Health Facilities Law Blog | The Health Law Firm Blog

HHS Releases Final Substance Use Disorder Confidentiality Rule

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

On February 8, 2024, the U.S. Department of Health and Human Services (HHS) released a final rule modifying the Confidentiality of Substance Use Disorder (SUD) Patient Records federal regulations (42 C.F.R. Part 2). The new regulation will supposedly help ensure that health care providers have more complete information when treating patients with substance use disorders and improve that regulations compatibility with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Regulations.

Background.

The SUD final rule came out of the bipartisan Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which, among other things, required HHS to align […]

18 Former NBA Players Indicted For Alleged $4 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 October 7, 2021, 18 former NBA players were charged in New York federal court for an alleged health insurance fraud scheme to rip off the league’s benefit plan, according to an indictment filed in the Southern District of New York. The defendants allegedly engaged in a scheme from at least 2017 through 2020 which involved the submission of fraudulent claims for reimbursement of medical and dental services that were not provided, prosecutors said. The claims totaled nearly $4 million.

The NBA Players Health and Welfare Benefit Plan provide additional medical coverage on top of […]

By The Health Law Firm|2024-05-04T20:00:14-04:00May 6, 2024|Health Facilities Law Blog|

8 Major Chinese Med Schools Taken Off World Directory Relied on by ECFMG and USMLE

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

In April 2014, the new World Directory of Medical Schools (“World Directory”) was published. It took over as the definitive list of medical schools in the world (yes, the whole world). There are 180 Chinese medical schools listed on the World Directory of Medical Schools. Medical graduates from these schools are routinely eligible to take the United States Medical Licensing Examination (USMLE) Step exams, required for licensing in the United States, after applying and obtaining permission through the Educational Commission for Foreign Medical Graduates (ECFMG).

However, in 2019, eight (8) previously recognized Chinese medical schools were […]

By The Health Law Firm|2024-05-03T20:00:03-04:00May 5, 2024|Health Facilities Law Blog|

9th Circuit Court Rules Former Nurse Can Proceed With Med Mal Suit Against VA Hospital

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

On September 29, 2021, the U.S. Court of Appeals for the Ninth Circuit ruled that a former federal employee can sue the United States under the Federal Tort Claims Act (FTCA). The suit alleges medical negligence that occurred during psychiatric treatment for a non-workplace-related injury.

As a result, the three-judge panel of the appeals court said that U.S. Navy veteran and VA nurse S.H.s’ lawsuit against a Seattle VA hospital can proceed. (Please note: we are not providing the nurse’s name out of respect for her privacy.)

In 2019, the district court dismissed S.H.’s federal tort lawsuit […]

By The Health Law Firm|2024-04-30T20:00:37-04:00May 2, 2024|Health Facilities Law Blog|

Florida Gov Signs Sweeping COVID-19 Liability Protections Into Law

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

On March 29, 2021, Florida Gov. Ron DeSantis signed a bill that protects businesses, governments, and healthcare providers in Florida from COVID-19 lawsuits if they make a reasonable effort to follow guidelines to prevent the spread of coronavirus (whatever that means). Specifically, the measure gives civil immunity to corporations, hospitals, nursing homes, government entities, schools, and churches as long as the alleged negligence doesn’t involve gross negligence or intentional misconduct. The House Passed S.B. 72 on March 26, in an 83-31 vote, and DeSantis signed it the same day he received it from the […]

By The Health Law Firm|2024-04-28T20:00:06-04:00April 30, 2024|Health Facilities 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. […]

By The Health Law Firm|2024-04-08T13:46:37-04:00April 29, 2024|Health Facilities Law Blog, Pharmacy Law Blog|

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

By 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 […]

By The Health Law Firm|2024-03-14T09:59:09-04:00April 1, 2024|Dental Law Blog, Health Facilities Law Blog, Nursing Law Blog|

Male Surgeon Wins $15 Million Verdict in Suit Based on “Reverse Discrimination” and Anti-Male Bias; Hospital Requests New Trial

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

In a massive jury verdict awarding a male attending physician more than he requested, a jury found that a hospital demonstrated reverse discrimination and an anti-mail bias in how it handled a female resident physician’s complaint against him.

On January 8, 2024, Thomas Jefferson University Hospital urged a Pennsylvania Federal court to reverse a $15 million judgment against it over its handling of a sexual assault investigation in a gender bias case. In December 2023, a federal jury in the U.S. District Court for the Eastern District of […]

By The Health Law Firm|2024-03-14T09:59:09-04:00March 26, 2024|Health Facilities Law Blog, Mental Health 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 […]

By The Health Law Firm|2024-03-14T09:59:09-04:00March 25, 2024|Health Facilities Law Blog, Nursing 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 The Health Law Firm|2024-03-14T09:59:09-04:00March 25, 2024|Health Facilities Law Blog|