereyda Infante, co-owners of the clinic, were charged with conspiracy to commit health care fraud.  The pair pleaded guilty on June 24, 2015, before United States District Judge Paul G. Byron of the Middle Distri...

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10/8/2015 Comments(0)

United States Appeals Court Determines District Court Did Not Err in Medicare Fraud Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Fifth Circuit Court of Appeals upheld the convictions and sentences of defendant, Lawrence Dale St. John, and his son and employee, Jeffrey St. John, in a case involving Medicare fraud.  The pair were convicted of conspiracy to commit health care fraud and 13 substantive counts of health care fraud.  Dale St. John and Jeffrey St. John were both sentenced to serve prison time as ...

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10/7/2015 Comments(0)

Adventist Health System to Pay $118.7 Million, One of the Largest Settlements in Health Care Fraud: Some Whistleblower is Going to Get Rich!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Adventist Health System ("Adventist") recently reached a settlement with the United States government and four states, including Florida, totaling a whopping $118.7 million.  A significant amount of that total--$47 million--is the result of allegations stemming from Florida Hospital Medical Group (owned by Adventist), and more than 30 Florida Hospitals throughout the state, including sev...

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10/1/2015 Comments(0)

Contract Renewal May Result in Loss of Business for Florida Hospital

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Adventist Health System, parent company to Florida Hospital, renewed its contract with Florida Blue in May of this year.  The contract renewal includes the termination (effective October 1, 2015) of four Florida Blue Medicare Supplement plans, leaving approximately 4,000 central Florida residents who previously had coverage without coverage at several area hospitals. Medicare Supplemen...

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9/25/2015 Comments(0)

Broward Health Agrees to Pay Almost $70M to Settle False Claims Act Allegations - Whistleblower Could Receive More Than $12M

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 15, 2015, the Department of Justice (DOJ) announced that Broward Health, an operator of more than 50 health care facilities in South Florida, agreed to pay $69.5 million to settle False Claims Act allegations. Broward Health violated the Federal Stark Law and Anti-Kickback Statute by allegedly overcompensating referring physicians for services to cover up illegal kickbacks for pa...

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9/23/2015 Comments(0)

Florida Bar Says Attorneys May Solicit Business By Text Messages

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law You've just been slapped with an indictment containing allegations of anti-fraud law violations.  Or your license is up for renewal and you are struggling through all of the red tape.  You are facing a DOH hearing or an audit.  You have an employment contract in-hand and are in need of someone to review it.  Then, all of a sudden, you receive a text message from an attorne...

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9/21/2015 Comments(0)

$3.7 Million Paid in Settlement of Tricare False Claims Allegations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The government found a significant increase in compound drug prescriptions reimbursed by Tricare over the last year.  In April 2015, just four months into the fiscal year, it was already determined that total costs for compound drug prescriptions filled for Tricare recipients were likely to come close to $1 billion.   The annual budget for the prescription drug benefit is curren...

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9/18/2015 Comments(0)

CONSTITUTIONAL LAW: Denial of Medical Care for an Inmate Was Cruel and Unusual Punishment

Our guest author of this is article is John Stone , a Senior Attorney with National Legal Research Group in Charlottesville, Virginia. It is no easy task for a prisoner to succeed on a claim that he was denied medical care in circumstances that violated his federal constitutional rights. Such a cause of action is not simply a prisoner's version of a medical malpractice case but, rather, requires a more demanding showing by the plaintiff. Mere negligence in diagnosis or treatment wil...

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9/17/2015 Comments(0)

Group Seeking New Recreational Marijuana Amendment in Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law There is a new effort to legalize the use of marijuana for in Florida and not just for medical purposes.  Two advocate groups, The Florida Cannabis Action Network and Floridians For Freedom, are pushing for a new recreational marijuana amendment for adults in Florida. Petitions will soon hit the streets for a proposed constitutional amendment that would completely legalize use, possessi...

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9/16/2015 Comments(0)

Cyberattacks May Target Health Care Systems: Vulnerabilities of Medical Devices and the FDA’s Reaction

By Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law Recently, major news sources covered a demonstration cyberattack on an automobile that was carried by researchers from Wired Magazine.  The demonstration showed how the car's onboard computer was vulnerable to a remote cyberattack potentially leading to disastrous consequences.  The manufacturer of the vehicle in the demonstration quickly announced a recall of approximately 1.4 million vehic...

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9/14/2015 Comments(0)

Research Misconduct on Grizzly Bear Study Leads to Paper Retraction

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A popular scientific paper investigating diabetes and obesity in grizzly bears was retracted from the journal Cell Metabolism on Tuesday, according to The Wall Street Journal. The reason: one of the scientists manipulated data. This is by no means the first time falsified data and researchers have crossed paths. Research misconduct between scientists and health care professionals is more comm...

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9/11/2015 Comments(0)

Dentists Targeted for Billing Medicaid for Dead Patients; Okay to Treat Dead Patients, You Just Can't Bill for It

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Two South Florida dentists are at the center of a fraud investigation after, among other things, allegedly billing Medicaid for unnecessary dentures for their patients, according to the Florida Attorney General's Office. Married couple Marino Vigna and Beth Reinstein operate Sunrise Dental Clinic in Fort Lauderdale. They have not yet been arrested or charged, however, their billing practices ...

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9/9/2015 Comments(0)

Orlando Chiropractor Faces 50 Years in Prison for PIP Scam

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An Orlando health clinic owner and one other person were recently arrested on charges of defrauding multiple insurance companies and payers, according to the Florida Division of Insurance Fraud.  Dr. Troy Godsey of Spine Health Solutions, P.A., allegedly provided treatments to"patients" involved in auto accidents.  Three insurance companies received a $300,000 bill for reimbursement...

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9/1/2015 Comments(0)

Physicians Watch Out: "Disruptive Physicians" Rising on Board of Medicine's Radar

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 7, 2015, the Florida Board of Medicine heard a presentation on "disruptive physicians" from psychiatrist Martha Brown, M.D. It was stated that the presentation aimed to further increase educational efforts regarding the importance of patient safety by identifying disruptive physicians. Dr. Brown recommended protocols for working with disruptive professionals, including developing a...

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8/28/2015 Comments(0)

Amarin Pharma, Inc., Wins Injunction Against FDA's Off-Label Marketing Ban

By Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law      The U.S. District Court for the Southern District of New York granted a preliminary injunction to Amarin Pharma, Inc. (Amarin), prohibiting the Food and Drug Administration (FDA) from enforcing its off-label marketing ban.  The injunction means that Amarin can engage in truthful marketing of Vascepa even when the marketing is used to promote an off-label use of Vascepa.   F...

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8/21/2015 Comments(0)

Medicare Part D: Measures Needed to Strengthen Program Integrity Testimony of Ann Maxwell Assistant Inspector General

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 14, 2015, Ann Maxwell, Assistant Inspector General for Evaluation and Inspections of the Office of Inspector General (OIG), U.S. Department of Health and Human Services (HHS), gave testimony to Congress on the Medicare Part D Program. She presented before the United States House of Representatives Committee on Energy and Commerce and the Subcommittee on Oversight and Investigations.&n...

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8/18/2015 Comments(0)

Five Pitfalls to Look for When Negotiating EHR Vendor Contracts

By: Lance O. Leider, J.D. In late 2012 a group of physicians filed a class action lawsuit against electronic health records (EHR) giant Allscripts.  The suit was brought on behalf of approximately 5,000 physician practices which purchased Allscripts MyWay EMR solution.  It is alleged that after years of problems related to functionality and quality, Allscripts abandoned MyWay and offered the physicians a "free" upgrade to a new EHR program. In this blog, I use "EHR" and "EMR...

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8/10/2015 Comments(0)

WHAT THE HEALTH PROFESSIONAL SHOULD DO WHEN A GOVERNMENT SUBPOENA ARRIVES

By Vivionne N. Barker, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A subpoena is an order of a court (or a government agency) that requires an individual to testify or to produce documents on or before a certain date.  There are many different types of subpoenas (state, federal, grand jury, administrative, etc.).  If you, your medical group, or your facility is served with a subpoena, the following advice could be help...

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8/5/2015 Comments(0)

More Than 100 Doctors Tell Big Pharma to Lower Drug Prices

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law     As drug prices rise, the number of complaints against pharmaceutical companies increase as well. Pressure is being placed on pharmaceutical companies by leading physicians to lower the prices on lifesaving drugs. Doctors From All Around the Country Put the Heat on Pharmaceutical Companies. At least 118 oncologists from top hospitals around the country are calling for ...

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8/4/2015 Comments(0)

What the Health Professional Needs to Know about Search Warrants (Though You Hope You Never Need to Know)

By Vivionne N. Barker, J.D.     A search warrant is a court order obtained by prosecutors that gives law enforcement agents the right to enter the premises specifically identified in the warrant for the purpose of seizing any documents and objects specified in the warrant.  In order to obtain approval for a search warrant, the government must establish that there is probable cause to believe that the premises sought to be searched will contain evidence of a specif...

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8/3/2015 Comments(0)

Responding to Medicaid Audits - Practical Tips

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law     The Agency for Health Care Administration (AHCA) —Office of Inspector General and Bureau of Medicaid Program Integrity—is the Florida agency responsible for routine audits of Medicaid health care providers. The agency ensures that the Medicaid program was properly billed for services.  Health care professionals receiving the greatest amounts of Med...

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7/30/2015 Comments(0)

DOH Issues a New Abandoned Medical Records Alert

By Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Department of Health is experiencing an increase in the number of reports regarding abandoned medical records. In an effort to curb this trend, The Florida Board of Medicine has issued an alert to educate doctors regarding the retention and disposition of medical records. To see the DOH alert, clic...

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7/24/2015 Comments(0)

Podiatrist/Attorney Did Not Put His Best Foot Forward: Multiple Professions Can Mean Multiple Problems

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Shelby Root Thomas Philpot, a former Lake County Clerk of Court in Indiana, was sentenced to 18 months in prison in 2013 for theft and mail fraud. Philpot's conviction was the result of his alleged theft of federal funds to pay himself bonuses in connection with the work he performed. The federal funds that were allegedly stolen were funds that were under his control as county clerk. ...

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7/23/2015 Comments(0)

UCLA Health Network Says It Was a Victim of Criminal Cyberattack

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law UCLA Health claims it was a victim of a data breach that may affect as many as 4.5 million people. What Did the Attackers Retrieve? Hackers accessed parts of the UCLA Health network, which contain personal and medical information. This included customers’ and patients’ names, addresses, social security numbers, health insurance IDs and diagnosis and treatment ...

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7/22/2015 Comments(0)

The Health Law Firm Attorneys Often Represent Medical Professionals in Last Minute Depositions and Hearings

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Our attorneys often receive calls from health care professionals regarding the possibility of representing them on short notice at a Board hearing or at a deposition related to a health care matter. We Take Last Minute Cases. There are some law firms that refuse to represent a client at a hearing unless given plenty of advance notice and preparation time. ...

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7/21/2015 Comments(0)

Study Finds ACA Plans Have a Third Fewer Providers than Employer-Based Plans

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A new study found that consumers who bought insurance on health exchanges last year had access to one-third fewer doctors and hospitals than people with traditional employer-provided insurance. Consulting firm Avalere Health conducted a study that provides a statistical basis which supports anecdotal reports from consumers and others. The study revealed more limited doctor and ...

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7/20/2015 Comments(0)

Florida Hospital Faces Two Data Breach Lawsuits

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida Hospital is facing two possible class action lawsuits. Each one of the lawsuits involves separate data breaches of patient information over the past four years. The lawsuits are both pending in the Orange County Circuit Court. Two Breaches Over Four Years. The first data breach was revealed in August 2011 and involved Florida Hospital employees Dale and Katrina Munroe, who swept...

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7/17/2015 Comments(0)

Preparing and Responding to an Initial Medicaid Audit Request

By Lance O. Leider, J.D. Florida health care providers servicing Medicaid patients are at a higher risk for audits than anywhere else in the country.  The unfortunate truth is that Florida has become synonymous with health care fraud.  As a result, auditing and subsequent overpayment demands are very real possibilities. Facts You Should Know About the Medicaid Audit Process. Should you find yourself, your facility or your health practice the subject of a Medicaid audit...

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7/17/2015 Comments(0)

Congress Sends Plea to HHS to Issue Medicaid Equal Access Regulations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The House Committee on Energy and Commerce and the Senate Committee on Finance both recently sent a letter to Secretary Burwell urging the U.S. Department of Health and Human Services (HHS) to actually issue the Medicaid Equal Access regulations. The regulatory guidance was proposed by the Centers for Medicare and Medicaid Services (CMS). The document is entitled Medicaid Program: Methods ...

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7/16/2015 Comments(0)

Marijuana Policy Growing in 2015 as More States Preparing to Legalize

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law     Marijuana policy has increasingly developed through the years. Today, 23 states have legalized medical marijuana and four states have approved recreational marijuana, including D.C. During 2015, the country and foreign nations will see big changes involving marijuana policies, according to a recent Brookings Institution report. New States are Planning and Preparing for Legal M...

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7/15/2015 Comments(0)

South Florida Nursing Home Chain to Pay $17M in Whistleblower Suit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law                         A Miami-based nursing home chain has agreed to pay a record $17 million to settle a False Claims Act suit that was brought by its former Chief Financial Officer (CFO). The United States Attorney's Office claims that Plaza Health Network, formerly known as Hebrew Homes, allegedly d...

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7/14/2015 Comments(0)

Are You Being Investigated for Health Care Fraud? Would You Know it if You Were?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Shelby Root Due to the large dollar amounts involved in health care, the great costs of many medical procedures and treatments and the complexity of payment plans, there are those who may attempt to take advantage and defraud the government or others. However, there are also those who just make honest mistakes in billing or whose billing personnel make mistakes; unfortunately, these hon...

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7/13/2015 Comments(0)

Food Truck Owners Must Possess a State-Issued to License in Order to Operate

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law     Following is a summary of a recent administrative hearing case on an issue relevant to health law, decided by the Florida Division of Administrative Hearings (DOAH). Department of Business & Prof'l Reg., Div. of Hotels and Restaurants v. Clinton Green , DOAH Case No. 14-2557 (Corrected Recommended Order Aug. 20, 2014). FACTS:  On April 7, 2014, the De...

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7/10/2015 Comments(0)

Agency’s Failure to Provide Teacher Hearing Notice Violated Due Process and Requires Reversal

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law The following is an appellate court case summary from The Florida Bar Administrative Law Section Newsletter, Vo. 36, No. 4 (June 2015). Facts: Bates appealed a final order revoking his educator's certificate by the Education Practices Commission, arguing that the Commission failed to afford him proper notice of his informal hearing. The Commission sent Bates a notice of his informal ...

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7/9/2015 Comments(0)

Ready or Not, It’s Irregular Behavior Season...

By Lenis L. Archer, J.D., M.P.H., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Every year at regular intervals, our firm receives calls from panicked medical students and residents about a recent letter they have received, alleging irregular behavior on standardized medical examinations. This letter may come from the National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE), or the Educationa...

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7/8/2015 Comments(0)

Clinical Research on Illegal Dispensing of Controlled Substances

By: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Shelby Root On July 2, 2014, the Administrator of the Drug Enforcement Administration (DEA) denied a DEA research registration application of an Arkansas clinical research company. The DEA found that the individual who would be primarily responsible for ordering and storing controlled substances was "surprisingly unaware" of the requirements imposed by the Controlled Substances Act (CSA) ...

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7/7/2015 Comments(0)

Health Facility Entitled to Attorney's Fees Against AHCA in Defending Medicaid Overpayment Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The following is a summary of a recent administrative hearing case on an issue relevant to health law, decided by the Florida Division of Administrative Hearings (DOAH). FACTS: Via three Final Audit Reports dated July 10, 2013, AHCA advised the Chrysalis Center that it had overbilled the Medicaid program by $284,535.83 for community mental health services.  The Chrysalis Center respo...

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7/6/2015 Comments(0)

Florida Information Protection Act (FIPA) Has More Stringent Notice Requirements than Federal Law

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In 2014, the Florida Legislature passed, SB 1524, which was signed into law on June 20, 2014. It became effective on July 1, 2014. This law, codified as Section 501.171, Florida Statues (2014), contains broader provisions than federal law for providing notice when there is a breach of or accidental release of personal individuals' information. It applies to much more than medical information; it...

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7/2/2015 Comments(0)

Don’t Be Afraid to Invoke Your Fifth Amendment Rights: Why You Should

By: Vivionne N. Barker, J.D., George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law    During a criminal proceeding, an accused individual has the right to remain silent or "plead the Fifth.” This theory has been commonly referred to as an individual's right to not be compelled to be a witness against himself or to avoid self-incrimination. It follows the accused from the inception of the case through any criminal proceeding o...

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7/2/2015 Comments(0)

Federal Employees Need to be Aware of These Warnings During an OIG Interview

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Shelby Root Federal employees are subject to criminal investigations and criminal prosecutions by the Office of Inspector General (OIG) within their respective federal agencies. The OIG of an agency routinely investigates and helps prosecute wrongdoing. If applicable, an investigator will state before the interview the employee's rights in regard to, among other things, remaining silent ...

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7/1/2015 Comments(0)

Bad Medicine? Anesthesiologist Caught Ridiculing Sedated Patient

By Vivionne N. Barker, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law     In a medical suite in Reston, Virginia, a man preparing for a colonoscopy hit the record button on his smartphone’s audio recorder to preserve instructions from his doctor after the procedure. When the patient pressed play on his way home, he was shocked by what he heard. You may be shocked, too. No Laughing Matter. While listening to t...

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6/30/2015 Comments(0)

Medicare to Publish Physician Payment Data Annually: Will This Prevent Medicare Fraud?

By Ritisha K. Chhaganlal, J.D.     Billions of dollars are spent annually on Medicare payments to individuals and organizations. For over three decades, the American Medical Association (AMA), a prominent physician group in the United States, had successfully argued that a doctor’s right to privacy outweighed the public’s interest in knowing how its tax dollars were used. However, primarily due to increased Medicare fraud, the U.S. government will begin to publish...

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6/30/2015 Comments(0)

Application and Removal from the OIG Exclusion List

By Lance O. Leider, J.D.       The OIG exclusion list is a tool to keep track of individuals who have been excluded from participation in federal healthcare programs due to crimes or convictions like fraud or patient neglect. But individuals who are placed on exclusion lists by the OIG don't stay there forever. Each exclusion comes with a different term, and when that term is up, individuals may apply for reinstatement (and removal from the exclusion database).  ...

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6/25/2015 Comments(1)

New OIG Fraud Alert Focuses On Physician Contracts: What to Watch Out For

By: Lance O. Leider, J.D., The Health Law Firm      On June 9, 2015, the U.S. Department of Health and Human Services, Office of the Inspector General issued a special fraud alert on physician compensation arrangements. The purpose of the alert was to warn physicians who enter into certain arrangements like medical directorships, department chairs, board of directors seats, and other similar positions to do so carefully. It also is used to ensure that the arrangement...

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6/23/2015 Comments(0)

Texas Medical Board Enjoined for Possible Antitrust Violations by Federal Court

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law and Shelby Root   On May 29, 2015, the U.S. District Court for the Western District of Texas granted an injunction against the Texas Medical Board (TMB). The suit was brought by a company called Teladoc, Inc. Teladoc, Inc provided medical services to patients through webchats, video chats, and other telemedicine modalities. The TMB had a new regulation which prohibited this type of practic...

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6/23/2015 Comments(0)

Big Bust Sweeps Out Medicare Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law and Shelby Root     The largest criminal health care fraud takedown in the history of the U.S. Justice Department, in terms of both loss amount and arrests, took place June 18, 2015. The U.S. Department of Justice, along with 900 law enforcement officials, arrested 243 people across the country, including doctors, nurses, and other licensed professionals, for their alleged partic...

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6/22/2015 Comments(0)

Disabilities and the Medical Education System

By Geor ge F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law Many do not realize it, but schools, universities, medical schools and most other educational progra ms provide access to psychotherapists for their current students and residents. It is important that students, residents and their advocates be knowledgeable about their rights and responsibilities. Although protections exist, the student or resident has the responsibility of notifying t...

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6/9/2015 Comments(0)

South Florida Pill Mill Shut Down

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Plantation-Florida based pain clinic was shut down and eight employees were arrested in connection to the alleged overdose deaths of eight former patients. The clinic, known as Real Care Medical clinic, is alleged to have issued prescriptions for alprazolam, oxycodone and methadone without medical necessity in 2010, resulting in the fatal overdoses of eight individuals.     Pain...

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6/9/2015 Comments(0)

Employee or Independent Contractor - The Test Used to Determine - Part 2 of 3

B y George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law   There are serious legal repercussions in incorrectly treating an employee as an independent contractor. Attention to the factors used by the IRS and other regulatory bodies in examining the issue may help to keep you out of trouble . In this 3-part blog, we will examine tests and factors used to determine whether a worker should be classified as an employee instead of an individua...

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6/3/2015 Comments(0)

Employee or Independent Contractor - The Test Used to Determine-Part 1 of 3

By George F. Indest III, J.D., M.P.A., LL.M, Board Certified by the Florida Bar in Health Law We are often asked by medical groups, health care clinics, and other care providers whether they are legally allowed to treat those working for them as independent contractors.  In attempting to determine whether an individual may be treated as an independent contractor or an employee, it is useful to apply the Internal Revenue Service (IRS) "20 Factor Test."   Many businesses prefer ...

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5/28/2015 Comments(0)

Health Care Professionals Face Strict Repercussions for Misuse of Florida's Prescription Drug Monitoring Program

After much political wrangling and lobbying, in 2009, Florida enacted the Electronic-Florida Online Reporting of Controlled Substances Evaluation (E-FORCSE), currently codified in Section 893.055, Florida Statutes . More often, it is referred to simply as the prescription drug monitoring program (PDMP) by Florida physicians. Since the beginning, the PDMP has been plagued with issues ranging from funding, patient privacy concerns and the legal uses of the database. All health care profe...

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By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law 5/15/2015 Comments(0)

Exclusion or Termination From Medicare or Medicaid Programs Can Mean Professional Death

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Have you ever been arrested for a criminal offense?  Have you ever had discipline on your license as a health professional?  Have you ever been assessed a repayment or fine by the Medicare or Medicaid Programs?  If so, then you may have also been terminated from or excluded from the federal Medicare Program or your state Medicaid Program. Check the List. To check if you ...

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5/12/2015 Comments(0)

The Florida Marchman Act-The Baker Act's Little-Known Cousin

One of the toughest things families of people with substance abuse problems encounter is convincing loved ones to get the help they need.  In the state of Florida, there is a law called the Marchman Act which may allow some relief. What is the Marchman Act? The Marchman Act is very similar to the Baker Act, in that it allows for the involuntary confinement of a person in order to receive treatment for a substance abuse problem . For more information on the Baker Act, click here...

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Lance O. Leider, J.D., The Health Law Firm 5/1/2015 Comments(0)

Telemedicine Still Up For Discussion In Florida Legislative Sessions

Telemedicine continues to be a heated issue during the 2015 Legislative session. With all the new technologies, mobile medical applications, expansion of health care access under the Affordable Care Act (ACA), and the emphasis on quality of care, telemedicine is at the forefront of the health care industry. Many major health insurance carriers are backing telehealth, adding online doctor visits as a covered benefit. For example, WellPoint and Aetna among other health insurers, are allowin...

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Lance O. Leider, J.D., The Health Law Firm 4/28/2015 Comments(0)

The American Pharmacists Association Weighs in on Participation in Executions

By Chris E. Brown, J.D., The Health Law Firm Here's a controversial topic to consider: During the annual meeting of the American Pharmacists Association (APhA) on March 30, 2015, the group voted to discourage its members from participating in lethal injection style executions. While this position is not legally binding, it does hold the same ethical sway as a policy announcement by the American Medical Association does for doctors. What The Stance Means. According to Nati...

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Chris E. Brown 3/30/2015 Comments(0)

U.S. Supreme Court Rules: State Professional Boards May Not Suppress Competition - How This Ruling Affects You

Are you regulated by a state board or do you sit on one? If you're a physician, dentist, pharmacist, nurse or other health care professional the answer is probably "yes," and you'll want to continue reading. On February 25, 2015, the U.S. Supreme Court ruled that the North Carolina Board of Dentistry, made up of mostly dentists, violated federal law against unfair competition. The Board tried to prevent lower-cost competitors in other fields from offering teeth-whitening services. The Su...

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By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law 3/18/2015 Comments(0)

Are you on the Deadbeat Doctor List? - Public Records of Student Loan Defaults

From 1978 through 1998, the federal government administered a program called the Health Education Assistance Loan (HEAL) Program.  HEAL loans were federally insured loans issued by qualified private lenders.  The loans were given to eligible students in schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, public health, pharmacy, chiropractic, health administration, and clinical psychology. Ultimately, the HEAL program was discontinued and its adm...

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Lance O. Leider, J.D. 2/25/2015 Comments(1)

Find Out What Could Bar a Florida Health Care Provider from Holding a License for 15 Years or More

With recent amendments, Section 456.0635, Florida Statutes, has enacted very harsh consequences for physicians, dentists, nurses and other professionals licensed by the Florida Department of Health (DOH), if they are convicted of certain crimes.  These consequences include prohibitions on holding a license for up to 15 years after serving the last day of a sentence or probation. Section 456.0635, Florida Statutes provides: 1.    If you have been convicted of, or ent...

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George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in the Legal Specialty of Health Law 2/19/2015 Comments(0)

Anthem Hack Largest Health Care Data Breach Ever: Does the Health Care Industry Have a Target on its Back?

If you are in the health care industry, WAKE UP! You are absolutely, 100 percent a target for cyberthieves. On February 4, 2015, Anthem, Inc., announced that it had been hacked by cyberthieves. The personal information of around 80 million customers and employees was exposed. If an attack like this can happen to one of the biggest health insurers in the United States, it can happen just as easily to small providers. How Did Hackers Get into the Anthem System? According to Becker'...

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George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in the Legal Specialty of Health Law 2/16/2015 Comments(0)

Massage Therapist Scam Continues: Florida Department of Health Continues to Investigate Massage Therapy Schools Which May Be Involved in Selling Phony Degrees, Certificates and Transcripts

We have recently become aware that the Florida Department of Health (DOH) and the Board of Massage Therapy are continuing to investigate and audit various schools in Florida with massage therapy programs.  There is a concern that many licensed massage therapists may have used fraudulent documents such as transcripts and course completion certificates from these schools to become licensed illegally. The Florida Board of Massage Therapy is a professional board under the Florida DOH. T...

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By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in the Legal Specialty of Health Law 2/10/2015 Comments(0)

Florida Cracking Down on Unlicensed Activity

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm   The administrator of the Florida Department of Health's (DOH) Unlicensed Activity Program presented an update on the investigations of unlicensed activity in the state. This report, presented at the recent Board of Psychology, is one of the many reports being presented to the various professional licensing boards. The presentation indicated that Florida has dramatically increased its efforts to not only investigate and pro...

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Lenis L. Archer 2/9/2015 Comments(0)

OIG Attacks Ophthalmologists with Investigative Subpoenas

It's no secret that the Office of Inspector General (OIG) is stepping up enforcement lately.  But the newest focus of those efforts may surprise you: ophthalmologists. Recently, we have seen an increase in the amounts of audits and subpoenas directed to ophthalmologists.   Zone Program Integrity Contractors (ZPIC) auditors (those are the fraud-focused ones) have been showing up in practices demanding access to records and employees more than before. For a checklist on wha...

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Lance O. Leider, J.D., The Health Law Firm 2/6/2015 Comments(0)

Starting This Year, Health Care Providers Will Be Short Changed in Medicaid Reimbursements

Here's a situation: If it costs a physician one dollar to care for a patient, and he/she is only getting 60 cents in reimbursements, the physician is actually paying to take care of a patient. This hypothetical situation begs the question: Why would physicians agree to treat Medicaid patients? Treating Medicaid patients has never been a money maker for physicians. However, for the past two years, Medicaid programs have been required to reimburse primary care providers at Medicare leve...

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Lance O. Leider, J.D., The Health Law Firm 1/29/2015 Comments(0)

It's Winter Time and Flurries of Subpoenas Are Flying on Medicare and Medicaid Cases

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Here it is: the New Year.  We all want to start it off on the right foot, with bills from last year paid and realistic resolutions made.  Then comes a knock on the door, or a certified letter, and it blows you away like the down of a thistle.  You've received your first subpoena of the year. Happy New Year! But don't worry, you are not alone.  From the calls we have rec...

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George F. Indest III 1/12/2015 Comments(0)

CMS Proposes Equal Rights Changes to Same-Sex Couples

By Lance O. Leider, J.D., The Health Law Firm Under a new proposed rule hospitals and other health care facilities would have to give equal rights to the spouse of same sex and straight patients as long as the marriages are legal somewhere in the country. The Centers for Medicare and Medicaid Services (CMS) issued the proposed rule broadening the definition of "representative" and "spouse" in its Medicare and Medicaid conditions of participation and conditions of coverage. This r...

