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 […]
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 […]
OIG Exclusion: Do You Know if You’re on the List?
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health La Have you ever faced a disciplinary action against your professional license? Have you ever been arrested or convicted of a criminal offense? If yes, then you may have also been terminated from the federal Medicare Program or your […]
OIG Exclusion: What You Need to Know if You’re on the List
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Have you ever had disciplinary action against your license as a health care professional? Have you ever been arrested or convicted of a criminal offense? Have you ever been convicted of fraud or patient neglect? If so, then […]
Helpful Tips to Speed Up the Medicare Prepayment Review Process
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For Medicare providers, being notified of an impending audit is not welcome news. Being notified of a prepayment review is even worse. In a prepayment review, the health care provider must submit documentation to the Centers for Medicare […]
At Last, a Ray of Hope for Florida Health Professionals Who Have Paid Their Debt to Society After Criminal Conviction
The Florida Legislature unanimously passed HB 653 which relaxes some of the draconian exclusions enacted under SB 1986, which went into effect on July 1, 2009. SB 1986, which added provisions to Chapter 456, Florida Statutes, among others, prevented numerous healthcare providers from obtaining or renewing licenses based on prior criminal convictions, which could have […]
A New Year Means New Audits and Site Visits for Assisted Living Facilities – Protect Yourself Now
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For Assisted Living Facilities (ALFs) in Florida, it’s time to do a little brushing up on your compliance material. Beginning in January 2015, the Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), Bureau of Medicaid […]
OIG Audit Finds Federal Database of Terminated Medicaid Providers Needs Improvement
By Lenis L. Archer, J.D., M.P.H., The Health Law Firm The Affordable Care Act (ACA) requires the Centers for Medicare and Medicaid Services (CMS) to establish a process for sharing information about terminated Medicaid providers. The federal database, called Medicaid and Children’s Health Insurance Program State Information Sharing System (MCSIS), is designed to prevent terminated […]
Copying and Pasting Clinical Notes in Electronic Health Records Could Be Considered Healthcare Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Department of Health and Human Services (HHS) Office of Inspector General (OIG) is concerned about healthcare providers carelessly copying and pasting clinical notes in electronic health records (EHRs). According to an audit report released on December 10, […]
How to Speed Up the Medicare Prepayment Review Process
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For Medicare providers, being notified of an impending audit is not welcome news. Being notified of a prepayment review is even worse. In a prepayment review, the health care provider must submit documentation to the Centers for Medicare […]
Hospital to Pay $3.59 Million to Settle False Claims Act Allegations Involving Ambulance Services
By Miles Indest A hospital located in Columbia, Tennesse, has agreed to pay the federal government over $3.5 million to settle False Claims Act allegations that occurred between 2004 and 2009. The hospital submitted a voluntary self-disclosure to the U.S. Attorney’s Office and the Department of Health and Human Services (DHHS) Office of Inspector General (OIG). Hospital […]
Senators Want National Investigation of State Medical Boards
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A bipartisan effort has been initiated by three U.S. Senators to launch a national evaluation of state medical boards. Senators Charles Grassley (R-Iowa), Orrin Hatch (R-Utah) and Max Baucus (D-Mont.) sent a letter to the director of the Office […]
Medicare Fraud Initiative Leads to Arrests of Over 100 Health Professionals
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A recent Medicare fraud operation conducted between several federal agencies has resulted in the arrest of over 100 doctors, nurses and other medical professionals. They have been charged with various crimes relating to Medicare fraud. The arrests were made on May […]
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 […]
Florida HB 0653 Signed Into Law; Effective 2/1/2012
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Legislature unanimously passed HB 653 which relaxes some of the draconian exclusions enacted under SB 1986, which went into effect on July 1, 2009. SB 1986, which added provisions to Chapter 456, Florida Statutes, among others, prevented […]
New OIG Guidance Publishes on Permissive Exclusions from Federal Health Care Program Participation May Interest Mental Health Care Professionals
By Miles Indest, J.D./M.B.A candidate at Tulane University: Law Clerk, The Health Law Firm On April 20, 2016, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released updated non-binding criteria that disclosed when a company or individual can be barred from participating in Medicare, Medicaid, and other federal health care […]