administrative law judge | The Health Law Firm Blog

Orlando-based Assisted Living Facilities Appeal ALJ Decision, Win Case Against AHCA

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

Two related assisted living facilities (ALFs) based in Orlando won a case against the Agency for Health Care Administration (AHCA) on appeal. The First District Court of Appeal heard the case and filed an opinion in favor of the ALFs on November 30, 2011.

To view the opinion in this case, click here.

Appeals Court Dismissed Three Complaints Made by AHCA.

On appeal, the ALFs challenged a final order issued by AHCA. The amended final order revoked the ALFs’ licenses, denied their licensure renewal applications, and […]

By The Health Law Firm|2024-03-14T10:00:32-04:00June 1, 2018|Assisted Living Facilities, The Health Law Firm Blog|

Appeal Court Rules AHCA Was Justified in Withdrawing Home Health Agency’s License Application

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

The First District Court of Appeal has ruled that the Agency for Health Care Administration (AHCA) had substantial justification to withdraw a home health agency’s application for licensure in a recent case. To view the opinion, click here.

Home Health Agency Challenged AHCA’s Decision to Withdraw Application.

AHCA withdrew the home health care facility’s license application because the application allegedly contained insufficient information. The application did not provide enough information for AHCA to verify actual ownership of the facility.

The home health agency challenged AHCA’s decision. The […]

By The Health Law Firm|2024-03-14T10:00:33-04:00June 1, 2018|Assisted Living Facilities, Home health care facility, The Health Law Firm Blog|

If Denial of Licensure is Disciplinary in Nature, Then Agency Must Prove Case by “Clear and Convincing Evidence”

The foregoing case summary was prepared by Mary F. Smallwood, Esquire, of The Administrative Law Section of The Florida Bar.

Davis Family Day Care Home (“Davis”) was issued a license as a family day care home in 2007. Davis applied annually for renewal of that license. In 2011, Davis applied for renewal of its license and also applied for a license as a large family child care home.

The Department of Children and Families (“DCF”) proposed to deny both the renewal application and the application for licensure as a large family child care home. Davis sought an administrative hearing on both denials. After an administrative hearing, the administrative law judge (“ALJ”) issued a recommended order recommending issuance of the renewal on a […]

By The Health Law Firm|2024-03-14T10:00:54-04:00June 1, 2018|Administrative law, Licensing issues, The Health Law Firm Blog|

Invoking Fifth Amendment by Applicant’s Personnel May Result in Denial of Their Application for a License

The foregoing case summary was prepared by and appeared in the DOAH case notes of the Administrative Law Section newsletter

FACTS: The Agency for Health Care Administration (“AHCA”) denied Avalon Assisted Living III’s (“Avalon III”) application for licensure of an assisted living facility in Orlando. Avalon III challenged the denial, and the case was referred to DOAH for a formal hearing. During AHCA’s attempts to obtain discovery, two people closely associated with Avalon III (Mr. Robert Walker and Mrs. Chiqquittia Carter-Walker) invoked their Fifth Amendment privilege against selfincrimination in response to questions regarding the grounds stated by AHCA in its initial decision to deny the license. These areas of inquiry included alleged unlicensed activity, the ownership and control of Avalon III, […]

By The Health Law Firm|2024-03-14T10:00:54-04:00June 1, 2018|Administrative law, Assisted Living Facilities, Licensing issues, The Health Law Firm Blog|

AHCA Expert Not Allowed to “Use His Discretion” in Deciding Claims Were Improper in Medicaid Appeal Hearing

FACTS: The Agency for Health Care Administration’s (“AHCA”) Office of Medicaid Program Integrity audited Dr. Rao, an authorized provider of Medicaid services, for claims between July 1, 2007, and June 30, 2009, and found him to be in violation of certain Medicaid provider policies. AHCA prepared a Final Audit Letter on June 1, 2011, notifying Dr. Rao that he had been overpaid by the Medicaid program by $110,712.09 for services provided during the audit period. Dr. Rao’s administrative hearing challenging AHCA’s overpayment determination was pending before DOAH. On August 17, 2012, Dr. Rao filed an unadopted rule challenge, alleging that AHCA’s overpayment determination was based on unadopted rules regarding the medical necessity of long-term monitored electroencephalograms (LTM EEGs).