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12/24/2014 Comments(0)

Hey, Health Care Professionals, Why Can't We Be Friends?!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This past year our firm has attended more medical industry events than ever before. Needless to say, our law firm table is not the most popular hangout spot. If we had a penny for every time we have heard "Yikes, an attorney! I hope I never need you." we could close our doors and all retire. The feeling is akin to being the last kid picked in gym class. So we ask ourselves: why are we atto...

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George F. Indest III 12/22/2014 Comments(0)

CMS Expands Medicare's Authority to Deny and Terminate Physicians and Other Providers-Why This Matters

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Stop me if you've heard this one before: the Centers for Medicare and Medicaid Services (CMS) recently increased Medicare's authority over physicians and other health care providers. On December 3, 2014, CMS released these new anti-fraud measures. This matters to physicians and health care providers because Medicare now maintains the authority to deny or revoke the enrollment of medical providers...

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George F. Indest III 12/11/2014 Comments(0)

Office of Inspector General Work Plan 2015: A Provider's Overview-Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law An ounce of prevention is worth a pound of cure. Through the 2015 Office of the Inspector General (OIG) Work Plan, the agency has revealed how it plans to carry out its mission to ensure the Medicare and Medicaid programs run more efficiently in the 2015 fiscal year. As a health care provider, knowing the ins...

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George F. Indest III and Michael L. Smith 11/24/2014 Comments(0)

Office of Inspector General Work Plan 2015: A Provider's Overview-Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law Each new fiscal year, the Office of the Inspector General (OIG) Department of Health and Human Services (HHS) releases its annual Work Plan.  This Work Plan is the general overview of how the OIG intends to carry out its mission to make the Medicare and Medicaid programs run more smoothly and efficient...

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George F. Indest III and Michael L. Smith 11/21/2014 Comments(0)

IRS Beefs Up Whistle-blower Awards Program

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Internal Revenue Service (IRS) is hoping that a change in the law and the possibility of a big payout will encourage more whistle-blowers snitching to authorities. Few people are aware of this program. The IRS issued brand new regulations for its own whistle-blower program in August 2012. These were written to recruit more whistle-blowing moles to help flush out financial fraud. The bigge...

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George F. Indest III 11/17/2014 Comments(0)

Failure to Comply With HIPAA Can Result in Both Civil and Criminal Penalties

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Even though a violation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security provisions does not allow a private civil cause of action, it does carry civil and criminal penalties. Anyone who is a health care professional or facility, or deals with a health care professional or facility, should be aware of these legal provisions. Criminal Pena...

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George F. Indest III 11/11/2014 Comments(3)

Medicare Providers: Make Sure Medicare Has Your Correct Address; Make Sure You Complete CMS Forms 855I Correctly

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are constantly consulted by and retained to represent physicians, medical groups, pharmacies, durable medical equipment (DME) distributors and other Medicare providers on issues relating to deficiencies from site visits and inspections by Medicare contractors and on notices of termination of Medicare billing privileges. Results of Termination from the Medicare Program. These are extre...

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George F. Indest III 10/29/2014 Comments(0)

Supreme Court Scrutinizes Dentist Regulating Dentists - Ruling Could Affect Other Regulatory Boards

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The United States Supreme Court is currently hearing arguments in North Carolina Board of Dental Examiners v. Federal Trade Commission . The justices will determine whether professional regulatory boards should be exempt from federal antitrust laws and thus be allowed to eliminate low-cost competitors. This case will also decide whether U.S. states can delegate the regulation of professionals, s...

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George F. Indest III 10/22/2014 Comments(1)

Baker Act Basics

By Lance O. Leider, J.D., The Health Law Firm The Florida Mental Health Act, more commonly known as the Baker Act, was passed to allow for the creation of programs designed to "reduce the occurrence, severity, duration, and disabling aspects of mental, emotional, and behavioral disorders." Section 394.453, Florida Statutes. The Baker Act contains a wide range of provisions ranging from screening to appointment of legal guardians.  But what the Act is most known for are the involunt...

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George F. Indest III 10/20/2014 Comments(2)

Reap the Benefits of Electronic Health Records, Not the Liabilities - Part 2

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm In part one, I discussed how the recent United States Ebola crisis in Texas appeared to bolster the argument for those wary of the implementation of electronic health records (EHRs). To read that blog, click here . Health information technology (health IT) brings both opportunities and challenges for healthcare providers . EHRs are one of the most debated health IT developments. The intent of such an innovative system is t...

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Lenis L. Archer 10/16/2014 Comments(0)

The United States Ebola Case May Have Cast Doubt On The Use of Electronic Health Records - Part 1

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm The evolving world of electronic technology saturates every type of industry imaginable. Organizational communication and the resources utilized have come full circle; from paper and pens to iPads and keyboards. Healthcare is not excluded from this advancement. Conversion to electronic health records (EHRs) has been a hot topic in the healthcare world for years. At its inception, the intent of EHRs was to streamline procedures and impro...

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Lenis L. Archer 10/10/2014 Comments(0)

Just What the Doctor Ordered: More Medicaid Reimbursements May Be On the Way For Florida Physicians

By Lance Leider, J.D., The Health Law Firm Taking Medicaid patients can be seen as a professional obligation for health care providers. In return, good deeds should not bankrupt a practice. There could soon be a resolution to a class-action lawsuit against Florida health and child-welfare officials that would adequately compensate physicians for treating children of poor families. According to the Miami Herald, the lawsuit was initially filed in 2005 by a group of pediatricians, dentist...

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10/7/2014 Comments(0)

What You Need to Know about the Rescheduling of Hydrocodone Combination Products

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm Physicians and pharmacists: mark your calendars. The Drug Enforcement Administration (DEA) is reclassifying "hydrocodone combination products" from Schedule III to the more-restrictive Schedule II under the Controlled Substances Act. The final regulation will take effect on October 6, 2014. Upon the effective date, this change will have a widespread impact on healthcare professionals, particularly physicians and pharmacists....

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Lenis L. Archer 10/2/2014 Comments(1)

Reinstatement After OIG Exclusion is Not Automatic

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An issue we frequently handle is Office of Inspector General (OIG) exclusion from the Medicare program following a conviction for a healthcare-related offense. An OIG exclusion blocks a healthcare provider from working for any individual or entity that contracts with federally funded programs in any capacity. For example, if a healthcare provider receives a five-year OIG exclusion, he or she cann...

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George F. Indest III 9/10/2014 Comments(0)

The ABCs of IRBs

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm The field of scientific research presents many challenges to academics.  When research is performed on human subjects in a health care setting, the stakes are even higher.   Allegations of research misconduct can throw academic researchers into a tangled web of institutional and legal challenges.  University policies, federal regulations, and legal concerns overlap in ways that may become quite frustrating for a health...

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Lenis L. Archer 8/25/2014 Comments(0)

Has Healthcare Compliance Gone Too Far?

By Lance O. Leider, J.D., The Health Law Firm From large hospital systems to solo practitioners, there is no escaping healthcare compliance in the industry. The concept of compliance can spark different thoughts in different people. For example, some believe it is an unnecessary government intrusion, and others believe it's a way to improve the quality and costs of healthcare. No matter your thoughts on healthcare compliance and government oversight, regulation of the healthcare industr...

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8/21/2014 Comments(0)

Warning: Texting Patients' Sensitive Information Could Have Serious Consequences

By Lance O. Leider, J.D., The Health Law Firm I regularly lecture to residents and interns of local hospital residency programs. I like to discuss life skills for health care professionals that they may not learn in a classroom. At the end of the discussion, it never fails that I get at least one question regarding text messaging. For example, "Can I text another doctor about a patient?" or "Is text messaging an acceptable way to communicate with my patients?" These questions are not un...

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8/19/2014 Comments(0)

As a Health Care Professional in Florida, You Need to Stay In the Know on Medical Marijuana

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law During the 2014 session, the Florida legislature passed Senate Bill 1030 or the Compassionate Medical Cannabis Act of 2014. The bill was signed into law by Florida Governor Rick Scott on June 16, 2014. The law makes it legal for qualified Florida patients to take low-THC cannabis in liquid form. The specific medical marijuana is approved to treat certain medical conditions such as epilepsy, muscl...

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8/12/2014 Comments(0)

Stay Sharp and Aware: Employee Embezzlement in the Medical Field - Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Embezzlement should be a concern to all healthcare facilities , medical practices and business owners . Part one of my embezzlement blog discussed the extent of embezzlement in the medical field, financial indicators of fraud, and the office criteria that fosters fraudulent activities. To read part one, click here . Embezzlement is rarely always a complex crime. This type of fra...

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George F. Indest III 8/5/2014 Comments(0)

Don't Bury Your Head in the Sand: Embezzlement in the Medical Field - Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law When his American Express Platinum Card with an unlimited credit line was declined, a doctor in DeBary, Florida, realized he had a big problem. According to the Orlando Sentinel, the office manager of the doctor's medical practice allegedly embezzled more than $136,000. For more than two years, the middle-aged woman who managed the doctor's finances allegedly used the doctor's money and...

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7/30/2014 Comments(0)

Thinking About Contacting the Professionals Resource Network (PRN) or the Intervention Project for Nurses (IPN)? Read This.

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Physicians, dentists, nurses and other health professionals, accused of wrongdoing, may be referred to or receive recommendations from colleagues to refer themselves to the Professionals Resource Network (PRN) or the Intervention Project for Nurses (IPN).  This is often done by someone who has absolutely no idea about these programs or what they require.  An individual who does this ma...

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7/28/2014 Comments(0)

What You Need to Know About Florida's Baker Act - Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are frequently consulted by family members or friends of individuals who are erroneously confined under Florida's Baker Act or the Marchman Act . An erroneous confinement under the Baker Act can occur for a number of different reasons.  However, the result is that an independent citizen is confined in violation of his constitutional rights to liberty and privacy.  There i...

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7/23/2014 Comments(0)

What You Need to Know About Florida's Baker Act - Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are frequently consulted by family members of individuals who are erroneously confined under Florida's Baker Act, Section 394.451, Florida Statutes . An erroneous confinement under the Baker Act can occur for a number of different reasons.  However, the result is that an independent citizen is confined in violation of his constitutional rights to liberty and privacy. There is a simila...

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7/21/2014 Comments(1)

Science Journal Retracts Stem-Cell Research Studies; Head Researcher Held Accountable

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The scientific journal, Nature, retracted two high-profile stem-cell research studies due to signs of inadequate data and plagiarism. According to Tech Times, researchers from the RIKEN Center for Development Biology in Kobe, Japan, published results on January 30, 2014, claiming that scientists of the institute had successfully reprogrammed mature cells into young stem-cells. The stem-cells, ...

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7/15/2014 Comments(0)

Limits on Number of Attempts and Time for Completion of USMLE Step Exams

By Catherine T. Hollis, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law According to the United States Medical Licensing Examination ( USMLE ) 2014 Bulletin of Information, individuals are permitted to attempt the same Step Exam or Step Exam Component a maximum of six times.  All attempts, including incomplete attempts, are counted toward the limit, regardless of when they were taken.  The USMLE Program its...

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7/11/2014 Comments(0)

Document Drop Off: Where One Health System Left Private Patient Medical Records

By Lenis L. Archer, J.D., M.P.H. A drop off of private patient files to a physician quickly turned into what may be one of the most expensive deliveries in healthcare regulatory history. In 2009, employees of Parkview Health System, a nonprofit organization with hospitals in Indiana and northwest Ohio, left 71 cardboard boxes of private patient medical records in the driveway of a retiring physician. Within 20 feet of the public road and in close proximity to a heavily trafficke...

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6/30/2014 Comments(0)

Does the DEA Use Intimidation Tactics to Force Doctors and Pharmacists to Give up Their DEA Number?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The U.S. Drug Enforcement Administration (DEA) continues to crackdown, at least in Florida, on physicians and pharmacists suspected of prescribing and dispensing narcotics.  We believe this effort is a continuation of the campaign against "pill mills" and the pharmacies that fill prescriptions written by them. However, just because you are not a pain management physician or pharmacis...

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6/24/2014 Comments(1)

Adventist Health System Self-Discloses Stark Law Violations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law When I served with the federal government, a frequent saying used over and over was: "It's better to ask for forgiveness than to ask for permission." This may be what Adventist Health System is hoping for in making its latest self-disclosure to the Office of Inspector General (OIG). Documents released on May 12, 2014, reveal that Adventist, which owns Florida Hospital and 44 other hospitals ...

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6/20/2014 Comments(0)

Outpatient Outsourcing: The Unconventional Methods of One Florida Urologist

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law "A menace to society," "board-certified in medical fraud," "one of the most dangerous doctors I've seen in a long time." These are some of the harsh words coming from the Florida Board of Medicine. The Board used those statements to describe a Sarasota, Florida, urologist who specializes in prostate problems. The urologist is accused of using unconventional diagnostic and treatment methods, even ...

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6/18/2014 Comments(0)

Halifax Health Back in the Hot Seat - Why the Hospital was Hit with Even More Sanctions

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar  in Health Law Always be wary of asking "could it get any worse?" Halifax Health Medical Center in Daytona Beach, Florida, is proof that a situation always has the possibility of taking a darker turn. On May 27, 2014, the federal judge overseeing the ongoing Halifax whistleblower/qui tam court cases ruled that the medical center wrongfully destroyed documents and files that were central to th...

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6/10/2014 Comments(1)

How Tightened Controls on Prescribing for Medicare Part D Patients May Affect Health Care Providers-Part 2

By Lance O. Leider, J.D., The Health Law Firm Under a rule finalized by the Centers for Medicare and Medicaid Services (CMS) on May 19, 2014, doctors and other health care professionals will be required to enroll in the Medicare program, or have a valid opt-out affidavit on file, for prescriptions to be covered under Part D. The new requirement takes effect on June 1, 2015. To read more on the details of this rule and why CMS implemented it, click here for the first blog of thi...

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6/6/2014 Comments(0)

How Tightened Controls on Prescribing for Medicare Part D Patients May Affect Health Care Providers-Part 1

By Lance O. Leider, J.D., The Health Law Firm On June 1, 2015, doctors and other health care providers will be under tighter restrictions when prescribing to Medicare Part D patients. A final rule released by the Centers for Medicare and Medicaid Services on May 19, 2014, requires health care providers to enroll in the Medicare program, or have a valid opt-out affidavit on file, for prescriptions to be covered under Part D. This requirement closes a loophole that previously allowed some pr...

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6/4/2014 Comments(0)

Court Orders Florida Oncologist to Pay $89.6 Million After False Claims Act Judgment

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Talk about cracking down on Medicare fraud. On May 14, 2014, a Brevard County radiation oncologist received his final judgment in a whistleblower Medicare fraud case . The doctor, who owned the American Cancer Treatment Centers with offices in Titusville and Rockledge for nearly 20 years, was ordered to pay the United States $89.6 million. The doctor was charged with defrauding Medicare under ...

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5/29/2014 Comments(0)

Pain Management Physicians Beware: Your Practice is Under Scrutiny

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The practice of pain management remains under direct scrutiny here in Florida. The Orlando area recently entered the limelight again after federal agents raided a local pain clinic with heavy allegations against the owner and his sole practitioner. On May 8, 2014, Metropolitan Bureau of Investigation (MBI) agents and Florida Department of Health (DOH) officials raided the Pain Care Place of Ce...

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5/21/2014 Comments(0)

Statistical Analysis, Often Performed on National Board Exams, May Result in Accusations of "Irregular Behavior" or Other Career-Killing Charges

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Before obtaining a professional license or degree, medical, dental, chiropractic and other professional students are subject to stringent testing.  Students must take and pass the national board examinations. These examinations are usually administered by private companies, such as the National Board of Medical Examiners (NBME), through the United States Medical Licensing Examination (USMLE)...

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5/13/2014 Comments(0)

Medicare Providers and Suppliers Deemed "High Risk" Must Submit to Fingerprint-Based Background Checks

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Centers for Medicare and Medicaid Services (CMS) is enforcing fingerprint-based background checks for Medicare suppliers and providers designated as "high risk." As a requirement of the Affordable Care Act (ACA), CMS must improve the screening for those Medicare suppliers and providers. According to CMS, all newly enrolling home health agencies (HHAs) and durable medical equipment (DME) suppl...

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5/9/2014 Comments(1)

CRIMINAL LAW: Search and Seizure - Cell Phone

Our guest author of this is article is Doug Plank , a legal research attorney with National Legal Research Group in Charlottesville, Virginia. In the case of City of Ontario v. Quon , 560 U.S. 746 (2010), a police officer filed a civil rights action after his superiors disciplined him based on what they had discovered after searching the content of the texts on the wireless communication device that the police department had issued to him. The U.S. Supreme Court assu...

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5/1/2014 Comments(0)

CONSTITUTIONAL LAW: To Be "Clearly Established" or Not "Clearly Established": That Is the Question

Our guest author of this is article is Steve Friedman, a legal research attorney with National Legal Research Group in Charlottesville, Virginia.   The doctrine of qualified immunity shields governmental officials "from liability for civil damages insofar as their conduct does not violate clearly established statutory or constitutional rights." Harlow v. Fitzgerald , 457 U.S. 800, 818 (1982). For qualified immunity purposes, "clearly established" means that "[t]he contours o...

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4/22/2014 Comments(0)

Physicians React to the Release of Medicare Reimbursements

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For years, the Centers for Medicare and Medicaid Services (CMS) kept private its records on Medicare reimbursement payments made to physicians, however, on April 9, 2014, that all changed.  The government released records revealing unprecedented details about Medicare payments made to physicians, nurse practitioners (NPs), physician assistants (PAs) and other health care providers.   ...

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4/21/2014 Comments(0)

CONTRACTS: Forum-Selection Clause—Enforcing by 28 U.S.C. § 1404(a) Motion to Transfer Venue

Our guest author of this is article is Charlene Hicks, a legal research attorney with National Legal Research Group in Charlottesville, Virginia.   Forum-selection clauses are commonly used in contracts to specify the location in which the parties agree to resolve any disputes that may arise between them. These clauses are important to businesses that wish to establish predictability and potential cost-savings in future litigation. Even so, until recently a split existed amongs...

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4/15/2014 Comments(0)

Contracting 101: Tips for Physicians and Health Professionals-Part 12

By Christopher E. Brown, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Tip 28-Verify That the Relationship Between the Physician and the Employer is Legal. Our contracting blog series was created to identify and explain the different provisions of a physician's employment or independent contractor agreement.  However, sometimes it's necessary to look beyond the written language of the contract and determi...

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4/14/2014 Comments(3)

Texas Medicaid Settlement Raises Questions Among Health Care Providers

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 17, 2014, Carousel Pediatrics in Austin, Texas, agreed to pay the state a $3.75 million settlement, after an investigation by the Texas Health and Humans Services Commission Office of Inspector General (OIG) allegedly found a number of billing errors.  According to a press release, the Texas OIG alleged the pediatric office char...

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4/8/2014 Comments(0)

CMS Revises Emergency Preparedness Checklist

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm On February 28, 2014, the Centers for Medicare and Medicaid Services (CMS) issued its revised emergency preparedness checklist for health care facility planning. Updates to the checklist provide more detailed guidance about patient and resident tracking, supply management, and collaboration with local emergency management agencies and health care coalitions. According to the Survey and Certification Memorandum, the information is curr...

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4/4/2014 Comments(0)

Lost Thumb Drive at Arnold Palmer Medical Center Contains Information on 586 Child Patients

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An unencrypted flash drive containing limited information of 586 children treated at Orlando Health's Arnold Palmer Medical Center between 2009 and 2013, was misplaced, according to the hospital. The lost drive is being treated as a data security breach. However, there is no evidence that any of the information on the flash drive was accessed or used by any unauthorized individual. As a preca...

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4/2/2014 Comments(0)

New National Practitioner Data Bank (NPDB) Guidebook to be Available Soon

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law When faced with an issue or question about the National Practitioner Data Bank (NPDB), most health care practitioners rely on the Data Bank Guidebook. Since September 2001, this Guidebook has been a reliable source to turn to for answers regarding reporting to and querying the NPDB. However, after twelve years, a new Guidebook will soon be released. In November 2013, the Health Resources and ...

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3/31/2014 Comments(0)

Massachusetts Physicians Who Don't Meet Meaningful Use EHR Criteria Could Lose Their Medical Licenses in 2015

Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law Effective January 2015, Massachusetts physicians who wish to renew their licenses must demonstrate that they utilize electronic health records (EHRs) that meet the requirements of the federal government's meaningful use program.  The purpose of the law was to improve the quality of healthcare provided to patients by Massachusetts doctors while reducing costs.  However, the law had unintended conseque...

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3/26/2014 Comments(0)

Equitable Tolling May Not Be Used To Save Late Hearing Request When It Could Have Been Easily Submitted on Time

The foregoing case summary was prepared by and appeared in DOAH case notes of the Administrative Law Section newsletter FACTS: The Department of Financial Services (“DFS”) resolves disputes over the costs of medical care provided to workers’ compensation claimants.  On April 8, 2013, Florists Mutual Ins. Co. (“Florists”) receive notice of DFS’s determination that Florists owed $100,894.54 to the Kendall Regional Medical Center.  The notice a...

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3/24/2014 Comments(0)

More Than 168,000 Patients' Information Stolen in Los Angeles County Computer Theft

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Around 168,500 patients of Los Angeles County medical facilities are receiving letters that their personal data was stolen. According to the Los Angeles Times, on February 5, 2014, an office of Sutherland Healthcare Solutions, which handles billing and collections for the county's Department of Health Services and Department of Public Health, was burglarized and computer equipment stolen. Cli...

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3/21/2014 Comments(0)

Professional Board Is Not Allowed to Ask About Misconduct Not Charged in Administrative Complaint at Informal Hearing

T h e Department of Health (“DOH”) filed an administrative complaint against Gonzalez, a licensed chiropractor, for alleged statutory and rule violations.  The alleged violations involved recordkeeping practices and failure to provide records to a patient upon request.   Gonzalez elected to have an informal hearing and did not dispute the findings of fact in the administrative complaint.  At the informal hearing, Gonzalez addressed the alleged violations in m...

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3/19/2014 Comments(0)

USMLE Hearing? Organization, Timing, and Evidence are Crucial-Part 2

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, medical student, or medical resident accused of "irregular behavior" by the United States Medical Licensee Examination (USMLE) Secretariat/National Board of Medical Examiners (NBME), you must challenge this accusation and defend yourself.  You should request a hearing, plan on a personal appearance at the hearing before the Committee for Individualized Review (CIR), a...

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3/14/2014 Comments(0)

USMLE Hearing? Organization, Timing, and Evidence are Crucial-Part 1

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, medical student, or medical resident accused of "irregular behavior" by the United States Medical Licensee Examination (USMLE) Secretariat/National Board of Medical Examiners (NBME), you must challenge this accusation and defend yourself.  You should request a hearing, plan on a personal appearance at the hearing before the Committee for Individualized Review (CIR), a...

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3/12/2014 Comments(0)

Halifax Health Reaches Record-Setting Settlement in Whistleblower/Qui Tam Fraud Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law At the eleventh hour Halifax Health Medical Center, a Daytona Beach hospital, agreed to pay a record-setting $85 million settlement in a whistleblower/qui tam lawsuit. The lawsuit alleged more than a decade of illegal compensation to doctors, violating the federal Stark Law, and Medicare fraud. According to the Orlando Sentinel, on March 3, 2014, Halifax and the U.S. Department of Justice (DOJ) r...

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3/10/2014 Comments(0)

CMS Extends Ban on New Home Health Agencies and Ambulance Suppliers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Centers for Medicare and Medicaid Services (CMS) continues to stop fraudulent repayment claims before they happen. In an effort to do so, the agency is temporarily blocking several home health agencies (HHAs) and ground ambulance suppliers in fraud hot spots around the country from enrolling in and receiving reimbursements from Medicare, Medicaid and the Children’s Health Insurance Prog...

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3/6/2014 Comments(0)

Mandatory Disqualification for Health License Because of Criminal Conviction? There May Still Be Hope

By Lance O. Leider, J.D., The Health Law Firm In 2009 the Florida Legislature passed a bill imposing severe restrictions on the professional boards regulating health care practitioners in Florida.  These include the Board of Medicine, Board of Nursing, Board of Dentistry, Board of Massage Therapy, Board of Osteopathic Medicine, Board of Psychology and Board of Marriage and Family Therapy, among all others.  These draconian measures were implemented in a supposed crackdown on heal...

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3/5/2014 Comments(0)

Looking for Florida Advanced Practice Nurses to Have an Expanded Role? You May Have to Wait

By Joanne Kenna, R.N., J.D., The Health Law Firm Although there has been renewed interest and activity during the current legislative session to expand the roles of Florida advanced nursing practitioners, it seems unlikely that these efforts will result in any changes in the ways these nurses practice in the near future.   A bill (PCB SCHCWI 14-01) was recently passed by the House Select Committee on Health Care Workforce Innovation.  It had bipartisan support.  The bill ...

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3/4/2014 Comments(0)

25 Arrested After Medicaid Fraud Round Up in Washington, D.C.

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In a citywide takedown, 25 people, including operators of home care agencies, operators of nurse staffing agencies, office workers and personal care assistants in Washington, D.C., were all arrested for alleged Medicare fraud schemes. According to the U.S. Attorney's Office, these individual scams involved at least $75 million in fraudulent Medicaid payments. On February 20, 2014, more than 200 l...

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2/27/2014 Comments(0)

Florida Speech Therapist Arrested for Allegedly Defrauding Medicaid

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A licensed speech therapist faces up to five years in prison for allegedly defrauding Medicaid during the summer of 2013. According to the Florida Attorney General (AG), the therapist was arrested on February 7, 2014, for allegedly using falsified records to collect payment for services never rendered. An investigation by the AG's Medicaid Fraud Control Unit (MFCU) and the Orange County Sheriff's...

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2/21/2014 Comments(0)

Florida Board of Pharmacy Recommends PRN Evaluation for all Applicants with History of Mental Problems or Substance Abuse

By Lance O. Leider, J.D., The Health Law Firm The Florida Board of Pharmacy made some rather concerning recommendations to present and future applicants at its February 12, 2014, meeting. During the portion of the agenda where the Board considers the approval of applicants for licensure with prior mental health or substance abuse related issues, some members of the Board expressed frustration with the fact that the applicants had not been evaluated by the Professionals Resource Network ...

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2/19/2014 Comments(0)

Bipartisan Plan for SGR Repeal Released

By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III,         J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law After months of negotiations on how to revise Medicare's payment system for physicians, the bipartisan team of Senate and House committees have reached a deal on the policy. On February 6, 2014, lawmakers unveiled the agreement to repeal Medicare's sustainable growth rate (SGR). The legislation replaces the SGR w...

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2/14/2014 Comments(0)

Appellate Court Rules Agency Personnel Should Not Have Ex Parte Contract With Hearing Officer on Case

Taylor-Tillotson sought medical supplies and prescriptions, and the Agency for Health Care Administration (“AHCA”) denied that request.  On appeal, AHCA filed a motion to dismiss. In its motion, AHCA stated that it believed Appellant should be entitled to a new hearing since an AHCA staff member had ex parte communications with the original hearing officer. While acknowledging the Appellant’s objection to dismissal of the appeal, the court treated AHCA’s motion ...

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2/12/2014 Comments(0)

Florida Law Enforcement Chemist Allegedly Stole Pain Pills Jeopardizing Thousands of Drug Cases

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Department of Law Enforcement (FDLE) is reviewing nearly 3,000 cases across Florida that were processed by a chemist in the FDLE's Pensacola Regional Crime Laboratory, according to a press release. It is alleged that for years the chemist stole pain pills from an evidence room in the Florida Panhandle, and therefore tainted thousands of criminal cases. To read the press release fro...

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2/4/2014 Comments(0)

Sometimes You Get Involved in Litigation Whether You Want to or Not

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Sometimes, despite your best efforts and your best practices, you get involved in litigation. Employees and former employees sue your organization or you or both. Sometimes you are brought in as a witness in such litigation. Contractors and vendors sometimes may sue over contractual matters. If you are not a party to such an action, you still may be called as a witness. Sometimes there ...

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1/31/2014 Comments(0)

Health Care Providers Must Wait for RAC Appeal Hearings While Medicare Beneficiaries Receive Top Priority

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In December 2013, the U.S. Department of Health and Human Services’ (HHS) Office of Medicare Hearings and Appeals (OMHA) notified hospitals, doctors, nursing homes and other health care providers that due to a backlog of Recovery Audit Contractor (RAC) appeals, the agency would be suspending acting on new requests for hearings filed. Health care providers were told they would not be able to...

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1/28/2014 Comments(0)

Department of Justice Recovers $2.6 Billion from Healthcare Fraud Cases in FY 2013

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law According to a press release posted on December 20, 2013, the Department of Justice (DOJ) announced that it secured $2.6 billion in settlements and judgments from healthcare fraud in fiscal year 2013. That amount makes 2013 the fourth consecutive year that the DOJ has recovered more than $2 billion in healthcare fraud cases. Recoveries from healthcare fraud made up a majority of total recoveries ...

