Florida Surgeon Gets 7 Years for Committing $28 Million in Health Care Fraud

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

On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. The scheme involved performing hundreds of medically unnecessary, invasive surgical procedures on his patients.

The defendant, a dual citizen of the United States and Ghana, pled guilty to all 58 counts against him in federal court on December 18, 2020. Jason R. Cody, Acting United States Attorney for the Northern District of Florida, announced the sentence. Read more about the sentencing here.

Compromising the Health and Safety of Patients For Illegal Profit.

For almost four years, beginning in 2016 until his arrest in February 2020, it is alleged that the surgeon solicited his victims by establishing relationships with churches, nursing homes, hospitals, and outreach organizations. The 58-count indictment alleges the surgeon defrauded Medicare and Medicaid by billing for dozens of procedures that he never performed. A detailed list shows each claim was for more than $21,000. Federal prosecutors said that the claims that were improperly billed reached $23 million.

A later motion filed by the government alleges that the doctor’s calendar showed that he performed 14 surgeries in one day.

In addition to performing unnecessary surgical procedures, the doctor was accused of victimizing others by falsifying their medical records to reflect surgical procedures that he did not perform. He created erroneous and misleading medical records that could cause doctors who treated the same patients in the future to commit errors in their treatment of the same patients.

The Consequences of the Surgeon’s Actions.

In addition to prison time, the sentence included forfeiture of the surgeon’s assets in the United States and overseas. The assets included luxury vehicles, jewelry, and homes located in Manhattan, Miami, and Houston. The court also ordered the payment of $28.4 million in restitution.

“Instead of caring for his patients, this defendant targeted vulnerable members of our community, subjected them to unnecessary surgical procedures, and falsified documents so he could line his pockets with millions of taxpayer dollars,” a law enforcement authority reportedly stated.

Click here to read the press release in full issued from the U.S. Department of Justice (DOJ) to learn more.

To read about a similar case involving another healthcare professional, click here to read my prior blog.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal defense representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists, and other health providers in healthcare fraud investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare and Medicaid investigations, Office of Inspector General (OIG) actions, Department of Health (DOH) investigations, and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Paavola, Amy. “Florida physician gets 7-year sentence for $29M fraud scheme.” Becker’s Hospital Review. (November 18, 2021). Web.

AHLA. “Florida Surgeon Draws Seven-Year Prison Term for $28 Million Health Care Fraud.” American Health Law Association. (December 3, 2021). Web.

Casey, Monica. “Florida Surgeon Draws Seven-Year Prison Term for $28 Million Health Care Fraud.” WCTV. (November 18, 2021). 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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“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 © 2022 The Health Law Firm. All rights reserved.

 

By |2024-03-14T09:59:29-04:00June 1, 2023|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Florida Surgeon Gets 7 Years for Committing $28 Million in Health Care Fraud
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Florida Surgeon Handed Seven Years in Prison for $28 Million Health Care Fraud 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 November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. The scheme involved performing hundreds of medically unnecessary, invasive surgical procedures on his patients.

The defendant, a dual citizen of the United States and Ghana, pled guilty to all 58 counts against him in federal court on December 18, 2020. Jason R. Cody, Acting United States Attorney for the Northern District of Florida, announced the sentence. Read more about the sentencing here.

Compromising the Health and Safety of Patients For Illegal Profit.

For almost four years, beginning in 2016 until his arrest in February 2020, it is alleged that the surgeon solicited his victims by establishing relationships with churches, nursing homes, hospitals, and outreach organizations. The 58-count indictment alleges the surgeon defrauded Medicare and Medicaid by billing for dozens of procedures that he never performed. A detailed list shows each claim was for more than $21,000. Federal prosecutors said that the claims that were improperly billed reached $23 million.

A later motion filed by the government alleges that the doctor’s calendar showed that he performed 14 surgeries in one day.

In addition to performing unnecessary surgical procedures, the doctor was accused of victimizing others by falsifying their medical records to reflect surgical procedures that he did not perform. He created erroneous and misleading medical records that could cause doctors who treated the same patients in the future to commit errors in their treatment of the same patients.

The Consequences of the Surgeon’s Actions.

In addition to prison time, the sentence included forfeiture of the surgeon’s assets in the United States and overseas. The assets included luxury vehicles, jewelry, and homes located in Manhattan, Miami, and Houston. The court also ordered the payment of $28.4 million in restitution.

