2015

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University of Florida Agrees to Pay Nearly $20 Million to Settle False Claims Act Allegations

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 The University of Florida (UF) has agreed to pay nearly $20 million to the federal government to settle allegations brought under the False Claims Act. The US Department of Justice (DOJ) announced the settlement Friday under allegations that it "improperly charged the US Department of Health and Human Services (HHS) for salary and administrative costs on hundreds of federal grants.

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Broward Health Agrees to Pay Almost $70M to Settle False Claims Act Allegations - Whistleblower Could Receive More Than $12M

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 September 15, 2015, the Department of Justice (DOJ) announced that Broward Health, an operator of more than 50 health care facilities in South Florida, agreed to pay $69.5 million to settle False Claims Act allegations. Broward Health violated the Federal Stark Law and Anti-Kickback Statute by allegedly overcompensating referring physicians for services to cover up illegal kickbacks for patient refe

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Texas Medical Board Enjoined for Possible Antitrust Violations by Federal Court

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 Shelby Root On May 29, 2015, the US District Court for the Western District of Texas granted an injunction against the Texas Medical Board (TMB). The suit was brought by a company called Teladoc, Inc. Teladoc, Inc provided medical services to patients through webchats, video chats, and other telemedicine modalities.

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New OIG Fraud Alert Focuses On Physician Contracts: What to Watch Out For

The Health Law Firm

By: Lance O. Leider, J.D., The Health Law Firm On June 9, 2015, the US Department of Health and Human Services, Office of the Inspector General issued a special fraud alert on physician compensation arrangements. The purpose of the alert was to warn physicians who enter into certain arrangements like medical directorships, department chairs, board of directors seats, and other similar positions to do so carefully.

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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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Employee Claims Wrongful Termination After Blowing the Whistle on New York Health Care Center

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 Monday, December 21, 2015, Debra Martin filed suit against former employer, Middletown Community Health Center Inc. (MCHC), in the US District Court for the Southern District of New York, claiming she was wrongfully terminated after exposing alleged illegal activities of the health center to her superiors.

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20 Years for Ohio Cardiologist Sentenced in $29 Million Overbilling 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 Assistant US Attorney Carole S. Rendon, said of a Westlake, Ohio cardiologist sentenced to 20 years in prison on Friday, December 18, 2015, "This defendant used his medical license as a license to steal." Dr. Harold Persaud was convicted earlier this year of one count of health care fraud, 13 counts of making false statements and one count of engaging in monetary transactions in property derived from c

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Court Finds Qui Tam Relators Failed to Satisfy Evidentiary Requirements for Alleged Kickback Scheme of Pharmaceutical Company in Texas Case

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 December 10, 2015, US District Court for the Southern District of Texas granted defendant's partial motion for summary judgment in a qui tam case alleging violations of the Anti-Kickback Statute (AKS). The case was originally filed on June 10, 2003, by relators John King and Tammy Drummond, naming several pharmaceutical companies as defendants including Solvay Pharmaceuticals Inc.

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Chicago Husband and Wife Sentenced to Prison Terms for Misappropriation of $3 Million in Grant Funds

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 husband and wife from Chicago, Illinois, were sentenced to prison terms by US District Judge Richard Mills on Monday, December 14, 2015, for their roles in the misappropriation of $3 million in grant funds. Leon Dingle Jr. and his wife, Karen Dingle, were convicted at a one-week long jury trial in December 2014 of conspiracy, mail fraud and money laundering.

Fraud 40
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24-Year-Old May Spend Nearly a Decade Behind Bars as the Alleged Mastermind in a $21 Million Medicare 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 On Thursday, December 10, 2015, 24-year-old, Daniel Suarez, was sentenced to nine years in prison and ordered to pay nearly $21 million in restitution by US District Judge Donald Middlebrooks, for his alleged leading role in a Medicare fraud scheme in Miami, Florida.

Fraud 40
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Central Florida Medical Student Shot While Saving Woman in New Orleans

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 Friday, November 20, 2015, during the early morning hours in New Orleans (my home town), a Tulane University (my alma mater) medical student from Longwood, Florida, Peter Gold, was shot in the stomach as he attempted to assist a woman who was being assaulted in a botched robbery.

