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Why Have You Received a Denial on Your Medicare Enrollment Application?

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

Did you receive a denial on your Medicare enrollment application and can’t figure out why? You may be surprised to find out that even the smallest punctuation error, such as a missing comma or period, could be the reason Medicare rejected your application.

The Centers for Medicare and Medicaid Services (CMS) will deny Medicare applications of physicians, medical groups, home health agencies (HHAs), pharmacies and durable medical equipment (DME) suppliers because the name on file with the National Plan & Provider Enumeration System (NPPES) is not the same legal business name as reported to the Internal Revenue Service (IRS). The use of punctuation marks and abbreviations in your name with NPPES could produce a no match […]

By The Health Law Firm|2024-03-14T10:00:57-04:00June 1, 2018|Categories: Health Care Industry, Medicare, The Health Law Firm Blog|Tags: Centers for Medicare and Medicaid Services, CMS, defense attorney, defense lawyer, health law firm, medicare, Medicare enrollment, Medicare program, Medicare Provider Enrollment Chain and Ownership System, Medicare provider number, National Plan & Provider Enumeration System (NPPES), NPI Registry, PECOS, request for reconsideration, termination of Medicare billing privileges, termination of Medicare provider number, the health law firm|Comments Off

Ready or Not, It’s Irregular Behavior Season…

By Lenis L. Archer, J.D., M.P.H., The Health Law Firm

Every year at regular intervals, our firm receives calls from panicked medical students and residents about a recent letter they have received, alleging irregular behavior.

This letter may come from the National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE), or the Educational Commission for Foreign Medical Graduates (ECFMG). No matter the organization, if you receive a letter alleging irregular behavior, it will typically say the following:

1. A bulletin or policy related to the exam stating that Irregular Behavior is not permitted.
2. The facts alleging irregular behavior in this case.
3. You have an opportunity to respond to the allegations, in person, with counsel.

Often there is a very short window of time to respond to such allegations. While this is important because it is urgent that you […]

By The Health Law Firm|2024-03-14T10:00:59-04:00June 1, 2018|Categories: Medical Student, Medical Students, NBME, The Health Law Firm Blog, USMLE|Tags: accused of irregular behavior, cheating, defense attorney, defense lawyer, Examination Committee for Foreign Medical Graduates (ECFMG), irregular behavior, legal representation, medical intern attorney, medical intern lawyer, medical resident, medical resident attorney, medical resident lawyer, medical student attorney, medical student lawyer, medical students, National Board of Medical Examiners (NBME), United States Medical Licensing Examination (USMLE), USMLE appeals, USMLE hearings, USMLE preparation course|Comments Off

Consequences of Having Your Massage Therapy License Revoked (Or Relinquishing it after Notice of an Investigation)

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

Many massage therapists, when confronted with an investigation against their license, do not fight the charges, sometimes they decide it is cheaper and easier just to give up their license. Either choice is likely to be a mistake.

A charge can be filed causing an investigation to be opened against a massage therapist by many different sources and often without any supporting evidence. If challenged and defended by an attorney with knowledge and experience in such matters, these investigations may often be dismissed with no disciplinary action against the massage therapist’s license.

Massage Therapists Often Go on to Obtain Licenses in Other Health Specialties.

A massage therapist often has to spend tens of thousands of dollars on school tuition and sacrifice a year or more of […]

By The Health Law Firm|2024-03-14T10:00:35-04:00June 1, 2018|Categories: In the Know, In the News, Massage Therapy, Massage Therapy License, The Health Law Firm Blog|Tags: administrative charges, administrative complaint, defense attorney, election of rights (EOR), Florida Board of Massage Therapy, Florida College of Natural Health, formal hearing, Informal hearing, license, license disciplined, license investigation, license revoked, licensure defense coverage, massage therapist, massage therapy defense, voluntary relinquishment|Comments Off

Do You Need A HIPAA Risk Assessment?

