DOJ Launches Whistleblower Rewards Program Inspired by Old West Posters
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Deputy U.S. Attorney General (DAG), Lisa Monaco, announced during her keynote speech at the American Bar Association’s 39th National Institute on White Collar Crime that the Department of Justice would be implementing a new whistleblower rewards program. According […]
Good News and Bad News: Medicare Decreases Physician Rates but Mental Health Counselors Now Allowed to Bill Medicare
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule […]
Many Adverse NPDB Actions Are Reported That Should Not Be; Here Are Some Examples
We are constantly being contacted by physicians, nurse practitioners, and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports. Often, we find that an adverse report has been made when the matter should not have been. Federal regulations and NPDB guidelines establish the types of incidents that are authorized to […]
Letter from the OIG Terminating You from the Medicare Program? What You Need to Do!
Have you received a letter from the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS) proposing to terminate you or exclude you from the Medicare Program? This is an extremely serious matter. You need to take action right away! For a physician or other health professional, this […]
FL Pharmacy Alleges Wrongful HHS PrEP Program Termination
On March 25, 2024, a Florida-based pharmacy alleged in a lawsuit it filed that the U.S. Department of Health and Human Services (HHS) abruptly cut it off from a federal program. This program provides free access to pre-exposure prophylaxis HIV-prevention (PrEP) medication for HIV patients. Turner Drugs filed a motion in the U.S. District Court […]
HHS Releases Final Substance Use Disorder Confidentiality Rule
By: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 8, 2024, the U.S. Department of Health and Human Services (HHS) released a final rule modifying the Confidentiality of Substance Use Disorder (SUD) Patient Records federal regulations (42 C.F.R. Part 2). The new regulation will supposedly […]
Florida Man Guilty in $36.2M Telemedicine Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 20th, 2024, the U.S. Attorney’s Office, in the Middle District of Florida, announced that a Florida man pled guilty to conspiring to commit health care fraud in a $36.2 million telemedicine fraud scheme. As part of […]
Male Surgeon Wins $15 Million Verdict in Suit Based on “Reverse Discrimination” and Anti-Male Bias; Hospital Requests New Trial
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm In a massive jury verdict awarding a male attending physician more than he requested, a jury found that a hospital demonstrated reverse discrimination and an anti-mail bias in how […]
Under Medical Peer Review from the Military or the VA? Get Experienced Legal Representation Now
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Our firm is often consulted by military physicians, Veterans Administration (VA) physicians, and former military and VA physicians concerning matters involving peer reviews of their care. In the military, whether Army, Navy, or Air Force, peer review for […]
Florida Man Agrees to Plead Guilty in $110 Million Telemedicine 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 February 16, 2024, a Parkland, Florida, man agreed to plead guilty to organizing a Medicare fraud scheme worth $110 million. The federal prosecution is taking place in the U.S. District Court for the District of Massachusetts. The […]
Supreme Court of Pennsylvania Says Serial Killer Cannot Sue Psychiatrist for Medical Malpractice
By: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 22, 2023, the Supreme Court of Pennsylvania unanimously decided that a serial killer cannot sue his psychiatrist for gross negligence because the action is barred by the […]
Florida Man Strikes Again–Government Wants Life Sentence for Florida Man in $187 Million Medicare Fraud Case
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one […]
Dentists, What If You or Someone on Your Staff Tests Positive for COVID-19?
