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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.

KeyWords: Legal representation for optometrists, optometrist defense attorney, ophthalmologist defense attorney, legal representation for eye doctors, medical license defense attorney, optometry license defense attorney, legal representation for optometry licensure issues, Board of Optometry investigation defense attorney, legal counsel for Board of Optometry investigations and hearings, Board of Medicine investigation defense attorney, legal counsel for Board of Medicine investigations and hearings, Department of Health investigation defense attorney, legal counsel for Department of Health investigations and hearings health care professional defense attorney, legal representation for medical professionals, Florida health law attorney, informal administrative hearing defense attorney, informal administrative hearing defense lawyer, informal administrative hearing defense legal counsel, complaint against professional license defense attorney, complaint against professional license defense lawyer, legal representation for Optometrists in Florida, The Health Law Firm, reviews of The Health Law Firm, The Health Law Firm attorney reviews, health law defense attorney, legal representation for health care professionals, complex health litigation defense attorney, complex health care litigation legal counsel

“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.

Negligence Will Determine the Success or Failure of the Meningitis Lawsuits Against Doctors and Clinics

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 victims and survivors of the meningitis outbreak are now filing lawsuits against the physicians and clinics that administered the tainted steroids. According to an article in The Tennessean, on January 29, 2013, a husband who lost his wife to fungal meningitis filed the first lawsuit against a Nashville outpatient clinic. It’s believed hundreds of people were injected at the same clinic with the tainted steroids. The man is now seeking $12.5 million in damages.

Click here to read the entire article from The Tennessean.

This lawsuit is just one in what is expected to be a series of lawsuits, in not just Tennessee, but across the country.

Compounding Pharmacy Allegedly Behind the Meningitis Outbreak is Out of Business.

The meningitis outbreak was at a peak in the fall of 2012. Contaminated steroid injections were allegedly made at the New England Compounding Center (NECC) in Framingham, Massachusetts. NECC is accused of shipping thousands of vials of tainted drugs across the country. There are allegedly 45 deaths nationwide from the steroids. The company shut down in October 2012, and filed for bankruptcy in December, according to an article in American Medical News.

Tennessee Complaint Alleges Outpatient Clinic Put Money Before Patients.

The man suing the Nashville outpatient clinic believes, among other things, that officials at the clinic put the company’s bottom line before patient care. The lawsuit specifically alleges:

1. The outpatient clinic ignored important information when it chose NECC to purchase thousands of vials of steroids,
2. That clinic officials failed to properly notify the victim that she had been injected with a potentially contaminated steroid,
3. That clinic officials failed to recommend the victim should receive treatment,
4. The clinic chose to purchase drugs from NECC because it was a cheaper than the safer alternatives.

Click here to read the entire complaint.

The Responsibility of Doctors and Clinics.

Negligence is the most common claim used against doctors in cases of defective medication. The assumption is that the physician breached the standard of care because he or she knew or should have known that NECC was not meeting applicable standards in compounding the medications. Another legal theory is that the physician should have known that certain medications should not have been compounded, but rather obtained directly from a manufacturer. I believe the liability of physicians and clinics might be established to the extent that the physicians were aware that the steroids distributed by NECC violated regulations on compounding prescription medications.

It’s imperative physicians and clinics are sure of the credentials of all vendors and suppliers.

I was recently quoted in an American Medical News article about physicians and clinics that are entangled in tainted drugs lawsuits. To read the entire article, click here.

Florida Compounding Pharmacy No Stranger to Fungal Outbreaks.

Florida has seen its share of fungal outbreaks. I previously blogged about the problems encountered by Franck’s pharmacy in Ocala, Florida. It was accused of distributing eye medications that contained a fungal infection. Click here for the first blog and here for the second blog.

Pharmacists Need to Obtain Good Professional Liability Insurance.

Many pharmacists, especially those who work for state agencies, large hospitals, pharmacy chains or other large institutions, scrimp on their purchase of professional liability insurance. Many mistakenly believe their employer will cover any legal defense expenses. This is not true and is often found out too late.

