Are You Working at an Illegal Health Care Clinic?

Despite the passage of Florida’s Health Care Clinic Act over nine years ago, there are apparently still many health practices which are violating it. Unfortunately, the violation of the Health Care Clinic Act can have extremely serious repercussions, including conviction of a felony, loss of all fees collected, and disciplinary/licensure action against any physicians, nurses or other licensed health professionals working there.

Over the past three years we have seen the following scenarios or ones similar to these (changed factually to ensure anonymity):

Scenario 1: A physician licensed in Florida decides to sell her practice and retire. Three non-licensed business people decide to form a corporation to purchase and operate the practice. The corporation purchases the medical practice’s assets, including patient records. The corporation has not applied for or received a Health Care Clinic License.

Results: On the day of closing or the day the practice is transferred to the new corporation, the corporation is operating illegally, in violation of Florida law. Each day of operation is a separate felony.

Scenario 2: A physician practices medicine through a limited liability company (LLC) which the physician owns with his non-licensed wife. The physician dies and his wife remains sole owner of the practice, hiring a locum tenens physician to come in and treat patients.

Results: As of the date of death of the physician, the practice is operating illegally, in violation of Florida law. Each day of operations is a separate felony offense.

Scenario 3: A physician licensed in Florida operates a medical practice as a sole proprietorship. The physician desires to reward her practice manager, a non-licensed business person, by making him a partner in her practice. The practice continues to operate as before without a health care clinic license.

Results: The practice is operating illegally as of the day the practice manager is made a partner.

Scenario 4: Osteopathic physician (D.O.) has a medical practice which he owns and operates through a business corporation which does not need or have a health care clinic license. He decides to relocate to another state. He sells the shares of stock to a medical doctor who is licensed in Georgia, but is not licensed in Florida. The new physician owner hires a medical doctor licensed in Florida to deliver all medical services in the Florida practice.

Results: The corporation, its owner, and the physician employee are operating illegally as of the date the shares in the corporation are transferred. Each day of operation constitutes a new offense.

The consequences of such actions are severe. The act provides that violating it constitutes a felony of the third degree for each day of operation. Any physician or licensed health professional having knowledge of the unlicensed status of the practice or clinic and who does not immediately report it can be disciplined by his or her professional board. Any fees of any kind collected from any source, Medicare, Medicaid, insurers, or cash from patients, are considered illegal as a matter of law and are subject to recoupment or refund.

If you are a licensed physician, nurse, physician’s assistant or other health professional, be sure you know who the actual owners of the medical practice are. If any are not licensed in Florida, inquire as to the existence of a current, valid health care clinic license from the Agency for Health Care Administration. If any doubt or suspicion, consult with an experienced health care attorney.

Please visit our website for more information at www.TheHealthLawFirm.com. 

New Popular Drug Called “Smiles” Outlawed in Florida – Zombie Attacks Still a Threat!

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

In previous blogs we’ve mentioned that Florida Governor Rick Scott signed House Bill 1175 on March 23, 2012. This bill outlawed more than 90 new forms of synthetic drugs and included bath salts, among others. It modifies Section 893.03(1)(c), Florida Statutes, by expanding the list of banned hallucinogenic substances in Schedule I of the Florida Comprehensive Abuse Prevention and Control Act. To see Florida HB 1175, click here. To see the entire list of banned substances, click here.

As you are no doubt aware, this was due, in part, to the recent outbreak of zombie attacks in the state of Florida. To see my prior blog on this, click here.

A new drug is popping up on the market with the name 2C-I or “smiles.” This drug is on the list of banned hallucinogenic substances, but has been linked to a number of deaths across the country.

Click here to learn more on the dangers of taking smiles.

Actor Thought to Have Taken Smiles Prior to Death.

According to CBS News, Johnny Lewis, an actor on the TV show “Sons of Anarchy,” is believed to have taken smiles before allegedly killing his landlady and falling to his death. Detectives believe the actor also had mental health issues.

To see the CBS News story, click here.

Florida’s Synthetic Drug Legislation Imposes Restrictions on Synthetic Substances.
The law that was passed in Florida put in place restrictions to prevent abuse of synthetic substances including certain synthetic cannabinoids and synthetic stimulants. Many of the synthetic substances are also commonly known as synthetic marijuana, smiles, bath salts, K2, potpourri, and incense.