“Instead of caring for his patients, this defendant targeted vulnerable members of our community, subjected them to unnecessary surgical procedures, and falsified documents so he could line his pockets with millions of taxpayer dollars,” a law enforcement authority reportedly stated.

Click here to read the press release in full issued from the U.S. Department of Justice (DOJ) to learn more.

To read about a similar case involving another healthcare professional, click here to read my prior blog.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal defense representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in healthcare fraud investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare and Medicaid investigations, Office of Inspector General (OIG) actions, Department of Health (DOH) investigations, and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Paavola, Amy. “Florida physician gets 7-year sentence for $29M fraud scheme.” Becker’s Hospital Review. (November 18, 2021). Web.

AHLA. “Florida Surgeon Draws Seven-Year Prison Term for $28 Million Health Care Fraud.” American Health Law Association. (December 3, 2021). Web.

Casey, Monica. “Florida Surgeon Draws Seven-Year Prison Term for $28 Million Health Care Fraud.” WCTV. (November 18, 2021). 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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“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 © 2022 The Health Law Firm. All rights reserved.

 

By |2024-03-14T09:59:31-04:00April 20, 2023|Categories: Health Facilities Law Blog, In the News|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Florida Surgeon Handed Seven Years in Prison for $28 Million Health Care Fraud Scheme
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Women Who Posed as Nurse Sentenced to Prison For Health Care Fraud, Identity Theft, and Wire Fraud

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

On September 23, 2020, a Tennessee woman who posed as a nurse working at several medical facilities was sentenced to more than four years in prison. In December 2019, she pled guilty to wire fraud, healthcare fraud, identity theft, and practicing nursing without a license.

How a Phony Nurse Gained Employment.

According to a news release from the U.S. Attorney’s Office, the woman posed as a registered nurse, despite not having a nursing degree or a nursing license, and having no nursing experience. To accomplish the fraud, she obtained the license numbers of real nurses with similar first names. She admitted to providing fraudulent information on job applications to gain employment. She was employed by at least eight different health care providers between September 2012 and November 2018. She also falsely claimed that she held nursing degrees from two educational institutions, Walters State College and Carson Newman University.

This is a long time, six years, to get away with health fraud. Usually, we only see things like this in Florida. However, in the past few years, Florida seems to be seeing fewer and fewer fake doctors, nurses, and health professionals. Perhaps the crackdown by the Florida Department of Health on the unlicensed practice of health professions has had some impact on this.

Continuing Lies & Fraudulent Behavior.

While posing as a nurse, the fake R.N. worked in various medical settings, including nursing homes, rehabilitation and assisted living facilities, a doctor’s office, and home health agencies. She rendered nursing care to numerous patients, dispensed prescription medications, and gained access to patients’ sensitive and private medical information, the U.S. Attorney’s Office said. Furthermore, the woman made false entries in patients’ medical records and submitted or caused the submission of at least $500,000 in false claims to public and private health care benefit programs.

The phony nurse performed procedures that she was, of course, unqualified to perform. She failed to act or to notify others of the necessary procedures for patients and failed to chart and document patient care. According to the written plea agreement, at least one patient required re-admittance to the hospital and an additional three-day hospital stay due to her inept care.

The Tennessee Bureau of Investigation Director David Rausch is quoted in the media as having stated: “Our Medicaid Fraud Control Division remains committed to working with our federal partners to ensure healthcare fraud and identity theft cases like this one are addressed and investigated thoroughly.”

Judge Clifton L. Corker of the U.S. District Court for the Eastern District of Tennessee sentenced her to 51 months in prison, followed by three years of supervised release. She was also ordered to repay $700,000 in restitution to her employers.

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

To read about a similar case in Florida, click here to view one of my prior blogs.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists, and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.
To contact The Health Law Firm, please call (407) 331-6620 or (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Morristown woman posed as nurse for 6 years at 8 health care providers.” ABC 6 Local News. (December 12, 2019). Web.

Starks, Ariel. “Fake nurse sentenced to 51 months in prison, ordered to repay employers $700,000.” WVLT 8 Local News. (September 23, 2020). Web.

Bonvissuto, Kimberly. “Nurse imposter who worked in assisted living sentenced for wire fraud, healthcare fraud, identity theft.” McKnight’s Senior Living. (September 25, 2020). 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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“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 © 2020 The Health Law Firm. All rights reserved.

