Ready or Not, It’s Irregular Behavior Season Once Again…
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Every year, our firm receives calls from panicked medical students and residents about a recent letter they have received, alleging irregular behavior on standardized medical examinations. This letter may come from the National Board of Medical Examiners (NBME), […]
Signing False Medicare Claims Lands Nurse Behind Bars for 30 Months
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Detroit-area registered nurse was sentenced on November 19, 2012, to 30 months in federal prison for his alleged part in a nearly $13.8 million Medicare fraud scheme. According to a Department of Justice (DOJ) press release, he […]
Zone 4 Program Integrity Contractor (ZPIC) for Medicare and Medicaid Programs is Health Integrity, LCC
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Health Integrity, LCC, was named the Zone 4 Program Integrity Contractor (ZPIC) for the Medicare and Medicaid programs. As the ZPIC for Zone 4, Health Integrity has been performing benefit integrity activities aimed to reduce fraud, waste and […]
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 […]
Specialty Pharmacy Agrees to Pay A $11.4 Million Settlement in Whistleblower Case
By Lance O. Leider, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Department of Justice (DOJ) announced on December 27, 2012, that a specialty pharmacy, based in San Diego, California, has agreed to pay a $11.4 million settlement. That payment is to resolve allegations […]
Ohio Hospital Settles Whistleblower Case to Resolve False Claims Act Allegations
By Lance O. Leider, J.D., Attorney, The Health Law Firm A group of doctors accused of performing an unusually high number of heart procedures on patients at an Ohio hospital has settled a whistleblower lawsuit, according to the Department of Justice (DOJ). The settlement agreement covers accusations that the doctors and the hospital billed Medicare […]
Medicare Put the Hospice Industry Under the Microscope
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law It’s no surprise to anyone that Medicare is cracking down on hospices around the country. According to a report by the Office of Inspector General (OIG), eighty-two percent (82%) of hospices’ claims did not meet Medicare coverage requirements. […]
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). […]
Speech Therapist Arrested for Billing Medicaid $500,000 for Work at Florida Day Care Centers While Living in Illinois
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A speech therapist was arrested on March 29, 2013, for allegedly billing Medicaid more than $500,000 for services that she did not provide, according to the Florida Office of the Attorney General (AG). The speech therapist now faces […]
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 […]
Two Separate Lawsuits Against Novartis Pharmaceuticals Corporation Allege Illegal Kickbacks and False Claims
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Novartis Pharmaceuticals Corporation (NPC) is currently fielding two different lawsuits, filed just days apart from each other, by the U.S. Department of Justice (DOJ). The first lawsuit was filed on April 23, 2013, alleging the company gave illegal […]
Department of Justice Seeks up to $600 Million in Whistleblower Case Against Halifax Health in Daytona Beach, Florida
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 Justice (DOJ) is asking for between $350 million and $600 million in damages and penalties from Halifax Health Medical Center in Daytona Beach, according to The Daytona Beach News-Journal. A Halifax employee filed the […]
Medical Students and Residents Must Fight Allegations of “Irregular Behavior” on the USMLE Step Exams
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I am constantly taking calls from medical students and residents (or future residents) relating to allegations brought against them of “irregular behavior” in connection with the United States Medical Licensing Examination (USMLE) exams. Although the term “irregular behavior” […]
Florida Hospice to Pay $1 Million to Settle Whistleblower Lawsuit Over False Billing Claims
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Hernando-Pasco Hospice (HPH Hospice) in Hudson, Florida, agreed to pay $1 million to resolve allegations that it violated the False Claims Act by submitting false claims for services to the Medicare and Medicaid Programs. According to the […]
Oncologist Accused of Billing Medicare for Unnecessary Chemotherapy-Employee Whistleblowers Filed First Claim
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Michigan oncologist is accused of deliberately misdiagnosing patients with cancer so he could allegedly administer chemotherapy treatments and bill the government for those treatments, according to the Department of Justice (DOJ). For more than two years the […]
New York-Based MRI Company to Pay $3.57 Million Settlement to Resolve False Claims Act Allegations in Whistleblower/Qui Tam Case
