legal defense | The Health Law Firm Blog

Florida Woman Arrested for $400,000 Medicaid Fraud Scheme

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

The owner of Homecare Unlimited, LLC, in Jacksonville, Florida, has allegedly been arrested for defrauding Medicaid out of more than $400,000, according to the Florida Office of the Attorney General (AG). The owner is charged with billing Florida’s Aged and Disabled Adult Waiver Program for services not rendered and billing for services to ineligible recipients. This Medicaid fraud scheme allegedly happened between January 2008 and June 2011.

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

Business Owner Accused of Fraud and Grand Theft.

The Florida Times-Union states that some of the people the business owner claimed to have provided services for were in jail at the time she supposedly rendered the services. The AG’s Medicaid Fraud Control Unit (MFCU) has charged the owner with two counts of Medicaid provider fraud and […]

Speech Therapist Arrested for Billing Medicaid $500,000 for Work at Florida Day Care Centers While Living in Illinois

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

A speech therapist was arrested on March 29, 2013, for allegedly billing Medicaid more than $500,000 for services that she did not provide, according to the Florida Office of the Attorney General (AG). The speech therapist now faces charges of Medicaid fraud and grand larceny.

Click here to read the press release from the AG.

Billed Medicaid for Services Provided in Florida, While Living in Illinois.

According to an article in The Palm Beach Post, authorities began investigating the speech therapist when they received a tip that she was overbilling for services provided. During the investigation it was found that while the speech therapist reported to Medicaid she lived in Florida, she has been allegedly living in Illinois for the past eight years. The speech therapist […]

By The Health Law Firm|2024-03-14T10:00:47-04:00June 1, 2018|Categories: Medicaid, Medicaid audit, The Health Law Firm Blog|Tags: defense attorney, defense lawyer, false claims act, FCA, Florida defense attorney, Florida defense lawyer, Florida Office of the Attorney General (AG), legal defense, legal representation, medicaid, medicaid audit, Medicaid defense attorney, Medicaid defense lawyer, Medicaid fraud, Medicaid Fraud Control Unit (MFCU), Medicaid fraud defense attorney, Medicaid fraud defense lawyer, Medicaid overbilling, Medicaid scheme, Medicaid therapist provider, speech therapist|Comments Off

$24 Million Medicaid Fraud Scheme Alleged by Connecticut Attorney General

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

Connecticut’s Attorney General, George Jepsen, alleges that 28 individuals, dental practices and corporations were involved in a $24 million Medicaid fraud scheme. He filed a civil action on May 31, 2012. It is the first case the state has initiated under the Connecticut False Claims Act. The Connecticut False Claims Act gives the state the ability to seek compensation for taxpayers from those who submit false claims for reimbursements they are not eligible to receive. To view the Connecticut False Claims Act, click here.

The complaint seeks restitution, treble damages and civil penalties as well as a permanent injunction against the unlawful acts and practices alleged in the complaint. To view the […]

By The Health Law Firm|2024-03-14T10:00:31-04:00June 1, 2018|Categories: Medicaid, The Health Law Firm Blog|Tags: Centers for Medicare & Medicaid Services (CMS), civil recovery for criminal actions, dental practice, dental services, dentist, dentist Medicaid fraud, Department of Health and Human Services, false claims act defense, fraud prevention, legal defense, medicaid, Medicaid exclusion, Medicaid fraud, Medicaid fraud defense attorney, medical groups, medical practices, medicare, Medicare defense attorneys and lawyers, Medicare exclusion, Medicare fraud, nurse, nursing, OIG exclusion, permanent exclusion, physicians, qui tam, state healthcare programs, whistle-blower|Comments Off

How to Respond to a Medicaid Fraud Control Unit (MFCU) Investigative Subpoena

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

The Medicaid Fraud Control Unit (MFCU) is a division of the Florida Office of Attorney General. It is in charge of investigating and prosecuting health care providers suspected of defrauding the state’s Medicaid program. When the unit opens a case against a provider, the first step is usually the issuance of an investigative subpoena, requesting specific patient records. The practice tips below were prepared to assist a health care provider in properly responding to such a subpoena and being prepared to defend oneself.