By |2024-03-14T09:59:50-04:00February 1, 2021|Categories: Uncategorized|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Women Who Posed as Nurse Sentenced to Prison For Health Care Fraud, Identity Theft, and Wire Fraud
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Woman Posing as Nurse For Six Years Sentenced to Prison For Health Care Fraud, Identity Theft, and Wire Fraud

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

On September 23, 2020, a Tennessee woman who posed as a nurse working at several medical facilities was sentenced to more than four years in prison. In December 2019, she pled guilty to wire fraud, healthcare fraud, identity theft, and practicing nursing without a license.

How a Phony Nurse Gained Employment.

According to a news release from the U.S. Attorney’s Office, the woman posed as a registered nurse, despite not having a nursing degree or a nursing license, and having no nursing experience. To accomplish the fraud, she obtained the license numbers of real nurses with similar first names. She admitted to providing fraudulent information on job applications to gain employment. She was employed by at least eight different health care providers between September 2012 and November 2018. She also falsely claimed that she held nursing degrees from two educational institutions, Walters State College and Carson Newman University.

This is a long time, six years, to get away with health fraud. Usually, we only see things like this in Florida. However, in the past few years, Florida seems to be seeing fewer and fewer fake doctors, nurses, and health professionals. Perhaps the crackdown by the Florida Department of Health on the unlicensed practice of health professions has had some impact on this.

Continuing Lies & Fraudulent Behavior.

While posing as a nurse, the fake R.N. worked in various medical settings, including nursing homes, rehabilitation and assisted living facilities, a doctor’s office, and home health agencies. She rendered nursing care to numerous patients, dispensed prescription medications, and gained access to patients’ sensitive and private medical information, the U.S. Attorney’s Office said. Furthermore, the woman made false entries in patients’ medical records and submitted or caused the submission of at least $500,000 in false claims to public and private health care benefit programs.

The phony nurse performed procedures that she was, of course, unqualified to perform. She failed to act or to notify others of the necessary procedures for patients and failed to chart and document patient care. According to the written plea agreement, at least one patient required re-admittance to the hospital and an additional three-day hospital stay due to her inept care.

The Tennessee Bureau of Investigation Director David Rausch is quoted in the media as having stated: “Our Medicaid Fraud Control Division remains committed to working with our federal partners to ensure healthcare fraud and identity theft cases like this one are addressed and investigated thoroughly.”

Judge Clifton L. Corker of the U.S. District Court for the Eastern District of Tennessee sentenced her to 51 months in prison, followed by three years of supervised release. She was also ordered to repay $700,000 in restitution to her employers.

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

To read about a similar case in Florida, click here to view one of my prior blogs.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists, and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.
To contact The Health Law Firm, please call (407) 331-6620 or (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Morristown woman posed as nurse for 6 years at 8 health care providers.” ABC 6 Local News. (December 12, 2019). Web.

Starks, Ariel. “Fake nurse sentenced to 51 months in prison, ordered to repay employers $700,000.” WVLT 8 Local News. (September 23, 2020). Web.

Bonvissuto, Kimberly. “Nurse imposter who worked in assisted living sentenced for wire fraud, healthcare fraud, identity theft.” McKnight’s Senior Living. (September 25, 2020). 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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“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 © 2020 The Health Law Firm. All rights reserved.

By |2024-03-14T09:59:53-04:00December 21, 2020|Categories: In the News, Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Woman Posing as Nurse For Six Years Sentenced to Prison For Health Care Fraud, Identity Theft, and Wire Fraud
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Woman Posing as Nurse For Six Years Sentenced to Prison For Health Care Fraud, Identity Theft, and Wire Fraud

 

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

Medical lawsuit. Arrest for medical crime concept. Handcuff near stethoscope on blue background top view.On September 23, 2020, a Tennessee woman who posed as a nurse working at several medical facilities was sentenced to more than four years in prison. In December 2019, she pled guilty to wire fraud, healthcare fraud, identity theft, and practicing nursing without a license.

How a Phony Nurse Gained Employment.

According to a news release from the U.S. Attorney’s Office, the woman posed as a registered nurse, despite not having a nursing degree or a nursing license, and having no nursing experience. To accomplish the fraud, she obtained the license numbers of real nurses with similar first names. She admitted to providing fraudulent information on job applications to gain employment. She was employed by at least eight different health care providers between September 2012 and November 2018. She also falsely claimed that she held nursing degrees from two educational institutions, Walters State College and Carson Newman University.

This is a long time, six years, to get away with health fraud. Usually, we only see things like this in Florida. However, in the past few years, Florida seems to be seeing fewer and fewer fake doctors, nurses, and health professionals. Perhaps the crackdown by the Florida Department of Health on the unlicensed practice of health professions has had some impact on this.

