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Category: In the Know

First Trial Over DePuy Hip Implants Finished – Plaintiff Receives $8.3 Million

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm On March 8, 2013, a California jury ruled that Johnson and Johnson’s DePuy unit designed a defective metal-on-metal ASR XL hip implant and was negligent, according to Bloomberg News. The […]

Tips for Responding to a Medicaid Audit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Should you find yourself, your facility or your health practice the subject of a Medicaid audit by your state Medicaid agency or audit contractor, there are a few things you should know. The most important thing is that […]

Tips for Medical Students and Medical Residents Accused of Irregular Behavior on the USMLE

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We frequently receive calls for consultations from students who receive a letter from the National Board of Medical Examiners (NBME) accusing the medical student or medical resident of “Irregular Behavior” on the United States Medical Licensing Examination (USMLE). […]

Number of Oxycodone-Related Deaths Down in Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law It looks like Florida’s prescription drug legislation, the statewide prescription drug monitoring database and the prescription drug crackdowns by law enforcement may be working, according to the Florida Department of Law Enforcement (FDLE). The FDLE states in its […]

Colorado Surgeon Accused of Botching Multiple Robotic Arm Surgeries

By Carole C. Schriefer, R.N., J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Colorado surgeon allegedly faces 14 counts of unprofessional conduct associated with the use a robotic arm used during surgeries, according to the formal administrative complaint. The Colorado […]

Florida Man Sentenced to Prison for Role in Florida Hospital Data Theft

By Lance O. Leider, J.D., The Health Law Firm A Davenport, Florida, man was sentenced to four years in prison for paying off two Florida Hospital employees to illegally access patient records, according to the Department of Justice (DOJ). A judge sentenced Sergie Kusyakov on April 10, 2013. He was charged with conspiracy and wrongful […]

Poll Shows Majority Supports the Legalization of Marijuana

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For the first time in four decades, a majority of Americans support the legalization of marijuana, according to a national survey conducted by Pew Research. The results from the survey, released on April 4, 2013, show fifty-two percent […]

The Doctors Company (TDC) Attorneys, Lawyers and Defense Council in Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Often we learn after the fact that a health professional such as physicians, dentist and other health professionals has received The Doctors Company (TDC) Insurance, has had a legal problem, and has not been able to locate an […]

American Medical Association Joins Minnesota Medical Staff in Its Fight for Autonomy

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The American Medical Association (AMA) and several other physician organizations announced support of a court appeal by physicians at Avera Marshall Regional Medical Center in Minnesota. The medical staff at Avera alleged the hospital’s governing board amended the […]

The Affordable Care Act Offers the Government New Tools to Fight Healthcare Fraud

By Catherine T. Hollis, J.D., The Health Law Firm In 2013, the government reported recovery of a record-breaking $10.7 billion in healthcare fraud in the past three years, according to the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Justice (DOJ). The HHS credits the Affordable Care Act’s tough stance […]

Texas Oncologist Accused of Poisoning Coworker/Boyfriend’s Coffee

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Houston, Texas, doctor is accused of spiking her co-worker’s coffee with a toxic chemical. Both the female doctor and the male co-worker she allegedly tried to poison worked as oncologists at The University of Texas M.D. Anderson […]

Drug Enforcement Administration Agents Raid Central Florida Pain Management Clinic

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Drug Enforcement Administration (DEA) agents along with local police and sheriffs’ deputies raided a Longwood, Florida, pain management clinic on June 14, 2013. According to the Orlando Sentinel, agents searched for evidence at the clinic associated with multiple […]

Top Medicare Prescribers Collect Speaking Fees from Drug Makers-Coincidence?

By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A recent investigation by ProPublica found that certain doctors who prescribed certain drug brands the most, also have financial ties to the companies that manufacture those prescription drugs. Using […]

Central Florida Pain Management Clinic Falls Victim to Civil Forfeiture

By Christopher E. Brown, J.D., The Health Law Firm On June 14, 2013, Drug Enforcement Administration (DEA) agents, along with local police and sheriffs’ deputies raided a Longwood, Florida, pain management clinic. In addition to criminal charges, the physicians and employees associated with this clinic face another lesser known threat,  the civil forfeiture of their […]