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1/24/2014 Comments(0)

USMLE Announces Increase to Minimum Passing Score for Step 1 Exam

By Catherine T. Hollis, J.D., The Health Law Firm and By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In September 2013, the United States Medical Licensee Examination (USMLE) announced that the Step 1 Committee would meet to review the minimum passing score for the USMLE Step 1 examination at its December meeting. On December 12, 2013, the USMLE announced that the Step 1 Committee had decided to raise the minimum passing score for the Step 1 ...

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1/22/2014 Comments(1)

The Health Law Firm Attorneys Often Represent Physicians and Health Professionals in Last Minute Depositions and Hearings

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Our attorneys often receive calls from physicians and other health professionals regarding the possibility of representing them on short notice at a Board of Medicine or Board of Osteopathic Medicine hearing, or at a deposition related to a health care matter. Many Law Firms Refuse To Take Last Minute Cases. Many law firms refuse to represent a client at a hearing unless given plenty of ...

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1/20/2014 Comments(0)

CRIMINAL LAW: Retroactivity of Supreme Court Decision in Padilla v. Kentucky and Possible Application for Health Professionals

Our guest author of this is article is Mark Rieber, a legal research attorney with National Legal Research Group in Charlottesville, Virginia. In Padilla v. Kentucky , 559 U.S. 356 (2010), the Supreme Court held that the Sixth Amendment right to effective assistance of counsel requires an attorney for a criminal defendant to provide advice about the risk of deportation arising from a guilty plea.  In Chaidez v. United States , 133 S. Ct. 1103 (2013), the Supreme Court held that ...

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1/17/2014 Comments(0)

Office of Medicare Hearings and Appeals Suspends Assignment of Appeal Requests Because of Large Backlog of RAC Appeals

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Appealing a bad decision by Medicare’s Recovery Audit Contractors (RACs) is taking longer than ever, according to an article on Modern Healthcare. The system is so overwhelmed by the number of appeals that some are calling it an “administrative quagmire that is denying basic due process rights.” In December 2013, the U.S. Department of Health and Human Services’ (HHS) Offi...

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1/15/2014 Comments(0)

CMS Announced Proposed Rule to Possibly Ban Providers Labeled as Harmful Medicare Part D Prescribers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law The Centers for Medicare and Medicaid Services (CMS) is proposing to exclude providers from Medicare if the government determines a pattern of abusive prescribing practices of Medicare Part D drugs. The agency also wants to prohibit doctors who are not enrolled in Medicare from prescribing drugs that are reimburs...

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1/13/2014 Comments(0)

CONTRACTS: Cyberlaw—Signed Email Constitutes Binding Legal Agreement

Our guest author of this is article is Charlene Hicks, a legal research attorney with National Legal Research Group in Charlottesville, Virginia. Emails and other electronic communications are changing certain time-honored precepts of contract formation. Attorneys should be aware that what used to be considered standard negotiating procedures may now result in a contract binding upon their clients. This trend is illuminated in Forcelli v. Gelco Corp. , 109 A.D.3d 244, ___ N.Y.S.2d _...

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1/6/2014 Comments(0)

Congress Moves Closer to Permanent Repeal of Medicare’s SGR Formula

By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 12, 2013, the U.S. House of Representatives passed a three-month patch to stabilize physicians’ Medicare payments, delaying a nearly twenty-four percent (24%) cut in Medicare payments that was scheduled for physicians in 2014. The delay gives lawmakers time to consider two bills developed by the House Ways and Means Committee and...

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1/2/2014 Comments(0)

ESTATES: Estate Plan of James Gandolfini

Our guest author of this is article is Jim Witt, a legal research attorney with National Legal Research Group in Charlottesville, Virginia. When Sopranos actor James Gandolfini died on June 19 of this year from a heart attack while he was on a vacation trip with his family in Italy, the media reported trivial facts surrounding his death, such as the details of his last meal and drinks. After a month or so had passed, however, attention turned to the details of Gandolfini's estate plan, wi...

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12/17/2013 Comments(0)

Orlando Health and Florida Blue Create Accountable Care Organization

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Lance O. Leider, J.D., The Health Law Firm On December 3, 2013, Orlando Health Physician Partners and Florida Blue announced the launch of an accountable care organization (ACO). The purpose of the ACO is to encourage providers to reduce healthcare costs by grouping together and assuming responsibility for the care of a group of beneficiaries. According to a press release, the ACO between Orl...

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12/12/2013 Comments(0)

Florida Board of Medicine Votes to Raise the Fees for Copies of Medical Records

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The cost of copying medical records is going up. On December 6, 2013, the Florida Board of Medicine voted unanimously to raise the cap on charges for copying medical records to $1 per page. Previously in Florida, physicians were allowed to charge up to $1 a page for the first 25 pages and 25 cents for every page after that. Under the new rule, for example, a physician could charge up to $1,000 fo...

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12/10/2013 Comments(0)

Halifax Health Whistleblower/Qui Tam Case Will Go To Trial

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Federal Judge Gregory A. Presnell has ruled that Halifax Health Medical Center, a Daytona Beach hospital, illegally compensated six (6) oncologists, violating the federal Stark Law. The case must still go to trial on the amount of damages and other legal issues. The Stark Law bars physicians from getting extra cash or benefits from patient referrals through kickbacks, split fees and other under-t...

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12/6/2013 Comments(0)

First Lady Challenges Florida Companies to Hire More Veterans

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 14, 2013, First Lady Michelle Obama attended and spoke at the first Veterans Institute Workshop, held at Disney World. This event encouraged companies from across the country to hire, train and support our nation’s military service members and their families as they transition into civilian life, according to the Orlando Sentinel. At the Veterans Institute Workshop, Mrs. Obama...

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11/25/2013 Comments(0)

Despite Affordable Care Act Individual Mandate, Concierge Medicine on the Rise

By Lance O. Leider, J.D., The Health Law Firm Despite the Affordable Care Act's (ACA) mandate that individuals acquire healthcare coverage, concierge medicine is on the rise in recent years.  Concierge medicine is a type of medicine where patients pay a physician practice a retainer or membership fee and then pay a la carte for discounted services offered by the physicians. In times past, concierge medicine was primarily for the wealthy with patients paying thousands of dollars a m...

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11/21/2013 Comments(1)

Purpose of Florida E-FORCSE Prescription Database Not for Disciplinary or Criminal Prosecution Purposes Against Physicians, Pharmacists or Other Health Professionals

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida now has an active prescription drug monitoring program (PDMP). It is called the “Electronic-Florida Online Reporting of Controlled Substances Evaluation” or “E-FORCSE.” More often it is referred to simply as the “prescription drug database” by Florida physicians. The Florida Legislature adopted the E-FORCSE system in Florida by Section 893.055, ...

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11/19/2013 Comments(1)

Hospice of the Comforter Settles Whistleblower/Qui Tam Lawsuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 28, 2013, a Florida federal judge approved a $3 million settlement in a False Claims Act lawsuit alleging Hospice of the Comforter Inc. (HOTCI), defrauded Medicare. The judge shot down objections from the whistleblower (sometimes called a “relator” or “plaintiff” who argued that the settlement amount is unfair, according to the Orlando Sentinel. Click here t...

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10/31/2013 Comments(0)

More Hospitals, Nursing Homes and Medical Facilities are Requiring Employees to Receive Flu Vaccine

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We’re coming up on that time of year when stuffy noses and scratchy throats turn into the full-blown influenza virus. According to the Centers for Disease Control and Prevention (CDC), the flu season usually runs from November 1 through March 31. With the flu season comes the debate over the legality of mandatory flu shots for health care professionals. Many hospitals in Florida, an...

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10/23/2013 Comments(1)

U.S. Food and Drug Administration Finalizes Rule on Codes that Will Track Medical Devices

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 20, 2013, the U.S. Food and Drug Administration (FDA) announced that companies will have to include unique device identification (UDI) codes on medical devices. These codes will provide a consistent way to identify medical devices, and therefore, should improve patient safety, according to the FDA. The codes allow regulators to track products, monitor them for safety and expedite rec...

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10/21/2013 Comments(0)

Rule Raising the Cost for Copies of Medical Records to be Tabled Until Next Florida Board of Medicine Meeting

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The cost of copying medical records will stay where it is, for now. On October 3, 2013, the Florida Board of Medicine voted to not allow an increase to the cost of medical records requested by patients and others from physicians. The Board did vote to conduct research on the topic and discuss the issue again at the next Board meeting. There is a proposal to the current Florida Administrative C...

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10/14/2013 Comments(1)

Medicare Audit Claims University of Miami Hospital Owes Government $3.7 Million

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The University of Miami Hospital allegedly owes Medicare $3.7 million. This is according to an audit report of the hospital’s billing practices that found the hospital allegedly overbilled the health care program in 2009 and 2010. The report was released on October 8, 2013, by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). According to a letter fro...

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10/9/2013 Comments(0)

Winter Park Urology Settles Whistleblower/Qui Tam Lawsuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A federal whistleblower or qui tam lawsuit against a local physician group has been settled, according to the Orlando Business Journal (OBJ) on September 30, 2013. The providers were accused of fraudulently billing Medicare and TRICARE from 2007 until 2010. The allegations allegedly stem from radiation therapy used to treat cancer patients. According to the OBJ, the defendants include Winter Park...

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10/2/2013 Comments(0)

What You Need to Know About the HIPAA Omnibus Final Rule-Part 3

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Health Insurance and Portability and Accountability Act (HIPAA) Privacy and Security Rules were amended by an Omnibus Final Rule published by the U.S. Department of Health and Human Services (HHS) in January 2013. The most significant changes involve business associates who are now directly subject to the mandates of the HIPAA Privacy and Security Rules and HIPAA enforcement. In addition, cov...

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9/26/2013 Comments(0)

What You Need to Know About the HIPAA Omnibus Final Rule-Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Health Insurance and Portability and Accountability Act (HIPAA) Privacy and Security Rules were amended by an Omnibus Final Rule published by the U.S. Department of Health and Human Services (HHS) in January 2013. By September 23, 2013, hospitals, physicians, covered entities and business associates must comply with the new changes. The most significant changes involve business associates ...

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9/25/2013 Comments(0)

What You Need to Know About the HIPAA Omnibus Final Rule-Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules were amended by an Omnibus Final Rule published by the U.S. Department of Health and Human Services (HHS) in January 2013. The Omnibus Final Rule marks the most significant changes to the HIPAA Privacy and Security Rules since they were first implemented. These changes greatly enhance a patient’s priv...

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9/24/2013 Comments(0)

Join The Health Law Firm Attorneys for a Presentation on Medicare and Medicaid Audits

By Cori Powers, Marketing Director, The Health Law Firm Attorneys Christopher E. Brown and Lance O. Leider with The Health Law Firm will be giving a presentation on Thursday, September 26, 2013, to the members of the Medical Office Resources of Florida (MOROF) and attending health care providers. This presentation is called, “Medicare and Medicaid Audits: Ready or Not, Here They Come.” The lecture is open, but attendees must register. It will be held at the Howard Johnson Pla...

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9/24/2013 Comments(0)

Florida Oncologists Pay $3.5 Million to Settle Whistleblower/Qui Tam Fraud Claims

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A group of Florida radiation oncology service providers settled a whistleblower or qui tam lawsuit for $3.5 million, according to the Department of Justice (DOJ) on September 13, 2013. The providers were accused of defrauding Medicare, Medicaid and TRICARE by performing unnecessary and improperly supervised procedures from 2007 until 2011. According to the DOJ press release, the defendants includ...

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9/23/2013 Comments(0)

Florida Home Health Care Company Settles with State Over Medicaid Fraud Charges

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Broward County, Florida, home health care company is accused of overbilling the Medicaid program for patient services by almost $500,000, according to the Sun Sentinel. This accusation comes after the Florida Agency for Health Care Administration (AHCA) conducted an audit of claims from July 2007 to March 2011. The audit allegedly found that the home health care company was overpaid for service...

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9/20/2013 Comments(0)

ICD-10 Is Coming: Are You Ready for the Transition?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The clock is ticking. It is just a little over a year away until the switch to ICD-10. If you are not already preparing for the fall 2014, implementation, you should be. ICD-9 codes will be replaced, after more than 30 years, with ICD-10 codes. The mandatory implementation date is October 1, 2014. This switch applies to all Health Insurance Portability Accountability Act (HIPAA) compliant health ...

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9/6/2013 Comments(0)

CRIMINAL LAW: False Confessions—Admissibility of Expert Testimony

The author of this is article is Mark Rieber, a legal research attorney with National Legal Research Group in Charlottesville, Virginia. A growing number of state courts have ruled that expert testimony concerning the phenomenon of false confessions may be admissible in a criminal trial.  The Supreme Court of Michigan recently addressed this matter and held that while such expert testimony is potentially admissible, the expert testimony at issue before the court was based on unreli...

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9/4/2013 Comments(0)

Emory University Accused of Overbilling Medicare and Medicaid for Patients Enrolled in Clinical Trial Research-Whistleblower Filed First Claim

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Emory University in Atlanta, Georgia, will pay $1.5 million to settle claims it overbilled Medicare and Medicaid for cancer clinical trial services that were not permitted by the Medicare and Medicaid rules. This announcement from the Department of Justice (DOJ) was released on August 28, 2013. This case came from a whistleblower/qui tam lawsuit filed by a former research finance manager at Emory...

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9/3/2013 Comments(1)

How 2014 IPPS Final Rule Impacts Physicians Admitting Patients to Hospitals

By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 2, 2013, the Centers for Medicare and Medicaid Services (CMS) released the 2014 Inpatient Prospective Payment System (IPPS) Final Rule (the 2014 IPPS Final Rule). The 2014 IPPS Final Rule substantially affects how hospitals will bill for observation stays, long outpatient stays and short inpatient stays. One of the most significant aspec...

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8/30/2013 Comments(0)

Florida Therapy Staffing Company Owner and Patient Recruiter Plead Guilty to $7 Million Medicare Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A therapy staffing company owner and a patient recruiter pleaded guilty on August 21, 2013, to one count each of conspiracy to commit health care fraud in connection with a $7 million Medicare fraud scheme. The scheme allegedly involved a now defunct home health care agency, Anna Nursing Services Corp., in Miami Springs, Florida, according to the Department of Justice (DOJ). The agency was suppos...

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8/29/2013 Comments(0)

Bostwick Laboratories Settles Whistleblower Claim Involving Illegal Physician Inducements

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Bostwick Laboratories (Bostwick) will pay the government $503,668 to settle whistleblower allegations that the company made illegal payments to induce physicians to utilize Bostwick’s laboratory testing services, according to a press release from the Department of Justice (DOJ) on August 20, 2013. The government claims Bostwick would bill Medicare and Tricare for testing services were not...

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8/28/2013 Comments(0)

Medicaid Fraud Control Unit Busts Florida Pharmacist in Alleged $600,000 Medicaid Fraud Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An investigation by the Florida Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU) uncovered almost $600,000 in alleged Medicaid fraud. According to the AG, a pharmacist and owner of a Hialeah, Florida, pharmacy, was arrested on August 22, 2013. A press release from the AG stated that the pharmacist was charged with one count of first-degree Medicaid fraud. Click here to read...

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8/26/2013 Comments(0)

Shands Healthcare to Pay $26 Million Settlement for Allegedly Submitting False Claims in Whistleblower/Qui Tam Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 19, 2013, Shands Healthcare agreed to pay $26 million to settle a lawsuit that stemmed from a whistleblower/qui tam claim. According to the settlement agreement, six of Shands’ Florida hospitals were accused of billing government health programs, such as Medicare and Medicaid, for inpatient claims that should have been coded as outpatient services for five years. Click here to...

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8/21/2013 Comments(0)

Planned Parenthood Pays $4.3 Million to Settle Allegations of Medicaid Fraud in Qui Tam/Whistleblower Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Planned Parenthood Gulf Coast recently paid $4.3 million to settle civil allegations under the False Claims Act, according to the Department of Justice (DOJ) on August 16, 2013. The nonprofit organization is accused of fraudulently billing Medicaid and other government programs for health services provided by some of its Texas clinics between 2003 and 2009, according to the DOJ. The settlement re...

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8/19/2013 Comments(0)

Daytona Beach Hospital Facing Recommendation for Medicare and Medicaid Termination After Wrong-Site Surgery

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law It’s usually a nightmare for a physician who performs wrong-site surgery. However, that’s what one surgeon at Halifax Hospital in Daytona Beach, Florida, is accused of doing. The term “wrong-site” refers to the fact that the surgeon has operated on the wrong leg, arm, eye or other organ. According to the Daytona Beach News-Journal, the surgeon allegedly made an initial inc...

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8/16/2013 Comments(0)

Consumer Reports Ranks Surgical Safety in Hospitals Throughout Florida and the U.S.

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For the first time, patients can view and compare surgery safety results at hospitals across the country. Consumer Reports recently rated nearly 2,500 hospitals in 50 states for surgical safety. This report measured infections, readmission rates, complications and adverse reactions (such as a heart attack or death) in patients after a surgery. The report was compiled using recently released Medic...

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8/15/2013 Comments(0)

Osceola Regional Medical Center Approved for OB-GYN and Internal Medicine Residency Programs

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Beginning July 2014, Osceola Regional Medical Center will launch its Obstetrics and Gynecology (OB-GYN) Residency Program. Osceola Regional announced on July 16, 2013, that it has been approved by the American Osteopathic Association (AOA) for the program. The approval makes the hospital’s OB-GYN Residency Program the first approved by the AOA in the Southeastern area of the United States. ...

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8/5/2013 Comments(0)

College Student Abandoned by DEA in Cell for Days to Receive $4.1 Million Settlement

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A California college student left in a small holding cell by the Drug Enforcement Administration (DEA) for five days without food, water, or a toilet has settled his claims for $4.1 million, according to a number of news sources. The student was taken by agents during a late April 2012, drug raid on his friend's house in which nine people were arrested. The engineering student at the Universi...

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8/1/2013 Comments(0)

Adverse Consequences of Settling a Malpractice Lawsuit Filed Against You-Part 1

By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law It is crucial to understand that settling a malpractice claim prior to trial, or even prior to a suit being filed, is not the end of the matter.  As stressful as having a malpractice claim hanging over your head can be, it is important to know that settling it may only be the beginning of your legal problems. Be Familiar With These Adverse ...

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7/31/2013 Comments(0)

Fake Department of Health Letters Continue to Pop Up-Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law There is an interesting phenomenon that pops up from time to time. It is the phony Department of Health letter. In 2008, we received information that letters, which appeared to be from the Maryland Department of Health (DOH), were being mailed out. The letters were mailed to residents of that state, advising the person that he or she was a carrier of a sexually transmitted disease (STD). The lett...

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7/30/2013 Comments(0)

Bill to Repeal Medicare SGR Physician Payment Formula Moves Forward-What This Could Mean for Physicians’ Payments

By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 23, 2013, the House Energy and Commerce Health Subcommittee approved a proposal to repeal Medicare’s sustainable growth rate (SGR) physician payment formula in lieu of a system that rewards doctors for high quality care. The Subcommittee on Health passed the bill, which could be the start of a permanent fix for physician payments, accor...

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7/26/2013 Comments(0)

California Medical Center Will Pay $275,000 to Settle Federal Patient Privacy Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Shasta Regional Medical Center in Redding, California, has agreed to pay $275,000 to settle a federal investigation concerning alleged violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. The settlement resolves allegations made by the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) that the medical center shared a patientR...

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7/23/2013 Comments(0)

CERT Contractors Identifying Documentation Errors for Home Health Services

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law About a year ago we told you about one of the newest acronyms in the Medicare Program’s audit process, “CERT” which stands for the Medicare Comprehensive Error Rate Testing Program. The CERT Program is one way CMS is trying to improve the quality and accuracy of Medicare claim submissions and payments of those claims. Recently Medicare Contractors have reported seeing an increas...

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7/22/2013 Comments(0)

Contracting 101: Tips for Physicians and Health Professionals - Part 11

By Christopher E. Brown, J.D., The Health Law Firm, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We continue with our blog series on contracting tips for physicians and health professionals. Collectively these blogs are intended to provide a review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts...

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7/17/2013 Comments(0)

Biopsy Self-referrals Draw Congressional Scrutiny

By Lance Leider, J.D., The Health Law Firm In a recently released report the Government Accountability Office (GAO) concludes that physicians who self-referred biopsy procedures cost Medicare approximately $69 million in potentially unnecessary services. To read the entire GAO report, click here . The report concludes that claims by physicians who self-referred the pathology procedures rose at a much faster rate than those made by physicians who do not self-refer.  The report foun...

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7/16/2013 Comments(0)

What Does the Future Hold for Florida’s Prescription Drug Monitoring Program?

By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Officials with the Florida Department of Health (DOH) listened to suggestions on how to improve the security of its prescription drug monitoring database at a special meeting held on July 8, 2013, in Tallahassee, Florida. This comes after a slew of criticism over the monitoring system. Most recently, the prescription drug monitoring database came und...

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7/10/2013 Comments(0)

Florida Health Clinic Owner Arrested on Charges of $300,000 in Medicaid Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The owner of a Lake County, Florida, medical center was arrested by the Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU) on June 27, 2013, for allegedly committing $300,000 in Medicaid fraud. According to the AG, the clinic owner allegedly billed Florida Medicaid for services never rendered and used the Medicaid provider number of a physician who was no longer employed at his fac...

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7/8/2013 Comments(0)

Contracting 101: Tips for Physicians and Health Professionals - Part 10

By Christopher E. Brown, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This blog is the tenth in a series intended to provide a review of contracting basics for physicians, nurse practitioners and health care professionals, primarily by discussing employment agreements. We will continue to highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see...

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7/5/2013 Comments(0)

Franck’s Pharmacy Files Motion to Consolidate Brilliant Blue G Eye Surgery Dye Lawsuits

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law More on the Franck’s Pharmacy fungus cases. In the past couple of months, there have been an increasing number of people filing product liability lawsuits over Brilliant Blue G, an eye surgery dye made by Franck’s Compounding Pharmacy in Ocala, Florida. In response, on April 12, 2013, Franck’s filed a request to consolidate all claims pending in the federal court system before o...

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7/3/2013 Comments(0)

Products Liability Lawsuits Filed Over Brilliant Blue G Surgical Dye Made By Franck’s Compounding Lab

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Franck’s Compounding Lab in Ocala, Florida, may be closed, but that isn’t stopping patients affected by the lab’s contaminated products from filing lawsuits against the compounding pharmacy. According to an article on About Lawsuits, at least four products liability lawsuits were filed against Franck’s just in March of 2013. All of the lawsuits allege that the plaintiffs s...

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7/1/2013 Comments(0)

Florida Prescription Drug Monitoring System Comes Under Fire After Privacy Breach

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida health officials are looking to step up security of the statewide prescription drug monitoring database to protect patients’ information. This comes after 3,300 Floridians’ names, addresses, phone numbers, pharmacies and drug dosages prescribed were leaked, according to an article in the Sun Sentinel, published on June 14, 2013. The information was allegedly being used as part...

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6/24/2013 Comments(0)

Florida Court Outlines Requirements for Emergency Suspension Orders

By Catherine T. Hollis, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In the November 2012, decision in Nath v. Department of Health , the Florida First District Court of Appeal analyzed an emergency suspension order (ESO) issued by the Florida Department of Health (DOH). The Court had to determine whether an ESO served on an acupuncturist accused of inappropriate behavior was sufficient and proper under Section 1...

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6/19/2013 Comments(0)

Fight Office of the Inspector General (OIG) Exclusion!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many health professionals don’t understand the significant repercussions that an exclusion action by the Office of the Inspector General (OIG) can have on the career and employment of a licensed health professional. Whether you are a physician, nurse, dentist, psychologist or other health professional, if you allow yourself to be excluded from the Medicare Program, devastating economic resu...

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6/18/2013 Comments(5)

PERSONAL INJURY: Tort of Malicious Prosecution Is Expanded in Hawaii

The author of this is article is Fred Shackelford, a legal research attorney with National Legal Research Group in Charlottesville, Virginia. In many states, one of the elements of the tort of malicious prosecution is initiating or procuring the institution of a criminal proceeding.  See generally Restatement (Second) of Torts § 653.  This element focuses on whether the alleged tortfeasor had probable cause at the time he or she initiated or procured the criminal action ...

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6/17/2013 Comments(0)

Walgreens Pays $80 Million to Settle Drug Enforcement Administration Painkiller Investigation

By Lance O. Leider, J.D., The Health Law Firm and Catherine T. Hollis, J.D., The Health Law Firm It seems the firefight between Walgreens and the Drug Enforcement Administration (DEA) has come to an end. On June 11, 2013, the DEA announced Walgreens agreed to pay $80 million to end an investigation into whether it violated rules on the distribution of prescription painkillers in Florida and throughout the country. According to the DEA, this is the largest settlement in its history. To...

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6/14/2013 Comments(0)

Civil Forfeiture of Property and Money: A New Weapon in the Government’s Arsenal Against Health Fraud and Pill Mills

By Christopher E. Brown, J.D., The Health Law Firm, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law More and more recently, we have seen government prosecutors and agencies, including the Medicaid Fraud Control Unit (MFCU), the U.S. Attorney General’s (AG) Office, and local sheriff and police departments use the Florida Contraband Forfeiture Act against health professionals and health facilities in health-related cases. A prompt,...

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6/13/2013 Comments(2)

Technical Corrections to HIPAA Omnibus Rule Released

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Department of Health and Human Services (HHS) acknowledged the need for technical corrections to a ruling published as part of the Health Insurance Portability and Accountability Act (HIPAA) omnibus rule on January 23, 2013, according to a final rule published on the Federal Registrar. According to the HHS, the errors necessitating technical corrections contained in January’s final rule...

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6/12/2013 Comments(0)

A Finding of “Irregular Behavior” on Your U.S.M.L.E. Step Transcript Can Ruin Your Medical Career Before it Starts

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many medical students and interns receive letters from the National Board of Medical Examiners (NBME), United States Medical Licensee Examination (USMLE) Secretariat advising them that they are suspected of "irregular behavior" on a Step examination.  Virtually any infraction of the USMLE rules contained in its Bulletin or the rules of the testing center can result in such an accusation.&n...

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6/10/2013 Comments(1)

MRI May be Able to Detect Complications Related to Metal-on-Metal Hip Implants

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Patients with any metal-on-metal hip implant might want to discuss getting an MRI, even if they are not experiencing any discomfort. A medical study published in Journal of Bone & Joint Surgery suggests an MRI may be able to detect problems before any damage is caused from a hip implant. This can include hip implant failures and metallosis, or metal poisoning, from the chromium and cobalt ion...

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6/7/2013 Comments(0)

Healthcare Integrity and Protection Data Bank Merger with National Practitioner Data Bank Completed

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Health Resources and Services Administration (HRSA) announced that on May 6, 2013, the Healthcare Integrity and Protection Data Bank (HIPDB) officially merged with the National Practitioner Data Bank (NPDB). The two data banks are now known as the NPDB. The HRSA published the final rule to eliminate duplicate data reporting and access requirements. To read the full text of the final rule, cl...

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6/6/2013 Comments(1)

Senate Committee Calls for Baker Act Study Instead of Expanding the Powers of Nurse Practitioners and Physician Assistants

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida’s nurse practitioners and physician assistants were hopeful the Senate would vote to allow them to have the authority to order the involuntary commitment of a patient for mental-health evaluation under the Baker Act. However, instead on April 15, 2013, the Children, Families and Elder Affairs Committee passed the formation of a work group to figure out how to improve the more than...

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6/5/2013 Comments(0)

Jury Awards Doctor $3.8 Million in Damages in Anthem Blue Cross Case

By Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 8, 2013, a Los Angeles jury awarded $3.8 million in compensatory damages to an urgent care and family practice physician who claimed he was wrongly excluded from Anthem Blue Cross’s provider network. Anthem Blue Cross is a unit of the insurance giant WellPoint Inc. It is expected that this r...

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5/31/2013 Comments(1)

Central Florida Undercover Detective Awarded Special Agent of the Year

By Catherine T. Hollis, J.D., The Health Law Firm The Orlando Sentinel reports that in April 2013 , the Florida Department of Law Enforcement (FDLE) named local undercover detective Billy Powell of the Metropolitan Bureau of Investigation (MBI) in Orlando as its Special Agent of the Year. Powell received this award for his outstanding efforts in pill mill investigations. To read the entire Orlando Sentinel Article on Powell’s award, click here . Powell was Instrumental in ...

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5/30/2013 Comments(0)

Steroid Injections Compounded at Tennessee Pharmacy Recalled Due to Possible Contamination

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The U.S. Food and Drug Administration (FDA) sent out a warning to health care professionals that steroid injections compounded by Main Street Family Pharmacy, LLC, in Tennessee, may be contaminated. The announcement came on May 24, 2013. So far, seven patients have allegedly suffered adverse reactions from the medications. The FDA says it is working with the Centers for Disease Control and Pre...

