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Two Pharmacists and One Dentist in Central Florida Arrested for Prescribing and Dispensing Prescription Drugs

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

The Lakeland Ledger reports that Polk County Sheriff’s Detectives arrested a dentist and two pharmacists on September 5, 2012, in three unrelated cases dealing with illegally prescribing and dispensing painkillers. The sheriff’s office said the three arrests are part of its efforts to target prescription drug abuse.

To read the entire Lakeland Ledger article, click here.

The Arrest of the Dentist’s Daughter Led to His Investigation and Arrest.

In May 2012, the dentist’s daughter was arrested for allegedly forging more than 500 hydrocodone prescriptions. That arrest led deputies and the Department of Health (DOH) to search the dentist’s clinic. According to the Lakeland Ledger article, out of 43 patient files randomly selected, 31 patients were being prescribed hydrocodone without any documentation.

The Polk County Sheriff’s Office stated that the dentist has been charged with knowingly overprescribing controlled narcotics.

To see the press release from the sheriff’s office on the dentist’s arrest, click here.

Both Pharmacists Caught by Undercover Detectives.

According to the Lakeland Ledger, the two pharmacists that were arrested allegedly illegally dispensed either oxycodone or hydrocodone to undercover detectives. The pharmacists have been charged with trafficking prescription painkillers.

Click here to see the press release on the pharmacists’ arrests from the Polk County Sheriff’s Office.

Arrests Part of Crack Down on Abuse of Prescription Drugs.

According to the Polk County Sheriff’s Office, these arrests are part of an ongoing investigation to target doctors and pharmacists that are improperly prescribing and dispensing prescription medications.

There is an article on our website on legal tips for physicians to manage pain patients. To read that piece, click here.

Criminal Arrest of Over-Prescribers May come From Many Different Agencies.

Physicians and pharmacists who are involved in schemes relating to overprescibing or trafficking in narcotics may be targeted by many different agencies. The local sheriff’s office or police department is just one of them.

We have represented physicians who have been the subjects of Drug Enforcement Administration (DEA) investigations. The DEA will often use undercover agents and informants to pose as patients, wired for audio recording. The DEA will often work with local law enforcement authorities and the Department of Health (DOH).

Other investigations and arrests may be initiated by a statewide prosecutor’s office, which is under the Attorney General. Still others have been initiated by the Medicaid Fraud Control Unit (MFCU) where Medicaid funds are used.

Contact Health Law Attorneys Experienced in Representing Health Care Providers in DOH Cases.

The Health Law Firm represents pharmacists, pharmacies, physicians, nurses, and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies.

If you are aware of an investigation of you or your practice, or if you have been contacted by the DEA or DOH, contact an experienced health law attorney immediately.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Malagon, Elvia. “Lakeland Dentist and Two Pharmacists Charged with Prescription Drug Violation.” The Lakeland Ledger. (September 5, 2012). From: http://www.theledger.com/article/20120905/NEWS/120909682?template=printart

Eleazer, Carrie. “PCSO Detectives Arrest Two Pharmacists from Trafficking in Prescription Drugs.” Polk County Sheriff’s Office. (September 5, 2012).  From: http://www.polksheriff.org/NewsRoom/Pages/09-05-2012PCSO%20DetectivesArrestTwoPharmacistsForTraffickinginPrescriptionDrugs.aspx

Eleazer, Carrie. “Dr. William Johnson of Sonrise Dental Clinic Arrested.” Polk County Sheriff’s Office. (September 5, 2012). From: http://www.polksheriff.org/NewsRoom/News%20Releases/Pages/09-05-2012.aspx

About the Authors: Danielle M. Murray is an attorney with 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

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 Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Finding a Healthcare Providers Service Organization (HPSO) Insurance Defense Lawyer

Patricia's Photos 013By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the Florida Department of Health (DOH) they had difficulty finding an experienced attorney in Florida who would accept their professional liability insurance.  In this case, I am speaking specifically about Healthcare Providers Service Organization (HPSO) Insurance.

Benefits of HPSO Insurance.