It is important to remember that the MFCU would not be involved unless criminal fraud was suspected. This is not a routine audit.

1. Speak with an attorney experienced in […]

By The Health Law Firm|2024-03-14T10:00:35-04:00June 1, 2018|Categories: Medicaid, Medicaid audit, The Health Law Firm Blog|Tags: defense attorney, legal defense, medicaid, Medicaid defense attorney, Medicaid fraud, Medicaid Fraud Control Unit (MFCU), Medicaid fraud defense attorney, MFCU investigation, mfcu subpoena|1 Comment

The Lone Star State’s New Task Force to Take a Bite Out of Medicaid Dental Fraud

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

There’s a new task force riding into Texas. According to The Texas Tribune, the Texas Attorney General’s (AG) Office and the Office of Inspector General (OIG) at the Health and Human Services Commission (HHSC) have teamed up to increase investigations of fraud in the state’s Medicaid dental program for children. The article, published on October 10, 2012, states the creation of the Medicaid and orthodontic task force was created in response to a significant increase in fraud by Medicaid providers.

To read the full article from The Texas Tribune, click here.

Everything is Bigger in Texas, Including Fraud.

A report released in April 2012, by the U.S. House Committee on Oversight and Government Reform, stated that in 2010 the Lone Star State spent as much […]

Director of Center for Developmentally Challenged Adults Accused of Medicaid Fraud

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

The director of a center for developmentally challenged adults in Okaloosa County, Florida, was arrested on August 16, 2012, for allegedly fraudulently billing Medicaid for more than $270,000 for services under the Medicaid Developmentally Disabled Waiver Program, according to the Attorney General’s (AG) office.

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

Director Allegedly Submitted False Claims for Non-Billable Services and Falsified Hours.

According to the press release, in 2009, the Medicaid Fraud Control Unit (MFCU) began investigating the center after it received a referral from the Agency for Persons with Disabilities (APD). The director allegedly submitted claims seeking $270,000 in reimbursements for non-billable services and falsified hours to the Medicaid program.

Director […]

By The Health Law Firm|2024-03-14T10:01:49-04:00May 15, 2018|Categories: Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law|Tags: defense attorney, legal defense, medicaid, medicaid audit, Medicaid defense attorney, Medicaid fraud, Medicaid Fraud Control Unit (MFCU), Medicaid fraud defense attorney, MFCU investigation, mfcu subpoena|Comments Off

Woman Admits to Defrauding Medicaid For Fake Mental and Behavior Health Services

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

A North Carolina woman pleaded guilty on September 14, 2012, for her involvement in a health care scheme that allegedly defrauded Medicaid from 2008 to 2011 for fake mental and behavior health services. Through this scheme, she allegedly obtained at least $6.1 million in fraudulent reimbursement payments, according to the Federal Bureau of Investigation (FBI).

Click here to see the press release from the FBI.

Medicaid Beneficiaries Were Primarily Children.

An article in the Gaston Gazette stated the former licensed professional counselor, who was enrolled with North Carolina Medicaid, allegedly claimed in the fraudulent billings that she was the attending clinician for provided services. The woman also allegedly supervised a network of co-conspirators who billed […]

By The Health Law Firm|2024-03-14T10:01:49-04:00May 15, 2018|Categories: Clinical Social Worker, Intern, Marital and Family Therapist, Medicaid audit, Mental Health Counselor, Mental Health Counselor Law, Psychology, Resident|Tags: defense attorney, Florida defense attorney, legal defense, medicaid, medicaid audit, Medicaid defense attorney, Medicaid fraud, Medicaid fraud defense attorney, Medicaid scheme, North Carolina defense attorney|1 Comment

Central Florida Mental Health Counselor Accused of Heading Up $3 Million Medicaid Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law, and Michael L. Smith, J.D., R.R.T., Board Certified by The Florida Bar in Health Law

A registered mental-health counselor is accused of running a $3 million Medicaid scheme through the mental health facility she owned, according to the Florida Office of the Attorney General (AG). On March 27, 2013, the facility owner was arrested. She faces charges of racketeering, Medicaid fraud and identity theft. According to the AG, local, state and federal law enforcement officers were all involved in the investigation.