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5/28/2013 Comments(1)

Mental Health Counselors, Psychologists, Social Workers and Family Therapists Should Be Sure They Carry Insurance to Cover Complaints Against Their Licenses

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law From our experience mental health counselors, psychologists, social workers and family therapists are at a high risk of having a client or patient file a complaint against them with their licensing board. Many of their clients/patients have mental health problems, emotional problems or personality disorders; this is why they are seeing a therapist to begin with. If there is a disagreement b...

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5/26/2013 Comments(0)

DePuy Orthopaedics to Discontinue All Metal-on-Metal and Ceramic-on-Metal Hip Implants

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Johnson and Johnson’s DePuy Orthopaedics announced on May 16, 2013, that the company is phasing out all of its metal-on-metal and ceramic-on-metal hip replacements. As of August 31, 2013, these DePuy products will no longer be available worldwide. Click here to read the press release from DePuy Orthopaedics . This decision comes after DePuy recalled 93,000 ASR XL hip implants in Aug...

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5/23/2013 Comments(0)

U.S. Department of Justice Files Two Lawsuits Against Novartis Pharmaceuticals Corporation Over Charges of Kickbacks

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Novartis Pharmaceuticals Corporation (NPC) is currently fielding two different lawsuits, filed just days apart from each other, by the U.S. Department of Justice (DOJ). The first lawsuit was filed on April 23, 2013, alleging the company gave illegal kickbacks to pharmacists. A second lawsuit was filed on April 26, 2013, alleging illegal kickbacks were paid by NPC to health care providers. Accor...

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5/21/2013 Comments(0)

Lawsuits Against Manufacturers of Metal-on-Metal Hip Implants: Things You Need to Know as an Implant Recipient-Part 3

By Carole C. Schriefer, R.N., J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Two nationwide recalls of metal-on-metal hip implants by Johnson and Johnson’s DePuy Orthopaedics and Stryker Orthopaedics has prompted The Health Law Firm to take on plaintiffs’ products liability cases against these manufacturers. In August 2010, DePuy recalled 93,000 ASR XL hip implants after a significant percentage failed...

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5/15/2013 Comments(0)

Food and Drug Administration (FDA) Recalls Sterile Drugs from Florida Compounding Pharmacy

By Lance O. Leider, J.D., The Health Law Firm There’s been yet another recall from a compounding pharmacy. On May 8, 2013, the U.S. Food and Drug Administration (FDA) sent a warning to doctors and pharmacists to avoid drugs made by The Compounding Shop, based in St. Petersburg, Florida. The recall is due to potential safety concerns. Click here to read the press release from the FDA . This recall is part of a nationwide crackdown by the FDA and state agencies on compounding p...

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5/14/2013 Comments(0)

Home Health Care Company’s Patient Recruiter Sentenced to More Than Three Years in Prison for Medicare Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Miami patient recruiter will spend the next 37 months in prison for his part in a $20 million Medicare fraud scheme, according to the Department of Justice (DOJ). Manuel Lozano was sentenced on May 6, 2013, in the Southern District of Florida. In addition to his prison sentence, Mr. Lozano will serve two years of supervised release and was ordered to pay more than $1,850,000 in restitution...

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5/10/2013 Comments(0)

Lawsuits Against Manufacturers of Metal-on-Metal Hip Implants: Things You Need to Know as an Implant Recipient-Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm The Health Law Firm has recently undertaken plaintiffs’ products liability cases against the manufacturers of defective hip implants, including both Johnson and Johnson’s DePuy Orthopaedics and Stryker Orthopaedics implants. DePuy recalled 93,000 ASR XL hip implants in August 2010, after a significant percentage failed with...

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5/9/2013 Comments(0)

Lawmakers Vote to Fund Florida’s Prescription Drug Monitoring Program

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The future of Florida’s prescription drug monitoring program looked bleak going into the last day of the legislative session. However, on May 3, 2013, lawmakers voted to fund the prescription drug database for one year, according to the Orlando Sentinel. Law enforcement officials have said the program is essential to fighting the war on prescription drug abuse The database, which wa...

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5/7/2013 Comments(4)

Lawsuits Against Manufacturers of Metal-on-Metal Hip Implants: Things You Need to Know as a Recipient-Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm In August 2010, Johnson and Johnson’s DePuy Orthopaedics recalled 93,000 ASR XL hip implants after a significant percentage failed within five years. ( Click here to read the press release from DePuy .) In July 2012, Stryker Orthopaedics issued a voluntary recall of the Rejuvenate and ABG II modular-neck femoral hip systems. ( Click...

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5/1/2013 Comments(0)

New Details Emerge on Central Florida Woman’s $3 Million Medicaid Fraud Scheme at Mental Health Facility

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law As the investigation into a Central Florida mental health counselor continues, new details are emerging on the extent of the $3 million Medicaid fraud scheme. On March 27, 2013, I blogged about a registered mental health counselor arrested on charges of racketeering, Medicaid fraud and identity theft. The Medicaid scheme was through the mental health facility she owned. She is accused of using...

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4/30/2013 Comments(0)

Healthcare Providers Service Organization (HPSO) Attorneys, Lawyers and Defense Council in Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Often we learn after the fact that a health professional such as a mental health counselor, psychologist, or pharmacist has received Healthcare Providers Service Organization (HPSO) insurance, has had a legal problem, and has not been able to locate an attorney or law firm that accepts this type of insurance. We have offices in Florida and Colorado, but we have attorneys licensed in Florida, Co...

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4/29/2013 Comments(0)

Do Heavy Metals from Metal-on-Metal Hip Implants Cause COPD and Other Respiratory Problems?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Some of the clients we are representing in hip implant cases against manufacturers DePuy (owned by Johnson & Johnson) and Howmedica Osteonics Corporations (n/k/a Stryker Corporation), d/b/a Stryker Orthopaedics, have signs and symptoms of respiratory illnesses similar to chronic obstructive pulmonary disease (COPD) and other illnesses. Signs of this include general fatigue, persistent ...

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4/25/2013 Comments(0)

Florida Compounding Pharmacy Recalls Eye Products

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Lake Mary, Florida, compounding pharmacy recently recalled products due to concerns from the Food and Drug Administration (FDA). The Balanced Solutions Compounding Pharmacy, LLC (Balanced Solutions), a division of Axium Healthcare Pharmacy Inc., announced a voluntary recall of all lots of its sterile unexpired ophthalmic products on April 17, 2013. Click here to read the press release ...

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4/24/2013 Comments(0)

EMPLOYMENT LAW: Florida Court Treats Independent Contractor as Employee for Purposes of Enforcing Covenant Not to Compete

The author of this is article is Charlene Hicks, a legal research attorney with National Legal Research Group in Charlottesville, Virginia. One of the legal arenas in which individual rights are pitted directly against business interests comes into play when an individual employee signs an employment contract containing a covenant not to compete.  Not surprisingly, state courts are often called upon to referee disputes concerning the enforceability of such contracts.  In a r...

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4/23/2013 Comments(0)

Florida Woman Will Spend Six Years in Prison and Must Repay the State for Medicaid Fraud Scheme

By Lance O. Leider, J.D., The Health Law Firm, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Edna Lorraine Watkins, the owner of Homecare Unlimited, LLC, in Jacksonville, Florida, has been sentenced to six years in prison for defrauding Medicaid, according to the Florida Office of the Attorney General (AG). She made more than $400,000 in false claims between January 2008 and June 2011. Ms. Watkins was sentenced on April 2, 2013. Cl...

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4/22/2013 Comments(0)

Johnson & Johnson’s DePuy Orthopaedics Wins Chicago DePuy ASR Hip Implant Trial

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm On April 16, 2013, a Chicago jury found in favor of Johnson and Johnson’s DePuy Orthopaedics, according to Reuters. The plaintiff was a nurse who had the DePuy ASR XL hip implant in her in 2008. It was replaced three years later. The plaintiff was requesting $5 million in damages. The 12-person jury deliberated for a little more th...

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4/19/2013 Comments(0)

Lake Mary Pain Doctor Sentenced to 25 Years in Prison for Drug Trafficking Charges

By George F. Indest, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Lake Mary, Florida, pain management doctor was ordered by a judge to spend 25 years in prison and to pay a $500,000 fine. Dr. Ronald Lynch, who operated Integrated Medicine, was sentenced on April 15, 2013, for charges of drug trafficking, according to the Florida Office of the Attorney General (AG). Click here to read a press release from the AG . Writing Prescriptions with a Revo...

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4/17/2013 Comments(0)

Florida Orthopedic Clinics Warn Patients That Not All Hip Implants Are the Same

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm Choosing one hip replacement over another is one of the most important decisions a patient and a surgeon can make together. In the last ten years, there have been many types of artificial hip implants approved for use in the U.S. These options include metal-on-metal, ceramic-on-ceramic or advanced plastics such as cross-linked polyethylen...

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4/15/2013 Comments(0)

The Association of Independent Doctors Has Concerns About Acquisitions by Hospitals and Medical Groups

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law According to The Physicians Foundation, a nonprofit organization that seeks to advance the work of physicians, one of the biggest concerns of practicing doctors is the continuing acquisition of small practices by hospitals and medical groups. On April 4, 2013, a new group called the Association of Independent Doctors met for the first time in Orlando, Florida. The group is made up of 80 indepen...

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4/12/2013 Comments(2)

Former DePuy Worker Testified He Had Prior Knowledge of ASR XL Hip Implant Design Defects

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm Currently jurors in Circuit Court of Cook County, Chicago are hearing the second trial against Johnson and Johnson’s DePuy Orthopaedics. According to Public Health Watchdog, a former DePuy employee testified on March 26, 2013, that the company knew the ASR XL hip implant’s design was defective a year prior to issuing the recal...

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4/10/2013 Comments(0)

Medical Examiner Blames Death of Teen on Bath Salts As Florida Law Enforcement Officials Ramp Up Fight Against Synthetic Drugs

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Orange-Osceola chief medical examiner ruled on April 5, 2013 , that a 17-year-old teen died as the result of an accidental “apparent” overdose on bath salts, according to the Orlando Sentinel. Four teens altogether were found unconscious in an Orange County, Florida, home in February 2013. All the teens reportedly snorted the same bath salts off a $10 bill and all were hospi...

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4/9/2013 Comments(0)

Patients Injured from the Stryker Orthopaedics Hip Implant Systems Want to Move Lawsuits to Federal Court

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm Stryker Orthopaedics is already facing more than 80 lawsuits from patients alleging injuries due to the recalled Stryker Rejuvenate and ABG II hip systems. As that number grows, plaintiffs are requesting that the cases be moved to a central federal court. You may remember, in July 2012, Stryker issued a voluntary recall of the Rejuv...

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4/4/2013 Comments(0)

Accused of Irregular Behavior on the USMLE? Here's What You Will Do Wrong

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We frequently receive calls for consultations from students who receive a letter from the National Board of Medical Examiners (NBME) accusing the medical student or medical resident of "Irregular Behavior" on the United States Medical Licensing Examination (USMLE). In many cases these are graduates of foreign medical schools who have applied through the Examination Committee for Foreign Medical...

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4/3/2013 Comments(0)

Oklahoma Dentist May Have Exposed More Than 7,000 Patients to HIV and Hepatitis

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The unsanitary practices of an Oklahoma dentist may have exposed more than 7,000 patients to HIV and hepatitis, according to a number of media sources and the Oklahoma Department of Health (DOH). Currently officials with the Oklahoma DOH are contacting all of the dentist’s patients since 2007, and urging them to get tested for blood-borne diseases. Since the news broke on March 28, 2013, t...

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4/1/2013 Comments(0)

Florida Cardiologist Sentenced to Six Years in Prison for Fen-Phen Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A 79-year-old Florida cardiologist was sentenced to six years in prison on March 26, 2013. He’s accused of participating in a fraud scheme involving a trust fund set up to compensate victims of the diet drug Fen-Phen. According to media reports, the cardiologist took fees for examining patients who suspected heart damage from taking Fen-Phen. He diagnosed heart damage in a majority of pat...

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3/29/2013 Comments(0)

Supreme Court Hears Arguments Over the Liability of Generic Drug Makers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 19, 2013, the Supreme Court justices discussed whether makers of generic drugs already approved by the Food and Drug Administration (FDA) can be held liable under state law for claims of design defects. According to the Los Angeles Times, nearly eighty percent (80%) of prescriptions that Americans fill are for generic drugs. The high court finds itself at a crossroads on how to re...

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3/28/2013 Comments(1)

Corporate Responsibility- Did DePuy Fail to Alert the Public of Mounting Hip Implant Failures?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm According to USA Today, in 2001 Johnson and Johnson’s DePuy set out to create a new metal hip implant that offered stability and longevity to patients. In 2005, the company introduced the ASR XL hip implant. According to reports in the media, a couple of years after launching the hip implant, a substantial amount of evidence began t...

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3/26/2013 Comments(0)

Common Deficiencies We See in Pharmacy Inspections

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm Pharmacies and pharmacists are subject to many types of inspections. These inspections are necessary to determine whether the business and its employees are complying with state and federal laws and regulations. Administrative agencies, such as the Drug Enforcement Administration (DEA), Food and Drug Administration (FDA) and the Departmen...

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3/21/2013 Comments(0)

Food and Drug Administration (FDA) Updates Safety Concerns on Metal-on-Metal Hip Implants After Two Wide-Spread Recalls

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm On January 17, 2013, the Food and Drug Administration (FDA) issued an updated public health communication about hip replacement components that have both a metal ball and a metal socket, or metal-on-metal hip devices. This comes after two recent hip replacement recalls that are sparking thousands of lawsuits. Click here to read the FDA c...

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3/20/2013 Comments(0)

Contracting 101: Tips for Physicians and Health Professionals - Part 9

By Christopher E. Brown, J.D., The Health Law Firm, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This blog is the ninth in a series intended to provide a review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practi...

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3/19/2013 Comments(0)

Recovery Audit Contractor (RAC) Activity Up in Hospitals Across the Country

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Hospitals across the country are being hammered by Recovery Audit Contractors (RACs). According to a survey by the American Hospital Association, RAC activity soared during the fourth quarter of 2012. The March 8, 2013, report explores the impact of the RAC program on the 1,233 hospitals that participated in the survey, according to an article on Healthcare IT News. Click here to read t...

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3/18/2013 Comments(0)

Choosing Wisely Campaign Expands List of Overused and Unnecessary Medical Tests and Procedures

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This year, seventeen (17) medical specialty societies added their names and recommendations to a list of medical procedures that are overused and often unnecessary. This updated list was released in February 2013, and includes ninety (90) new tests and procedures. The first version of the list was released in April 2012, with recommendations from nine (9) leading medical groups. It was created ...

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3/15/2013 Comments(0)

Jury Awards Plaintiff $8.3 Million in First Trial Over DePuy Hip Implants

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm On March 8, 2013, a California jury ruled that Johnson and Johnson’s DePuy unit  designed a defective metal-on-metal ASR XL hip implant and was negligent, according to Bloomberg News. The plaintiff in this case was awarded $8.3 million in compensation damages, after the jury found that the design of the hip implant was th...

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3/14/2013 Comments(0)

Whistleblowers Who Report Fraud and False Claims Against the Government Stand to Receive Large Rewards - Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Individuals working in the health care industry, whether for hospitals, nursing homes, medical groups, home health agencies or others, often become aware of questionable activities.  Often they are even asked to participate in it. In many cases the activity may amount to fraud on the government. This is the second blog in a two-part series on whistleblower/qui tam lawsuits. In th...

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3/14/2013 Comments(0)

Whistleblowers Who Report Fraud and False Claims Against the Government Stand to Receive Large Rewards - Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Individuals working in the health care industry, whether for hospitals, nursing homes, medical groups, home health agencies or others, often become aware of questionable activities.  Often they are even asked to participate in it. In many cases the activity may amount to fraud on the government. This is the first blog of a two-part series. Throughout these two blogs, I will explain ty...

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3/13/2013 Comments(0)

Central Florida Chiropractor Convicted in False Claims Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Central Florida chiropractor was convicted of conspiracy to commit health care fraud by a federal jury on March 1, 2013. Since 2009, the chiropractor fraudulently claimed to own a rehabilitation center in Cape Coral, Florida. According to the Department of Justice (DOJ), in March 2012, the chiropractor and several co-conspirators were formally charged with conspiracy to commit health care fra...

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3/12/2013 Comments(0)

Contracting 101: Tips for Physicians and Health Professionals - Part 8

By Christopher E. Brown, J.D., The Health Law Firm, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This blog is the eighth in a series intended to provide a review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day pract...

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3/11/2013 Comments(0)

Stryker Orthopaedics Facing Dozens of Hip Implant Lawsuits

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law As of February 2013, more than 80 lawsuits have been consolidated into multicounty litigation (MCL) in the Superior Court in New Jersey against Stryker Orthopaedics. Patients are claiming the company’s Rejuvenate and ABG II modular-neck femoral hip systems are defective, according to a number of news sources. The case is on track to becoming one of the largest mass-tort litigations in the...

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3/8/2013 Comments(1)

Zone 5 Program Integrity Contractor (ZPIC) for Medicare and Medicaid Programs is AdvanceMed

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law AdvanceMed Corporation, an NCI company, was named the Zone 5 Program Integrity Contractor (ZPIC) for the Medicare and Medicaid programs, in December 16, 2009. As the ZPIC for Zone 5, AdvanceMed has been performing benefit integrity activities aimed to reduce fraud, waste and abuse in Medicare and Medicaid data matching programs. A ZPIC is a business entity that contracts with Medicare and...

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3/7/2013 Comments(0)

Occupational Therapists, Physical Therapists, Speech Therapists and Rehabilitation Therapists Should Retain Legal Counsel for Medicare and Medicaid Audits

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Most Medicare and Medicaid auditors are cracking down on occupation therapists (OTs), physical therapists (PTs), speech therapists (STs) and rehabilitation therapists (RTs). We have recently been consulted by a number of large therapy groups and small therapy providers undergoing or who have recently undergone Medicare or Medicaid audits.  In too many circumstances the audit agency has com...

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3/6/2013 Comments(0)

Contracting 101: Tips for Physicians and Health Professionals - Part 7

By Christopher E. Brown, J.D., The Health Law Firm, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This blog is the seventh in a series intended to provide a review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practic...

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3/5/2013 Comments(0)

Medicare Remains "High-Risk" Program

By Lance O. Leider, J.D., The Health Law Firm A report released by the Government Accountability Office (GAO) on February 27, 2013, announced that Medicare will remain a "high-risk" program with respect to its fraud and waste vulnerability.  The GAO cites the inability of the Center for Medicare and Medicaid Services' (CMS) inability to reduce the rate of improper payments released by the agency as the reason for its ruling. Click here to view the full report from the GAO . ...

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3/4/2013 Comments(0)

Opioid Epidemic Not likely to Slow Any Time Soon

By Lance O. Leider, J.D., The Health Law Firm According to the American Society of Interventional Pain Physicians (ASIPP), Americans consume nearly eighty percent (80%) of the world's opioid supply and ninety-nine percent (99%) of the world's hydrocodone supply. ( Click here to see the ASIPP’s fact sheet on prescription drug abuse .)  The scariest part of these numbers is that the United States comprises about five percent (5%) of the world's population. Food and Drug Adm...

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3/1/2013 Comments(0)

MEDICAL MALPRACTICE: Montana Supreme Court Recognizes Cause of Action for Negligent Credentialing

The author of this is article is Fred Shackelford, a legal research attorney with National Legal Research Group in Charlottesville, Virginia. In a case of first impression, the Montana Supreme Court has joined courts from many other states in recognizing a cause of action for negligent credentialing of a physician.  In Brookins v. Mote , 2012 MT 283, ___ P.3d ___ (not yet released for publication), an expectant mother hired an obstetrician who maintained a practice in his ho...

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2/28/2013 Comments(0)

Medicaid Providers Beware: Failure to Appeal Audit Results or Pay Medicaid Overpayments May Result in Termination of License

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Our firm has been consulted recently by owners of different health care entities, including assisted living facilities (ALFs), group homes, home health agencies and even medical groups that had received Medicaid overpayment demands.  Instead of requesting a formal administrative hearing to contest the overpayment assessment, they had failed to respond or only requested an informal hearing....

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2/27/2013 Comments(0)

CIVIL PROCEDURE: Recovery of Costs in Federal Court by Prevailing Party

The author of this is article is Paul Ferrer, a legal research attorney with  National Legal Research Group in Charlottesville, Virginia. Parties who secure a favorable judgment in federal court may be happy with the outcome but should not forgo seeking their recoverable costs as well.  The Federal Rules of Civil Procedure specifically provide that "[u]nless a federal statute, these rules, or a court order provides otherwise, costs—other than attorney's fees—should b...

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2/26/2013 Comments(0)

Contracting 101: Tips for Physicians and Health Professionals - Part 6

By Christopher E. Brown, J.D., The Health Law Firm, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This blog is the sixth in a series intended to provide a review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practi...

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2/22/2013 Comments(0)

Negligence Will Determine the Success or Failure of the Meningitis Lawsuits Against Doctors and Clinics

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The victims and survivors of the meningitis outbreak are now filing lawsuits against the physicians and clinics that administered the tainted steroids. According to an article in The Tennessean, on January 29, 2013, a husband who lost his wife to fungal meningitis filed the first lawsuit against a Nashville outpatient clinic. It’s believed hundreds of people were injected at the same clin...

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2/18/2013 Comments(0)

Central Florida Doctor Pleads No Contest to Racketeering Charge

By George F. Indest, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Winter Park, Florida, doctor pleaded no contest on February 11, 2012, to a racketeering charge. The charge stems from his arrest in a pill-mill probe in June 2010. The doctor’s arrest was one of the first in the Central Florida area relating to improper prescribing practices. Click here to see the complaint against the doctor . Since the doctor’s arrest, Florida law enfor...

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2/14/2013 Comments(0)

CEO of Sanford-Burnham Resigns for Job in the Pharmaceutical Industry

By George F. Indest, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Sanford-Burnham Medical Research Institute announced on January 14, 2013, that John C. Reed, M.D., Ph.D., has resigned as Chief Executive Officer (CEO). According to a press release from Sanford-Burnham, Dr. Reed accepted the position of Head of Roche Pharma Research and Early Development and member of the Corporate Executive Committee. Kristiina Vuori, M.D., Ph.D., president of Sanford-Burnham, wi...

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2/13/2013 Comments(0)

Tips to Stay Off the Office for Civil Rights’ “Wall of Shame”

By George F. Indest, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law As of February 2013, there are 537 cases listed on the Office for Civil Rights’ (OCR) “Wall of Shame.” These are breaches of unsecured health information affecting 500 or more individuals. The reports of these breaches of patient confidentiality are required by the Health Information Technology for Economic and Clinical Health (HITECH) Act. The OCR continuously updates this ...

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2/8/2013 Comments(0)

Food and Drug Administration Likely to Tighten Controls on Hydrocodone Combination Drugs

By Lance O. Leider, J.D., The Health Law Firm, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Food and Drug Administration (FDA) advisory committee voted 19 to 10 in favor of moving hydrocodone combination drugs from schedule III into the more restrictive schedule II category of controlled substances. According to a number of different sources, on January 25, 2013, the committee presented this recommendation to the FDA. If approved, hydr...

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1/31/2013 Comments(0)

What the New HIPAA Rules Mean for Health Professionals, Texting and Use of Social Media

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law, and Lance O. Leider, J.D., The Health Law Firm With the popularity of electronic health records (EHRs), social media and everything in between, the U.S. Department of Health and Human Services (HHS) has released stronger rules and protections governing patient privacy. On January 17, 2013, the HHS announced the omnibus rule to strengthen the privacy and security protection established under th...

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1/29/2013 Comments(0)

South Florida Pharmacy Owner Allegedly Used Dead Beneficiaries to Defraud Medicare

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A family that owns a number of South Florida pharmacies is allegedly under investigation for Medicare fraud, according to a number of sources. On January 17, 2013, federal authorities raided one pharmacy location in Naples, Florida. Drug Enforcement Administration (DEA) agents removed boxes of documents and computers from the pharmacy, according to Naples News. The pharmacy owner and his mot...

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1/28/2013 Comments(0)

VA Physicians and Health Professionals Should Fight Allegations of Substandard Care in Peer Review Matters

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I have represented physicians, psychologists, nurse practitioners, nurses and other health professionals working in Veterans Administration (VA) medical centers and clinics throughout the United States.  My representation has included personnel and employment issues, disciplinary actions, investigations, peer review investigations, clinical privileges actions, fair hearings, National Pract...

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1/25/2013 Comments(1)

Relocating Your Practice? Don't Forget to Notify Your Patients

By Thu Pham, O.D., Law Clerk, The Health Law Firm Relocating your practice can be stressful. There are many things that you need to do such as physically moving all of your equipment, moving your utility services, notifying your insurance companies, notifying the Department of Health (DOH), notifying Medicare and Medicaid and, most important, notifying your patients. Optometrists sometimes forget that they should also notify their patients of the move. Florida Regulations. Rule 64B...

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1/24/2013 Comments(0)

Are Medicare Investigations Leaving the Hospice Industry on Life Support?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law It’s no surprise to anyone that Medicare is cracking down on hospices around the country. According to a report by the Office of Inspector General (OIG), eighty-two percent (82%) of hospices’ claims did not meet Medicare coverage requirements. That is why Medicare is investigating the industry as a whole. Specific details on what Medicare is looking for can be found in the 2013 OIG ...

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1/23/2013 Comments(4)

Some Professional Liability Insurers Increase and Add New Coverages for Health Professionals

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I have been pleasantly surprised recently to discover that several professional liability insurance companies have raised their coverage amounts and added coverage in areas sorely needed by health professionals.  I'm referring to coverage for incidents not necessarily related to malpractice or professional liability. I do note that Healthcare Providers Service Organization (HPSO) Insu...

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1/22/2013 Comments(0)

Phony DEA Agents Attempt to Extort “Fines” in Central Florida: Telephone Con Men Claim to Have Arrest Warrants

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Health care providers beware, there is a scam making its rounds in Central Florida. Con men are telephoning citizens, including physicians, and pretending to be Drug Enforcement Administration (DEA) agents in the hope of extorting money from them. It’s a scam we first told you about in December 2012, but have since learned more. Click here to read my first blog on this nationwide te...

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1/21/2013 Comments(0)

Former Florida Hospital Employee Sentenced for Stealing Confidential Patient Information

By Lance O. Leider, J.D., The Health Law Firm A former Florida Hospital employee, who admitted to stealing confidential patient information, was sentenced to spend one year and one day in federal prison on January 14, 2013. He pleaded guilty in October 2012, to one count of conspiracy and one count of wrongful disclosure of health information, according to the Orlando Sentinel. You may remember the news story about the privacy breach at Florida Hospital back in October 2011. The ...

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1/18/2013 Comments(0)

Ohio Hospital Pays $4.4 Million to Settle Accusations of Performing Unnecessary Procedures

By Lance O. Leider, J.D., Attorney, The Health Law Firm A group of doctors accused of performing an unusually high number of heart procedures on patients at an Ohio hospital has settled a whistleblower lawsuit, according to the Department of Justice (DOJ). The settlement agreement covers accusations that the doctors and the hospital billed Medicare for unnecessary cardiac procedures from 2001 to 2006. Click here to read the press release from the DOJ . The Ohio hospital agr...

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1/17/2013 Comments(0)

Locating a Healthcare Providers Service Organization (HPSO) Insurance Defense Attorney in Florida Company Cases

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the Florida Department of Health (DOH) they had difficulty finding an experienced attorney in Florida who wou...

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1/16/2013 Comments(0)

Inappropriate Billing by Optometrists Could Result in An Audit and Significant Repayment

By Thu Pham, O.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Optometrists' scope of practice has expanded significantly in the last 10 years.  With that expansion has come a more complicated medical billing process.  Inappropriate billing could result in an audit by insurance companies, the state Medicaid program, the Medicare program or other third party payors, and a request for repayment of the amount of money paid d...

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1/15/2013 Comments(0)

Massage Therapists Need Good Professional Liability Insurance with Broad Coverage

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Whether you’re an independent contractor, an employee of a chiropractor, physician or spa, or you travel to clients’ homes, insurance is essential for all massage therapists. Not only can professional liability insurance protect you in the event of a lawsuit, but it may also pay your legal defenses in the event of a complaint against your license to practice or for other legal prob...

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1/14/2013 Comments(1)

Health Care Professionals Fired for Refusing to Get Flu Shots

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The warnings have been loud and clear from the Centers for Disease Control and Prevention (CDC). This influenza season is off to an early and serious start. With that in mind, a number of states are requiring all health professionals in the state to receive the flu vaccination. Some of those opposed to getting vaccinated are being fired by hospitals and health facilities. Because of this, a c...

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1/11/2013 Comments(2)

Central Florida Nurse Accused of Illegally Obtaining Prescriptions for Painkillers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Central Florida nurse is in trouble with the law for allegedly writing fake prescriptions and illegally obtaining painkillers for herself, according to the Orlando NBC affiliate, WESH television. The nurse was allegedly arrested during the week of December 31, 2012. She is accused of trafficking in oxycodone and trying to fill forged prescriptions. Click here to read the WESH article . ...

