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 […]
Florid Man Strikes Again–Government Asks for Life Sentence for Florida Man in $187M Medicare Fraud Case
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 August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one […]
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. § […]
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 […]
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 […]
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 […]
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 […]
Feds Charge Three For Role in Multi-Million Dollar Scheme to Defraud Medicare, HIPAA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three people for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient data and sold it to the purported mastermind, who used it to […]
Three People Charged For $109 Million Scheme to Defraud Medicare & HIPAA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three people for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient data and sold it to the purported mastermind, who used it to […]
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 […]
Three Charged For Roles in $109 Million Medicare Fraud Scheme, HIPAA Violations
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three people for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient data and sold it to the purported mastermind, who used it to […]
Dentists, What Should You Do If You Or Your Staff Tests Positive For COVID-19 at Your Practice?
By Achal A. Aggarwal, M.B.A., J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law You or a member of your staff has a confirmed case of COVID-19. What now? Your primary concern is for the individual affected. However, as a health professional operating a professional practice, […]
Question: What Should You, as a Dentist, Do If You Or One of Your Employees Tests Positive For the COVID-19 Coronavirus?
By Achal A. Aggarwal, M.B.A., J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law You or a member of your staff has a confirmed case of COVID-19. What now? Your primary concern is for the individual affected. However, as a health professional operating a professional practice, […]
Prosecutors Push to Keep Florida TeleMedicine Suspect in Jail for $424 Million 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 19, 2020, federal prosecutors in New Jersey federal court pushed to keep a suspect involved in a $424 million telemedicine scheme in jail. Authorities called him an “unrepentant conman” who carried out one of the largest […]
Florida Prosecutors Want Telehealth Suspect to Remain in Jail For $424 Million 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 19, 2020, federal prosecutors in New Jersey federal court pushed to keep a suspect involved in a $424 million telemedicine scheme in jail. Authorities called him an “unrepentant conman” who carried out one of the largest […]
Prosecutors Push To Keep Florida Telehealth Fraud Suspect in Jail for $424 Million Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On March 19, 2020, federal prosecutors in New Jersey federal court pushed to keep a suspect involved in a $424 million telemedicine scheme in jail. Authorities called him an “unrepentant conman” who carried out one of the largest […]
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 […]
Telemedicine Company Owners Charged in $56 Million Kickback Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On February 5, 2020, the owners of two telemedicine companies were charged in New Jersey federal court with defrauding Medicare in an alleged $56 million telehealth scheme involving orthotic braces. Some of the fraud alleged to have occurred […]
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. […]
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 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 […]
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 […]
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 […]
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 […]
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 […]
Florida Pharmacist Gets More Than Six Years in Prison For Role in Compounding 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 29, 2018, a Florida pharmacist was sentenced to six and a half years in prison and ordered to pay $3.4 million, for her role in a scheme to defraud the government. Marjorie Robinson pled guilty one […]
New Update to the Medicare Program Integrity Manual Issued by CMS
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On June 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued further guidance for reporting and reviewing final adverse legal actions (ALAs) in provider enrollment applications. Section 15.5.3 of the Medicare Program Integrity Manual (MPIM) was […]
Texas Doctor Charged With Faking Diagnoses in $240 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 May 14, 2018, a Texas doctor was arrested on charges he led a $240 million health care fraud and money laundering scheme. He allegedly falsely diagnosed at least 16 patients with degenerative diseases and gave them unneeded […]
More Medicare Audits Now Than Ever Before
George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in the Legal Specialty of Health Law A Medicare audit, whether it is performed by a contractor of the Centers for Medicare & Medicaid Services (CMS), or by another organization, can be a daunting process. It is never “routine” and should never […]
Health Care Fraud Puts Miami Man in Jail
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law 4.5 Year Sentence for Role in Fraud. A Miami Man voluntarily returned to Miami from Cuba and was immediately met with a 4.5-year long prison sentence. Jose Gerardo Gonzalez, played a role in a scheme to defraud public […]
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 […]
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 […]
Jury Finds Four New Orleans Doctors and Others Guilty for Participation in $13.6 Million Medicare Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 9, 2017, a federal jury found four New Orleans doctors and two others guilty for their participation in a Medicare fraud scheme. According to prosecutors the defendants netted more than $13.6 million in fraudulent Medicare reimbursements. […]