health law | The Health Law Firm Blog

Watch Out for Legal Pitfalls Associated with Telemedicine

By Lance O. Leider, J.D., The Health Law Firm

With all the new technologies, mobile medical applications, expansion of access to health care under the Affordable Care Act (ACA), and the emphasis on quality care, telemedicine is at the forefront of the health care industry.

Now is the time to educate yourself on the new opportunities in practicing telemedicine. As with any new health care business model, you also have to assess the risks and be sure you are complying with the ever increasing number of regulations.

Where Telemedicine Stands Today.

The Centers for Medicare and Medicaid Services (CMS) can be credited for the telemedicine revival. In 2011, CMS issued a final rule permitting a more flexible process for credentialing and privileging practitioners who provide telemedicine services. Telemedicine escalated in 2013, when federal and state legislation and major insurers expanded the types of […]

By The Health Law Firm|2024-03-14T10:00:57-04:00June 1, 2018|Categories: HHS, The Health Law Firm Blog|Tags: administrative law, Centers for Medicare and Medicaid (CMS), defense attorney, defense lawyer, doctor shortage, e-visit, electronic medical questionnaire, Florida standards for telemedicine, Florida telemedicine, health care attorney, health care lawyer, health care reform, health law, online house call, physician shortage, Telemedicine|Comments Off

Florida Dentist Hit with an Emergency Suspension Order for Allegedly Inhaling Nitrous Oxide

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

A Debary, Florida, dentist has been served with an emergency suspension order (ESO) by the Florida Department of Health (DOH) for allegedly inhaling nitrous oxide or laughing gas in front of patients. The administrative complaint filed against the dentist on November 2, 2012, by the Florida DOH stated a department-approved evaluator deemed the dentist unfit to practice dentistry and was recommended to undergo residential treatment.

Click here to read the full administrative complaint against the dentist.

We want to point out that these are just allegations made against the dentist at this point in time and have not been proven by the state.

Dentist Allegedly Ordered to Rehabilitation.

In June 2012, the Florida DOH ordered the dentist […]

By The Health Law Firm|2024-03-14T10:00:41-04:00June 1, 2018|Categories: Dentist, Department of Health, Informal Hearings, The Health Law Firm Blog|Tags: D.D.S., defense attorney, defense lawyer, dentist defense, dentist investigation, dentists, department of health, Division of Administrative Hearings (DOAH), doh, DOH investigation, emergency suspension order, family dentist investigation, formal hearing, health law, license revoked, pediatric dentist investigation, quality assurance|Comments Off

Internal Medicine Specialists Should Be Aware of Impending Medicare Audits

Coming to a medical practice near you. . . It’s scary, it’s horrible, and it could cost you a lot of money!

It’s the dreaded Comprehensive Error Rate Testing (CERT) audit.

The Horror! The Horror!

First Coast Service Options, the Medicare contractor for Florida, announced a new prepayment audit program that will impact Internal Medicine Specialists. The prepayment program is focused on Initial and Subsequent Hospital Evaluation and Management Services, CPT Codes 99223 and 99233. The program is being launched due to the high CERT error rate associated with these codes.

The audits will start on October 21, 2014.

What is the CERT Program?

CMS created the CERT program to measure the paid claims error rate for Medicare claims submitted to Medicare administrative contractors, carriers, durable medical equipment regional carriers, and Medicare Administrative Contractors (MACs). CMS receives more than two billion claims annually. The CERT program […]

By The Health Law Firm|2024-03-14T10:00:58-04:00June 1, 2018|Categories: CERT, Comprehensive Error Rate Testing, Internal Medicine, Medicaid, Medicaid audit, Medicaid Fraud Control Unit, Medicaid managed care, Medicare, Medicare Audit, Medicare Fraud, The Health Law Firm Blog|Tags: Centers for Medicare and Medicaid Services, CERT attorney, CERT audit, CERT contractor, CERT documentation contractor (CDC), CERT lawyer, CERT Program errors, CERT review contractor (CRC), CMS, Comprehensive Error Rate Testing audit, defense attorney, defense lawyer, First Coast Audit Program, health law, health law firm, Internal Medicine Specialist audits, Internal Medicine Specialists, medicare, Medicare Administrative Contractor, medicare audit, Medicare claim, Medicare Comprehensive Error Rate Testing program audit|Comments Off

Responding to a Medicare Audit – Practice Tips

Although you may speak of a “routine” Medicare audit, there is really no such creature. This is like saying you have a “routine IRS audit.” The fact is that there is some item you have claimed as a Medicare provider or the amount of claims Medicare has paid in a certain category that has caused you or your practice to be audited.