Enforcing Your Right to Access Public Records

By Lance O. Leider, J.D., The Health Law Firm Citizens of the state of Florida enjoy broad access to the public records created by state agencies.  Those records range from information on state contracts to certain police records to information on state licensees. Almost all records created by or held by state agencies on you […]

First Year Pioneer ACO Results: Medicare Money Saved But Some Physicians Leave Program

By Lance O. Leider, J.D., The Health Law Firm On July 16, 2013, the Centers for Medicare and Medicaid Services (CMS) issued a press release summarizing the performance results for the first year of the Pioneer Accountable Care Organization (ACO) Model. Made possible by the Patient Protection and Affordable Care Act (PPACA), the Pioneer ACO […]

Physician Payment Sunshine Act Deadline is Here-Are You Ready?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Lance O. Leider, J.D., The Health Law Firm As of August 1, 2013, the Physician Payment Sunshine Act (Sunshine Act) goes into effect. The Sunshine Act, contained in Section 6002 of the Patient Protection and Affordable Care […]

Orlando Health’s Restructuring Efforts Might Mean Pay Cuts and Layoffs for Employees

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many employees at Orlando Health might be getting hit hard in the wallet with pay cuts schedule for later this year. According to the Orlando Sentinel, the eight-hospital health system notified its night-shift workers that their differential pay […]

Doctor Sentenced to Almost 27 Years in Prison for Pill Mill Charges

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A doctor was sentenced to almost 27 years in prison on July 24, 2013, according to the Sun Sentinel. The former doctor, Sergio Rodriguez, had worked as a pediatrician at Children Plus Health Center near Palm Beach County, […]

Removal of Past Criminal History from Florida Department of Health Practitioner Profile

By Lance O. Leider, J.D., The Health Law Firm and  George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law By statute, the Florida Legislature requires that the Department of Health (DOH) maintain an online practitioner profile for medical doctors, osteopathic physicians (DOs), chiropractors (DCs), advanced practice registered nurses […]

Miami “Rock Doc” Arrested on Medicare Fraud Charges

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An osteopathic physician in Miami, Florida, dubbed the “Rock Doc,” was arrested on September 30, 2013. He is charged with twelve (12) counts of health care fraud, according to the Department of Justice (DOJ). The “Rock Doc” is […]

Two Laptops Containing Information of 729,000 Patients Stolen from California Hospital Group

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The personal health information of around 729,000 patients has been compromised following the theft of two laptops. The password-protected computers were taken from an administration building of AHMC Healthcare Inc., a hospital group in Alhambra, California. According to […]

Florida Nursing Home Owner Arrested for Alleged $395,000 Medicaid Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Miami-Dade nursing home owner was arrested for allegedly committing $395,000 worth of Medicaid fraud. The Florida Attorney General (AG) accused the nursing home owner of using the billing names of non-existent businesses to submit fraudulent invoices. The […]

MedPAC Wants to Hold Accountable Care Organizations More Accountable

By Lance O. Leider, J.D., The Health Law Firm As the Centers for Medicare and Medicaid Services (CMS) prepares to designate the next class of accountable care organizations (ACOs), the agency sought the advice and input of the Medicare Payment Advisory Commission (MedPAC) on how to proceed.  MedPAC is an independent Congressional Agency established to […]

Adventist Health System Settles Whistleblower Lawsuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 18, 2013, Adventist Health System/Sunbelt Inc., the parent company of Orlando-based Florida Hospital, settled a whistleblower lawsuit, according to court documents. The whistleblower lawsuit, filed in 2010, stated that seven Adventist hospitals in Florida overbilled the […]

CMS Delays Stage 3 Meaningful Use for Medicare and Medicaid EHR Incentive Programs

By Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law, and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 6, 2013, the Centers for Medicare and Medicaid Services (CMS) announced a revised timeline for implementing Stage 3 meaningful use measures […]

Miami Medical Clinic Owner Pleads Guilty to $20 Million in Medicare Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The owner of a Miami-based medical clinic pleaded guilty on January 8, 2014, for her involvement in several health care fraud schemes that allegedly cost the Medicare program around $20 million. The schemes allegedly involved fraudulent billing for […]

Scribes Offer Physicians Some Relief from EHR Frustrations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In November 2013, a physician satisfaction study, sponsored by the American Medical Society (AMA), was published. In the study, physicians stated one of the most hated items in the medical industry is the electronic health record (EHR). According […]

