Mental Health Law Blog

Esformes Reaches Plea Deal in Major Nursing Home Medicare Fraud Scheme

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

On February 1, 2024, the District Court for the Southern District of Florida announced that Florida nursing home mogul Phillip Esformes had reached a plea deal on pending conspiracy to commit healthcare fraud charges.

Esformes, who then owned more than 30 Miami-area nursing and assisted living facilities, was first charged in July 2016 with what the Department of Justice (DOJ) called a $1 billion, decades-long Medicare fraud and money-laundering scheme. Click here to read the DOJ’s press release. (https://www.justice.gov/opa/pr/three-individuals-charged-1-billion-medicare-fraud-and-money-laundering-scheme)

The Fraudulent Health Care Scheme.

The government initially accused The Florida Man of bribing physicians to refer patients to the nursing homes he owned in the Miami area. He would then move the patients […]

Florida Telehealth Laws for Mental Health Counselors, Social Workers and Marriage and Family Therapists

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

The Florida Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling has published the following guidance regarding the provision of telehealth services.

As of October 11, 2021, it is still effective and is provided verbatim as follows:
(See more at: https://floridasmentalhealthprofessions.gov/latest-news/telehealth/)

During the 2019 legislative session, Florida passed section 456.47 Florida Statutes, which establishes standards of practice for telehealth services, including patient evaluations, and record-keeping. The law also authorizes out-of-state health care practitioners to perform telehealth services for patients in Florida. Signed by the Governor on June 25, 2019, this law became effective on July 1, 2019.

Out-of-State Health Care Practitioners.

Out-of-state health care practitioners must be registered with the Florida Department of Health to perform telehealth services for patients in Florida. The out-of-state telehealth provider […]

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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

In a massive jury verdict awarding a male attending physician more than he requested, a jury found that a hospital demonstrated reverse discrimination and an anti-mail bias in how it handled a female resident physician’s complaint against him.

On January 8, 2024, Thomas Jefferson University Hospital urged a Pennsylvania Federal court to reverse a $15 million judgment against it over its handling of a sexual assault investigation in a gender bias case. In December 2023, a federal jury in the U.S. District Court for the Eastern District of Pennsylvania found that there was proof that the hospital exhibited anti-male bias and violated a male orthopedic surgeon’s civil rights when it investigated allegations that he sexually assaulted a medical […]

By The Health Law Firm|2024-03-14T09:59:09-04:00March 26, 2024|Categories: Health Facilities Law Blog, Mental Health Law Blog|Tags: attorney for legal dispute with residency graduate medical education program, attorney for residency program physician, clinical privileges defense lawyer, complex healthcare litigation attorney, complex medical litigation lawyer, discrimination defense attorney, education law attorney for health professionals attorney, gender discrimination lawsuit, Graduate medical education (GME) defense lawyer near me, health law attorney near me, legal defense representation attorney for medical resident dispute, legal dispute with university medical school litigation attorney, legal representation against residency program, legal representation for medical resident and fellows discrimination, legal representation for medical residents near me, legal representation for residency program medical resident discrimination, legal representation for Title IX hearing, medical law attorney near me, medical residency program dispute attorney near me, medical resident physician defense attorney, medical staff clinical privileges defense attorney, orthopaedic surgery defense counsel, orthopedic surgeon defense attorney, residency program appeal hearing attorney, residency program appeal hearing legal counsel, residency program disciplinary appeal hearing lawyer, residency program discipline termination defense attorney, residency program grievance lawyer, residency program grievance legal advice, residency program grievance legal counsel, resident physician defense lawyer, reviews of The Health Law Firm attorneys, The Health Law Firm reviews|Comments Off

Supreme Court of Pennsylvania Says Serial Killer Cannot Sue Psychiatrist for Medical Malpractice

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

On November 22, 2023, the Supreme Court of Pennsylvania unanimously decided that a serial killer cannot sue his psychiatrist for gross negligence because the action is barred by the Pennsylvania state law that prohibits criminals from benefitting from their crimes.

The Murderer’s Mental Health History.

In February 2016, Cosmo DiNardo was diagnosed with a major depressive disorder. Three months later, DiNardo was in an ATV accident in which he sustained head injuries. His mother reported that he began acting bizarrely a month after the accident. Additionally, DiNardo was also diagnosed with bipolar disorder and schizophrenia. He was prescribed strong antidepressants and antipsychotics.

DiNardo also had a violent […]

By The Health Law Firm|2024-03-14T09:59:10-04:00March 11, 2024|Categories: Mental Health Law Blog, The Health Law Firm Blog|Tags: board of medicine hearing defense attorney, board of mental health counseling defense lawyer, board of psychology defense legal representation, Board of Psychology legal representation, defense lawyer for counselors and psychotherapists, Defense lawyer for psychiatrist near me, department of health (DOH) defense attorney, department of health complaint investigation defense counsel, HPSO Insurance defense attorney near me, informal hearing defense lawyer, legal representation for psychiatrists psychologists counsleors, licensed professional counselor (LPC) defense attorney, licensed professional counselor (LPC) legal representation, mental health counselor legal representation, psychotherapist defense attorney near me, representation for administrative complaint hearings, representation for board of mental health investigations, representation for Department of Health (DOH) complaint investigations, representation for psychiatric nurse practitioners, reviews of The Health Law Firm, subpoena defense lawyer for counselor or psychotherapist, subpoena for psychotherapy patient health records attorney, The Health Law Firm attorney reviews|Comments Off

Medicare Final Rule Decreased Physician Payments But Expands Coverage to Counselors

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

On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule (PFS). However, the final rule increased payment rates for outpatient services and expanded telehealth services. The rule went into effect January 1, 2024.

Physician Fee Schedule Rate Reductions; Counselors Added.

