Office of Inspector General (OIG) investigation defense legal representation

Florida Surgeon, Device Company Owner Arrested For Paying Bribes, Kickbacks

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

On September 7, 2021, federal prosecutors announced the arrest of a Florida surgeon and owner of device company SpineFrontier Inc on charges of bribing surgeons to use products by paying sham consulting fees.

Accused in an indictment in Boston federal court for violating the federal Anti-Kickback Statute (AKS) and conspiracy to commit money laundering, is the company’s founder and CEO from Florida. Also charged in the indictment were the company’s chief financial officer from Massachusetts and the device company itself. The charges of AKS violations carry a maximum prison sentence of 10 years, while the money […]

By The Health Law Firm|2024-10-22T14:22:20-04:00July 15, 2024|Health Facilities Law Blog, In the Know|

What Payers Are Considered to Be “Federal Payers” Under the Federal Anti-kickback Statute?

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

The federal Anti-Kickback Statute prohibits remuneration in relation to the provision of a “good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program.” 42 U.S.C. § 1320a-7b(b). The Anti-Kickback Statute goes on to define “federal health care program” as any government-funded plan or program that provides health benefits or any state health care program. 42 U.S.C. § 1320a-7b(f). But exactly which payers are considered Federal health care programs? […]

By The Health Law Firm|2024-03-14T09:59:21-04:00September 5, 2023|Mental Health Law Blog|

Doctor Indicted in $1.3 Million Medicare Fraud Kickback Case Seeks Reinstatement of Medicare Billing Privileges

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

On November 2, 2021, a doctor and his wife who had been indicted for their roles in a $1.3 million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. The doctor argued that the bail condition impeded his ability to practice medicine. Additionally, the doctor indicated that he was seeking to directly address CMS and the Medical Practice’s ability to bill Medicare and Medicaid.

According to the brief, the defendants argued that the court should not get involved in a licensed physician’s medical practice. They argued that this is the role […]

By The Health Law Firm|2024-03-14T09:59:28-04:00June 10, 2023|Health Facilities Law Blog|

Doctors Beware: Genetic Testing Scams Rip off Government Payers for Hundreds of Millions – Part 1 of 2

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

Several genetic testing companies have come into the spotlight for allegations of ripping off Medicare and False Claims Act (FCA) violations. Health care professionals need to be aware of these types of schemes and the dangers they may face if involved. In each of these cases, the companies agreed to pay a settlement in the millions to resolve allegations they submitted claims for unnecessary genetic testing.

This is part one of a two-part blog series. […]

By The Health Law Firm|2024-03-14T09:59:45-04:00March 25, 2021|Health Facilities Law Blog|

HHS Announces Proposed Rules to Reform Stark Law and AKS Regulations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On October 9, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued two proposed rules to reform the federal Stark Law (dealing with prohibited self-referrals) and Anti-Kickback Statute (AKS) (addressing giving or receiving any thing of value in exchange for a patient referral) regulations.

The long-awaited proposed rules aim to “modernize and clarify” federal laws relevant to value-based and patient coordinated care programs. The proposals would ease the compliance burden for healthcare providers across the industry while maintaining strong safeguards […]

By The Health Law Firm|2024-03-14T10:00:08-04:00December 5, 2019|Health Facilities Law Blog|

Florida Doctor Charged for $2.1 Billion Medicare Fraud; Largest Healthcare Fraud Scheme Ever Reported

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. According to prosecutors, the doctor allegedly authorized genetic testing for patients he never met, in a state where he’s not licensed to practice.

The vast fraud scheme totaled $2.1 billion worth of false Medicare and Medicaid claims between July 2018 and January 2019. The physician is being charged in the United States District Court of New Jersey with […]

By The Health Law Firm|2024-03-14T10:00:08-04:00December 5, 2019|Medical Education Law Blog|

Florida Doctor Charged in Largest Medicare Fraud Scheme Ever Reported

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

On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. According to prosecutors, the doctor allegedly authorized genetic testing for patients he never met, in a state where he’s not licensed to practice.

The vast fraud scheme totaled $2.1 billion worth of false Medicare and Medicaid claims between July 2018 and January 2019. The physician is being charged in the United States District Court of New Jersey with conspiracy to commit health care fraud.

Fraudulent Orders for […]

By The Health Law Firm|2024-03-14T10:00:08-04:00November 22, 2019|Pharmacy Law Blog|

Genetic Testing Scams Ripping off Government Programs for Millions, Part 1 of 2

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

Several genetic testing companies have come into the spotlight for allegations of ripping off Medicare and False Claims Act (FCA) violations. Health care professionals need to be aware of these types of schemes and the dangers they may face if involved. In each of these cases, the companies agreed to a pay a settlement in the millions to resolve allegations they submitted claims for unnecessary genetic testing.

This is part one of a two part blog series. […]

By The Health Law Firm|2024-03-14T10:00:14-04:00May 10, 2019|Health Facilities Law Blog|