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Signing False Medicare Claims Lands Nurse Behind Bars for 30 Months

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

A Detroit-area registered nurse was sentenced on November 19, 2012, to 30 months in federal prison for his alleged part in a nearly $13.8 million Medicare fraud scheme. According to a Department of Justice (DOJ) press release, he will serve probation after being released from prison. He was also ordered to pay more than $450,000 in restitution, together with his co-defendants.

Click here to read the entire press release from the DOJ.

Nurse Signed Medical Records for Services Never Rendered.

According to the nurse’s plea agreement, from […]

By The Health Law Firm|2024-03-14T10:00:41-04:00June 1, 2018|Home health care facility, Medicare, Medicare Fraud, The Health Law Firm Blog|

Florida Woman Arrested for $400,000 Medicaid Fraud Scheme

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

The owner of Homecare Unlimited, LLC, in Jacksonville, Florida, has allegedly been arrested for defrauding Medicaid out of more than $400,000, according to the Florida Office of the Attorney General (AG). The owner is charged with billing Florida’s Aged and Disabled Adult Waiver Program for services not rendered and billing for services to ineligible recipients. This Medicaid fraud scheme allegedly happened between January 2008 and June 2011.

To read the press release from the AG, click here.

Business Owner Accused of Fraud and Grand Theft.

The Florida Times-Union states that some of the people the business owner claimed to have provided services for […]

By The Health Law Firm|2024-03-14T10:00:45-04:00June 1, 2018|Home health care facility, In the News, Medicaid, Medicaid audit, The Health Law Firm Blog|

Avoiding HIPAA Violations

By Michael L. Smith, JD, RRT

Every respiratory therapist knows that the Health Insurance Portability and Accountability Act (HIPAA) requires hospitals and health care providers to maintain the confidentiality of their patients’ protected health information (PHI). RTs may not know that the Department of Health and Human Services (HHS) Office of Civil Rights (OCR) is investigating HIPAA violations and imposing sanctions on hospitals and other covered entities for violations. RTs also may not know that the Department of Justice is criminally prosecuting particularly egregious HIPAA violations.

HIPAA violations still occur despite the fact that we have years of training and experience in protecting patient privacy. Hospitals and health […]

By The Health Law Firm|2024-03-14T10:00:25-04:00June 1, 2018|In the Know, The Health Law Firm Blog|

Patient-supplied Respiratory Equipment in the Hospital

By Michael L. Smith, JD, RRT

Hospitals and respiratory therapists regularly receive requests from patients asking to use their own respiratory therapy equipment in the hospital. Chronic pulmonary patients are generally reluctant to change their treatment regimen and may request they be permitted to continue using their home ventilators or positive airway pressure units in the hospital. Generally, hospitals should not allow patients to use their own medical equipment.

Patient-supplied medical equipment poses numerous risks for hospitals and their RTs. Patient supplied equipment may be a different model than what the hospital’s RTs and other staff routinely use, which can contribute to […]

By The Health Law Firm|2024-03-14T10:00:25-04:00June 1, 2018|In the Know, The Health Law Firm Blog|

Responding to a Medicare Audit – Practice Tips

Although you may speak of a “routine” Medicare audit, there is really no such creature. This is like saying you have a “routine IRS audit.” The fact is that there is some item you have claimed as a Medicare provider or the amount of claims Medicare has paid in a certain category that has caused you or your practice to be audited.

Having too many claims for level five CPT codes might, for example, cause you to be audited. Having multiple claims submitted for the same date of service, may cause you to be audited. Submitting claims for CPT codes outside of your medical speciality area, might cause you to be audited. Having the dollar amount of claims greater than the […]

By The Health Law Firm|2024-03-14T10:00:25-04:00June 1, 2018|Health Care Industry, In the Know, Medicare, The Health Law Firm Blog|

Cheating, Irregular Behavior and Other Maladies Plaguing Future Physicians: A Two-Part Series

The road to becoming a physician is paved with many unique challenges. The uphill battle begins with rigorous undergraduate course work, followed by the MCAT and medical school applications. Upon acceptance into medical school, the USMLE (United States Medical Licensing Examination) and its STEP 1 and STEP 2 exams provide another hurdle. At any of these stages, a student can be accused of numerous faults including cheating, misrepresentation, falsification of information, unfair advantages and the many faces of “irregular behavior.”