The overall payment rates under the 2024 PFS were reduced by 1.25 percent for 2024. The conversion factor is $32.74, which is a $1.15 decrease from 2023. Physicians’ Medicare reimbursements will fall by 3.4 percent under the PFS in 2024.

However, in a piece of good news, the 2024 final rule allows marriage and […]

By The Health Law Firm|2024-03-14T09:59:10-04:00March 4, 2024|Categories: Mental Health Law Blog, The Health Law Firm Blog|Tags: allegations of healthcare fraud, allegations of overbilling Medicaid, Centers for Medicare and Medicaid (CMS) investigations and audits, False Claims attorney, FCA attorney, FCA defense lawyer, FCA lawyer, healthcare fraud representation, healthcare lawyer near me, legal representation for CMS audits and investigations, legal representation in Medicare Medicaid audit investigation, medical lawyer near me, medical overbilling, Medicare billing defense lawyer, Medicare Medicaid fraud defense attorney, representation for CMS investigations, representation for healthcare investigations, representation for medical overbilling, representation for overbilling Medicare, representation for submitting false claims, reviews for The Health Law Firm, The Health Law Firm attorney reviews|Comments Off

Florid Man Strikes Again–Government Asks for Life Sentence for Florida Man in $187M Medicare Fraud Case

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

On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one hundred million dollars. At the December 2022 trial of the Florida man, the jury convicted the Florida Man of all ten counts against him, including health care fraud, payment of kickbacks, and conspiracy to commit money laundering. He was ordered to pay $187 million in restitution.

I have to say it. They need to lock up that Florida man once and for all! I see his wanton actions all over Florida, reported time and time again. Now that Tim Dorsey is deceased (bless his Florida soul) we don’t […]

By The Health Law Firm|2024-03-14T09:59:12-04:00February 8, 2024|Categories: Mental Health Law Blog|Tags: AKS defense attorney, AKS lawyer, AKS representation, Anti-Kickback Statute (AKS) defense legal representation, Centers for Medicare & Medicaid Services (CMS) defense attorney, CMS defense attorney, CMS legal defense lawyer, CMS legal defense representation, healthcare fraud defense attorney, healthcare fraud defense lawyer, Healthcare fraud defense lawyer near me, Healthcare fraud legal defense representation, Legal defense representation for healthcare fraud investigations and audits, legal representation for CMS investigation, Medicaid Fraud Control Unit (MFCU) defense legal representation, Medicaid audit defense attorney, Medicaid audit defense lawyer, Medicaid audit defense legal representation, Medicaid Fraud Control Unit (MFCU) defense attorney, medical fraud defense lawyer, Medicare audit defense attorney, Medicare audit defense lawyer, Medicare audit defense legal representation, reviews of The Health Law Firm, The Health Law Firm attorney reviews|Comments Off

Supreme Court of Pennsylvania Says Serial Killer Cannot Sue Psychiatrist for Medical Malpractice

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

The Murderer’s Mental Health History.

DiNardo also had a violent history. During his institutionalizations, he […]

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Mental Health Counselors & Social Workers: If You’re Applying for Your Professional License, Read This First!

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 mental health counselor or social worker professional license can be challenging and time-consuming. When seeking initial licensure or applying for a license in another state, you should be aware of delays in the application process due to the investigation of credentials and past practice, as well as the need to comply with licensing standards.

Examples That Would Delay Your Mental Healthcare License Application:

• Disciplinary or academic actions during postgraduate training (probation, suspension, remediation)
• Action by another state’s regulatory or licensing board
• Action by a different professional licensing board
• Misdemeanor or felony convictions
• Results of the criminal background check (remember, […]

Centene to Pay Washington State $19 Million to Resolve Medicaid Fraud Allegations

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

On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, it has been reported that Centene/Sunshine Health reportedly has over $31 billion in contracts with the state of Florida alone. Click here to learn more.

The agreement with Washington State resolves allegations that it overcharged its Medicaid program for pharmacy benefit management services, Washington Attorney General Bob Ferguson announced in a press release.

Under the deal, in addition to the $19 million payment to Washington State, the federal government will receive $13.3 million related to the settlement, according to the Attorney General’s […]

By Amanda I. Forbes, J.D.

Starting in 2020 and throughout the COVID-19 pandemic, tele-behavioral health services, also known as “e-counseling,” rapidly expanded. Because individuals were quarantined or fearful to venture out, remote mental health care services became very popular among patients. A study published in The Journal of the American Medical Association (JAMA), including 36 million working-age individuals, revealed that tele-health services increased by 766% in the first three months of the pandemic.

Thanks to remote services like tele-behavioral health, the doctor’s “house call” is making a comeback; but instead of ringing the doorbell, your doctor will be ringing your smartphone.

What is Tele-behavioral Health?

The National Institute of Mental Health defines telebehavioral health as “the use of telecommunications or videoconferencing technology to provide remote mental health services.” Providers can use video conferencing, text messaging, or smartphone apps. Additionally, many different types of behavioral […]

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Esformes Reaches Plea Deal in Major Nursing Home Medicare Fraud Scheme

Male Surgeon Wins $15 Million Verdict in Suit Based on “Reverse Discrimination” and Anti-Male Bias; Hospital Requests New Trial

Supreme Court of Pennsylvania Says Serial Killer Cannot Sue Psychiatrist for Medical Malpractice

Medicare Final Rule Decreased Physician Payments But Expands Coverage to Counselors

Florid Man Strikes Again–Government Asks for Life Sentence for Florida Man in $187M Medicare Fraud Case

Supreme Court of Pennsylvania Says Serial Killer Cannot Sue Psychiatrist for Medical Malpractice

Centene to Pay Washington State $19 Million to Resolve Medicaid Fraud Allegations