The large quantities of synthetic substances are included in HB 1175 because the chemical compounds in these substances are easy to change. The ease of converting these substances into illegal drugs helps illegal drug makers, users and sellers to avoid arrest and prosecution. For example, one synthetic substance might be illegal under the Florida Comprehensive Abuse Prevention and Control Act, but a minor change in the molecular makeup might make the substance legal. Florida residents who desired to become zombies could just take one of these synthetic substances (don’t ask how). They no longer have to go to Haiti or watch “Weekend at Bernie’s” three times in a row.

Banning Synthetic Drugs Was An Attempt To Reduce Cannibalistic Attacks.

Who can forget the story of the Miami cannibal believed to have been on bath salts?

To refresh your memory, click here to see the story from CNN. Warning this does include actual video of the attack.

It was rumored that one prominent Florida lawmaker stated that banning bath salts, smiles and other synthetic drugs should help to reduce the reported acts of cannibalism and zombie-like behavior in Florida.

Manufacturers and Retailers, Watch Your Back.

The passing of HB 1175 could mean more issues for manufacturers and retailers of any products utilizing synthetic substances such as bath salts, herbal incense, or potpourri. If you manufacture or sell any product that is composed of synthetic substances you should regularly test your products to ensure that you are in full compliance with the new law.

On October 2, 2012, a Port Orange, Florida, store owner was charged with drug possession with intent to sell. Officials accused him of selling synthetic drugs, including marijuana and bath salts.

To see the Orlando Sentinel story on this arrest, click here.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

What do you think about the ban on synthetic drugs? Do you think it is working or not working? Please submit any thoughtful comments below.

Sources:

Jaslow, Ryan. “‘Smiles’ Druge Implicated in Actor’s Death: What Are They?” CBS News. (September 28, 2012). From: http://www.cbsnews.com/8301-204_162-57522571/smiles-drug-implicated-in-actors-death-what-are-they/

Weiss, Piper. “2C-I or ‘Smiles’: The New Killer Drug Every Parent Should Know About.” Yahoo. (September 20, 2012). From: http://shine.yahoo.com/healthy-living/2c-smiles-killer-drug-every-parent-know-234200299.html

Hernandez, Arelis. “Store Owner Accused of Selling Synthetic Drugs, Bath Salts.” Orlando Sentinel. (October 2, 2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-bath-salts-arrest-20121002,0,7437907.story

CNN. “Security Video Shows Entire Miami ‘Zombie’ Attack.” CNN. (May 30, 2012). From: http://news.blogs.cnn.com/2012/05/30/security-video-shows-entire-miami-zombie-attack/

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.

“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 © 1996-2012 The Health Law Firm. All rights reserved.

Central Florida Has Been Invaded By Zombies – No Twinkies Means No Food Source

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

You are already aware of Floridians’ fear of zombies, as shown by recent legislation against bath salts. Despite this, there continue to be reports of rampant zombie outbreaks across the Sunshine State. The zombie apocalypse has hit Central Florida, hard. As a citizen of Florida, you know you are not safe; not from zombies, not from British tourists, not from inability to count (notes in an election) and not from the state legislature. To make matters worse, Twinkies, the only food known to mankind that can survive a post-apocalyptic zombie outbreak (reference: Zombieland 2009) or a nuclear holocaust (reference: Family Guy, second season, third episode Dec. 26, 1999), may soon be out of production. Everyone knows Twinkies have a shelf life of 246 years.

Since Florida seems to be the only state infected with this flesh-eating disease, we are taking a poll. Should we be renamed “the Zombie State?”

A Run With the Living Dead in Clermont.

For those of your reading this blog from another state, you’re in luck. There is actual video footage of how bad the zombie outbreak has gotten in Florida. In Clermont, thousands of cardio-enthusiasts showed up to run a 5K course filled with numerous obstacles that forced participants to crawl in the sticky mud to avoid being pricked by barbed wire above and walking along an unstable beam of wood. Unfortunately, the runners were bombarded along the way by the living dead looking for a quick bite to eat. The participants had to protect their brains while running for their lives. Only the fastest survived.

To see video of attack, click here.