By Achal A. Aggarwal, M.B.A., J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law You or a member of your staff has a confirmed case of COVID-19. What now? Your primary concern is for the individual affected. However, as a health professional operating a professional practice, you also have a […]
Female Scientist Files Suit Against Duke School of Medicine For Discrimination, Retaliation
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 10, 2023, a female scientist in the anesthesiology department at Duke University’s School of Medicine filed a complaint against the school under Title VII and the Equal Pay Act. She told the U.S. District Court for the Middle […]
Nurses: You Must Insure Your Legal Protection
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I have news for you: You need professional liability insurance! But you only need the kind that includes professional liability insurance coverage, and in amount of $25,000 or more. Are you a traveling nurse? Are you a nurse who works for a hospital or nursing home? Are you […]
Doctor’s Defamation Suit Okayed for Termination by University over Use of Resident Physicians
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On July 11, 2023, the United States District Court for the Eastern District of Kentucky allowed a doctor to move forward with one of his defamation claims against the university’s provost for allegations made to support his […]
Health Law Attorneys Available for Expert Witness Work
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Health Law Firm has a number of experienced health law attorneys who are available as experts to provide opinions and testify as expert witnesses and to speak with newspaper and other media reporters and representatives on various issues, providing background, color, information and […]
Recent Reactionary Law Requires Florida Health Records To Be Maintained Inside U.S.
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On July 1, 2023, an amendment to the Florida Electronic Health Records Exchange Act went into effect that prohibits any storage of health care data outside the continental United States, United States territories, or Canada. The amendment came from […]
California Dental Practice Pays $23,000 Settlement For Potential HIPAA Privacy Violations Involving Yelp Posts
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 14, 2022, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) settled with New Vision Dental (NVD) over a potential HIPAA Privacy violation. The California-based dental practice paid $23,000 to OCR and agreed to implement a corrective action plan after […]
Facebook’s $725 Million Data-Privacy Settlement’s Impact on Healthcare
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm Facebook agreed to the largest ever data-privacy settlement in December 2022. The $725 million settlement comes after nearly five years of litigation and contentious negotiations. The class action lawsuit revolves around allegations that Facebook has been sharing […]
Finding a Lawyer Who Accepts NORCAL Insurance to Defend Your License
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many nurses, nurse practitioners, and certified registered nurse anesthetists (CRNAs) carry professional malpractice insurance through NORCAL Mutual Insurance or one of the other similar insurance companies. This insurance is inexpensive and provides excellent coverage. What you may not realize, however, is that such insurance provides many added benefits, other than just coverage on nursing liability lawsuits, provided […]
Medicare Revocation and the Collateral Damage It Can Cause Health Care Providers
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. However, if you are a physician, dentist, nurse, mental health counselor, psychologist, pharmacist, physician assistant, nurse practitioner, massage therapist, or other licensed health professional whose license is revoked or suspended, there may […]
North Carolina Medical Malpractice Suit Against the U.S. Dismissed Due to 4-Year Time Limitation
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On July 18, 2023, a federal judge in North Carolina granted a motion to dismiss a suit against Naval Hospital Camp Lejeune based on a state law four-year time bar on malpractice claims. Background Facts. […]
What Payers Are Considered to Be “Federal Payers” Under the Federal Anti-kickback Statute?
