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Many Adverse NPDB Actions Are Reported That Should Not Be; Here Are Examples

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

We are constantly being contacted by physicians, nurse practitioners and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports. Often, we find that an adverse report has been made when the matter should not have been. Federal regulations and NPDB guidelines establish the types of incidents that are authorized to be reported to the NPDB. When an employer or other organization makes an improper report, it should be challenged and removed.

Types of Matters That Are Not Authorized for […]

By The Health Law Firm|2024-03-14T09:59:09-04:00April 1, 2024|Dental Law Blog, Health Facilities Law Blog, Nursing Law Blog|

Many Adverse NPDB Actions Are Reported That Should Not Be; Here Are Examples

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

We are constantly being contacted by physicians, nurse practitioners, and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports. Often, we find that an adverse report has been made when the matter should not have been. Federal regulations and NPDB guidelines establish the types of incidents authorized to be reported to the NPDB. When an employer or other organization makes an improper report, it should be challenged and removed.

Types of Matters That Are Not Authorized for NPDB Reports.

Following are some of the incidents for […]

By The Health Law Firm|2024-03-14T09:59:09-04:00March 12, 2024|Dental Law|

Many Adverse NPDB Actions Are Reported That Should Not Be; Here Are Examples

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

We are constantly being contacted by physicians, nurse practitioners and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports. Often, we find that an adverse report has been made when the matter should not have been. Federal regulations and NPDB guidelines establish the types of incidents that are authorized to be reported to the NPDB. When an employer or other organization makes an improper report, it should be challenged and removed.

Types of Matters That Are Not Authorized for NPDB Reports.

Following are some of the incidents for which we have seen adverse […]

By The Health Law Firm|2024-03-14T09:59:10-04:00March 4, 2024|Massage Law Blog, Nursing Law Blog, The Health Law Firm Blog|

Are You the Target of a Medicaid Audit? Tips Health Professionals Should Be Following

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

The Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), and Bureau of Medicaid Program Integrity is the Florida agency responsible for routine Medicaid audits The agency ensures that the Medicaid program was billed correctly for services by health care professionals. Those receiving the greatest amounts of Medicaid payments are also the ones most likely to be audited.

These include pediatricians, Ob/Gyns, family practice physicians, and dentists. The Medicaid audit usually requests information in a questionnaire form. It also includes a request for […]

By The Health Law Firm|2024-03-14T09:59:17-04:00November 18, 2023|Health Facilities Law Blog|

Additional Negative Consequences for Discipline on Your Professional License, Part 1 of 2

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

Do you have a medical, pharmacist, counselor, or nursing license in more than one state? Do you have a license in more than one profession? Have you been notified that an investigation has been opened against your professional license? Are you thinking about resigning your professional license or voluntarily relinquishing (giving up) your license? Then you should be aware of some important facts you may not have known.

First, you should never voluntarily relinquish or resign your professional license after you know that an investigation has been opened or that disciplinary action has been […]

By The Health Law Firm|2024-03-14T09:59:18-04:00October 5, 2023|Dental Law Blog|

Fight Back in National Practitioner Data Bank Disputes and Appeal Adverse Reports

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

The National Practitioner Data Bank (NPDB), created in 1986, was part of the Health Care Quality Improvement Act (HCQIA). Its purpose is to improve the quality of health care by encouraging state licensing boards, hospitals, health care entities, and professional societies to report into a national data bank those physicians and health professionals who demonstrate substandard skills or engage in unprofessional behavior. In part, it is used to make sure that incompetent physicians do not move from one state to another in order to avoid the consequences.

Adverse Reports Stay in the NPDB for Life.

How long does […]

By The Health Law Firm|2024-03-14T09:59:27-04:00June 25, 2023|Nursing Law Blog|

NPDB Disputes and Appeals: Fight Back Against Adverse Reports

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

The National Practitioner Data Bank (NPDB), created in 1986, was part of the Health Care Quality Improvement Act (HCQIA). Its purpose is to improve the quality of health care by encouraging state licensing boards, hospitals, health care entities, and professional societies to report into a national data bank those physicians and health professionals who demonstrate substandard skills or engage in unprofessional behavior. In part, it is used to make sure that incompetent physicians do not move from one state to another in order to avoid the consequences.

Adverse Reports Stay in the NPDB for […]

By The Health Law Firm|2024-03-14T09:59:29-04:00June 9, 2023|Health Facilities Law Blog|

OIG Exclusion: Do You Know if You’re on the List?

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

Have you ever faced a disciplinary action against your professional license? Have you ever been arrested or convicted of a criminal offense? If yes, then you may have also been terminated from the federal Medicare Program or your state Medicaid Program.

Many health care professionals don’t think about the repercussions that an exclusion action by the Office of the Inspector General (OIG) can have on their professional career. Whether you are a physician, nurse, dentist, psychologist or other health professional, if you allow yourself to be excluded from the Medicare Program, devastating economic […]

By The Health Law Firm|2024-03-14T10:00:19-04:00December 27, 2018|The Health Law Firm Blog|

OIG Exclusion: What You Need to Know if You’re on the List

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

Have you ever had disciplinary action against your license as a health care professional? Have you ever been arrested or convicted of a criminal offense? Have you ever been convicted of fraud or patient neglect? If so, then you may have also been terminated or excluded from the federal Medicare Program or your state Medicaid Program.

Many health professionals don’t understand the significant repercussions that an exclusion action by the Office of the Inspector General (OIG) can have on their career and employment. Whether you are a physician, nurse, dentist, psychologist or other health professional, if you […]

By The Health Law Firm|2024-03-14T10:00:21-04:00October 10, 2018|In the Know, The Health Law Firm Blog|

New Update to the Medicare Program Integrity Manual Issued by CMS

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

On June 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued further guidance for reporting and reviewing final adverse legal actions (ALAs) in provider enrollment applications. Section 15.5.3 of the Medicare Program Integrity Manual (MPIM) was updated through Transmittal 797 to provide more guidance on the types of final adverse actions that must be disclosed. It also provides additional instruction to Medicare Administrative Contractors (MACs) on how to process disclosed final adverse actions.

New Language Basics.

The update in Section 15.5.3 of the MPIM clarifies the scope of disclosure, the time frames for disclosure and the […]

By The Health Law Firm|2024-03-14T10:00:23-04:00September 7, 2018|Health Facilities Law Blog|