Zombies Take Over the University of Central Florida (UCF).

If you are in Florida and were hoping to take shelter on the campus of the University of Central Florida (UCF), you’re too late. From now until December 2, 2012, the campus will be crawling with zombies who have taken to the stage in a production called “Zombie Town: A Documentary Play.”

We’ve heard it’s not bad. Click here to read a review of the performance.

No Twinkies = No Hope.

By now you’ve heard Hostess, the maker of Twinkies, may be on its way to a complete shutdown. As you know, these delicious treats are the only food that can survive a zombie outbreak. If Hostess closes its doors, we are doomed for sure. Thank goodness Hostess and its striking union members are renegotiating. If Hostess does shut down, it’s rumored a Boca Raton, Florida, company will purchase the brand. We can only hope.

To read the latest on the Hostess debacle, click here.

Given the increasing number of zombie attacks in Florida, the price of Twinkies could soar into the hundreds of dollars each in Florida. Doomsday enthusiasts and disenchanted stock market investors are allegedly pouring funds into warehouse loads of Twinkies.

Is the Ban on Synthetic Drugs in Florida Working?

If you remember, Florida Governor Rick Scott signed House Bill 1175 on March 23, 2012. This bill outlawed more than 90 new forms of synthetic drugs. It modified Section 893.03(1)(c), Florida Statutes, by expanding the list of banned hallucinogenic substances in Schedule I of the Florida Comprehensive Abuse Prevention and Control Act. To view Florida HB 1175, click here. To read more on the ban, click here.

HB 1175 was in response to the first known zombie attack in Miami. This cannibalistic attack was allegedly because the one man was high on bath salts. It was rumored that one prominent Florida lawmaker stated that banning bath salts, smiles and other synthetic drugs should help to reduce the reported acts of cannibalism and zombie-like behavior in Florida.

And he was wrong, the walking dead are alive, sort of, and well in Florida.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

What do you think about all the zombies around town? What are you doing to survive? Are you stocking up on Twinkies now? Tell us, do you think we should rename Florida the Zombie state? Vote in a poll on our Facebook page.

Sources:

Armstrong, Cassie. “Zombies Invade Clermont in 5K Challenge.” Florida 360. (November 17, 2012). From: http://www.orlandosentinel.com/multimedia/os-fla360-zombies-invade-clermont-in-5k-challenge,0,110644.story

Palm, Matthew. “Theater review: ‘Zombie Town: A Documentary Play’ from Theatre UCF.” Orlando Sentinel. (November 18, 2012). From: http://www.orlandosentinel.com/community/ucf/os-zombie-town-review-ucf-20121116,0,4007008.story

Hsu, Tiffany. “Hostess, Union to Give Talks Another Chance.” Orlando Sentinel. (Novemeber 2012). From: http://www.orlandosentinel.com/la-fi-mo-twinkies-hostess-union-mediation-20121119,0,4220893.story

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.

“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 © 1996-2012 The Health Law Firm. All rights reserved.

22 New Synthetic Drugs Outlawed in Florida: Citizens Keep an Eye Out for Zombies

10 Indest-2008-7By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 11, 2012, Attorney General (AG) Pam Bondi filed an emergency rule outlawing 22 new synthetic drugs, commonly known as “bath salts,” “K2,” and “Spice.” This emergency rule modifies Section 893.03(1)(c), Florida Statutes, by expanding the list of synthetic drugs in Schedule I of controlled substances of the Florida Comprehensive Abuse Prevention and Control Act.

Click here to view a copy of the emergency rule.

I previously wrote a blog on House Bill 1175 in July 2012, which originally outlawed 90 forms of synthetic drugs. Click here to read that blog.

Authorities Having a Hard Time Staying on Top of These Drugs.

The new law puts restrictions on those who manufacture, sell or deliver synthetic substances including certain synthetic cannabinoids and synthetic stimulants. Many of the synthetic substances are also commonly known as synthetic marijuana, bath salts, K2, potpourri, and incense. According to an article in the Orlando Sentinel many of these drugs look like snacks for children. One of these drugs is even marketed as a “Scooby Snack,” another looks like cotton candy. To read the entire article from the Orlando Sentinel, click here.

