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Tag: legal representation for health care professionals

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 […]

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 […]

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 […]

When the DEA Comes Knocking: 15 Tips For a “Routine” DEA Inspection

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law As the United States continues to open back up from the COVID-19 shutdown, the Drug Enforcement Agency (DEA) is resuming on-site routine inspections.  Therefore, healthcare professionals must ensure compliance and regulatory efforts are in place. This is part […]

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. […]

DOJ Drops Charges in Appalachia Opioid Case After Supreme Court Ruling

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 12, 2022, the U.S. Department of Justice (DOJ) announced that it dropped charges against the remaining defendants in a case against a former Ohio drug distributor. In 2019, Miami-Luken, two of its executives, and two pharmacists […]

New Study Faults Coding Structures For Increased Medical Billing Costs in U.S.

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A study publicized in August 2022 revealed that the complex coding structures used in the United States drive up medical billing costs. This helps to make the U.S. one of the most expensive countries for health providers to […]

From the archives: Supreme Court Explores Doctor Intent in “Pill Mill” Criminal Prosecutions Under the Controlled Substances Act

Previously published on June 24, 2022By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Physicians and other healthcare professionals usually have broad scope to prescribe most drugs, including potentially dangerous ones. However, over the past decade, many limits, often imposed arbitrarily through criminal prosecutions or drastic administrative […]

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 […]

Impaired Practitioner Programs: What You Need to Know if You’ve Been Accused

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In an industry that revolves around helping others physicians and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes […]

Accused of Impairment or Misconduct? Here’s What You Should Do Next!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In an industry that revolves around helping others, physicians and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes […]

Impaired Practitioner Programs: What Happens if You’ve Been Accused?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In an industry that revolves around helping others, physicians and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes […]

Military Non-judicial Punishments or Article 15 Proceedings Are Not Criminal Convictions–Military Physicians, Dentists and Nurses Should Know This

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Our firm represents many military and former military health professionals. We are often asked how a non-judicial punishment or Article 15 proceeding will be treated for license applications, clinical privileges applications, and background screenings. Article 15 Non-judicial Punishment […]

You’ve Been Accused of Impairment or Misconduct, What Happens Now?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In an industry that revolves around helping others, physicians and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes […]

Impaired Practitioner Programs: What To Do if You’ve Been Accused?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In an industry that revolves around helping others, physicians and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes […]

10 Biggest Mistakes Dentists Make That Cause DOH Complaints

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In representing dentists in complaints against their licenses, we see similar cases over and over again. The dentists could have avoided many Department of Health (DOH) complaints that may wind up before the Board of Dentistry. These are […]

How an American Board of Internal Medicine Policy is Robbing America of Qualified Physicians

By Achal A. Aggarwal, M.B.A., J.D. In July 2012, the American Board of Internal Medicine (“ABIM”) implemented a policy change placing limits on how long a physician could be considered “board eligible.”  This policy nearly ended the ability of many otherwise qualified physicians to become certified in internal medicine.  In many cases, this also caused […]

Two Admins at a Veterans Home Criminally Charged For Mishandling Deadly COVID-19 Outbreak

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified in Health Law On September 25, 2020, two administrators at a Massachusetts veterans home were criminally charged with negligence for their role in a COVID-19 outbreak that killed 76 veterans. Attorney General (AG) Maura Healey reportedly stated that the criminal case involving Soldiers’ Home in […]

Two Administrators Charged With Negligence For Deadly COVID-19 Outbreak at Veterans Home

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified in Health Law On September 25, 2020, two administrators at a Massachusetts veterans home were criminally charged with negligence for their role in a COVID-19 outbreak that killed 76 veterans. Attorney General (AG) Maura Healey reportedly stated that the criminal case involving Soldiers’ Home in […]

Did You Lose Your ABIM Board Eligible Credentials?

We have been contacted by numerous physicians who had completed residency programs in internal medicine and only recently discovered that their time has now expired to become board certified.  ABIM considers internal medicine and subspecialist physicians who had met the standards for Board Certification in general internal medicine or any subspecialties to be “Board Eligible” […]

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 […]

Thinking About Contacting the PRN or IPN Programs? Read This First!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Physicians, dentists, nurses, and other health professionals, accused of wrongdoing, may be referred to or receive recommendations from colleagues to refer themselves to the Professionals Resource Network (PRN) or the Intervention Project for Nurses (IPN).  This is often […]

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 […]

One in Four Florida Healthcare Providers Skipped Required Opioid Prescribing Class

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 5, 2019, state officials announced that about one in four Florida health care providers failed to take a required two-hour continuing education (CE) course on prescribing controlled substances.  The deadline for the mandated course was January […]

The Most Common Cases The Health Law Firm Takes

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law One of the most common questions we get asked by doctors and lawyers alike, is about the types of cases our firm takes. They often mistake the practice of health law as medical malpractice defense. However, this is […]

Law School Agrees to Drop Accreditation Suit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On January 16, 2019, the Summit School of Law in Arizona (Arizona Summit) settled a lawsuit against the American Bar Association (ABA) over the decision to pull the law school’s accreditation. The for-profit law school, which is in […]

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 […]

Nurse Website Files Copyright Suit, Claims Florida Blog Aggregator Stole Over 800 Articles

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 28, 2018, MidLevelU, an online hub for nurse practitioners and health care professionals, filed a copyright suit in the Southern District of Florida. MidLevelU accused a subscription-based blog aggregator, ACI Information Group, of stealing and re-posting […]