Continuing Lies & Fraudulent Behavior.

While posing as a nurse, the fake R.N. worked in various medical settings, including nursing homes, rehabilitation and assisted living facilities, a doctor’s office, and home health agencies. She rendered nursing care to numerous patients, dispensed prescription medications, and gained access to patients’ sensitive and private medical information, the U.S. Attorney’s Office said. Furthermore, the woman made false entries in patients’ medical records and submitted or caused the submission of at least $500,000 in false claims to public and private health care benefit programs.

The phony nurse performed procedures that she was, of course, unqualified to perform. She failed to act or to notify others of the necessary procedures for patients and failed to chart and document patient care. According to the written plea agreement, at least one patient required re-admittance to the hospital and an additional three-day hospital stay due to her inept care.

The Tennessee Bureau of Investigation Director David Rausch is quoted in the media as having stated: “Our Medicaid Fraud Control Division remains committed to working with our federal partners to ensure healthcare fraud and identity theft cases like this one are addressed and investigated thoroughly.”

Judge Clifton L. Corker of the U.S. District Court for the Eastern District of Tennessee sentenced her to 51 months in prison, followed by three years of supervised release. She was also ordered to repay $700,000 in restitution to her employers.

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

To read about a similar case in Florida, click here to view one of my prior blogs.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists, and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.
To contact The Health Law Firm, please call (407) 331-6620 or (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Morristown woman posed as nurse for 6 years at 8 health care providers.” ABC 6 Local News. (December 12, 2019). Web.

Starks, Ariel. “Fake nurse sentenced to 51 months in prison, ordered to repay employers $700,000.” WVLT 8 Local News. (September 23, 2020). Web.

Bonvissuto, Kimberly. “Nurse imposter who worked in assisted living sentenced for wire fraud, healthcare fraud, identity theft.” McKnight’s Senior Living. (September 25, 2020). Web.

Headshot of The Health Law Firm's attorney George F. Indest IIIAbout 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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

KeyWords: nursing license defense attorney, legal representation for nursing license defense, legal representation for board of nursing complaints and investigations, unlicensed practice of medicine defense attorney, unlicensed practice of nursing defense lawyer, Department of Health defense attorney, DORA investigation defense lawyer, legal representation for DOH or DORA investigations, DOJ defense lawyer, legal representation for DOJ investigations, legal representation for nurses, health law attorney, nursing law attorney, health care fraud defense attorney, legal representation for health care fraud, legal representation for health care fraud investigations, health care fraud investigation representation, legal representation for U.S. Department of Justice (DOJ) investigations, DOJ investigation representation, Medicare fraud defense lawyer, Medicaid fraud defense attorney, representation for Medicare and Medicaid fraud, representation for false billing, representation for submitting false claims, False Claims Act (FCA) defense attorney, FCA legal representation, FCA investigation representation, representation for FCA investigations, review of The Health Law Firm attorneys, The Health Law Firm reviews, Medicaid Fraud Control Unit (MFCU) defense attorney

“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 © 2020 The Health Law Firm. All rights reserved.

By |2024-03-14T09:59:54-04:00November 21, 2020|Categories: In the News, Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |1 Comment
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Florida Woman Accused of Operating Illegal Dental Practice Out of Her Garage

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

On November 16, 2018, a Florida woman was accused of practicing as an unlicensed dentist, operating out of her home garage. After receiving an anonymous tip, Palm Beach County Sheriff’s deputies arrested Alexandra Gallego after a month-long investigation into the illegal practice.

She is facing charges of Practicing Dentistry without a License, and Unlawful Use and Control of Dental Equipment.

Practicing Without a License.

In addition to running an illegal practice, Gallego is accused of offering discounted rates to patients who paid in cash, couldn’t afford insurance or did not have the proper documents to legally be in the United States. When investigators searched the home, they found a makeshift dental office, including X-rays, medications and payment receipts located in the garage.

She told authorities she would see about 160 patients a month and made about $20,000 from those appointments. She funneled the money through a cleaning company that she legally owned so that she would be paying taxes on the income. She admitted to authorities that she knew she was legally not allowed to practice dentistry in Florida without a license.

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 check current medical and dentistry licenses in the state of Florida here.

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.

Click here to read one of my prior blogs on a similar case of a Floridian posing as a doctor.

Contact Health Law Attorneys Experienced in Representing Health Care Providers Licensure and Regulatory Matters and in DOH Cases.