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 27, 2013, the Department of Justice (DOJ) announced a settlement between the government and New York-based Imagimed LLC, its former owners and its former chief radiologist. This $3.57 million settlement resolves whistleblower/qui tam allegations of false […]
Hawaii Hospital to Pay More Than $451,000 to Resolve Whistleblower/Qui Tam Allegation of Improper Claims
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Wahiawa General Hospital in Honolulu, Hawaii, agreed to pay $451,428 to settle two lawsuits alleging that the hospital improperly billed Medicare, Medicaid and Tricare. The settlement stemmed from a civil whistleblower/qui tam lawsuit. The lawsuit was filed by […]
ZPICs Seek “Voluntary” Agreements from Physicians for Auto-Denial Edits for Home Health Services
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 According to the Centers for Medicare and Medicaid Services (CMS), the primary purpose of Zone Program Integrity Contractors (ZPICs) is to investigate instances […]
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 […]
Duke University Health System Pays $1 Million to Settle Allegations of False Claims in Whistleblower Lawsuit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 21, 2014, Duke University Health System in Raleigh, North Carolina, settled a whistleblower/qui tam lawsuit, according to the Department of Justice (DOJ). The lawsuit, filed in 2012, stated that the three-hospital academic medical center is alleged […]
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 […]
Kansas Cancer Treatment Center and Owner Pay $2.9 Million Settlement for Alleged False Claims Act Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A whistleblower or qui tam lawsuit against a cancer treatment facility in Kansas has been settled. On April 14, 2014, the Hope Cancer Institute and its owner agreed to pay $2.9 million to resolve allegations that they violated […]
“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 […]
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 […]
University of Miami Employee Allegedly Caught Red Handed Stealing More Than $14 Million in Cancer Drugs
By Michael L. Smith, J.D., R.R.T., Board Certified by The Florida Bar in Health Law For three years, hundreds of life-saving cancer drugs disappeared from the shelves of the University of Miami’s (UM) Sylvester Comprehensive Cancer Center. A pharmacy technician at the center was arrested in connection to the thefts in May of 2011, and […]
OCR Releases Results From First Round of HIPAA Audits
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Office for Civil Rights’ (OCR) has release information on the initial round of mandated audits of Health Insurance Portability and Accountability Act (HIPAA) covered entities. The OCR announced official details concerning the audits at an OCR and National Institute […]
WellCare Health Plans Reaches Settlement in False Claims Act Case
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law WellCare Health Plans Inc.(WellCare) has reached a $137.5 million settlement with the federal government and nine states. The settlement resolves four lawsuits alleging violations of the False Claims Act. WellCare is based in Tampa, Florida. The company provides managed […]
Preparing for HIPAA Audits
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Office of Civil Rights (OCR) has recently released the initial results for the first round of HIPAA audits, as well as the HIPAA audit protocol. Covered entities need to review both the audit results and audit protocol […]
Whistleblower Lawsuit Alleges Florida Adventist Hospitals Overbilled Millions of Dollars
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A whistleblower lawsuit based on information from a former Florida Hospital Orlando billing employee and a former staff physician alleges that seven of Adventist’s Florida hospitals overbilled the federal government between 1995 and 2009, resulting in tens of […]
Office of Inspector General (OIG) Scrutinizes Billing at South Florida Mental Health Clinics
By Lance O. Leider, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 16, 2012, the Office of Inspector General (OIG) released a report on questionable billing by mental health centers. The report focuses on the nation’s mental health clinics that overbilled Medicare in […]
Hospice of the Comforter Inc., Faces Whistleblower Lawsuit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 6, 2012, the Department of Justice (DOJ) announced it will join in a whistleblower lawsuit alleging false Medicare billings against Hospice of the Comforter Inc., (HOTCI). The hospice is located in Altamonte Springs, a suburb of […]
Power Wheelchair Suppliers Voice Concerns over New Government Program
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 19, 2012, power wheelchair suppliers voiced their concerns over a new government program called the Power Mobility Devices (PMDs) Demonstration at a Senate Special Committee on Aging. Durable Medical Equipment Suppliers (DMES) protested the program because […]