Today’s post focuses on the challenges imposed on a student prior to entering medical school. On Friday, the implications of various forms of “misconduct” for med students will be dissected (including USMLE irregular behavior and the case of NBME and FSMB […]

By The Health Law Firm|2024-03-14T10:00:26-04:00June 1, 2018|Health Care Industry, In the Know, Medical Students, The Health Law Firm Blog|

Florida Doctor Arrested for Drug Sales and Other Criminal Charges

Drug trafficking charges against a medical doctor are not a new concept, especially in Florida. Recent pill mill busts throughout the state have resulted in an omnipresent DEA, always on the lookout for illegal drug sales by pharmacies, pharmacists, pain management clinics and physicians. However, the recent arrest of a Central Florida doctor extends beyond the run of the mill “pill mill” bust, as the accusations in this case involve sex with a minor and delivering a controlled substance to a minor.

According to Florida Today, this Central Florida doctor was arrested Tuesday following a raid by the Florida Department of Law Enforcement. This is his second arrest after he was charged with possession of marijuana […]

By The Health Law Firm|2024-03-14T10:00:26-04:00June 1, 2018|Health Care Industry, In the Know, In the News, Pain Management, Pharmacy, The Health Law Firm Blog|

Legally Speaking: Psychologists, Mental Health Counselors, Social Workers and Therapists

Today begins a multi-part series focusing on the legal matters and needs concerning healthcare professionals, starting with those who practice in the field of psychology, including psychologists, Licensed Mental Health Counselors (LMHCs), Clinical Social Workers (CSWs) and Licensed Marriage and Family Therapists (LMFTs).

Supervised by the Board of Psychology and the Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling, psychologists, Licensed Mental Health Counselors, Clinical Social Workers and Licensed Marriage and Family Therapists are responsible for an important component of patient care: mental health. Insuring the mental health of a patient does not come without risks.

For this reason, every mental health professional should carry professional liability insurance that […]

By The Health Law Firm|2024-03-14T10:00:26-04:00June 1, 2018|Health Care Industry, In the Know, Mental Health, The Health Law Firm Blog|

Cheating, Irregular Behavior and Other Maladies Plaguing Future Physicians: A Two-Part Series

The road to becoming a physician is paved with many unique challenges. The uphill battle begins with rigorous undergraduate course work, followed by the MCAT and medical school applications. Upon acceptance into medical school, you are faced with the USMLE (United States Medical Licensing Examination) and its STEP 1 and STEP 2 exams. At any of these stages, a student can be accused of numerous faults including cheating, misrepresentation, falsification of information, unfair advantages and the many faces of “irregular behavior.”

On Wednesday, the challenges of a pre-med student were discussed. Today’s post focuses on the challenges imposed on a student after entering medical school.

So you made it to medical school. Congratulations! After years of slaving away in biology and […]

By The Health Law Firm|2024-03-14T10:00:26-04:00June 1, 2018|Health Care Industry, In the Know, Medical Students, NBME, The Health Law Firm Blog|

Accused of “Irregular Behavior” on Your USMLE Step Exams: What to Do

Many students, foreign medical graduates and those applying to receive a medical license in the United States find themselves accused of “irregular behavior” while taking the Step 1, Step 2 or Step 3 exams of the United States Medical Licensing Examinations (USMLE) administered by the National Board of Medical Examiners (NBME). Often the conduct turns out to be something that is not significant, was inadvertent, was not intended to provide any unfair advantage to the test-taker or is otherwise justifiable or explainable. Nevertheless, because of the extremely serious consequences a finding of “irregular behavior” may have, the applicant should act immediately […]

By The Health Law Firm|2024-03-14T10:00:26-04:00June 1, 2018|Health Care Industry, In the Know, Medicaid, NBME, The Health Law Firm Blog|