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 […]
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 […]
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, […]
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 […]
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 […]
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, […]
The Biggest Healthcare Fraud Case Ever Prosecuted in 2019: Big Surprise! Florida Wins!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making […]
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 […]
Taking a Looking at 2019’s Largest Healthcare Fraud Case Ever Prosecuted: No Surprise, Florida Wins!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making […]
One of 2019’s Largest Healthcare Fraud Case Ever: No Surprise, Florida Wins!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making […]
2019’s Largest Healthcare Fraud Case Ever Prosecuted: No Surprise, Florida Wins!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making […]
Looking Back at 2019’s Largest Healthcare Fraud Case Ever Prosecuted: Surprise! No Surprise, Florida Wins!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making […]
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 […]
Miami Man to Remain Jailed for Trial in Nation’s Largest Medicare Fraud Case
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 3, 2018, a Florida judge ruled that a Miami businessman who has been jailed for more than two years on $1 billion health care fraud charges, must remain in custody through his trial next year. U.S. […]
Walgreens Agrees to Pay $269 Million to Settle Two FCA Suits
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On January 22, 2019, Walgreens agreed to pay more than $269 million to settle allegations of False Claims Act (FCA) violations for overbilling of various drugs. The deals are some of the largest pay-outs ever by a retail […]
DOJ Announces $2.8 Billion Recovered Funds From Healthcare Cases in 2018
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 21, 2018, the U.S. Department of Justice (DOJ) announced that it recovered more than $2.8 billion from False Claims Act (FCA) (also known as “qui tam” or “whistleblower cases”) cases in 2018. Of the $2.8 billion […]
DOJ Announces $2.8 Billion Recovered From Healthcare FCA Cases in 2018
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 21, 2018, the U.S. Department of Justice (DOJ) announced that it recovered more than $2.8 billion from False Claims Act (FCA) (also known as “qui tam” or “whistleblower cases”) cases in 2018. Of the $2.8 billion […]
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 […]
Jury Finds Four New Orleans Doctors and Others Guilty for Participation in $13.6 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 9, 2017, a federal jury found four New Orleans doctors and two others guilty for their participation in a Medicare fraud scheme. According to prosecutors the defendants netted more than $13.6 million in fraudulent Medicare reimbursements. […]
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 […]
Florida Government Officer Charged in Billion Dollar Medicare Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Health Care Administrator Accepts Bribes. An alleged $1 billion health care scheme has lead to the first known prosecution against a Florida Agency for Health Care Administration official. Bertha Blanco faces a wide range of charges including accepting […]
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 […]
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 […]
6 Charged In Florida Chiropractic PIP Insurance Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 4, 2017, federal prosecutors charged six Florida residents with running a multi-million dollar insurance fraud scheme through a dozen chiropractic clinics. The alleged scheme involved paying kickbacks to chiropractors and tow truck companies to refer accident […]
Michigan Dentist Accused of Million Dollar Medicaid Fraud Scheme Captured in Caribbean
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Michigan dentist accused of Medicaid fraud was recently captured in the Dominican Republic after evading charges for months, state authorities announced. Dr. David Johnson operated the alleged scheme through Livernois Dental in Detroit, which he owned at […]
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 […]
Florida Woman Lands Herself 6.5 Years in Prison, Owes $45 Million for 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 November 22, 2017, a Florida woman who was accused of a $45 million Medicare fraud, received a six-and-a-half-year prison sentence, following a 2016 U.S. Supreme Court decision in her case holding that the government could not freeze […]
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 […]
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. […]