The professionals who are covered by HPSO Insurance have excellent insurance coverage.  HPSO Insurance provides professional liability coverage that protects in the event of a lawsuit or negligence claim.  But much more often the professional receives a notice of an investigation, a subpoena for a deposition in someone else’s case, a demand because of an allegation of sexual harassment or sexual impropriety, a complaint because of a breach of medical records confidentiality or Health Insurance Portability and Accountability Act (HIPAA) Privacy complaint, or some other administrative type of action.

HPSO provides great coverage for these.  For example, HPSO currently reimburses up to $10,000 in legal fees and expenses just for representation of you at depositions.  HPSO currently reimburses up to $25,000 in legal fees and expenses for your defense in a DOH or Agency for Health Care Administration (AHCA) notice of investigation or complaint.  HPSO currently reimburses up to $25,000 in legal fees and expenses for your legal representation in defense of a complaint or investigation regarding breach of medical confidentiality.

If you are a pharmacist, own a pharmacy, are a massage therapist, own an assisted living facility (ALF), are a mental health counselor or a social worker, or you are one of the many other types of health care professionals who HPSO insures, it should be fairly easy to find experienced health lawyers to represent you, especially in Florida.

Our firm and our attorneys, including George F. Indest III, Michael L. Smith, Joanne Kenna, Carole C. Schriefer, Lance O. Leider, Christopher E. Brown and Danielle M. Murray, routinely represent licensed health care professionals, interns and students in all types of administrative investigations and hearings and in defending lawsuits and other actions that have been filed.  We also represent health facilities in license defense, survey complaints and administrative hearings.  We represent them throughout Florida, from Pensacola, to Jacksonville, to Key West.  We also occasionally represent them in other states, as well.  We accept HPSO Insurance assignments.

Free Legal Advice: Get Insurance Immediately.

It is very important for every health professional to carry insurance that covers any investigation, complaint or administrative hearing that might be filed or opened against your license.  You may think that you are covered for this by your employer, but you are not.  If your employer contradicts this, ask for a statement in writing that your employer will pay for your legal defense for any such matter arising during your employment.

What typically happens, especially in the case of a hospital employee, nursing home employee, pharmacy employee or corporate employee, is that the employer is the one who terminates the employee and then files a complaint with the DOH.  The DOH then opens an investigation against the health professional.  The employer is not going to pay your legal defense costs if the employer has reported you.

You may very well be out of work, out of money and face an investigation and complaint that could terminate your professional license and career.  You should not take this chance.  Insurance such as HPSO Insurance is inexpensive and reliable.  Buy it while you can afford it. After the actions have occurred, it is too late.

Find an Experience Health Law Attorney in the Event of an Investigation.

Also, you should immediately contact an experienced health law attorney if you are telephoned or visited by any investigator, or if you receive a letter advising you that an investigation has been opened regarding your care.  Call immediately for advice before you speak with an investigator or provide any documents or statements of any kind.

You cannot and should not seek “legal advice” on what to do from the investigator, from a DOH employee, from your professional board or from any attorney representing any of them.  They are not your friends.  They are on the side against you. You should definitely not take any advice from them.

Do Not Skimp on Insurance Coverage.

If you have good insurance, it will pay for your legal expenses from the very beginning, so use it.  However, beware of cheap insurance policies from professional associations that do not provide any coverage for disciplinary complaints and licensure investigations.  Always check to be sure this is covered.  Get it in writing.  With some companies you have to pay an extra premium to obtain this coverage.  With some insurers, they do not offer it, and you have to purchase a completely separate policy covering just this.  It is worth it!  Do it!

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

Our firm regularly represents pharmacists, massage therapists, mental health counselors, registered nurses, assisted living facilities, home health agencies, nurse practitioners, lab technicians, occupational therapists, physical therapists, social workers, physician assistants, psychologists and other health professionals in many different legal matters.

Services we provide include representation before your professional board, in DOH investigations, in administrative hearings, in civil litigation, in defense of malpractice claims, in professional licensing matters, in defense of allegations concerning HIPAA privacy violations and medical record breaches, in Drug Enforcement Administration (DEA) actions, and in many other matters.

We routinely represent physicians, dentists, nurse practitioners, and others in defending against malpractice claims, civil lawsuits, administrative complaints, peer review actions, DOH investigations, Medicare audits, Medicaid audits, and other matters. In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company.  If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Do you have professional liability insurance? Why or why not. Please leave any thoughtful comments below.

