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Esformes Reaches Plea Deal in Major Nursing Home Medicare Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On February 1, 2024, the District Court for the Southern District of Florida announced that Florida nursing home mogul Phillip Esformes had reached a plea deal on pending conspiracy […]

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. […]

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. […]

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 […]

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 […]