New Study Reveals Complex Coding Structures in U.S. For Rise in Medical Billing Costs
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A study publicized in August 2022 revealed that the complex coding structures used in the United States drive up medical billing costs. This helps to make the U.S. one of the most expensive countries for health providers to get paid. According to the study, researchers used a micro-level accounting of billing and insurance-related (often abbreviated "BIR") expenses in different national settings at six provider locations in five nations: Australia, Canada, Germany, the Netherlands, and Singapore. This most recent study supplements a prior study measuring [...]
How Medical Information Bureau (MIB) Reports Can Affect Your Insurance Policy Rates
By Amanda I. Forbes, J.D. When you apply for insurance, an insurance company will look at various factors regarding your history to determine how much your insurance policy will cost. Most insurers obtain a report from the Medical Information Bureau ("MIB") and use this in determining the risk you pose and, hence, your policy premium. The MIB checks past records to identify any errors, misrepresentations, or omissions made on an insurance application. An MIB report is similar to a credit report except it is specifically tailored for the insurance process. Click here to learn more. What Does the MIB do? Since [...]
AHCA Exemptions From Employment Disqualification for Florida Health Professionals
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida law requires that health professionals (including physicians, nurses, physical therapists, nurse practitioners, professional counselors, and social workers, among others) obtain a Level 2 background screening before working in a facility licensed by the Agency for Health Care Administration (AHCA). This includes third and fourth-year medical students, resident physicians, and nursing students. Often an arrest from years ago, sometimes decades ago, will be located during this screening. A letter stating that the individual is disqualified from employment or requiring an explanation may result. What [...]
Don’t Voluntarily Relinquish Your Medical License or DEA Registration Number, Here’s Why
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. In many cases, the individuals involved do not think to consult with an attorney until many months later. This may be too late to save the business or professional practice involved. This holds for physicians, dentists, nurses, pharmacists, pharmacies, pain management clinics, physician assistants, group homes, assisted living facilities (ALFs), and home [...]
Completing an Application for a Nursing License? Here Are Some Helpful Tips!
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The process of obtaining a nursing or health care professional license is not only challenging, but it’s also time-consuming. If you have a criminal conviction or unique circumstance which may negatively impact your ability to be granted a health care license, you must consult with an experienced attorney. Your career or future depends on your ability to positively present yourself to the board. In instances where the applicant has a criminal history, substance abuse/alcohol problem, or discipline in another state, the board members are [...]
DOJ Drops Charges in Appalachia Opioid Case After Supreme Court Ruling
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 12, 2022, the U.S. Department of Justice (DOJ) announced that it dropped charges against the remaining defendants in a case against a former Ohio drug distributor. In 2019, Miami-Luken, two of its executives, and two pharmacists were charged with unlawfully conspiring to distribute millions of addictive painkillers across rural Appalachia. The Original Indictment. The DOJ issued an indictment against the five defendants in 2019 and charged all with conspiracy to distribute a controlled substance. It alleged Miami-Luken had sent millions of Class [...]
New Study Faults Coding Structures For Increased Medical Billing Costs in U.S.
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A study publicized in August 2022 revealed that the complex coding structures used in the United States drive up medical billing costs. This helps to make the U.S. one of the most expensive countries for health providers to get paid. According to the study, researchers used a micro-level accounting of billing and insurance-related (often abbreviated "BIR") expenses in different national settings at six provider locations in five nations: Australia, Canada, Germany, the Netherlands, and Singapore. This most recent study supplements a prior study measuring [...]