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The federal Anti-Kickback Statute prohibits remuneration in relation to the provision of a “good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program.” 42 U.S.C. § 1320a-7b(b). The Anti-Kickback Statute goes on to define […]
United States Court of Appeals Denies U.S. Nursing Corporations Indemnification Challenge Against Nurse Staffing Agency
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law, and Hartley Brooks, Law Clerk, The Health Law Firm On May 18, 2023, the United States Court of Appeals for the Sixth Circuit affirmed a U.S. district court’s decision to deny U.S. Nursing Corporation a new trial. The appellate court stated that […]
Iowa Appellate Court Reverses $6 Million Nursing Home Negligence Decision Because of Hearsay Testimony
By George F. Indest III, J.D., M.P.A, LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On June 21, 2023, the Court of Appeals of Iowa overturned the verdict in a nursing home negligence case that awarded $6 million in compensation and damages to the plaintiff. The case was […]
Harvard May Fight Liability Claims for Morgue Manager’s Sale of Cadaver Body Parts
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law, and Hartley Brooks, Law Clerk, The Health Law Firm To read the indictment, click here. On June 14, 2023, the previous Harvard morgue manager, his wife, and three others were indicted on charges of conspiracy and interstate transport of stolen goods in […]
Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests: Cocaine and Imposter Substances (Part 2 of Series)
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law, and Hartley Brooks, Law Clerk, The Health Law Firm When representing nurses and other license health professionals, our firm often encounters issues regarding positive drug tests that employers request. These clients include nurses, pharmacists, dental professional, mental health counselors, therapists, etc. Job seekers should be aware that employers, […]
Walmart Announces Pay Raise For Thousands of Pharmacists and Opticians
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 31, 2023, Walmart announced it is raising wages for 7,700 U.S. pharmacists and opticians in a nationwide plan to expand healthcare services. The retailer said about 3,700 pharmacists would get a bump in pay, bringing their total average pay to more than […]
Florida Man Gets 15 Years in Prison for HIV Drug Fraud Scheme; $230 Million Lost to Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. The defendant was […]
Harvard Med School Morgue Director Allegedly Sold Body Parts, Class Action Alleges
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In a morbid, but extremely popular class action lawsuit filed on June 16, 2023, illegal body parts sales was alleged. The lawsuit was filed against Harvard University and contained allegations that its morgue manager was selling body parts from 350-400 donated cadavers. […]
Medications and Other Substances that Mimic Prohibited Drugs on Urinalysis Drug Tests (Part 1 of a Blog Series)
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In representing nurses and other licensed health professionals, we constantly discuss positive drug screenings, usually from employer-ordered drug testing, with our clients. These clients include nurses, pharmacists, dental professionals, mental health counselors, therapists, etc. Often these individuals need to remember that if they apply for […]
Supreme Court Says FCA Case Liability Requires Defendants’ Subjective Belief
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In a precedential decision that leaves the whistleblower plaintiffs bar reeling, on June 1, 2023, the Supreme Court handed down an opinion on the knowledge standard required in False Claims Act (FCA) cases. In a unanimous ruling, the high court said liability of defendants […]
Florida Lawyer Says AHCA Medicaid Final Orders Must Be Accessible Online
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida’s Agency for Health Care Administration (AHCA) has come under fire for failing to make Medicaid final orders easily accessible to the public. On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against AHCA, trying to force AHCA into compliance […]