The Health Law Firm represents dentists, pharmacists, pharmacies, physicians, nurses, and other health 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.

Sources:

Detman, Gary. “Woman practiced dentistry out of garage, deputies say.” CBS 12News. (November 16, 2018). Web.

“Royal Palm Beach woman charged with practicing dental hygiene without license.” WPTV. (November 16, 2018). Web.

Hitchcock, Olivia. “Royal Palm woman accused of running illegal dental practice, making about $20K a month.” The Palm Beach Post. (November 16, 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.

KeyWords: licensure defense attorney, representation for professional license, representation for professional licensure matters, DOH attorney, representation for DOH investigations, representation for board representation, representation for dentists, dentist lawyer, representation for dentistry matters, dentist defense lawyer, legal representation for health care professionals, legal representation for licensed health care professionals, licensed health care defense attorney, health law defense attorney, Florida health law attorney, health care fraud defense attorney, legal representation for health care fraud, legal representation for health care fraud investigations, health care fraud investigation representation, legal representation for U.S. Department of Justice (DOJ) investigations, DOJ investigation representation, review of The Health Law Firm attorneys, The Health Law Firm reviews

“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 |2024-03-14T10:00:20-04:00November 28, 2018|Categories: Dental Law Blog, Uncategorized|Tags: , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Florida Woman Accused of Operating Illegal Dental Practice Out of Her Garage
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New DOJ Memo Shifting Government Policy in False Claims Act Cases Should make Healthcare Providers Happy!

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

On January 29, 2018, the U.S. Department of Justice (DOJ) released a new internal memorandum that we believe signals a backing-off of government support for False Claims Act cases. The memorandum sent by Associate Attorney General Rachel Brand, references “vast reams” of government agency guidance explaining the government’s views and interpretation of various laws. It includes laws related to requirements for accurate billing of Medicare and Medicaid by healthcare providers.

The “Brand Memorandum.”

In the memo, Brand said the DOJ “may not use its enforcement authority to effectively convert agency guidance documents into binding rules.” The memo is a product of Attorney General Jeff Sessions’ move in November 2017, to curtail “regulation by guidance.”

It states that it specifically applies to civil enforcement of laws, including the False Claims Act (FCA), that the Associate Attorney General oversees.

Click here to view the DOJ’s Brand Memorandum in full on our website.

Implications of the Brand Memorandum.

Brand’s memorandum stopped short of completely forbidding the use of agency guidance in support of DOJ cases. The memorandum indicates that, while violations of agency guidance can’t be used to prove violations of law, they can still be used “to help prove that the party had the requisite knowledge” of its legal obligations, Brand wrote.

FCA cases can be affected by many types of guidance. Medicare contractors provide guidance on billing when appropriate and the U.S. Food and Drug Administration (FDA) issues guidance on illicit off-label promotion. Additionally, the Office of the Inspector General (OIG) issues guidance and bulletins related to kickbacks and improper physician referrals.

To learn more about the DOJ’s role in health care fraud and compliance, click here to read one of my prior blogs.

Visit our website to find out how The Health Law Firm can assist you with Medicaid fraud defense, Medicare fraud defense and False Claims Act defense cases.

What Will the Long Term Effects Be?

We see these latest actions by the DOJ to announce a policy of allowing big corporations unbridled discretion to steal from the tax payers. We believe it signals a change to discouraging False Claims Act cases from being brought. It is difficult to see why DOJ is easing off of matters that help the prosecution of False Claims Act cases, especially those by individual relators (whistle blowers). Whistle blower or qui tam cases brought by hundreds of individual whistle blowers are now recovering billions of dollars each year in Medicare and Medicaid fraud. Why would anyone want to stifle such a successful program?

It is argued by DOJ that the DOJ’s budget is limited and U.S. Attorneys need to be freed up to go after serious crime, but that is exactly why the False Claims Act was passed in the first place. If the government doesn’t have the resources, personnel or, more importantly, the interest in pursuing those who files false claims and state form the tax payer, then private whistle blowers or relators are authorized to do this. All the government has to do is to decline to intervene in the case and then the relator can go ahead and pursue the case on its own, without costing the government anything. It was because of war profiteers’ treating the U.S. treasury as a piggy bank, to be looted anytime they felt like it, that caused the False Claims Act’s passage in the Civil War era.

There is also a big concern that if there is less guidance on such complex topics as how to properly document valid medical services and procedures delivered to patients, then how can busy doctors, health care professionals and health facilities hope to understand what is require of them. It is my understanding that such “guidance” is for just such a purpose, to guide those who are trying to comply.

