Health Facilities Law Blog

Harvard May Fight Liability Claims for Morgue Manager’s Sale of Cadaver Body Parts

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

To read the indictment, click here.

On June 14, 2023, the previous Harvard morgue manager, his wife, and three others were indicted on charges of conspiracy and interstate transport of stolen goods in relation to their scheme of selling body parts from the Harvard medical school morgue.

Following this indictment, two proposed class actions and a third claim have been filed against Harvard alleging it was negligent in its supervision of the morgue. To learn more, read my previous blog.

Similar Cases.

While grotesque, this is not the only case of its kind. In January 2023, a Colorado funeral home owner was sentenced to the maximum of 20 years in federal prison due to her defrauding relatives of the dead by dissecting and selling body parts from 560 corpses. Another example of this illegal misconduct is that of the mortuary worker in Arkansas who would send body parts to a man in Pennsylvania, this man (not a Florida man) was charged with abuse of a corpse, receiving stolen property, and dealing in proceeds of unlawful acts.

And how could we fail to mention the criminal conduct of a young Dr. Frankenstein, who sent his medical assistant Igor (pronounced Eye-gōre) to purloin the brain of Abbie Normal and used it for his own salacious purposes.

Harvard’s Options.

Lawyers involved in similar cases to those above predicted that Harvard may fight the liability charges and pursue a “rogue employee” defense. Harvard may claim that it is not responsible for the criminal actions of an employee acting out of the scope of their employment. It could also argue that it is not responsible for an employee’s action that was not reasonably foreseeable. Due to this, Harvard could file a motion to dismiss. In fact, I, myself, have “predicted” this.

To succeed, if it does not win a dismissal, Harvard will have to show that it took all reasonable steps to ensure that the bodies were being used only for their intended educational use. This is due to Massachusetts recognizing liability for negligence because of lax security. Examples of such reasonable steps could be a background check on a prospective morgue manager before employment, established policies and procedures forbidding such practices, a system of tracking the human remains, or having a direct supervisor for the morgue manager.

The Harvard case differs from other cases mentioned above due to the class actions being pursued against it. Since only some members of the class received the same injuries or damages, it would be hard to argue for a class so large. A legal question about the class’s rights also arises in this instance because the families agreed to transfer the remains as an anatomical gift to a third party (Harvard). Their right to a say in the disposition of the bodies may be limited or end at the point of the transfer. Though, the answer to this question may lay in the contract between Harvard and the families if it articulates a case for the release of the bodies. The contents of such a contract are unknown to the public at this time.

Harvard, show us the contract!

One alarming thought: could there be legal negligence on the part of the lawyers drafting the Harvard donation contract? I’ll be the judge of that one, I’m sure.

If Harvard does fight the liability claims, the plaintiffs could seek to add Harvard officials who oversaw the activities of the morgue, where the manager was said to be the only employee. These individuals may make similar arguments to those mentioned above. All this being said, there have been no updates or responses in the case of Harvard aside from its public statement condemning the manager’s actions as an abhorrent betrayal of trust.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all healthcare providers and professionals. This includes scientists, pathologists, morgue directors (technically not usually licensed health professionals), clinical professors, medical researchers, clinical investigators, physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. Our representation includes the defense of complex medical litigation. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex health litigation and both formal and informal administrative hearings. We also represent professionals accused of wrongdoing, patient complaints, and in audits and investigations.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Associated Press. “Former Harvard Morgue Manager Stole Brains, Skin, and Other Body Partys to Sell Them, Indictment Say.” (14 June 2023). https://www.usnews.com/news/us/articles/2023-06-14/harvard-medical-school-morgue-manager-4-others-indicted-in-theft-sale-of-human-remains

Manganis, Julie and Brian Dowling. “Harvard May Fight Liability in Body Parts Sale Scandal.” Law360. (5 July 2023). https://www.law360.com/health/articles/1696291?nl_pk=0cbd4c0b-c6c8-416a-9e67-b4affa63b102&utm_source=newsletter&utm_medium=email&utm_campaign=health&utm_content=2023-07-06&nlsidx=0&nlaidx=3

Shiffman, John. “Former Colorado Funeral Home Owner Sentenced to 20 yrs for Selling Body Parts.” Reutuers. (4 January 2023). https://www.reuters.com/world/us/former-colorado-funeral-home-owner-sentenced-20-yrs-selling-body-parts-2023-01-04/

Sloop, Hope. “Mortuary worker in Arkansas is indicted for selling stolen body parts to tattoo-covered Pennsylvania man she met on Facebook for $11K.” Daily Mail. (30 April 2023). https://www.dailymail.co.uk/news/article-12031285/Ex-mortuary-worker-Arkansas-indicted-selling-11K-worth-body-parts-Facebook.html

About the Authors: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714. Phone: (407) 331-6620; Toll-Free: (888) 331-6620.