By Danielle M. Murray, J.D.

As a health care provider or owner of a health facility, you know about the Health Insurance Portability and Accountability Act (HIPAA) of 1996. You know that you must safeguard and protect confidential patient medical information to avoid civil and criminal penalties against you and your practice. Did you know that you may need a HIPAA Risk Assessment?

If You Are A Health Care Provider You Face an Audit Risk.

The Office for Civil Rights (OCR) is stepping up enforcement around the country of “covered entities” and business associates. OCR auditors will send a letter informing you that within 30 days, they will be in your office reviewing your organization and interviewing your key staff members. If the auditor finds flaws with your office, you will be made aware of them, and then […]

By The Health Law Firm|2024-03-14T10:00:38-04:00June 1, 2018|Categories: HIPAA, In the Know, The Health Law Firm Blog|Tags: administrative, civil, compliance, criminal, defense attorney, defense lawyer, doctor, fines, Health Insurance Portability and Accountability Act, hipaa, HIPAA audit protocol, HIPAA compliance, HIPPA audits, license, licensed clinical social worker, licensed mental health counselor, mental health, physician, policy, practice, privacy, psychologist, psychology, risk assessment, sanctions, security|Comments Off

Tightened Restrictions Placed on Pain Management Clinics in Seminole County

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

Seminole County, Florida, is the latest county to adopt tightened regulations for pain management clinics. On November 13, 2012, County Commissioners unanimously voted to adopt the ordinance enacting Chapter 186 of the Seminole County Code to establish regulations regarding pain management clinics.

Click here to read the entire Seminole County Ordinance.

County Commissioners hope these new regulations will aid law enforcement in fighting illegal pill mill operations in Florida.

Officials Believe Restrictions Will Help Prevent Overprescribing.

The ordinance requires clinics to get a license, produce monthly reports on how many prescriptions are issued for controlled substances and report patient information, such as a patient’s address. This only applies to practices where doctors issue prescriptions for painkillers […]

By The Health Law Firm|2024-03-14T10:00:40-04:00June 1, 2018|Categories: In the Know, Pain Management, The Health Law Firm Blog|Tags: controlled substances, defense attorney, defense lawyer, Department of Health (DOH), doctor, florida pill mills, Florida prescription drug abuse, Florida prescription drug crackdown, nurse, Osceola County pill mills, overprescribing, pain clinics, pain management, pharmacies, pharmacists, pharmacy, physician, pill mill, prescription drug monitoring program, prescription drug trafficking, Seminole County pain clinics, Seminole County pill mills|Comments Off

Students Graduating Medical School in Three Years

By Danielle M. Murray, J.D.

To combat the nationwide shortage of primary care physicians and the increase in student debt, several medical schools around the country are offering the chance for students to finish school in three years, instead of four. According to a number of news articles, these programs are geared specifically toward medical students looking to practice primary care. The hope is that these programs will be cost less for students and add more primary care physicians to under-served areas.

Schools Across the U.S. Offer Three-Year Degrees.

According to an article in The New York Times, a small number of students are currently participating in the three-year degree program. There are about 16 incoming students in the program at New York University (N.Y.U.), nine students at Texas Tech Health Science Center School of Medicine and […]

By The Health Law Firm|2024-03-14T10:00:43-04:00June 1, 2018|Categories: Medical Student, Medical Students, The Health Law Firm Blog|Tags: defense attorney, defense lawyer, doctor shortage, doctors, fellow representation, health law attorney, health lawyer, intern representation, medical resident representation, medical school, medical student representation, medical students, medical training, physician shortage, physicians|Comments Off

Hydrocodone Combination Drugs Could Be Reclassified to Schedule II Category of Controlled Substances

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

A Food and Drug Administration (FDA) advisory committee voted 19 to 10 in favor of moving hydrocodone combination drugs from schedule III into the more restrictive schedule II category of controlled substances. According to a number of different sources, on January 25, 2013, the committee presented this recommendation to the FDA. If approved, hydrocodone combination drugs, such as Vicodin, will be harder for physicians to prescribe.