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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Nation Rx Drug Abuse Summit Held in Central Florida-Leaders Share Struggles and Triumphs in “War Against Prescription Drugs”

11 Indest-2008-8By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

From April 2 through April 4, 2013, the country’s leading experts on the prescription drug epidemic met in Central Florida for the National Rx Drug Abuse Summit, according to the Orlando Sentinel. National leaders including the White House drug czar, the director of the Centers for Disease Control and Prevention (CDC), U.S. Food and Drug Administration (FDA) commissioner and Florida’s Attorney General (AG) shared ongoing challenges and strides each department has made in its fight against prescription drugs.

Good News in the War Against Prescription Drugs.

The Florida Department of Law Enforcement (FDLE) stated in its semi-annual report that oxycodone-related deaths statewide dropped between January and June of 2012, compared to the same period of time in 2011. In the first half of 2012, there were 759 oxycodone-related deaths in Florida. That number is down from 1,058 during the same time period a year before.

A look at the national numbers shows that the number of people abusing prescription drugs is down. According to the White House drug czar, seven million people abused prescription drugs in 2010. By 2011, that number had dropped to 6.1 million. Studies also show prescription drug use among young adults ages 18 to 25 is also on the decline. To read the article from the Orlando Sentinel, click here.

Summit Focused on Need for More State Prescriptions Drug Monitoring Programs.

During the summit leaders spoke of the need to help state prescription drug monitoring programs succeed.

Just in March 2013, three states made moves to tighten monitoring and prescribing of controlled substances. Legislators in California, Pennsylvania and Kentucky are contemplating new regulations regarding the use of prescription drug monitoring programs. What this means is that whatever state you may be in, you should be aware that lawmakers are implementing similar programs and laws in their governments. To learn more, click here.

Drug Monitoring Programs Can Be Used as a Prosecution Tool.

Health professionals should take note, these prescription drug monitoring programs can, and will be, used as a prosecution tool. Enforcement of drug laws and prescribing regulations has been ever increasing in recent years. The implementation of these databases and corresponding regulations are going to provide more tools for law enforcement and state medical boards to crack down on physicians. In order to avoid trouble it is crucial that you take time to review your state’s prescribing and record keeping laws with an experienced health care attorney.

From experience, we have seen the database in Florida used mostly as a tool for prosecution of pain management physicians and pharmacists. Even in cases where the pharmacist has been the one to notify the authorities of suspected forged prescriptions and where the pharmacist has cooperated in prosecuting the criminals, I have seen this database cited as evidence against him or her. I do not believe this is what the legislation intended. Physicians and pharmacists should consider using whatever database is implemented in their respective states, or otherwise remaining vigilant to avoid being labeled an overprescriber.

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

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, pain management doctors, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Does the state where you are located have a prescription drug monitoring program? What do you think of these programs? Are they necessary? Please leave any thoughtful comments below.

Sources:

Pavuk, Amy. “‘We Can Stop This Epidemic,’ CDC Boss Says at Rx-Drug Abuse Summit in Orlando.” Orlando Sentinel. (April 2, 2013). From: http://www.orlandosentinel.com/news/local/breakingnews/os-prescription-drug-abuse-summit-20130402,0,4693169.story

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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

New Florida Rules Shorten Required Hours For Community Pharmacies and Change Start of Business Requirements

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Florida Board of Pharmacy (BOP) amended its rules regarding community pharmacies following a request for relief by industry health care professionals. The amended rules include shortening community pharmacy hours of operation from 40 to 20 hours per week, pharmacy delays to open business after the receipt of a permit and changes regarding ownership. Rules promulgated by The Florida BOP are published in the Florida Administrative Code (FAC).

Community Pharmacies May Delay Opening After Application is Approved.

The rule changes allow community pharmacies to delay the opening of business after receipt of the pharmacy permit. The BOP acknowledged that a delay may exist between the time a pharmacy receives a permit and when the pharmacy commences operations. For example, the delay in receiving the Drug Enforcement Administration (DEA) registration would make it difficult to structure an asset purchase. Ordinarily the pharmacy would have to obtain a new pharmacy permit and then obtain its DEA registration in an asset purchase transaction. Once the pharmacy permit has been received under prior rules, the pharmacy had to start operations (then 40 hours a week), but could not dispense controlled substances or obtain insurance contracts without the DEA registration.