Hartley Brooks is a law clerk at The Health Law Firm. She is preparing to attend law school.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.

By The Health Law Firm|2024-03-14T09:59:23-04:00August 15, 2023|Categories: Health Facilities Law Blog|Tags: clinical investigator fraud defense lawyer, clinical research misconduct investigation defense attorney, complex litigation defense attorney for medical professionals, defense of misconduct in science allegations, Department of Health DORA investigation defense attorney, institutional review board (IRB) investigation defense attorney, legal defense attorney for healthcare professionals, legal defense representation for DOH DORA complaint, legal representation for medical investigations defense attorney, legal representation in complex medical litigation, medical research fraud defense attorney, misconduct in science defense attorney, NIH grant research grant fraud defense attorney, physician defense attorney, principal investigator fraud defense attorney, reviews of The Health Law Firm attorneys, The Health Law Firm reviews|Comments Off

Rapper 50 Cent Reaches Settlement with Floridians in Lawsuit Over Fake Penis Enlargement Ad

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

On February 21, 2023, Houston rapper 50 Cent settled a lawsuit with a publication over alleged false penis enlargement claims. The rapper, whose real name is Curtis J. Jackson III, sued The Shade Room LLC using three alternative theories of defamation, per se, per quod, and by implication.

The lawsuit revolved around a website article and social media posts, including a photo of him standing next to Angela Kogan of Perfection Plastic Surgery & Medspa in Florida. Both Kogan and Perfection are also named in the rapper’s complaint, which you can read here.

The Complaint.

The rapper initially sued Kogan in September 2022. He maintains that she stole a photo of him to promote her business under the false pretense he’d used the company’s services. In addition, he accused The Shade Room of further enlarging the story by re-posting it and opening him up to further “ridicule.” 50 Cent and his legal team claimed: “By publishing the article and falsely stating or implying that Jackson had received plastic surgery procedures from Kogan or MedSpa, or the penile enhancement or other procedures described in the article, TSR committed a clear act of defamation.

The Settlement.

According to the settlement notice, 50 Cent and the publication “are in the process of executing their respective obligations pursuant to the agreement.” Additionally, it stated that a notice of voluntary dismissal would be forthcoming. The terms of the settlement were not disclosed. You can read the notice of settlement in the case here.

For more information on this case, read my prior blog.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services, including defense in complex medical litigation, for physicians, medical groups, plastic surgeons, cosmetic dermatologists, and other healthcare providers. This includes plastic surgeons, cosmetic dermatologists, nurse practitioners, oral and maxillofacial surgeons, psychologists, psychiatrists, mental health counselors, and many others. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We also represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are also experienced in litigation at formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Keller, Aaron. “50 Cent Settles Penile Enhancement Ad Suit With Publication.” Law360. (February 21, 2023). Web.

AllHipHop. “EXCLUSIVE: 50 Cent’s Penis Enlargement Lawsuit Grows: He’s Now Suing The Shade Room.” MSN. (January 21, 2023). Web.

Brown, Preezy. “50 Cent Settles Lawsuit With The Shade Room Over Alleged Penis Enhancement Photo.” Vibe. (February 21, 2023). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in the practice of health law. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.

Former Harvard Med School Morgue Director Allegedly Sold Body Parts, Class Action Alleges

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

In a morbid but extremely popular class action lawsuit filed on June 16, 2023, illegal body parts sales was alleged. The lawsuit against Harvard University contained allegations that its morgue manager was selling body parts from 350-400 donated cadavers. Many donors have now requested their bodies back.

Family members of the deceased had voluntarily donated the cadavers to the prestigious institution to further the medical and scientific study of the human body.

Massachusetts state law recognizes that human beings are entitled to be treated with decency and digital after death, which includes the bodies not being mishandled, viewed, dismembered, or sold by those entrusted with them. The previous morgue manager allegedly violated this law and countless other state, federal, and international laws and treaties. State and federal law prohibits the sale of body parts, often referred to as anatomical donations. These laws have been derived from international laws and conventions that prohibit such conduct, mostly written and agreed to as a result of the Nazi atrocities of World War II.

The Class Action Lawsuit.