20 Tips for Medicare Audit Preparation & Contractor Visit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law When a healthcare provider receives notice of an audit or site visit from Medicare, the Medicare Administrative Carrier (MAC), or the Integrity Contractor, they must act quickly. These auditing organizations tend to move swiftly, with little warning and even less opportunity for preparation. Below is […]
Jury Finds Miami Clinical Drug Trial Company Not Guilty in Research Fraud Case
By George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law On May 19, 2023, jurors rendered a verdict to federal prosecutors in a trial against executives from a Miami clinical drug trial company and a local doctor. The CEO of Tellus Clinical Research and one employee were found not guilty […]
What To Know About the New Proposed HIPAA Privacy Rule Changes
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 12, 2023, the United States Department of Health and Human Services (HHS), through its Office for Civil Rights, proposed a rule to strengthen the protections under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. The proposed rule would prohibit using or […]
Nursing Students Sue Florida College For Deceptive NCLEX Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 2, 2022, four nursing students from HCI College (formerly Health Career Institute) in Florida filed a federal class action lawsuit against the school. The students claim the school conducted a “malicious scheme” to block 95% of students from graduating and taking the National Council Licensure Examination (NCLEX). The […]
Finding a Lawyer Who Takes CPH & Associates Insurance
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Our firm often gets calls from nurses and other health professionals who retain us to represent them in complaints against their licenses or in professional licensing complaints and investigations. This includes investigation letters from the Florida Department of Health (DOH), D.C. Health or Louisiana State Board. […]
Rapper 50 Cent Reaches Settlement with Floridians in Lawsuit Over Fake Penis Enlargement Ad
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 21, 2023, Houston rapper 50 Cent settled a lawsuit with a publication over alleged false penis enlargement claims. The rapper, whose real name is Curtis J. Jackson III, sued The Shade Room LLC using three alternative theories of defamation, […]
Doctor’s Opioid Convictions Tossed After Supreme Court Ruling on Intent
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 3, 2023, a federal appeals court overturned the conviction of a doctor accused of unlawfully prescribing opioids after the U.S. Supreme Court issued a ruling making it harder to prosecute such cases. The Denver-based 10th U.S. Circuit Court of Appeals […]
DOJ Withdraws Outdated Antitrust Policy Statements For Healthcare Industry; “Safety Zones” Abolished
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 3, 2023, the Antitrust Division of the U.S. Department of Justice (DOJ) announced its withdrawal of three “outdated” antitrust policy statements applicable to healthcare markets. These have been in effect and relied upon for decades by those in the healthcare industry. The […]
States Take Action to Stop Nurses From Certain Schools From Caring For Patients
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In late February 2023, multiple states began taking action against licensed practical nurses (LPNs) and registered nurses (RNs) because of the FBI’s “Operation Nightingale.” This is also being pushed by the National Council of State Boards of Nursing (NCBSN). “Operation […]
Phony Florida Nursing Diploma Scam: Federal Criminal Indictments in “Operation Nightingale”
In January 2023, the U.S. Department of Justice (DOJ) announced the prosecution of a massive fake nursing diploma scheme against three Florida-based nursing schools. The investigation has now expanded to include at least eight (8) schools of nursing. The investigation has now resulted in charges against 25 people in five states and found evidence that […]
$43 Million False Claims Act Jury Verdict Against Ophthalmology Group
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 28, 2023, a federal civil jury returned a verdict against an ophthalmology group in favor of the United States for more than $43 million for violations of the False Claims Act (FCA) and Anti-Kickback Statute (AKS). During the six-week trial, the jury […]
