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Psychiatric Practice to Pay $310,000 in FCA Settlement for Employing Doctor on OIG Exclusion List

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

On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG’s exclusion list, the “List of Excluded Individuals and Entities” (LEIE). As a result, the government took the position that claims for services the physician provided filed against government programs were illegal pursuant to the false Claims Act (FCA). Details were disclosed in a Press Release by the U.S. Attorney for the District of Connecticut.

Geriatric & Adult Psychiatry, LLC (GAP), along with the owner, entered into a civil settlement agreement to resolve their liability under the federal and state False Claims Acts, the U.S. […]

Psychiatric Practice Reaches Settlement in FCA Suit to End Allegations of Employing Physician on OIG Exclusion List

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

On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG’s exclusion list, the “List of Excluded Individuals and Entities” (LEIE). As a result, the government took the position that claims for services the physician provided filed against government programs were illegal pursuant to the false Claims Act (FCA). Details were disclosed in a Press Release by the U.S. Attorney for the District of Connecticut.

Geriatric & Adult Psychiatry, LLC (GAP), along with the owner, entered into a civil settlement agreement to resolve their liability under the federal and state False Claims Acts, the U.S. […]

By The Health Law Firm|2024-03-14T09:59:26-04:00July 7, 2023|Categories: Health Facilities Law Blog|Tags: allegations of healthcare fraud, attorney legal representation for OIG notice of intent to exclude, Centers for Medicare and Medicaid (CMS) defsne attorney, False Claims attorney, FCA attorney, FCA lawyer, health care fraud defense attorney, health care professional defense attorney, healthcare fraud representation, legal defense representation for healthcare investigations, legal representation for CMS investigations, legal representation for fraud investigations, legal representation for health care fraud defense, legal representation for health care professionals, legal representation for medical overbilling, legal representation for Medicare and Medicaid audits, List of Excluded Individuals and Entities (LEIE) legal counsel, medicaid fraud control unit, Medicare and Medicaid audit defense attorney, Medicare audit defense attorney, Medicare audit defense legal counsel, Medicare exclusion hearing defense attorney, Medicare reinstatement attorney, Medicare Reinstatement representation, Office of Inspector General (OIG) Medicare exclusion attorney, Office of Inspector General (OIG) Medicare exclusion defense counsel, Office of Inspector General (OIG) Medicare exclusion legal defense counsel, OIG exclusion defense attorney, OIG exclusion defense lawyer, OIG investigation legal defense representation, Recovery Audit Contractor (RAC) lawyer, removal from List of Excluded Individuals and Entities (LEIE) attorney, representation for CMS investigations, reviews for The Health Law Firm, The Health Law Firm attorney reviews, Zone Program Integrity Contractor (ZPIC) audit lawyer|Comments Off

Owner of Psychiatry Practice Pays Hefty Settlement in FCA Case for Employing Doc on OIG Exclusion List

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

On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG’s exclusion list, the “List of Excluded Individuals and Entities” (LEIE). As a result, the government took the position that claims for services the physician provided filed against government programs were illegal pursuant to the false Claims Act (FCA). Details were disclosed in a Press Release by the U.S. Attorney for the District of Connecticut.

Geriatric & Adult Psychiatry, LLC (GAP), along with the owner, entered into a civil settlement agreement to resolve their liability under the federal and state False Claims Acts, the U.S. […]

By The Health Law Firm|2024-03-14T09:59:27-04:00June 16, 2023|Categories: Dental Law Blog|Tags: allegations of healthcare fraud, attorney legal representation for OIG notice of intent to exclude, Centers for Medicare and Medicaid (CMS) defsne attorney, False Claims attorney, FCA attorney, FCA lawyer, health care fraud defense attorney, health care professional defense attorney, healthcare fraud representation, legal defense representation for healthcare investigations, legal representation for CMS investigations, legal representation for fraud investigations, legal representation for health care fraud defense, legal representation for health care professionals, legal representation for medical overbilling, legal representation for Medicare and Medicaid audits, List of Excluded Individuals and Entities (LEIE) legal counsel, medicaid fraud control unit, Medicare and Medicaid audit defense attorney, Medicare audit defense attorney, Medicare audit defense legal counsel, Medicare exclusion hearing defense attorney, Medicare reinstatement attorney, Medicare Reinstatement representation, Office of Inspector General (OIG) Medicare exclusion attorney, Office of Inspector General (OIG) Medicare exclusion defense counsel, Office of Inspector General (OIG) Medicare exclusion legal defense counsel, OIG exclusion defense attorney, OIG exclusion defense lawyer, OIG investigation legal defense representation, Recovery Audit Contractor (RAC) lawyer, removal from List of Excluded Individuals and Entities (LEIE) attorney, representation for CMS investigations, reviews for The Health Law Firm, The Health Law Firm attorney reviews, Zone Program Integrity Contractor (ZPIC) audit lawyer|Comments Off