The manager allegedly allowed unauthorized third-party members to view the cadavers in the morgue and select which body parts they wanted to purchase. The lawsuit did not state what times and days the store was open. However, once the order was placed, the morgue manager would unlawfully dissect and sell the body parts in person and online. Additionally, the defendant would allegedly ship the body parts to various locations in the United States on demand. Officials believe that this scheme occurred from at least 2018 until March 2023. During that time, the entrepreneurial morgue manager is suspected of having done his dastardly deeds to 350 to 400 separate cadavers.

The lawsuit did not reveal what the purchasers used the body parts for. However, this is expected to come out in discovery.

The class action lawsuit claims negligence and breach of care for the morgue manager and Harvard. According to the suit, the class is defined as: “all individuals whose family members donated their bodies to Harvard and Harvard Medical School for medical research and academic study and whose cadavers were mishandled, dissected, and/or sold by the morgue manager.”

The suit claims that Harvard breached its fiduciary duty of care by allowing the cadavers to be mishandled, dissected, and sold. The negligence claim focuses on the university not taking reasonable steps to ensure that the cadavers were appropriately handled, maintained, and used for their intended purposes. The class claims that Harvard is liable for its employee’s actions because the morgue manager acted within his scope of duty when he unlawfully dissected and sold body parts from the cadavers in the medical school’s onsite morgue.

This argument made in the lawsuit seems somewhat internally inconsistent. It does not seem logical that it could have possibly been within the morgue manager’s scope of duty to act illegally. One cannot have a contract that has for its purpose carrying out an illegal act. Otherwise, I would like to see a copy of that job description (it obviously would not have been written by a Harvard lawyer)!

Massachusetts law imposes a statutory duty to preserve the rights and dignity of a deceased person’s body when a medical school takes custody for scientific and academic purposes, which is another basis for the negligence claims by the class. The plaintiffs are also claiming negligent infliction of emotional distress from both Harvard and the morgue manager since Massachusetts recognizes emotional distress in situations of knowing that the remains of a deceased family member have not been preserved as the family desired.

Harvard will undoubtedly defend itself by arguing that the acts of the errant morgue manager were intentional torts and illegal acts outside of his scope of duties. The doctrine of caveat emptor, by which an employer is held vicariously liable of the negligent acts of its employee, does not apply to intentional torts.

The plaintiffs are requesting a decision from the court stating that both Harvard and the morgue manager are liable for negligence, that the class is awarded damages for the emotional distress, and that the defendants are enjoined from continuing their unlawful practices.

Click here to visit our website and read the complaint in full (but don’t expect to be able to fall asleep after you do!)

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

The Health Law Firm provides legal services for all healthcare providers and professionals. This includes scientists, pathologists, morgue directors (technically not usually licensed health professionals), clinical professors, medical researchers, clinical investigators, physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, fellows, medical school professors, and clinical staff. Our representation includes the defense of complex medical litigation. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex health litigation and both formal and informal administrative hearings. We also represent professionals accused of wrongdoing, patient complaints, and in audits and investigations.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Dowling, Brian. “Harvard Sued Over Morgue Director’s Alleged Body Part Sales.” Law360. (June 16, 2023). Web.

Levenson, Michael. “Harvard Medical School Morgue Manager Sold Body Parts, U.S. Says.” The New York Times. (June 14, 2023). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714. Phone: (407) 331-6620; Toll-Free: (888) 331-6620.

By The Health Law Firm|2024-03-14T09:59:24-04:00August 2, 2023|Categories: Health Facilities Law Blog|Tags: clinical investigator fraud defense lawyer, clinical research misconduct investigation defense attorney, complex litigation defense attorney for medical professionals, defense of misconduct in science allegations, Department of Health DORA investigation defense attorney, institutional review board (IRB) investigation defense attorney, legal defense attorney for healthcare professionals, legal defense representation for DOH DORA complaint, legal representation for medical investigations defense attorney, legal representation in complex medical litigation, medical research fraud defense attorney, NIH grant research grant fraud defense attorney, physician defense attorney, reviews of The Health Law Firm attorneys, The Health Law Firm reviews|Comments Off

Walmart Increases Pay For Thousands of Pharmacists and Opticians

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

On May 31, 2023, Walmart announced it is raising wages for 7,700 U.S. pharmacists and opticians in a nationwide plan to expand healthcare services. The retailer said about 3,700 pharmacists would get a bump in pay, bringing their total average pay to more than $140,000 annually. Additionally, more than 4,000 opticians will receive pay raises, with their average hourly pay rising to more than $22.50. The company also said it plans to start a program in which associates who work in its Vision Center could receive certification and licensing to move into higher-paying positions.

Currently, Walmart employs 16,000 pharmacists and 12,000 opticians overall.

Competitive Pay in a Competitive Market.