A pharmacist should always carry his/her own professional negligence insurance. It is inexpensive and can cover many types of legal actions other than just civil negligence cases. Always, always, always be sure your insurance includes at least $25,000 in professional license defense coverage. Get this in writing!

Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.

The Health Law Firm represents pharmacists and pharmacies in investigations, regulatory matters, licensing issues, litigation, 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.

Comments?

What do you think about the lawsuits against these doctors and clinics? Who do you think should be help responsible: the compounding pharmacy that shipped the contaminated steroids, or the doctors and clinics that administered the steroid shots? Please leave any thoughtful comments below.

Sources:

Roche Jr., Walter. “Meningitis Outbreak: Victim’s Husband Sues Saint Thomas Clinic.” The Tennessean. (January 31, 2013). From: http://www.tennessean.com/apps/pbcs.dll/article?AID=2013301300211&nclick_check=1

Wayne A. Reed v. Saint Thomas Outpatient Neurosurgical Center. Case Number 13C-417. Complaint. (January 29, 2013). From: http://www.thehealthlawfirm.com/uploads/Reed%20v.%20St.%20Thomas%20Outpatient.pdf

Gallegos, Alicia. “Physicians Entangled in Tainted Drugs Lawsuits.” American Medical News. (February 11, 2013). From: http://www.thehealthlawfirm.com/uploads/AMN_PhysicianLawsuits.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.

CVS Blacklists Second Set of Doctors Accused of Overprescribing Painkillers

1 Indest-2008-1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

CVS is again stepping up its own internal efforts to combat the nation’s prescription drug abuse epidemic. According to Reuters, the second largest retail pharmacy chain announced it is cutting off access to the most powerful painkillers for more than 36 doctors and health care providers around the country. The Drug Enforcement Administration (DEA) has been keeping a close eye on CVS over the past few years. According to Reuters, CVS began revoking the dispensing privileges of certain providers back in 2011. CVS disclosed this round of suspensions on August 21, 2013.

To read the article from Reuters, click here.

CVS Closely Analyzed Prescription Practices of Health Care Providers Before Suspending Dispensing Privileges.

CVS said the suspension followed an analysis of prescriptions brought to its drugstores from March 2010 through January 2012, for painkillers such as oxycondone, hydrocodone, and methadone, according to Reuters. CVS said it first identified several dozen health care providers, from its database of nearly one million, with “extreme” patters of prescribing high-risk drugs. CVS allegedly compared their prescription rates to other providers in the same specialty and geographic region, the ages of the patients, and the number of patients paying with cash for the drugs.

After analyzing the results, CVS said the company’s stores and mail-order pharmacy will no longer dispense controlled substances for 36 providers who it said could not justify their prescribing habits, according to the Orlando Sentinel. CVS did not disclose the names or location of the physicians blacklisted this time around.

Click here to read the Orlando Sentinel article.

Second Time CVS Has Blacked Listed Specific Doctors.

In November 2011, at least 22 Central Florida doctors received an unsigned letter from CVS telling them that the company’s pharmacists would no longer fill prescriptions they write for painkillers and other powerful drugs. The letter was called a “blacklist” and was criticized as discriminatory. One Orlando doctor tried to fight back with legal action, claiming that CVS basically called him a criminal. To read more on the previous blacklist, click here to read my blog.

So far, we have not heard of any legal action pending against CVS from providers recently added to the blacklist.

DEA Previously Pulled Controlled Substance Licenses from Two Sanford, Florida, CVS Pharmacies.

As previously stated, the DEA has had its eyes on CVS for a while. You may remember that in September 2012, the DEA revoked the registrations (controlled substance licenses) from two CVS pharmacies in Sanford, Florida. I previously wrote about this, click here to read that blog.

Who is Responsible for the Prescription Drug Epidemic?

