May 2024

18 Former NBA Players Indicted For Alleged $4 Million Health Care Fraud Scheme

By |2024-05-04T20:00:14-04:00May 6, 2024|Health Facilities Law Blog|

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

On October 7, 2021, 18 former NBA players were charged in New York federal court for an alleged health insurance fraud scheme to rip off the league’s benefit plan, according to an indictment filed in the Southern District of New York. The defendants allegedly engaged in a scheme from at least 2017 through 2020 which involved the submission of fraudulent claims for reimbursement of medical and dental services that were not provided, prosecutors said. The claims totaled nearly $4 million.

The NBA Players Health and Welfare Benefit Plan provide additional medical coverage on top of […]

March 2024

Centene Agrees to Pay $19 Million to Washington State For Medicaid Fraud Allegations

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

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

On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, it has been reported that Centene/Sunshine Health reportedly has over $31 billion in contracts with the state of Florida alone. Click here to learn more.

The agreement with Washington State resolves allegations that it overcharged its Medicaid program for pharmacy benefit management services, Washington Attorney General Bob Ferguson announced in a […]

February 2024

Centene Will Pay $19 Million to Washington State For Medicaid Fraud Allegations

By |2024-03-14T09:59:11-04:00February 23, 2024|Pharmacy Law Blog|

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

On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, it has been reported that Centene/Sunshine Health reportedly has over $31 billion in contracts with the state of Florida alone. Click here to learn more.

The agreement with Washington State resolves allegations that it overcharged its Medicaid program for pharmacy benefit management services, Washington Attorney General Bob Ferguson announced in a […]

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

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

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one hundred million dollars. At the December 2022 trial of the Florida man, the jury convicted the Florida Man of all ten counts against him, including health care fraud, payment of kickbacks, and conspiracy to commit money laundering. He was ordered to pay $187 million in restitution.

I have to say it. They need to lock up that Florida […]

Centene Will Pay $19 Million Settlement to Washington State For Medicaid Fraud Allegations

By |2024-03-14T09:59:13-04:00February 1, 2024|Health Facilities Law Blog|

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

On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, it has been reported that Centene/Sunshine Health reportedly has over $31 billion in contracts with the state of Florida alone. Click here to learn more.

The agreement with Washington State resolves allegations that it overcharged its Medicaid program for pharmacy benefit management services, Washington Attorney General Bob Ferguson announced in a […]

January 2024

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

By |2024-03-14T09:59:13-04:00January 18, 2024|Health Facilities Law Blog|

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one hundred million dollars. At the December 2022 trial of the Florida man, the jury convicted the Florida Man of all ten counts against him, including health care fraud, payment of kickbacks, and conspiracy to commit money laundering. He was ordered to pay $187 million in restitution.

I have to say it. They need to lock up that Florida […]

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

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

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

On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, it has been reported that Centene/Sunshine Health reportedly has over $31 billion in contracts with the state of Florida alone. Click here to learn more.

The agreement with Washington State resolves allegations that it overcharged its Medicaid program for pharmacy benefit management services, Washington Attorney General Bob Ferguson announced in a […]

December 2023

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

By |2024-03-14T09:59:15-04:00December 28, 2023|Pharmacy Law Blog|

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one hundred million dollars. At the December 2022 trial of the Florida man, the jury convicted the Florida Man of all ten counts against him, including health care fraud, payment of kickbacks, and conspiracy to commit money laundering. He was ordered to pay $187 million in restitution.

I have to say it. They need to lock up that Florida […]

September 2023

What Payers Are Considered to Be “Federal Payers” Under the Federal Anti-kickback Statute?

By |2024-03-14T09:59:21-04:00September 5, 2023|Mental Health Law Blog|

Author Headshot standing with arms crossed in dark suitBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
The federal Anti-Kickback Statute prohibits remuneration in relation to the provision of a “good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program.”  42 U.S.C. § 1320a-7b(b).  The Anti-Kickback Statute goes on to define “federal health care program” as any government-funded plan or program that provides health benefits or any state health care program.  42 U.S.C. § 1320a-7b(f).  But exactly which payers are considered Federal health care programs?  […]

June 2023

Doctor Indicted in $1.3 Million Medicare Fraud Kickback Case Seeks Reinstatement of Medicare Billing Privileges

By |2024-03-14T09:59:28-04:00June 10, 2023|Health Facilities Law Blog|

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

On November 2, 2021, a doctor and his wife who had been indicted for their roles in a $1.3 million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. The doctor argued that the bail condition impeded his ability to practice medicine. Additionally, the doctor indicated that he was seeking to directly address CMS and the Medical Practice’s ability to bill Medicare and Medicaid.

According to the brief, the defendants argued that the court should not get involved in a licensed physician’s medical practice. They argued that this is the role […]

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