According to the Bureau of Labor Statistics, the mean annual wage for a pharmacist in the United States is $129,410 (https://www.bls.gov/oes/current/oes291051.htm), and the mean hourly wage for opticians is $21.58 (https://www.bls.gov/oes/current/oes292081.htm).

The retail giant’s decision to increase wages for workers across its business is a way to compete for talent in a competitive market.

In 2022, the company also increased wages for 36,000 Pharmacy technicians. “As our Health & Wellness business continues to grow, we’re serious about being an employer of choice for talented individuals in these fields,” said Kevin Host, Senior Vice President of Walmart Health & Wellness, Pharmacy, in a press release.

To read the press release on Walmart’s website and learn more, click here.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes pharmacists, optometrists, physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. We represent facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians in investigations and at Board of Medicine and Board of Osteopathic Medicine hearings. We represent physicians accused of wrongdoing, in patient complaints and in Department of Health investigations.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Holman, Jordan. “Walmart Raises Wages for Some Pharmacists and Opticians.” The New York Times. (May 31, 2023). Web.

“Walmart announces raise for pharmacists and opticians, new optician training program.” 5NewsOnline. (May 31, 2023). Web.

Diaz, Naomi. “Walmart Health to add 28 new clinics by 2024.” Becker’s Hospital Review. (March 2, 2023). Web.

Cavale, Siddharth. “Walmart is raising wages for pharmacists, opticians in healthcare push.” Reuters. (May 31, 2023). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

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

On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. The defendant was initially indicted on June 17, 2022, and charged with six counts of conspiracy and money laundering. Unlike most of the fraud convictions we report on, this one was directed against the U.S. Food and Drug Administration (FDA) and involved adulterating and misbranding drugs. The defendant pled guilty to only two counts: conspiracy to defraud the United States and conspiracy to commit money laundering. Click here to view the press release from the U.S. Attorney’s Office, Southern District of Florida, to learn more about the arrest

The Charges: Adulterated and Misbranded HIV Medications.

Prescription drug diversion is when prescription drugs are removed from regulated distribution channels and reintroduced into the wholesale market or otherwise illegally distributed. These drugs can be acquired through theft, fraud, or patients who were prescribed the medication and intentionally did not consume them.

In this case, U.S. vs. Lazaro Hernandez, the defendant would obtain prescribed drugs illegally, repackage them, falsify the documentation, and resell them to coconspirators through conspiracy wholesalers. To successfully divert the prescription medications, they got wholesale drug distributor licenses for LLC’s in Florida, New Jersey, Connecticut, and New York. These conspiracy wholesalers would purchase the diverted, adulterated, and misbranded drugs and documentation and sell them to pharmacies.

Adulteration occurs when any substance is added to or substituted, in part or in whole, or mixed with an approved drug. Misbranding of a drug occurs when someone places a label on it that is false or misleading in any way, as defined in Title 21 U.S. Code sections 351(d) and 352 (a)(1). In this case, the pharmacies billed health care benefit programs and dispensed adulterated and misbranded drugs to patients. The pharmacies paid $232,800,000 for the diverted drugs between April 2019 and at least October 2021.

The six counts that the defendant was initially charged with include conspiracy to introduce adulterated and misbranded drugs and to defraud the United States, conspiracy to traffic pre-retail medical products with false documentation, conspiracy to commit money laundering, and three counts of money laundering. The false documentation and money laundering charges were later dropped in the plea deal.

The Sentencing.

The government recommended a sentence of 188 to 235 months, which aligns with the defendant’s criminal history and total offense level (calculated in accordance with federal statutes and regulations), while the defense argued for a lesser amount of time due to the allegedly “secondary” role the defendant played in the fraud. The judge sentenced the defendant to 180 months. Also included in the sentence was a forfeiture of all proceeds from the scam and restitution in an amount that has yet to be determined.

This lower-than-recommended prison sentence came after the defendant spoke about his gambling addiction, which allegedly led him to participate in the fraud. Also, two of his 47 character references addressed the court in person. The judge was swayed to give him a lower sentence as a result. View the indictment in the case in full here.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to pharmacists, pharmacy facilities, physicians, nurse practitioners, CRNAs, dentists, psychologists, mental health professionals, nurses, and other health providers in Department of Health (DOH) investigations and hearings, Drug Enforcement Administration (DEA) investigations, audits and hearings, Food and Drug Administration (FDA) investigations and hearings, FBI investigations, Medicare/Medicaid investigations, audits and hearings, and many other actions involving defense of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Minsky, David. “Fla. Man Sentenced To 15 Years In Prison Over HIV Drug Fraud.” Law360. (June 16, 2023). Web.