The act of prescribing powerful, and sometimes deadly, addictive drugs inappropriately for a health care provider’s personal gain has grown. It’s argued that pharmacies have a role to play in the oversight of controlled substance prescriptions. Pharmacists, as well as physicians and all health care providers, have an ethical (and legal duty) to ensure that a prescription for a controlled substance is appropriate.

Contact Health Law Attorneys Experienced with DEA Cases.

The Health Law Firm represents physicians, pharmacists, pharmacies, 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.

Comments?

What do you think of CVS’ ban on filling controlled substance prescriptions from certain doctors? Do you think this will help with the national prescription drug abuse epidemic? Please leave any thoughtful comments below.

Sources:

Pavuk, Amy. “CVS Cracks Down on Doctors with ‘Extreme Patters’ of Prescribing High-Risk Drugs.” Orlando Sentinel. (August 29, 2013). From: http://www.orlandosentinel.com/news/local/breakingnews/os-cvs-crackdown-doctors-20130829,0,5193527.story?dssReturn

Wohl, Jessica. “CVS Cuts Access to Opiod Pain-Killers for Suspect Doctors.” Reuters. (August 21, 2013). From: http://www.reuters.com/article/2013/08/21/us-cvscaremark-painkillers-idUSBRE97K17120130821

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.

By |2013-08-30T15:44:02+00:00May 15th, 2018|Pharmacist, Pharmacy|0 Comments

Feds Reach Deal With Florida Compounding Pharmacy Owners, Agree to Pay Almost $7.8 Million to Settle FCA Suit

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On September 14, 2016, co-owners of a Maitland, Florida, compounding pharmacy agreed to pay $7.75 million to the federal government to resolve False Claims Act (FCA) allegations. QMedRx reached the settlement in connection with alleged fraudulent billing practices for services that weren’t eligible for reimbursement through federal health care programs, prosecutors said.

The U.S. attorney’s office for the Middle District of Florida sought penalties and fines for Andy Miller, Tracy Miller and the Healthmark Investment Trust, who are partial owners of QMedRx and allegedly participated in the fraud scheme.

“Deceptive” Prescriptions.

According to prosecutors, from January 2013 to January 2014, QMedRx knowingly billed federal health care programs for prescriptions that weren’t qualified for reimbursement. Under the federal Anti-Kickback Statute, the exchange of money or goods for federal health care program referrals is illegal.

“The United States Attorney’s Office is committed to protecting TriCare and other federal health care programs from fraud,” U.S. Attorney A. Lee Bentley III said in a statement. “Those who violate the Anti-Kickback Statute to generate business will be held accountable.”

 

The Federal Government’s Ongoing Battle.

Unfortunately, these types of elaborate fraud schemes have been seen many times before.
For example, this case stemmed from an ongoing investigation to unearth improper claims submitted to the TriCare program, a health care program that provides benefits for United States military personnel.

To read more on this ongoing health care fraud investigation, click here.

At The Health Law Firm, we have experience with FCA, whistle-blower/qui tam cases and allegations, click here to read a press release from one of our cases in 2015.

Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.

The attorneys of The Health Law Firm represent pharmacies and pharmacists in defending investigations, defending False Claims Act and whistleblower cases, defending against actions by the Drug Enforcement Agency (DEA) and the Department of Health (DOH), and in licensing, regulatory and corporate matters. They also represent health care 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. They represent companies in buying and selling health care businesses and prepare contracts.

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

Sources:

Kang, Peter. “Fla. Pharmacy Owners to Pay $7.8M to Settle FCA Suit.” Law360. (September 14, 2016). Web.

Jacobson, Susan. “Feds reach deal on pharmacy fraud case.” Orlando Sentinel. (September 15, 2016). Print.

