Florida Surgeon Handed Seven Years in Prison for $28 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 On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. The scheme involved performing hundreds of medically unnecessary, […]
Manager of Dental Office Sentenced to Prison for Defrauding Medicaid Out of More Than $813,000
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based dental practice, according […]
Florida Man Pleads Guilty To $36.2 Million Telehealth 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 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 […]
Dental Office Manager Sentenced to One Year in Prison for Defrauding Medicaid Out of More Than $813,000
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based dental practice, according […]
What You Need to Know Right Now If the DEA is Knocking on Your Door!
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? If so, this is what you need to know right now! YES, you do have the right to […]
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 […]
Follow These Steps If You Receive an OIG Subpoena from the DOH
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. […]
Florida Pharmacy Owner Pleads Guilty For Role in $8.3 Million Medicare Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 27, 2022, a Florida pharmacy owner pled guilty to conspiring to commit healthcare fraud in an $8.3 million scheme. The scheme involved securing orders for medically unnecessary prescriptions billed to Medicare and paying bribes and kickbacks, […]
Steps to Take If You Receive an OIG Subpoena from the DOH
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. […]
Steps to Take If You Receive an OIG Subpoena from the U.S. Department of Health and Human Services
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. […]
Psychiatric Practice, Owner Agree to Pay $310,000 in FCA Settlement for Employing Doctor on OIG Exclusion List
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 […]
Licensed Professional Counselor Sentenced to Prison for $1.3 Million Medicaid Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 million, announced the U.S. Attorney for the U.S. District of Connecticut. […]
Psychiatric Practice to Pay $310,000 in FCA Settlement for Employing Doctor on OIG Exclusion List
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 […]
Psychiatric Practice Reaches Settlement in FCA Suit to End Allegations of Employing Physician on OIG Exclusion List
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 […]
Owner of Psychiatry Practice Pays Hefty Settlement in FCA Case for Employing Doc on OIG Exclusion List
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 […]
Psychiatric Practice Pays $310,000 in FCA Settlement for Employing Physician on OIG Exclusion List
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 […]
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 On June 1, 2023, the Supreme Court handed down an opinion on the knowledge standard required in False Claims Act (FCA) cases in a precedential decision that leaves the whistleblower plaintiffs bar reeling. In a unanimous ruling, the […]
Florida Surgeon Gets 7 Years for Committing $28 Million in Health Care Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. The scheme involved performing hundreds of medically unnecessary, […]
Florida Attorney Says AHCA Must Put Medicaid Final Orders 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 accessible to the public. On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against […]
Court Assesses $170 Million in Fines Against Two Texas Ophthalmologists For False Claims
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law 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 […]
Three Charged For $109 Million Medicare Fraud Plot and HIPAA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three individuals for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient health data and sold it to the purported mastermind, who then used […]
Feds Charge Three For Role in Multi-Million Dollar Scheme to Defraud Medicare, HIPAA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three people for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient data and sold it to the purported mastermind, who used it to […]
Three Charged For $109 Million Medicare Fraud Scheme in Massachusetts
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three individuals for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient health data and sold it to the purported mastermind, who then used […]
Three People Charged For $109 Million Scheme to Defraud Medicare & HIPAA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three people for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient data and sold it to the purported mastermind, who used it to […]
Three Charged For Roles in Multi-Million Dollar Medicare Fraud Scheme, HIPAA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three individuals for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient health data and sold it to the purported mastermind, who then used […]
Three People Charged For Roles in $109 Million Medicare Fraud Scheme, HIPAA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three individuals for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient health data and sold it to the purported mastermind, who then used […]
Three Charged For Roles in $109 Million Medicare Fraud Scheme, HIPAA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three people for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient data and sold it to the purported mastermind, who used it to […]
Women Who Posed as Nurse Sentenced to Prison For Health Care Fraud, Identity Theft, and Wire Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 23, 2020, a Tennessee woman who posed as a nurse working at several medical facilities was sentenced to more than four years in prison. In December 2019, she pled guilty to wire fraud, healthcare fraud, identity […]
Three Charged For Roles in $109 Million Medicare Fraud Scheme and HIPAA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three individuals for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient health data and sold it to the purported mastermind, who then used […]
Woman Posing as Nurse For Six Years Sentenced to Prison For Health Care Fraud, Identity Theft, and Wire Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 23, 2020, a Tennessee woman who posed as a nurse working at several medical facilities was sentenced to more than four years in prison. In December 2019, she pled guilty to wire fraud, healthcare fraud, […]
Will a Death from COVID-19 be Considered “Accidental Death” for Life Insurance Policies or a Death from “Accidental Causes?”