Becker, Zoey. “In fraud case targeting HIV meds, Florida man gets 15 years in prison.” FiercePharma. (June 21, 2023). Web.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.

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Psychiatric Practice Reaches Settlement in FCA Suit to End Allegations of Employing Physician on OIG Exclusion List

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

On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG’s exclusion list, the “List of Excluded Individuals and Entities” (LEIE). As a result, the government took the position that claims for services the physician provided filed against government programs were illegal pursuant to the false Claims Act (FCA). Details were disclosed in a Press Release by the U.S. Attorney for the District of Connecticut.

Geriatric & Adult Psychiatry, LLC (GAP), along with the owner, entered into a civil settlement agreement to resolve their liability under the federal and state False Claims Acts, the U.S. Department of Justice (DOJ) said in a press release.

Past Conviction Overlooked.

In 2006, the physician had been convicted in the Southern District of Florida of conspiracy to commit healthcare fraud. Because of his conviction, the Office of the Inspector General (OIG) excluded him from all federal healthcare programs. Such exclusion includes Medicare, Medicaid, Tricare, Veterans Administration (V.A.), and Indian Health Service (I.H.S.) programs.

When the OIG excludes an individual or entity from federal health care programs, no payments may be made for items or services furnished by that excluded individual. Additionally, the law prohibits any person or organization that receives such funds from employing or contracting with a person on the LEIE, in any way. To avoid potential liability, it is advised that health care providers check the List of Excluded Individuals/Entities (LEIE) on the OIG website: http://oig.hhs.gov/exclusions.

In addition, the OIG has issued a Special Advisory Bulletin to providers who might employ or contract with an excluded individual or entity to provide guidance. To review this OIG Bulletin, click here.

For more helpful information, click here.

Despite this, to medical group hired the former physician as the clinical director in 2016 where he served in that position until 2021. During that time, both the practice and its owner billed and sought reimbursements from Medicare, Medicaid, TRICARE, and the Railroad Retirement Medicare Program. Additionally, GAP’s reimbursements were used to pay the physician’s salary and benefits.

Payment Prohibition & Civil Monetary Penalties (CMPs).

Health care providers receiving funds from federal health care programs must check to see if potential employees and contractors are excluded by searching the LEIE to ensure that person is not listed. Providers have mistakenly assumed that exclusion does not apply to an individual or entity that provides services that extend beyond direct patient care; this is wrong. Payment prohibition extends to anyone who chooses to employ or contract with an excluded individual or entity in any capacity. Providers who violate this prohibition are required to pay back all federal health care program funds inappropriately received and may also be subject to civil monetary penalties (CMPs) and action under the False Claims Act (FCA).

Furthermore, payment of an excluded individual’s salary, benefits, or expenses, directly linked to federal health care program funds is expressly prohibited. Click here to read my prior blog and learn more about this.

Little Known Fact: You Must Actively Apply to Get Taken Off the LEIE.

A little-known fact, often overlooked, is that a person or entity on the LEIE must actually apply to be removed from it, no matter how short the period of exclusion. Thus if a person is excluded and placed on the LEIE for only two years, they must apply to the OIG after that period of time, completing its detailed, notarized application, and be removed from the list. Removal is not automatic.

Contact Health Law Attorneys Experienced in Defending Against Action to Exclude an Individual or Business from the Medicare Program and Assisting in Reinstatement Applications.

The attorneys of The Health Law Firm have experience in dealing with the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS), and defending against action to exclude an individual or business entity from the Medicare Program, in administrative hearings on this type of action, in submitting applications requesting reinstatement to the Medicare Program after exclusion, and removal from the List of Excluded Individuals and Entities (LEIE).

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Yankowski, Peter. “Officials: Hamden psychiatric practice to pay $310,000 settlement over employee who lost medical license.” Stamford Advocate. (February 23, 2022). Web.

Health Law Weekly. “Psychiatric Practice, Owner Pay $310K for Employing “Excluded” Individual.”American Health Law Association (AHLA). (February 25, 2022). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714; Phone: (407) 331-6620; Toll-Free: (888) 331-6620.

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Attorneys Involved In Multi-Million Dollar UnitedHealth Case Want $3.35 Million Fee Award

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

In October 2021, attorneys who had acted as the class counsel in litigation suing UnitedHealth Group over mental health reimbursement policies asked a New York federal court to approve a $3.35 million fee award. If approved, it would be an award of attorney’s fees in addition to the $10 million the insurer agreed to pay to settle their case.