FDA Releases Draft Guidance to Revamp Drug Indication and Usage Labels

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 6, 2018, the U.S. Food and Drug Administration (FDA) released draft guidance outlining its recommendations for how drug companies should word the indications and usage sections on a drug’s label. The new guidance aims to increase […]

Two Nursing Home Co-Conspirators Sentenced in $19 Million Fraud Kickback Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 9, 2018, two co-conspirators in a $19.4 million healthcare fraud scheme involving a nursing home chain, American Senior Communities, were sentenced in Indiana federal court. Both pled guilty to various conspiracy and money laundering charges. The […]

CMS Issues Final Rule to Revise Home Health Conditions of Participation

By George F. Indest III, J.D. M.P.A., L.L.M., The Health Law Firm On January 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that revises the conditions of participation (CoPs) that home health agencies (HHAs) must meet to participate in the Medicare and Medicaid. The requirements focus on the care […]

Pennsylvania Nursing Home Settles Wrongful Death Suit, Agrees to Pay $800,000

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 21, 2017, the Devereux Foundation in Philadelphia, agreed to pay $800,000 to end a wrongful death suit against staff at The Devereux Pocono Center. The suit accused staff at the organization’s residential behavioral health facility in […]

Avoid Being Labeled as a “Disruptive Physician” at All Costs

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Although “old news” at this point, on July 9, 2008, the Joint Commission (TJC) published the following alert to health care organizations: Sentinel Event Alert;  Issue 40, July 9, 2008 Behaviors That Undermine a Culture of Safety Intimidating […]

CMS Approves Five Year Extension of Florida Medicaid Managed Care Demonstration

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 3, 2017, the Centers for Medicare & Medicaid Services (CMS) approved a five-year extension of Florida’s Managed Medical Assistance (MMA) section 1115 demonstration. It allows the state to operate a capitated Medicaid managed care program and […]

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 […]

Concierge Medical Services Bring Cash With Few Hassles to Physicians

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law What is concierge medical services? A concierge medical service or practice is a similar to having a primary care provider such as a family practice physician. However, concierge practices are marked by a promise, explicit or implied, that […]

Florida Gov. Rick Scott Makes Changes to Florida Impaired Practitioners Program

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 31, 2017, Florida Governor, Rick Scott, signed into law House Bill 229 (Ch. 2017-41, Laws of Florida), which made changes to the statutory basis for Florida’s impaired practitioner programs. The impaired practitioner program for nurses in Florida […]

Mentally Ill Inmate Gouges Out Own Eyes, Sues County for Negligence

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 7, 2017, a mentally ill inmate in the Boulder, Colorado, jail sued Sheriff Joe Pelle in federal court, claiming that the jail staff failed to stop the man from using his fingers to gouge out his […]

Appeals Court Affirms Discipline for Doctor Who Sold Prescriptions at Bar

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 15, 2017, a physician who sold painkiller prescriptions to patients at a bar and restaurant, had his two-year probation for unprofessional conduct upheld by a Maryland appeals court. The court upheld the decision after it found […]

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 […]

Trump Administration Reverses Guidelines for Penalties Against Nursing Homes

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Trump administration is actively reversing nursing home guidelines previously put in place under President Barack Obama. The current administration is scaling back the use of fines against nursing homes that harm residents or place them in grave […]

Broward Health Executives Charged for Conspiring to Get Rid of CEO

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 12, 2017, five North Broward Health District executives were hit with criminal charges. A state attorney is alleging violations of Florida’s open government laws for supposedly holding secret meetings at which they decided to terminate the […]

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 […]

Federal Judge Refuses to Dismiss Florida Compounding Pharmacy’s FCA Suit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 4, 2017, a Florida federal judge refused to dismiss the federal government’s False Claims Act (FCA) suit against a compounding pharmacy. RS Compounding LLC and its owner, Renier Gobea, are accused of overbilling Tricare for prescriptions. […]

Recommendations For Physicians Who Receive Notice of Investigation From the ABIM

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In 2010, the American Board of Internal Medicine (ABIM) sanctioned 139 physicians for seeking out and sharing board examination questions with a testing preparation company. For the physicians involved in that cheating scandal, disciplinary action taken by the […]

Florida Board of Dentistry Makes Changes to Anesthesia Rules

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 13, 2017, The Florida Board of Dentistry updated rules and terminology for the use of anesthesia. The Board changed terminology from “conscious sedation” or “pediatric conscious sedation” to “moderate sedation” or “pediatric moderate sedation.” The updates […]

Florida Senate Health Committee Approves Change In Optometrist Certification

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On December 5, 2017, the Florida Senate Health Policy Committee approved a bill that would allow the Florida Board of Optometry to offer practical and written “certification” examinations to applicants. The bill would assist optometrists who were licensed […]

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Medicare/Medicaid Audits, Health Care Law, Contracts, Hospital Privileges Hearings, Investigations, DEA Defense, Board of Medicine Defense, Healthcare Fraud Defense, Medical Staff Fair Hearings, Administrative Hearings, PRN, IPN, Professional Licensing, Medicare/Medicaid Fraud Defense, Nursing Law, Hospital Peer Review,  Hospital Law, Board of Dentistry, Board of Nursing Complaint Defense, Board of Pharmacy, Medicaid Fraud Control Unit (MFCU) Defense, Search Warrant and Subpoena Defense, NBME Representation, USMLE Challenges, ABIM Representation, Resident Physician Defense, VA & Military Physician Defense, Department of Health Investigation Defense, and more…

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