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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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Rare Occurrence: Dermatologist Acquitted of More Than 40 Counts of Health Care Fraud Following a 16-Day Trial: Part 2 of a 3-Part Series Part Two: Prosecutorial Overcharging

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 Virginia dermatologist, revered by several publications as one of the top doctors in the nation for several years running, was recently acquitted of more than 40 counts of health care fraud following an unusually lengthy 16-day trial. Dr. Amir Bajoghli was originally indicted in August 2014 on 60 counts; 53 counts of health care fraud, six counts of aggravated identity theft and one count of obstruct

Fraud 40
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Speaking of Religious Discrimination: Second Appeal to Supreme Court on Former Nursing Home Employee's Termination for Refusal to Pray with Residents

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 Former nursing home employee, Kelsey Nobach, a Jehovah's Witness, filed a discrimination suit against former employer, Woodland Village Nursing Center Inc. (Woodland), alleging her termination from the facility was the direct result of her religious beliefs.

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Baker Acts Are on the Rise Among Students at the University of Central Florida

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 It's beginning to look a lot like Christmas; candy canes and toys, holly and trees, bells and carols, and. Baker Acts? You read that right. According to University of Central Florida (UCF) police Cpl. Peter Osterrieder, a rise in Baker Acts is to be expected among college students this time of year.

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U.S. Department of Justice's Antitrust Division Has Yet to Weigh In on Anthem/Cigna Mega-Merger Given the Go-Ahead by Shareholders

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 Thursday, December 3, 2015, shareholders of Anthem Inc. (Anthem) and Cigna Corp. (Cigna) approved a previously announced $54 billion mega-merger in an overwhelming 99 percent favorable vote. The pending acquisition of Cigna by Anthem would cover approximately 53 million medical members resulting in the formation of the nation's largest health insurance company.

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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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Rare Occurrence: Dermatologist Acquitted of More Than 40 Counts of Health Care Fraud Following a 16-Day Trial: Part 1 of a 3-Part Series Part One: Reviewing the Charges

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 Dr. Amir Bajoghli, of McLean, Virginia, was a dermatologist and owner of the Skin & Laser Surgery Center. Dr. Bajoghli was recognized by former Washingtonian Magazine, Northern Virginia Magazine, US News & World Report and Castle Connolly as "Top Doctor.

Doctors 40
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Pharmaceutical Company Says Former Employee is Not "Original Source" of False Claims Act Allegations and Cannot Bring Whistleblower Suit

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 Medco Health Solutions Inc. (Medco) asked a Delaware federal judge to dismiss a False Claims Act (FCA) lawsuit brought by former employee and vice president of the company's pharmaceutical contracting group. Paul Denis brought the qui tam suit against Medco alleging the company defrauded state and federal insurance companies by hiding discounts it was receiving on drugs.

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Former New York Assembly Speaker Convicted on Corruption Charges in Scheme for Referral Fees

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 Former New York Assembly Speaker, Sheldon Silver, was convicted by a jury on Monday, November 30, 2015, on federal corruption charges. Silver had spent nearly 40 years as an elected New York Assemblyman. Prosecutors say Silver was using public money to fund an asbestos disease researcher in exchange for patient referrals to Silver's colleagues and personal injury law firm, Weitz & Luxenberg PC.

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Florida Court of Appeal Says Federal Law Preempts Florida's Amendment 7; The Peer Review Privilege May Still Be Alive

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 Southern Baptist Hospital of Florida Inc. (Baptist) filed a Petition for Writ of Certiorari with the First District Court of Appeal in Florida following a Florida circuit court ruling on the compelled disclosure of certain documents. The plaintiffs in a medical malpractice case were attempting to obtain peer review documents from the hospital on their claims.

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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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Oncologist Falsified Data on Research Once Described as "Holy Grail" of Cancer Treatment

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 Back in 2006, Anil Potti, a cancer researcher at Duke University, claimed to identify genetic markers that would allow customized treatment for cancer patients based on the types of tumors they had. Several reports from Potti and his team claimed it could predict a patient's response to chemotherapy with up to 90 percent accuracy.

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U.S. District Court Awards Costs to Prevailing Defendants in False Claims Act Case; Whistleblower Appeals to Second Circuit

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 US District Judge Jed S. Rakoff, ordered relator, Associates Against Outlier Fraud (Associates), to pay $15,000 in costs to the prevailing defendants, Huron Consulting Group Inc. (Huron) and Empire HealthChoice Assurance Inc. (Empire), in a failed False Claims Act (FCA) suit.

Fraud 40
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Florida HMO Owners File $1.2 Billion Lawsuit Against BankUnited for Alleged Racketeering and 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 Former owners of a health maintenance organization (HMO), Haider Ali Khan and Sabiha Haider Khan, recently filed suit in Florida federal court against BankUnited Inc. and its acquired New York-based Herald National Bank. The Khans formerly operated the Tampa-based HMO, Quality Health Plans Inc.

