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Dental Clinic Owners Found Guilty of $1 Million Medicaid, Tax Scheme

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

On February 21, 2019, a federal jury found the owners of several dental clinics in Missouri guilty of a $1 million scheme to defraud the government. The owners of All About Smiles LLC, were convicted of submitting false claims to Medicaid for dentures and other services and payroll tax fraud, according to prosecutors.

Submitting False Claims.

Prosecutors alleged that the couple that owned the practice ran several schemes through the dental clinics from 2010 to 2015, including conspiring to defraud Medicaid. A main part of the scheme was to provide dentures and other services to adults who didn’t qualify for Medicaid. They would then bill the Medicaid program anyway, receiving more than $720,000, according to the DOJ.

The pair also allegedly ran a similar scheme with orthodontic equipment, racking up an estimated 241 false claims, said prosecutors. All About Smiles was paid approximately $165,700 during the the duration of the scheme.

Payroll Problems.

In addition to the fraud, the owners allegedly failed to forward payroll taxes to the Internal Revenue Service (IRS) even though the money was withheld from employee paychecks. Instead, the married pair used the almost $195,000 to cover lavish personal expenses and make payments on a variety of vehicles, said the DOJ.

Not Smiling Anymore.

Jurors found the couple guilty on all charges detailed in a 40-count indictment accusing them of fraudulently operating three All About Smiles LLC dental clinics, said the DOJ. Additionally, their legal woes continued to stack up as each was also convicted on a count of theft of public money for collecting unemployment benefits while working.

The female owner faces up to 10 years in prison on every count besides the payroll tax conspiracy charge, which comes with a maximum penalty of five years. The husband owner could get up to a decade for obtaining unemployment benefits and five years for each additional charge, prosecutors said.

Click here to read the DOJ’s press release.

To read one of my prior blogs on a similar case about a dentist defrauding medicaid, click here.

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

The attorneys of The Health Law Firm represent dentists, oral surgeons, and other health care providers in Medicaid audits, Medicare audits, insurance billing audits, ZPIC audits, RAC audits, administrative litigation and civil litigation 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 licensure complaints and investigations, DEA investigations, Medicare and Medicaid fraud investigations, audits, recovery actions and terminations 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.

Sources:

“All About Smiles Owners Convicted of Fraud.” Ozark Independent. (February 21, 2019). Web.
Posses, Shayna. “Couple Found Guilty Of $1M Medicaid, Payroll Tax Scheme.” Law360. (February 21, 2019). 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.

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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 © 2019 The Health Law Firm. All rights reserved.

By |2019-04-18T18:44:05+00:00April 18th, 2019|Categories: Centers for Medicare and Medicaid Services, Dental Law Blog, Dentist Defense attorney, Health Care Fraud, Health care Law, Medicaid Fraud, Medicaid fraud|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Cardiologist Faces HIPAA Privacy Violation Charges for Over Sharing Patient Information

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

On February 26, 2018, a pediatric cardiologist was charged with wrongfully disclosing protected patient health information in Massachusetts federal court. Prosecutors alleged that in 2013, Dr. Eduardo Montaña disclosed patient data to representatives of Aegerion Pharmaceuticals.

The Alleged HIPAA Privacy Violations.

Prosecutors said that Dr. Montaña violated the Health Insurance Portability and Accountability Act (HIPAA) by sharing electronic medical records and prescription forms with representatives of Aegerion in 2013 without patient permission. He also allegedly gave his personal access code for an electronic medical records system to an Aegerion representative in March 2013 so the employee could review the patients’ health information without the patient’s knowledge or permission. That unauthorized disclosure constitutes a violation of HIPAA, prosecutors alleged.

Click here to read the court document in full.

The Consequences of HIPAA Violations.

The failure to comply with HIPAA can result in both civil and criminal penalties. There has been an increase in penalties regarding HIPAA violations. With an increase in the popularity and availability of social media platforms, also comes an increase in potential privacy violations. To read a previous blog I wrote on this, click here.

Contact a Health Law Attorney Experienced in Defending HIPAA Complaints and Violations.

The attorneys of The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other health care providers and institutions in investigating and defending alleged HIPAA complaints and violations and in preparing Corrective Action Plans (CAPs).

For more information about HIPAA violations, electronic health records or corrective action plans (CAPs) please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Sources:
Posses, Shayna. “Doctor Charged Over Sharing Patient Info With Aegerion.” Law360. (February 26, 2018). Web.

Raymond, Nate. “Georgia doctor to plead guilty to disclosing patient info to Aegerion.” Reuters. (February 27, 2018). 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.

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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 |2018-03-22T22:52:10+00:00May 15th, 2018|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Cardiologist Faces HIPAA Privacy Violation Charges for Over Sharing Patient Information

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

On February 26, 2018, a pediatric cardiologist was charged with wrongfully disclosing protected patient health information in Massachusetts federal court. Prosecutors alleged that in 2013, Dr. Eduardo Montaña disclosed patient data to representatives of Aegerion Pharmaceuticals.

The Alleged HIPAA Privacy Violations.

Prosecutors said that Dr. Montaña violated the Health Insurance Portability and Accountability Act (HIPAA) by sharing electronic medical records and prescription forms with representatives of Aegerion in 2013 without patient permission. He also allegedly gave his personal access code for an electronic medical records system to an Aegerion representative in March 2013 so the employee could review the patients’ health information without the patient’s knowledge or permission. That unauthorized disclosure constitutes a violation of HIPAA, prosecutors alleged.

Click here to read the court document in full.

The Consequences of HIPAA Violations.

The failure to comply with HIPAA can result in both civil and criminal penalties. There has been an increase in penalties regarding HIPAA violations. With an increase in the popularity and availability of social media platforms, also comes an increase in potential privacy violations. To read a previous blog I wrote on this, click here.

Contact a Health Law Attorney Experienced in Defending HIPAA Complaints and Violations.

The attorneys of The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other health care providers and institutions in investigating and defending alleged HIPAA complaints and violations and in preparing Corrective Action Plans (CAPs).

For more information about HIPAA violations, electronic health records or corrective action plans (CAPs) please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Sources:
Posses, Shayna. “Doctor Charged Over Sharing Patient Info With Aegerion.” Law360. (February 26, 2018). Web.

Raymond, Nate. “Georgia doctor to plead guilty to disclosing patient info to Aegerion.” Reuters. (February 27, 2018). 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.

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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.

 

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