Florida’s officials are continuously updating the list of outlawed synthetic substances because the chemical compounds in these substances are easy to change. The ease of converting these substances into illegal drugs helps drug makers, users and sellers avoid arrest and prosecution.

Click here to see the entire list of outlawed controlled substances.

Anyone with These Drugs Asked to Voluntarily Surrender Supply.

The emergency rule by the AG makes it a third-degree felony for an individual to sell, manufacture or deliver these synthetic drugs.

These drugs are widely available in smoke shops, truck stops, convenience stores and on the internet. In a press release the AG and local law enforcement reached out to people handling these drugs, asking them to voluntarily surrender the substances or face action from law enforcement.

To read the entire press release from the AG, click here.

AG Wants a Zombie-Free Holiday.

This emergency rule is evidence of Floridians’ fear of zombies and cannibal attacks allegedly linked to the misuse of the outlawed substances. Florida has been linked to both in the national news, thus scaring away many of our tourists who usually flood the state. For an update on the zombie apocalypse in Florida, click here. Of course, there are those detractor who contend that face-chewing and other alleged zombie behavior is just natural behavior for Floridians, regardless of the chemicals imbibed.

Since Florida seems to be the only state infected with these flesh-eaters, we are taking a poll. Should Florida be renamed “the Zombie State?” Let us hear from you.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

What do you think of this new list of outlawed synthetic drugs? Do you think sellers will voluntarily surrender their products? Will this new list keep the zombies away? Tell us, do you think we should rename Florida the Zombie state? Click here to vote in a poll on our Facebook page.

Sources:

Meale, Jenn. “Attorney General Pam Bondi Outlaws Additional Synthetic Drugs.” Office of the Attorney General. (December 11, 2012). From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/C2FED4E8849E737685257AD1006EED54

Haughney, K. “Bondi Files Emergency Rule to Outlaw Additional Synthetic Drugs.” Orlando Sentinel. (December 11, 2012). From: http://blogs.orlandosentinel.com/news_politics/2012/12/bondi-files-emergency-rule-to-outlaw-additional-synthetic-drugs.html

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.
“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 © 1996-2012 The Health Law Firm. All rights reserved.

Poll Shows Majority Supports the Legalization of Marijuana

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

For the first time in four decades, a majority of Americans support the legalization of marijuana, according to a national survey conducted by Pew Research. The results from the survey, released on April 4, 2013, show fifty-two percent (52%) of adult Americans back making marijuana legal.

To read all of the poll results from Pew Research, click here.

The Pew Research polled 1,501 American adults from March 13 to 17, 2013, for this survey.

Demographics on Adults Who Support Legal Marijuana.

According to the survey results, forty-eight percent (48%) of poll respondents said they have used marijuana at some point in their life. Younger Americans are more likely to support legalization than their elders. However, the poll does show legalization gaining support among all generations. According to the survey, fifty percent (50%) of baby boomers support legalized marijuana.

Two Big Shifts in Opinion to Support Legalizing Marijuana.

According to an article in the Los Angeles Times, there are two big opinion shifts Americans have gone through that have swayed their way of thinking. The first thought is most Americans no longer see marijuana as a gateway drug, and the second is most adults no longer see the use of marijuana as immoral.

In fact, according to the survey results, most respondents feel the federal government’s efforts to criminalize marijuana “cost more than they are worth.”

Government’s Stance on Marijuana.

Currently, 24 states and the District of Columbia either have decriminalized personal use of medical marijuana, legalized it or allowed it to be used for medical purposes. These state laws clash with federal law that treats marijuana as a dangerous drug with no legitimate medical uses, according to the Los Angeles Times.

Click here to read the article from the Los Angeles Times.

Florida’s Fight for Medical Marijuana.

According to an article in the Orlando Sentinel, Florida attorney John Morgan of Morgan & Morgan recently jumped behind an effort to legalized medical marijuana in Florida. Morgan’s reputation throughout the community and his personal story on why he is lobbying for medical marijuana has people listening.

Morgan’s father suffered from emphysema and cancer, according to the Orlando Sentinel. His appetite was suppressed apparently due to the medicine he was on near the end of his life, and medical marijuana gave him some relief. Morgan said he was motivated to join this cause when he saw a poll that stated seven out of ten Floridians would support a constitutional amendment to support legalized medical marijuana. According to the Orlando Sentinel, Morgan has seen the benefits of medical marijuana firsthand.

