About The Health Law Firm

The Health Law Firm concentrates on representing health care providers. Our health law attorneys and paralegals have decades of experience in the legal and health care fields. Our health law attorneys include those Board Certified in Health Law, Masters degree trained, former hospital counsel and licensed health care professionals. Our clients include physicians, dentists, nurses, psychiatrists, psychologists, medical students, nursing homes, home health agencies, hospitals, health insurers, medical groups, durable medical equipment (DME) suppliers, and other health care providers.

Esformes Reaches Plea Deal in Major Nursing Home Medicare Fraud Scheme

Attorney and Author George F. Indest III HeadshotBy 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 February 1, 2024, the District Court for the Southern District of Florida announced that Florida nursing home mogul Phillip Esformes had reached a plea deal on pending conspiracy to commit healthcare fraud charges.

Esformes, who then owned more than 30 Miami-area nursing and assisted living facilities, was first charged in July 2016 with what the Department of Justice (DOJ) called a $1 billion, decades-long Medicare fraud and money-laundering scheme. Click here to read the DOJ’s press release. (https://www.justice.gov/opa/pr/three-individuals-charged-1-billion-medicare-fraud-and-money-laundering-scheme)

The Fraudulent Health […]

By |2024-03-14T09:59:08-04:00April 15, 2024|Mental Health Law Blog|

Florida Man Agrees to Plead Guilty in $110 Million Telemedicine 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 February 16, 2024, a Parkland, Florida, man agreed to plead guilty to organizing a Medicare fraud scheme worth $110 million. The federal prosecution is taking place in the U.S. District Court for the District of Massachusetts. The fraud was allegedly perpetrated through two Florida companies the man owned, Expansion Media, LLC, and Hybrid Management Group, LLC. According to federal prosecutors in Boston, the scheme involved utilizing telemedicine and telemarketing enterprises to create fabricated orders for medical equipment, particularly knee braces. The scheme allegedly lasted from March 2016 to January 2023.

Specifics on this Medicare Fraud Scheme.

The […]

By |2024-07-30T09:49:38-04:00April 15, 2024|Pharmacy Law Blog|

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 (PFS). However, the final rule increased payment rates for outpatient services and expanded telehealth services. The rule went into effect January 1, 2024.

Physician Fee Schedule Rate Reductions; Counselors Added.

The overall payment rates under the 2024 PFS were reduced by 1.25 percent for 2024. The conversion factor is $32.74, which is a $1.15 decrease from 2023. Physicians’ Medicare reimbursements […]

By |2024-07-30T09:52:50-04:00April 15, 2024|Pharmacy Law Blog|

California Dental Practice Pays $23,000 Settlement For Potential HIPAA Privacy Violations Involving Yelp Posts

Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 14, 2022, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) settled with New Vision Dental (NVD) over a potential HIPAA Privacy violation. The California-based dental practice paid $23,000 to OCR and agreed to implement a corrective action plan after allegedly including protected health information (PHI) in its responses to reviews on Yelp.

The Complaint and Investigation.

On November 29, 2017, the Office for Civil Rights (OCR) received a complaint alleging New Vision Dental had posted responses to several unfavorable reviews by patients on Yelp and frequently disclosed confidential protected health […]

By |2024-04-10T20:00:49-04:00April 12, 2024|Dental Law Blog|

Florida Pharmacy Sues Claiming HHS Wrongly Terminated it from Federal PrEP Program

Attorney and Author George F. Indest III HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 25, 2024, a pharmacy in Celebration, Florida, alleged HHS abruptly terminated it from a federal program that provides free access to preexposure prophylaxis HIV-prevention (PrEP) medication. Turner Brothers Inc., which does business as Turner Drugs, filed a motion in its lawsuit in the U.S. District Court for the District of Columbia for a temporary restraining order and preliminary injunction.  In the motion, Turner Drugs asked a D.C. federal judge to force the U.S. Department of Health and Human Services (HHS) and two contractors to reinstate it to […]
By |2024-07-30T09:53:49-04:00April 9, 2024|Pharmacy Law Blog|

Florida Man Pleads Guilty To $36.2 Million Telehealth 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 March 20th, 2024, the U.S. Attorney’s Office, in the Middle District of Florida, announced that a Florida man pled guilty to conspiring to commit health care fraud in a $36.2 million telemedicine fraud scheme. As part of the scheme, the Fort Lauderdale-based pharmacy owner paid kickbacks and bribes to telemarketers and telemedicine providers for medically unnecessary prescriptions that were billed to Medicare.

Kickbacks & Bribes to Telemarketing Companies.

According to the plea agreement, the Fort Lauderdale-based, Florida man and his co-conspirators owned and operated pharmacies participating in the Medicare program. From September 2018 through November 2021, they […]

By |2024-04-08T13:33:43-04:00April 8, 2024|The Health Law Firm Blog|

Many Adverse NPDB Actions Are Reported That Should Not Be; Here Are Examples

Author headshot standing in dark suit with red tie against a dark grey backgroundBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
We are constantly being contacted by physicians, nurse practitioners and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports.  Often, we find that an adverse report has been made when the matter should not have been.  Federal regulations and NPDB guidelines establish the types of incidents that are authorized to be reported to the NPDB.  When an employer or other organization makes an improper report, it should be challenged and removed.
Types of Matters That Are Not Authorized for […]

Humana Agrees To Pay $11.2 Million to End Nurses’ Overtime Suit

By George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law

On September 27, 2021, Humana agreed to pay $11.2 million to end claims that the health insurance company denied a group of nurses overtime pay by misclassifying them as exempt employees. A Wisconsin federal judge approved the deal with Humana, and a group of more than 200 nurses reached, securing a $36,000 average payment for each nurse involved in the suit.

A Violation of the Fair Labor Standards Act (FLSA).

This dispute stems from a class-action lawsuit filed in 2017 alleging that Humana misclassified its clinical nurse advisers as exempt employees and denied them overtime compensation, violating […]

By |2024-03-24T20:02:08-04:00March 26, 2024|In the News, Nursing Law Blog|

Dental Office Manager Sentenced to One Year in Prison for Defrauding Medicaid Out of More Than $813,000

George Indest Headshot

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 to the U.S. Attorney’s Office for Washington, D.C.

She was indicted in January 2019, along with the dentist who ran the practice. The dentist pleaded guilty in May 2021 in the U.S. District Court for the District of Columbia and reportedly admitted that she received over $813,000 through false billings.

The Fraudulent Billing Scheme.

Both the office manager and […]

By |2024-03-24T20:02:07-04:00March 26, 2024|Dental Law Blog|
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