Under the new rules, the BOP must be given notice (within 15 days) if the pharmacy is delaying its opening and give its reason. When it does open for business, the Board must be notified within two days. If the permittee delays commencement of operations, it must:

Display a sign in block letters not less than one inch in height at the main entrance of the establishment stating that the pharmacy is not yet open for business and that medicinal drugs may not be dispensed or sold nor prescriptions filled or dispensed; and

Within two business days of commencement of operations the permittee must notify the Board in writing that the permittee has commenced to operate and the date of such commencement.

Additionally, it is important to know that any pharmacy which does not commence operations within six months of the date of receipt of its permit, must provide a written statement to the Board that includes the reason(s) that the pharmacy has failed to commence operations, the efforts the pharmacy has made to commence to operate, the exact date the pharmacy expects to commence operations.

Changes in Ownership.

The BOP also amended the rules regarding changes of ownership and clarified that transfers of ownership in business entities (i.e., a corporation, limited liability company, limited partnership, etc.) holding pharmacy permits do not constitute “changes of ownership” when such entity continues to hold the permit without change in identity (purchase of stock or membership interests for example). Upon the transfer of ownership interests in the business entity, the following steps must also be taken:

Within fifteen days of closing the transfer, the permittee must notify the BOP of the transfer of ownership; and

All persons, members, partners, officers, directors, and agents having an ownership or other financial interest of greater than five percent and all persons who directly or indirectly manage, oversee, or control the operation of the business entity must file their fingerprints with the BOP.

The rule amendments, especially the reduction in community pharmacy operating hours from 40 per week to 20 per week, may give pharmacies the leeway for new opportunities and to try new business ventures, without incurring the expense of having to pay a full-time pharmacist.

Whether opening a new establishment, changing locations or changing owners, it is important to be aware of the licensing requirements and rules, process, fees and statutes.

A pharmacy permit is required prior to operating in the State of Florida. To learn about the changes and important information on obtaining a community pharmacy permit, click here to visit the Florida Board of Pharmacy.

To learn more on how we can help you or your practice if such a situation arises, click here to read one of my prior blogs.

Consult With A Health Law Attorney Experienced in the Representation of Pharmacists and Pharmacies.

We routinely provide deposition coverage to pharmacists, pharmacies and other health professionals being deposed in criminal cases, negligence cases, civil cases or disciplinary cases involving other health professionals.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians, physician assistants and other health professionals in investigations and at Board of Pharmacy hearings. Call now or visit our website www.TheHealthLawFirm.com.

Source:

Akerman LLP. “The Board of Pharmacy’s 40 Hour Rule is Dead! Long live the 20 Hour Rule! Community Pharmacy Ownership Rule Change Creates new Opportunities.” Lexology. (August 30, 2016). 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: The Florida Board of Pharmacy (BOP) attorneys, pharmacy hours of operation, reduced daily operating hours for pharmacies, community pharmacies may delay opening of business after receipt of permit, Drug Enforcement Administration (DEA) registration lawyers, community pharmacy permit, legal representation of pharmacies and pharmacists, pharmacy and pharmacist defense attorney, The Health Law Firm attorney reviews, reviews of The Health Law Firm attorneys, The Health Law Firm, pharmacy law attorney, change in ownership application

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

 

By |2016-09-15T13:55:31+00:00May 15th, 2018|Pharmacy Law Blog|0 Comments

3 Sentenced in Florida for $175 Million Drug Compounding Fraud Scheme

11 Indest-2008-8By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On March 24, 2017, three participants were sentenced in Florida federal court, for a scheme that used call centers and kickbacks to generate fake prescriptions for compounding pharmacies. The scheme was able to scam the government and private insurers for $175 million.

U.S. District Judge Daniel T.K. Hurley, sentenced one of the defendants, Todd Stephens, to ten years. He sentenced Todd Hanson to eight years and one month. He sentenced Christopher Mucha to 30 months in prison. Each defendant also received three years of supervised release (probation) after they are released from prison.

Illegal Enterprise.