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Almost all life insurance policies, including term policies, pay a “double indemnity,” that is, double the limits of coverage if a death occurs from “accidental causes” as opposed to “natural causes.” A question arises, given the COVID-19 pandemic, of whether a death caused by […]
How Can I Be Sure I Don’t Have Employees, Contractors Who Are on Medicare’s Exclusion List?
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are often consulted by companies in the health care industry and by health professionals after they receive a subpoena or audit regarding their employing or contracting with an individual or business that is on the Office of […]
Mental Health Professionals: You Must Challenge Overpayment Demands from Medicare and Medicaid Audits
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We have gotten calls from many mental health professionals who have been placed on prepayment review after failing to challenge Medicare or Medicaid audit results. Once placed on prepayment review, the payments are held up for many months. […]
Dentists: Challenge Overpayment Demands from Medicare, Medicaid Audits!
During our years of experience, we have gotten many calls from dentists who have been placed on prepayment review after failing to challenge the results of Medicare and Medicaid audits. Once placed on prepayment review, the payments are held up for many months. Some providers are even forced out of business as a result. Failing […]
CMS Announces Final Rule to Reduce Criminal Behavior in Medicare, Medicaid
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 5, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that strengthens the ability to stop fraud and abuse before it happens. The “Program Integrity Enhancements to the Provider Enrollment Process” goes […]
Follow These Steps to Challenge OIG Exclusion From Medicare
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many health professionals don’t understand the significant repercussions that an exclusion action by the Office of the Inspector General (OIG) can have on their professional careers and future employment. Whether you are a physician, nurse, dentist, psychologist or […]
The Administrative Process to Challenge OIG Exclusion Actions
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many health professionals don’t understand the significant repercussions that an exclusion action by the Office of the Inspector General (OIG) can have on their professional careers and future employment. Whether you are a physician, nurse, dentist, psychologist or […]
Steps to Challenge OIG Exclusion Action from Medicare Program
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many health professionals don’t understand the significant repercussions that an exclusion action by the Office of the Inspector General (OIG) can have on their professional careers and future employment. Whether you are a physician, nurse, dentist, psychologist or […]
How to Challenge an OIG Exclusion Action from Medicare
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many health professionals don’t understand the significant repercussions that an exclusion action by the Office of the Inspector General (OIG) can have on their professional careers and future employment. Whether you are a physician, nurse, dentist, psychologist or […]
So, the ZPIC Medicare Auditor Wants to Talk to You? What You Should Expect
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law You are a physician, nurse or other health care provider who bills Medicare. You have received that dreaded letter from the Zone Program Integrity Contractor (ZPIC) for Medicare advising you that it is auditing you for the Centers […]
Florida Pharmacist Gets More Than Six Years in Prison For Role in Compounding Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 29, 2018, a Florida pharmacist was sentenced to six and a half years in prison and ordered to pay $3.4 million, for her role in a scheme to defraud the government. Marjorie Robinson pled guilty one […]
Florida Woman Accused of Operating Illegal Dental Practice Out of Her Garage
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 16, 2018, a Florida woman was accused of practicing as an unlicensed dentist, operating out of her home garage. After receiving an anonymous tip, Palm Beach County Sheriff’s deputies arrested Alexandra Gallego after a month-long investigation […]
Florida Pharmacy Owner to Serve 15 Years in Prison for $100 Million Billing Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On April 26, 2018, the owner of several Florida pharmacies was sentenced to 15 years in prison and ordered to give up $54.5 million in restitution. Nicholas A. Borgesano Jr., owner of A to Z Pharmacies, pled guilty to his role in a […]
South Florida Man Admits to a $42 Million Medicare Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The owner and operator of a Miami home health care agency pleaded guilty for his part in a $42 million home health Medicare fraud scheme, according to the Department of Justice (DOJ), the FBI and the Department of […]
Home Health Provider Sues Medicare Contractor and HHS Over Unfair Audit and Denied Medicare Reimbursement Payments
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 2, 2017, an Illinois home health care provider launched a class action law suit against Medicare reimbursement auditor AdvanceMed and the U.S. Department of Health and Human Services (HHS) Secretary Tom Price. MedPro Health Providers LLC […]
Owner of Louisiana Health Care Company To Pay Nearly $7 Million for Medicaid Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 20, 2016, the owner of Louisiana-based Millennium Health Care Services (Millennium) must pay the state nearly $7 million in restitution and will spend 10 years behind bars for his role in a scheme to defraud the […]
What You Need to Know About Preparing and Responding to an Initial Medicaid Audit Request
