Being Excluded From the Medicare Program and Placed on LEIE Carry Many, Many Adverse Consequences for Future Employment
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Many health professionals decide, with little research or forethought, to give up a license to practice when faced with a complaint or an investigation. Most often, this is because they have another one in a different state. Unfortunately, […]
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 […]
DOH Releases Quarterly Report Covering Through March 2021
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Department of Health’s Quarterly Performance Report (QPR) for the Third Quarter of Fiscal Year 2020-2021, was recently released. It provides information and statistics on actions involving licensed health professionals through March 2021. Scope of the Florida […]
Department of Health Quarterly Report Released Covering Through March 2021
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Department of Health’s Quarterly Performance Report (QPR) for the Third Quarter of Fiscal Year 2020-2021, was recently released. It provides information and statistics on actions involving licensed health professionals through March 2021. Scope of the Florida […]
Medicare Final Rule Decreased Physician Payments But Expands Coverage to Counselors
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 November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule […]
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. […]
Steps to Take If You Receive an OIG Subpoena from the U.S. Department of Health and Human Services
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. […]
Psychiatric Practice, Owner Agree to Pay $310,000 in FCA Settlement for Employing Doctor on OIG Exclusion List
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on […]
Licensed Professional Counselor Sentenced to Prison for $1.3 Million Medicaid 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 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 million, announced the U.S. Attorney for the U.S. District of Connecticut. […]
Psychiatric Practice to Pay $310,000 in FCA Settlement for Employing Doctor on OIG Exclusion List
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on […]
Psychiatric Practice Reaches Settlement in FCA Suit to End Allegations of Employing Physician on OIG Exclusion List
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on […]
Owner of Psychiatry Practice Pays Hefty Settlement in FCA Case for Employing Doc on OIG Exclusion List
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on […]
Psychiatric Practice Pays $310,000 in FCA Settlement for Employing Physician on OIG Exclusion List
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on […]
Supreme Court Says FCA Case Liability Requires Defendants’ Subjective Belief
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 1, 2023, the Supreme Court handed down an opinion on the knowledge standard required in False Claims Act (FCA) cases in a precedential decision that leaves the whistleblower plaintiffs bar reeling. In a unanimous ruling, the […]
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 […]
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 […]
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 […]
Review Your Department Of Health Practitioner Profile or it Could Cost You!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In 1997, the Florida Legislature passed a statute that requires the Department of Health (DOH) to maintain online practitioner profiles for certain health care professionals. Practitioner profiles are required for medical doctors, osteopathic physicians (DOs), chiropractors (DCs), advanced […]
You Could Face Steep Repercussions From License Discipline or Resignation After Notice of Investigation
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Do you have a dental, medical, pharmacy or nursing license in several different states? Do you have a license in more than one health care profession? Have you been notified that an investigation has been opened against you? […]
Review Your Florida DOH Practitioner Profile or it Could Cost You!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In 1997, the Florida Legislature passed a statute that requires the Department of Health (DOH) maintain online practitioner profiles for certain health care professionals. Practitioner profiles are required for medical doctors, osteopathic physicians (DOs), chiropractors (DCs), advanced practice […]
Although the Law Stacks the Deck Against You, Leaving a Foreign Body in a Patient Doesn’t Always Mean Negligence or Discipline
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Leaving a foreign object (sometimes referred to as a “retained foreign body” or “RFB”) in a patient, such as a sponge, clamp, forceps, surgical needle, guide wire, part of a surgical instrument or other paraphernalia commonly used in […]
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 […]
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 […]
Big News For Nursing Homes: Federal Government’s Ban On Nursing Home Arbitration Blocked
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On November 7, 2016, a Mississippi federal judge temporarily blocked enforcement of the federal government’s ban on mandatory arbitration in cases involving nursing homes. The order from U.S. District Judge Michael P. Mills granted a preliminary injunction sought […]
Nursing Home Chain Reaches Record High False Claims Act Settlement With DOJ
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 24, 2016, the U.S. Department of Justice (DOJ) announced that Life Care Centers of America will be paying $145 million to end False Claims Act (FCA) litigation that alleged the company submitted false claims to Medicare […]