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: Florida compounding pharmacy defense attorney, False Claims Act (FCA) defense counsel, improper billing practices, knowingly submitting fraudulent claims, federal Anti-Kickback Statute, qui tam whistleblower defense attorney, legal representation for whistleblower and qui tam cases, legal representation for pharmacies, Medicare and Medicaid fraud defense attorney, health care fraud defense lawyer, whistleblower/qui tam attorney, reviews for The Health Law Firm attorneys, The Health Law Firm reviews, The Health Law Firm, Board of Pharmacy attorney, Department of Health (DOH) defense lawyer, Drug Enforcement Administration (DEA) defense counsel, Food and Drug Administration (FDA) defense 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 © 2016 The Health Law Firm. All rights reserved.

By |2016-09-21T08:57:09+00:00May 15th, 2018|Pharmacy Law Blog|0 Comments

20 Tips Plus a Bonus for Physicians Negotiating Their Own Employment Contracts

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

At The Health Law Firm, we often receive calls from physicians and health professionals about reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, voiding contracts, getting out of contracts and litigating various contract provisions. Physicians and other health professionals should understand the common language and terms found in employment contracts for professionals so they can recognize mistakes commonly when negotiating them.

Our comments here are meant to provide general tips we have learned from our experience. However, please remember, every situation is different and there are exceptions to every rule. I have added a “bonus tip” here, because of recent problems our clients have had.

“Bonus Tip;” The Prime Directive.

My primary tip, and I would say it is the most important, is to know the persons and parties with whom you are contracting and be sure the contract contains that information. Make sure you know the complete name and residence address of the principal person with whom you are dealing. Then be sure you know the complete information on any business entity with which you are dealing, including state of incorporation (or organization), shareholders (or “owners” or members), and address of its main headquarters (principal place of business). If other business entities are the shareholders, owners or members of the entity for which you will be working, you need to find out the same information for each of them. Make sure they are all authorized to do business in your state and have the appropriate licenses that your state requires.

In Florida, any medical business that is not actually 100% owned by Florida licensed physicians or health professionals must have a Health Care Clinic license issued by the Florida Agency for Health Care Administration. Dental practices and optometry practices cannot be owned by anyone who is not licensed to practice dentistry in the state of Florida. Some unscrupulous business people attempt to skirt the law by setting up phoney or “straw man” owners that are physicians or dentists. This is illegal, a felony in many cases, so be cautious. My advice would be not to sign up with a business entity that has been created solely for the purpose of contracting with you and which has no assets. This has been a real problem, lately.

20 More Tips.

The following are a few tips for any physician who is involved in negotiating his or her own employment agreement.

1. There is no such thing as a “standard physician employment agreement.”

2. Everything is negotiable.

3. Be sure the wording of the contract represents exactly the agreement you made. If it is different or not specified, the language in the contract will govern in any future dispute.

4. Be sure that every blank in the contract is completed and filled in before you sign.

5. Be sure that every Exhibit, Addendum or Schedule referred to in the contract is completed and attached before you sign.

6. Shun “legal” advice from your peers and, especially, from the accountants and representatives of your future employer. Misinformation about legal issues abounds. Just because one court may have decided a legal issue a certain way in one case in one state does not mean a different court would not reach a different decision, even in the same state or county. Every set of facts and circumstances, every contract and every case are different.

7. Obtain and review copies of every document referred to in the agreement. These are considered part of the agreement. These may include the practice’s policies and procedures, the employee handbook, a code of conduct, sexual harassment policy, compliance agreements, etc. Keep these in a file with a copy of your contract.

8. Carefully consider clauses that allow the employer to terminate the agreement without cause on a 30 day, 60 day, 90 day or 180 day notice. With such a clause in your contract, you no longer have a one year or two year agreement. Instead, you have a 30 day, 60 day, 90 day or 180 day contract. Can you find another job and relocate in 30 days or 60 days?

9. If there is a “for cause” termination provision in the contract, be sure to include a “cure” provision. This is a provision which requires the employer to provide you written notice of any deficiency or breach and allows you a certain period of time (usually anywhere from 10 to 30 days) to cure it.

10. Ensure the contract is clear throughout that you are an employee and not an independent contractor. Employees receive far more benefits and have more protections under the law than do independent contractors. If you sign on as an independent contractor, you will be assuming many expenses and liabilities that the employer would ordinarily be required to assume.

