Health Care Industry | The Health Law Firm Blog

MedPAC Wants to Hold Accountable Care Organizations More Accountable

By Lance O. Leider, J.D., The Health Law Firm

As the Centers for Medicare and Medicaid Services (CMS) prepares to designate the next class of accountable care organizations (ACOs), the agency sought the advice and input of the Medicare Payment Advisory Commission (MedPAC) on how to proceed. MedPAC is an independent Congressional Agency established to advise the U.S. Congress on issues affecting Medicare.

Click here to read our previous blog on the background and purpose of ACOs.

MedPAC Suggests All Medicare Shared Savings Program ACOs Join the Two-Sided Risk Model.

In response to the request from the CMS, MedPAC reiterated its previous position that it would like to see […]

By The Health Law Firm|2024-03-14T10:00:53-04:00June 1, 2018|ACO, Health Care Industry, In the Know, Medicare, The Health Law Firm Blog|

The American Academy of Family Physicians Releases Third List for Choosing Wisely Campaign

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

On September 24, 2013, the American Academy of Family Physicians (AAFP) released its third list of commonly prescribed tests and procedures that may not be necessary. This list is part of the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely campaign.

The Choosing Wisely Campaign was initiated to give patients a catalog of procedures, tests and treatments that have been overused, misused or have been identified as ineffective. Since its launch in April 2012, more than fifty (50) medical specialty societies have created lists of procedures, tests and drug treatments that deserve […]

By The Health Law Firm|2024-03-14T10:00:52-04:00June 1, 2018|Health Care Industry, The Health Law Firm Blog, Whistleblower|

Miami “Rock Doc” Arrested on Medicare Fraud Charges

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

An osteopathic physician in Miami, Florida, dubbed the “Rock Doc,” was arrested on September 30, 2013. He is charged with twelve (12) counts of health care fraud, according to the Department of Justice (DOJ). The “Rock Doc” is accused of falsely billing the Medicare program for physical therapy procedures, such as massages and electrical stimulation, which were not necessary. If convicted the doctor faces up to ten (10) years in prison and a $250,000 fine.

Click here to read the press release from the DOJ.

In 2010, this osteopathic physician was the feature […]

By The Health Law Firm|2024-03-14T10:00:52-04:00June 1, 2018|Health Care Industry, Medicare, Medicare Audit, Medicare Fraud, The Health Law Firm Blog|

Orlando Health’s Restructuring Efforts Might Mean Pay Cuts and Layoffs for Employees

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

Many employees at Orlando Health might be getting hit hard in the wallet with pay cuts schedule for later this year. According to the Orlando Sentinel, the eight-hospital health system notified its night-shift workers that their differential pay would be trimmed by several dollars an hour. For some employees that could be a twenty percent (20%) reduction in salary. The differential pay cuts are scheduled to take effect on September 8, 2013.

Meanwhile the hospital allegedly raised prices in the cafeteria, reduced the tuition reimbursement benefit, cut some workers hours and made a number of […]

By The Health Law Firm|2024-03-14T10:00:51-04:00June 1, 2018|Health Care Industry, In the Know, In the News, The Health Law Firm Blog|

Physician Payment Sunshine Act Deadline is Here-Are You Ready?

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

As of August 1, 2013, the Physician Payment Sunshine Act (Sunshine Act) goes into effect. The Sunshine Act, contained in Section 6002 of the Patient Protection and Affordable Care Act (PPACA), is designed to highlight the financial relationship between doctors and the manufacturers of medical devices and pharmaceuticals. The act requires that light be shined on the payments being made to physicians by pharmaceutical and medical device manufacturers, bringing these out into the “sunshine.”

Some of the items tracked include gifts worth more than $10, […]

By The Health Law Firm|2024-03-14T10:00:51-04:00June 1, 2018|Affordable Care Act, Health Care Industry, In the Know, The Health Law Firm Blog|

Top Medicare Prescribers Collect Speaking Fees from Drug Makers-Coincidence?

