Pharmacy Law Blog | The Health Law Firm Blog

Humana Agrees To Pay $11.2 Million Settlement in Nursing 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 The Health Law Firm|2024-07-30T09:08:16-04:00July 14, 2024|Pharmacy Law 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, […]

By The Health Law Firm|2024-07-30T09:34:15-04:00May 23, 2024|Nursing Law Blog, Pharmacy 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|2024-07-30T09:36:58-04:00May 1, 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. […]

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

Texas Hospital’s COVID-19 Vaccine Mandate Upheld by Federal Court

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

As some states lift COVID-19 restrictions, the business community is still grappling with the dynamic between the COVID-19 vaccine and workplace operations. To address this, some U.S. employers have elected to adopt mandatory vaccination policies. These policies, in essence, require that, subject to a few exceptions, all employees must receive the COVID-19 vaccine as a condition of continued employment.

Not surprisingly, we see various legal challenges to mandatory COVID-19 vaccination policies across the country. On June 12, 2021, a federal court in Texas became the first to rule on the permissibility of such policies […]

By The Health Law Firm|2024-07-30T09:42:43-04:00April 23, 2024|Pharmacy Law Blog|

Walgreens Accused of Providing Insufficient COBRA Notices, Class Action Lawsuit Says

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

On November 30, 2022, a group of former Walgreens workers filed a proposed class action in Florida federal court that accuses the pharmacy chain of sending confusing, incomplete COBRA notices. The former employees sued, saying the company purposely sent former employees “haphazard and piecemeal” information about their rights to continued insurance coverage under the federal COBRA law to save itself money.

As a result, the lawsuit claims, they lost access to their medical coverage when they were terminated and, therefore, had to pay out-of-pocket to cover medical expenses.

Details of the Class Action.

The plaintiffs filed the […]

By The Health Law Firm|2024-07-30T09:46:28-04:00April 19, 2024|Pharmacy 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|2024-07-30T09:49:38-04:00April 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 The Health Law Firm|2024-07-30T09:52:50-04:00April 15, 2024|Pharmacy Law Blog|

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

By 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 The Health Law Firm|2024-07-30T09:53:49-04:00April 9, 2024|Pharmacy Law Blog|

Walgreens Accused of Providing Insufficient COBRA Notices, Class Action Says

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

On November 30, 2022, a group of former Walgreens workers filed a proposed class action in Florida federal court that accuses the pharmacy chain of sending confusing, incomplete COBRA notices. The former employees sued, saying the company purposely sent former employees “haphazard and piece-meal” information about their rights to continued insurance coverage under the federal COBRA law to save itself money.

As a result, they lost access to their medical coverage when terminated and therefore had to pay out of pocket to cover medical expenses.

Details of the Class Action.

The plaintiffs filed the class action complaint against Walgreen […]

By The Health Law Firm|2024-03-20T20:01:55-04:00March 22, 2024|Pharmacy Law Blog|