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Health care providers in Florida who service Medicaid patients are at a higher risk for audits than anywhere else in the country. The unfortunate truth is that Florida has become synonymous with health care fraud. As a result, […]
Jury Convicts Doctor and Medical Billing Company Owner for $28 Million Medicare Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 1, 2017, a federal jury in Michigan found a Detroit-area doctor and owner of a medical billing company guilty of perpetrating a $28 million health care fraud scheme. The scheme involved billing Medicare for pain treatments […]
Florida Substance Abuse Center Owner Gets 27 Years for Multi-Million Dollar Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 17, 2017, a Florida man who pled guilty to running a health care fraud scheme out of substance abuse treatment facilities he owned was sentenced to 27 years in prison. U.S. District Judge Donald M. Middlebrooks, […]
DOJ Releases 2016 False Claims Act Recovery Statistics: Third Highest Annual Recovery Ever
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 14, 2016, the U. S. Department of Justice (DOJ) released its annual False Claims Act (FCA) recovery statistics. It revealed that the DOJ obtained more than $4.7 billion in settlements and judgments from civil cases involving […]
3 Sentenced in Florida for $175 Million Drug Compounding Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 24, 2017, three participants were sentenced in Florida federal court, for a scheme that used call centers and kickbacks to generate fake prescriptions for compounding pharmacies. The scheme was able to scam the government and private […]
Embezzling Administrator of Pediatric Clinic Faces Health Care Fraud Sentencing
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An administrator of a Louisiana pediatric clinic has recently pleaded guilty in a health care fraud case. She faces up to 10 years in prison and over $200,000 in fines. The charges allege embezzling more than $500,000 of […]
CMS Woes: Zone Program Integrity Contractors (ZPICs) Criticized for Oversight in Fraud Investigations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Zone Program Integrity Contractors (ZPIC) are private companies or business entities, that have contracted with the Centers for Medicare and Medicaid Services (CMS). Their purpose is to carry out certain functions related to auditing for possible fraud, that […]
Responding to a Medicaid Audit: Important Tips You Should Know
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), Bureau of Medicaid Program Integrity, is the Florida agency responsible for routine audits of Medicaid health care providers. Each state has a similar state agency, though […]
U.S. Court in Florida Dismisses Whistleblower’s Complaint Against Nuclear Pharmacy
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 28, 2017, the U.S. District Court for the Middle District of Florida dismissed a relator’s (whistle blower’s) False Claims Act (FCA) complaint against a nuclear pharmacy in Tampa. The court found that the relator failed to […]
Health Care Software Double-Bills Government For Anesthesia Services According to FCA Suit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 2, 2017, a relator in a Florida federal False Claims Act (FCA) case, claimed that Epic Systems’ (Epic) health software wrongly defaults to double-billing for anesthesia services. As a result, the government is being overbilled by […]
Massachusetts Mental Health Centers Submitted False Claims According to Suit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On January 5, 2018, the state of Massachusetts lodged a False Claims Act (FCA) suit in federal court against the operators of a number of mental health centers. In the suit, it is alleged that they improperly billed […]
Kmart Agrees to Pay $32.3 million to Settle Whistle Blower’s False Claims Act Suit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 22, 2017, Kmart Corporation agreed to pay $32.3 million to settle a whistle blower lawsuit alleging its pharmacies caused federal health programs to overpay for prescription drugs by not telling the government about discounted prices. The […]
Qui Tam Cases: If You Are Thinking About Blowing the Whistle, Follow These Tips
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law At The Health Law Firm, we have represented many clients that were involved in qui tam cases brought because of false claims under the Medicare False Claims Act (FCA). We have defended health facilities and health professionals, but […]
Florida Woman Who Performed Illegal Silicone Injections Sentenced After “Patient’s” Death
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 26, 2017, a Sanford, Florida, woman who performed illegal cosmetic silicone injections was sentenced to 11 years in federal prison. According to prosecutors, the illegal procedures done by Deanna Roberts, led to serious health problems and […]
New DOJ Memo Shifting Government Policy in False Claims Act Cases Should make Healthcare Providers Happy!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On January 29, 2018, the U.S. Department of Justice (DOJ) released a new internal memorandum that we believe signals a backing-off of government support for False Claims Act cases. The memorandum sent by Associate Attorney General Rachel Brand, […]
Owner of Louisiana-Based Health Care Company Ordered To Pay Nearly $7 Million for Medicaid Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 20, 2016, the owner of Louisiana-based Millennium Health Care Services (Millennium) was ordered to pay the state nearly $7 million in restitution and will spend 10 years behind bars for his role in a scheme to […]
Miami Woman Gets 4 Years in Prison for Illegal Silicone Injection Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 20, 2017, a Florida federal judge sentenced a Florida woman to more than four years in prison for her part in a conspiracy to inject non-medical silicone into the buttocks of hundreds of spa customers. U.S. […]