Stephens, Hanson and Mucha were among 16 defendants the federal government charged in September 2016. The U.S. Department of Justice (DOJ) described an extensive enterprise that operated from 2013 to 2015. According to the DOJ, the enterprise controlled numerous stops along the supply chain, including the selection of ingredients for compounded drugs, solicitation of patients for unnecessary prescriptions, and funneling of kickbacks to “corrupt physicians.”

To learn more about the defendants being charged, click here.

According to prosecutors, the participants purchased pharmacies that functioned as fronts for the illegal conduct and held licenses that made the operation possible. Specific drugs were chosen and produced by the pharmacies based on the amount of money reimbursed by the military health care program TriCare, as well as other private insurers. More than $175 million was eventually paid out in false claims, prosecutors alleged.

Key Component of the Scheme.

The defendants used call centers as a major part of the scheme to generate bogus prescriptions. The call center staff obtained information on potential patients, including military veterans, who had previously been prescribed medications. They then proceeded to contact the patients to convince them to authorize the faxing of the medically unnecessary prescriptions to doctors’ offices.

A group of “corrupt” physicians would then issue prescriptions for compounded medications for the patients regardless of the absence of medical necessity. It was alleged that this was done in exchange for illegal compensation to the doctors such as cash, gift cards and free consulting. The defendants disguised the illegal payments as reimbursement for “data collection.” These were allegedly distributed through a phony software company called ClinicalCorp LLC, prosecutors said.

To read the sentencing memorandum in full, click here.

To read about a similar health care fraud case involving TRICARE, click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in Representing Pharmacists, Pharmacies, and Other Health Care Providers.

At the Health Law Firm we provide legal services for all health care providers and professionals. This includes pharmacists, pharmacies, 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.

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

Sources:

Hale, Nathan. “3 Sentenced In Fla. For $175M Health Care Fraud Scheme.” Law360. (March 24, 2017). Web.

McMahon, Paula. “Feds charge 16 in massive $175M prescription cream fraud based in South Florida.” Sun-Sentinel. (September 1, 2016). 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for allegations of violating Anti-Kickback Statute, TRICARE false claims legal defense attorney, TRICARE physician representation, pharmaceutical fraud lawyer, compounding pharmacy attorney, legal representation for military physicians, fraudulent practices of pharmaceutical companies, financial interest in physician referrals, TRICARE fraud attorney, compounding pharmacy lawyer, legal defense of military physicians, legal defense of TRICARE providers, attorney reviews of The Health Law Firm, Veterans Administration (VA) physician defense attorney, The Health Law Firm attorney reviews, Health care fraud defense attorney, legal representation for health care fraud, legal counsel for allegations of health care fraud, AKS defense attorney, False Claims Act (FCA) defense attorney, legal representation for FCA claims, legal representation for illegal kickback schemes, health care fraud defense lawyer, health care fraud scheme, legal representation for DOJ investigations, DOJ investigation defense attorney

“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 © 2017 The Health Law Firm. All rights reserved.

By |2017-03-29T20:29:15+00:00May 15th, 2018|Pharmacy Law Blog|0 Comments

Miami Medicare Fraud Fugitive Returns After Hiding in Cuba

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On Friday, a Miami pharmacy owner charged in a Medicare fraud scheme, surrendered to U.S. authorities after hiding in Cuba for over two years. Sandy De La Fe, was charged in 2013 with unlawfully pocketing $2.8 million in taxpayer-funded Medicare payments through his former business Goldenway Pharmacy Discount.

False Claims for Prescription Drugs.

According to the indictment, De La Fe submitted false claims for prescription drugs by using Medicare beneficiaries’ ID numbers. He also forged doctors’ signatures for medication that was either unnecessary or not provided at all. The scheme ran between 2011 and 2013, and according to the U.S. Attorney, is hardly unique. The U.S. Attorney’s Office has increasingly made cases against South Florida Pharmacy offenders who steal from the Medicare Part D drug program. To read a previous blog I wrote on the fraud and abuse plaguing the Medicare Part D program, click here.

Goldenway Pharmacy Discount Scheme.