Click here to read the entire Orlando Sentinel article.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Do you think marijuana should be legalized? Do you think Florida will legalize medical marijuana? Please leave any thoughtful comments below.

|Sources:

“Majority Now Supports Legalizing Marijuana.” Pew Research. (April 4, 2013). From: http://www.people-press.org/2013/04/04/majority-now-supports-legalizing-marijuana/#comfort-level

Kassab, Beth. “John Morgan Could Take Medical Marijuana Mainstream.” Orlando Sentinel. (March 18, 2013). From: http://www.orlandosentinel.com/news/politics/os-beth-kassab-medical-marijuana-20130318,0,2558234.column

Lauter, David. “Marijuana Legalization Wins Majority Support in Poll.” Los Angeles Times. (April 4, 2013). From: http://www.latimes.com/news/politics/la-pn-marijuana-legalization-majority-support-20130404,0,2533952.story

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.

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 © 1996-2012 The Health Law Firm. All rights reserved.

Miami “Rock Doc” Arrested on Medicare Fraud Charges

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

An osteopathic physician in Miami, Florida, dubbed the “Rock Doc,” was arrested on September 30, 2013. He is charged with twelve (12) counts of health care fraud, according to the Department of Justice (DOJ). The “Rock Doc” is accused of falsely billing the Medicare program for physical therapy procedures, such as massages and electrical stimulation, which were not necessary. If convicted the doctor faces up to ten (10) years in prison and a $250,000 fine.

Click here to read the press release from the DOJ.

In 2010, this osteopathic physician was the feature of a Wall Street Journal article called “Confidentiality Cloaks Medicare Abuse.” The article looked into the billing practices of the “Rock Doc” and many other doctors performing physical therapy and reaping the reimbursements from Medicare.

The physician’s nickname, “Rock Doc,” stems from his appearance of spiked, punk-styled hair, along with accessories of chains, bangles and leather bracelets.

Indictment Accuses Doctor of Spending Reimbursements on Himself.

According to the indictment, the “Rock Doc” is accused of falsely and fraudulently representing that his physical therapy treatments and services were medically necessary and had been provided to Medicare beneficiaries between December 2007 and August 2009. The indictment also alleges that he used the Medicare payments on himself or others.

To read the indictment against the osteopathic “Rock Doc” physician, click here.

Medicare regulations require that physical therapists billing under a physician must have completed an accredited physical-therapy education program. However, in the Wall Street Journal article, the “Rock Doc” said that he trained his “office girls” to do the work because hiring a physical therapist was too expensive.

Wall Street Journal Article Highlighted Physician’s High Medicare Reimbursements.

According to the Wall Street Journal article released in 2010, the “Rock Doc” admitted to receiving more than $2.6 million from Medicare between 2007 and 2009. His gross payments were allegedly more than 24 times the Medicare income of the average family doctor.

In 2009, Medicare administrators caught onto the doctor’s billing activity and began scrutinizing his bills. That increased oversight led him to sell his business.

According to the Miami Herald, the doctor was currently working at a hospital in Larkin County, Florida, when he was arrested.

To read the Miami Herald article, click here.

Fraud Charges Must Be Taken Seriously.

We have been consulted by many individuals, both before and after criminal convictions for fraud or related offenses. There are many times audit investigators must make a judgment on whether overcharges are simply an honest mistake or fraud. In many instances, we are convinced that the person is actually not guilty of fraud. However, in many cases those subject to Medicaid or Medicare fraud audits and investigations refuse to acknowledge the seriousness of the matter or they decide not to spend the money required for a top quality attorney to defend them.

If you are accused of Medicare or Medicaid fraud, realize that you are in the fight of your life. You need to sell everything you own, borrow everything you can and hire the absolute best criminal defense attorney available who has experience in defending such cases to represent you.

If you win and are acquitted, at least you still have a professional license and can start over. However, if you lose, you will most probably be in prison for years. You will lose your license. You will be excluded from Medicare. You will be a convicted felon. You will have nothing and will have no way of starting over successfully. Do not delude yourself. This is extremely serious. Be prepared to give up whatever you have if you can avoid a conviction.

