Pediatric Group in Florida Claims EHR Program Not Compliant in Suit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 16, 2020, a pediatrics group in Altamonte Springs, Florida, filed a proposed class-action lawsuit against a health care technology company called Greenway Health LLC (Greenway). Altamonte Pediatric Associates PA (Altamonte Pediatrics) says Greenway sold it an […]
The American Association of Nurse Attorneys (TAANA) Releases COVID-19 Paper in Support of Front Line Health Workers
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 2, 2020, The American Association of Nurse Attorneys (TAANA) released a position paper providing an analysis of several key legal issues now facing nurses, physicians and other healthcare professionals dealing with the novel coronavirus pandemic throughout […]
Prosecutors Push to Keep Florida TeleMedicine Suspect in Jail for $424 Million 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 19, 2020, federal prosecutors in New Jersey federal court pushed to keep a suspect involved in a $424 million telemedicine scheme in jail. Authorities called him an “unrepentant conman” who carried out one of the largest […]
Dermatologist in Florida Agrees to Pay $1.74 Million To Settle Medicaid FCA Suit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 13, 2020, a Florida dermatologist and cosmetic surgeon agreed to pay $1.74 million to resolve allegations that he violated the False Claims Act (FCA). United States Attorney Maria Chapa Lopez announced that Dr. Thi Thien Nguyen […]
Will a Death from COVID-19 be Considered “Accidental Death” for Life Insurance Policies or a Death from “Accidental Causes?”
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Almost all life insurance policies, including term policies, pay a “double indemnity,” that is, double the limits of coverage if a death occurs from “accidental causes” as opposed to “natural causes.” A question arises, given the COVID-19 pandemic, of whether a death caused by […]
Healthcare Workers: Is Exposure to COVID-19 Causing Illness, Disability, or Death, Covered Under Workers’ Comp?
By Amanda I. Forbes, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In answering the question posed in the title of this blog, first, it should be noted that the World Health Organization (WHO) classifies COVID-19 as an “occupational disease.” (Reference: World Health Organization, “Coronavirus Disease (COVID-19) Outbreak: Rights, Roles […]
Insurer Faces Possible Class Action Over Rejected Pandemic Business Interruption Claims
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 14, 2020, several companies announced they are considering a class action lawsuit against Hiscox Insurance over its failure to pay business interruption claims relating to the coronavirus lockdown. Hiscox, sold policies before COVID-19 hit. The policies […]
National Nurse Attorneys Association Releases COVID-19 Paper in Support of Front Line Nurses and Health Workers
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 2, 2020, The American Association of Nurse Attorneys (TAANA) released a position paper providing an analysis of several key legal issues now facing nurses, physicians and other healthcare professionals dealing with the novel coronavirus pandemic throughout […]
EEOC Sues Yale Hospital For Age, Disability Discrimination
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 11, 2020, the U.S. Equal Employment Opportunity Commission (EEOC) sued Yale-New Haven Hospital (YNNH), accusing the university’s hospital of discriminating against older doctors. The lawsuit was filed in the U.S. District Court for the District of […]
Prosecutors Push To Keep Florida Telehealth Fraud Suspect in Jail for $424 Million Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 19, 2020, federal prosecutors in New Jersey federal court pushed to keep a suspect involved in a $424 million telemedicine scheme in jail. Authorities called him an “unrepentant conman” who carried out one of the largest […]
Did You Lose Your ABIM Board Eligible Credentials?
We have been contacted by numerous physicians who had completed residency programs in internal medicine and only recently discovered that their time has now expired to become board certified. ABIM considers internal medicine and subspecialist physicians who had met the standards for Board Certification in general internal medicine or any subspecialties to be “Board Eligible” […]
How Can I Be Sure I Don’t Have Employees, Contractors Who Are on Medicare’s Exclusion List?