11. A promise to make you a “partner” or “shareholder” in the practice after a certain period of time will not be enforceable unless all of the terms are specified in order for a court to enforce it. (Price, timing, percentage of ownership, method of payment of the buy-in, etc.). Think of an option to purchase a house. Unless all of the terms for a binding contract are set forth in writing and agreed to by the parties, it will not be enforceable.

12. If you sign the agreement, be prepared to honor it. Do not sign an agreement thinking that there may be certain provisions that won’t be enforceable or that you won’t be required to follow in the future. Assume that every part of the contract is enforceable.

13. Restrictive covenants (sometimes referred to as covenants not to compete) are enforceable in Florida. Although there are many exceptions and defenses that can be used to defeat or prevent the enforcement of a restrictive covenant, unless you have the money set aside to finance litigation, expect to honor it if it is in the agreement. As an employee, your negotiation strategy should be to: a) have it removed completely, or b) reduce the period of time and reduce the geographic area as low as possible. Also, it should be worded so as to only apply to the office or location in which you work and to the medical subspecialty or type of practice in which you will work.

14. Avoid assuming any obligation to pay the premium for tail coverage for professional liability (medical malpractice) insurance, especially if the employer terminates the employment. If you are not able to negotiate this away completely: a) reduce the percentage you agree to pay to 50% or have it reduced 25% for each year you are in the practice, and b) insert a provision that if you maintain the same insurance company or obtain retroactive coverage, this will be substituted for tail coverage.

15. Visit the practice, hospital and area at least three (3) times before signing. One of these visits should be without the knowledge of the potential employer when you can tour the geographic area and, perhaps, the hospitals on your own.

16. Contact any physicians you know or have met in the past who live in the area or any surrounding areas. They may be able to provide you information regarding your potential employer, hospital or city that may affect your decision.

17. Do your “due diligence” before agreeing. Ask to see actual billing and collections figures and income statements. Talk to other associates. If your compensation will be based on productivity, speak with another physician who is similarly compensated about how his/her compensation is computed. Visit any hospital, nursing home or other facility where you will have privileges or see patients. Discuss the quality of the equipment and stuff with other physicians and physicians in surrounding communities.

18. Do not buy a permanent residence (house or condominium) during your first two years of employment with a new practice in a new location. Rent or rent with an option to purchase. This will give you much more flexibility if the employment situation does not work out to your expectations.

19. If you receive a signing bonus, put it in the bank in a CD or money market to use as needed in connection with tips 14 and 15 above. This may be your personal “golden parachute” if you need to leave a bad situation.

20. Do not start working until you have a copy of the employment agreement. A draft copy if not sufficient. A copy signed by you but not by the employer is not sufficient. The most common problem we see when there is a physician employment dispute is that the employee does not have a copy of the contract that is signed by the employer.

Contact a Health Care Attorney Experienced in Negotiating and Evaluating Physician and Health Professional’s Business Transactions.

At the Health Law Firm we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, durable medical equipment suppliers (DME), medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider.

The services we provide include reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, advice on setting aside or voiding contracts, litigation of contracts (in start or federal court), business transactions, professional license defense, opinion letters, representation in investigations, fair hearing defense, representation in peer review and clinical privileges hearings, litigation of restrictive covenant (covenants not to compete), Medicare and Medicaid audits, commercial litigation, and administrative hearings.

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

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: Physician employment agreement, physician employment contract, health professional contracting, negotiating business transactions, physician contracts, contracting tips, legal representation for physician contracts, legal representation for negotiating physician contracts, contracting defense attorney, physician contract attorney, legal representation for contract litigation, legal representation for business litigation, legal counsel for contract terms, legal representation for physician agreements, legal representation for business transactions, legal counsel for restrictive covenants, legal counsel for noncompetition agreements, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, health law defense attorney, health law attorney

“The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., and Florida professional service corporation, since 1999, and is also a registered service mark. Copyright © 2017 The Health Law Firm. All rights reserved.