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

A recent investigation by ProPublica found that certain doctors who prescribed certain drug brands the most, also have financial ties to the companies that manufacture those prescription drugs. Using Medicare payment data, ProPublica and National Public Radio (NPR) researched physicians who prescribed the most heavily promoted drugs of 2010 and 2011. It was discovered that many of the doctors allegedly had financial relationships with prescription drug manufacturers. ProPublica states that they initiated this investigation out of fear that pharmaceutical payments are influencing […]

By The Health Law Firm|2024-03-14T10:00:50-04:00June 1, 2018|Affordable Care Act, Health Care Industry, Medicare, Pharmaceutical Drugs, The Health Law Firm Blog, Whistleblower|

New Details Released on Drug Enforcement Administration’s Investigation of Central Florida Pain Management Clinic

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

The Drug Enforcement Administration’s (DEA) investigation into a Longwood, Florida, pain management clinic continues. More details are being revealed about the case. DEA agents along with local police and sheriffs’ deputies raided the pain management clinic on June 14, 2013. Agents believe the evidence they have gathered suggests the clinic was operating as a “pill mill,” according to the Orlando Sentinel. Officials allegedly seized evidence at the clinic associated with at least ten (10) doctors and other clinic employees. No one has been arrested yet, but documents filed in federal court in Orlando […]

By The Health Law Firm|2024-03-14T10:00:49-04:00June 1, 2018|DEA, Health Care Industry, In the News, Pain Management, Pharmaceutical Drugs, Pharmacy, The Health Law Firm Blog|

Nurses Rx: Medication Administration

From George Indest’s Nursing Law Manual

Nurses face a busy schedule often including a long list of patients and extensive work hours. As a result, they can become overworked and overtired, which may lead to mistakes when carrying out essential job duties like administering medication. An Institute of Medicine (IOM) report titled To Err is Human: Building a Safer Health System (IOM, Dec. 1999) states the deaths from medication errors that take place both in and out of hospitals, more than 7,000 annually, exceed those from workplace injuries. In a separate report, investigation by the Chicago-Tribune states that since 1995, at least 1,720 hospital patients have died and 9,548 others have been injured because of mistakes made by […]

By The Health Law Firm|2024-03-14T10:00:26-04:00June 1, 2018|Health Care Industry, Nurses, Pharmacy, The Health Law Firm Blog|

CVS Refuses to Fill Prescriptions For Some Florida Doctors

The crack down on Florida pill mills continues with CVS pharmacies notifying some doctors that they no longer will fill their prescriptions for certain narcotic medications.

According to Health News Florida, this new policy appears to be limited to Florida, but CVS has not clearly stated what is being used to determine which doctors can have their prescriptions filled for which drugs (though oxycodone definitely appears to be a target).

The Florida Academy of Pain Management, released a letter via email alert that was sent by CVS to a Central Florida physician. The physician who received the letter had never been disciplined by state medical regulators and had extensive pain management training. The email alert, stated that CVS appears […]

By The Health Law Firm|2024-03-14T10:00:27-04:00June 1, 2018|Department of Health, Health Care Industry, In the News, Pain Management, Pharmacy, The Health Law Firm Blog|

Clinical Trial: When Research Goes Wrong

Three patients died in an unapproved medical trial conducted between 2003 and 2004. Now, the executives of Snythes Inc., a medical-device company, are awaiting sentencing this week after pleading guilty to a misdemeanor as “responsible corporate officers,” according to Business Week.

The Synthes officials allegedly bypassed FDA protocol to have surgeons test bone cement in people with spine fractures. The product was not approved for that use, and three people died in the operating room in 2003 and 2004. The patients who died suffered a severe drop in blood pressure following the injections. The surgeons involved could not rule out the bone cement as a factor in the deaths, but it also wasn’t definitively responsible.

Synthes pleaded guilty to corporate health care […]

By The Health Law Firm|2024-03-14T10:00:27-04:00June 1, 2018|Health Care Industry, Medical Research, The Health Law Firm Blog|