Click here to read the press release from the AG.

Mental Health Counselor Reportedly Billed Medicaid for Services Never Rendered.

According to the Orlando Sentinel, between 2012 and 2013, the mental health counselor billed Medicaid more than $3 million for services provided to Medicaid recipients with […]

By The Health Law Firm|2024-03-14T10:01:50-04:00May 15, 2018|Categories: Medicaid audit, Mental Health Counselor, Mental Health Counselor Law|Tags: attorney general’s (AG) office, defense attorney, defense lawyer, Florida defense attorney, Florida Medicaid, legal defense, medicaid audit, Medicaid defense attorney, Medicaid fraud, Medicaid fraud defense lawyer, Medicaid numbers, Medicaid scheme, mental health professional, mental health service program|Comments Off

Health Professionals Who Are Employees Must Have Personal Professional Liability Insurance

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

We are often asked what we consider to be the biggest problem that a health professional experiences in defending himself or herself in a complaint against their license. In our opinion, it is not having the financial resources to retain the services of an experienced attorney to defend him or her. Because of this, we believe that any licensed mental health counselor, psychologist, social worker and family therapist who is an employee of any hospital, skilled nursing facility, home health agency, assisted living facility, medical group, or any other organization must have his or her own personal professional liability policy that provides ample insurance coverage for professional license defense expenses.

We see more license complaints that must be defended than we ever see civil […]

By The Health Law Firm|2024-03-14T10:01:50-04:00May 15, 2018|Categories: Clinical Social Worker, Marital and Family Therapist, Mental Health Counselor, Occupational Therapist, Psychology|Tags: and Family Therapists, assisted living facility, best insurance coverage for nurses, CHP & Associates, complaint against a family therapist, complaint against a mental health counselor, complaint against a psychologist, complaint against a social worker, complaint on a mental health counselor’s license, complaint on a psychologist’s license, complaint on a social worker’s license, complaints on a family therapist’s license, defense attorney, defense lawyer, Department of Health (DOH), Department of Health complaint, do health care professionals need insurance, employer insurance, family therapist defense, health attorney, health lawyer, Healthcare Professionals Service Organization (HPSO), home health agency, hospital, legal defense, legal expenses, license complaint, Lloyd’s of London, medical group, mental health counselor defense, mental health counselors, Nurses Service Organization (NSO), professional liability insurance, professional license defense, psychologist defense, psychologists, skilled nursing facility, social worker defense, Social Workers, the health law firm|Comments Off

Advice for Nurses Regarding Department of Health Investigations

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

We see and hear about a lot of incorrect legal advice being given to nurses regarding what they should do if they are being investigated.

The incorrect advice being given even includes mailings they may have received containing a brochure “What Every Nurse Needs to Know” published by the National Council of State Boards of Nursing. It gives advice in response to the question: “What should you do if you are the subject of a complaint?” It advises the nurse to contact the Board of Nursing (BON) immediately in such an event and states that the complaint will be handled in a “fair and appropriate matter.” It advises that a BON representative will describe the investigation process and answer any questions that you may have about an investigation if a complaint is filed against you.

This […]

By The Health Law Firm|2024-03-14T10:01:54-04:00May 15, 2018|Categories: Administrative Complaints, Administrative Hearing, Board of Nursing, CRNA, Defense, Department of Health, Discipline, Insurance, Malpractice|Tags: administrative charges, administrative complaint, attorney, certified registered nurse anesthetists (CRNA), Department of Health (DOH) Investigation, disciplinary action, Florida Board of Nursing, investigator, legal defense, malpractice insurance, nurse practitioners, nurses, nursing insurance, nursing license|Comments Off