Psychiatric Practice Pays $310,000 in FCA Settlement for Employing Physician on OIG Exclusion List

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

On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on the OIG’s exclusion list, the “List of Excluded Individuals and Entities” (LEIE). As a result, the government took the position that claims for services the physician provided filed against government programs were illegal pursuant to the false Claims Act (FCA). Details were disclosed in a Press Release by the U.S. Attorney for the District of Connecticut.

Geriatric & Adult Psychiatry, LLC (GAP), along with the owner, entered into a civil settlement agreement to resolve their liability under the federal and state False Claims Acts, the U.S. […]

Court Assesses $170 Million in Fines Against Two Texas Ophthalmologists For False Claims

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

On November 18, 2021, the Justice Department announced that two Texas ophthalmologists and their eye clinic must pay millions of dollars in penalties for fraudulently billing Medicare. The penalties were assessed in connection with their evaluation and treatment of glaucoma.

U.S. District Judge Lynn Hughes assessed $170 million in penalties against the ophthalmologists and their eye clinic in Houston, Outreach Diagnostic Clinic.

A Former Employee Blew the Whistle.

According to the U.S. Department of Justice (DOJ), the action resulted from a False Claims Act (FCA) or “qui tam” suit. The whistleblower was a former employee of the clinic. The suit alleged that between February 2006 and December 2011, the two ophthalmologists fraudulently billed the Medicare Program for single eye pressure measurement tests […]

Manager of Dental Office Sentenced to Prison for Defrauding Medicaid Out of More Than $813,000

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

On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based dental practice, according to the U.S. Attorney’s Office for Washington, D.C.

She was indicted in January 2019, along with the dentist who ran the practice. The dentist pleaded guilty in May 2021 in the U.S. District Court for the District of Columbia and reportedly admitted that she received over $813,000 through false billings.

The Fraudulent Billing Scheme.

Both the office manager and the dentist were alleged to have participated in a scheme to defraud the D.C. Medicaid Program through their operation of the dental practice. The dentist was a Medicaid provider. As […]

By The Health Law Firm|2024-03-14T09:59:33-04:00February 25, 2023|Categories: Health Facilities Law Blog|Tags: allegations of healthcare fraud, allegations of overbilling Medicaid, attorney for dentists, Centers for Medicare and Medicaid (CMS), civil monetary penalty defense counsel, Civil Monetary Penalty defense lawyer, civil monetary penalty litigation defense attorney, defense attorney for dental practice, dental practice legal defense representation, dentist legal defense counsel, dentist legal representation, False Claims attorney, FCA attorney, FCA defense lawyer, FCA lawyer, health care fraud defense attorney, health care professional defense attorney, healthcare fraud defense lawyer, healthcare fraud representation, legal counsel for dentists, legal representation for CMS investigations, legal representation for fraud investigations, legal representation for health care fraud, legal representation for health care professionals, legal representation for medical overbilling, legal representation for Medicare and Medicaid audits, Medicaid administrative law judge hearing defense attorney, Medicaid administrative law judge hearing legal representation, Medicaid and Medicare audit defense attorney, Medicaid audit defense attorney, Medicaid audit defense legal counsel, Medicaid exclusion hearing defense attorney, medical overbilling, Medicare Medicaid defense lawyer, Medicare Medicaid fraud defense attorney, Medicare Medicaid fraud defense counsel, Medicare Medicaid fraud defense legal representation, Office of Inspector General (OIG) Medicaid exclusion attorney, Office of Inspector General (OIG) Medicaid exclusion defense counsel, Office of Inspector General (OIG) Medicaid exclusion legal defense counsel, OIG exclusion defense attorney, OIG exclusion defense lawyer, OIG investigation legal defense representation, representation for healthcare investigations, representation for overbilling Medicare, representation for submitting false claims, reviews for The Health Law Firm, The Health Law Firm attorney reviews|Comments Off