Having too many claims for level five CPT codes might, for example, cause you to be audited. Having multiple claims submitted for the same date of service, may cause you to be audited. Submitting claims for CPT codes outside of your medical speciality area, might cause you to be audited. Having the dollar amount of claims greater than the average for a similar health practitioner in the same geographical area of the country, may cause you to get audited. Having a greater number of claims submitted than the average […]

By The Health Law Firm|2024-03-14T10:00:25-04:00June 1, 2018|Categories: Health Care Industry, In the Know, Medicare, The Health Law Firm Blog|Tags: attorney, florida, health law, medical, medicare, medicare audit|Comments Off

What Health Providers Need to Know About Telemedicine

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

For years providing health care to patients has been at a location that is convenient to the health provider. With emerging trends in telemedicine and upcoming healthcare reforms, recently enacted, patients may begin to enjoy the convenience of medical evaluation and follow-up by video, telephone and computer. The biggest bar to this to date has been the refusal of Medicare, Medicaid and insurers to pay for this, along with restrictive state board of medicine regulations prohibiting it. For example, a big thorn in the side of physicians treating pain management patients has been regulatory prohibitions by the Florida Board of Medicine.

According to a Star Tribune article, 30 million Americans are expected to gain access to insurance through the Health Care Reform Act […]

By The Health Law Firm|2024-03-14T10:00:42-04:00June 1, 2018|Categories: In the Know, The Health Law Firm Blog|Tags: administrative law, Centers for Medicare and Medicaid (CMS), defense attorney, defense lawyer, doctor shortage, e-visit, electronic medical questionnaire, Florida standards for telemedicine, health care attorney, health care lawyer, health care reform, health law, online house call, physician shortage, Telemedicine|1 Comment

A New Year Means New Audits and Site Visits for Assisted Living Facilities – Protect Yourself Now

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

For Assisted Living Facilities (ALFs) in Florida, it’s time to do a little brushing up on your compliance material.

Beginning in January 2015, the Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), Bureau of Medicaid Program Integrity (MPI), will conduct site visits to determine compliance with the Florida Medicaid Provider General Handbook and the Assistive Care Services Coverage and Limitations Handbook. This is just one of several initiatives aimed at ALFs to curtail fraud, waste, and abuse in the Florida Medicaid program.

Be Prepared.

The goal of a site visit is to determine if providers are rendering and documenting required services; to determine if assistive care services are being rendered by qualified and properly trained staff; to identify quality of care/environmental issues; and, to document […]

Florida Doctor Arrested for Drug Sales and Other Criminal Charges

Drug trafficking charges against a medical doctor are not a new concept, especially in Florida. Recent pill mill busts throughout the state have resulted in an omnipresent DEA, always on the lookout for illegal drug sales by pharmacies, pharmacists, pain management clinics and physicians. However, the recent arrest of a Central Florida doctor extends beyond the run of the mill “pill mill” bust, as the accusations in this case involve sex with a minor and delivering a controlled substance to a minor.

According to Florida Today, this Central Florida doctor was arrested Tuesday following a raid by the Florida Department of Law Enforcement. This is his second arrest after he was charged with possession of marijuana and drug paraphernalia in August.

Tuesday’s arrest resulted from evidence of the doctor’s sexual relationship with a high school student. The doctor was arrested in 2009 after being caught during a […]

By The Health Law Firm|2024-03-14T10:00:26-04:00June 1, 2018|Categories: Health Care Industry, In the Know, In the News, Pain Management, Pharmacy, The Health Law Firm Blog|Tags: dea, defense attorney, doctor, drug trafficking, fdle, florida, health law, oxycodone, pain management|3 Comments

Colorado Surgeon Accused of Botching Multiple Robotic Arm Surgeries

By Carole C. Schriefer, R.N., J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Colorado surgeon allegedly faces 14 counts of unprofessional conduct associated with the use a robotic arm used during surgeries, according to the formal administrative complaint. The Colorado Medical Board filed the complaint on April 2, 2013, alleging that from 2008 until 2010, the surgeon cut and tore blood vessels, left sponges and other instruments inside of patients, injured patients through padding and positioning, subjected some patients to overly long surgeries and had to abort kidney donation procedures because of mistakes. The surgeon is also accused of not documenting the mistakes in patient charts.

