The Biggest Healthcare Fraud Case Ever Prosecuted in 2019: Big Surprise! Florida Wins!

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making Florida, once again, the leader in fakes and frauds. Often joked and written about by Florida novelists such as Carl Hiassin and Tim Dorsey, this case serves to highlight why the “Debtor’s Haven” state often excels in cases of healthcare fraud.

In April 2019, after decades of alleged schemes, illegal kickbacks and money laundering in connection with fraudulent claims to Medicare and Medicaid, Phillip Esformes was sentenced to 20 years in prison. He was also ordered […]

By |2024-03-14T10:00:02-04:00March 23, 2020|Categories: Dental Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on The Biggest Healthcare Fraud Case Ever Prosecuted in 2019: Big Surprise! Florida Wins!

Taking a Look at 2019’s Largest Healthcare Fraud Case Ever Prosecuted

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making Florida, once again, the leader in fakes and frauds. Often joked and written about by Florida novelists such as Carl Hiassin and Tim Dorsey, this case serves to highlight why the “Debtor’s Haven” state often excels in cases of healthcare fraud.

In April 2019, after decades of alleged schemes, illegal kickbacks and money laundering in connection with fraudulent claims to Medicare and Medicaid, Phillip Esformes was sentenced to 20 years in prison. He was also ordered […]

By |2024-03-14T10:00:03-04:00March 6, 2020|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Taking a Look at 2019’s Largest Healthcare Fraud Case Ever Prosecuted

Taking a Looking at 2019’s Largest Healthcare Fraud Case Ever Prosecuted: No Surprise, Florida Wins!

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making Florida, once again, the leader in fakes and frauds. Often joked and written about by Florida novelists such as Carl Hiassin and Tim Dorsey, this case serves to highlight why the “Debtor’s Haven” state often excels in cases of healthcare fraud.

In April 2019, after decades of alleged schemes, illegal kickbacks and money laundering in connection with fraudulent claims to Medicare and Medicaid, Phillip Esformes was sentenced to 20 years in prison. He was also ordered […]

By |2024-03-14T10:00:04-04:00February 24, 2020|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Taking a Looking at 2019’s Largest Healthcare Fraud Case Ever Prosecuted: No Surprise, Florida Wins!

One of 2019’s Largest Healthcare Fraud Case Ever: No Surprise, Florida Wins!

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making Florida, once again, the leader in fakes and frauds. Often joked and written about by Florida novelists such as Carl Hiassin and Tim Dorsey, this case serves to highlight why the “Debtor’s Haven” state often excels in cases of healthcare fraud.

In April 2019, after decades of alleged schemes, illegal kickbacks and money laundering in connection with fraudulent claims to Medicare and Medicaid, Phillip Esformes was sentenced to 20 years in prison. He was also ordered […]

By |2024-03-14T10:00:04-04:00February 10, 2020|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on One of 2019’s Largest Healthcare Fraud Case Ever: No Surprise, Florida Wins!

2019’s Largest Healthcare Fraud Case Ever Prosecuted: No Surprise, Florida Wins!

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making Florida, once again, the leader in fakes and frauds. Often joked and written about by Florida novelists such as Carl Hiassin and Tim Dorsey, this case serves to highlight why the “Debtor’s Haven” state often excels in cases of healthcare fraud.

In April 2019, after decades of alleged schemes, illegal kickbacks and money laundering in connection with fraudulent claims to Medicare and Medicaid, Phillip Esformes was sentenced to 20 years in prison. He was also ordered […]

By |2024-03-14T10:00:05-04:00January 27, 2020|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on 2019’s Largest Healthcare Fraud Case Ever Prosecuted: No Surprise, Florida Wins!

Looking Back at 2019’s Largest Healthcare Fraud Case Ever Prosecuted: Surprise! No Surprise, Florida Wins!

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making Florida, once again, the leader in fakes and frauds. Often joked and written about by Florida novelists such as Carl Hiassin and Tim Dorsey, this case serves to highlight why the “Debtor’s Haven” state often excels in cases of healthcare fraud.

In April 2019, after decades of alleged schemes, illegal kickbacks and money laundering in connection with fraudulent claims to Medicare and Medicaid, Phillip Esformes was sentenced to 20 years in prison. He was also ordered […]

By |2024-03-14T10:00:06-04:00January 13, 2020|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Looking Back at 2019’s Largest Healthcare Fraud Case Ever Prosecuted: Surprise! No Surprise, Florida Wins!

Copying and Pasting Clinical Notes in Electronic Health Records Could Be Considered Healthcare Fraud

1 Indest-2008-1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) is concerned about healthcare providers carelessly copying and pasting clinical notes in electronic health records (EHRs). According to an audit report released on December 10, 2013, copying and pasting in EHRs can lead to fraudulently duplicated clinical notes, which can be considered healthcare fraud. This practice is allegedly widespread across medicine, according to a Modern Healthcare article. Federal officials say there is a need to crackdown on this behavior.

Click here to read the entire audit report from the HHS OIG.

This is the first of two reports on fraud and vulnerabilities in EHR systems. The second report from the OIG will be on weaknesses in how the Centers for […]

Centers for Medicare and Medicaid Services Puts Recovery Audit Contractor Program on Hold

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

On February 18, 2014, the Centers for Medicare and Medicaid Services (CMS) announced it is in the procurement process for the next round of Recovery Audit Program contracts. This means the program is, for the time being, on hold while CMS awards new contracts. According to CMS, it will select new vendors to continue the Recovery Audit Contractor (RAC) program, which is responsible for detecting improper Medicare payments. It is expected that this pause will also be used to refine and improve the RAC program. In the announcement it was not disclosed how long the program would be on hold.

Click here to read the announcement from CMS.

This news comes months after CMS revealed an enormous backlog of RAC appeals. The backup […]

OIG Audit Finds Federal Database of Terminated Medicaid Providers Needs Improvement

LLA Headshot smBy Lenis L. Archer, J.D., M.P.H., The Health Law Firm

The Affordable Care Act (ACA) requires the Centers for Medicare and Medicaid Services (CMS) to establish a process for sharing information about terminated Medicaid providers. The federal database, called Medicaid and Children’s Health Insurance Program State Information Sharing System (MCSIS), is designed to prevent terminated health care providers from billing another state’s program. However, an audit by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), released in March 2014, states the MCSIS is not working as intended.

The MCSIS is supposed to collect data from every state Medicaid program on providers that were terminated from Medicaid for cause. However, the report found that the HHS OIG is not receiving data from 17 states or the District of Columbia. It was also found that a […]

CMS in the Hot Seat for Lax Oversight of Medicaid Managed Care Organizations

LLA Headshot smBy Lenis L. Archer, J.D., M.P.H., The Health Law Firm

For years, each state has kept an eye on its own Medicaid managed care plans, while the Centers for Medicare and Medicaid Services (CMS) is required to monitor how well each individual state is doing. However, a recent Government Accountability Office (GAO) report claims CMS is sleeping on the job. The report, released on June 20, 2014, stresses the need for more federal oversight of these plans.

With the implementation of the Affordable Care Act (ACA), the Medicaid program is expected to expand significantly. Most of the new beneficiaries enrolled in managed care are covered almost entirely by federal funds. The need for federal oversight in this area is of growing importance to ensure accountability of taxpayers’ dollars.

To read the entire report from the GAO, […]

Go to Top