health care fraud

A New Trend in the Government’s Fight Against Health Care Fraud and Pill Mills: Civil Forfeiture

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

Recently, we have noticed government prosecutors and agencies, including the Medicaid Fraud Control Unit (MFCU), the U.S. Attorney General’s (AG) Office, and local sheriff and police departments use the Civil Forfeiture Act against licensed health professionals and health facilities in health-related cases.

A quick, aggressive defense to these actions may recover the property or funds seized. A good defense can also be used to help resolve any pending criminal charges.

The Florida Contraband Forfeiture Act and the Federal Forfeiture Act.

In Florida, the Florida Contraband Forfeiture Act, Sections 932.701 through 932.707, Florida Statues permits the government to seize personal property if there is probable cause to believe that property is either an instrumentality or the proceeds of […]

By The Health Law Firm|2024-03-14T10:01:40-04:00May 15, 2018|Categories: Pharmacy Law Blog|Tags: accused of health care fraud, burden of proof in forfeiture cases, Civil forfeiture, Civil Forfeiture Act, civil forfeiture of money, civil forfeiture of property, criminal charges against a health care facility, criminal charges against a health care professional, criminal charges against a health care provider, defense attorney, defense lawyer, Florida Contraband Forfeiture Act, forfeiture, forfeiture action, forfeiture case, forfeiture proceedings, health care facilities, health care fraud, health care professionals, health law, Medicaid Fraud Control Unity (MFCU), pill mills, police, preliminary adversarial hearing, preventing health care fraud, seized personal property probably cause to seizer personal property, seized property, sheriff, the health law firm, U.S. Attorney’s Office|Comments Off

Florida Pharmacy Owner Admits to $23 Million Health Care Fraud Scheme

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

A co-owner and operator of three Miami-area pharmacies pleaded guilty on December 6, 2012, for his part in a $23 million health care fraud scheme. The pharmacy owner allegedly admitted in the Florida Southern Federal District Court to one count of conspiracy to commit health care fraud and one count of conspiracy to pay illegal health care kickbacks, according to a Department of Justice (DOJ) press release.

Click here to read the entire press release from the DOJ.

Pharmacy Owner and Co-Conspirators Used a Network of Beneficiaries to Bill Medicare and Medicaid.

According to court documents, the pharmacy owner allegedly admitted to paying illegal kickbacks to an unnamed number of co-conspirators in return for Medicare and Medicaid […]

By The Health Law Firm|2024-03-14T10:01:09-04:00May 15, 2018|Categories: Legal Defense for Pharmacists, Pharmacy|Tags: Assisted Living Facilities (ALFs), defense attorney, defense lawyer, Department of Justice (DOJ), Florida health care attorney, Florida health care lawyer, health care fraud, health care fraud scheme, kickbacks, medicaid, Medicaid fraud, Medicaid investigation, medicare, Medicare fraud, Medicare investigation, pharmacy, prescriptions referrals|1 Comment

Connecticut Dentist Gets Drilled in Huge Medicaid Fraud Case

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

A dentist and owner of a number of clinics in Connecticut is feeling the pain of justice. According to a number of news sources, Gary Anusavice will spend the next eight (8) years in prison for targeting poor patients, performing unnecessary dental procedures and collecting $21 million in fraudulent Medicaid claims. He was sentenced on October 9, 2013.

To read an article on the dentist’s sentencing from The Hartford Courant, click here.

Dentist Must Forfeit Luxury Items.

On top of prison time, the dentist will have to pay $3.3 million in restitution and $1.9 million to the Internal Revenue Service (IRS) as a result of his Medicaid fraud scheme, according to The Hartford Courant. He was also ordered to forfeit his mansion, a […]

By The Health Law Firm|2024-03-14T10:01:43-04:00May 15, 2018|Categories: Dental Law, Dentist Defense attorney, Dentistry Law, Licensure matters|Tags: barred from Medicaid, barred from practicing dentistry, Board of Dentistry, defense attorney, defense lawyer, dental group, dental license, dental office, dental practice, dentist, dentist attorney, dentist lawyer, dentistry, health care fraud, medicaid, Medicaid fraud, Medicaid fraud attorney, medicaid fraud lawyer, patient recruiters, the health law firm|Comments Off

Specialty Pharmacy Settles Lawsuit Over Illegal Kickbacks

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

The Department of Justice (DOJ) announced on December 27, 2012, that a specialty pharmacy, based in San Diego, California, has agreed to pay a $11.4 million settlement. That payment is to resolve allegations that the company used kickbacks to persuade doctors to write prescription for its products. The allegations came from a whistleblower lawsuit filed by a former employee.