According to the Colorado Board of Medicine’s administrative complaint, the surgeon was using the da Vinci robot, manufactured by Intuitive […]

By The Health Law Firm|2024-03-14T10:00:47-04:00June 1, 2018|Categories: Administrative law, Board of Medicine, Health Care Industry, In the News, Licensing issues, Medical License, The Health Law Firm Blog|Tags: administrative complaint, administrative judge, administrative law, Colorado law, Colorado medical board, da Vinci-brand surgery units, discipline license to practice medicine, discipline to medical license, doctor, Food and Drug Administration (FDA), formal complaint against surgeon, health care attorney, health care lawyer, health law, license to practice medicine, malpractice lawsuit, medical board, medical board complaint, medical board hearing, medical errors, physician, robotic surgery, robotic surgery arm, standard of care, surgeon, unprofessional conduct|Comments Off

Physician Argues Definition of “Peer” at Formal Administrative Hearing

FACTS: The Agency for Health Care Administration (“AHCA”) is responsible for administering Florida’s Medicaid program and conducting investigations and audits of paid claims to ascertain if Medicaid providers have been overpaid. With regard to investigations of physicians, section 409.9131, Florida Statutes, provides that AHCA must have a “peer” evaluate Medicaid claims before the initiation of formal proceedings by AHCA to recover overpayments. Section 409.9131(2)(c) defines a “peer” as “a Florida licensed physician who is, to the maximum extent possible, of the same specialty or subspecialty, licensed under the same chapter, and in active practice.” Section “109.9131(2)(a) deems a physician to be in “active practice” if he or she has “regularly provided medical care and treatment to patients within the past two years.”

Alfred Murciano, M.D., treats patients who are hospitalized in Level III neonatal intensive care units and pediatric intensive care units in […]

By The Health Law Firm|2024-03-14T10:00:58-04:00June 1, 2018|Categories: Administrative law, Agency for Health Care Administration, Appeal, Health Care Industry, Medicaid, Medicaid audit, Medicaid Fraud, The Health Law Firm Blog|Tags: Administrative Hearing, administrative law, administrative law judge, Agency for Health Care Administration (AHCA), AHCA appeal, AHCA petition, credentials, defense attorney, defense lawyer, final agency audit report, formal administrative hearing, formal hearing, health care attorney, health law, health law attorney, health law defense attorney, Medicaid Audits, Medicaid claims, Medicaid fraud, Medicaid overpayment, partial final order, pediatrician, pediatrics, peer, peer review|Comments Off

Healthcare Providers Service Organization (HPSO) Attorneys, Lawyers and Defense Council in Florida

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

Often we learn after the fact that a health professional such as a mental health counselor, psychologist, or pharmacist has received Healthcare Providers Service Organization (HPSO) insurance, has had a legal problem, and has not been able to locate an attorney or law firm that accepts this type of insurance. We have offices in Florida and Colorado, but we have attorneys licensed in Florida, Colorado, Louisiana, the District of Columbia, Virginia and other states.

Additionally, we can provide legal advice and representation in license investigations and administrative proceedings in many other states.

If you have HPSO Insurance, do not go without an attorney or with a lawyer that has little or no experience where you need it. Contact us, and we will help you.

Don’t Worry About […]

By The Health Law Firm|2024-03-14T10:00:47-04:00June 1, 2018|Categories: Administrative law, Health Care Industry, Healthcare Providers Service Organization (HPSO), Insurance, Licensing issues, The Health Law Firm Blog|Tags: administrative law, administrative proceedings, attorney, complaint against a health care professional, complaint against a health care provider, doctor, health attorney, health care lawyer, health care professional, health care provider, health insurance, health law, health law attorney, Healthcare Providers Service Organization (HPSO) Insurance, insurance, insurance health care, investigation of a health care professional, investigation of a health care provider, legal bills, legal defense expenses, mental health counselor, pharmacist, physician, professional discipline, professional liability insurance, psychologist|1 Comment