Doctors’ Medicare Payment Data to be Released Spring 2014

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For years, the Centers for Medicare and Medicaid Services (CMS) has kept private its records on Medicare claims payments made to individual physicians. However, beginning March 18, 2014, the government may disclose the payment data on a case-by-case […]

Dermatology Practice Settles with Government After Stolen USB Drive Results in HIPAA Breach

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) Office for Civil Rights (OCR), and Adult & Pediatric Dermatology (APDerm), reached a $150,000 settlement for privacy and security violations of the Health Insurance Portability and Accountability Act (HIPAA). […]

Some Providers Billing PIP Claims No Longer Exempt From Health Care Clinic Act

By Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law Some health care providers that were previously exempt from the requirements of the Health Care Clinic Act are now required to obtain a Health Care Clinic license in order to bill for care provided to their patients injured in car […]

Will Florida Board of Medicine Follow Board of Pharmacy’s Lead and Recommend PRN Evaluations for Applicants Before Application is Considered?

By Lance Leider, J.D., The Health Law Firm At the February 12, 2014, Florida Board of Pharmacy meeting, some board members expressed frustration with the fact that applicants for licensure with prior mental health or substance abuse related issues had not been evaluated by the Professionals Resource Network (PRN) prior to the consideration of their […]

Data Breach at Colorado Hospital Highlights IT Security Risks

By Lance O. Leider, J.D., The Health Law Firm A small rural hospital in Glenwood Springs, Colorado, has identified a virus on its computer network that had captured and stored screen shots of protected health information in a hidden file system. The hidden folder was created on Sept. 23, 2013, but was not discovered until […]

Florida Supreme Court Overturns Medical Malpractice Caps

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida’s Supreme Court ruled 5-to-2 in favor of invalidating medical malpractice caps on non-economic damages. The initial legislation was put into place in 2003 by the Florida Legislature due to an alleged medical malpractice crisis. The caps limited […]

Use Caution in USMLE Step Exam Preparation

By Catherine T. Hollis, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The United States Medical Licensing Examination (USMLE) Bulletin of Information outlines several examples of conduct that is deemed to be irregular behavior.  On February 27, 2014, the USMLE posted […]

OIG Audit Finds Federal Database of Terminated Medicaid Providers Needs Improvement

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm The Affordable Care Act (ACA) requires the Centers for Medicare and Medicaid Services (CMS) to establish a process for sharing information about terminated Medicaid providers. The federal database, called Medicaid and Children’s Health Insurance Program State Information Sharing System (MCSIS), is designed to prevent terminated […]

HIPAA Fines, Mobile Devices and Risk Assessments: Follow the Steps or Pay the Price

By Lance O. Leider, J.D., The Health Law Firm Two separate entities have agreed to pay the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) $1,975,220 in fines collectively. The settlements resolve potential violations of the Health Insurance Portability and Accountability Act (HIPAA) privacy and security rules involving stolen, unencrypted […]

CMS in the Hot Seat for Lax Oversight of Medicaid Managed Care Organizations

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm For years, each state has kept an eye on its own Medicaid managed care plans, while the Centers for Medicare and Medicaid Services (CMS) is required to monitor how well each individual state is doing. However, a recent Government Accountability Office (GAO) report claims CMS […]

Why Have You Received a Denial on Your Medicare Enrollment Application?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Did you receive a denial on your Medicare enrollment application and can’t figure out why? You may be surprised to find out that even the smallest punctuation error, such as a missing comma or period, could be the […]

The RACs, They’re Back! The Return of Medicare Recovery Audits

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law All good things must come to an end. This includes the two-month hiatus from Recovery Audit Contractors (RACs) that healthcare professionals enjoyed. The Centers for Medicare and Medicaid Services (CMS) is restarting audits of Medicare fee-for-service claims on […]

Internal Medicine Specialists Should Be Aware of Impending Medicare Audits

Coming to a medical practice near you. . . It’s scary, it’s horrible, and it could cost you a lot of money! It’s the dreaded Comprehensive Error Rate Testing (CERT) audit. The Horror! The Horror! First Coast Service Options, the Medicare contractor for Florida, announced a new prepayment audit program that will impact Internal Medicine […]

