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Tag: defense attorney

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 […]

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 […]

Cardiologists Face Higher Scrutiny by CMS

By Lance O. Leider, J.D., The Health Law Firm As the U.S. population ages and heart disease continues to be a leading cause of health issues, cardiologists and cardiology practices are finding themselves billing Medicare for more and more visits and procedures. Along with that increase in reimbursement from Medicare comes an increase in scrutiny.  […]

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 […]

Fake Doctor in Texas Accused of Injecting Patients with Silicone Instead of Botox

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A South Texas woman was charged on October 31, 2013, for allegedly injecting people with silicone, that she claimed was Botox. The phony health professional, described in some media reports as an “unlicensed plastic surgeon,” has been charged […]

Florida Doctor Faces Administrative Hearing Over Allegations of Torturing Patient

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Lake Worth, Florida, doctor accused of “punishment therapy” that included the use of whips, blindfolds, handcuffs and other instruments of torture could have his license revoked by the Florida Board of Osteopathic Medicine. At the meeting on […]

Fake Surgeon in Florida Accused of Performing Liposuction Without a License

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Kissimmee, Florida, man was arrested on December 18, 2013, on charges that he has been allegedly performing liposuction without a medical license in a Central Florida clinic. According to the Orlando Sentinel, the Metropolitan Bureau of Investigation […]

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 the implementation of Stage 3 meaningful […]

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 […]

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). […]

Florida Respiratory Therapist Arrested for Alleged Elder Abuse

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Lee County, Florida, registered respiratory therapist at HealthPark Medical Center in Fort Myers, Florida, was arrested and charged with battery on an elderly patient. The respiratory therapist was arrested by the Attorney General’s (AG) Medicaid Fraud Control […]

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 […]

Florida Attorney General Targets Targeted Case Management Fraud

By Christopher E. Brown, J.D., The Health Law Firm Due to increased fraud throughout the system, the Florida Attorney General (AG), through the Medicaid Fraud Control Unit (MFCU), is focusing its attention on Medicaid targeted case management (TCM) services. TCM services were created to assist children with documented mental health conditions in gaining access to […]

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 […]

Disruptive Physicians: Nobody Likes a Nuisance

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Christopher E. Brown, J.D., The Health Law Firm Identifying and eliminating disruptive physicians has become a paramount concern of many hospitals and healthcare systems. Disruptive physicians hinder the safe and orderly operation of a healthcare facility and […]

Watch Out for Legal Pitfalls Associated with Telemedicine

By Lance O. Leider, J.D., The Health Law Firm With all the new technologies, mobile medical applications, expansion of access to health care under the Affordable Care Act (ACA), and the emphasis on quality care, telemedicine is at the forefront of the health care industry. Now is the time to educate yourself on the new […]

“Doctor of Death” Trial Could Ignite Stricter Oversight in the Healthcare Industry

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On paper, one Detroit-area oncologist appeared to be a wildly successful professional with impeccable medical credentials. According to his medical practice’s website, he went to medical school at Cornell Medical College, did an internal medicine residency at Maimonides […]

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 […]

CMS Extends Waivers under the ACO Shared Savings Program

By Lance O. Leider, J.D., The Health Law Firm On November 2, 2011, the Centers for Medicare and Medicaid Services (CMS) promulgated the interim final rule on fraud and abuse waivers for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program. The interim rule can be found at 76 Fed. Reg. 67801. The […]

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 […]

Chinese Nationals Indicted in Alleged U.S. Test-Taking Scheme

By George F. Indest, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Fifteen Chinese citizens living in the United States reportedly conspired to take college entrance exams for others so they could obtain student visas, according to the Associated Press. The frauds allegedly took standardized exams including the Scholastic Aptitude Test […]

Apopka Woman to Serve 18-Month Prison Sentence After $47K Medicaid Scam

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An Apopka businesswoman was recently sentenced to 18 months in prison after she was found guilty of a Medicaid scam. According to the Florida Attorney General’s Office, Shanqual Marshall-Gunn was arrested in September on suspicion of submitting more […]

Breach of HIPAA Privacy Regulations May be a Basis for Negligence Actions

By Shelby Root and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law Given the advances in information technology, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was enacted by Congress as a comprehensive legislative and regulatory scheme to ensure basic protections of patients’ right of […]

Phony Dentist Charged with Child Abuse After Injuring Teen During Procedures

George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Miami man, his wife and their daughter have been charged with child abuse following two alleged dental procedures that left a 14-year-old girl permanently disfigured. According to a number of sources, the three were arrested on September 12, […]

Have You Received a Notice of Termination of Your Medicare Provider Number?