Centene Pays California $215 Million in Alleged Medicaid Overbilling Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 8, 2023, Centene Corp. agreed to pay more than $215 million to the state of California over allegations that Centene overcharged the state for pharmacy services. It is the biggest payout to date by the nation’s largest Medicaid insurer over its drug […]
USMLE Step Exam: Tips For Higher Scores
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Here are some common-sense tips you should be sure you follow that may help you to reduce stress and score higher when you take your United States Medical Licensing Examination (USMLE) Step examinations. You should be doing everything within your control to […]
Physician Found Guilty of Re-Using Single-Use Devices During Surgeries
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On January 27, 2023, a North Carolina doctor was found guilty of re-using “unsanitary” medical equipment meant for one-time use on unsuspecting patients during surgeries, the U.S. Department of Justice (DOJ) announced. After a three-week federal jury trial, she was found guilty […]
Are You a VA Physician Notified of Possible NPDB Report–What To Do
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law When there is a Federal Tort Claim filed against the Veterans Administration (VA) on behalf of a patient, the physicians, nurse practitioners, mental health counselors and other health professionals involved in the care will usually be asked for a statement regarding their role in the care. Be […]
Federal Agents Charge 25 Individuals in Fake Nursing Diploma Scheme in Florida
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On January 25, 2023, the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) launched a multi-state coordinated law enforcement action to apprehend individuals engaged in a scheme to sell false and fraudulent nursing degree diplomas and transcripts. The enforcement action […]
FTC Proposes Rule to Ban Noncompetition Clauses in Employer Agreements
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In a precedent setting move, on January 5, 2023, the Federal Trade Commission (FTC) proposed a new rule that would ban noncompetition clauses in employment agreements as an unfair method of competition. According to the FTC, noncompetition agreements (also referred […]
Florida Judge Awards Nearly $31 Million in Fees For Customers in Contact Lens Price-Fixing Litigation
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 12, 2022, a federal judge in Florida awarded nearly $31 million in attorney expenses and fees for customers who sued Alcon Vision LLC, Johnson & Johnson Vision Care Inc., and other companies involved in the multi-district litigation. The order issued by […]
Is the DEA Knocking on Your Door? What You Need to Know Right Now!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Is the Drug Enforcement Administration (DEA) knocking at your door or, even worse, going through your files inside your office? This is what you need to know right now! YES, you do have the right to call your attorney. Call your attorney right now. […]
Florida EHR Vendor Pays $45 Million in Whistleblower Case Alleging Kickbacks, FCA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 1, 2022, the Department of Justice (DOJ) announced that a Florida electronic health record (EHR) vendor would pay $45 million to resolve claims that it violated the False Claims Act (FCA) and Anti-Kickback Statute (AKS). The Justice Department alleges that Modernizing Medicine, Inc. (ModMed) […]
Supreme Court To Review Scope of Identity Theft in Medicaid Fraud Case
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 10, 2022, the U.S. Supreme Court announced that it would weigh in on what it means to commit identity theft. In the case the Supreme Court accepted for review, the petitioner, a managing partner at a psychological services company, […]
When the DEA Comes Knocking: 15 Tips To Remember For a “Routine” DEA Inspection
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law As the United States continues to open back up from the COVID-19 shutdown, the Drug Enforcement Agency (DEA) is resuming on-site routine inspections. Therefore, health care professionals must ensure compliance and regulatory efforts are in place. This is part 1 of a 2 part […]