Fraud 40
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OIG Annual Work Plan for 2016 Series: Spotlight on OIG Investigations and Affordable Care Act Review Part Two of Two

The Health Law Firm

By Michelle Bedoya and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. The United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its 2016 Annual Work Plan (Work Plan) on November 2, 2015, with an effective date of October 1, 2015. The 2016 Work Plan identifies the new and ongoing investigative, enforcement and compliance activities that the OIG will undertake.

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Generative AI for Contracts Is Here: New Tools to Accelerate Drafting and Editing

The emergence of generative AI is reshaping the landscape of contract management, enabling businesses to generate and negotiate legal agreements with greater ease and speed. In this on-demand webinar, Hal Marcus, VP of Product Marketing at Evisort discusses how Evisort's generative AI transforms contract creation and negotiation, empowering legal teams to streamline processes while reducing risk.

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OIG Annual Work Plan for 2016 Series: Spotlight on Medicare and Medicaid Areas of Fraud Part One of Two

The Health Law Firm

By Michelle Bedoya and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. The United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its 2016 Annual Work Plan (Work Plan) on November 2, 2015, with an effective date of October 1, 2015. The Work Plan describes more than 40 new investigations and strategic inquiries concerning pharmacy fraud and increased drug prices, among other topics.

Fraud 40
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Eight Tips to Speed Up the Medicare Prepayment Review Process

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 Medicare providers generally recoil at the news of an impending audit. However, being notified of a prepayment review is even worse. In a prepayment review, health care providers are required to submit documentation to a contractor for the Centers for Medicare & Medicaid Services (CMS) before ever even receiving payment.

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Florida Man Sentenced to 30 Months in Prison; Four Defendants Previously Sentenced; Two Defendants Plead Guilty in $126 Million Health 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 federal judge decided that a Florida man convicted of conspiracy to commit health fraud will spend the next 30 months behind bars. Humberto Martinez Rodriguez was the nominee owner of two clinics involved in an elaborate fraud scheme to submit $126 million in false health care claims to private insurers.

Fraud 40
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Medical Licensing Exams to Include Questions on Military Medicine, Requiring Physicians to Know Their Veterans

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 Just prior to Veteran's Day this year, an announcement was made by former US Representative and licensed clinical psychologist, Brian Baird, and his colleague, Steven Haist. Moving forward, examinations for medical students and new physicians seeking licensure will now include questions about military medicine issues.

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Best Practices for Sharing Protected Health Information (PHI)

In this ebook, you will learn about the 18 PHI indicators, the legal requirements and penalties surrounding PHI, and how your healthcare teams should securely exchange this data. Key takeaways from this ebook: Gain confidence in identifying PHI. Acquire practical implementation strategies for exchanging PHI within your organization. Emphasize the importance of using compliant communication tools within healthcare teams.

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HCA Settlement in Shareholder Class Action Suit Over Failure to Disclose False Claims Act Cases Will Cost the Company Another $215 Million

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 Just days after settling with the US Department of Justice (DOJ) agreeing to pay $16 million to resolve allegations of False Claims Act (FCA) violations, HCA Holdings, Inc. (HCA), a notable Tennessee-based health care company, announced yet another settlement, this time with its shareholders.

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Federal Judge Denies Florida Cardiovascular Center's Motion to Dismiss Whistleblower Suit: Judge Rules that U.S. and Florida A.G. Did Not File "Shotgun Pleadings"

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 US District Judge for the Middle District of Florida, Roy B. Dalton, Jr., denied a motion to dismiss filed by a cardiovascular center based in Ocala, Florida, and its top physician. The case the defendants sought to dismiss is a False Claims Act (FCA) qui tam suit brought by two whistleblowers in which the United States and Florida have intervened.

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450 Hospitals Pay $250 Million in One of Nation's Largest False Claims Act Cases for Number of Defendants

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 In an investigation that has spanned several years and is still ongoing, the Department of Justice (DOJ) has reached False Claims Act (FCA) settlements with more than 450 hospitals totaling $250 million over alleged improper billing of Medicare for unnecessary cardiac implants.

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Peer Review Confidentiality in Florida: Does it Exist?

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 The confidentiality of peer review documents in Florida has been very questionable since a state constitutional amendment was passed in 2004. Amendment 7, found in Section 25, Article X of the Florida Constitution, restricts Section 395.0193(7), Florida Statutes, which originally established peer review confidentiality.

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HIPAA: Why It Matters to Your Practice

85% of practices are not complying with the government’s HIPAA standards. The large majority of practices are likely trying to protect patients’ information, but they may not be doing all that they need to meet government requirements. Not complying with HIPAA has definite drawbacks, with one major one being massive fines. The government can fine up to 1.5 million dollars for a single HIPAA breach incident - an amount that would put most small practices out of business.