According to the memorandum of law filed with the court, the mental health advocacy law firm argued that the results which they had achieved on behalf of the class of victims (who were all health insurance plan clients) easily justified the seemingly large requested fees and expenses.

We would agree with their argument. Too often disabled individuals, especially those suffering from mental disabilities, who need the help most, are victimized by large for-profit corporations. The attorneys and law firms who stand up for these individuals, especially those who are able to actually see the case through to completion, should be rewarded for their efforts.

Background.

The settlement reached in August 2021 resolved several consolidated lawsuits over UnitedHealth’s use of a “tiered” system to reimburse patients for out-of-pocket mental health treatment at lower rates than medical and surgical care were reimbursed. In addition to the $10 million private settlement agreement, UnitedHealth agreed to pay out $5.6 million to end claims from the New York State Attorney General and the U.S. Department of Labor. Read more about that here.

Payment of Full Legal Fees and Expenses.

The attorneys who are designated as “class counsel” in a class-action lawsuit are entitled to reasonable reimbursement of litigation expenses incurred in prosecuting a class action. In this case, after settling the case in chief, the class counsel negotiated a separate payment by United of up to $3.35 million for legal fees and expenses subject to court approval, according to the memorandum.

Additionally, the attorneys requested the court grant payment of $20,000 each for service (or incentive) awards for the three different class representatives. Incentive awards are designed to compensate the named plaintiffs for bearing the risks of bringing the suit, as well as for any time spent participating in the actual litigation of the case as an individual would have to do.

To be clear, the attorney’s fees will not be deducted from the $10 million settlement paid to the class members; they will be paid separately By UnitedHealth.

Is the Requested Amount Reasonable?

According to the memorandum filed with the court, the plaintiffs’ lawyers spent thousands of hours combing through data for over 110,000 class members and leading negotiations that included the federal and state agencies and the parties to the litigation. “Given the substantial risks plaintiffs faced in every phase of this case, the results achieved by class counsel are exceptional by any measure,” the memorandum argued.

To view the memorandum in full, click here to view it on our webpage.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free (888) 331-6620 and visit our website at www.ThehealthLawFirm.com

Sources:

Stone, Rachel. “Attys Who Struck $10M UnitedHealth Deal Seek $3M Payday.” Law360. (October 28, 2021). Web.

Stone, Rachel. “UnitedHealth Strikes Deal To End Mental Health Policy Suits.” Law360. (August 12, 2021). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888)-331-6620.

Florida Attorney Says AHCA Must Put Medicaid Final Orders Online

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

Florida’s Agency for Health Care Administration (AHCA) has come under fire for failing to make Medicaid final orders accessible to the public. On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against AHCA, trying to force AHCA into compliance with state public records laws.

Attorney Nancy Wright says the AHCA orders fall under a state law that requires all proceedings determined by a state agency to be placed into a centralized electronic database accessible to the public. This would allow citizens and healthcare providers more accessible access to those decisions and transparency when understanding Medicaid policies and decisions made by AHCA.

Access to Medicaid Final Orders.

The plaintiff’s attorney argued before a three-judge panel of the court of appeal that she should not be required to pay hundreds of dollars to gain access to Medicaid final orders to prepare for clients’ Medicaid hearings when the law requires the agency to publish these. The attorney further argued that this fee was an unfair and unjustified barrier to justice and that she should be given free access to these orders to ensure that she could provide the best possible representation for her clients.

More Details of the Case.

The Florida Health Justice Project and the National Health Law Program filed the lawsuit against AHCA on behalf of Wright in December 2020 in the First District Court of Appeal of Florida.
“[Medicaid law’s] notorious complexity and rapid regulatory changes put even lawyers on edge,” she said in a statement at the time she filed her suit. “AHCA’s unwillingness to make their [sic] final orders accessible means that I am not able to fully advise my clients on how and why decisions on services are being made. For the many enrollees who are unrepresented, this lack of transparency makes a complicated system almost impossible to navigate.”

Click here to view the press release from The Florida Health Justice Project.

However, the trial court sided with AHCA and granted summary judgment to the agency.

The Appeal.

The Elder Law Section of the Florida Bar expressed their support for Wright and submitted an amicus brief on appeal. They highlighted that the Florida Department of Children and Families regulates Medicaid eligibility proceedings with the same law that provides authority to AHCA. Furthermore, the Department publishes its final orders in an electronic database, making them readily available to the public.

However, accessing these same orders on Medicaid coverage requires a public records request which can be costly and time-consuming. The Elder Law Section argued in its brief that this disparity is unfair as it burdens those attempting to gain access to said records. The brief further suggested that upholding the trial court’s summary judgment would only perpetuate this inequality of access to public records.

