March, 2013

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Florida Cardiologist Sentenced to Six Years in Prison for Fen-Phen Fraud Scheme

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. A 79-year-old Florida cardiologist was sentenced to six years in prison on March 26, 2013. He’s accused of participating in a fraud scheme involving a trust fund set up to compensate victims of the diet drug Fen-Phen. According to media reports, the cardiologist took fees for examining patients who suspected heart damage from taking Fen-Phen.

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Administrative Simplification and ICD-10: Streamlining Health Care Operations

CMS.gov

By: Christine Stahlecker, Director, Administrative Simplification Group, Office of E-Health Standards and Services, Centers for Medicare & Medicaid Services. Did you know that the United States spends more than $150 billion annually on health care administration, and for the average physician, two-thirds of a full time employee is needed to carry out billing and insurance related tasks?

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Supreme Court Hears Arguments Over the Liability of Generic Drug Makers

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. On March 19, 2013, the Supreme Court justices discussed whether makers of generic drugs already approved by the Food and Drug Administration (FDA) can be held liable under state law for claims of design defects. According to the Los Angeles Times, nearly eighty percent (80%) of prescriptions that Americans fill are for generic drugs.

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Corporate Responsibility- Did DePuy Fail to Alert the Public of Mounting Hip Implant Failures?

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm. According to USA Today, in 2001 Johnson and Johnson’s DePuy set out to create a new metal hip implant that offered stability and longevity to patients. In 2005, the company introduced the ASR XL hip implant.

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Optimizing Medical Waste Management: A Guide to Best Practices

Feeling overwhelmed by medical waste regulations? This comprehensive guide unravels the complexities of medical waste disposal, ensuring you stay compliant and prioritize safety. Inside you'll find: Clear categorization: Learn to precisely classify medical waste for proper handling and disposal. Labeling & Storage: Discover best practices for clear labeling and secure storage of medical waste.

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Common Deficiencies We See in Pharmacy Inspections

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm. Pharmacies and pharmacists are subject to many types of inspections. These inspections are necessary to determine whether the business and its employees are complying with state and federal laws and regulations.

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Food and Drug Administration (FDA) Updates Safety Concerns on Metal-on-Metal Hip Implants After Two Wide-Spread Recalls

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm. On January 17, 2013, the Food and Drug Administration (FDA) issued an updated public health communication about hip replacement components that have both a metal ball and a metal socket, or metal-on-metal hip devices.

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Recovery Audit Contractor (RAC) Activity Up in Hospitals Across the Country

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. Hospitals across the country are being hammered by Recovery Audit Contractors (RACs). According to a survey by the American Hospital Association, RAC activity soared during the fourth quarter of 2012. The March 8, 2013, report explores the impact of the RAC program on the 1,233 hospitals that participated in the survey, according to an article on Healthcare IT News.

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Choosing Wisely Campaign Expands List of Overused and Unnecessary Medical Tests and Procedures

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. This year, seventeen (17) medical specialty societies added their names and recommendations to a list of medical procedures that are overused and often unnecessary. This updated list was released in February 2013, and includes ninety (90) new tests and procedures.

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Whistleblowers Who Report Fraud and False Claims Against the Government Stand to Receive Large Rewards - Part 2

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. Individuals working in the health care industry, whether for hospitals, nursing homes, medical groups, home health agencies or others, often become aware of questionable activities. Often they are even asked to participate in it. In many cases the activity may amount to fraud on the government.

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Jury Awards Plaintiff $8.3 Million in First Trial Over DePuy Hip Implants

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm. On March 8, 2013, a California jury ruled that Johnson and Johnson’s DePuy unit designed a defective metal-on-metal ASR XL hip implant and was negligent, according to Bloomberg News. The plaintiff in this case was awarded $8.3 million in compensation damages, after the jury found that the design of the hip implant was the reason behind the

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HIPAA Compliance: Can Your Organization Avoid Costly Government Penalties and Fines?

Colington Consulting was established in 2013 and helps organizations achieve HIPAA compliance and ensures clients stay current with the latest enforcement trends. We provide a full range of HIPAA compliance services and consulting. What separates us from our competitors is our knowledge of HIPAA compliance regulations and their application to each of our client’s particular scenarios and requirements.

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Whistleblowers Who Report Fraud and False Claims Against the Government Stand to Receive Large Rewards - Part 1

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. Individuals working in the health care industry, whether for hospitals, nursing homes, medical groups, home health agencies or others, often become aware of questionable activities. Often they are even asked to participate in it. In many cases the activity may amount to fraud on the government.

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Central Florida Chiropractor Convicted in False Claims Scheme

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. A Central Florida chiropractor was convicted of conspiracy to commit health care fraud by a federal jury on March 1, 2013. Since 2009, the chiropractor fraudulently claimed to own a rehabilitation center in Cape Coral, Florida. According to the Department of Justice (DOJ), in March 2012, the chiropractor and several co-conspirators were formally charged with conspiracy to commit health care fraud, con

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Contracting 101: Tips for Physicians and Health Professionals - Part 8

The Health Law Firm

By Christopher E. Brown, 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. This blog is the eighth in a series intended to provide a review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practice.