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1/10/2013 Comments(0)

Burden of Proof in Administrative Cases Involving Discipline of Professional Licenses - Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I am often asked about the burden of proof that must be met by the state Department of Health (DOH)  in professional licensing disciplinary cases.  This could be a complaint against a physician, dentists, mental health counselor, nurse, psychologist, pharmacist or anyone else.  It also includes, for example, engineers, general contractors, school teachers, architects, cosmetologi...

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1/9/2013 Comments(0)

Licensees must Be Certain to Maintain Their Continuing Education Requirements

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Those who are licensed by the Department of Health (DOH) must be sure they are maintaining their continuing education requirements by taking the required courses in a timely manner. We have attended at least one professional board meeting recently where there was concern expressed about licensees failing to meet their continuing education requirements. One estimate was that approximately sixty...

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1/8/2013 Comments(0)

Burden of Proof in Administrative Cases Involving Discipline of Professional Licenses - Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I am often asked about the burden of proof that must be met by the state Department of Health (DOH) in professional licensing disciplinary cases.  This could be a complaint against a physician, dentists, mental health counselor, nurse, psychologist, pharmacist or anyone else.  It also includes, for example, engineers, general contractors, school teachers, architects, cosmetologists, o...

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1/7/2013 Comments(0)

San Diego-Based Specialty Pharmacy Settles Whistleblower Lawsuit for $11.4 Million

By Lance O. Leider, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Department of Justice (DOJ) announced on December 27, 2012, that a specialty pharmacy, based in San Diego, California, has agreed to pay a $11.4 million settlement. That payment is to resolve allegations that the company used kickbacks to persuade doctors to write prescription for its products. The allegations came from a whistleblower lawsuit filed by a former em...

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1/4/2013 Comments(0)

Three-Year Medical School Degree: Putting Physicians on the Fast Track to Practicing Medicine

By Danielle M. Murray, J.D. To combat the nationwide shortage of primary care physicians and the increase in student debt, several medical schools around the country are offering the chance for students to finish school in three years, instead of four. According to a number of news articles, these programs are geared specifically toward medical students looking to practice primary care. The hope is that these programs will be cost less for students and add more primary care physicians to...

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1/3/2013 Comments(0)

Whistleblowers Accuse Nursing Care Company of Medicare Fraud

By Danielle M. Murray, J.D. The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) is investigating a Tennessee-based nursing care company. The company runs more than 200 skilled nursing homes (SNFs), assisted living facilities (ALFs), retirement living communities, home care services, and Alzheimer's centers across the country. The nursing care company is accused of defrauding Medicare of millions of dollars for unnecessary and expensive therapy ...

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1/2/2013 Comments(1)

Making the Grade - How Florida Hospitals Rank in National Safety

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law It’s been a long time since most of us have seen a report card, but hospitals all over the nation received their safety grades on November 28, 2012. Leapfrog, a national group that advocates for safer health care, determined the grades. According to the Orlando Sentinel, Florida hospitals ranked well. Overall, 39 percent (39%) of the 156 hospitals graded received A’s, earning the Su...

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12/31/2012 Comments(0)

The American College of Physicians Asks the Government to Stay Out of Health Care

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In light of some recently passed laws around the country, the American College of Physicians (ACP) took a stance against government involvement in the doctor-patient relationship. The ACP released a statement in July of 2012, outlining the role of government regulation in health care. In an American Medical News article, the president of the ACP stated this document needs to be taken into consi...

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12/28/2012 Comments(0)

The Latest News on Telemedicine

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For years providing health care to patients has been at a location that is convenient to the health provider. With emerging trends in telemedicine and upcoming healthcare reforms, recently enacted, patients may begin to enjoy the convenience of medical evaluation and follow-up by video, telephone and computer. The biggest bar to this to date has been the refusal of Medicare, Medicaid and insurer...

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12/27/2012 Comments(0)

New Database Informs Consumers of Federal Fines Imposed at Nursing Homes Across the Country

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Consumers have a new online tool to see which nursing homes are being hit with fines for poor quality, safety or maintenance. Nursing Home Inspect 2.0 is a free database that assists users in evaluating nursing homes across the country. The database was first introduced by ProPublica, a nonprofit investigative news organization, in August 2012. On December 17, 2012, the same organization introd...

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12/21/2012 Comments(0)

Fake Prescription Ring Busted in Osceola County

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A sting on a prescription fraud ring netted 29 arrests in Osceola County, Florida. On December 13, 2012. Osceola County Investigative Bureau (OCIB) agents, along with the Osceola County Sheriff’s Office, Kissimmee Police Department and St. Cloud Police Department conducted an operation nicknamed “Rx Printshop,” according to a press release from the Osceola County Sheriff’...

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12/19/2012 Comments(0)

The 25 Biggest Mistakes Respiratory Therapists Make After Being Notified of a Department of Health Complaint

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The investigation of a complaint which could lead to the revocation of a respiratory therapist's license to practice and the assessment of tens of thousands of dollars in fines, usually starts with a simple letter from the Department of Health (DOH). This is a very serious legal matter and it should be treated as such by the respiratory therapist who receives it. Yet, in many cases, attorneys a...

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12/18/2012 Comments(0)

Miami Pharmacy Owner Pleads Guilty to Participating in $23 Million Health Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A co-owner and operator of three Miami-area pharmacies pleaded guilty on December 6, 2012, for his part in a $23 million health care fraud scheme. The pharmacy owner allegedly admitted in the Florida Southern Federal District Court to one count of conspiracy to commit health care fraud and one count of conspiracy to pay illegal health care kickbacks, according to a Department of Justice (DOJ) ...

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12/17/2012 Comments(0)

Doctors Under Pressure to Meet Quotas and Fill Hospital Beds

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Doctors and hospitals around the country seem to be butting heads. In the past month, an article in The New York Times and a segment on the television “magazine” show 60 Minutes shed light on some questionable practices being enforced by hospitals on physicians working for them. I previously wrote a blog on this structural shift in the practice of medicine. Click here to read ...

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12/14/2012 Comments(0)

Drug Enforcement Administration (DEA) Busts New York Doctor Allegedly on Crack Cocaine Charges

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A raid by the Drug Enforcement Administration (DEA) on November 27, 2012, at a New York home led to the arrest of an emergency room (ER) doctor, according to a number of sources. Once inside, agents allegedly found crack cocaine, crack pipes, needles and other drug paraphernalia belonging to the doctor. It’s reported by The Buffalo News that the raid came just as the alleged drug abuse...

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12/13/2012 Comments(0)

Beware of Nationwide Telephone Prescription Drug Scam: Callers Claim to be DEA Agents

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Drug Enforcement Administration (DEA) is warning the public to be aware of a prescription drug scam. This telephone scheme is extorting money from people all over the country. On November 28, 2012, the DEA released a press release explaining the details of the scam. Don’t Give Money to Criminals Posing as DEA Agents Over the Phone. The scam starts with criminals posing ...

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12/12/2012 Comments(0)

Former Daytona Beach Chiropractor Receives More Than 15 Years in Federal Prison

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A former Daytona Beach chiropractor will spend more than 15 years in federal prison for an alleged health care fraud scheme and illegally prescribing pills, according to the Federal Bureau of Investigation (FBI), Jacksonville Division. He was also ordered to pay more than $2 million in restitution to his victims. The former chiropractor was sentenced on November 29, 2012, by a United States ...

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12/11/2012 Comments(0)

Detroit-Area Nurse Sentenced to Prison for Signing False Medicare Claims

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Detroit-area registered nurse was sentenced on November 19, 2012, to 30 months in federal prison for his alleged part in a nearly $13.8 million Medicare fraud scheme. According to a Department of Justice (DOJ) press release, he will serve probation after being released from prison. He was also ordered to pay more than $450,000 in restitution, together with his co-defendants. Click her...

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12/10/2012 Comments(0)

No Laughing Matter: Emergency Suspension Order Filed on Debary Dentist for Allegedly Getting High in Front of Patients

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Debary, Florida, dentist has been served with an emergency suspension order (ESO) by the Florida Department of Health (DOH) for allegedly inhaling nitrous oxide or laughing gas in front of patients. The administrative complaint filed against the dentist on November 2, 2012, by the Florida DOH stated a department-approved evaluator deemed the dentist unfit to practice dentistry and was recomme...

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12/7/2012 Comments(0)

Sex, Drugs and Money Lands Orlando Pharmacist in Deep Trouble (Sounds Like a Rock ‘n’ Roll Song, Doesn’t It?)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Sex, prescription drugs and money - sounds like the next big rock ‘n’ roll song, doesn’t it? According to a number of news sources, the owner of an Avalon Park-area pharmacist was allegedly knowingly filling phony prescriptions for painkillers. The pharmacist is also accused of exchanging sex for drugs with at least one woman, according to the Orlando Sentinel. This investigat...

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12/6/2012 Comments(0)

Seminole County Commissioners Vote to Regulate Pain Management Clinics

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Seminole County, Florida, is the latest county to adopt tightened regulations for pain management clinics. On November 13, 2012, County Commissioners unanimously voted to adopt the ordinance enacting Chapter 186 of the Seminole County Code to establish regulations regarding pain management clinics. Click here to read the entire Seminole County ordinance . County Commissioners hope...

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12/5/2012 Comments(0)

Are You Compliant with the Stark Law and Other Anti-Fraud Laws?

By Lance O. Leider, J.D. The federal government has several tools in its toolbox to combat Medicare fraud.  Among those are the Stark Act, Anti-Kickback laws, and Civil Monetary Penalty Laws.  Each of these typically focuses on a particular type of behavior that is prone to abuse by healthcare providers. The following focuses on the Stark law and what is prohibited by it.  Primarily, the Stark laws exist to combat the problems that can arise from physician self-referr...

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12/4/2012 Comments(3)

Massage Therapists: Please, Please, Please Talk to an Attorney Before You Talk to the Department of Health (DOH) Investigator

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Massage therapists, I beseech you: please do not talk to a Department of Health (DOH) investigator until you have talked to a health lawyer who is experienced with DOH investigations and board licensing complaints.  Do not answer or respond to even the most basic questions about where you work now, what your address is or if you know patient x, until consulting with counsel. Admitti...

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12/3/2012 Comments(0)

Florida Law Enforcement Losing War on Synthetic Drugs

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Who can forget the infamous cannibalism attack in Miami that sparked the threat of zombies, or the “Sons of Anarchy” actor killing his landlady and falling to his death? These are just a few of the more publicized incidents where synthetic drugs are thought to be the cause of erratic behavior. Click here to read a previous blog on the Miami cannibal and Florida’s Legislation ...

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11/30/2012 Comments(1)

Fake Florida Pharmacist Sentenced to Prison; Fraudulently Worked as a Pharmacist in Central Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 2, 2012, a former Altamonte Springs resident was sentenced to three and a half years in federal prison for fraudulently working as a Central Florida pharmacist from 2000 to 2009, according to the Department of Justice (DOJ). Click here to read the press release from the DOJ . I previously blogged about this story when the fake pharmacist pleaded guilty. Click here to r...

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11/29/2012 Comments(0)

Kissimmee Teen Sentenced to One Year in Jail for Impersonating Physician Assistant

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Kissimmee, Florida, teen found guilty in August 2012 for impersonating a physician assistant (P.A.) faced up to 20 years in prison for two counts of impersonation and two counts of practicing without a license. On November 14, 2012, the teen was sentenced to one year in jail by an Osceola County judge. The phony P.A. was given credit for his 264 days already served in jail, so he will...

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11/28/2012 Comments(0)

Meningitis Cases Grow to 24 in Florida - Doctors Getting Hit With Lawsuits

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Department of Health (DOH) confirmed another case of fungal meningitis in Florida on November 19, 2012. A 56-year-old man allegedly received a contaminated steroid injection at Florida Pain Clinic in Marion County, Florida. This brings the state’s total number of fungal meningitis cases up to 24, including three deaths. To read the entire press release from the ...

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11/27/2012 Comments(0)

Preserving Your License: Pretrial Intervention and Drug Court as Alternatives to Conviction, Nolo Contendere, or Adjudication Withheld

By Lance O. Leider, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law As if being faced with the consequences of criminal charges wasn't frightening enough, physicians, nurses, dentists, psychologists and other health professionals have the added danger of having their licenses disciplined or revoked if they plead nolo contendere or guilty to a criminal charge. Whether you are applying for a new license to practice or have been pract...

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11/27/2012 Comments(1)

University of Miami Employee Allegedly Stole More Than $14 Million in Cancer Drugs

By Michael L. Smith, J.D., R.R.T., Board Certified by The Florida Bar in Health Law For three years, hundreds of life-saving cancer drugs disappeared from the shelves of the University of Miami’s (UM) Sylvester Comprehensive Cancer Center. A pharmacy technician at the center was arrested in connection to the thefts in May of 2011, and is accused of stealing more than $14 million in cancer drugs, according to the Miami Herald. The pharmacy tech faces four counts of grand theft, two ...

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11/26/2012 Comments(0)

Zombie Invasion of Florida Continues – Threat of No Twinkies Has Population Panicked

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law You are already aware of Floridians’ fear of zombies, as shown by recent legislation against bath salts. Despite this, there continue to be reports of rampant zombie outbreaks across the Sunshine State. The zombie apocalypse has hit Central Florida, hard. As a citizen of Florida, you know you are not safe; not from zombies, not from British tourists, not from inability to count (notes in...

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11/24/2012 Comments(0)

Health Care Industry Trend Hospital Systems Merging and Acquiring Private Practices All Across the U.S.

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law There’s a structural shift that is sweeping the health care system - hospitals are acquiring private physician practices. It is happening all over the U.S., including right here in Central Florida. On December 31, 2012, Orlando Health - a nonprofit, multi-hospital system that owns Orlando Regional Medical Center and eight other hospitals - will allegedly merge with Physician Associates - ...

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11/21/2012 Comments(0)

Contracting 101: Tips for Physicians and Health Professionals - Part 5

By Christopher E. Brown, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This blog is the fifth in a series intended to provide an introductory review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practice. ...

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11/20/2012 Comments(0)

Hundreds of Doctors and Nurses Without Licenses in Georgia Due to New Immigration Law

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Hundreds of Georgia health providers are without a professional license to practice, because a new immigration law is causing massive backups in paperwork, according to a number of sources. The Illegal Immigration Reform and Enforcement Act of 2011 or House Bill 87 went into effect on January 1, 2012, and requires every person to prove his or her citizenship or legal residency when the individ...

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11/16/2012 Comments(0)

Ex-Florida Hospital Employee Pleaded Guilty to Stealing Confidential Patient Information

By Lance O. Leider, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 22, 2012, a former Florida Hospital employee admitted to stealing patient information that was used to target customers for lawyers and chiropractors, according to a number of sources. The man allegedly pleaded guilty in Orlando federal court to one count of conspiracy and one count of wrongful disclosure of health information, according to the Department o...

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11/15/2012 Comments(0)

Drug Enforcement Administration (DEA) Releases Details of Investigation into Two CVS Stores in Sanford, Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In September 2012, the Drug Enforcement Administration (DEA) revoked the controlled substance licenses from two CVS pharmacies in Sanford, Florida. Details into the investigation were made public on October 12, 2012, in a final order released by the DEA. The order explains how the stores operated, whom they prescribed painkillers such as oxycodone to, and identified Central Florida’...

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11/14/2012 Comments(0)

Contracting 101: Tips for Physicians and Health Professionals - Part 4

By Christopher E. Brown, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This blog is the fourth in a series intended to provide an introductory review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practice. ...

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11/13/2012 Comments(0)

Florida Department of Health (DOH) Issues Emergency Suspension Order (ESO) of Boca Raton Compounding Pharmacy

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 26, 2012, the Florida Department of Health (DOH) issued an emergency suspension order (ESO) against a Boca Raton compounding pharmacy, according to a number of sources. The DOH in a press release called the conditions in the pharmacy so “deplorable” that nothing short of immediately shutting down the pharmacy would suffice. Click here to read the press r...

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11/12/2012 Comments(0)

CVS’ Practice for Refilling Prescriptions Maybe Under Investigation for Medicare Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) has reportedly launched an investigation into CVS’ practice for refilling prescriptions. According to an article in the Los Angeles Times, authorities are looking into reports that CVS has been refilling prescriptions and submitting insurance claims without patients’ permission. The Los...

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11/9/2012 Comments(0)

American Hospital Association (AHA) Sues Government for Allegedly Unfair Medicare Practices by RAC, ZPIC and Other Auditors

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 1, 2012, the American Hospital Association (AHA) filed a lawsuit against the U.S. Department of Health and Human Services (HHS) claiming that private auditors hired to crack down on improper Medicare payments are denying hospitals millions of dollars in medically necessary care, this is according to a number of sources. The AHA is seeking a court order declaring the practice invalid...

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11/9/2012 Comments(0)

The Deadliest Drug: Prescription Drug Abuse

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law America’s deadliest drug doesn’t come from Columbia and isn’t smuggled in from Mexico. It is sold legally at the most frequently visited pharmacies. Overdosing on prescription painkillers, or opioids, kills more than 15,000 people a year in the U.S., according to an article in the Wall Street Journal. The war on prescription drugs is different than fighting cocaine and heroin,...

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11/8/2012 Comments(0)

Prescription Drug Monitoring Program Flops - A Majority of Doctors Not Using It

By Danielle M. Murray, J.D. The Florida Prescription Drug Monitoring Program is apparently collecting dust as physicians are choosing not to use it. The Tampa Bay Times reported on October 5, 2012, that as few as one in twelve doctors have ever used the database. That is about eight percent (8%) of all physicians. Approximately fourteen percent (14%) of physicians are registered for the database. Click here to read the entire story from the Tampa Bay Times . Database Us...

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11/7/2012 Comments(0)

Phony Occupational Therapist Made Rounds at a Number of Florida Hospitals

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Kissimmee, Florida, man is accused of posing as an occupational therapist (OT) and working at various health care facilities in Central Florida, according to the Department of Justice (DOJ). On October 16, 2012, the DOJ announced that the phony OT was charged with three counts of mail fraud, five counts of wire fraud, and one count of aggravated identity theft. Click here to see the p...

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11/6/2012 Comments(0)

Avoid HIPAA Violations: Get a HIPAA Risk Assessment

By Danielle M. Murray, J.D. As a health care provider or owner of a health facility, you know about the Health Insurance Portability and Accountability Act (HIPAA) of 1996.  You know that you must safeguard and protect confidential patient medical information to avoid civil and criminal penalties against you and your practice. Did you know that you may need a HIPAA Risk Assessment? All Health Care Providers Face a Real Audit Risk. The Office for Civil Rights (OCR) is st...

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11/5/2012 Comments(0)

Medicare Fraud Scheme Lands Medical Equipment Supplier in Prison for 30 Months

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Los Angeles medical equipment supplier will spend 30 months in prison for submitting nearly $1 million in false claims to Medicare. The claims were almost all for expensive, high-end power wheelchairs. The man was sentenced on October 5, 2012. To see the press release from the Department of Justice (DOJ), click here . Man Used Kickbacks and Illegally Solicited Medicare Beneficia...

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11/2/2012 Comments(1)

Sarasota Sheriff Wants Patients to Waive HIPAA Privacy Rights

By Danielle M. Murray, J.D. Law enforcement has been working hard to bust pill mills and stop prescription drug abuse. Pharmacists and pain management doctors are under intense scrutiny by various law enforcement agencies, including the Drug Enforcement Administration (DEA) and the Department of Health (DOH), for their role in giving out controlled substances. "Doctor shopping" is a common phrase used to describe patients who see multiple doctors in a short period of time in an attem...

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11/1/2012 Comments(0)

Osceola County Approves Ordinance to Regulate Pain Management Clinics

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 8, 2012, the Osceola County, Florida, Commissioners unanimously approved an ordinance that will regulate pain management clinics, according to the Orlando Sentinel. The ordinance will take effect on October 31, 2012, and will be in effect for 10 years. Click here to see the ordinance passed at the Osceola County Commissioner’s meeting . This is part of the continuing...

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10/31/2012 Comments(0)

Almost 19% of Nurse Aides Charged with Abuse and Neglect, had Prior Criminal Records

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A report released by the Department of Health and Human Services (HHS) Office of Inspector General (OIG) on October 5, 2012, found that nineteen percent (19%) of long-term care nurse aides who were found guilty of on-the-job abuse, neglect or property theft in 2010 had prior criminal records that would have showed up on a background check. Click here to read the entire report from the HHS...

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10/30/2012 Comments(0)

Does Putting Doctors’ Notes Online Violate HIPAA Privacy Rights?

By Danielle M. Murray, J.D. According to the Orlando Sentinel, a study published in the Annals of Internal Medicine shows that patients like to read their doctors’ notes.  In the study, published in April of 2012, doctors put their notes online, and gave patients online access to the file.  While some patients had privacy concerns, ninety-nine percent (99%) of them requested to keep access to the file after the study was over. To read the entire article from the Orl...

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10/29/2012 Comments(0)

The Lone Star State’s New Task Force to Take a Bite Out of Medicaid Dental Fraud

George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law There’s a new task force riding into Texas. According to The Texas Tribune, the Texas Attorney General’s (AG) Office and the Office of Inspector General (OIG) at the Health and Human Services Commission (HHSC) have teamed up to increase investigations of fraud in the state’s Medicaid dental program for children. The article, published on October 10, 2012, states the creat...

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10/26/2012 Comments(0)

Two South Florida Doctors Sentenced to 10 Years in Prison for Medicare Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Two South Florida doctors, both former medical directors at the mental health care company American Therapeutic Corporation (ATC), will spend 10 years in prison for their part in a $205 million Medicare fraud scheme. A U.S. district judge handed down the sentence on October 1, 2012. Click here to see the press release on the sentencing from the Department of Justice (DOJ) . I previous...

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10/25/2012 Comments(0)

Problems with Obtaining Certification From the ABIM? Recommendations For Physicians and Prospective Employers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Physicians who run into difficulty in obtaining certification by the American Board of Internal Medicine (ABIM) need to act to ensure that they properly exercise their rights to hearings and appeals.  Because of the extremely serious repercussions adverse action by the ABIM might have on a physician's career and livelihood, it is critical to approach this from an educated perspective. ...

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10/24/2012 Comments(0)

South Florida Authorities Arrest More Than 30 Suspects For Medicare Fraud

By Dr. Thu Pham, O.D., Law Clerk On October 4, 2012, federal authorities arrested 33 suspects in South Florida for allegedly filing fraudulent Medicare claims totaling $205 million. Payment of bribes and kickbacks, as well as payments to patient recruiters were an issue in this investigation. To read the entire article from the Miami Herald, click here . Arrests Part of a Nationwide Initiative. These arrests are part of a nationwide initiative to crack down on the...

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10/23/2012 Comments(1)

Tiny Key West Pharmacy Blows Whistle on Medicaid Fraud

By Danielle M. Murray, J.D. On September 27, 2012, Public Citizen, a watchdog group, reported whistleblowers have initiated $6.6 billion in penalties against drug manufacturers in 2012. Most of these penalties are for fraudulently overcharging government programs. The report names a small Key West, Florida, pharmacy as one of the top whistleblowers in the country. The pharmacy noticed and reported that drug manufacturers were charging highly inflated prices to Medicaid. To read th...

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10/22/2012 Comments(0)

Errors in Initial Calculations Cause Medicare to Revise Readmission Penalties

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Back in August of 2012, I wrote that lower Medicare reimbursement rates were coming to more than 2,000 hospitals around the country due to excessive readmission rates. To see that blog, click here . In October of 2012, the Centers for Medicare and Medicaid Services (CMS) announced it has discovered errors in its initial calculations. This means, 1,422 hospitals with high readmission rates w...

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10/19/2012 Comments(0)

Patient Recruiter is Convicted of Medicare Fraud for Power Wheelchairs

By Thu Pham, O.D., Law Clerk, The Health Law Firm On August 9, 2012, the United States Court of Appeals for the Fifth Circuit, located in New Orleans, Louisianna, affirmed the conviction of a patient recruiter in Texas for Medicare Fraud committed after Hurricane Katrina. To read the court's decision, click here . The Recruiter's Charges. The patient recruiter was charged with conspiracy to defraud Medicare.  Starting in 2007, the recruiter solicited potential benef...

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10/18/2012 Comments(0)

Walgreens Fights the Drug Enforcement Administration’s (DEA) Immediate Suspension Order

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law There’s a firefight brewing between Walgreens and the Drug Enforcement Administration (DEA). On October 10, 2012, Walgreens filed a petition asking a federal judge to lift the Immediate Suspension Order (ISO) that bans its distribution center in Jupiter, Florida, from shipping controlled substances to its stores in Florida and on the East Coast. Back on September 14, 2012, the DEA i...

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10/17/2012 Comments(26)

Pharmacy in Meningitis Outbreak May Have Violated License

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The compounding pharmacy behind the meningitis outbreak was allegedly not following the requirements of its state license, according to the Massachusetts Department of Health (DOH) in a released statement on October 10, 2012. To read the entire statement from the Massachusetts DOH, click here . The New England Compounding Center (NECC) shipped more than 17,000 vials of a steroi...

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10/17/2012 Comments(0)

Miami Couple Arrested for Practicing Medicine Without A License

By Danielle M. Murray, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law By now, you have heard stories of fake doctors and dentists in South Florida working on patients and causing severe injuries. Usually, these are solo efforts. However, according to CBS Miami, a couple was arrested back in August of 2011, for practicing medicine without a license. The wife owned a clinic where the husband treated patients. The majority of the ...

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10/16/2012 Comments(0)

Filling Fake Prescriptions for Painkillers Lands Orlando Pharmacist in Handcuffs

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Another pharmacist was led away in handcuffs during a September 25, 2012, raid on an Orlando-area pharmacy, according to a number of sources. The pharmacist is accused of filling prescriptions for oxycodone, even though he allegedly knew the prescriptions were not legitimate. Click here to see video of the arrest from WFTV in Orlando . The Raid and Arrest Were Part of an Ongoing ...

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10/15/2012 Comments(0)

The Collateral Effects of Voluntary Relinquishment with Investigation Pending or other Discipline on Your Massage Therapy License

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many massage therapists are unaware of the drastic long-term effects that discipline on their massage therapist license could have.  This includes submitting a voluntary relinquishment of the massage therapist's license while there is an investigation pending or while there are charges pending.  Although this particular article is being prepared specifically for massage therapists, si...

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10/12/2012 Comments(1)

Accountable Care Organizations: Exemptions From and Antitrust Law and Other Healthcare Laws Offer Many Advantages

By: Lance O. Leider, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The recently enacted Medicare Shared Savings Program (MSSP) has created a new form of healthcare delivery system, the Accountable Care Organization (ACO).  The purpose of the ACO is to encourage providers to reduce healthcare costs by grouping together and assuming responsibility for the care of a group of beneficiaries.  In order to accomplish this goal...

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10/11/2012 Comments(0)

Medicare and Medicaid Audits of Psychologists and Other Mental Health Professionals - Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Over the past year I have observed an increasing number of Medicare and Medicaid audits being initiated against psychologists and other mental health professionals. I have recently seen a number of audits initiated against psychologists and mental health professionals who treat assisted living facility (ALF) and skilled nursing facility (SNF) residents. Most often these are audits by the M...

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10/10/2012 Comments(0)

Tennessee Ambulance Company Settles Lawsuit Over A $2 Million Bill

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Dr. Thu Pham, O.D., Law Clerk, The Health Law Firm Attorney A Tennessee ambulance company and the U.S. Department of Health and Human Services (DHHS) announced a settlement in a case over a post payment audit for more than two million dollars in May 2012. Back in March of 2010, the Nashville ambulance company sued the DHHS after being sent a $2.65 million overpayment demand, according to t...

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10/10/2012 Comments(0)

Recovery Audit Contractors (RACs) Receive Approval to Conduct Medical Review of E&M Services

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In September 2012, the Centers for Medicare and Medicaid Services (CMS) made the decision to allow Recovery Audit Contractors (RACs) to begin reviewing the billing codes for office visits for healthcare providers. Those at issue are the codes referred to as evaluation and management (E&M) codes. These claims had previously been off-limits to RACS. Connolly, Inc., the contractor for RA...

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10/9/2012 Comments(1)

New England Compounding Center Issues Voluntary Nationwide Recall of All Products Due to Meningitis Outbreak; Closes Manufacturing Center

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law At least 105 people in nine states, including Florida, have contracted meningitis. The outbreak is allegedly due to contaminated epidural spinal injections of methylprednisolone linked to New England Compounding Center (NECC) in Framingham, Massachusetts. The manufacturing center is now closed, and the company has issued a voluntary recall of all products distributed since January 201...