Whistleblower Lawsuit Alleging Medicare Fraud Against Blackstone Medical, Inc., Dismissed
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A whistleblower lawsuit against Blackstone Medical, Inc., alleging Medicare fraud against Parrish Medical Center, was dismissed by a U.S. District Judge in Tampa, Florida, on August 15, 2012. According to Orthopedics This Week, the case was unsealed on […]
E&M Services Now Under Review by the Recovery Audit Contractors (RACs)
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 Centers for Medicare and Medicaid Services (CMS) made the decision to allow Recovery Audit Contractors (RACs) to begin reviewing the billing codes for office visits for healthcare providers. Those at issue are the codes […]
Remedies for Violation of HIPAA Privacy Rights and Medical Confidentiality – Part 2
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I receive many questions and e-mails about possible violations of the Health Insurance Portability and Accountability Act’s (HIPAA) Privacy Regulations and Security Regulations, and breaches of confidentiality of medical records and medical information. More detailed information on HIPAA […]
Ex-Hospital Employee Admits to Stealing and Selling Confidential Patient Information
By Lance O. Leider, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 22, 2012, a former Florida Hospital employee admitted to stealing patient information that was used to target customers for lawyers and chiropractors, according to a number of sources. The man allegedly […]
Patients Like to Read Doctors’ Notes Online
By Danielle M. Murray, J.D. According to the Orlando Sentinel, a study published in the Annals of Internal Medicine shows that patients like to read their doctors’ notes. In the study, published in April of 2012, doctors put their notes online, and gave patients online access to the file. While some patients had privacy concerns, […]
Phony Medical Equipment Supplier will Spend 30 months in Prison for Medicare Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Los Angeles medical equipment supplier will spend 30 months in prison for submitting nearly $1 million in false claims to Medicare. The claims were almost all for expensive, high-end power wheelchairs. The man was sentenced on October […]
Remedies for Violation of HIPAA Privacy Rights and Medical Confidentiality – Part 1
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I receive many questions and e-mails about possible violations of the Health Insurance Portability and Accountability Act’s (HIPAA) Privacy Regulations and Security Regulations, and breaches of confidentiality of medical records and medical information. I will attempt to explain […]
Sarasota Sheriff Wants Patients to Waive HIPAA Privacy Rights
By Danielle M. Murray, J.D. Law enforcement has been working hard to bust pill mills and stop prescription drug abuse. Pharmacists and pain management doctors are under intense scrutiny by various law enforcement agencies, including the Drug Enforcement Administration (DEA) and the Department of Health (DOH), for their role in giving out controlled substances. “Doctor […]
American Hospital Association (AHA) Sues U.S. Government for Denied Medicare Payments by RACs, ZPICs and Other Auditors
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 1, 2012, the American Hospital Association (AHA) filed a lawsuit against the U.S. Department of Health and Human Services (HHS) claiming that private auditors hired to crack down on improper Medicare payments are denying hospitals millions […]
It is Always a Bad Idea For a Dentist To…
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New Mexico’s Largest Mental Health Providers Accused of Defrauding Medicaid Out of $36 Million
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For months now, 15 New Mexico behavioral health agencies have been the subject of a Medicaid fraud investigation. The state’s largest mental health providers had their Medicaid funding frozen by the New Mexico Human Services Department (HSD) due […]
Our Firm Often Represents Psychologists, Psychiatrists, Mental Health Counselors, Social Workers and Other Mental Health Professionals in Last Minute Depositions and Hearings
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 psychiatrists, mental health counselors, social workers, licensed marriage and family therapists and other mental health professionals regarding the possibility of representing them on short notice at a hearing before the Board of […]
Florida Registered Nurses Finalize Union Agreement with HCA
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Registered nurses at ten HCA hospitals in Florida have reached a collective bargaining agreement with the hospital chain. After negotiating for over a year, National Nurses United–a union for registered nurses–announced that it finalized the agreement with HCA […]
Settlement Reached in WellCare False Claims Case