To learn more, read the complaint in full here.

Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations, and other Legal Proceedings

Physicians, therapists, counselors and other health professionals who accept Medicaid are routinely audited by the Medicaid Program to detect any overpayments or fraudulent claims. Medicaid fraud is a serious crime and is vigorously investigated by the state Medicaid Fraud Control Unit (MFCU), the Agency for Healthcare Administration (AHCA), Program Integrity Contractors (PICs), the FBI, and the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies may also participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health law attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.

The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, mental health counselors, therapists, home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

To contact The Health Law Firm, please call (407) 331-6620 or toll free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.

By The Health Law Firm|2024-03-14T09:59:26-04:00June 27, 2023|Categories: Health Facilities Law Blog|Tags: Agency for Health Care Administration defense attorney, AHCA preliminary audit report defense attorney, behavioral therapist defense attorney, Bureau of Medicaid Program Integrity defense attorney, defense attorney, defense lawyer, Florida health law attorney, Florida Medicaid attorney, Florida Medicaid lawyer, health care fraud defense attorney, health care fraud defense representation, health care law firm, health law attorney, health law lawyer, legal representation for health professional license, legal representation for Medicaid overpayment demand, legal representation for overbilling, Medicaid audit administrative hearing defense attorney, Medicaid audit administrative hearing legal representation, Medicaid audit appeal attorney, Medicaid audit attorney, Medicaid audit defense lawyer, Medicaid audit legal representation, Medicaid overpayment demand defense attorney, Medicaid overpayment demand lawyer, medical license defense attorney, mental health counselor defense attorney, Office of Inspector General defense attorney, overbilling defense attorney, physician defense attorney, professional counselor defense attorney, psychotherapist defense attorney, representation for Medicaid program audit, The Health Law Firm review|Comments Off

Florida’s Protecting DNA Privacy Act: How Will It Affect Healthcare Providers?

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

On June 29, 2021, Florida Gov. Ron DeSantis signed into law HB 833, known as the “Protecting DNA Privacy Act,” which took effect in Florida October 1, 2021. Under the act, collecting or submitting another person’s DNA sample for analysis without his or her express consent now constitutes a second-degree felony in the state of Florida. It amends Section 760.40, Florida Statutes, with the criminal penalties being set forth in Section 817.5655, Florida Statutes.

The new law clarifies the extent to which individuals own their genetic information. It also creates new crimes for the unlawful collection, retention, analysis, disclosure, or sale of an individual’s DNA sample and the results of a DNA analysis. The act also has important implications for secondary uses of data by health care providers and others that perform genetic testing and analyze genetic information.

What is Genetic/DNA Privacy Law?

The use and accessibility of genetic testing, primarily through direct-to-consumer options (companies such as 23andMe and Ancestry.com ), has significantly increased in recent years, which has resulted in growing concerns about the privacy of genetic information and its use by third parties.

The Florida Legislature has focused on strengthening the protections surrounding genetic information. In 2020, it amended Florida law to limit the use of genetic information by life insurance companies for specific insurance purposes, including underwriting. Click here to read the final bill analysis for the act.

The Impact on Healthcare Professionals.

The new law will have the biggest impact on physicians who employ DNA testing in their practices. Physicians who collect or submit a patient’s DNA sample for DNA analysis will have to first obtain the patient’s express consent to do so.

“Express consent” is defined as “authorization by the person whose DNA is to be extracted or analyzed, or such person’s legal guardian or authorized representative, evidenced by an affirmative action demonstrating an intentional decision after the person receives a clear and prominent disclosure regarding the manner of collection, use, retention, maintenance, or disclosure of a DNA sample or results of a DNA analysis for specified purposes.”

This means that physicians who wish to have a patient’s DNA analyzed for a specified purpose need first to explain how the DNA sample will be collected, used, retained, and maintained and how the results of the DNA analysis will be used. This information ideally will be outlined in a formal, written document that the patient will sign. In addition, the legislation allows physicians to obtain a single express consent for every instance of a specified purpose or use.

What This Means For You.

Any healthcare professional engaged in such activities should consider reevaluating their consent processes to determine whether they obtain appropriate consent for all uses of de-identified results of DNA analysis. To learn more, click here.

Click here to view HB 833 in full.

Click here to review Section 760.40, Florida Statutes.

Click Here to review Section 817.5655, Florida Statutes, containing the criminal penalties.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Peloquin, David. “What Fla. DNA Privacy Law Means For Health Providers.” Law360. (October 4, 2021). Web.