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10/9/2012 Comments(0)

Disclosure of Private Employee Information by Employers

By Lance O. Leider, J.D.     Personnel files contain many different kinds of potentially harmful information.  Not only is there a tremendous amount of personal information that could be misused, but also information that could be harmful to future employment prospects and potential license discipline.  Fortunately, healthcare providers in Florida have a strong right to privacy in the information contained in their personnel records. The greatest potential danger in ...

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10/8/2012 Comments(3)

Government Proposes New System for Patients to Report Medical Mistakes

By Danielle M. Murray, J.D. According to the New York Times, the government wants to implement a new system that would allow patients to report medical mistakes and unsafe practices by health care providers to a central reporting organization. This includes doctors, hospitals, pharmacists, and all other professionals or entities that provide medical treatment. While it is only an idea at this point, the government envisions patients reporting problems through a website or a phone number ...

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10/5/2012 Comments(0)

New Popular Drug Called “Smiles” on the List of Florida’s Outlawed Synthetic Drugs - No Local Zombie Attacks, So Far!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In previous blogs we’ve mentioned that Florida Governor Rick Scott signed House Bill 1175 on March 23, 2012. This bill outlawed more than 90 new forms of synthetic drugs and included bath salts, among others. It modifies Section 893.03(1)(c) , Florida Statutes, by expanding the list of banned hallucinogenic substances in Schedule I of the Florida Comprehensive Abuse Prevention and Con...

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10/5/2012 Comments(0)

Whistleblower Lawsuit Against Blackstone Medical, Inc., Dismissed

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A whistleblower lawsuit against Blackstone Medical, Inc., alleging Medicare fraud against Parrish Medical Center, was dismissed by a U.S. District Judge in Tampa, Florida, on August 15, 2012. According to Orthopedics This Week, the case was unsealed on August 8, 2012, but dismissed without prejudice, all pending motions were denied as moot, and the clerk was directed to close the case, just one...

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10/4/2012 Comments(0)

Feds Tap the Brakes on Power Wheelchair Medicare Fraud = New Program Requires Advance Approval

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 19, 2012, power wheelchair suppliers voiced their concerns over a new government program called the Power Mobility Devices (PMDs) Demonstration at a Senate Special Committee on Aging. Durable Medical Equipment Suppliers (DMES) protested the program because it requires the permission of a Medicare Administrative Contractor (MAC) prior to the delivery of a power wheelchair to the con...

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10/3/2012 Comments(0)

Overcoming License Suspension and Revocation Pending Appeal

By Lance O. Leider, J.D. If you are a doctor, nurse, dentist, psychologist, pharmacist, massage therapist or other licensed health professional whose license has been recently revoked or suspended, there may still be hope. Ordinarily, you must immediately stop practicing or you risk being prosecuted for unlicensed practice, a felony. Although this blog deals with Florida law, similar relief may be available in other states, too. One of the hardest things about having a license suspe...

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10/2/2012 Comments(1)

Medicare and Medicaid Audits of Psychologists and Other Mental Health Professionals - Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Over the past year I have observed an increasing number of Medicare and Medicaid audits being initiated against psychologists and other mental health professionals. I have recently seen a number of audits initiated against psychologists and mental health professionals who treat assisted living facility (ALF) and skilled nursing facility (SNF) residents. Most often these are audits by the M...

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10/2/2012 Comments(0)

Department of Justice (DOJ) Joins Whistleblower Lawsuit Against Hospice of the Comforter

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 6, 2012, the Department of Justice (DOJ) announced it will join in a whistleblower lawsuit alleging false Medicare billings against Hospice of the Comforter Inc., (HOTCI). The hospice is located in Altamonte Springs, a suburb of the Orlando area, and provides hospice services to local patients. To read the entire whistleblower complaint filed, click here . Alleg...

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10/1/2012 Comments(0)

Remedies for Violation of HIPAA Privacy Rights and Medical Confidentiality - Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I receive many questions and e-mails about possible violations of the Health Insurance Portability and Accountability Act's (HIPAA) Privacy Regulations and Security Regulations, and breaches of confidentiality of medical records and medical information.    More detailed information on HIPAA Privacy Regulations and Security Regulations, can be found at: http://www.hhs.gov/oc...

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10/1/2012 Comments(7)

The Number of Massage Licenses Suspended in Florida Now Almost Doubled

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Secretary of Health announced on September 27, 2012, that he has now signed 161 emergency suspension orders (ESOs) for massage therapists in Florida. The suspension orders are aimed at massage therapists who allegedly obtained their licenses to practice through a transcript-buying scandal at the Florida College of Natural Health. Officials believe the scheme could be linked to ...

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10/1/2012 Comments(2)

Remedies for Violation of HIPAA Privacy Rights and Medical Confidentiality - Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I receive many questions and e-mails about possible violations of the Health Insurance Portability and Accountability Act's (HIPAA) Privacy Regulations and Security Regulations, and breaches of confidentiality of medical records and medical information.  I will attempt to explain and clarify this issue a little in this short blog. More detailed information on HIPAA Privacy Regulatio...

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9/28/2012 Comments(2)

Department of Health (DOH) Asking Suspended Florida Massage Therapists to Voluntarily Relinquish Their Licenses

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law, and Christopher E. Brown, J.D. On September 19, 2012, Florida state authorities announced the suspension of more than 80 massage therapists’ licenses. They are accused of fraudulently obtaining their licenses based on fake documentation obtained from a staff member at the Florida College of Natural Health, in Pompano Beach, Florida. On September 20, 2012, one massage therapist, whose li...

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9/28/2012 Comments(0)

Three Charged with Child Abuse After Miami Imposter Injures Teen with Illegal Dental Work

George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Miami man, his wife and their daughter have been charged with child abuse following two alleged dental procedures that left a 14-year-old girl permanently disfigured. According to a number of sources, the three were arrested on September 12, 2012, at their home-operated dental office. Click here to see the man’s arrest affidavit from the Miami Police Department . Dental Pr...

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9/27/2012 Comments(0)

25 Arrest Warrants Issued by Polk County Sheriff’s Office with Connection to Pill Mill Investigation

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Polk County Sheriff’s Office issued 25 arrest warrants in connection to an ongoing pill mill investigation involving a medical clinic in Winter Haven, Florida. On September 19, 2012, the sheriff’s office announced that ten suspects in the case have been arrested, and 15 suspects with arrest warrants remain at large. Click here to see the press release from the Polk County...

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9/26/2012 Comments(1)

You Might Be A Disruptive Physician If...Avoiding the Disruptive Physician Label - Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This is the second blog dedicated to physicians who are accused of being a disruptive. To read part 1 on the types of conduct that might make you a "disruptive physician," click here . Consequences of Disruptive Physician Behavior. According to one article on the subject by a physician leader, the consequences of disruptive behavior by a physician in a hospi...

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9/25/2012 Comments(0)

Fake New York Plastic Surgeon Convicted for Performing Surgeries on Patients Without a Medical License

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A fake New York plastic surgeon was convicted on September 7, 2012, for performing cosmetic surgeries between April 2011 and December 2011, without a medical license. He’s also accused of completing the surgeries without general anesthesia and permanently disfiguring his patients. This is all according to the New York Attorney General’s (AG) Office. To see the entire press re...

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9/24/2012 Comments(0)

North Carolina Woman Pleaded Guilty to a $6.1 Million Medicaid Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A North Carolina woman pleaded guilty on September 14, 2012, for her involvement in a health care scheme that allegedly defrauded Medicaid from 2008 to 2011 for fake mental and behavior health services. Through this scheme, she allegedly obtained at least $6.1 million in fraudulent reimbursement payments, according to the Federal Bureau of Investigation (FBI). Click here to see the press...

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9/21/2012 Comments(0)

Florida Suspends 81 Massage Therapists’ Licenses

By Joanne Kenna, J.D., R.N., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law According to a number of sources, state authorities have announced the suspension of more than 80 massage therapists’ licenses, who appear to have fraudulently obtained their licenses with the help of an employee at the Florida College of Natural Health. On September 19, 2012, 81 emergency suspension orders (ESOs) were signed, suspending the licenses of...

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9/20/2012 Comments(1)

Contracting 101: Tips for Physicians and Health Professionals - Part 3

By Christopher E. Brown, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This blog is the third in a series intended to provide an introductory review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practice. ...

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9/20/2012 Comments(0)

Alachua County Woman Arrested for Exploiting 11 Disabled Adults

By Dr. Thu Pham, O.D., Law Clerk, The Health Law Firm Attorney and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A former employee of an organization that provides services to developmentally disabled adults in Alachua County, Florida, was arrested on June 15, 2012, according to the Attorney General’s (AG) Office. The woman was arrested for allegedly stealing money from 11 clients in 2010 and 2011. To see the press release from t...

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9/19/2012 Comments(0)

You Might Be A Disruptive Physician If...Avoiding the Disruptive Physician Label - Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I have never read a Jeff Foxworthy book, and I have never watched more than a minute or two of one of his comedy routines, so my apologies to him in advance. However, I find his comedy routine about rednecks (or what I know of the little bit I have heard) to be a good vehicle for conveying what might be a joke to many, but should be taken very seriously, especially  by one accused ...

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9/18/2012 Comments(0)

Walgreens Distribution Center in Florida Served with an Immediate Suspension Order from the Drug Enforcement Agency (DEA)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law  On September 14, 2012, the Drug Enforcement Administration (DEA) blocked the Walgreens distribution center in Jupiter, Florida, from shipping oxycodone and other controlled drugs to its pharmacies in Florida and the East Coast with an immediate suspension order, according to the DEA. In the press release, the DEA called the Walgreens distribution facility an "imminent danger" to the publ...

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9/18/2012 Comments(7)

Consequences of Having Your Massage Therapy License Revoked (Or Relinquishing it after Notice of an Investigation)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many massage therapists, when confronted with an investigation against their license, do not fight the charges, sometimes they decide it is cheaper and easier just to give up their license.  Either choice is likely to be a mistake. A charge can be filed causing an investigation to be opened against a massage therapist by many different sources and often without any supporting eviden...

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9/17/2012 Comments(4)

Contracting 101: Tips for Physicians and Health Professionals - Part 2

By Christopher E. Brown, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This blog is the second in a series intended to provide an introductory review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practice. ...

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9/14/2012 Comments(0)

Dentist and Two Pharmacists From Central Florida Face Drug Charges for Prescribing and Dispensing Painkillers

By Danielle M. Murray, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Lakeland Ledger reports that Polk County Sheriff’s Detectives arrested a dentist and two pharmacists on September 5, 2012, in three unrelated cases dealing with illegally prescribing and dispensing painkillers. The sheriff’s office said the three arrests are part of its efforts to target prescription drug abuse. To read the entire Lakeland ...

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9/13/2012 Comments(0)

Drug Enforcement Administration (DEA) Pulls Controlled Substance Licenses from Two Central Florida CVS Pharmacies

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The U.S. Drug Enforcement Administration (DEA) revoked the registrations (controlled substance licenses) from two CVS pharmacies in Sanford, Florida, on September 12, 2012, according to a number of sources. The two pharmacies will no longer be able to fill prescriptions for drugs such as oxycodone, Dilaudid, Vicodin, Ritalin and Xanax. This decision is in response to a government crackdown on t...

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9/13/2012 Comments(0)

South Florida Mental Health Clinics Under Scrutiny by the Office of Inspector General for Medicare Fraud

By Lance O. Leider, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 16, 2012, the Office of Inspector General (OIG) released a report on questionable billing by mental health centers. The report focuses on the nation’s mental health clinics that overbilled Medicare in 2010, some by tens of millions of dollars. The majority of these clinics were located in South Florida, Texas and Louisiana. To see the full repo...

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9/12/2012 Comments(0)

Former Medical Examiner Arrested for Allegedly Keeping Human Body Parts in Self-Storage Facility

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A former medical examiner, who is accused of keeping the body parts of more than 100 people in his Pensacola storage facility, was arrested September 7, 2012. He now faces a felony charge of improper storage of hazardous waste, a misdemeanor charge of “nuisance injurious to public health” and driving with a suspended license, according to a number of sources. To see the case ...

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9/11/2012 Comments(0)

The 25 Biggest Mistakes Massage Therapists Make After Being Notified of a Department of Health Complaint

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The investigation of a complaint which could lead to the revocation of a massage therapist's license to practice and the assessment of tens of thousands of dollars in fines, usually starts with a simple letter from the Department of Health (DOH). This is a very serious legal matter and it should be treated as such by the massage therapist who receives it. Yet, in many cases, attorneys are consu...

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9/11/2012 Comments(0)

Ex-Florida Hospital Employee Faces Federal Charges For Accessing More Than 700,000 Patient Records

By: Lance O. Leider, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Federal court records from August 13, 2012, show that a former Florida Hospital employee faces fraud-conspiracy charges after he illegally accessed patient records in a solicitation scheme, according to the Orlando Sentinel. The breach in patient information was first thought to involve 2,000 patients, but according to a Federal Bureau of Investigation (FBI) affidavi...

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9/10/2012 Comments(0)

Florida Teenager Found Guilty of Impersonating a Physician’s Assistant (PA)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An 18-year-old Florida teenager was found guilty on August 30, 2012, of impersonating a physician’s assistant (PA) and practicing medicine without a license. According to the court case, he will be sentenced on November 14, 2012, and faces up to 25 years in prison on the felony counts. To view the court records from this case, click here . Teen Allegedly Treated...

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9/10/2012 Comments(0)

Contracting 101: Tips for Physicians and Health Professionals - Part 1

By Christopher E. Brown, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law This blog is the first in a series intended to provide an introductory review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practice. B...

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9/7/2012 Comments(0)

The OIG Reads My Blog! (And Probably Yours, Too)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law As a participant in many listservs, including those of the American Health Lawyers Association (AHLA), I had always been warned to watch what I said online as the OIG, the FBI and other law enforcement authorities and regulators monitored these. Not that I really believed this, and this was unnecessary, because who would be dumb enough to say anything that might cause problems for himself ...

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9/7/2012 Comments(0)

Director of Florida Center for Developmentally Challenged Adults Charged with Medicaid Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The director of a center for developmentally challenged adults in Okaloosa County, Florida, was arrested on August 16, 2012, for allegedly fraudulently billing Medicaid for more than $270,000 for services under the Medicaid Developmentally Disabled Waiver Program, according to the Attorney General’s (AG) office. To read the entire press release from the AG’s office, click her...

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9/6/2012 Comments(0)

Seven Tips to Speed Up the Medicare Prepayment Review Process

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For Medicare providers, being notified of an impending audit is not welcome news. Being notified of a prepayment review is even worse. In a prepayment review, the health care provider must submit documentation to the Centers for Medicare & Medicaid Services (CMS) contractor before ever receiving payment. The health care provider will only receive payment (typically months later) if the cont...

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9/5/2012 Comments(0)

Pharmacists: Please, Please, Please Talk to an Attorney Before You Talk to an Investigator

By Christopher E. Brown, J.D. In Florida, You DO NOT Have to Speak to an Investigator!   Despite mailing out hundreds of thousands of postcards and letters to pharmacists, throughout Florida, we continue to receive calls from new clients and from potential clients, after they have already spoken to and made critical harmful admissions against their own interests to investigators. In Florida, you do not have any duty to cooperate with any investigator who is investigating you...

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9/4/2012 Comments(0)

Daytona Beach Chiropractor Pleads Guilty to Health Care Fraud, Illegally Prescribing Pills and Money Laundering

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Department of Justice (DOJ) announced that a Daytona Beach chiropractor pleaded guilty to health care fraud, conspiracy to illegally distribute prescription drugs and money laundering on August 28, 2012. An article in the Daytona Beach News Journal states that he is facing a penalty of 30 years in federal prison. Click here to read the entire press release from the DOJ . Chir...

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8/31/2012 Comments(0)

North Florida Nurse Arrested for Neglecting Elderly Patient

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An investigation led by the Attorney General’s Medicaid Fraud Control Unit (MFCU) ended with an arrest of a north Florida registered nurse (RN), in Suwannee County. The arrest was based on allegations of failing to assess and monitor a 94-year-old patient’s condition. The patient fell and broke her hip and shoulder, and later died. Click here to see the full press release fro...

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8/30/2012 Comments(0)

37 Defendants Charged with Illicit Pharmaceutical Drug Trafficking in Central Florida

By Dr. Thu Pham, O.D., Law Clerk, The Health Law Firm Attorney General Pam Bondi along with special agent Mark R. Trouville of the Drug Enforcement Administration (DEA) and Longwood Police Chief Troy Hickson announced, on June 20, 2012, the execution of 37 arrest warrants stemming from state drug charges.  The defendants all reside in Central Florida. Click here t o read the entire press release from the Florida Attorney General . The Defendants’ Charges Va...

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8/29/2012 Comments(0)

Arrest of a Palm Beach Speech Pathologist for Medicaid Fraud

By Dr. Thu Pham, O.D., Law Clerk, The Health Law Firm   A Palm Beach, Florida, speech pathologist has allegedly been charged with Medicaid fraud and grand theft by the Attorney General’s (AG) Office of Statewide Prosecution. According to the press release posted on June 29, 2012, from the AG’s office, the speech pathologists is accused of attempting to defraud Medicaid out of more than $459,000. To read the entire press release from the Florida Attorney General, ...

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8/28/2012 Comments(0)

MedVance Institute Reaches Agreement With Attorney General’s Office to Retrain Students and Donate Direct Scholarships to Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Joanne Kenna, J.D., R.N. MedVance Institute, which is a healthcare training school with four Florida campuses, reached an agreement with the Florida Office of the Attorney General (AG) on June 13, 2012. MedVance was alleged to have made misleading marketing claims to students. Under the agreement, the for-profit college is required to offer retraining to eligible students who attended spe...

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8/27/2012 Comments(0)

Adventist Health System Accused of Filing Millions of Dollars in False Medicare, Medicaid and Tricare Claims

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A whistleblower lawsuit based on information from a former Florida Hospital Orlando billing employee and a former staff physician alleges that seven of Adventist’s Florida hospitals overbilled the federal government between 1995 and 2009, resulting in tens of millions of dollars in false or padded medical claims, according to an article in the Orlando Sentinel and other sources. To ...

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8/24/2012 Comments(0)

Responding to a Medicaid Fraud Control Unit Investigative Subpoena

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Christopher E. Brown, J.D. The Medicaid Fraud Control Unit (MFCU) is a division of the Florida Office of Attorney General. It is in charge of investigating and prosecuting health care providers suspected of defrauding the state's Medicaid program.  When the unit opens a case against a provider, the first step is usually the issuance of an investigative subpoena, requesting specific pat...

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8/23/2012 Comments(0)

Nurses Beware of Disciplinary Action Database

By Christopher E. Brown, J.D. Nurses, did you know the National Council of State Boards of Nursing (NCSBN) maintains a database of all state disciplinary actions?  This database, called Licensure QuickConfirm, lists all disciplinary actions from the Florida Board of Nursing and forty-six (46) other state boards. It is frequently used by hospitals and medical groups to screen potential employees. To search the Licensure QuickConfirm list, click here . Where the Informa...

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8/23/2012 Comments(0)

Franck's Pharmacy Closes Its Doors; Compounding Lab Becomes Wells Pharmacy Network

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law July 31, 2012, marked the end of an era for Franck’s Pharmacy in Ocala, Florida, as the retail location closed its doors for good. According to an Ocala Star-Banner article, in July 2012, Franck’s Compounding Lab, which was one of the largest compounding labs in the country, was bought by Wells Pharmacy Network. The deal included Franck’s Lifestyles, which sells supplements an...

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8/22/2012 Comments(0)

Two Recent Rulings Allow Certified Registered Nurse Anesthetists (CRNAs) to Administer Anesthesia Without the Supervision of a Physician

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Recently, courts in both California and Colorado ruled that Certified Registered Nurse Anesthetists (CRNAs) are now allowed to independently administer anesthesia to patients without the supervision of a physician. In California, the decision came from the First District Court of Appeals on March 15, 2012. In Colorado, an appeals court allowed the same practice on July 19, 2012. A recen...

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8/21/2012 Comments(0)

More than 2,000 Hospitals, Including 131 in Florida, will be Penalized by Medicare for Excess Readmissions

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Lower Medicare reimbursement rates are coming in October of 2012, to 2,211 hospitals around the country, including 131 in Florida. This is allegedly due to excessive readmission rates in these hospitals between July 2008 and June 2011, according to the Centers for Medicare and Medicaid Services (CMS). This story was originally reported by Kaiser Health News on August 13, 2012, and by other sour...

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8/20/2012 Comments(1)

Why You Should Choose an Attorney Who is Board Certified by The Florida Bar in Health Law

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Doctors, nurses, dentists, health professionals, and health facilities often face legal challenges from many different sources, including federal and state regulators, medical malpractice trial lawyers, hospitals, clinics and colleagues. When faced with a legal problem, the first person they should turn to should be an attorney who is Board Certified by The Florida Bar in Health Law. ...

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8/15/2012 Comments(0)

Cardiology Services at Florida Hospitals Are Being Investigated by U.S. Attorney’s Office

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On Monday, August 6, 2012, a New York Times article revealed that cardiology services at some Florida HCA hospitals are under investigation by the U.S. Department of Justice (DOJ) for allegedly performing unnecessary procedures to increase profits. Click here to see the entire New York Times article posted August 6, 2012 . I previously blogged about and published an article on ...

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8/13/2012 Comments(0)

Doctor Gives Up License Due to Allegations of Malpractice and Over-Prescribing Pills

By Danielle M. Murray, J.D., Attorney, The Health Law Firm A doctor in Polk County, Florida, has lost his license to practice medicine. Rather than risk having his license revoked in an administrative proceeding, the now former doctor offered to voluntarily relinquish his license. The Florida Board of Medicine voted to accept the voluntary relinquishment on Friday, August 3, 2012, according to a Lakeland Ledger article. Click here to read the entire Lakeland Ledger article . ...

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8/10/2012 Comments(0)

Article by George F. Indest III Featured in the July Issue of Medical Economics

By Cori Pope, The Health Law Firm The July 25, 2012, issue of  Medical Economics features an article written by George F. Indest III, President and Managing Partner of The Health Law Firm . The article, “Beware Legal Ramifications of Unnecessary Tests,” discusses lists that were recently released by nine medical specialty societies on medical tests and procedures patients and physicians should question or avoid. What These Lists Mean for Patients and Docto...

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8/9/2012 Comments(0)

Miami Man Pleads Guilty in $42 Million Medicare Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The owner and operator of a Miami home health care agency pleaded guilty for his part in a $42 million home health Medicare fraud scheme, according to the Department of Justice (DOJ), the FBI and the Department of Health and Human Services (DHHS). The 43 year-old man pleaded guilty before a U.S. district court judge to one count of conspiracy to commit health care fraud on August 2, 2012. ...

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8/8/2012 Comments(0)

CIVIL RIGHTS: Police Can Be Sued Under 42 U.S.C. § 1983 for Arresting Plaintiff in Safe Location and Releasing Her in Dangerous Neighborhood

The author of this is article is John Stone, a legal research attorney with  National Legal Research Group in Charlottesville, VA. Police arrested Christina outside Chicago's Midway Airport.  She had purchased a ticket from Southwest Airlines but was behaving so oddly while waiting to board the airplane that agents called the police, who escorted her from the airport.  Christina walked to the rail and bus terminal of the Chicago Transit Authority, immediately outside the ai...

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By: John Stone, Senior Attorney, National Legal Research Group 8/7/2012 Comments(0)

25 Mistakes Osteopathic Physicians Make After Being Notified of a Department of Health (DOH) Complaint

By Christopher E. Brown, J.D. The investigation of a complaint which could lead to the revocation of an osteopathic physician's license to practice and the assessment of tens of thousands of dollars in fines, usually starts with a simple letter from the Department of Health (DOH). This is a very serious legal matter and it should be treated as such by the osteopathic physician who receives it. Yet, in many cases, attorneys are consulted by osteopathic physicians after the entire investig...

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8/6/2012 Comments(0)

CMS Recovery Audit Prepayment Review (RAPR) Begins August 27, 2012

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 31, 2012, the Centers for Medicare and Medicaid Services (CMS) announced on its website that hospitals should brace themselves for prepayment audits beginning August 27, 2012. The CMS originally announced the Recovery Audit Prepayment Review (RAPR) Demonstration Project in November of 2011 for a January 1, 2012 start date, then delayed it to June 1, 2012, then again to, “s...

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8/2/2012 Comments(0)

North Carolina Department of Health and Human Services (DHHS) Investigating Almost Three Dozen Medicaid Billing Fraud Cases

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The North Carolina Department of Health and Human Services (DHHS) announced on July 25, 2012, in a press release, that it investigated 75 cases for potential Medicaid billing fraud. The DHHS has already referred 35 cases totaling $21 million to the special Medicaid Investigations Unit of the North Carolina Attorney General’s office. Investigators Used Data Analytics Software to...

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8/2/2012 Comments(0)

New Hampshire City Conducts Audit of Ambulance Service Due to Overbilling

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 16, 2012, a New Hampshire city allegedly launched an audit into its primary ambulance service, American Medical Response (AMR), after the company acknowledged overbilling hundreds of patients since 2011, according to a Union Leader article . AMR Allegedly Incorrectly Billed 323 Ambulance Trips. According to the report, an in-house audit by the city showed that 323 amb...

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8/2/2012 Comments(0)

Repercussions of Clinical Research Fraud and Misconduct

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Michael L. Smith, J.D., R.R.T.,  Board Certified by The Florida Bar in Health Law Medical and clinical researchers, whether in an academic community or in a practice setting, spend years on clinical trials and investigations in hopes of contributing to their respective fields. Many of these researchers, however, find themselves defending their reputation after being accused of research...

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8/1/2012 Comments(0)

Respiratory Therapists: Please, Please, Please Talk to an Attorney Before You Talk to an Investigator

By Michael L. Smith, J.D., R.R.T., Board Certified by The Florida Bar in Health Law In Florida, You DO NOT Have to Speak to an Investigator!   Despite mailing out hundreds of thousands of postcards and letters to respiratory therapists, throughout Florida, we continue to receive calls from new clients and from potential clients, after they have already spoken to and made critical harmful admissions against their own interests to investigators. In Florida, you do not have any d...

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7/30/2012 Comments(1)

China's Expanding Health Care Industry

By Miles Indest China's increasing health concerns for its aging population, combined with the government's proposed health care reform, has generated much optimism in multi-national corporations concerning the future of China's health care industry. Many U.S. health care providers are already reaping the rewards of participating in China's health care investments, preparing for the promising boom that is sure to come. Any U.S. health provider that is serious about expanding internationa...

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7/30/2012 Comments(0)

South Florida Man Pleads Guilty to Fraudulently Working as a Pharmacist

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 24, 2012, a 49-year-old man from Ruskin, Fla., pleaded guilty in federal court to fraudulently working as a Central Florida pharmacist from 2000 to 2009, according to the  Department of Justice (DOJ) in a press release. Man was Working at Central Florida Pharmacies. Prosecutors said this man worked at pharmacies throughout Central Florida, including CVS pharmacy an...

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7/27/2012 Comments(0)

Medicare Compliance Review of West Florida Hospital in Pensacola

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 2, 2012 the  Officer of Inspector General (OIG) released its Medicare compliance review of West Florida Hospital in Pensacola. According to the audit, the hospital complied with Medicare billing requirements for the documentation majority of inpatient and outpatient claims. However, the overpayments for the years 2009 and 2010 totaled up to $173,000. Official Break Down o...

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7/26/2012 Comments(1)

The 25 Biggest Mistakes Dentists Make After Being Notified of a Department of Health Complaint

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The investigation of a complaint which could lead to the revocation of a dentist's license to practice and the assessment of tens of thousands of dollars in fines, usually starts with a simple letter from the Department of Health (DOH). This is a very serious legal matter and it should be treated as such by the dentist who receives it. Yet, in many cases, attorneys are consulted by dentists aft...

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7/25/2012 Comments(0)

Two Central Florida Physicians Linked to Statewide Pill-Mill Network

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An Orlando and Jacksonville physician have been linked to a statewide pill-mill operation that brought in millions of dollars to pain clinic owners and doctors, according to the Orlando Sentinel . On June 27, 2012 seven doctors and seven pain clinic owners were arrested in the raid that was dubbed "Operation Pill Street Blues.” The two-year, multiagency investigation into the pill...

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7/23/2012 Comments(0)

Nurse: Please, Please, Please Talk to an Attorney Before You Talk to an Investigator

By Lance Leider, J.D.   In Florida, You DO NOT Have to Speak to an Investigator!   Despite mailing out hundreds of thousands of postcards and letters to nurses throughout Florida, we continue to receive calls from new clients and from potential clients, after they have already spoken to and made critical harmful admissions against their own interests to investigators. In Florida, you do not have any duty to cooperate with any investigator who is investigating you. This exte...

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7/19/2012 Comments(1)

Florida Outlaws 90 Forms of Synthetic Drugs: Lawmakers Greatly Reduce Risk of Zombie and Cannibal Attacks for First Time Ever!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida Governor Rick Scott signed House Bill 1175 on March 23, 2012. This bill outlaws over 90 new forms of synthetic drugs. It modifies Section 893.03(1)(c), Florida Statutes , by expanding the list of banned hallucinogenic substances in Schedule I of the Florida Comprehensive Abuse Prevention and Control Act . To view Florida HB 1175, click here . Florida's Synthetic Drug Legislatio...

