Mental Health Law Blog | The Health Law Firm Blog

What You Need to Know About Preparing and Responding to an Initial Medicaid Audit Request

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

Health care providers in Florida who service Medicaid patients are at a higher risk for audits than anywhere else in the country. The unfortunate truth is that Florida has become synonymous with health care fraud. As a result, auditing and subsequent overpayment demands are very real possibilities.

The Health Law Firm and its legal professionals represent health care providers in virtually every aspect of Medicaid program audits, investigations and litigation. These include physicians, medical groups, mental health professionals, pharmacies, nursing homes, home health agencies, hospitals and other […]

By The Health Law Firm|2024-03-14T10:01:52-04:00May 15, 2018|Mental Health Law Blog|

Jury Awards $4.4 Million To Chicago Anesthesiologist Defrauded By Business Associate

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

On June 9, 2017, a jury in Illinois awarded a Chicago-area anesthesiologist nearly $4.4 million. The jury unanimously agreed that his business associate defrauded him on a revenue sharing agreement and fraudulently reported his earnings to the Internal Revenue Service (IRS).

The jury found that Dr. Martin R. Hall, owner of Keystone Orthopedic Specialists SC (Keystone), stuck Dr. Nicholas Angelopoulos with unwarranted expenses throughout the course of their business dealings. The jury ultimately agreed in favor of Dr. Angelopoulos on all five counts, including two breach of contract counts, breach of fiduciary duty, fraud and violation […]

By The Health Law Firm|2024-03-14T10:01:53-04:00May 15, 2018|Mental Health Law Blog|

Responding to a Medicaid Audit: Important Tips You Should Know

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

The Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), Bureau of Medicaid Program Integrity, is the Florida agency responsible for routine audits of Medicaid health care providers. Each state has a similar state agency, though it may have a different name. The agency’s job is to ensure that the Medicaid Program was properly billed for services. Health care professionals receiving large payments from Medicaid or who practice in areas that typically see the most abuse or fraudulent billings, are the ones most likely to be audited. These include pediatricians, Ob/Gyns, family practice physicians […]

By The Health Law Firm|2024-03-14T10:01:53-04:00May 15, 2018|Mental Health Law Blog|

Florida Government Officer Charged in Billion Dollar Medicare Fraud

By The Health Law Firm|2024-03-14T10:01:53-04:00May 15, 2018|Mental Health Law Blog|

Inmates Family Sues Jail After Improper Care

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

Orange Country Jail Sued.

A wrongful death suit has been filed against Orange County Jail due to what some are saying was a preventable death. The suit was filed directly against Robert Buck, the head of the jails health services department, along with four nurses that cared for the late inmate.

Dog Bites Leads to Death In Jail.

In 2015, Max Gracia was arrested. During his arrest, he sustained many bites from one of the police dogs. He was treated in the hospital until he was stable. Once he was moved to the jail cell he was found unconscious […]

By The Health Law Firm|2024-03-14T10:01:53-04:00May 15, 2018|Mental Health Law Blog|

The 20 Major Mistakes Physicians Make After Being Notified of a Department of Health Investigation

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

The investigation of a complaint which could lead to the revocation of a physician’s license to practice, usually starts with a simple letter from the Department of Health (DOH). This is a very serious legal matter and it should be treated as such by the physician who receives it. Yet, in many cases, attorneys are consulted by physicians after the entire investigation is over and the damage is already done. Often, the mistakes that have been made severely compromise an attorney’s ability to achieve a favorable result for the physician.

These are the ten biggest mistakes […]

By The Health Law Firm|2024-03-14T10:01:53-04:00May 15, 2018|Mental Health Law Blog|

CMS Approves Five Year Extension of Florida Medicaid Managed Care Demonstration

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

On August 3, 2017, the Centers for Medicare & Medicaid Services (CMS) approved a five-year extension of Florida’s Managed Medical Assistance (MMA) section 1115 demonstration. It allows the state to operate a capitated Medicaid managed care program and a low-income pool (LIP) to provide continuing support for the safety net providers that furnish charity care to the uninsured.

CMS touted the approval as part of its efforts to give states more flexibility to design and tailor Medicaid programs to their specific needs.

Tools For More Effective Medicaid Programs.

This demonstration provides the state with new […]

By The Health Law Firm|2024-03-14T10:01:53-04:00May 15, 2018|Mental Health Law Blog|

Florida Department of Health and Law Enforcement Investigate School Providing Nurse Practitioner Courses

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

A subpoena purportedly issued by the Clerk of Court for Seminole County, Florida, recently requested academic records on advanced registered nurse practitioner (ARNP) students, including preceptorship agreements for clinical courses they had taken. A follow-up inquiry revealed that the Florida Department of Health was behind the subpoena, seeking evidence concerning possible fraudulent practices involving the supervision of those clinicals.

Apparently South University, which has its main campus and headquarters located in Savannah, Georgia, but offers courses in Florida, had agreements with one or more physicians in the Orlando area to furnish training for nurse practitioner […]

By The Health Law Firm|2024-03-14T10:01:53-04:00May 15, 2018|Mental Health Law Blog|

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 Medicare regional carriers (now called Medicare Administrative Contractors or “MACs”) performed in the past. They are specifically charged by CMS to data mine, identify, and investigate potentially fraudulent behavior in Medicare providers.

Because of this, health care providers that receive a letter from the ZPIC often see it as a potential death sentence, and certainly […]

By The Health Law Firm|2024-03-14T10:01:53-04:00May 15, 2018|Mental Health Law Blog|

Little Known Facts About State and DOH Investigations That Could Save Your Professional License

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

The notice that you are under investigation may seem nonthreatening. It may come in the mail, be delivered personally by an investigator or you may receive a telephone call from the investigator. This is a very serious matter for you.

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals. Our attorneys represent health care professionals and providers at formal administrative hearings at the Division of Administrative Hearings (DOAH), in defense of administrative complaints and in informal hearings […]

By The Health Law Firm|2024-03-14T10:01:53-04:00May 15, 2018|Mental Health Law Blog|