By |2017-08-07T09:19:39+00:00May 15th, 2018|Pharmacy Law Blog|0 Comments

Miami Medicare Fraud Ring Busted By FBI: Many Suspects arrested, Some Flee to 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 April 28, 2016, agents from the Federal Bureau of Investigations (FBI) arrested 21 suspects on charges of operating Miami-Dade pharmacies as fronts to steal $17 million from the Medicare program. Four additional suspects are believed to have fled to Cuba, where Medicare fraud fugitives have found refuge for years. The immediate question is that with political relations with Cuba easing up, how much longer are crooks going to be able to do this? Hopefully, not much longer.

String of Local Pharmacies Used as a Front.

In September 2015, FBI agents showed up at Hialeah dental office looking for the alleged ringleader of the Medicare fraud scam. He managed to slip away before authorities could make an arrest and he and three others are believed to have escaped to Cuba.

But on April 28, 2016, 18 other members of his network were not so lucky. They were arrested and charged with operating the Miami-Dade pharmacies as a front to defraud the Medicare program of $17 million.

Federal agents and special agents of the Department of Health and Human Services (HHS) Office of Inspector General (OIG) spread out to arrest the suspects. The suspects who were arrested are also charged with conspiring to defraud the federal health insurance program by paying off recruiters to reel in Medicare beneficiaries so they could use their ID numbers to file false claims for prescription drugs, according to authorities.

Multi-Million Dollar Scheme.

Authorities state that the suspects were able to pull off the multi-million dollar scheme by forging doctors’ signatures for medication that was either unnecessary or not provided. Because of a longstanding problem of lax oversight by federal health care regulators, Medicare and private insurers failed to detect the fraud after paying out millions. “Unfortunately, South Florida remain ground zero for these types of scams,” said William Maddalena, assistant special agent in charge of the FBI’s Miami office.

A Longstanding Problem.

Pharmacy fraud has become increasingly common in Florida, the nation’s perennial capital of Medicare fraud. In several recent cases, pharmacy owners paid kickbacks to patients or patient recruiters to generate a steady stream of false Medicare claims and bilk the Part D program. To read one of my prior blogs on a similar case of fraud in Florida, click here.

Fleeing Criminals Take Our Taxpayer Money to Foreign Countries.

This seems to be a recurring theme. In every big arrest of multiple conspirators and Medicare fraudsters, there seems to be a bunch who have fled oversees. Even in our dealings with pain management clinics, it is often discovered theat millions of dollars have been sent by the nonphysician owners overseas, beyond government reach. In Florida, the fugitives’ haven seems to be Cuba more often than not. It is our hope that the U.S. is making headway in its thawing of relations with Cuba, to reach an agreement with Cuba to be able to extradite these fugitives and seize their assets. While Cuba remains a poor, embargoed country, this is unlikely to happen. When it can see billions in tourist and investment dollars at stake, it will be a different story. Why should we allow criminals to sit 90 miles offshore with their stolen millions and thumb their noses at the rest of us, when the “good” criminals would rather live in federal prison than live in Cuba?

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.

Source:

Weaver, Jay. “FBI agents bust Miami Medicare ring while some suspects flee to Cuba.” Miami Herald. (April 28, 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, 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 © 2016 The Health Law Firm. All rights reserved

By |2016-05-08T17:22:10+00:00May 15th, 2018|Pharmacy Law Blog|0 Comments

Kmart Agrees to Pay $32.3 million to Settle Whistle Blower’s False Claims Act Suit

PS 3 Indest-2009-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 22, 2017, Kmart Corporation agreed to pay $32.3 million to settle a whistle blower lawsuit alleging its pharmacies caused federal health programs to overpay for prescription drugs by not telling the government about discounted prices. The department store chain withheld certain information from Medicare Part D, Medicaid and Tricare, the Department of Justice (DOJ) said.