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

The attorneys of The Health Law Firm 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.

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

Sources:

Overley, Jeff. “New DOJ Memo Will Make Waves In Fraud Cases.” Law360. (January 29, 2018). Web.

“New DOJ Memo Will Make Waves In Fraud Cases.” Institute for Legal Reform. (January 29, 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.

KeyWords: Fraudulent billing defense attorney, fraudulent billing representation, Medicare fraud defense attorney, Medicaid fraud defense attorney, representation for health care fraud, representation for Medicare fraud, representation for Medicaid fraud, False Claims Act (FCA) attorney, FCA defense attorney, FCA representation, false filling representation, false billing defense attorney, health care fraud defense attorney, U.S. Department of Justice (DOJ) guidance representation, DOJ investigation representation, DOJ defense attorney, DOJ investigation defense attorney, OIG investigation representation, OIG defense attorney, health care professional defense attorney, health care professional representation, health care compliance representation, health care compliance attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“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 |2024-03-14T10:01:28-04:00May 15, 2018|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on New DOJ Memo Shifting Government Policy in False Claims Act Cases Should make Healthcare Providers Happy!
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Florida Woman Who Performed Illegal Silicone Injections Sentenced After “Patient’s” Death

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 May 26, 2017, a Sanford, Florida, woman who performed illegal cosmetic silicone injections was sentenced to 11 years in federal prison. According to prosecutors, the illegal procedures done by Deanna Roberts, led to serious health problems and the death of a prominent night club performer.
Illegal Injections.

From reports, Deanna Roberts bought about 178 gallons of non-medical grade liquid silicone between 2004 and 2015. She apparently told officials checking on this that she used the substance to lubricate medical equipment, according to the U.S. Department of Justice (DOJ). Despite what she told officials, prosecutors said she falsely claimed to be a licensed medical practitioner and illegally injected liquid silicone into at least five people during cosmetic procedures.

Come on, you know that if she purchased 178 gallons of silicone, she must have injected hundreds of patients.

Health Risks of Liquid Silicone.

The U.S. Food and Drug Administration (FDA) does not allow liquid silicone to be injected because of the health problems it can cause. Many of her “clients” were hospitalized with respiratory problems and other ailments when the silicone migrated to different parts of the body like their lungs, which is what it does. A prominent Atlanta performer died after the substance moved into her lungs, heart, brain and other organs, only 36 hours after the injection.

Roberts pleaded guilty. She was sentenced to 11 years and three months in federal prison, followed by three years of supervised release.

Why Don’t Patients Check Out the Credentials of Their Physicians?

Why don’t patients check out the credentials of their physicians? This just seems like common sense. Yet Florida abounds with phony doctors, phony paramedics, phony dentists and others practicing medicine or some other health profession without being licensed or even knowing anything about the field. Is it driven by the expense of medical procedures? To a certain extent it may very well be. It may also be partially explained by a failure of the “patients” to comprehend the possible adverse consequences of what may be viewed as a “minor” procedure. To a large extent, the unlicensed individuals who do this also prey on foreign born immigrants and foreigners, trusting them because they speak the same language.

I think the problem goes way beyond just the lack of licensure of the person providing the medical services. I constantly see cases of licensed medical doctors holding themselves out as experienced practitioners in medical specialties for which they are not board certified. I seen cases where board certified obstetricians/gynecologists are practicing pain management, where family practice physicians are performing plastic surgery procedures, where dentists are running medical spas providing cosmetic laser services, where nurses are performing cosmetic medical procedures, etc.

If you were diagnosed with a brain tumor, would you go to a family practice doctor to have it removed because he didn’t charge as much. If you needed a hernia repair, would you go to the “doctor” at the flea market, because she was so inexpensive? Consumers really need to be more worried about the experience and credentials of their physicians and check them out completely. Neighbors who have “doctors” set up clinics in their homes and garages need to rat these people out. Phony plastic surgeons who only advertise in Spanish on Spanish radio stations need to be reported to the authorities. Florida needs to do more about these unlicensed and licensed, but unqualified, health practitioners.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations 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:

Hayes, Crystal. “Sanford woman sentenced after silicone injection scheme led to drag queen’s death.” Orlando Sentinel. (May 26, 2017). Print.