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 companies in the health care industry and by health professionals after they receive a subpoena or audit regarding their employing or contracting with an individual or business that is on the Office of […]
Telemedicine Company Owners Charged in $56 Million Kickback Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 5, 2020, the owners of two telemedicine companies were charged in New Jersey federal court with defrauding Medicare in an alleged $56 million telehealth scheme involving orthotic braces. Some of the fraud alleged to have occurred […]
One of 2019’s Largest Healthcare Fraud Case Ever: No Surprise, Florida Wins!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making […]
Hospital Countersues Whistleblower for Failing to Report Information Internally in FCA Suit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the […]
Nursing Student Files Sexual Harassment, Retaliation Lawsuit Against UNC Greensboro
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 29, 2019, a former University of North Carolina nursing student sued the school’s Greensboro campus, saying it improperly dismissed from her a program a month before graduation. She filed two separate suits. She claims she was […]
ADA Files Class Action Lawsuit For Antitrust Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 26, 2019, the American Dental Association (ADA) and two individual dentists filed a class-action lawsuit against the Delta Dental Plans Association, its affiliated national entities, and 39 independent Delta Dental companies. The suit alleges the provider […]
Physician Gets 40 Years For Illegally Prescribing More Than Half a Million Opioid Doses
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 2, 2019, a Virginia doctor received a 40-year prison sentence for illegally prescribing more than half a million opioid pills over 19 months. The U.S. District Court for the Western District of Virginia handed down the […]
ADA Files Class Action Lawsuit Against Delta Dental For Antitrust Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 26, 2019, the American Dental Association (ADA) and two individual dentists filed a class-action lawsuit against the Delta Dental Plans Association, its affiliated national entities, and 39 independent Delta Dental companies. The suit alleges the provider […]
Florida’s New E-Prescribing Law: How It May Affect You and Your Career
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In 2019, Florida’s Governor Ron DeSantis signed House Bill 831 (2019), Electronic Prescribing, into law. The new bill provides important requirements for prescribers to generate and transmit all prescriptions electronically upon their license renewal or by July 1, […]
HHS Announces Proposed Rules to Reform Stark Law and AKS Regulations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 9, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued two proposed rules to reform the federal Stark Law (dealing with […]
Tips to Prepare For Clinical Privileges and Peer Review Hearings Part 2 of 2
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In Part 1 of this blog, I began a list of tips that should serve you well if you are notified by your hospital or medical staff that you are the subject of internal or external peer review […]
Tips to Prepare For Clinical Privileges and Peer Review Hearings Part 2
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In Part 1 of this blog, I began a list of tips that should serve you well if you are notified by your hospital or medical staff that you are the subject of an internal or external peer […]
Tips to Prepare For Clinical Privileges and Peer Review Hearings Part 1
If you are a physician or licensed other licensed health professional with clinical privileges in a hospital, chances are that one day you will be subject to peer review hearings. It may be a simple one-time matter based on an adverse outcome, or it may be a lengthy process involving a large number or your […]
Florida Psychiatric Hospital Accused of Cashing in on Baker Act Patients
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In September 2019, a report on an investigation by The Tampa Bay Times stated that a North Tampa psychiatric hospital might be more harmful than helpful to its patients. The Tampa Bay Times claimed the health facility exploited […]
Florida Oncology Center Wants Noncompete, Antitrust Suit Dismissed
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 9, 2019, 21st Century Oncology filed a motion to dismiss a noncompete antitrust suit that a group of oncologists filed against them in a Florida federal court on March 2019. According to their dismissal motion, the […]
Surgeon to Keep $17.5 Million Award, Despite Arrest for Soliciting Prostitute
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 25, 2019, a Washington state appeals court sided with an arbitrator’s decision to award $17.5 million to a neurosurgeon who was fired after he didn’t disclose his arrest for soliciting prostitute. Swedish Health Services had appealed […]