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7/18/2012 Comments(2)

Responding to an Initial Medicaid Audit Request

By Lance O. Leider, J.D.   Florida healthcare providers servicing Medicaid patients are at a higher risk for audits than anywhere else in the country.  The unfortunate truth is that Florida has become synonymous with healthcare fraud.  As a result, auditing and subsequent overpayment demands are some very real possibilities. Should you find yourself, your facility, or your health practice the subject of a Medicaid audit by your state Medicaid agency or audit contractor...

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7/17/2012 Comments(0)

Florida Outlaws 90 Forms of Synthetic Drugs for First Time

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida Governor Rick Scott signed House Bill 1175 on March 23, 2012. This bill outlaws over 90 new forms of synthetic drugs. It modifies Section 893.03(1)(c), Florida Statutes , by expanding the list of banned hallucinogenic substances in Schedule I of the Florida Comprehensive Abuse Prevention and Control Act . To view Florida HB 1175 , click here . Florida's Synthetic Drug Legi...

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7/16/2012 Comments(0)

Compliance with Conditions of Participation Necessary for Reinstatement of Terminated Medicare Billing Privileges or Revoked Medicare Provider Number and Participation Agreement

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We have recently experienced an alarming increase in the number of Medicare providers receiving notices that their Medicare billing privileges are being terminated.  These include home health agencies (HHAs), independent diagnostic testing facilities (IDTFs), ambulance and emergency transport providers, physicians, pharmacies, durable medical equipment (DME) providers, medical groups, p...

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7/13/2012 Comments(2)

Florida Nurse Charged With Patient Abuse

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A licensed practical nurse (LPN) at Florida State Hospital has been arrested and charged with one count of abuse of a disabled adult at the hospital. The nurse was arrested on a felony warrant by the Attorney General’s Medicaid Fraud Control Unit (MFCU). The arrest was announced by the Florida Attorney General on June 29, 2012. Abuse Allegedly Occurred During Medication Administ...

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7/12/2012 Comments(0)

Tennessee Hospital Agrees to Pay $3.59 Million to Settle False Claims Act Allegations Concerning Ambulance Services

By Miles Indest Maury Regional Hospital, located in Columbia, Tennesse, has agreed to pay the federal government over $3.5 million to settle  False Claims Act allegations that occurred between 2004 and 2009. Maury Regional submitted a voluntary self-disclosure to the U.S. Attorney's Office and the Department of Health and Human Services (DHHS) Office of Inspector General (OIG). Hospital Self-Reported After Compliance Program Revealed Billing Errors. The hospital sel...

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7/11/2012 Comments(0)

GlaxoSmithKline Agrees to $3 Billion Settlement in Healthcare Fraud Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law GlaxoSmithKline (GSK), a prescription drug manufacturer, has agreed to pay $3 billion in fines to resolve healthcare fraud allegations. The settlement was announced by federal prosecutors on July 1, 2012, and in a press release from the Florida Attorney General on July 2, 2012. This is the largest healthcare fraud settlement in U.S. history. Settlement Resolves List of Allegations Related...

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7/10/2012 Comments(0)

Pennsylvania Man Charged with Medicare Fraud in Ambulance Scheme

By Miles Indest A Pennsylvania man has been charged in a 23-count indictment in relation to an alleged scheme to defraud Medicare by billing for fraudulent ambulance services. The charges were announced by the Department of Justice (DOJ) on June 29, 2012. "Straw" Owner Allegedly Used to Start Ambulance Company. The indictment alleges that the man used a "straw" owner (someone who was not actually the owner) to fraudulently open Starcare Ambulance because he was otherwise i...

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7/9/2012 Comments(0)

Department of Health Licensees Have Statutory Duty to Update Addresses

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A recent case involving the Florida Department of Business and Professional Regulation (DBPR) demonstrates how important it is for all professional licensees, including Department of Health (DOH) licensees, to immediately update their addresses with the licensing agency when there is change. Appellant Sought to Reverse Revocation of Two Licenses. In Griffis v. Department of Busine...

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7/7/2012 Comments(0)

Appeal Court Rules AHCA Was Justified in Withdrawing Home Health Agency's License Application

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The First District Court of Appeal has ruled that the Agency for Health Care Administration (AHCA) had substantial justification to withdraw a home health agency's application for licensure in a recent case. To view the opinion, click here . Home Health Agency Challenged AHCA's Decision to Withdraw Application. AHCA withdrew the home health care facility's license application becaus...

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7/6/2012 Comments(0)

Assisted Living Facilities Win Case Against AHCA on Appeal

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Two Orlando assisted living facilities (ALFs) won a case against the Agency for Health Care Administration (AHCA) on appeal. The First District Court of Appeal heard the case and filed an opinion in favor of the ALFs on November 30, 2011. To view the opinion, click here . Appeals Court Dismissed Three Complaints Made by AHCA Due to Uncorroborated Hearsay Evidence. On appeal, the...

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7/5/2012 Comments(0)

OCR Releases HIPAA Audit Protocol

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Office for Civil Rights (OCR) has released an audit protocol for audits of Health Insurance Portability and Accountability Act (HIPAA) covered entities. The audit protocol covers audit procedures and requirements for assessing compliance with HIPAA's Privacy Rule, Security Rule, and Breach Notification Rule. This information is extremely valuable for covered entities. Covered entities ca...

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7/3/2012 Comments(0)

Health Care Providers are Facing Increased False Claims Act Liability: False Data in Clinical Research Investigations New Theory

By Miles Indest and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A recent "whistle-blower case" filed under the False Claims Act (FCA) has emphasized the indispensability of fact verification when submitting claims, grant applications or other information to the federal government. Health care providers may face FCA liability for false records or mediocre research methods when seeking research grants from a federal agency. Click he...

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7/2/2012 Comments(0)

Operation "Pill Street Blues" Targets Doctors, Clinic Owners Across Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Drug Enforcement Administration (DEA) and Florida law enforcement announced a statewide pill mill bust that spanned several cities in Florida on June 27, 2012. Seven doctors and seven pain clinic owners were arrested. The raid has been dubbed "Operation Pill Street Blues" by the DEA. To view the DEA's press release concerning the raid, click here . Charges Against the Docto...

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6/29/2012 Comments(1)

Results from Initial Round of HIPAA Audits Released by the OCR

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law New information is available regarding the Office for Civil Rights’ (OCR) initial round of mandated audits of Health Insurance Portability and Accountability Act (HIPAA) covered entities. The OCR announced official details concerning the audits at an OCR and National Institute of Standards and Technology (NIST) conference held June 6, 2012. Initial HIPAA Audits Began November 2011. ...

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6/28/2012 Comments(1)

Treating Employees as Independent Contractors Can Lead to Stop-Work Orders and Fines From the Department of Financial Services

By Christopher E. Brown, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Often a business obtains faulty legal advice that it can treat its employees as "independent contractors" and avoid a number of mandatory costs associated with hiring an actual employee.  These may include, for example, paying social security, Medicare and other mandatory assessments.  Additionally, the employer may believe that it can avoid expense...

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6/26/2012 Comments(0)

WellCare Health Plans Reaches $137.5 Million Settlement in False Claims Act Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law WellCare Health Plans Inc.(WellCare) will pay $137.5 million to the federal government and nine states to settle four lawsuits alleging violations of the False Claims Act. WellCare is based in Tampa, Florida. The company provides managed health care services for approximately 2.6 million Medicare and Medicaid beneficiaries across the United States. Lawsuits Allege WellCare Submitted ...

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6/21/2012 Comments(0)

Federal Appeals Court Rules Investors can Continue to Bring Claims Against KV Pharmaceutical

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The U.S. Eighth Circuit Court of Appeals ruled that investors can continue to bring claims against KV Pharmaceutical Co. (KV) for making false or misleading statements to the U.S. Food and Drug Administration (FDA). The ruling was reached on June 4, 2012. To view the appeals court ruling in Public Pension Fund Group v. KV Pharmaceutical Company, click here . Appeals Court Rulin...

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6/20/2012 Comments(0)

CMS Allows Medicare Providers to Submit Documents Electronically to CMS Contractors

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Medicare providers are now able to submit medical documents to the Centers for Medicare & Medicaid Services (CMS) review contractors electronically for almost all of them. This includes the Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs) and will soon include several Zone Program Integrity Contractors (ZPICs). For a list of review contractors currently a...

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6/19/2012 Comments(0)

OIG Issues Advisory Opinion on Anesthesia Services Arrangements for Physician-Owned Ambulatory Surgical Centers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Department of Health and Human Services (DHHS) Office of the Inspector General (OIG) posted an advisory opinion on June 1, 2012. In the advisory opinion the OIG concluded that two different arrangements between an ambulatory surgical center (ASC) and anesthesia services provider could result in prohibited remuneration under the federal anti-kickback statute and lead to administrative sa...

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6/18/2012 Comments(5)

ALFs Can Terminate a Resident for Almost Any Reason

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida law and regulations currently allow an assisted living facility (ALF) to relocate or terminate a resident for almost any reason. However, the administrator must provide a 45-day notice and document the reason for termination or relocation. Section 429.28(k), Florida Statutes (2011), states that an ALF resident must receive: At least 45 days' notice of relocation or te...

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6/16/2012 Comments(0)

Walgreens Reaches $7.9 Million Settlement in False Claims Act Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Walgreens has reached a $7.9 million settlement with the United States and participating states. The settlement resolves allegations that Walgreens violated the False Claims Act. The DOJ announced the settlement on April 20, 2012. To view the DOJ's press release concerning the settlement with Walgreens, click here . To view the False Claims Act, click here . Walgreens Allegedly Offere...

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6/15/2012 Comments(0)

Doctors, Nurse Practitioner Arrested in New York Crackdown on Prescription Drug Abuse

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A New York law enforcement crackdown on prescription drug abuse has resulted in the arrests of 98 people. Among those charged are two doctors and a nurse practitioner. Brooklyn federal prosecutors joined with the Drug Enforcement Administration (DEA), district attorney's offices, and local law enforcement agencies, to carry out a series of raids that began June 5, 2012 and resulted in th...

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6/14/2012 Comments(1)

Connecticut Legalizes Medical Marijuana

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The medical use of marijuana is now legal in Connecticut. The state's governor signed into law HB 5389 on May 31, 2012, which allows licensed physicians to certify a patient's use of marijuana for medical purposes. Connecticut is the 17th state to legalize marijuana for medical use. To view Connecticut HB 5389, click here . Connecticut's Medical Marijuana Legislation Imposes Res...

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6/13/2012 Comments(2)

News Flash Regarding Electronic Funds Transfer (EFT) for all Existing Medicare Providers

The following recent update was released by the Centers for Medicare & Medicaid Services (CMS) on May 30, 2012, updating the original from December 16, 2011: Existing regulations at  42 CFR 424.510(e)(1)(2) require that at the time of enrollment, enrollment change request, or revalidation, providers and suppliers that expect to receive payment from Medicare for services provided must also agree to receive Medicare payments through Electronic Funds Transfer (EFT). Section 1104...

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6/11/2012 Comments(1)

South Florida Doctors Convicted of Medicare Fraud by Federal Jury

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A federal jury convicted two South Florida doctors, one Miami-area therapist, and two other individuals for their participation in a Medicare fraud scheme. The scheme allegedly involved more than $205 million in fraudulent billings by American Therapeutic Corporation (ATC), a corporation which provided mental health care services. The jury reached a decision on June 1, 2012. To see the Depar...

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6/8/2012 Comments(3)

Florida Attorney General Reaches Settlement with 411-PAIN

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida Attorney General Pam Bondi announced that her office has reached a settlement with 411-PAIN. The settlement requires 411-PAIN to pay $550,000 and change its advertising practices for allegedly making misrepresentations to consumers. 411-PAIN is a Florida-based attorney and chiropractic referral service. Lawyer Referral Service Allegedly Misrepresented Consumer Entitlements. ...

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6/8/2012 Comments(0)

Connecticut Attorney General Alleges $24 Million Medicaid Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Connecticut Attorney General George Jepsen alleges that 28 individuals, dental practices and corporations were involved in a $24 million Medicaid fraud scheme. Jepsen filed a civil action  on May 31, 2012. It is the first case the state has initiated under the Connecticut False Claims Act. The Connecticut False Claims Act gives the state the ability to seek compensation for taxpayers fro...

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6/8/2012 Comments(0)

CMS Recovery Audit Prepayment Reviews Slated to Begin Summer 2012

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Centers for Medicare & Medicaid Services (CMS) is planning to move forward with the Recovery Audit Prepayment Review (RAPR) Demonstration Project on [stat.] June 1, 2012. It was originally scheduled to begin January 1, 2012. Recovery Audit Contractors (RACs) will Review Claims with High Rates of Improper Billing. The Recovery Audit Prepayment Review allows Recovery Audit C...

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6/8/2012 Comments(0)

Advantages to Allowing the Corporate Practice of Medicine

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law There are many benefits to operating a business in a corporate form. These may include favorable income tax treatment and immunity from certain types of liability. A physician who practices under the structure of a sole proprietorship or a partnership mayor may not be able to enjoy similar advantages. Practice of Medicine May Be Heading Towards Corporate Environment. The practice of medic...

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6/6/2012 Comments(0)

How to Prepare for an Informal Hearing Before the Florida Board of Massage Therapy

By George F. Indest III, J.D., M.P.A., LL.M. Board Certified by The Florida Bar in Health Law If you are scheduled to appear for an informal hearing before the Florida Board of Massage Therapy, there are a number of facts that you will want to know in order to be properly prepared.  This article will cover many of them. Limited Circumstances for Informal Administrative Hearing First, you should understand that you will only be at an informal hearing in which you a...

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6/1/2012 Comments(1)

Franck's Pharmacy Announces Compounding Prescriptions Recall, Shuts Down Sterile Compounding Service

Beleaguered Franck's Pharmacy, Inc. located in Ocala, Florida, has issued a recall for its compounded prescriptions. The prescriptions impacted by this recall include all sterile human and veterinary compounded prescriptions distributed by Franck’s Pharmacy from November 21, 2011 to May 21, 2012. Franck's Pharmacy made the announcement on the company's website on May 24, 2012. To see the recall click here . Recall Based on FDA Findings of Fungal Growth in Pharmacy's Clean Room. ...

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6/1/2012 Comments(1)

Florida Legal Community Mourns Joseph DuRocher: Naval Aviator, Attorney, Public Defender, Hero

I am sad to announce that we have lost a great legal mind and friend with the passing of Joseph DuRocher on May 19, 2012. A fellow Naval aviator, Joe served in the early Viet Nam war era, through 1965. Joe later went on to pursue a career as an attorney after leaving the Navy. He served as the Public Defender for the Ninth Judicial Circuit Court for Orange and Osceola Counties, for 20 years, through 2001, perhaps the most important role an attorney can have in our legal system. He also...

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6/1/2012 Comments(0)

Professor Appeals DEA's Medical Marijuana Research Ban

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A professor at the University of Massachusetts-Amherst is appealing a final order issued by the Drug Enforcement Administration (DEA) that prohibits him from growing marijuana for medical research purposes. Appeals Court Hears Oral Arguments in Medical Marijuana Research Case. The U.S. Court of Appeals for the First Circuit heard oral arguments in the case on May 11, 2012. During ...

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5/25/2012 Comments(1)

Florida Cardiologist Issued Emergency Suspension Order for Performing Stem Cell Treatments

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Florida cardiologist recently had his medical license emergently suspended by the Florida Department of Health (DOH) for performing stem cell treatments. According to the emergency suspension order (ESO), the DOH had previously warned the doctor to stop performing these treatments in 2011. Now, his license is at risk of being revoked. To view the ESO click here . DOH Suspends Cardiol...

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5/24/2012 Comments(0)

Florida HB 0653 Signed Into Law; Effective 7/1/2012

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Legislature unanimously passed  HB 653 which relaxes some of the draconian exclusions enacted under SB 1986, which went into effect on July 1, 2009. SB 1986, which added provisions to Chapter 456, Florida Statutes, among others, prevented numerous healthcare providers from obtaining or renewing licenses based on prior criminal convictions, which could have occurred decades ...

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5/23/2012 Comments(0)

Cardinal Health Reaches Settlement with DEA; Suspends Shipments From Florida Facility for Two Years

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Cardinal Health has reached a settlement with the Drug Enforcement Administration (DEA). The settlement suspends Cardinal Health's ability to ship controlled substances from its Florida distribution facility for two years. The company will now supply controlled substances from its distribution center in Jackson, Mississippi. Cardinal Health's Settlement Does Not Prevent the DEA from Pu...

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5/22/2012 Comments(0)

Registered Nurses in Florida Finalize Union Agreement with HCA

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Registered nurses at ten HCA hospitals in Florida have reached a collective bargaining agreement with the hospital chain. After negotiating for over a year, National Nurses United--a union for registered nurses--announced that it finalized the agreement with HCA on May 7, 2012. The agreement affects over 3,000 Florida registered nurses at HCA hospitals. It will be effective for three years...

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5/20/2012 Comments(1)

Have You Seen the DEA's List of Cases Against Doctors?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Did you know that the Drug Enforcement Administration (DEA) has a public list of physicians with DEA registrations that have been arrested and prosecuted? On the DEA's website, there is a list of all investigations of physician registrants in which the DEA was involved that resulted in the arrest and prosecution of the registrant which was updated and released on April 3, 2012. The list ...

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5/18/2012 Comments(3)

DEA Forgets College Student in Cell for Days Without Food, Water: Drinks Urine to Survive

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A California college student was left in a small holding cell by the Drug Enforcement Administration (DEA) for five days without food, water, or a toilet. He believes that the DEA forgot about him. He was taken by agents during a late April 2012 drug raid on his friend's house in which nine people were arrested. The engineering student at the University of California, San Diego, was not ...

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5/18/2012 Comments(0)

Did You Know You Have Fifth Amendment Rights in a Florida Department of Health Investigation Involving Your License?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law If you are contacted by a Florida Department of Health investigator, did you know that you cannot be required to make a statement or give information that can be used against you?  If you are being investigated you have a right to refuse to speak with an investigator pursuant to the  Fifth Amendment of the U.S. Constitution and the equivalent rights given by the Florida Cons...

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5/16/2012 Comments(0)

Doctor or Nurse: Please, Please, Please Talk to an Attorney Before You Talk to an Investigator

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In Florida, You DO NOT Have to Speak to an Investigator! Despite mailing out hundreds of thousands of postcards and letters to physicians, nurses, dentists, pharmacists, and psychologists throughout Florida, we continue to receive calls from new clients and from potential clients, after they have already spoken to and made critical harmful admissions against their own interests to investiga...

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5/15/2012 Comments(1)

Have You Updated All of Your Addresses with Medicare? The Consequences of Not Doing So Are Severe!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law When Was the Last Time You Checked Your Addresses on File with CMS/Medicare? When was the last time you checked all four of the addresses you should have on file for any individual or any group/company Medicare number you may have?  The consequences of not doing so can be severe.  In addition to your mailing (or correspondence address), and your billing address, you also sh...

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5/14/2012 Comments(0)

How to Prepare for an Informal Hearing Before the Florida Board of Clinical Social Work, Marriage & Family Therapy & Mental Health Counseling

By George F. Indest III, J.D., M.P.A., LL.M. Board Certified by The Florida Bar in Health Law If you are scheduled to appear for an informal hearing before the Florida Board of Clinical Social Work, Marriage & Family Therapy & Mental Health Counseling, there are a number of facts that you will want to know in order to be properly prepared.  This article will cover many of them. Limited Circumstances for Informal Administrative Hearing First, you shou...

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5/11/2012 Comments(0)

IRS Will Begin Issuing Medical Resident FICA Refunds

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Internal Revenue Service (IRS) is now alerting hospitals that it has completed the review of their medical resident  Federal Insurance Contributions Act (FICA) refund claims. The first hospitals to be notified may receive their FICA refund checks as early as May 2012. FICA deductions are a percentage of the employee's wages that are withheld to help fund both the Social Security and t...

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5/10/2012 Comments(12)

Physician Group Reaches Settlement with HHS Over Alleged HIPAA Privacy Violations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The United States Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has reached a settlement with Phoenix Cardiac Surgery (PCS) over alleged Health Insurance Portability and Accountability Act of 1996 ( HIPAA ) violations. The settlement was reached on April 17, 2012 and requires PSC to pay OCR $100,000 and enter into a one-year corrective action plan (CAP). The...

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5/9/2012 Comments(0)

How to Prepare for an Informal Hearing Before the Florida Board of Pharmacy

By George F. Indest III, J.D., M.P.A., LL.M. Board Certified by The Florida Bar in Health Law If you are scheduled to appear for an informal hearing before the Florida Board of Pharmacy, there are a number of facts that you will want to know in order to be properly prepared.  This article will cover many of them. Limited Circumstances for Informal Administrative Hearing First, you should understand that you will only be at an informal hearing in which you appear b...

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5/9/2012 Comments(1)

U.S. Senators Seek Investigation of State Medical Boards

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Three U.S. Senators have teamed up to request an evaluation of state medical boards. This bipartisan effort was initiated at the end of February 2012 when Senators Charles Grassley (R-Iowa), Orrin Hatch (R-Utah) and Max Baucus (D-Mont.) sent a letter to the director of the Office of the Inspector General (OIG) for the Department of Health and Human Services (HHS). In the letter the sena...

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5/8/2012 Comments(0)

How to Prepare for an Informal Hearing Before the Florida Board of Dentistry

By George F. Indest III, J.D., M.P.A., LL.M. Board Certified by The Florida Bar in Health Law If you are scheduled to appear for an informal hearing before the Florida Board of Dentistry, there are a number of facts that you will want to know in order to be properly prepared.  This article will cover many of them. Limited Circumstances for Informal Administrative Hearing First, you should understand that you will only be at an informal hearing in which you appear before the...

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5/7/2012 Comments(0)

Medicare Fraud Busts Result in Over 100 Arrests

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Over 100 doctors, nurses and other health professionals were arrested on charges relating to Medicare fraud by federal agents on May 2, 2012. The arrests were made in seven cities nationwide, but more than half took place in South Florida. This was a multi-agency attack on health providers involving law enforcement agents from the Federal Bureau of Investigation (FBI), Department of Heal...

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5/4/2012 Comments(0)

Central Florida Pharmacy Accused of Causing Eye Infection Outbreak

According to media reports, the Centers for Disease Control (CDC) has traced a rare fungal infection to a Central Florida pharmacy. As reported, Franck's Compounding Lab, located in Ocala, Florida, is believed to be at least partially responsible for spreading a rare fungal eye infection to over 30 patients across the U.S. The CDC reports that eye drops and injections traced back to the lab caused the infections. These ophthalmic products contained multiple fungal and bacteri...

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5/4/2012 Comments(0)

The Greatest Health Advances that Changed our Lives in the Past Century: Part 4

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In the last century, major changes in health care and technology, as well as simple progress in such innocuous conveniences such as public water fountains, have dramatically improved the quality of life. These have increased the average life expectancy in the United States from 47 years in 1900 to 78 years in 2011 almost doubling life expectancies. Health advances achieved throughout the 20t...

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5/3/2012 Comments(0)

How to Prepare for an Informal Hearing Before the Florida Board of Nursing

By George F. Indest III, J.D., M.P.A., LL.M. Board Certified by The Florida Bar in Health Law If you are scheduled to appear for an informal hearing before the Florida Board of Nursing, there are a number of facts that you will want to know in order to be properly prepared.  This article will cover many of them. Limited Circumstances for Informal Administrative Hearing First, you should understand that you will only be at an informal hearing in which you appear before the ...

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5/3/2012 Comments(0)

How to Prepare for an Informal Hearing Before the Florida Board of Psychology

By George F. Indest III, J.D., M.P.A., LL.M. Board Certified by The Florida Bar in Health Law If you are scheduled to appear for an informal hearing before the Florida Board of Psychology, there are a number of facts that you will want to know in order to be properly prepared.  This article will cover many of them. Limited Circumstances for Informal Administrative Hearing First, you should understand that you will only be at an informal hearing in which you appear before...

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5/2/2012 Comments(0)

Florida Pharmacies Receive Fake Department of Health Letters

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We have recently received notice from the Florida Department of Health (DOH) that Florida pharmacies have been receiving fraudulent letters from someone claiming to be from "DOH Investigative Services." These fake letters contain numerous errors including poor grammar, incorrect letterhead and an incorrect phone number. The notice from the DOH regarding these forged letters, as we...

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5/2/2012 Comments(0)

How to Prepare for an Informal Hearing Before the Florida Board of Medicine

By George F. Indest III, J.D., M.P.A., LL.M. Board Certified by The Florida Bar in Health Law If you are scheduled to appear for an informal hearing before the Florida Board of Medicine, there are a number of facts that you will want to know in order to be properly prepared.  This article will cover many of them. Limited Circumstances for Informal Administrative Hearing First, you should understand that you will only be at an informal hearing in which you appear before th...

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5/2/2012 Comments(0)

The Greatest Health Advances that Changed our Lives in the Past Century: Part 3

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In the last century, major changes in health care and technology, as well as simple progress in such innocuous conveniences such as public water fountains, have dramatically improved the quality of life. These have increased the average life expectancy in the United States from 47 years in 1900 to 78 years in 2011 almost doubling life expectancies. Health advances achieved throughout the 20th cen...

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5/2/2012 Comments(0)

The Greatest Health Advances that Changed our Lives in the Past Century: Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In the last century, major changes in health care and technology, as well as simple progress in such innocuous conveniences such as public water fountains, have dramatically improved the quality of life. These have increased the average life expectancy in the United States from 47 years in 1900 to 78 years in 2011 almost doubling life expectancies. Health advances achieved throughout the 20th...

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4/30/2012 Comments(0)

The Greatest Health Advances that Changed our Lives in the Past Century: Part 1

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In the last century, major changes in health care and technology, as well as simple progress in such innocuous conveniences such as public water fountains, have dramatically improved the quality of life. These have increased the average life expectancy in the United States from 47 years in 1900 to 78 years in 2011 almost doubling life expectancies. Health advances achieved throughout the 20th ce...

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4/27/2012 Comments(0)

Many Common Medical Tests Announced Unnecessary by Medical Specialty Associations: Will Litigation Follow?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 4, 2012, nine different medical specialty groups each released its list of the top five medical tests and procedures that are overused and often unnecessary. Each list also includes information about when a test or treatment may be appropriate based on clinical evidence and guidelines. The lists cover a wide range of tests, procedures and treatments including stress tests, nonst...

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4/25/2012 Comments(0)

U.S. Appeals Court Overturns 2010 District Ruling for $44.9 Million in Tuomey

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Tuomey Reversed On March 30, 2012, the 4th U.S. Circuit Court of Appeals overturned a federal district judge's 2010 decision for Tuomey Healthcare System. ( U.S. ex rel. Drakeford v. Tuomey Health. Sys., Inc. , 4th Cir., No. 10-1819 (Mar. 30, 2012) )  The lower court's decision ordered Toumey Healthcare System to pay $44.9 million for allegedly violating the Stark Law. ( 42 U.S...

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4/23/2012 Comments(1)

Medicare Program Exclusion Can have Devastating and Far-reaching Effects

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Few health care practitioners really understand the significance that being excluded from the Medicare Program may have.  Exclusion usually occurs as a direct result of disciplinary action being taken by the state board of medicine, board of nursing, board of psychology, board of pharmacy or other health care licensing entity.  If revocation, suspension, restriction or limitation of...

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4/18/2012 Comments(5)

Pinellas County Takes Anti-Prescription Drug Abuse Campaign to the Streets

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Pinellas County has started a new billboard campaign aimed at curbing prescription drug abuse. The billboard message reads, "We're shutting down Pill Mills in Pinellas County." The first two billboards were erected on April 1, 2012. Several smaller boards will be put up in the next few weeks, with even more planned for the future. This continues the long-standing battle by Pinellas County law...

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4/17/2012 Comments(0)

New Medicare Administrative Carrier for Jurisdiction 12: Highmark Medicare Services Acquired by Diversified Service Options, Inc.

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Diversified Service Options (DSO) acquired Highmark Medicare Services (Highmark) on January 1, 2012. DSO is a holding company and a wholly-owned subsidiary of Blue Cross and Blue Shield of Florida, Inc. (BCBS Florida). Highmark had the contract with the Centers for Medicare & Medicaid Services (CMS) to be the Medicare Administrative Contractor (MAC), formerly known as a "Carrier" or "Fisc...

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4/16/2012 Comments(0)

What are the Differences Among a Home Health Agency, a Nurse Registry and a Homemaker and Companion Services Provider in Florida?

There are important distinctions in the licensure requirements, the insurance requirements and the types of services that can be provided by home health agencies, nurse registries and homemaker and companion organizations in Florida.  The owners and operators of such businesses must should be aware of these.  Diligence must be taken to ensure that employees of one type of provider do not deliver services to clients/patients that are not authorized by the company's license. ...