The Whistle Blower False Claims Act (FCA) Suit.

The new agreement resolves allegations arising from a 2008 lawsuit brought under the qui tam, or whistle blower, provisions of the False Claims Act (FCA). This provision permits private citizens with knowledge of fraud against the government to bring an action on behalf of the United States and to share in any recovery.

The 2008 lawsuit, which was filed by a former Kmart pharmacist, alleged that Kmart pharmacies offered discounted generic drug prices to cash paying customers through various club programs. The pharmacies then knowingly failed to disclose those prices when reporting to federal health programs. According to the suit, in one case, Kmart had sold a 30-day supply of a generic version of a prescription drug for $5 to customers of its discount program, but then filed for reimbursement from the government for $152 for that same drug for its Medicare customers.
To read more on the 2008 suit, click here.

The settlement agreement with the United States is a part of a global $59 million settlement that includes a resolution of state Medicaid and insurance claims against Kmart. The former pharmacist will receive a whistle blower award of $9.3 million. The case was heard in the U.S. District Court in the Southern District of Illinois.

To read the DOJ’s press release on this case in full, click here.

To read about a similar case of a pharmacy inflating prices to government health care programs, click here to read one of my prior blogs.

Who Knew Medicare Part D Claims Could Yield Such Big Whistle Blower Settlements?

Who knew Medicare part D claims could yield such big whistle blower settlements? I know I didn’t. I didn’t even think about such claims until I read this case. This could mean some serious compliance issues for big chain stores that have pharmacies (note that I said “could”). Walmart, Publix, Albertsons, Costco, Sam’s Club, Winn Dixie, Engel’s, and every other chain that owns and operates pharmacies, may be in jeopardy.

Contact an Experienced Health Law Attorney to Assist in Whistleblower/Qui Tam Cases.

If you have knowledge of false claims being filed against Medicare, Medicaid, TRICARE/CHAMPUS or any other type of government program, please contact us, and we will be happy to assist you. Our law firm represents health professionals and health care organizations almost exclusively. Yet, we have been involved in a number of whistleblower/qui tam cases, in which we represent the person who files the claim (the whistle blower). We have also defended health professionals and institutions in litigation of whistle blower complaints filed against them.

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

Sources:

McCausland, Phil. “Kmart to pay $32.3M to settle health care-related whistleblower case.” NBC News. (December 22, 2017). Web.

The Associated Press. “Kmart to pay $32.3 million to settle prescription drugs case.” ABC News. (December 22, 2017). 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: False Claims Act case, legal representation for whistle blower suits, legal representation of plaintiffs in whistle blower cases, legal representation of defendants in whistle blower cases, legal representation in complex health care litigation cases attorney lawyer, legal representation in federal and state courts attorney lawyer, whistle blower defense attorney, legal representation in qui tam lawsuits, qui tam defense attorney, pharmacy defense attorney, pharmacist defense attorney, pharmacy defense lawyer, pharmacist defense lawyer, pharmacy defense counsel, pharmacist defense counsel, Board of Pharmacy license defense attorney, Board of Pharmacy license defense lawyer, Board of Pharmacy license defense counsel, FCA defense attorney, legal representation for Medicare false claims, legal representation for false billing, Medicare fraud defense attorney, legal representation for Medicare fraud, legal representation for Medicare audit, complex health care litigation defense attorney, health care fraud defense attorney, complex health care litigation defense lawyer, legal representation for health care professionals, health law defense attorney, The Health Law Firm attorney reviews, reviews of The Health Law Firm, whistle blower plaintiff attorney, health care professionals defense counsel, health care professional defense lawyer, health care professional defense counsel, whistle blower defense attorney, whistle blower defense lawyer, legal representation for whistle blower suits, legal representation for qui tam suits, qui tam relator attorney, qui tam relator lawyer, qui tam relator legal counsel

 

“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 |2018-01-30T07:21:11+00:00May 15th, 2018|Pharmacy Law Blog|0 Comments
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