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, […]

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, […]

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 […]

Apopka Woman to Serve 18-Month Prison Sentence After $47K Medicaid Scam

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An Apopka businesswoman was recently sentenced to 18 months in prison after she was found guilty of a Medicaid scam. According to the Florida Attorney General’s Office, Shanqual Marshall-Gunn was arrested in September on suspicion of submitting more […]

Florida Attorney General Focuses on Targeted Case Management Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Due to a rise in fraud across the system, the Florida Attorney General (AG), through the Medicaid Fraud Control Unit (MFCU), is directing its focus toward Medicaid targeted case management (TCM) services. TCM services were established to help […]

Florida Nursing Home Owner Arrested for Alleged $395,000 Medicaid Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A Miami-Dade nursing home owner was arrested for allegedly committing $395,000 worth of Medicaid fraud. The Florida Attorney General (AG) accused the nursing home owner of using the billing names of non-existent businesses to submit fraudulent invoices. The […]

How to Respond to a Medicaid Fraud Control Unit (MFCU) Investigative Subpoena

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Christopher E. Brown, J.D. The Medicaid Fraud Control Unit (MFCU) is a division of the Florida Office of Attorney General. It is in charge of investigating and prosecuting health care providers suspected of defrauding the state’s Medicaid […]

$24 Million Medicaid Fraud Scheme Alleged by Connecticut Attorney General

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Connecticut’s Attorney General, George Jepsen, alleges that 28 individuals, dental practices and corporations were involved in a $24 million Medicaid fraud scheme. He filed a civil action  on May 31, 2012. It is the first case the state has […]

Florida Woman Arrested for Allegedly Stealing from Disabled Adults

  By Dr. Thu Pham, O.D., Law Clerk, The Health Law Firm Attorney and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A former employee of an organization that provides services to developmentally disabled adults in Alachua County, Florida, was arrested on June 15, 2012, according to […]

Woman Admits to Defrauding Medicaid For Fake Mental and Behavior Health Services

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A North Carolina woman pleaded guilty on September 14, 2012, for her involvement in a health care scheme that allegedly defrauded Medicaid from 2008 to 2011 for fake mental and behavior health services. Through this scheme, she allegedly […]

Director of Center for Developmentally Challenged Adults Accused of Medicaid Fraud

By George F. Indest III J.D., LL.M., Board Certified by The Florida Bar in Health Law The director of a center for developmentally challenged adults in Okaloosa County, Florida, was arrested on August 16, 2012, for allegedly fraudulently billing Medicaid for more than $270,000 for services under the Medicaid Developmentally Disabled Waiver Program, according to […]

If You Are a Dentist Facing Legal Challenges, Choose an Attorney Who is Board Certified by The Florida Bar in Health Law

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Dentists, nurses, pharmacists, health professionals, and health facilities often face legal challenges from many different sources. These challenges can come from federal and state regulators, medical malpractice trial lawyers, hospitals, clinics and colleagues. If you find yourself faced […]

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. […]

Florida Federal Judge Triples Award to $347 Million in Rare Whistleblower Case

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 1, 2017, a Florida federal judge tripled a $115 million damages award for the government to $347 million after a jury found that the operators of 53 nursing facilities submitted false claims to Medicare and Medicaid. […]

CMS Requires Home Health Claims to be Selected for Probe and Education Review

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Medicare Administrative Contractors (MACs) in conjunction with the Center for Medicare and Medicaid Services (CMS) have initialized the “Home Health Probe and Educate” medical review strategy. The reason for CMS’s coined “Probe and Educate Review Strategy” is to […]

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 […]

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 […]

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 […]