Click here to read the press release from the DOJ.

Expensive Kickbacks Used on Doctors.

An article in Modern Healthcare states that the specialty pharmacy allegedly used tickets to sporting events, concerts, plays, spa outings, golf games and ski trips to bribe doctors to write prescriptions for its products. The company […]

By The Health Law Firm|2024-03-14T10:01:09-04:00May 15, 2018|Categories: Legal Defense for Pharmacists, Pharmacist, Pharmacy, Pharmacy Law, Whistleblower|Tags: Anti-kickback statue, Department of Justice (DOJ), false claims act, health care fraud, health care scheme, kickback scheme, legal representation, pharmaceutical company, qui tam suits, specialty pharmaceutical company, whistleblower, whistleblower attorney, whistleblower lawyers, whistleblower protection|Comments Off

New Hampshire Dentist Indicted on 189 Counts of Medicaid Fraud

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

On December 20, 2013, a New Hampshire dentist was indicted on 189 counts of Medicaid fraud, according to a number of news sources. The dentist is alleged to have made false claims to the New Hampshire Medicaid office for procedures such as oral exams, X-rays, tooth extractions and orthopedic treatments performed between 2008 and 2013. According to the Concord Monitor, the dentist faces a maximum sentence of 1,323 years in prison. However, it is unlikely the dentist will receive such a long sentence. It is even more unlikely that he will serve the entire sentence, even if he does receive the maximum.

To read an article from the Concord Monitor, click here.

Medicaid Fraud Control Unit of the New Hampshire Attorney General’s […]

By The Health Law Firm|2024-03-14T10:01:44-04:00May 15, 2018|Categories: Dentist Defense attorney, Dentists|Tags: AG, alter medical records, Attorney General, defense attorney, defense lawyer, defraud Medicaid, dental license, dental office, dental practice, dentist, dentist attorney, dentist lawyer, Department of Justice, DOJ, false claims, health care fraud, health law firm, medicaid, Medicaid billing practices, Medicaid fraud, Medicaid fraud attorney, medicaid fraud control unit, Medicaid fraud indictment, medicaid fraud lawyer, Medicaid reimbursements, mfcu, mfcu subpoena, the health law firm|Comments Off

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

Recently we have seen government prosecutors and agencies, including the Medicaid Fraud Control Unit (MFCU), the U.S. Attorney General’s (AG) Office, and local sheriff and police departments use the Florida Contraband Forfeiture Act against health professionals and health facilities in health-related cases.

A prompt, aggressive defense to these actions may recover the property or funds seized and, more importantly, a good defense can be used to help resolve any pending criminal charges.

Civil Forfeiture of Property is Used to Fight Alleged Criminal Activity.

The civil forfeiture of property has become a popular tool for state and federal agencies to combat alleged criminal activity. In Florida, the Florida Contraband […]

By The Health Law Firm|2024-03-14T10:01:14-04:00May 15, 2018|Categories: Department of Health, Legal Defense for Pharmacists, Pharmacist, Pharmacy|Tags: accused of health care fraud, burden of proof in forfeiture cases, Civil forfeiture, Civil Forfeiture Act, civil forfeiture of money, civil forfeiture of property, criminal charges against a health care facility, criminal charges against a health care professional, criminal charges against a health care provider, defense attorney, defense lawyer, Florida Contraband Forfeiture Act, forfeiture, forfeiture action, forfeiture case, forfeiture proceedings, health care facilities, health care fraud, health care professionals, health law, Medicaid Fraud Control Unity (MFCU), pill mills, police, preliminary adversarial hearing, preventing health care fraud, seized personal property probably cause to seizer personal property, seized property, sheriff, the health law firm, U.S. Attorney’s Office|Comments Off

Florida HB 0653 Signed Into Law; Effective 2/1/2012

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

The Florida Legislature unanimously passed HB 653 which relaxes some of the draconian exclusions enacted under SB 1986, which went into effect on July 1, 2009. SB 1986, which added provisions to Chapter 456, Florida Statutes, among others, prevented numerous healthcare providers from obtaining or renewing licenses based on prior criminal convictions, which could have occurred decades earlier.