De La Fe is also charged with conspiring with his business associates Jose Teijeiro and Michael Gonzalez Cabral, to pay recruiters to bring in Medicare beneficiaries. Both business associates have already plead guilty to fraud charges and are serving nine-year and five-year jail sentences. De La Fe had his first court appearance on Monday, since turning himself in. The prosecutor in the case plans to recommend no bail, arguing the defendant is a flight risk. Click here to read a previous blog I wrote on a similar case of Medicare fraud.

Voluntary Surrender.

In the case of Medicare fraud and fugitives, an estimated 150 South Florida defendants are at large in Cuba, Mexico and other countries. Normally, fugitives are stopped on federal arrest warrants or upon trying to enter the United States. A defendant voluntarily surrendering is highly unusual in cases like this. Apparently, De La Fe didn’t like life on the lam, and sources say that he missed his young son whom he left behind in the states.

De la Fe purchased his own plane ticket to Miami International Airport, where U.S. Marshall’s apprehended him.

Is Cuba No Longer a Safe Haven for Medicare Thieves?

We have defended physicians and other health professionals who have had their Medicare numbers and identities stolen by those seeking to use them to submit false bills to Medicare. Often in such cases, at least here in Florida, the perpetrator of such crimes has fled with the illegal proceeds. We suspect, in many cases, that they have gone to Cuba. With the relaxation of the relationship between the U.S. and Cuba, this may mean that Cuba is no longer a safe haven for such criminals. It is yet to be seen whether Cuba is likely to allow the extradition of such criminals or cooperate with government officials in the return of stolen funds. However, such may well be the case.

Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.

The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.

For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Comments?

As a pharmacy owner, pharmacy employee or health care facility owner, what do you think of the increased effort to find fraud? Do you think all facilities, not just pharmacies, are under the microscope? Please leave any thoughtful comments below.

Sources:

“Miami Pharmacy Owner Charged in Medicare Fraud Scheme Returns After Hiding in Cuba.” AHLA. (January 14, 2016). Web.

Weaver, Jay. “Miami Medicare-fraud fugitive returns from Cuba.” Miami Herald. (January 14, 2016). 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Medicare fraud, Centers for Medicare and Medicaid Services (CMS), pharmacy, Florida pharmacy investigation, false claims, Office of Inspector General (OIG), Department of Health (DOH), U.S. Department of Health and Human Services (HHS), pharmacy raid, defense attorney, defense lawyer, pharmacist defense, Medicare fraud defense lawyer, Legal counsel for pharmacists, Goldenway Pharmacy Discount, Florida pharmacy defense attorney, Florida health care attorney, Florida health care lawyer

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2016 The Health Law Firm. All rights reserved.

By |2016-01-20T21:10:44+00:00May 15th, 2018|Pharmacy Law Blog|0 Comments

Florida Senate Health Committee Approves Change In Optometrist Certification

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 5, 2017, the Florida Senate Health Policy Committee approved a bill that would allow the Florida Board of Optometry to offer practical and written “certification” examinations to applicants. The bill would assist optometrists who were licensed before July 1993 and, therefore, were not required to be “certified.”

Certified vs. Licensed.

In Florida, the law allows certified optometrists to prescribe pharmaceuticals for the treatment of glaucoma. However, licensed optometrists who aren’t certified cannot prescribe those drugs. They are required to make the public aware by posting in their offices a sign that states, “I am a Licensed Practitioner, not a Certified Optometrist, and I am not able to prescribe ocular pharmaceutical agents.”

Applicants are required to submit proof to the Department of Health (DOH) that she or he meets certain requirements and pass an exam within a specified time frame if they wish to be certified.

The Senate Health Policy Committee unanimously approved the bill (SB 520). To read more on SB 520, click here.
To stay on top of news and regulations for optometrists, check our Vision Law Blog regularly.

 

Contact Health Law Attorneys Experienced in Representing Optometrists.

The attorneys of The Health Law Firm provide legal representation to optometrists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, contract matters, business law matters, business litigation and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Miller, Daylina. “Panel Approves Change In Optometrist Certification.” Health News Florida. (December 6, 2017). Web.

“Panel Approves Change In Optometrist Certification.” WLRN TV. (December 6, 2017). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with 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, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“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 © 2018 The Health Law Firm. All rights reserved.