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

The attorneys of The Health Law Firm represent healthcare 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.

Comments?

Do you think that being the subject of the Wall Street Journal article back in 2010, the “Rock Doc” basically alerted the government to his fraudulent billing practices? Please leave any thoughtful comments below.

Sources:

Weaver, Jay. “Miami Beach’s ‘Rock Doc’ Busted on Medicare Fraud Charges.” Miami Herald. (September 30, 2013). From: http://www.miamiherald.com/2013/09/30/3660611/miami-beachs-rock-doc-busted-on.html

Department of Justice. “Miami Physician Indicted in Medicare Fraud Scheme.” Department of Justice. (September 30, 2013). From: http://www.justice.gov/usao/fls/PressReleases/130930-01.html

United States of America vs. Christopher Gregory Wayne. Case Number 13-206912. Indictment. (September 30, 2013). From: http://www.thehealthlawfirm.com/uploads/RockDoc.Indictment.pdf

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.

 

“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 © 1996-2012 The Health Law Firm. All rights reserved.

Two Laptops Containing Information of 729,000 Patients Stolen from California Hospital Group

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The personal health information of around 729,000 patients has been compromised following the theft of two laptops. The password-protected computers were taken from an administration building of AHMC Healthcare Inc., a hospital group in Alhambra, California. According to the Los Angeles Times, the laptops contain data from patients treated at six different AHMC Healthcare hospitals. Surveillance video shows that the theft occurred on October 12, 2013, but hospital officials did not discover the laptops were missing until two days later.

To read the article from the Los Angeles Times, click here.

Laptops Contain Patient Information, But No Evidence Information Has Been Hacked.

According to the hospital group, the laptops contain data including patients’ names, Medicare/insurance identification numbers, diagnosis/procedure codes, and insurance/patient payment records. Some of the files allegedly contain the Social Security numbers of Medicare patients.

So far, there is no evidence the information has been accessed or used, according to the CBS affiliate in Los Angeles. Click here to read the article from the CBS affiliate.

However, given that this just occurred a few days ago, it is probably too early to tell, anyway.

Breach Must Be Reported to the Department of Health and Human Services.

Hospitals are required, under federal law, to report potential medical data breaches involving more than 500 people to the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR). The OCR is responsible for investigating all allegation of violations of HIPAA Privacy and Security Regulations.

According to the Los Angeles Times, AHMC Healthcare has already asked for an auditing firm to perform a security risk assessment. Hospital administrators are also expediting a policy to encrypt all laptops.

HIPAA Omnibus Final Rule Effective September 23, 2013–Get a Risk Assessment.

The HIPAA Omnibus Final Rule went into effect on September 23, 2013. By now, hospitals, physicians and all covered entities must comply with the HIPAA Omnibus Final Rule. The amendments to the rule are available on the HHS OCR website. I previously wrote a blog series about the HIPAA Omnibus Final Rule. Click here for part one, click here for part two and here for part three.

Covered entities should be performing HIPAA risk assessments to identify their security risks and implement protections before a data breach occurs. HIPAA has always required covered entities to perform HIPAA risk assessments. Very often, the first question the OCR asks when investigating a possible HIPAA violation is what risk assessment the health care provider has performed.

The objectives of an adequate HIPAA risk analysis are:

1. Identify the scope of the analysis – the analysis should include all the risks and vulnerabilities to the confidentiality, availability and integrity of all electronic health information regardless of its location.
2. Gather data – the covered entity must identify every location where electronic data is stored.
3. Identify and document potential threats and vulnerabilities – the covered entity should consider natural threats, human threats and environmental threats.
4. Assess current security measures – the covered entity must examine and assess the effectiveness of its current measures.
5. Determine the likelihood of threat occurrence – the covered entity should evaluate each potential threat and prioritize its plan to address each threat.
6. Determine the potential impact of threat occurrence – the covered entity should assess the possible outcomes of each identified threat such as unauthorized disclosure of confidential information.
7. Determine the level of risk – the covered entity should categorize each risk and plan its procedures to mitigate any damage cause by each risk.
8. Identify security measures and finalize documentation – the covered entity should thoroughly document all the steps it used in its risk assessment process.