How to Find the Right Attorney for Your Irregular Behavior Case Before the USMLE or ECFMG
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law If you have received a letter from the United States Medical Licensing Examination (USMLE) Secretariat or the Educational Commission for Foreign Medical Graduates (ECFMG) accusing you of “irregular behavior,” this is very serious stuff. You need an experienced lawyer to assist you. […]
Centene Reaches $166 Million Settlement With Texas Over Its Medicaid Drug Pricing
The nation’s largest Medicaid insurer, Centene, has agreed to pay $165.6 million to Texas to resolve claims that it overcharged the state’s Medicaid program for pharmacy services. The deal was signed July 11, 2022 but hadn’t been publicly announced until September 19, 2022. The agreement makes Texas at least the 12th state to settle pharmacy billing claims with St. Louis-based Centene. It’s also […]
Florida Nurse Wins Reversal of Board’s Revocation of License; “Due Process Rights Violated” Says Court of Appeal
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 22, 2022, Florida’s First District Court of Appeal reversed a final administrative order from the Board of Nursing, saying that the state agencies engaged in “a game of bait and switch” when revoking a Florida nurse‘s license. As a result, the […]
Rapper 50 Cent Sues Florida Plastic Surgeon Over “Penile Enhancement” Ads & Social Media Photos
On September 16, 2022, 50 Cent, the rapper and entrepreneur, sued a plastic surgeon and her Sunny Isle Beach, Florida, medical practice in federal court. The suit alleges that the doctor used photographs she took with 50 Cent to promote her business on social media. without his consent. The suit also alleges that the ads and social […]
Centene to Pay Washington State $19 Million to Settle Fraud Allegations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, it has been reported that […]
New Florida Legislation Allows Pharmacy Technicians to Administer Immunizations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 1, 2022, Florida passed HB 1209, which now allows registered pharmacy technicians to administer immunizations to patients. The new law authorizes pharmacy technicians to seek certification to provide immunizations and become “Certified Registered Pharmacy Technicians.” These pharmacy technicians will then be allowed to administer all vaccines […]
Have You Received an OIG Subpoena From the DOH? Follow These Steps!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The U.S. Department of Health and Human Services (HHS) issues investigative subpoenas through the Office of the Inspector General (OIG). This agency investigates allegations of fraud, waste, and abuse against Medicare, Medicaid, and other federally funded healthcare programs. These subpoenas are very broad, usually requiring the […]
DOJ Drops Charges in Opioid Case After Supreme Court Ruling
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 12, 2022, the U.S. Department of Justice (DOJ) announced that it dropped charges against the remaining defendants in a case against a former Ohio drug distributor. In 2019, Miami-Luken, two of its executives, and two pharmacists had been charged with […]
New Study Reveals Complex Coding Requirements Are Increasing Medical Billing Costs 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 On August 3, 2022, a study published by the Health Affairs Journal revealed that complex coding structures in the United States are driving up medical billing costs. This is a primary factor helping to make it one of the most expensive countries […]
Beware Of the Negative Consequences After Discipline on Your Professional License, 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 Do you have a medical, pharmacist, counselor, or nursing license in more than one state? Do you have a license in more than one profession? Have you been notified that an investigation has been opened against your professional license? Are you thinking about resigning your professional license or […]
Healthcare Professionals: Do You Know How to Prepare For, and Respond To, a Medicaid Audit Request?