By |2018-02-20T18:35:25+00:00May 15th, 2018|Pharmacy Law Blog|0 Comments

Florida Woman Arrested for Allegedly Posing as a Nurse, Giving Botox Injections-For Second Time

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

A Boca Raton, Florida, woman was arrested on June 21, 2013, after authorities say she posed as a nurse and offered Botox injections. The fake nurse has been charged with unlicensed practice of a health care professional. If found guilty, the phony nurse could be sentenced to up to five years in jail. This was a joint investigation between the Florida Department of Health (DOH) Investigative Services Unit, the City of Boca Raton Police Department and the Florida Department of Corrections.

To read the press release from the DOH, click here.

Undercover Agents Visited Fake Nurse at her Place of Business.

According to The Palm Beach Post, officials began their investigation of the fake nurse on June 6, 2013, after receiving an anonymous tip. Local police officials and the DOH set up an undercover sting. Days later an undercover agent scheduled a Botox appointment with the phony nurse and then visited the office. Hours later, investigators allegedly arrested the fake nurse.

Click here to read the entire article from The Palm Beach Post.

According to the DOH, this is not the first time she has claimed to be a nurse and got caught. The same phony nurse was allegedly previous arrested for unlicensed activity in Palm Beach, Florida, according to DOH authorities.

Verifying the License of a Health Care Professional.

This particular woman allegedly claimed to be an operating room nurse and on the website Groupon.com she allegedly claimed to be a surgical nurse.

The DOH has several resources to fight unlicensed activity. Patients are encouraged to check the DOH’s website to verify the license information of their health care providers. Complaints can also be filed calling the DOH. Click here to view the DOH’s website.

Practicing Without a License Is a Crime.

Practicing medicine without a license is a crime. Additionally, so is helping someone practice medicine without a license. As a practitioner, you may be asked to supervise or join a practice. Remember, your license may be at stake with any wrongdoing by your subordinates. Before you join a practice or agree to supervise others, check first with the DOH that the other providers are legitimate. You can verify a license for free on the DOH’s website.

Remember, a license to practice medicine in Venezuela, Cuba, or anywhere else, is just that: a license to practice in that country. It does not allow a person to practice medicine in the United States.

More Stories on Fake Physicians and Other Health Professionals to Come.

In the future on this blog, we will continue to include additional articles on fake doctors and health professionals.

To see a blog on a fake South Florida dentist and the damage he inflicted on a teenage girl, click here. To read a blog on an infamous Florida teen impersonating a physician assistant (PA), click here. You can also read the story of a fake plastic surgeon in New York by clicking here.

Contact a Health Law Attorney Experienced in Representing Health Care Providers in DOH Cases.

If you find yourself working for or supervising someone that does not have a valid Florida license, your own license may be at risk. If and when the Department of Health (DOH) becomes involved, do not sign anything, do not speak to the investigators and do not make any statements. Contact an experienced health law attorney immediately to review your case.

The Health Law Firm represents physicians, nurses, dentists, pharmacists, pharmacies and other health care providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the Drug Enforcement Agency (DEA), Department of Health (DOH), and other law enforcement agencies. If you are aware of an investigation of you or your practice, or if you have been contacted by the DEA or DOH, contact an experienced health law attorney immediately.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

What are your thoughts on this story? Please leave any thoughtful comments below.

Sources:

Florida Department of Health. “Joint Investigation Leads to Arrest in Palm Beach County.” Florida Department of Health. (June 21, 2013). From: http://newsroom.doh.state.fl.us/wp-content/uploads/newsroom/2013/05/062113Goldman.pdf

Alcantara, Chris. “Woman Arrested a Second Time for Allegedly Posing as Nurse, Offering Botox Injections in Boca Raton.” The Palm Beach Post. (June 22, 2013). From: http://www.palmbeachpost.com/news/news/crime-law/woman-arrested-a-second-time-for-allegedly-posing-/nYSDh/

Entin, Brian. “Sheri Goldman: Boca Woman Arrested After Police Say She Offered Botox, Told People She was a Nurse.” WPTV. (June 21, 2013). From: http://www.wptv.com/dpp/news/region_s_palm_beach_county/boca_raton/boca-woman-arrested-after-police-say-she-offered-botox-and-told-people-she-was-a-nurse

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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Other Options Must Be Considered Before Emergency Suspension Order Will Be Upheld

The Department of Health (“DOH”) issued an emergency order suspending Burton’s license to practice nursing.