Eldridge, Ellen. “Woman who killed Atlanta drag queen with silicone injection heads to prison.” The Atlanta Journal Constitution. (May 26, 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: Legal representation for health care professionals, health law defense attorney, Florida health law attorney, health care fraud defense attorney, legal representation for health care fraud, legal representation for health care fraud investigations, health care fraud investigation representation, legal representation for U.S. Department of Justice (DOJ) investigations, DOJ investigation representation, review of The Health Law Firm attorneys, The Health Law Firm reviews

“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 © 2017 The Health Law Firm. All rights reserved.

By |2024-03-14T10:01:35-04:00May 15, 2018|Categories: Nursing Law Blog|Tags: , , , , , , , , , , |Comments Off on Florida Woman Who Performed Illegal Silicone Injections Sentenced After “Patient’s” Death
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Florida Woman Who Performed Illegal Silicone Injections Sentenced After “Patient’s” Death

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

On May 26, 2017, a Sanford, Florida, woman who performed illegal cosmetic silicone injections was sentenced to 11 years in federal prison. According to prosecutors, the illegal procedures done by Deanna Roberts, led to serious health problems and the death of a prominent night club performer.
Illegal Injections.

From reports, Deanna Roberts bought about 178 gallons of non-medical grade liquid silicone between 2004 and 2015. She apparently told officials checking on this that she used the substance to lubricate medical equipment, according to the U.S. Department of Justice (DOJ). Despite what she told officials, prosecutors said she falsely claimed to be a licensed medical practitioner and illegally injected liquid silicone into at least five people during cosmetic procedures.

Come on, you know that if she purchased 178 gallons of silicone, she must have injected hundreds of patients.

Health Risks of Liquid Silicone.

The U.S. Food and Drug Administration (FDA) does not allow liquid silicone to be injected because of the health problems it can cause. Many of her “clients” were hospitalized with respiratory problems and other ailments when the silicone migrated to different parts of the body like their lungs, which is what it does. A prominent Atlanta performer died after the substance moved into her lungs, heart, brain and other organs, only 36 hours after the injection.

Roberts pleaded guilty. She was sentenced to 11 years and three months in federal prison, followed by three years of supervised release.

Why Don’t Patients Check Out the Credentials of Their Physicians?

Why don’t patients check out the credentials of their physicians? This just seems like common sense. Yet Florida abounds with phony doctors, phony paramedics, phony dentists and others practicing medicine or some other health profession without being licensed or even knowing anything about the field. Is it driven by the expense of medical procedures? To a certain extent it may very well be. It may also be partially explained by a failure of the “patients” to comprehend the possible adverse consequences of what may be viewed as a “minor” procedure. To a large extent, the unlicensed individuals who do this also prey on foreign born immigrants and foreigners, trusting them because they speak the same language.

I think the problem goes way beyond just the lack of licensure of the person providing the medical services. I constantly see cases of licensed medical doctors holding themselves out as experienced practitioners in medical specialties for which they are not board certified. I seen cases where board certified obstetricians/gynecologists are practicing pain management, where family practice physicians are performing plastic surgery procedures, where dentists are running medical spas providing cosmetic laser services, where nurses are performing cosmetic medical procedures, etc.

If you were diagnosed with a brain tumor, would you go to a family practice doctor to have it removed because he didn’t charge as much. If you needed a hernia repair, would you go to the “doctor” at the flea market, because she was so inexpensive? Consumers really need to be more worried about the experience and credentials of their physicians and check them out completely. Neighbors who have “doctors” set up clinics in their homes and garages need to rat these people out. Phony plastic surgeons who only advertise in Spanish on Spanish radio stations need to be reported to the authorities. Florida needs to do more about these unlicensed and licensed, but unqualified, health practitioners.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations 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:

Hayes, Crystal. “Sanford woman sentenced after silicone injection scheme led to drag queen’s death.” Orlando Sentinel. (May 26, 2017). Print.

Eldridge, Ellen. “Woman who killed Atlanta drag queen with silicone injection heads to prison.” The Atlanta Journal Constitution. (May 26, 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: Legal representation for health care professionals, health law defense attorney, Florida health law attorney, health care fraud defense attorney, legal representation for health care fraud, legal representation for health care fraud investigations, health care fraud investigation representation, legal representation for U.S. Department of Justice (DOJ) investigations, DOJ investigation representation, review of The Health Law Firm attorneys, The Health Law Firm reviews

“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 © 2017 The Health Law Firm. All rights reserved.