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida healthcare providers servicing Medicaid patients are at a higher risk for audits than anywhere else in the country. Unfortunately, the unfortunate truth is that Florida has become synonymous with healthcare fraud. As a result, auditing and subsequent overpayment demands are some […]
Doctor Acquitted in $85 Million Medicare Fraud Scheme Requests Reimbursement of Legal Expenses
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 12, 2022, a doctor acquitted in a $85 million Medicare fraud scheme filed a motion in the U.S. District Court for the Eastern District of New York requesting prosecutors cover the legal fees and expenses she incurred. Mayura Kanekar, a Brooklyn-based doctor, claims […]
Exemptions for Employment Disqualification By the Agency for Health Care Administration (AHCA) for Health Professionals in Florida
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida law requires that health professionals (including physicians, nurses, physical therapists, nurse practitioners, professional counselors and social workers, among others) obtain a Level 2 background screening prior to working in a facility licensed by the Agency for Health Care Administration (AHCA). This includes third and fourth year medical […]
U.S. Government Renews Coronavirus Public Health Emergency, Extending Health Benefits for Americans
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 15, 2022, the United States once again renewed the COVID-19 public health emergency, allowing millions of Americans special access to free tests, vaccines, and treatments. The public health emergency was initially declared in January 2020, when the coronavirus pandemic began. Since then, […]
DOJ Files False Claims Suit Against Nursing Homes Over “Substandard Services and Nonexistent” Care
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. Department of Justice (DOJ) announced it has sued three nursing homes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.” The False Claims Act (FCA) complaint against the American Health Foundation (AHF), its affiliate AHF Management […]
Completing an Application for a Nursing License? Here Are Some Helpful Tips!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The process of obtaining a nursing or health care professional license is not only challenging, but it’s also time-consuming. If you have a criminal conviction or unique circumstance which may negatively impact your ability to be granted a health care license, it’s imperative that you consult with […]
Follow These Rules To Proactively Safeguard Your Mental Health Professional License
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Licensed mental health counselors, psychologists, and other mental health care professionals are potential targets of licensure complaints from clients in any practice setting. Many legal situations and cases arise because the therapist has strayed over the line and crossed the therapist-client boundary. In reviewing […]
Supreme Court Rules Against HHS in Hospital Medicare Reimbursement Case
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. This came in a ruling that limits regulators’ power to control what the program pays for certain drugs. […]
Supreme Court Weighs Physician Intent in “Pill Mill” Physician Criminal Prosecutions Under the Controlled Substances Act
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Physicians and other healthcare professionals usually have broad scope to prescribe most drugs, including potentially dangerous ones. However, over the past decade, many limits, often imposed arbitrarily through criminal prosecutions or drastic administrative sanctions, have been used to impose limits. The […]
Former Florida Radiology Group Employee Files Class Action, Alleges Stock Value Plan Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 15, 2022, a participant in a Florida-based radiology chain’s employee stock plan filed a federal lawsuit in Florida, accusing company executives of scheming to drain the plan’s value for their personal benefit. The former employee of Advanced Diagnostic […]
Psychiatric Practice and Owner Pay $310,000 to Resolve Allegations They Employed a Physician on OIG’s LEIE
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG‘s exclusion list, the […]
State Nursing Boards Continue to Delay Licenses Across the U.S. As COVID-19 Pandemic Continues
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Staffing shortages at hospitals across the U.S. are worsening helped along by state boards and other licensing authorities taking months to process nursing licenses, a recent NPR survey claims. As a result, thousands of new nurses who want to help during the […]
Helpful Tips to Avoid Healthcare Fraud Prosecutions
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Physicians who are approached by non-physicians seeking to entice them into business ventures that make money quickly, should be very leery. If the business venture offers good financial compensation for little or no work, RUN! Most often those involved in criminal […]
Ten Defendants in Florida Indicted For Role in $67 Million Health Care Fraud Scheme Involving Genetic Testing
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 28, 2022, ten (10) Florida residents were charged in an indictment in the U.S. District Court for the Southern District of Florida for their alleged roles in a $67 million health care fraud, wire fraud, kickback, and money laundering scheme. […]
Coronavirus Pandemic Provider Relief Fund Expected To Run Out of Money If Congress Doesn’t Act Soon
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In 2020, the U.S. Department of Health and Human Services (HHS) created the “Provider Relief Fund” (PRF) to help support healthcare providers in the battle against the COVID-19 pandemic. The federal program has served as a lifeline to frontline healthcare workers who’ve […]
Governor of Mississippi Signs Medical Marijuana Legalization Bill Into Law
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 2, 2022, the Gov. of Mississippi signed the “Mississippi Medical Cannabis Act” legalizing medical marijuana in the state. The law permits the use of medical cannabis to treat certain debilitating medical conditions, including cancer, Parkinson’s disease, Huntington’s disease, muscular dystrophy, […]
Attorneys Who Negotiated Multi-Million Dollar UnitedHealth Settlement Ask Court For $3.35 Million Fee Award
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2021, attorneys who had acted as the class counsel in litigation suing UnitedHealth Group over mental health reimbursement policies asked a New York federal court to approve a $3.35 million fee award. If approved, it would be an award of attorney‘s fees in […]
Ophthalmologist Gets Eight Years for COVID-19 PPP Loan Fraud and Multi-Million Dollar Improper Billing Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March , 2022, a New York ophthalmologist was sentenced to 96 months in prison for fraudulently obtaining two government-guaranteed small business loans and for a seven-year fraudulent healthcare billing scheme, the Justice Department announced. According to the indictment, the […]
How Will Florida’s DNA Privacy Law (HB 833) Affect Healthcare Providers?