HB 653 has been passed unanimously by the Florida Legislature and has been signed by the Governor to be effective July 1, 2012. It has been signed into law as Chapter 2012-64, Florida Laws and amends Section 456.0635(5), Florida Statutes (2012).

Under HB 653, the professional boards within the Department of Health (such as the Board of Medicine, Board of Nursing, Board of Psychology, Board of Massage Therapy, etc.) now will, if signed by the Governor, […]

By The Health Law Firm|2024-03-14T10:01:55-04:00May 15, 2018|Categories: Board of Nursing, Department of Health, Nurse License|Tags: criminal charges, Florida law, Florida legislature, Florida Statutes, HB 653, health care fraud, health care license, healthcare providers, LEIE, List of Excluded Individuals and Entities, Medicaid fraud, medical license, Medicare fraud, National Practitoner Data Bank, npdb, nursing license, OIG|Comments Off

Settlement Reached in WellCare False Claims Case

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

WellCare Health Plans Inc.(WellCare) has reached a settlement in its False Claims Act case. WellCare will pay $137.5 million to the federal government and nine states to settle four lawsuits. The lawsuits alleged violations of the False Claims Act.

WellCare is based in Tampa, Florida. The company provides managed health care services for approximately 2.6 million Medicare and Medicaid beneficiaries across the United States.

WellCare Allegedly Submitted False Claims to Medicare and Medicaid Programs.

The lawsuits accused WellCare of submitting false claims to Medicare and Medicaid programs. WellCare allegedly falsely inflated the amount it claimed to be spending on medical care. Allegedly, this was done in order to avoid returning money to Medicaid and other programs in various states, including the Florida […]

By The Health Law Firm|2024-03-14T10:01:55-04:00May 15, 2018|Categories: Nursing Law Blog|Tags: audit, billing, Department of Justice, DOJ, false claims act, Florida Medicaid, fraud defense attorneys, fraud prevention, fraud schemes, government health programs, health care fraud, lawyers, legal representation, managed care, medicaid, medicare, qui tam, realtor, settlement, Wellcare Health Plans, whistleblower|2 Comments

New Database Allows Consumers to Evaluate Nursing Homes Across the Country

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

Consumers have a new online tool to see which nursing homes are being hit with fines for poor quality, safety or maintenance. Nursing Home Inspect 2.0 is a free database that assists users in evaluating nursing homes across the country. The database was first introduced by ProPublica, a nonprofit investigative news organization, in August 2012. On December 17, 2012, the same organization introduced the 2.0 version that includes information about federal fines imposed on nursing homes in the past three years.

The website can be found at Propublica.org/nursinghomes.

According to the website, the information provided comes from government inspection reports from the Centers for Medicare and Medicaid Services (CMS).

Fines Against Nursing Homes are Handed Out Inconsistently.

On the front page the website shows colored maps of […]

By The Health Law Firm|2024-03-14T10:01:56-04:00May 15, 2018|Categories: ALFs, Discipline, Nursing Law Blog|Tags: best nursing homes, Centers for Medicare and Medicaid Services, CMS, defense attorney, defense lawyer, health care attorney, health care fraud, health care lawyer, nursing home fines, nursing home fraud, nursing home inspection report, nursing homes, Office of Inspector General (OIG) Department of Health and Human Services (HHS)|Comments Off

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A New Trend in the Government’s Fight Against Health Care Fraud and Pill Mills: Civil Forfeiture

Florida Pharmacy Owner Admits to $23 Million Health Care Fraud Scheme

Connecticut Dentist Gets Drilled in Huge Medicaid Fraud Case

Specialty Pharmacy Settles Lawsuit Over Illegal Kickbacks

New Hampshire Dentist Indicted on 189 Counts of Medicaid Fraud

The Government’s Use of Civil Forfeiture to Combat Health Care Fraud and Pill Mills in Florida

Settlement Reached in WellCare False Claims Case

New Database Allows Consumers to Evaluate Nursing Homes Across the Country