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law WellCare Health Plans Inc.(WellCare) has reached a settlement in its False Claims Act case. WellCare will pay $137.5 million to the federal government and nine states to settle four lawsuits. The lawsuits alleged violations of the False Claims Act. […]
The 27 Biggest Mistakes Nurses Make in 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 Following are the 27 biggest mistakes that we have seen nurses make over and over again that cause them the worst trouble in DOH investigations. 1. Failing to keep a current, valid address on file with the DOH […]
Detroit Nurse Will Spend Time Behind Bars for Signing False Medicare Claims
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Detroit-area registered nurse was sentenced on November 19, 2012, to 30 months in federal prison for his alleged part in a nearly $13.8 million Medicare fraud scheme. According to a Department of Justice (DOJ) press release, he […]
What Nurses Need to Know about Florida Law and HIV Testing
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Section 381.004, Florida Statutes, provides for an increased level of protection of medical records that contain human immunodeficiency virus (HIV) test results. The super confidentiality requirements imposed by Florida law are viewed as the precautions which must be taken both […]
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. […]
Whistleblower Case Against Tennessee-Based Nursing Care Company
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law 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 […]
Dentists: Call The Health Law Firm Attorneys From Representation in Short-Notice Depositions and Hearings
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 dentists and other health professionals regarding the possibility of representing them on short notice at a Board of Dentistry hearing, or at a deposition related to a health care matter. We Take […]
Need Last Minute Deposition or Hearing Representation? Call The Health Law Firm
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Our office often takes phone calls from pharmacies and pharmacists needing short-notice representation at a Board of Pharmacy hearing or at a deposition related to a health care matter. In our experience, many other law firms refuse to […]
United Parcel Service (UPS) Agrees to Pay Settlement for Online Pharmacy Shipping
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law United Parcel Service, Inc. (UPS) will pay $40 million to the Department of Justice (DOJ) to settle a probe related to its shipments on behalf of illicit online pharmacies. This announcement came on March 29, 2013. Click here […]
Employee Steals More Than $14 Million in Cancer Drugs from University of Miami Pharmacy
By Michael L. Smith, J.D., R.R.T., Board Certified by The Florida Bar in Health Law For three years, hundreds of life-saving cancer drugs disappeared from the shelves of the University of Miami’s (UM) Sylvester Comprehensive Cancer Center. A pharmacy technician at the center was arrested in connection to the thefts in May of 2011, and […]
Specialty Pharmacy Settles Lawsuit Over Illegal Kickbacks
By Lance O. Leider, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Department of Justice (DOJ) announced on December 27, 2012, that a specialty pharmacy, based in San Diego, California, has agreed to pay a $11.4 million settlement. That payment is to resolve allegations […]
The Health Law Firm Attorneys Often Represent Massage Therapists in Last Minute Depositions and Hearings
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 massage therapists regarding the possibility of representing them on short notice at a Board of Massage Therapy hearing, or at a deposition related to a health care matter. We Take Last Minute […]
Feds File Two Lawsuits Against Novartis for Allegedly Giving Kickback to Pharmacists and Physicians
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Novartis Pharmaceuticals Corporation (NPC) is currently fielding two different lawsuits, filed just days apart from each other, by the U.S. Department of Justice (DOJ). The first lawsuit was filed on April 23, 2013, alleging the company gave illegal […]
It’s Always a Bad Idea For Mental Health Professionals To…
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Nurses: Contact The Health Law Firm for Representation in Last Minute Depositions and Hearings
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We often receive calls from health professionals, including registered nurses (RNs), advanced registered nurse practitioners (ARNPs), certified registered nurse anesthetists (CRNAs), licensed practical nurses (LPNs), nurse midwives and nurse practitioners regarding the possibility of representing them on short […]
Health Care Fraud Puts Miami Man in Jail
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law 4.5 Year Sentence for Role in Fraud. A Miami Man voluntarily returned to Miami from Cuba and was immediately met with a 4.5-year long prison sentence. Jose Gerardo Gonzalez, played a role in a scheme to defraud public […]
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 […]