By George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law On June 29, 2021, Florida Gov. Ron DeSantis signed into law HB 833, known as the “Protecting DNA Privacy Act,” which took effect in Florida October 1, 2021. Under the act, collecting or submitting another person’s DNA sample for […]
National Practitioner Data Bank (NPDB) Disputes and Appeals: Fight Back Against Adverse Reports
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The National Practitioner Data Bank (NPDB), created in 1986, was part of the Health Care Quality Improvement Act (HCQIA). Its purpose is to improve the quality of health care by encouraging state licensing boards, hospitals, health care entities, and professional societies to report into a national data bank those physicians and health professionals who demonstrate […]
Doctor Indicted in $1.3 Million Medicare Fraud Kickback Case Seeks Reinstatement of Medicare Billing Privileges
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 2, 2021, a doctor and his wife who had been indicted for their roles in a $1.3 million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. The doctor argued that the bail condition impeded his ability to practice medicine. […]
CMS Using Medicare Termination to Squash Doctors Involved in Overprescribing Opioids
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids and other narcotic medications. We have seen letters sent out by CMS MACs to physicians notifying them […]
10 Biggest Mistakes Physicians Make That Cause DOH Complaints
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In representing healthcare professionals in complaints against their licenses, we see similar cases repeatedly. The physician could have avoided many Department of Health (DOH) complaints that may wind up before the Board of Medicine. These are the ten biggest mistakes […]
Medical Staff Fair Hearings and Peer Review Investigations: Fair Hearings Not Always Fair, Part 1
The term “fair hearing” is a term of art used by different individuals and organizations to refer to an internal administrative-type hearing or a private hearing in a hospital or professional association. There are several different types of proceedings that are often referred to as “fair hearings.” First, however, this blog will discuss those initiated and held […]
Medical Staff Fair Hearings and Peer Review Investigations: Fair Hearings Not Always Fair, 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, nurse practitioner, psychologist, clinical pharmacist, oral surgeon, ophthalmologist, or other licensed health professional with clinical privileges in a hospital, chances are that one day you will be subject to a peer review investigation or Medical Staff Fair Hearing. It may be a simple one-time matter based […]
Court Assesses $170 Million in Penalties For False Claims Against Two Texas Ophthalmologists and Their Clinic
On November 18, 2021, the Justice Department announced that two Texas ophthalmologists and their eye clinic must pay millions of dollars in penalties for fraudulently billing Medicare. The penalties were assessed in connection with their evaluation and treatment of glaucoma. U.S. District Judge Lynn Hughes assessed $170 million in penalties against the ophthalmologists and their eye […]
Formal vs. Informal Florida Board of Medicine Hearings: What’s the Difference?
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. Often you will find that merely having an experienced attorney to represent you at a […]
Doctors: Do You Know How to Prepare for a Florida Board of Medicine Informal Hearing? Follow Our Tips!
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 important facts that you will want to know in order to be properly prepared. This article will cover many of them. The […]
Florida Medical Board Meetings: Beware of Surprise DEA Visits
By George F. Indest III, J.D., M.P.A., LL.M. Board Certified by The Florida Bar in Health Law At several recent Florida Board meetings, after hearings at which disciplinary cases were considered by the Board, Drug Enforcement Administration (DEA) agents approached the health professional. Even in instances where the physician was represented by a health law attorney and he/she was present, the DEA agents confronted the […]
Alabama Doctors’ Pill Mill Convictions Get U.S. Supreme Court Review
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 5, 2021, the U.S. Supreme Court agreed to hear the appeals of two doctors who were convicted of running a massive opioid “pill mill” operation at their Alabama clinic known as “Pain Specialists of Alabama.” An Alabama federal jury found […]
On the Medicare Exclusion List? Get Off of It!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Often a physician, dentist, nurse, or other health professional will be placed on the Medicare List of Excluded Individuals and Entities, or the LEIE. This can occur because of a state licensing board action against them, a conviction involving a health-related crime, failure to repay a […]
Pennsylvania Hospital Asks Court To Dismiss FCA Suit For Billing Simultaneous Surgeries
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 2, 2021, the University of Pittsburgh Medical Center (UPMC) urged a Pennsylvania federal court to dismiss allegations that its physician and star surgeon submitted false medical billings. Last month, the U.S. Justice Department filed a lawsuit alleging that […]
Humana Agrees To Pay $11.2 Million to End Nurses’ Overtime Suit
By George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law On September 27, 2021, Humana agreed to pay $11.2 million to end claims that the health insurance company denied a group of nurses overtime pay by misclassifying them as exempt employees. A Wisconsin federal judge approved the deal with Humana, and a […]
Good News and Bad News for ECFMG & USMLE Applicants: Recent Changes for the USMLE Step Exams
By George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law These are some recently announced changes that could significantly impact anyone seeking to take the USMLE Step exams. This could be construed as good news by many and bad news by many others. Regardless, here it is. Step 1 Exam Changing to Pass/Fail […]