Medicare Revocation and the Collateral Damage It Can Cause Health Care Providers
Lasting Consequences of Medicare Revocation.
Former 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. The office manager for Universal Smiles, a D.C.-based dental practice was sentenced for her guilt in bilking Medicaid, according to the U.S. attorney’s office for D.C.
The office manager was indicted in January 2019, along with the dentist who ran the practice. The office manager pleaded guilty in May 2021 in the U.S. District Court for the District of Columbia and admitted she received over $813,000 through false billings.
The Fraudulent Billing […]
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 […]
From the archives: CMS Using Medicare Termination to Squash Doctors Involved in Overprescribing Opioids
Previously published on February 11, 2022
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids and other narcotic medications. We have seen letters sent out by CMS MACs to physicians notifying them that their Medicare program billing privileges have been terminated because CMS has identified them as a provider who is overprescribing.
Nationwide Effort to Run “Pill Mills” Out of Business.
We are well aware of efforts by the various law enforcement authorities at the […]
Florida Federal Judge Says Pediatric Group Must Face Nurse EEOC Suit
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On November 4, 2020, a Florida federal court judge ruled that a Tampa-based pediatric medical group cannot escape a U.S. Equal Employment Opportunity Commission (EEOC) lawsuit, denying its attempts to dismiss the case. According to the federal agency, Pediatric Health Care Alliance unlawfully retaliated against a nurse after the nurse reported a doctor for sexual harassment. U.S. District Judge Thomas Barber denied the medical group’s motion to dismiss, saying it neglected to confront or defend […]
Medical Information Bureau (MIB) Reports and How They Affect Your Insurance Rates
When you apply for insurance, an insurance company will look at various factors regarding your history to determine how much your insurance policy will cost. Most insurers obtain a report from the Medical Information Bureau (“MIB”) and use this in determining the risk you pose and, hence, your policy premium.
The MIB checks past records to identify any errors, misrepresentations, or omissions made on an insurance application. An MIB report is similar to a credit report except it is specifically tailored for the insurance process. Click here to learn more.
What Does the MIB do?
Since 1902, the MIB […]
Three Charged For Roles in Multi-Million Dollar 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 individuals for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient health data and sold it to the purported mastermind, who then used it to submit $109 million in false Medicare claims.
Both individuals obtaining the personal health information were located in Florida, wouldn’t you know it. Each was charged with one […]
You’ve Been Instructed to Report Yourself to an Impaired Practitioners Program, Here’s What You Should Do Next!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In an industry that revolves around helping others, dentists, physicians, and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes lead to unsafe, unprofessional behavior and impairment allegations.
We routinely work with dentists, and other health professionals who are accused by employers, hospitals, competitors, or terminated employees of impairment due to drug or alcohol abuse, or mental impairment, of […]
Impaired Practitioner Programs: What To Do if You’ve Been Accused of Irregular Behavior?
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
In an industry that revolves around helping others, physicians and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes lead to unsafe, unprofessional behavior and impairment allegations.
We routinely work with physicians, nurses, and other health professionals who are accused by employers, hospitals, competitors, or terminated employees of impairment due to drug or alcohol abuse, or mental impairment, of being a “disruptive physician” or of sexual boundary issues. However, not all physicians and health […]