Don’t Ring in the New Year with a HIPAA Audit – Safeguard Yourself Now

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Here’s a scary reminder: There are people attempting to hack into electronic health systems every second of every day. Thankfully, most of these attempts are unsuccessful due to the preventive technologies in place to safeguard such information. However, […]

Physician Argues Definition of “Peer” at Formal Administrative Hearing

FACTS: The Agency for Health Care Administration (“AHCA”) is responsible for administering Florida’s Medicaid program and conducting investigations and audits of paid claims to ascertain if Medicaid providers have been overpaid. With regard to investigations of physicians, section 409.9131, Florida Statutes, provides that AHCA must have a “peer” evaluate Medicaid claims before the initiation of formal […]

Open for Registration: Telemedicine Association Begins Telemedicine Accreditation

By Lance O. Leider, J.D., The Health Law Firm The American Telemedicine Association (ATA) recently announced that it was accepting a limited number of applications for its telemedicine provider accreditation program. According to the ATA the purpose of the accreditation is to recognize organizations that provide top-notch online health care services. The ATA calls the […]

More Medicare Audits Now Than Ever Before

George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in the Legal Specialty of Health Law A Medicare audit, whether it is performed by a contractor of the Centers for Medicare & Medicaid Services (CMS), or by another organization, can be a daunting process. It is never “routine” and should never […]

New MCAT Will Put the Social Skills of Potential Doctors to the Test

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The 8,200 aspiring doctors expected to take the Medical College Admission Test (MCAT) this year will be seeing a different exam than their predecessors. The doctor-patient dynamic is changing. So, to stay on top of this shift in […]

Ready or Not, It’s Irregular Behavior Season…

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm Every year at regular intervals, our firm receives calls from panicked medical students and residents about a recent letter they have received, alleging irregular behavior. This letter may come from the National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE), or […]

Florida Attorney General Focuses on Targeted Case Management Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Due to a rise in fraud across the system, the Florida Attorney General (AG), through the Medicaid Fraud Control Unit (MFCU), is directing its focus toward Medicaid targeted case management (TCM) services. TCM services were established to help […]

Locating a Healthcare Providers Service Organization (HPSO) Insurance Defense Attorney in Florida Company Cases

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the […]

Selling Tobacco Can Get You Penalized By Insurance Panels

By Lance O. Leider, J.D., The Health Law Firm Beware: selling cigarettes could burn a hole in your pocket. The CVS Health Corporation (CVS), the nation’s second-largest drug store, is currently in the midst of launching a tobacco-free prescription-drug network. The company announced in October 2014, that it will begin offering a tobacco-free pharmacy plan […]

Finding a Healthcare Providers Service Organization (HPSO) Insurance Defense Lawyer

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the […]

Why Nurses Should Purchase Professional Liability Insurance

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Though many nurses pursue a career in nursing hoping that they will never face disciplinary charges, any number of events not in a nurse’s control can lead to an investigation or administrative action. Nurses need to make sure […]

Advice for Nurses Regarding Department of Health Investigations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We see and hear about a lot of incorrect legal advice being given to nurses regarding what they should do if they are being investigated. The incorrect advice being given even includes mailings they may have received containing […]

Nursing Professionals Cannot Afford to Not Carry Nursing Malpractice Insurance

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Nurses: Please Protect Yourself With Professional Liability Insurance. I am writing to strongly encourage you to purchase nursing professional liability insurance that covers you for complaints and investigations initiated against you and your nursing license. I am not […]

Florida Nurse Allegedly Filled Fake Prescriptions for Painkillers

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Central Florida nurse is in trouble with the law for allegedly writing fake prescriptions and illegally obtaining painkillers for herself, according to the Orlando NBC affiliate, WESH television. The nurse was allegedly arrested during the week of […]

Nurses: Locate a Healthcare Providers Service Organization (HPSO) Insurance Defense Attorney in Florida Company Cases

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the […]

Nurses Service Organization (NSO) Attorneys, Lawyers and Defense Council in Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Often we learn after the fact that a health professional such as nurses, advance registered nurse practitioners (ARNPs), certified registered nurse practitioners (CRNPs) and nurse midwives (NMs) has received Nurses Service Organization (NSO) insurance, has had a legal […]

Traveling Nurses Must Have Appropriate Professional Liability Insurance

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are often asked what we consider to be the biggest problem that a nurse has in defending herself in a complaint against her license.  In our opinion, it is not having the financial resources to retain the […]

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