Assisted Living Facilities (ALFs) Allowed to 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 Currently, Florida law and regulations 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), […]
Orlando-based Assisted Living Facilities Appeal ALJ Decision, Win Case Against AHCA
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Two related assisted living facilities (ALFs) based in Orlando 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 […]
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. […]
South Florida Pharmacy Owner Pleads Guilty to $23 Million Health Care 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 […]
Tennessee-Based Nursing Care Company Being Investigated for 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 […]
Occupational Therapists, Podiatrists, Psychologists and Optometrists Being Scrutinized in Medicare Audits
George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Our firm has recently seen an increase in the number of occupational therapists (OTs), speech therapists (STs), podiatrists, psychologists, optometrists and other licensed health professionals being scrutinized in Medicare audits and recovery actions. Often these result from claims submitted […]
Major Medicare Offender Sentenced to Prison for Multi-Million Dollar Health Care Fraud Scheme
By Lance O. Leider, J.D., The Health Law Firm The former owner of four mental health facilities in South Florida and North Carolina was sentenced to fourteen (14) years in federal prison on February 25, 2013. The former business owner pleaded guilty to defrauding Medicare out of tens of millions of dollars from 2004 through […]
Invoking Fifth Amendment by Applicant’s Personnel May Result in Denial of Their Application for a License
The foregoing case summary was prepared by and appeared in the DOAH case notes of the Administrative Law Section newsletter FACTS: The Agency for Health Care Administration (“AHCA”) denied Avalon Assisted Living III’s (“Avalon III”) application for licensure of an assisted living facility in Orlando. Avalon III challenged the denial, and the case was referred […]
AHCA Expert Not Allowed to “Use His Discretion” in Deciding Claims Were Improper in Medicaid Appeal Hearing
FACTS: The Agency for Health Care Administration’s (“AHCA”) Office of Medicaid Program Integrity audited Dr. Rao, an authorized provider of Medicaid services, for claims between July 1, 2007, and June 30, 2009, and found him to be in violation of certain Medicaid provider policies. AHCA prepared a Final Audit Letter on June 1, 2011, notifying […]
A New Year Means New Audits and Site Visits for Assisted Living Facilities – Protect Yourself Now
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For Assisted Living Facilities (ALFs) in Florida, it’s time to do a little brushing up on your compliance material. Beginning in January 2015, the Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), Bureau of Medicaid […]
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, […]