On appeal, the court quashed the emergency order. It held that DOH had failed to examine other disciplinary options available to it short of suspension. While recognizing DOH might be able to support license suspension as an appropriate penalty, it held that Burton was entitled to a hearing to contest the charges.

In the dissenting opinion, Judge Osterhaus cited numerous findings in the DOH order that supported suspension.

Source:

Burton v. Department of Health, 116 So. 3d 1285 (Fla. 1st DCA 2013) (Opinion filed July 24, 2013).

About the Author: The forgoing case summary was prepared by Mary F. Smallwood, Esquire, of the Administrative Law Section of The Florida Bar. It originally appeared in the Administrative Law Section newsletter, Vol. 35, No. 2 (Dec. 2013).

Two Central Florida CVS Pharmacies Get Controlled Substance Licenses Pulled by Drug Enforcement Administration (DEA)

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

The U.S. Drug Enforcement Administration (DEA) revoked the registrations (controlled substance licenses) from two CVS pharmacies in Sanford, Florida, on September 12, 2012, according to a number of sources. The two pharmacies will no longer be able to fill prescriptions for drugs such as oxycodone, Dilaudid, Vicodin, Ritalin and Xanax. This decision is in response to a government crackdown on the distribution of painkillers. Sanford is in Seminole County, a suburb of the greater Orlando area.

To see the court records from this case, click here.

We’ve been following this story and previously blogged on this topic in our blogs on February 10, 2012, February 29, 2012, and March 7, 2012.

DEA Believed the Two Pharmacies Filled an Inappropriate Number of Prescriptions for Oxycodone.

According to an article from Reuters, the DEA believed the stores, located on Orlando Drive and West First Street, in Sanford, were allegedly filling an inappropriate number of prescriptions for oxycodone and had a suspicious number of sales of other controlled substances.

In the same article, CVS argued that the large number of oxycodone and other prescription painkillers from the two stores is due to that fact that the two locations are busy stores, with one store open 24 hours a day. The DEA apparently did not accept this justification.

Click here to read the entire article from Reuters.

Same Two CVS Pharmacies were Raided in February 2012.

Back in February of 2012, the DEA raided the same two Sanford CVS pharmacies. The DEA called the pharmacies an “imminent danger” to the public and filed immediate suspension orders against both stores. I previously wrote a blog about the emergency suspension order and the subsequent request from CVS for a restraining order against the DEA. Click here to read the blog.

DEA Fights Prescription Drug Epidemic.

In a press release, a special agent in charge of the DEA’s Miami Division said the final order reflects “the continued commitment of the DEA to identify and bring to light the diversion of controlled substance pharmaceutical drugs.”

To see the entire press release from the DEA, click here.

According to the Orlando Sentinel, the major newspaper in Orange County and Seminole County, this measure is thought to be the first of its kind against a national retail pharmacy chain.

In my personal opinion, if the large retail giants can’t survive such an attack, the small independent pharmacies stand little chance.

Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.

The Health Law Firm represents pharmacists and pharmacies in DEA investigations, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits. The firm’s attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Reuters. “U.S. Revoking 2 CVS Stores’ Controlled Substance Licenses” Thomson Reuter. (September 12, 2012). From: http://www.reuters.com/article/2012/09/12/us-usa-drugstores-cvs-idUSBRE88B0KN20120912

Pavuk, Amy. “Two Sanford CVS Pharmacies Banned from Selling Oxycodone, Other Controlled Substances.” Orlando Sentinel. (September 12, 2012). From: http://articles.orlandosentinel.com/2012-09-12/news/os-sanford-cvs-caremark-revoke-drugs-20120912_1_revokes-prescription-drug-abuse-oxycodone-and-other-prescription

Holiday CVS, L.L.C., v. Eric H. Holder, JR., et al., No. 12-5072 United States Court of Appeals for the District of Columbia Circuit. (September 11, 2012), available at http://www.thehealthlawfirm.com/uploads/CVS%20License%20Revoked.pdf.

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 Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

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