Florida Surgeon, Device Company Owner Arrested For Paying Bribes, Kickbacks
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 7, 2021, federal prosecutors announced the arrest of a Florida surgeon and owner of device company SpineFrontier Inc on charges of bribing surgeons to use products by paying sham consulting fees. Accused in an indictment in […]
18 Former NBA Players Indicted For Alleged $4 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 October 7, 2021, 18 former NBA players were charged in New York federal court for an alleged health insurance fraud scheme to rip off the league’s benefit plan, according to an indictment filed in the Southern District […]
Centene to Pay Washington State $19 Million to Resolve Medicaid Fraud Allegations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, […]
What Payers Are Considered to Be “Federal Payers” Under the Federal Anti-kickback Statute?
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The federal Anti-Kickback Statute prohibits remuneration in relation to the provision of a “good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program.” 42 U.S.C. § […]
Doctor Indicted in $1.3 Million Medicare Fraud Kickback Case Seeks Reinstatement of Medicare Billing Privileges
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 2, 2021, a doctor and his wife who had been indicted for their roles in a $1.3 million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. The doctor argued that the […]
Centene Reaches $166 Million Settlement With Texas Over Its Medicaid Drug Pricing
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The nation’s largest Medicaid insurer, Centene, has agreed to pay $165.6 million to Texas to resolve claims that it overcharged the state’s Medicaid program for pharmacy services. The deal was signed on July 11, 2022, but wasn’t publicly […]
Doctors Beware: Genetic Testing Scams Rip off Government Payers for Hundreds of Millions – Part 1 of 2
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Several genetic testing companies have come into the spotlight for allegations of ripping off Medicare and False Claims Act (FCA) violations. Health care professionals need to be aware of these types of schemes and the dangers they may […]
Florida Doctor Charged for $2.1 Billion Medicare Fraud; Largest Healthcare Fraud Scheme Ever Reported
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. According to prosecutors, the doctor allegedly authorized genetic testing for patients he never […]
HHS Announces Proposed Rules to Reform Stark Law and AKS Regulations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 9, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued two proposed rules to reform the federal Stark Law (dealing with […]
Florida Doctor Charged in Largest Medicare Fraud Scheme Ever Reported
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. According to prosecutors, the doctor allegedly authorized genetic testing for patients he never […]
Genetic Testing Scams Ripping off Government Programs for Millions, Part 1 of 2
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Several genetic testing companies have come into the spotlight for allegations of ripping off Medicare and False Claims Act (FCA) violations. Health care professionals need to be aware of these types of schemes and the dangers they may […]