Many Adverse NPDB Actions Are Reported That Should Not Be; Here Are Examples

Author headshot standing in dark suit with red tie against a dark grey backgroundBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
We are constantly being contacted by physicians, nurse practitioners and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports.  Often, we find that an adverse report has been made when the matter should not have been.  Federal regulations and NPDB guidelines establish the types of incidents that are authorized to be reported to the NPDB.  When an employer or other organization makes an improper report, it should be challenged and removed.
Types of Matters That Are Not Authorized for […]

9th Circuit Says Former Federal Nurse Can Proceed With Medical Malpractice Suit Against VA Hospital

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

On September 29, 2021, the U.S. Court of Appeals for the Ninth Circuit ruled that a former federal employee can sue the United States under the Federal Tort Claims Act (FTCA). The suit alleges medical negligence that occurred during psychiatric treatment for a non-workplace-related injury.

As a result, the three-judge panel of the appeals court said that U.S. Navy veteran and VA nurse S.H.s’ lawsuit against a Seattle VA hospital can proceed. (Please note: we are not providing the nurse’s name out of respect for her privacy.)

In 2019, the district court dismissed S.H.’s federal tort […]

By |2024-03-24T20:02:06-04:00March 26, 2024|Nursing Law Blog|

Humana Agrees To Pay $11.2 Million to End Nurses’ Overtime Suit

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

On September 27, 2021, Humana agreed to pay $11.2 million to end claims that the health insurance company denied a group of nurses overtime pay by misclassifying them as exempt employees. A Wisconsin federal judge approved the deal with Humana, and a group of more than 200 nurses reached, securing a $36,000 average payment for each nurse involved in the suit.

A Violation of the Fair Labor Standards Act (FLSA).

This dispute stems from a class-action lawsuit filed in 2017 alleging that Humana misclassified its clinical nurse advisers as exempt employees and denied them overtime compensation, violating […]

By |2024-03-24T20:02:08-04:00March 26, 2024|In the News, Nursing Law Blog|

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 […]

By |2024-03-14T09:59:09-04:00March 25, 2024|Health Facilities Law Blog, Nursing Law Blog|

Esformes Reaches Plea Deal in Major Nursing Home Medicare Fraud Scheme

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 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 […]

By |2024-03-14T09:59:09-04:00March 25, 2024|Nursing Law Blog|

What You Need to Know Right Now If the DEA is Knocking on Your Door!

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

Is the Drug Enforcement Administration (DEA) knocking at your door or, even worse, going through your files inside your office?

If so, this is what you need to know right now!

YES, you do have the right to call your attorney. Call your attorney right now. If you cannot, ask one of your employees or spouse to call your attorney. Get your attorney involved right now!

NO, do not sign a document to relinquish or voluntarily give up your DEA registration number. If you do so, this will probably be the biggest mistake you make in […]

By |2024-03-14T20:00:41-04:00March 16, 2024|Medical Education Law Blog, Nursing Law Blog|

Centene Agrees to Pay $19 Million to Washington State For 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 |2024-03-14T09:59:09-04:00March 14, 2024|Nursing Law Blog|

Many Adverse NPDB Actions Are Reported That Should Not Be; Here Are Examples

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
We are constantly being contacted by physicians, nurse practitioners and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports.  Often, we find that an adverse report has been made when the matter should not have been.  Federal regulations and NPDB guidelines establish the types of incidents that are authorized to be reported to the NPDB.  When an employer or other organization makes an improper report, it should be challenged and removed.
Types of Matters That Are Not Authorized for NPDB Reports.
Following are some of the incidents for which we have seen adverse […]

Nurse Faces Suit for Wrongful Death of Jail Inmate Says 10th Circuit Court of Appeals

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

On March 3, 2021, the U.S. 10th Circuit Court of Appeals reversed in part, a Utah court’s decision on a lawsuit for the death of a 21-year-old inmate, affirming that the jail’s doctor could claim qualified immunity, but not the nurse. After the inmate’s death, her estate sued for depriving her of her civil rights. The U.S. district court granted summary judgment in favor of the county. It ruled that qualified immunity applied to shield jail supervisors and staff. However, it denied qualified immunity to jail nurse Jana Clyde and to a […]

By |2024-03-14T09:59:11-04:00February 18, 2024|Nursing Law Blog|

Pharmacy Technicians Allowed to Administer Immunizations After New Florida Legislation

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

On July 1, 2022, Florida passed HB 1209, allowing registered pharmacy technicians to administer immunizations to patients. The new law utilizes pharmacy technicians to seek certification to provide immunizations and become “Certified Registered Pharmacy Technicians.” These pharmacy technicians will then be allowed to administer all vaccines listed by the CDC in the Adult Immunization Schedule or recommended by the CDC for international travel. Additionally, it includes vaccines authorized by the FDA under an emergency use authorization or by the Florida Board of Pharmacy in response to a state of emergency declared by the […]

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