Medicare Final Rule Decreased Physician Payments But Expands Coverage to Counselors

Attorney and Author 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 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 […]

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

George IndestBy 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 […]

By |2024-03-14T09:59:12-04:00February 8, 2024|Mental Health Law Blog|

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

author headshot standing in dark suit with arms crossedBy: 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 […]

By |2024-03-14T09:59:12-04:00February 6, 2024|Mental Health Law Blog|

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

Author HeadshotBy 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 […]

By |2024-03-14T09:59:14-04:00January 8, 2024|Mental Health Law Blog|

Tele-behavioral Health: Important Legal Considerations for Mental Health Providers

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 […]
By |2024-03-14T09:59:14-04:00January 2, 2024|Mental Health Law Blog|

Mental Health Counselors and Psychotherapists: Simple Rules for Keeping Your License and Avoiding Complaints

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

I represent many mental health counselors, social workers, psychologists, and professional counselors, defending them on complaints being investigated against their professional licenses. Many complaints and investigations arise because the therapist has strayed over the line and crossed the therapist-client boundary. In reviewing these cases, I have drawn up a list of a few simple “bright line” rules that can help save you many hours of stress and mental anguish as well as thousands of dollars […]

By |2024-03-14T09:59:15-04:00December 27, 2023|Mental Health Law Blog|

New Study Reveals Complex Coding Structures in U.S. For Rise in Medical Billing Costs

Author HeadshotBy 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 such costs in the U.S.

The findings, published […]

By |2024-03-14T09:59:15-04:00December 21, 2023|Mental Health Law Blog|

Top 5 Reasons Professional Counselors and Psychotherapists Receive Complaints Against Their Licenses;  What to Do to Prevent It

By Michelle E. Missigman, J.D., Attorney, The Health Law Firm

What is a Licensure Complaint?

A licensure complaint against a professional counselor, mental health counselor, or other psychotherapist is usually initiated by the filing of a complaint with the professional board or other regulatory authority.  Although some states authorize the licensing board to investigate and resolve such complaints, in other states, there may be an “umbrella” agency that receives them and investigates them.  For example, in Florida, the Florida Department of Health (or “DOH”) will receive and investigate complaints. In Colorado, the Division of Regulatory Agencies (or “DORA”). In Washington, D.C., the D.C. Department of Health (or “DC Health”), receives and investigates them.
Regardless, you will […]
By |2024-03-14T09:59:16-04:00November 20, 2023|Mental Health Law Blog|

U.S. Government Renews COVID-19 Public Health Emergency, Extending Health Benefits for Millions of Americans

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

On July 15, 2022, the United States again renewed the COVID-19 public health emergency, allowing millions of Americans special access to free tests, vaccines, and treatments. The public health emergency was initially declared in January 2020, when the coronavirus pandemic began. Since then, the Department of Health and Human Services has renewed it each quarter. HHS Secretary Xavier Becerra officially renewed the declaration extending it through October 13, 2022. View it in full here.

Ensuring Continued Access to Special Services During the Public-Health Emergency.

The declaration allows the U.S. to grant […]

By |2024-03-14T09:59:18-04:00October 12, 2023|Mental Health Law Blog|
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