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 healthcare 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.

Comments?

What do you think if this alleged HIPAA violation? Do you have policies and procedures in place to protect your patients’ right to privacy? Have you received a HIPAA risk assessment lately? Please leave any thoughtful comments below.

Sources:

Winton, Richard. “Laptop Thefts Compromise 729,000 Hospital Patient Files.” Los Angeles Times. (October 21, 2013). From: http://www.latimes.com/local/la-me-hospital-theft-20131022,0,1936078.story#axzz2iRg6Rh3Y

Los Angeles CBS. “Laptops Containing Patient Information Stolen from Alhambra Hospital.” Los Angeles CBS. (October 22, 2013). From: http://losangeles.cbslocal.com/2013/10/22/laptops-containing-patient-information-stolen-from-alhambra-hospital/

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.

“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 © 1996-2012 The Health Law Firm. All rights reserved.

The DEA’s War on Pain Management

The Health Law Firm George F. Indest III HeadshotWithin the last few years, raids on pain management clinics, as well as pharmacies, have been increasingly commonplace. The doctors, pharmacists, nurses and other health care professionals involved are carted away in handcuffs and must defend their practice.

According to the St. Petersburg Times, a South Florida pain management clinic has recently been shut down under emergency action by the Florida Department of Health (DOH). Several health care professionals at the clinic were arrested, their licenses revoked.

In this instance, the charges against these health care employees are not completely unwarranted. Patients confessed to authorities that members of the clinic knew they were shopping for drugs, and an employee revealed that he was asked to recruit patients by promising powerful drugs.

However, it is not uncommon for a pain management clinic or related practice to face investigation, especially in Florida. Federal and state agencies are doing everything and anything they can to prevent drug farming, which means a crackdown on health care providers. Dubbed “Operation Pill Nation,” this strict enforcement means more worries for health care professionals, who now must monitor patient needs under the DEA’s close watch.

If your medical practice specializes in pain management or a similar area, have a plan in place in the event that the DEA comes knocking on your door. Be aware of health lawyers that are familiar with these cases and can defend you in the event of a DEA raid. These proceedings are often very complicated, and you’ll want an experienced team of health law attorneys to properly defend you from criminal charges.

At The Health Law Firm, our team of lawyers specialize in the representation of doctors, nurses, pharmacists, physicians assistants, nurse practitioners and other health care professionals involved in Department of Health, Diversion Control and Drug Enforcement Administration in Florida and throughout the United States. For more information about our knowledge in the practice of health law and DEA cases read our article on Pain Management and the DEA.

Doctor Indicted In Home Health Medicaid Fraud Suit Hit With 3-Year Prison Sentence

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 December 7, 2016, Banio Koroma was convicted in a northern Illinois court of falsely certifying elderly patients for in-home care will spend the next three years in prison and be forced to reimburse the government for the $1.5 million in losses he caused, an Illinois federal judge ruled.

Paying For His Crimes.

In June 2016, Banio Koroma, 67, appeared in court in an orange jumpsuit after being jailed for violating his bond when it was discovered that he had again committed fraud by mailing fake checks to strangers. On December 7,2016, he was told he would spend a total of 40 months in prison for the crime that placed him on that bond. The crime committed included cheating Medicaid out of at least $1.5 million during his employment with home health care provider Mobile Doctors USA (Mobile Doctors).

“That sentence would be substantially higher were it not for his age,” U.S. District Judge John J. Tharp said. The judge also ordered restitution of $1.5 million and said that Dr. Koroma would be under three years of supervised probation following his release from prison.
The Fraudulent Scheme.

In 2013, Dr. Koroma was indicted along with Mobile Doctors’ Chief Executive Officer, Dike Ajiri, who pled guilty and was sentenced in May 2016 to 15 months in prison. Dr. Koroma had worked for Mobile Doctors, a company that contracted with physicians to arrange home health care services in Illinois, Michigan, Indiana and elsewhere before its 2013 closure due to the indictment.

According to the government, Dr. Koroma, signed off on documents authorizing the in-home care treatment of elderly patients who were not confined to their homes and could in fact leave their houses to see a doctor.