By |2024-03-14T10:01:38-04:00May 15, 2018|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , |Comments Off on Florida Woman Who Performed Illegal Silicone Injections Sentenced After “Patient’s” Death
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New DOJ Memo Shifting Government Policy in False Claims Act Cases Should make Healthcare Providers Happy!

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

On January 29, 2018, the U.S. Department of Justice (DOJ) released a new internal memorandum that we believe signals a backing-off of government support for False Claims Act cases. The memorandum sent by Associate Attorney General Rachel Brand, references “vast reams” of government agency guidance explaining the government’s views and interpretation of various laws. It includes laws related to requirements for accurate billing of Medicare and Medicaid by healthcare providers.

The “Brand Memorandum.”

In the memo, Brand said the DOJ “may not use its enforcement authority to effectively convert agency guidance documents into binding rules.” The memo is a product of Attorney General Jeff Sessions’ move in November 2017, to curtail “regulation by guidance.”

It states that it specifically applies to civil enforcement of laws, including the False Claims Act (FCA), that the Associate Attorney General oversees.

Click here to view the DOJ’s Brand Memorandum in full on our website.

Implications of the Brand Memorandum.

Brand’s memorandum stopped short of completely forbidding the use of agency guidance in support of DOJ cases. The memorandum indicates that, while violations of agency guidance can’t be used to prove violations of law, they can still be used “to help prove that the party had the requisite knowledge” of its legal obligations, Brand wrote.

FCA cases can be affected by many types of guidance. Medicare contractors provide guidance on billing when appropriate and the U.S. Food and Drug Administration (FDA) issues guidance on illicit off-label promotion. Additionally, the Office of the Inspector General (OIG) issues guidance and bulletins related to kickbacks and improper physician referrals.

To learn more about the DOJ’s role in health care fraud and compliance, click here to read one of my prior blogs.

Visit our website to find out how The Health Law Firm can assist you with Medicaid fraud defense, Medicare fraud defense and False Claims Act defense cases.

What Will the Long Term Effects Be?

We see these latest actions by the DOJ to announce a policy of allowing big corporations unbridled discretion to steal from the tax payers. We believe it signals a change to discouraging False Claims Act cases from being brought. It is difficult to see why DOJ is easing off of matters that help the prosecution of False Claims Act cases, especially those by individual relators (whistle blowers). Whistle blower or qui tam cases brought by hundreds of individual whistle blowers are now recovering billions of dollars each year in Medicare and Medicaid fraud. Why would anyone want to stifle such a successful program?

It is argued by DOJ that the DOJ’s budget is limited and U.S. Attorneys need to be freed up to go after serious crime, but that is exactly why the False Claims Act was passed in the first place. If the government doesn’t have the resources, personnel or, more importantly, the interest in pursuing those who files false claims and state form the tax payer, then private whistle blowers or relators are authorized to do this. All the government has to do is to decline to intervene in the case and then the relator can go ahead and pursue the case on its own, without costing the government anything. It was because of war profiteers’ treating the U.S. treasury as a piggy bank, to be looted anytime they felt like it, that caused the False Claims Act’s passage in the Civil War era.

There is also a big concern that if there is less guidance on such complex topics as how to properly document valid medical services and procedures delivered to patients, then how can busy doctors, health care professionals and health facilities hope to understand what is require of them. It is my understanding that such “guidance” is for just such a purpose, to guide those who are trying to comply.

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

The attorneys of The Health Law Firm 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.

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

Sources:

Overley, Jeff. “New DOJ Memo Will Make Waves In Fraud Cases.” Law360. (January 29, 2018). Web.

“New DOJ Memo Will Make Waves In Fraud Cases.” Institute for Legal Reform. (January 29, 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.

KeyWords: Fraudulent billing defense attorney, fraudulent billing representation, Medicare fraud defense attorney, Medicaid fraud defense attorney, representation for health care fraud, representation for Medicare fraud, representation for Medicaid fraud, False Claims Act (FCA) attorney, FCA defense attorney, FCA representation, false filling representation, false billing defense attorney, health care fraud defense attorney, U.S. Department of Justice (DOJ) guidance representation, DOJ investigation representation, DOJ defense attorney, DOJ investigation defense attorney, OIG investigation representation, OIG defense attorney, health care professional defense attorney, health care professional representation, health care compliance representation, health care compliance attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“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 |2024-03-14T10:01:38-04:00May 15, 2018|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on New DOJ Memo Shifting Government Policy in False Claims Act Cases Should make Healthcare Providers Happy!
Read More
“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 © 2022 The Health Law Firm. All rights reserved.
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