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4/11/2012 Comments(0)

The DEA Targets Florida Walgreens Pharmacies, Issues Inspection Warrants

The U.S. Drug Enforcement Administration (DEA) is continuing to attack pharmacies, including the largest pharmacy chains, with the recent investigation of a Walgreens distribution center and six Walgreens pharmacy stores in Florida. On Wednesday, April 4, 2012, the DEA issued inspection warrants to the Florida Walgreens distribution center and six pharmacies. According to the warrant, the DEA is investigating these Walgreens pharmacies in Florida to determine if the pharmacies are disp...

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4/9/2012 Comments(7)

No Good Deed Goes Unpunished for Physicians Who Extend "Professional Courtesy" or Waive Co-pays: Medicare Prohibits Waiver of Co-pays and Deductibles

In today's heavily regulated health care environment there seems to be little room for the time-honored tradition of professional courtesy. Practiced for hundreds of years, professional courtesy originally referred to the provision of health care to physician colleagues or their families free of charge or at a reduced rate. Many argue, rightfully so, that the Hippocratic Oath even requires this for the patient who is a physician and his or her family. More recently the scope of professional c...

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4/5/2012 Comments(12)

Checklist on What to Do When Notified of a ZPIC or Medicare Audit and Site Visit - Part 2

When a physician, medical group or other healthcare provider receives a notice of an audit and site visit from Medicare, the Medicare Administrative Carrier (MAC) or the Zone Program Integrity Contractor (ZPIC), things happen fast with little opportunity to prepare.  Hopefully this checklist will help you to prepare for the on-site visit that will shortly follow. Many items on this checklist may seem common sense to the reader;  however, they would not be on here if I did not e...

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4/4/2012 Comments(0)

Dissecting Clinical Research Misconduct and Fraud

Medical and clinical researchers, whether in an academic community or in a practice setting, spend years on clinical trials and investigations in hopes of contributing to the field of medicine. However, many of these researchers instead find themselves defending their reputation after being accused of research misconduct or research fraud. One of the most notorious recent cases of research misconduct involved a South Korean stem cell researcher who claimed to have cloned human em...

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3/30/2012 Comments(1)

More "Disruptive Physician" Clinical Privileges Cases Physicians Should Know

In a recent blog post, we discussed the precedent set by Meyers v. Columbia/HCA Healthcare Corp. in determining court review standards for clinical privileges and peer review actions. Although Meyers is one of the major cases concerning peer review and termination of hospital privileges, there have been other recent clinical privileges cases that are important for physicians to be aware of when facing a peer review action. This is especially true if the physician is being accused of disru...

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3/27/2012 Comments(0)

Checklist on What to Do When Notified of a ZPIC or Medicare Audit and Site Visit - Part 1

When a physician, medical group or other healthcare provider receives a notice of an audit and site visit from Medicare, the Medicare Administrative Carrier (MAC) or the Zone Program Integrity Contractor (ZPIC), things happen fast with little opportunity to prepare. Hopefully this checklist will help you to prepare for the on-site visit that will shortly follow. Many items on this checklist may seem common sense to the reader; however, they would not be on here if I did not encounter th...

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3/26/2012 Comments(0)

New Changes Looming for Florida Pain Clinics in Orange County

Pain management clinics in Orange County, Florida can expect to face more regulations in upcoming months. As of March 19, 2012, county lawmakers are planning to make major changes to the way pain management clinics operate in this Central Florida County, in order to minimize prescription drug abuse, according to the Orlando Sentinel . Some of the proposed regulations include: Pain management clinics will be required to provide Orange County with monthly business records documenting ...

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3/21/2012 Comments(1)

Don't Work At An Illegal Health Care Clinic

Despite the passage of Florida's Health Care Clinic Act over nine years ago, there are apparently still many health practices which are violating it. Unfortunately, the violation of the Health Care Clinic Act can have extremely serious repercussions, including conviction of a felony, loss of all fees collected, and disciplinary/licensure action against any physicians, nurses or other licensed health professionals working there. Over the past three years we have seen the following sce...

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3/20/2012 Comments(0)

Florida Legislature Passes Bill To Relax Healthcare License Restrictions

The Florida Legislature unanimously passed HB 653 which relaxes some of the draconian exclusions enacted under SB 1986, which went into effect on July 1, 2009. SB 1986, which added provisions to Chapter 456, Florida Statutes, among others, prevented numerous healthcare providers from obtaining or renewing licenses based on prior criminal convictions, which could have occurred decades earlier. As of this writing (March 16, 2012), HB 653 has been passed unanimously by the Florida Legislature,...

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3/19/2012 Comments(1)

Law Enforcement Will Continue to Bully Pain Clinics in Florida

About a year ago, Florida pain clinics began to really feel the impact of becoming law enforcement's newest target. This was based in part on televison "magazine" shows and investigative reporters' shows and articles publicizing many abuses by patients who were "doctor shopping" and physicians who were allegedly "over-prescribing." Regulations increased, and lawmakers enacted severe penalties for doctors accused of over-prescribing, including prison sentences. Most physicians were banned...

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3/17/2012 Comments(1)

Legal Strategies For Doctors to Fight Bad Online Reviews

Defamatory attacks against doctors have become increasingly prevalent as more and more review sites join the world wide web, allowing patients to post virtually anything they want - good or bad - about a physician or any professional. With more physicians becoming employees of hospital systems or large healthcare institutions, adverse surveys, reports or reviews can affect advancement, bonuses and basic income. Internet ratings on review sites like Vitals.com and Yelp.com can range from sn...

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3/17/2012 Comments(2)

The Meyers Case Provided Basis for Later Court Cases Ruling Against Disruptive Physicians

If you are a physician with hospital privileges, one of the most important cases for you to be aware of concerning "disruptive physician" actions is Meyers v. Columbia/HCA Healthcare Corp. , which was finally decided in 2003. In ruling on disruptive physician cases, courts almost always rely on Meyers , and it has been cited repeatedly in other disruptive physician cases to justify a hospital or medical staff's peer review actions disciplining the physician. In this case, Dr. Meyers, an o...

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3/16/2012 Comments(0)

More Reasons Not to Voluntarily Relinquish Your Professional License or Fail to Appeal an Exclusion Action

Previously, I have written articles and blogs on why a physician, dentist, pharmacist, nurse, psychologist, mental health counselor or other licensed health professional should never agree to voluntarily relinquish his or her license after any notice of a possible investigation being opened. This is treated the same as if the state licensing agency had revoked that license for cause. This applies even if the license is in another state, is inactive, or has expired. The consequences of thi...

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3/15/2012 Comments(0)

"Cert Audits" Newest in Medicare Audit Contractor Alphabet

One of the newest acronyms we have encountered in the Medicare Program's audit process is the Medicare Comprehensive Error Rate Testing program audit or CERT audit. It could be that we just haven't had clients who had problems with this in the past, as we have seen plenty of Zone Program Integrity Contractor (ZPIC) audits, Medicare Administrative Contractor (MAC) audits and actions, Medicaid Fraud Control Unit (MFCU) audits, etc. However, we did have a client recently who was being audited by ...

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3/14/2012 Comments(0)

Update on Medicare Number Terminations: You Can Check the Status of a Corrective Action Plan (CAP) Online

For those Medicare providers who had their Medicare numbers terminated by the Medicare Administrative Contractor (MAC) (formerly called the "carrier" or "fiscal intermediary"), you can actually check the status of a corrective action plan (CAP) you submitted timely. If you go to the following:  http://medicare.fcso.com/Enrollment/PEStatus.asp you should be able to view the status. Note that the date that will be listed as being received will probably be days, if not weeks after you s...

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3/14/2012 Comments(0)

“Incident To” Rules Allow New Physicians to be Billed as "Incident To"

Many nonphysician providers work in family practices, including nurses, medical assistants, clinical nurse specialists, nurse practitioners, psychologists, respiratory therapists, physician assistants, physical therapists, social workers and laboratory technicians, among others. These nonphysician healthcare providers not only assist with patients, they often see patients in the physician’s absence. One way Medicare recognizes these individuals for payment purposes is by claims coding th...

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3/13/2012 Comments(1)

New ABMS Policy Sets Time Limits for Physician Board Certification

The American Board of Medical Specialities (ABMS) recently announced that it has adopted a new policy that will require doctors to attain board certification within three (3) to seven (7) years after finishing residency. Prior to the establishment of this new rule, the period between training and board certification was undefined, and physician's had an indefinite amount of time to become board certified. This new policy was created in order to diminish confusion created by the term "board...

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3/9/2012 Comments(0)

CVS Pharmacy's Temporary Restraining Order Against DEA Extended by Judge

On Friday, March 2, 2012, a judge ordered that the temporary restraining order entered on behalf of CVS Pharmacy against the Drug Enforcement Administration (DEA) will remain in effect until March 13. This temporary restraining order prohibits the DEA from banning two Sanford CVS pharmacies from filling prescriptions for controlled substances like oxycodone and hydrocodone. CVS Pharmacy filed a request with the court for the temporary restraining order in early February 2012, after the D...

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3/7/2012 Comments(1)

Responding to a Medicaid Audit

The Agency for Health Care Administration (AHCA), Office of Inspector General, Bureau of Medicaid Program Integrity, is the Florida agency responsible for routine audits of Medicaid health care providers to ensure that the Medicaid Program was properly billed for services. Health care professionals receiving the greatest amounts of Medicaid payments are also the ones most likely to be audited. These include pediatricians, Ob/Gyns, family practice physicians and dentists. The Medicaid audit usu...

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3/6/2012 Comments(0)

Responding to a Medicaid Fraud Control Unit Investigative Subpoena

The Medicaid Fraud Control Unit is a division of the Florida Office of the Attorney General charged with investigating and prosecuting health care providers suspected of defrauding the state's Medicaid program. When the unit opens a case against a provider, the first step is usually the issuance of an investigative subpoena, requesting specific patient records. The practice tips below were prepared to assist a health care provider in properly responding to and defending against such a subpoena...

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3/5/2012 Comments(0)

Have You Received a Notice of Termination of Your Medicare Provider Number?

Have you received a notice of termination of your Medicare provider number? Medicare has been revoking the Medicare provider numbers of many different Medicare providers including physicians, medical groups, home health agencies (HHAs), pharmacies, and durable medical equipment (DME) providers, based on returned mail sent to old addresses which have not been updated or based on inspection team site visits to old addresses. Often the termination is retroactive to a much earlier date the c...

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3/1/2012 Comments(0)

The DEA Begins Attacking Legitimate Pharmaceutical Distributors, Starting with CVS Pharmacy and Cardinal Health

Earlier in February 2012, the DEA accused both CVS Pharmacy, one of the nation's largest drug store chains, and Cardinal Health, one of the nation's largest legitimate distributors of pharmaceuticals, of endangering the public by selling excessive amounts of oxycodone to four Florida pharmacies. For Cardinal Health, the charges came in an immediate suspension order served Feb. 3, 2012, when the DEA suspended Cardinal's license to distribute controlled substances from its Lakeland, Florida loc...

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2/29/2012 Comments(0)

Groupon for Physicians?

In the current state of the economy, consumers are relying on new discount programs to help fund everything from ice cream outings to laser tag adventures to liposuction. Groupon and similar sites like Living Social offer subscribers daily deals for local products, services and businesses ranging from 20% to 90% off the original price. These virtual coupon inspired sites allow consumers to afford experiences they wouldn't be able to fund otherwise, and also send high-volume&nbs...

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2/14/2012 Comments(0)

CVS and Cardinal Health Targeted by the DEA

CVS Asking Judge to Prevent DEA Ban CVS/pharmacy has asked a federal judge for a temporary restraining order to prevent the U.S. Drug Enforcement Administration (DEA) from banning two of its Florida stores in Sanford from selling controlled substances, according to the Orlando Sentinel . The DEA raided the two Sanford CVS stores on February 4, calling the CVS pharmacies on Orlando Drive and West First Street an "imminent danger" to the public. Each location was also served with...

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2/10/2012 Comments(1)

Self Audit Now to Save Your Practice Later

Healthcare audits are now occurring frequently. It has become common for state and federal regulators to enforce even the smallest violations, resulting in investigations and monetary fines and penalties. If found in violation, you will not only have to pay fines and face disciplinary action, you will also lose revenue because you will have to spend time dealing with the investigation, instead of practicing medicine. The adage 'prevention is worth a pound of cure' is definitely true when...

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2/1/2012 Comments(0)

Doctors Blacklisted by CVS Seeking Legal Action

Back in November, some Florida doctors received an unsigned letter from CVS/pharmacy telling them that the company's pharmacists would no longer fill prescriptions they write for painkillers and other powerful drugs. Community members against pill mills and overprescribing doctors are thrilled with the actions taken by CVS. The company is being praised for taking proactive steps at a time when prescription drug abuse has become out of control in Florida. However, the letter has also...

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1/25/2012 Comments(4)

Newly Proposed Laws for Assisted Living Facilities in Florida are Strict

Florida lawmakers are currently proposing one of the toughest laws in the nation against assisted living facilities. Specifically targeting abusive care, lawmakers are demanding for homes to be shut down when residents die from poor care. This is one of the biggest changes in Florida law since the creation of assisted living facilities, according to the Tampa Bay Tribune . Two Senate committees unveiled the dual bills in January after months of reports by the Miami Herald that show...

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1/20/2012 Comments(1)

Proposed Bill Hopes to Crackdown on Over-Prescribing

A new bill aimed at giving the Surgeon General more power to stop doctors who over-prescribe narcotics has passed its first House panel. The bill would allow the Surgeon General to issue an emergency order restricting a practitioner from prescribing controlled drugs if a case is pending, according to Health News Florida . However, the emergency order will not suspend the doctor from practice. Additionally, a probable-cause panel from a professional licensing board will have 20 days to ...

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1/17/2012 Comments(0)

Under Review: What You Need to Know About Clinical Privileges Hearings

The term "fair hearing" is used by different individuals and different organizations to refer to an administrative hearing or a private hearing in a hospital or professional association. There are a number of different types of proceedings that are often referred to as "fair hearings," including clinical privileges (or peer review) hearings, which allow a physician who has had his or her clinical privileges revoked to be reviewed. This type of hearing can also be referred to as: • ...

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1/4/2012 Comments(0)

What Does Proposed Liposuction Bill Mean For Florida Plastic Surgeons?

A new Florida bill aimed at making liposuction procedures safer is making its way through the Senate in Tallahassee. The bill was created as a result of the deaths of four South Florida mothers in their 30s during liposuction procedures, according to the Orlando Sentinel. Present state rules say physician surgery offices must be inspected by the state Department of Health or accrediting organizations, unless the doctor performs procedures using only local sedatives that leave the patient aw...

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12/28/2011 Comments(0)

Recent Changes to Florida Pain Management Laws

If you are a pain management physician, it is important for you to be aware of changes in the laws governing the practice of pain management. The following laws were updated this summer, so the Florida Department of Health (DOH) will be enforcing these changes, including new penalities for inappropriate prescribing and new regulations for prescribing controlled substances. Minimum penalties for inappropriate prescribing for licensed health professionals - six (6) month suspension and $...

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12/27/2011 Comments(1)

Florida Strike Force Raids Pain Management Physicians

Florida is reported to have one of the worst prescription drug abuse problems in the country. Because of this issue, pain management physicians have been under increasing scrutiny and attack by federal and state agencies. If you are a pain management physician or you work in a pain a management clinic, you need to be aware of the measures that state and federal agencies are taking against doctors who practice pain management and the owners of pain management clinics. A news release sent o...

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12/19/2011 Comments(0)

National Practitioner Data Bank (NPDB) Update

On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (PPACA). This legislation made many reforms to the American health care system and with it came many changes that will affect both health care providers and consumers alike. One such change brought about by this legislation was the elimination of the independent Health Integrity and Protection Data Bank (HIPDB), and its merger with the National Practitioner Data Bank (NPDB). This will no...

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12/18/2011 Comments(0)

CVS Refuses to Fill Prescriptions For Some Florida Doctors

The crack down on Florida pill mills continues with CVS pharmacies notifying some doctors that they no longer will fill their prescriptions for certain narcotic medications. According to Health News Florida , this new policy appears to be limited to Florida, but CVS has not clearly stated what is being used to determine which doctors can have their prescriptions filled for which drugs (though oxycodone definitely appears to be a target). The Florida Academy of Pain Management, releas...

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11/30/2011 Comments(0)

Clinical Trial: When Research Goes Wrong

Three patients died in an unapproved medical trial conducted between 2003 and 2004. Now, the executives of Snythes Inc., a medical-device company, are awaiting sentencing this week after pleading guilty to a misdemeanor as "responsible corporate officers," according to Business Week. The Synthes officials allegedly bypassed FDA protocol to have surgeons test bone cement in people with spine fractures. The product was not approved for that use, and three people died in the operating room i...

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11/28/2011 Comments(0)

In Treatment: Physicians and the Professionals Resource Network (PRN)

In an industry so concerned with serving others, physicians and other health professionals sometimes find that they are the ones being pushed towards a treatment program. According to a recent study , alcohol abuse is the most common reason for enrolling in a physician health program. Other reasons for treatment included opioid, stimulant and sedative abuse. However, not all physicians and health professionals that are referred to a health program are in need of rehabilitation servic...

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11/23/2011 Comments(0)

Why You May Be Waiting For Your Florida Medical License

Applying for a Florida medical license ? Read this now, so you don't have to wait later.   What are the most common problems that hinder an application for a medical license or other health professional license in Florida? Still waiting for your Florida medical license or other health professional license? Here are some reasons why it may be taking so long. According to the Florida Board of Medicine 's website on May 17, 2011: NOT BEING COMPLETELY CANDID ABOUT YOUR ...

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11/21/2011 Comments(0)

Nurses: Advanced Practice May Mean Advanced Legal Issues

From George Indest’s  Nursing Law Manual The advanced nurse is a registered nurse (RN) who has completed some form of advanced nursing education and training. Two types of advanced nurses are the advanced registered nurse practitioner (ARNP) and the certified nurse specialist. In Florida, there are three types of certified nurse specialists: certified registered nurse anesthetists, certified nurse midwives, and nurse practitioners. The potential risk of liability for an ...

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11/19/2011 Comments(0)

Florida Pill Mills Still a Target

Last week, the DEA announced the results of enforcement efforts directed at Florida's illegal prescription drug distributors. According to the DEA, more than 100 individuals have been arrested in operations targeting pill mills in Florida, and the DEA, as well as Florida law enforcement, will continue to investigate and prosecute pain clinics, pharmacies and physicians who are contributing to Florida's prescription drug trafficking epidemic. Operation Pill Nation I, initiated in Feb...

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11/17/2011 Comments(0)

Are You Ready for HIPAA and HITECH Audits?

The Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS) is launching a pilot program this month to make sure covered entities are in compliance with HIPAA privacy and security rules and breach notification standards, according to the OCR . The OCR will perform up to 150 audits to assess HIPAA compliance . The HITECH Act requires HHS to perform periodic audits to check for HIPAA compliance. The audits will be conducted from November 20...

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11/16/2011 Comments(0)

Benchmark: DEA Conduct Resulted in Dismissed Charges

In light of the DEA's recent focus on Florida's prescription drug trafficking problem, we wanted to discuss a former case in which the DEA's actions resulted in a favorable outcome for alleged drug dealers. According to the Daily Journal, in 2004, U.S. District Judge Florence-Marie Cooper dismissed charges against three alleged methamphetamine dealers after an attorney to one of the defendants argued that the informant improperly relied on a "subinformant" to set up drug transactions i...

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11/15/2011 Comments(0)

Halifax Whistleblower Claims Hospital Overbilled Medicare

The U.S. Department of Justice has joined a whistleblower suit filed against Halifax Hospital by the hospital's director of physician services, according to the Daytona Beach News-Journal . The U.S. Department of Justice filed its part of the lawsuit on Friday. It claims that Halifax Health defrauded the federal government by submitting thousands of false claims for Medicare and Medicaid payments worth millions of dollars. By filing, the U.S. Department of Justice hopes to recover mi...

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11/14/2011 Comments(0)

Kissimmee, Pine Hills Pain Clinics Investigated

Clinics in Kissimmee and Pine Hills are under investigation. A doctor involved with the clinics is accused of over-prescribing painkillers and other addictive medicine, according to the Orlando Sentinel . Drug agents with the Metropolitan Bureau of Investigation collected evidence and talked to patients at the Miracle Health Center/Pine Hills Medical Center, and at the Keneday Medical Clinic. This doctor has had previous complaints filed against him by The Department of Health (DOH), a...

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11/11/2011 Comments(0)

Nurses Rx: Medication Administration

From George Indest's  Nursing Law Manual Nurses face a busy schedule often including a long list of patients and extensive work hours. As a result, they can become overworked and overtired, which may lead to mistakes when carrying out essential job duties like administering medication. An Institute of Medicine (IOM) report titled To Err is Human: Building a Safer Health System (IOM, Dec. 1999) states the deaths from medication errors that take place both in and out of hosp...

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11/11/2011 Comments(4)

Nurses: Insuring Your Legal Protection

Though many nurses pursue a career in nursing hoping that they will never face disciplinary charges, any number of events not in a nurse's control can lead to an investigation or administrative action . Nurses need to make sure they are covered if this ever occurs, with appropriate insurance . The primary reason that a nurse should purchase a professional liability insurance policy is that this type of insurance usually includes coverage for legal defense of licensin...

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11/8/2011 Comments(0)

Former Texas Official Sentenced for Retaliation Against Nurses

According to ABC News , Scott Tidwell, a former West Texas county attorney, will serve four months in jail and 10 years of probation for retaliating against two nurses . The nurses filed an anonymous complaint to state medical regulators against a doctor who used herbal remedies and hospital supplies to perform at-home procedures. The doctor then ordered a friend, a county sheriff at the time, to investigate the complaint, which resulted in the nurses being fired from th...

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11/7/2011 Comments(0)

Emergency Suspension Orders and Medicaid Fraud

In the recent case of Mendelsohn v. State of Florida Department of Health , Dr. Mendelsohn's license to practice medicine was suspended under an Emergency Suspension Order (ESO). According to the ESO, Dr. Mendelsohn is licensed to practice medicine in Florida pursuant to the provisions of chapter 458, Florida Statutes. Doctor Pleas Nolo Contendre to Fraud Charge. On December 9, 2010, he entered a plea of nolo contendere in federal court to a charge of conspiracy to commit fraud up...

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11/7/2011 Comments(0)

Cheating, Irregular Behavior and Other Maladies Plaguing Future Physicians: Part Two

The road to becoming a physician is paved with many unique challenges. The uphill battle begins with rigorous undergraduate course work, followed by the MCAT and medical school applications. Upon acceptance into medical school, you are faced with the USMLE (United States Medical Licensing Examination) and its STEP 1 and STEP 2 exams. At any of these stages, a student can be accused of numerous faults including cheating, misrepresentation, falsification of information, unfair advantages and ...

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11/5/2011 Comments(1)

Legally Speaking: Psychologists, Mental Health Counselors, Social Workers and Therapists

Supervised by the Board of Psychology and the Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling, psychologists, Licensed Mental Health Counselors, Clinical Social Workers and Licensed Marriage and Family Therapists are responsible for an important component of patient care: mental health.   Insuring the mental health of a patient does not come without risks. For this reason, every mental health professional should carry professional liabil...

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11/3/2011 Comments(0)

In Brief: Florida Pain Management Clinic Laws

Every health profession has its own set of rules and regulations. This week, we're examining Florida laws under which pain management clinics operate. Because Florida has one of the worst drug trafficking problems in the country, law enforcement is making sure that punishments for any violations are severe. For example, if a patient dies of drug overdose and the prescriber is found to be responsible, he or she can be charged with homicide, which was the case for a Palm Beach County pain m...

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11/2/2011 Comments(0)

South Florida Painkiller Network Newest Target in String of Florida Pill Mill Raids

Another South Florida pill mill was busted by federal agents this month, adding to Florida's increasingly negative reputation as one of the worst drug trafficking states. According to the Miami Herald , 24 people were indicted on charges of defrauding Medicare while distributing oxycodone and oxymorphone across Miami-Dade and Broward counties. These healthcare providers were involved in a distribution network allegedly worth $40 million. Five pain management clinics in Mi...

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11/1/2011 Comments(1)

Florida Doctor Arrested for Drug Sales and Other Criminal Charges

Drug trafficking charges against a medical doctor are not a new concept, especially in Florida. Recent pill mill busts throughout the state have resulted in an omnipresent DEA, always on the lookout for illegal drug sales by pharmacies, pharmacists, pain management clinics and physicians. However, the recent arrest of a Central Florida doctor extends beyond the run of the mill "pill mill" bust, as the accusations in this case involve sex with a minor and delivering a controlled substance to a...

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10/31/2011 Comments(0)

Cheating, Irregular Behavior and Other Maladies Plaguing Future Physicians: A Two-Part Series

The road to becoming a physician is paved with many unique challenges. The uphill battle begins with rigorous undergraduate course work, followed by the MCAT and medical school applications. Upon acceptance into medical school, the USMLE (United States Medical Licensing Examination) and its STEP 1 and STEP 2 exams provide another hurdle. At any of these stages, a student can be accused of numerous faults including cheating, misrepresentation, falsification of information, unfair advantages a...

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10/30/2011 Comments(1)

Responding to a Medicare Audit - Practice Tips

Although you may speak of a "routine" Medicare audit, there is really no such creature. This is like saying you have a "routine IRS audit." The fact is that there is some item you have claimed as a Medicare provider or the amount of claims Medicare has paid in a certain category that has caused you or your practice to be audited. Having too many claims for level five CPT codes might, for example, cause you to be audited. Having multiple claims submitted for the same date of service, may cau...

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10/28/2011 Comments(1)

The Collateral Effects of a Criminal Case on a Health Care Licensee

Criminal charges against a health care professional can have serious consequences. This post will discuss the impact of a criminal charge on a Florida licensed health professional.   What is the Effect of a Plea of Nolo Contendere for a Florida Licensed Health Professional? Pursuant to the general chapter of Florida Statutes applicable to all licensed health professionals (Chapter 456), a plea of nolo contendere is treated the same as a plea of guilty for all purposes. A...

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10/26/2011 Comments(0)

The 25 Biggest Mistakes Physicians Make After Being Notified of a Department of Health Complaint

The investigation of a complaint which could lead to the revocation of a physician's license to practice medicine and the assessment of tens of thousands of dollars in fines, usually starts with a simple letter from the Department of Health (DOH). This is a very serious legal matter and it should be treated as such by the physician who receives it. Yet, in many cases, attorneys are consulted by physicians after the entire investigation is over, and they have attempted to represent themselves ...

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10/24/2011 Comments(0)

New Florida Drug Database Aimed at Preventing Drug Abuse

Recently, Florida pharmacists, physicians and pain management clinics have received negative attention over frequent Drug Enforcement Administration (DEA) raids. Now, Florida is once again in the spotlight as the state has launched a drug database in an attempt to reduce drug abuse perpetuated by visits to the doctor.   According to the Orlando Sentinel , this database will allow physicians and pharmacists to review a patient's prescription history before issuing prescripti...

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10/22/2011 Comments(1)

Patient Privacy Breach at Nemours Follows Florida Hospital Information Leak

  After a patient privacy breach at Florida Hospital a few weeks ago, another patient records scare has hit Florida - this time at Nemours. According to the Orlando Sentinel , information belonging to Central Florida patients of Nemours Children's Health System has gone missing. Computer back-up tapes containing old patient billing information have disappeared from the Wilmington, Del., office of Nemours. These tapes were not password protected and stored in a locked...

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10/21/2011 Comments(1)

The DEA's War on Pain Management

Within the last few years, raids on pain management clinics, as well as pharmacies, have been increasingly commonplace. The doctors, pharmacists, nurses and other health care professionals involved are carted away in handcuffs and must defend their practice. According to the St. Petersburg Times , a South Florida pain management clinic has recently been shut down under emergency action by the Florida Department of Health (DOH). Several health care professionals at the clinic were ...

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10/17/2011 Comments(0)

Florida Hospital Recovering from Privacy Breach

As a health care provider, keeping patient medical records confidential is a fundamental aspect of the job description. Within those records, the most private details of a person's life are revealed, details, that if leaked, may ruin the reputation of the patient and the health care provider. According to the Orlando Sentinel , Florida Hospital is currently trying to recover from the damaging effects of a breach of its medical electronic records. Three employees were to blame for "in...

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10/14/2011 Comments(0)

Florida "Wrongful Births" Leave Health Providers Liable

According to statistics , approximately 98,000 Americans die each year as a result of medical errors that could have been prevented. This is an example of 'wrongful death,' a term recognizable to many. However, the term 'wrongful birth' may not provide the same familiarity, but is causing just as much commotion in the legal arena. In 2007, the Tampa Tribune provided details of such a case involving a University of South Florida doctor. This doctor told Daniel and Amara Estrad...

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10/12/2011 Comments(0)