Prosecutors allege that Dr. Koroma did so without first verifying that the patients were in fact homebound and was motivated purely by greed. A jury convicted him in January 2016 of four counts of Medicare fraud. Click here to read more on his conviction.

To learn more about the repercussions of Medicaid fraud such as this, click here to read one of my prior blogs on a similar case.

Health Care Fraud Should Not Be Taken Lightly.

We have been consulted by many individuals, both before and after criminal charges were brought for fraud or related offenses. In many cases, those subject to Medicare and Medicaid fraud audits and investigations refuse to acknowledge the seriousness of the matter. Some may even decide not to spend the money required for a highly experienced health attorney to defend them.

Click here to read one of my previous blog posts regarding Medicare and Medicaid audits.

The government is serious about combating health care fraud. It created a Medicare Fraud Strike Force in March of 2007, in an effort to further prevent and eliminate fraud and abuse of government health care programs. False claims are a growing problem in the program, costing the government billions of dollars each year. Accordingly, punishments for defrauding the system can be quite severe.

If you are accused of Medicare or Medicaid fraud, realize that you are in a fight for your life. Your liberty, property/possessions and profession are all at stake. Often it is possible to settle allegations of fraud by agreeing to pay civil monetary penalties and fines. If given such an opportunity, the provider should consider whether it is worth the risk of facing decades in prison. Be prepared to give up whatever you need to in order to avoid a conviction and preserve your liberty.

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

The attorneys of The Health Law Firm represent healthcare 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:

Corso, Jessica. “Doctor In Home Health Fraud Hit With 3-Year Sentence.” Law360. (December 9, 2016). Web.

Robeznieks, Andis. “Mobile Doctors CEO, physician arrested in alleged Medicare fraud scheme.” Modern Healthcare. (August 27, 2013). 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 © 2016 The Health Law Firm. All rights reserved.

South Florida Hospital Agrees To Pay $12 Million To Settle FCA Claims

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

On December 7, 2016, a Miami-area hospital will pay the federal government about $12 million to resolve allegations that it violated the False Claims Act (FCA) by submitting false claims to federal health care programs for medically unnecessary cardiac procedures, the U.S. Department of Justice (DOJ) said.

The Allegations.

The allegations against South Miami Hospital stem from procedures allegedly performed by Dr. John R. Dylewski while he worked for the hospital. “Performing medically unnecessary heart procedures is shocking to the conscience,” Shimon R. Richmond, the U.S. Health and Human Services’ (HHS) Office of Inspector General’s (OIG) special agent in charge, said in a statement. “Conducting cardiac catheterizations purely for profit, not patient care, seriously breaches the ‘do no harm’ commitment physicians pledge.”

Two Whistle Blowers Add to the Mix.

Two whistle blowers, Dr. James A. Burks and Dr. James D. Davenport, brought the suit to light and stand to receive about $2.75 million of the settlement. Dr. Burks is a vascular surgeon who started working at South Miami Hospital in 2003 and Dr. Davenport is a cardiologist who was active in various peer review committees at the hospital between 2010 and 2014.

Both whistle blowers claimed to have personal knowledge of Dr. Dylewski and the hospital performing a number of unnecessary cardiac procedures for the sole purpose of increasing the amount of reimbursements paid to the hospital and its doctors by Medicare the DOJ said. According to the two whistleblowers, the alleged wrongdoing was known throughout the hospitals’ corporate hierarchy, including top executives, department officers, medical division chiefs and members of peer review committees. Additionally, both whistleblowers claim to have witnessed “repeated and continuing instances” of the improper medical and billing practices.

Dr. Dylewski, who no longer works at the hospital, was not a party to the settlement. Click here to read the press release on the suit from the DOJ.

To learn more about FCA suit, click here to read one of my prior blogs on a similar case.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistle blower or qui tam) case. This case just shows that even physicians can and should bring such claims and be rewarded for their whistle blowing activities. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities who have been sued in False Claims Act (whistle blower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistle blower cases, as well.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Kennedy, John. “Florida Hospital To Pay $12M To Settle FCA Claims.” Law360. (December 7, 2016). Web.

Lincoff, Nina. “BREAKING: South Miami Hospital to pay $12M to settle false claims allegations.” South Florida Business Journal. (December 7, 2016). 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 The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2016 The Health Law Firm. All rights reserved

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