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Stryker Orthopaedics Facing Dozens of Hip Implant Lawsuits

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. As of February 2013, more than 80 lawsuits have been consolidated into multicounty litigation (MCL) in the Superior Court in New Jersey against Stryker Orthopaedics. Patients are claiming the company’s Rejuvenate and ABG II modular-neck femoral hip systems are defective, according to a number of news sources.

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The Big Payoff of Application Analytics

Outdated or absent analytics won’t cut it in today’s data-driven applications – not for your end users, your development team, or your business. That’s what drove the five companies in this e-book to change their approach to analytics. Download this e-book to learn about the unique problems each company faced and how they achieved huge returns beyond expectation by embedding analytics into applications.

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Zone 5 Program Integrity Contractor (ZPIC) for Medicare and Medicaid Programs is AdvanceMed

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. AdvanceMed Corporation, an NCI company, was named the Zone 5 Program Integrity Contractor (ZPIC) for the Medicare and Medicaid programs, in December 16, 2009. As the ZPIC for Zone 5, AdvanceMed has been performing benefit integrity activities aimed to reduce fraud, waste and abuse in Medicare and Medicaid data matching programs.

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Occupational Therapists, Physical Therapists, Speech Therapists and Rehabilitation Therapists Should Retain Legal Counsel for Medicare and Medicaid Audits

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. Most Medicare and Medicaid auditors are cracking down on occupation therapists (OTs), physical therapists (PTs), speech therapists (STs) and rehabilitation therapists (RTs). We have recently been consulted by a number of large therapy groups and small therapy providers undergoing or who have recently undergone Medicare or Medicaid audits.

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Contracting 101: Tips for Physicians and Health Professionals - Part 7

The Health Law Firm

By Christopher E. Brown, 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. This blog is the seventh in a series intended to provide a review of the basics of contracting for physicians and health professionals, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practice.

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Medicare Remains "High-Risk" Program

The Health Law Firm

By Lance O. Leider, J.D., The Health Law Firm. A report released by the Government Accountability Office (GAO) on February 27, 2013, announced that Medicare will remain a "high-risk" program with respect to its fraud and waste vulnerability. The GAO cites the inability of the Center for Medicare and Medicaid Services' (CMS) inability to reduce the rate of improper payments released by the agency as the reason for its ruling.

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Everything You Wanted to Know About FACIS, but Didn’t Know to Ask

Speaker: Amy Anderson

FACIS® helps organizations mitigate patient and organizational risk. Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. Most healthcare organizations screen and monitor providers against the OIG but that’s only ONE of FACIS®’ primary sources. FACIS® pulls data for every taxonomy from the lowest level employee to the highest level licensed professional.

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Opioid Epidemic Not likely to Slow Any Time Soon

The Health Law Firm

By Lance O. Leider, J.D., The Health Law Firm. According to the American Society of Interventional Pain Physicians (ASIPP), Americans consume nearly eighty percent (80%) of the world's opioid supply and ninety-nine percent (99%) of the world's hydrocodone supply. ( Click here to see the ASIPP’s fact sheet on prescription drug abuse.) The scariest part of these numbers is that the United States comprises about five percent (5%) of the world's population.

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Privacy and Security’s Role in the eHealth Transformation

CMS.gov

By Maribel Franey. Improving the delivery of health care is the focus of the eHealth initiative. But eHealth also involves promoting standards and processes that will enable patient information to be shared in a more efficient and timely manner, while ensuring the data is kept private and secure. This brings me to the topic of privacy and security. What is the big deal about privacy and security, anyway?

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EHR Incentive Programs: Moving into the Next Stage

CMS.gov

By Elizabeth Holland. This week, industry leaders from all over the country gather for the Healthcare Information and Management Systems Society conference and discuss the future of health information technology implementation, and we at CMS are pleased to report updates on our efforts to promote and support the meaningful use of electronic health record (EHR) technology in health care.

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Welcome to the CMS eHealth Blog

CMS.gov

By Robert Tagalicod, Director, Office of E-Health Standards and Services. Welcome to the CMS eHealth blog. Here you can find information about the eHealth initiative that CMS is launching at the annual HIMSS conference in New Orleans. Upcoming blogs will highlight HIMSS sessions about eHealth and its programs, and we look forward to continuing the conversation as our eHealth programs reach key milestones over the coming months.

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Ensure Continuous Patient Care: How to Avoid Disruptions Due to Ransomware

The industry has seen an increasing pace of ransomware, zero-day, and remote-code execution attacks. Learn how to defend against these against these attacks in this eBook.

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Building the Future through CMS eHealth

CMS.gov

By Robert Tagalicod, Director, Office of E-Health Standards and Services. Transforming Health Care. What is the most important electronic initiative in health care today? Is it the switch to ICD-10 that will enable us to capture information more accurately? The widespread adoption and use of electronic health records (EHRs) to provide an infrastructure for electronic data exchange?

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eHealth: Aligning Quality Measurement at CMS

CMS.gov

By Patrick Conway, MD, MSc. Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The next step on the path of meaningful adoption of health information technology (HIT) for providers—will launch later this year for hospitals and next year for eligible professionals. How will this next phase improve health care and reduce the burden on providers?