By Danielle M. Murray, J.D. Have you received a notice of termination of your Medicare provider number? Medicare has been revoking the Medicare provider numbers of many different Medicare providers including psychologists and other mental health providers, based on returned mail sent to old addresses which have not been updated or based on inspection team […]

37 Central Floridians Charged with Illicit Pharmaceutical Drug Trafficking

By Dr. Thu Pham, O.D., Law Clerk, The Health Law Firm Attorney General Pam Bondi along with special agent Mark R. Trouville of the Drug Enforcement Administration (DEA) and Longwood Police Chief Troy Hickson announced, on June 20, 2012, the execution of 37 arrest warrants stemming from state drug charges.  The defendants all reside in […]

Debary Dentist Served with Emergency Suspension Order for Allegedly Inhaling Laughing Gas

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Key West Pharmacy Blows Whistle on Medicaid Fraud and Comes Out on Top

By Danielle M. Murray, J.D. On September 27, 2012, Public Citizen, a watchdog group, reported whistleblowers have initiated $6.6 billion in penalties against drug manufacturers in 2012. Most of these penalties are for fraudulently overcharging government programs. The report names a small Key West, Florida, pharmacy as one of the top whistleblowers in the country. […]

Dentists: Beware of Nationwide Telephone Prescription Drug Scam – Callers Claim to be DEA Agents

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Cancer Patients Must Provide DOH Approval for Seizures and Muscle Spasms, or May Be Unqualified for Low-THC Medical Marijuana

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New Medical-Marijuana Amendment to be Reviewed for Inclusion on Ballot

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A new medical-marijuana amendment will be reviewed by the Department of State. The second push in Florida has more than 100,000 signatures in favor to date. The petitions were given to the state on Wednesday by an organization […]

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 […]

Walgreens Files a Petition to Lift the Immediate Suspension Order

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law There’s a firefight brewing between Walgreens and the Drug Enforcement Administration (DEA). On October 10, 2012, Walgreens filed a petition asking a federal judge to lift the Immediate Suspension Order (ISO) that bans its distribution center in Jupiter, […]

Group Pushing For New Marijuana Legalization Amendment in Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law There is a new effort to legalize the use of marijuana in Florida and not just for medical purposes. Petitions will soon hit the streets for a proposed constitutional amendment that would completely legalize use, possession and cultivation […]

Florida Department of Health (DOH) Shuts Down Boca Raton Compounding Pharmacy

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 26, 2012, the Florida Department of Health (DOH) issued an emergency suspension order (ESO) against a Boca Raton compounding pharmacy, according to a number of sources. The DOH in a press release called the conditions in […]

Sanford CVS Pharmacies in Hot Water for Ignoring Red Flags

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In September 2012, the Drug Enforcement Administration (DEA) revoked the controlled substance licenses from two CVS pharmacies in Sanford, Florida. Details into the investigation were made public on October 12, 2012, in a final order released by the […]

Florida Law Prohibits Control of a Dental Practice by a Nondentist

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida has long been a state that does not prohibit the corporate practice of medicine, unlike many other states. However, it does prohibit the corporate practice of dentistry.  The key provision in Florida law that establishes this is […]

Phony Pharmacist Gets Prison Time for Working at Pharmacies in Central Florida

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 2, 2012, a former Altamonte Springs resident was sentenced to three and a half years in federal prison for fraudulently working as a Central Florida pharmacist from 2000 to 2009, according to the Department of Justice […]

Please, Please, Please Do NOT Talk to the Department of Health (DOH) Investigator

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Massage therapists, I beseech you: please do not talk to a Department of Health (DOH) investigator until you have talked to a health lawyer who is experienced with DOH investigations and board licensing complaints. Do not answer or respond […]

New Regulations for Pain Management Clinics in Seminole County Coming

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Seminole County, Florida, is the latest county to adopt tightened regulations for pain management clinics. On November 13, 2012, County Commissioners unanimously voted to adopt the ordinance enacting Chapter 186 of the Seminole County Code to establish regulations […]

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