OUTCOME: […]

By The Health Law Firm|2024-03-14T10:00:55-04:00June 1, 2018|Administrative law, Assisted Living Facilities, Medicaid, Medicaid audit, The Health Law Firm Blog|

Physician Argues Definition of “Peer” at Formal Administrative Hearing

FACTS: The Agency for Health Care Administration (“AHCA”) is responsible for administering Florida’s Medicaid program and conducting investigations and audits of paid claims to ascertain if Medicaid providers have been overpaid. With regard to investigations of physicians, section 409.9131, Florida Statutes, provides that AHCA must have a “peer” evaluate Medicaid claims before the initiation of formal proceedings by AHCA to recover overpayments. Section 409.9131(2)(c) defines a “peer” as “a Florida licensed physician who is, to the maximum extent possible, of the same specialty or subspecialty, licensed under the same chapter, and in active practice.” Section “109.9131(2)(a) deems a physician to be in “active practice” if he or she has “regularly provided […]

By The Health Law Firm|2024-03-14T10:00:58-04:00June 1, 2018|Administrative law, Agency for Health Care Administration, Appeal, Health Care Industry, Medicaid, Medicaid audit, Medicaid Fraud, The Health Law Firm Blog|

Cancer Patients Must Provide DOH Approval for Seizures and Muscle Spasms, or May Be Unqualified for Low-THC Medical Marijuana

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

Barnhart v. Dep’t of Health, Div. Admin. Hearings, Case No. 15-1271RP (Final Order April 10, 2015).

Following is a summary of a recent Division of Administrative Hearings case summary, taken from The Florida Bar Administrative Law Section Newsletter, Vol. 36, No. 4 (June 2015).

FACTS: On February 6, 2015, the Department of Health (“DOH”) published a notice of proposed rule-making setting forth the text of six proposed rules to implement the Compassionate Medical Cannabis Act of 2014 (“the Act”). The Act provides in part that certain physicians treating patients suffering from cancer or a condition that chronically produces […]

By The Health Law Firm|2024-03-14T10:01:06-04:00May 15, 2018|Marijuana Law Blog, Medical Marijuana|

The Health Law Firm Attorneys Often Represent Massage Therapists in Last Minute Depositions and Hearings

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

Our attorneys often receive calls from massage therapists regarding the possibility of representing them on short notice at a Board of Massage Therapy hearing, or at a deposition related to a health care matter.

We Take Last Minute Cases.

There are some law firms that refuse to represent a client at a hearing unless given plenty of advance notice and preparation time. We always prefer to have sufficient time to obtain documents, review files, interview witnesses, conduct research and prepare, in order to provide our clients the best possible representation. But we realize […]

By The Health Law Firm|2024-03-14T10:01:11-04:00May 15, 2018|Florida Board of Massage Therapy, Massage Therapy|

Administrative Law Judge Recommends Dismissal of All Charges Against Massage Therapist

FACTS: As reported in the June 2013 edition of DOAH Case Notes, Guiping Diamond graduated from the Florida College of Natural Health (“FCNH”) and became a Florida-licensed massage therapist in 2009. However, FCNH’s former registrar falsely told her that FCNH would accept all of the credits from her previous school and that those transfer credits fulfilled FCNH’s requirements for issuance of a diploma satisfying state licensure requirements. There was no evidence that Ms. Diamond was aware of the falsified documentation, which the FCNH registrar submitted directly to the Board of Massage Therapy (“the Board”).

The Department of Health (“DOH”) issued an administrative complaint seeking revocation of Ms. Diamond’s license based on a variety of charges, including that Ms. Diamond obtained […]

By The Health Law Firm|2024-03-14T10:01:11-04:00May 15, 2018|Massage Therapy, Massage Therapy License|

Nurses: Contact The Health Law Firm for Representation in Last Minute Depositions and Hearings

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

We often receive calls from health professionals, including registered nurses (RNs), advanced registered nurse practitioners (ARNPs), certified registered nurse anesthetists (CRNAs), licensed practical nurses (LPNs), nurse midwives and nurse practitioners regarding the possibility of representing them on short notice at a Board of Nursing hearing, or at a deposition related to a health care matter.

We Take Last Minute Cases.

Many law firms refuse to represent a client at a hearing unless given plenty of advance notice and preparation time. We, also, always prefer to have sufficient time to obtain documents, review files, interview witnesses, conduct […]

By The Health Law Firm|2024-03-14T10:01:18-04:00May 15, 2018|ARNP, Board of Nursing, CRNA, Defense, Nurse Depositions, Nurse Practitioner|