Study Blames Coding Structures For Increased Medical Billing Costs in the United States

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

A study publicized in August 2022 revealed that the complex coding structures used in the United States drive up medical billing costs. This helps to make the U.S. one of the most expensive countries for health providers to get paid. According to the study, researchers used a micro-level accounting of billing and insurance-related (often abbreviated “BIR”) expenses in different national settings at six provider locations in five nations: Australia, Canada, Germany, the Netherlands, and Singapore. This most recent study supplements a prior study measuring such costs in the U.S.

The findings, published in Health Affairs Journal, revealed “BIR (billing and insurance-related) costs in the U.S. are generally much higher than the costs in other countries.” This means that all the extra costs […]

Have You Been Recommended to an Impaired Practitioner Program? What You Need to Know if You’ve Been Accused

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

In an industry that revolves around helping others, physicians and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes lead to unsafe, unprofessional behavior and impairment allegations.

We routinely work with mental health providers, nurses, and other health professionals who are accused by employers, hospitals, competitors, or terminated employees of impairment due to drug or alcohol abuse, or mental impairment, of being a “disruptive physician” or of sexual boundary issues. However, not all nurses and health professionals who are referred to a health program are in actual need of […]

Military Non-judicial Punishments or Article 15 Proceedings Are Not Criminal Convictions–Military Physicians, Dentists and Nurses Should Know This

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

Our firm represents many military and former military health professionals. We are often asked how a non-judicial punishment or Article 15 proceeding will be treated for license applications, clinical privileges applications, and background screenings.

Article 15 Non-judicial Punishment Is Not the Same as a Court-martial or a Criminal Proceeding.

Under Article 15 of the Uniform Code of Military Justice (UCMJ), which is also codified in 10 U.S.C. § 815, a commanding officer may issue an administrative punishment to enlisted or officer personnel under her command. These are not considered criminal convictions for any purpose, hence their other name, “non-judicial punishment.” These are usually for minor offenses and may be considered similar to civilian non-criminal traffic offenses.

An Article 15 non-judicial proceeding is less judicial […]

By The Health Law Firm|2024-03-14T09:59:39-04:00May 25, 2021|Categories: Mental Health Law Blog|Tags: Army Navy Air Force dentist defense lawyer, Army Navy Air Force nurse lawyer, Army Navy Air Force physician attorney, Army Navy Air Force psychologist attorney, Defense Health Agency Procedures Manual 6025.13 hearing defense attorney, Department of Defense clinical privileges defense attorney, DHA peer review defense lawyer, DHA PM 6025.13 investigation defense lawyer, DHA PM 6025.13 legal representation, DOD peer review defense attorney, DOD quality assurance investigation defense lawyer, legal representation for challenging NPDB reports, Legal representation for Department of Health (DOH) investigations, legal representation for health care professionals, legal representation for VA doctors, military dentists defense attorney, military physician defense lawyer, military physician legal representation, military quality assurance investigation defense attorney, NPDB appeal attorney, NPDB report defense lawyer, Public Health Service physician defense lawyer, representation of former military health professionals, representation of military healthcare professionals, reviews of The Health Law Firm, The Health Law Firm attorney reviews, VA doctor defense lawyer, VA nurse defense lawyer, VA nurse lawyer, Veterans Administration (VA) physician defense attorney|Comments Off

Impaired Practitioner Programs: What You Need to Know if You’ve Been Accused

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

In an industry that revolves around helping others physicians and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes lead to unsafe, unprofessional behavior and impairment allegations.

We routinely work with pharmacists and other health professionals who are accused by employers, hospitals, competitors, or terminated employees of impairment due to drug or alcohol abuse, or mental impairment, of being a “disruptive physician” or of sexual boundary issues. However, not all health professionals who are referred to a health program are in actual need of rehabilitation services.

What is the […]