Former UCLA Phlebotomist Awarded Nearly $1.6 Million in Harassment Suit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 7, 2019, a jury awarded almost $1.6 million to a woman who alleged she was fired for complaining about coworker’s subjecting her to racial insults and discriminatory comments at her job. Nicole Birden claimed that UCLA […]
Steps to Challenge OIG Exclusion Action from Medicare Program
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 their professional careers and future employment. Whether you are a physician, nurse, dentist, psychologist or […]
New Changes to Florida’s Certificate of Need Law Eliminate CONs for Hospitals
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 3, 2019, Tallahassee healthcare regulators began the complex process of reshaping the state’s certificate of need (CON) program. Florida regulators are moving ahead to eliminate the certificate of need program for hospitals and to focus it […]
Although the Law Stacks the Deck Against You, Leaving a Foreign Body in a Patient Doesn’t Always Mean Negligence or Discipline
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Leaving a foreign object (sometimes referred to as a “retained foreign body” or “RFB”) in a patient, such as a sponge, clamp, forceps, surgical needle, guide wire, part of a surgical instrument or other paraphernalia commonly used in […]
Genetic Testing Scams Ripping off Government Programs for Millions, Part 1 of 2
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Several genetic testing companies have come into the spotlight for allegations of ripping off Medicare and False Claims Act (FCA) violations. Health care professionals need to be aware of these types of schemes and the dangers they may […]
Gov. DeSantis’ Prescription Drug Import Plan Gains FL House Support
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 12, 2019, the Florida House of Representatives’ Health Quality Subcommittee voted 15 to 2 to approve House Bill 19 (HB 19) that would implement one of Florida Gov. Ron DeSantis’ recently announced health care proposals. In […]
Miami Man to Remain Jailed for Trial in Nation’s Largest Medicare Fraud Case
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 3, 2018, a Florida judge ruled that a Miami businessman who has been jailed for more than two years on $1 billion health care fraud charges, must remain in custody through his trial next year. U.S. […]
DOJ Announces $2.8 Billion Recovered Funds From Healthcare Cases in 2018
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 21, 2018, the U.S. Department of Justice (DOJ) announced that it recovered more than $2.8 billion from False Claims Act (FCA) (also known as “qui tam” or “whistleblower cases”) cases in 2018. Of the $2.8 billion […]
Dentists Smiling as $80 Million Settlement Reached in Dental Supply Price-Fixing Class Action Suit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 30, 2018, after two years of litigation, a group of dentists tentatively reached an $80 million settlement in a proposed class action accusing the country’s biggest dental supply companies of colluding to fix prices. The three […]
New Update to the Medicare Program Integrity Manual Issued by CMS
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued further guidance for reporting and reviewing final adverse legal actions (ALAs) in provider enrollment applications. Section 15.5.3 of the Medicare Program Integrity Manual (MPIM) was […]
Two Nursing Home Co-Conspirators Sentenced in $19 Million Fraud Kickback Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 9, 2018, two co-conspirators in a $19.4 million healthcare fraud scheme involving a nursing home chain, American Senior Communities, were sentenced in Indiana federal court. Both pled guilty to various conspiracy and money laundering charges. The […]
CMS Launches the Home Health Value-Based Purchasing Program: What Providers Need to Know
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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)
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Florida Doctor, Clinic Owner Charged With Drug Trafficking in Orlando Area
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An Orlando based pain clinic that had patients from the panhandle to Miami has come under investigation according to Metropolitan Bureau of Investigation agents. The owner of the clinic, A Stop Pain Management, as well as it’s doctor […]
New York Hospital Pays $2.2 Million Settlement With OCR After Allowing Crew to Film Dying Patient
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 21, 2016, The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced that New York Presbyterian Hospital (NYP) has agreed to pay $2.2 million to settle allegations that it violated the Health […]
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 […]
Increasing Use of Evictions in Nursing Homes: A Tool to Get Rid of Difficult Patients?