The advisory committee met because the Drug Enforcement Administration (DEA) is requesting the FDA to approve the reclassification of hydrocodone combination products. The DEA wants to help curb the growing number of people across the country addicted to painkillers.

Click here […]

By The Health Law Firm|2024-03-14T10:00:45-04:00June 1, 2018|Categories: Administrative law, Department of Health, In the Know, Pain Management, The Health Law Firm Blog|Tags: administrative hearings, defense attorney, defense lawyer, Department of Health (DOH), doctors, Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), Food and Drug Administration (FDA), hydrocodone, license defense counsel, nurse practitioner, pharmacists, physician assistants (PAs), physicians, schedule II controlled substances, schedule III controlled substances|Comments Off

Tips for Responding to a Medicaid Audit

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

Should you find yourself, your facility or your health practice the subject of a Medicaid audit by your state Medicaid agency or audit contractor, there are a few things you should know.

The most important thing is that just because you are being audited, it does not mean that you or your business has done anything wrong. State and federal governments conduct audits for many different reasons. Typical reasons include: special audits of high-fraud geographic areas, auditing of particular billing codes, randomly selected provider auditing, and complaints of possible fraud.

Medicaid Audits in Florida.

The Agency for Health Care Administration (AHCA), Office of Inspector General (OIG) and Bureau of Medicaid Program Integrity are the Florida agencies responsible for routine audits of Medicaid health care providers to ensure […]

Terrible Things That Can Happen after Discipline on Your Professional License or Resignation of a License after Notice of Investigation

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

Do you have a medical, pharmacy or nursing license in several different states? Do you have a license in more than one health profession? Have you been notified that an investigation has been opened against you? Are you thinking about resigning your professional license or voluntarily relinquishing such a license? Then you must be aware of the following.

First, you should never voluntarily relinquish or resign your license after you know that an investigation has been opened or that disciplinary action has been taken against you. Such a resignation is considered to be a “disciplinary relinquishment” and is treated the same as if your license had been revoked on disciplinary grounds.

Second, this will be reported out to other states, agencies, to the National Practitioner […]

By The Health Law Firm|2024-03-14T10:00:49-04:00June 1, 2018|Categories: Administrative law, Health Care Industry, Licensing issues, The Health Law Firm Blog|Tags: Administrative Hearing, and Lloyd's of London Insurance, CPH & Associates Insurance, defense attorney, defense lawyer, dentist, Department of Health and Human Services (HHS), Department of Health investigation, Department of Health investigation of a health care provider, disciplinary relinquishment, discipline on a health care professional’s license, exclusion from the Medicare Program, health care attorney, health care professional, health care professional license, Healthcare Providers Organization (HPSO) Insurance, investigation of a health care professional, investigation of a health care provider, List of Excluded Individuals and Entities, massage therapist, nurse, nurse excluded from the Medicare Program, Nurses Service Organization (NSO) Insurance, Office of the Inspector General (OIG), pharmacist, pharmacy, physician, professional licensing matter, resignation of a professional license, the health law firm, voluntary relinquishment, voluntary relinquishment of a health care provider’s license|2 Comments

New Requirements Released for Physician Medical Records Related to Compounded Medications

By Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On September 5, 2013, the Florida Board of Medicine and the Florida Board of Osteopathic Medicine published new requirements for medical record documentation related to compounded medications administered to patients in an office setting. These standards become effective September 9, 2013. The standards are contained in Florida Administrative Code Rules adopted by each board.

We believe the updated requirements are a result of the recent recalls of tainted compounded medications that have spread across the country and infected thousands of patients. These new standards will make it easier for health care professionals to trace drug reactions and spot tainted batches of medications quickly. The new changes apply […]