“How the new DNA privacy law could affect your practice.” Florida Society of Clinical Oncology. (September 20, 2021). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999. Copyright © 2022 The Health Law Firm. All rights reserved.

By The Health Law Firm|2024-03-14T09:59:27-04:00June 25, 2023|Categories: Health Facilities Law Blog|Tags: attorney for physician suits against insurers, Board of Medicine defense attorney, business insurance representation, business interruption insurance claims defense, complex civil litigation defense attorney, complex health care litigation attorney, complex healthcare litigation lawyer, complex medical business litigation against health insurers, complex medical litigation lawyer, Department of Health defense attorney, Health law defense lawyer, healthcare employment issue defense, healthcare employment law representation, legal representation for physicians, legal representation of health care professionals, nurse defense lawyer, physician complaint defense attorneys, representation for administrative hearing, representation for complex medical litigation, representation for disciplinary charges, representation for disciplinary complaint, representation for healthcare business litigation matters, representation for healthcare employment matters, reviews of The Health Law Firm, The Health Law Firm attorney reviews|Comments Off

COVID-19 Provider Relief Fund Expected To Run Out of Money If Congress Doesn’t Act Soon

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

In 2020, the U.S. Department of Health and Human Services (HHS) created the “Provider Relief Fund” (PRF) to help support healthcare providers in the battle against the COVID-19 pandemic. The federal program has served as a lifeline to frontline healthcare workers who’ve experienced revenue losses and increased demand for their services during the pandemic.

To date, it has allocated more than $178 billion in payments to over 410,000 providers across the United States. Click here to learn more.

COVID-19 Uninsured Relief Fund.

Let’s start with some good news: Under the COVID-19 relief funding, HHS created the “uninsured relief fund.” This program provides claims reimbursement to health care providers for testing, treating, diagnosis, and administering vaccines to uninsured individuals for COVID-19. It has paid out more than $17 billion throughout the pandemic. It has paid out more than $17 billion throughout the pandemic.

Of the $17 billion, HHS has distributed nearly $10 billion for testing, more than $6 billion reimbursed for treatment, and the remainder covered vaccinations. Read more on the statistics here.

Running Out of Money.

Now for the bad news: According to an HHS spokesperson, there’s only $7.6 billion left, and the money will run out in the coming months. Congress isn’t currently considering making more funding available, meaning providers and patients are likely to have soon to bear the costs themselves.

Therefore, many hospitals and healthcare organizations urge Congress to replenish the PRF. “One of the most helpful and patient-oriented uses of the PRF was to help those people who for whatever reasons are uninsured and suffer from COVID-19,” said Federation of American Hospitals CEO Chip Kahn. “It meant that no one should have any reluctance to go to the hospital if they have COVID but no insurance.”

Additionally, on February 9, 2022, the American Hospital Association released a statement urging readers to contact lawmakers to get Congress to provide another $25 billion for the PRF in the government funding package. Read the AHA’s action alert here.

As we approach nearly two years since HHS declared COVID-19 a national public health emergency, PRF has been a lifeline to hospitals, health systems, and medical professionals. It has been helping to keep doors open during the pandemic to continue providing essential care to patients and communities. However, if the program runs out of money and Congress doesn’t appropriate more, hospitals could be left footing the bill, which will hurt both providers and patients in the end.

Read one of my previous blogs on a similar case regarding a Florida Dentist’s COVID-19 Business Interruption Insurance Claim to learn even more.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Hellmann, Jessie. “HHS running out of money to pay providers for treating uninsured COVID-19 patients.” Modern Healthcare. (February 8, 2022). Web.

HRSA. “Covid Uninsured Claim.” Health Resources & Services Administration. (February 2022). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

By The Health Law Firm|2024-03-14T09:59:27-04:00June 16, 2023|Categories: Health Facilities Law Blog, In the News|Tags: attorney for physician suits against insurers, Board of Medicine defense attorney, business insurance representation, business interruption insurance claims defense, complex civil litigation attorney, complex health care litigation attorney, complex healthcare litigation lawyer, complex medical business litigation against health insurers, complex medical litigation lawyer, COVID-19 business insurance claim representation, defense lawyer for physicians, doctor defense legal representation, Health law defense lawyer, healthcare employment law representation, legal representation for healthcare professionals, legal representation for physicians, legal representation for physicians and health care professionals, legal representation of health care professionals, nurse defense lawyer, physician complaint defense attorneys, representation for administrative hearing, representation for complex medical litigation, representation for healthcare business litigation matters, reviews of The Health Law Firm attorneys, the health law firm, The Health Law Firm attorney reviews|Comments Off

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