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 8, 2016, the Associated Press (AP) covered a news story on the increasing rates of eviction in nursing homes and other health facilities. According to the AP, nursing homes are increasingly evicting their most challenging and […]
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 […]
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 […]
Home Health Care Company Admits to FCA Violations, Agrees to Pay Millions
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, a Kentucky-based home health care chain, MD2U Holding Co. (MD2U), agreed to pay up to $21.5 million and admit False Claims Act (FCA) violations. According to the U.S. Department of Justice (DOJ), the deal […]
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 […]
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 […]
Florida Massage Therapist Charged in Sexual Battery Case Following Several Complaints
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, a South Florida massage therapist was charged with sexual battery after being accused of assaulting a client during a session in February 2016. The therapist who allegedly worked at Chi Spa in Pompano Beach, […]
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 […]
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 […]
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 […]
Doctor Dubbed “King Of Nursing Homes” Downplayed Patient Harm From Illegal Kickback Scheme
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 prosecutors blasted Dr. Venkateswara Kuchipudi, a Chicago physician nicknamed the “King of Nursing Homes,” convicted of sending nursing home patients to a hospital he believed was subpar allegedly in exchange for free staff. […]
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 […]
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 […]
Decision Paves the Way for Graduate Student Unionization
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CMS’s Pre-Claim Review Project for Home Health Agencies Delayed Indefinitely For Florida
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Community Health Exploring Options Including the Possible Sale of Its Business
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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 […]
A Record High False Claims Act Settlement Reached For Nursing Home Chain 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) declared that Life Care Centers of America will be paying $145 million to end False Claims Act (FCA) litigation that alleged the company entered false claims to Medicare […]
Previous MetroHealth Hospital’s COO Charged In Dental Program Bribery Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Former MetroHealth Medical Center Chief Operating Officer (COO) and Dental Director Edward Hills was charged on October 25, 2016 for running an intricate bribery and kickback scheme selling positions in the medical center’s residency program at MetroHealth Hospital […]
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 […]
This Is One Thing You Absolutely Want to Check up On: Medicare Administrative Contractor and Other Contractors Continue to Penalize Medicare Providers Who Do Not Have Correct, Current Address Information on File.
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. It is a must that […]
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. […]
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 […]
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. […]
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. […]
Millions Paid Out By Florida Orthopedic Center 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 Southeast Orthopedic Specialists (SOS), located in Jacksonville, Florida, agreed to pay $4,488 million on December 7, 2016, to settle allegations that it violated the False Claims Act (FCA) by allegedly billing federal health care programs for millions of […]
Hospital Negligence Suit Dismissed by Florida High Court
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 30, 2016, The Florida Supreme Court announced the decision to drop a negligence suit filed against a hospital over the death of patient Ashley Lawson. Lawson was able to escaped from Shands Teaching Hospital and Clinic, […]
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 […]
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 […]
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 […]
Extensive Bribery Scheme At Dallas’ Forest Park Medical Center, 21 Charged
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law 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 on December 1, 2016. The range of felony offenses stem from […]
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 […]
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 […]
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 […]
CMS Issues Final Rule to Revise Home Health Conditions of Participation
By George F. Indest III, J.D. M.P.A., L.L.M., 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 […]
Owner of Louisiana 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 Louisiana-based 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 […]
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 […]
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 […]
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. […]
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, […]
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 […]
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 […]
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. […]
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 […]
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, […]
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. Teh government claimed that the Florida pharmacy acted in […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
CMS Woes: Zone Program Integrity Contractors (ZPICs) Criticized for Oversight in Fraud Investigations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Zone Program Integrity Contractors (ZPIC) are private companies or business entities, that have contracted with the Centers for Medicare and Medicaid Services (CMS). Their purpose is to carry out certain functions related to auditing for possible fraud, that […]
U.S. Court in Florida Dismisses Whistleblower’s Complaint Against Nuclear Pharmacy
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 28, 2017, the U.S. District Court for the Middle District of Florida dismissed a relator’s (whistle blower’s) False Claims Act (FCA) complaint against a nuclear pharmacy in Tampa. The court found that the relator failed to […]
6 Charged In Florida Chiropractic PIP Insurance Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 4, 2017, federal prosecutors charged six Florida residents with running a multi-million dollar insurance fraud scheme through a dozen chiropractic clinics. The alleged scheme involved paying kickbacks to chiropractors and tow truck companies to refer accident […]