May 2018

Central Florida Mental Health Counselor Accused of Heading Up $3 Million Medicaid Fraud Scheme

By |2024-03-14T10:01:50-04:00May 15, 2018|Medicaid audit, Mental Health Counselor, Mental Health Counselor Law|

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law, and Michael L. Smith, J.D., R.R.T., Board Certified by The Florida Bar in Health Law

A registered mental-health counselor is accused of running a $3 million Medicaid scheme through the mental health facility she owned, according to the Florida Office of the Attorney General (AG). On March 27, 2013, the facility owner was arrested. She faces charges of racketeering, Medicaid fraud and identity theft. According to the AG, local, state and federal law enforcement officers were all involved in the investigation.

Click here to read the press release from the AG.

Mental Health Counselor Reportedly Billed […]

New Mexico’s Largest Mental Health Providers Accused of Defrauding Medicaid Out of $36 Million

By |2024-03-14T10:01:50-04:00May 15, 2018|Medicaid audit, Medicaid fraud, Mental Health Counselor, Mental Health Counselor Law|

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

For months now, 15 New Mexico behavioral health agencies have been the subject of a Medicaid fraud investigation. The state’s largest mental health providers had their Medicaid funding frozen by the New Mexico Human Services Department (HSD) due to credible allegations of fraud, according to KUNM News. The behavioral health agencies are accused of collectively defrauding Medicaid of $36 million over three years. The findings in an audit conducted in 2012, by OptumHealth, the contractor that handles Medicaid payments for New Mexico’s behavioral health system, […]

Department of Health and Human Services Announces Mental Health Parity Final Rule

By |2024-03-14T10:01:51-04:00May 15, 2018|Mental Health Counselor, Mental Health Counselor Law, Psychology|

By Lance O. Leider, J.D., The Health Law Firm

On November 8, 2013, the U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the promulgation of the agency’s final rule related to parity of coverage of mental health and substance use treatment. According to Sebelius: “For way too long, the healthcare system has openly discriminated against Americans with behavioral health problems.”

The purpose of the regulations is to close the gaps in coverage that permit insurance carriers to treat mental and substance-abuse related treatment different from traditional medical and surgical benefits.

Among the key provisions of the regulations are the elimination of separate mental health deductibles, co-insurance, etc.; elimination of limits on […]

Have You Received a Notice of Termination of Your Medicare Provider Number?

By |2024-03-14T10:01:05-04:00May 15, 2018|Medicare Audit, Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law, Psychology|

By Danielle M. Murray, J.D.

Have you received a notice of termination of your Medicare provider number? Medicare has been revoking the Medicare provider numbers of many different Medicare providers including psychologists and other mental health providers, based on returned mail sent to old addresses which have not been updated or based on inspection team site visits to old addresses.

Often the termination is retroactive to a much earlier date the change or move may have been determined to have occurred. Even if the mailing address is correct or was changed, the physical address of the business must have been updated, as well. It is usually an incorrect or old physical […]

Your Professional Therapist License Is a Valuable Asset; Insure It!

By |2024-03-14T10:01:51-04:00May 15, 2018|Mental Health Counselor, Mental Health Counselor Law|

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

Time and time again, I am contacted by mental health counselors, social workers, and other therapists who have worked hard for years, have paid tens of thousands of dollars for tuition, fees, books, and board, and made sacrifices in order to obtain a professional degree and a professional license. Yet they have not purchased professional insurance to protect their licenses.

Your professional license is arguably your most valuable asset. Yet, I am continuously surprised to learn the number of health professionals who come to our firm in serious trouble because a complaint has been […]

Two South Florida Doctors Convicted of Fraudulently Billing American Therapeutic Corporation (ATC)

By |2024-03-14T10:01:49-04:00May 15, 2018|Mental Health Counselor, Mental Health Counselor Law|

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

A federal jury convicted two South Florida doctors, one Miami-area therapist, and two other individuals for their participation in a Medicare fraud scheme. The scheme allegedly involved more than $205 million in fraudulent billings by American Therapeutic Corporation (ATC), a corporation which provided mental health care services. The jury reached a decision on June 1, 2012.


To see the Department of Justice press release, click here
.

The two doctors and the therapist were each found guilty of one count of conspiracy to commit health care fraud. The other two individuals were each found guilty of one count […]

Director of Center for Developmentally Challenged Adults Accused of Medicaid Fraud

By |2024-03-14T10:01:49-04:00May 15, 2018|Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law|

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

The director of a center for developmentally challenged adults in Okaloosa County, Florida, was arrested on August 16, 2012, for allegedly fraudulently billing Medicaid for more than $270,000 for services under the Medicaid Developmentally Disabled Waiver Program, according to the Attorney General’s (AG) office.

To read the entire press release from the AG’s office, click here.

Director Allegedly Submitted False Claims for Non-Billable Services and Falsified Hours.

According to the press release, in 2009, the Medicaid Fraud Control Unit (MFCU) began investigating the center after it […]

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