Medicaid fraud defense attorney | The Health Law Firm Blog

Mother and Daughter-In-Law Arrested for Allegedly Defrauding Medicaid Out of More Than $70,000

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

A mother and daughter-in-law duo each face up to 30 years in prison for allegedly defrauding the Florida Medicaid program out of more than $70,000. According to a press release from the Florida Attorney General (AG), released February 20, 2014, the pair was arrested for allegedly running a scheme that involved billing the Medicaid program for services never rendered.

Click here to read the press release from the AG.

Mother and Daughter-In-Law Claimed to Provide Services to Developmentally Disabled Child.

According to the AG, the mother and daughter-in-law allegedly ran a scheme that involved billing the Medicaid program for services that were not actually provided to the mother’s developmentally disabled son. It’s alleged the mother submitted timesheets for work that was not provided. The […]

By The Health Law Firm|2024-03-14T10:01:51-04:00May 15, 2018|Categories: Medicaid audit|Tags: Attorney General (AG), defense attorney, defense lawyer, false claims, falsified records, florida attorney, Florida Attorney General, Florida lawyer, Florida Medicaid, Florida Medicaid Program, fraudulent claims, health law firm, medicaid, medicaid audit, Medicaid claims, Medicaid fraud, medicaid fraud control unit, Medicaid fraud defense attorney, Medicaid fraud defense lawyer, Medicaid investigation, mfcu, services never rendered, the health law firm|Comments Off

Florida Government Officer Charged in Billion Dollar Medicare Fraud

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

Health Care Administrator Accepts Bribes.
An alleged $1 billion health care scheme has lead to the first known prosecution against a Florida Agency for Health Care Administration official. Bertha Blanco faces a wide range of charges including accepting bribes to tip off individuals when state wide investigations were to begin.

The Ring Alleged Ring Leader.

It is reported that Blanco oversaw inspections by the Florida Agency for Health Care Administration or “AHCA” of Florida nursing homes owned by Phillip Esformes. Blanco was allegedly taking bribes to tip off Esformes of violations reported to the state agency before the investigation (or “survey”) even began. This allegedly allowed Esformes to attempt to fix or remedy the deficiencies that were reported even before the investigation began and to maintain his. Esformes […]

President of Miami-Based Medical Transportation Company Convicted For His Role in $70M Health Care Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On Friday, a Florida federal jury convicted the president of a Miami-based transportation company of helping coordinate the payment of illegal kickbacks in a $70 million health care fraud scheme. The scheme involved three Miami mental health facilities.

Conspiracy to Pay Health Care Kickbacks.

According to the U.S. Department of Justice (DOJ), Damian Mayol, president of Transportation Services Providers Inc., was convicted of one count of conspiracy to pay health care kickbacks. Mayol used the company to coordinate the illegal kickbacks to recruiters, who then referred patients to three clinics: R&S Community Mental Health Inc., St. Theresa Community Mental Health Center Inc. and New Day Community Mental Health Center LLC.

According to prosecutors, the three mental health clinics billed Medicare for partial hospitalization program services that were not medically […]

By The Health Law Firm|2024-03-14T10:01:51-04:00May 15, 2018|Categories: Mental Health Law Blog|Tags: florida, florida health attorney, health care professional defense lawyer, Medicaid audit defense, Medicaid fraud defense attorney, Medicaid fraudulent billing, mental health care provider fraud audit|Comments Off

What You Need to Know About Preparing and Responding to an Initial Medicaid Audit Request

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

Health care providers in Florida who service Medicaid patients are at a higher risk for audits than anywhere else in the country. The unfortunate truth is that Florida has become synonymous with health care fraud. As a result, auditing and subsequent overpayment demands are very real possibilities.

The Health Law Firm and its legal professionals represent health care providers in virtually every aspect of Medicaid program audits, investigations and litigation. These include physicians, medical groups, mental health professionals, pharmacies, nursing homes, home health agencies, hospitals and other health facilities.

Facts You Should Know About the Medicaid Audit Process.

Should you find yourself, your facility or your health practice the subject of a Medicaid audit by your state Medicaid agency […]

By The Health Law Firm|2024-03-14T10:01:52-04:00May 15, 2018|Categories: Mental Health Law Blog|Tags: audit defense attorney, health care fraud defense attorney, legal counsel for Medicaid audits, legal counsel for responding to Medicaid audits, legal representation for allegations of overbilling, legal representation for false billing, legal representation for Medicaid audit, legal representation for Medicaid fraud allegations, legal representation for Medicaid investigation, legal representation for Medicaid overpayment, Medicaid audit defense attorney, Medicaid fraud attorney, Medicaid fraud defense attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, ZPIC audit defense attorney|Comments Off

Responding to a Medicaid Audit: Important Tips You Should Know

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), Bureau of Medicaid Program Integrity, is the Florida agency responsible for routine audits of Medicaid health care providers. Each state has a similar state agency, though it may have a different name. The agency’s job is to ensure that the Medicaid Program was properly billed for services. Health care professionals receiving large payments from Medicaid or who practice in areas that typically see the most abuse or fraudulent billings, are the ones most likely to be audited. These include pediatricians, Ob/Gyns, family practice physicians and pediatric dentists.

A different state agency that may also conduct Medicaid audits is the state Medicaid Fraud Control Unit (MFCU). However, by definition, the MFCU is investigating allegations […]

By The Health Law Firm|2024-03-14T10:01:30-04:00May 15, 2018|Categories: Pharmacy Law Blog|Tags: health care fraud attorney, health care fraud defense attorney, health care fraud investigation defense attorney, legal representation for fraudulent billing, legal representation for health care fraud, legal representation for health care fraud investigation, legal representation for Medicaid audits, legal representation for Medicaid fraud, legal representation for overbilling, legal representation for submitting false claims to the government, Medicaid audit defense attorney, Medicaid fraud defense attorney, reviews of The Health Law Firm, reviews of The Health Law Firm attorneys, the health law firm|Comments Off

Responding to a Medicaid Audit: Important Tips You Should Know

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), Bureau of Medicaid Program Integrity, is the Florida agency responsible for routine audits of Medicaid health care providers. Each state has a similar state agency, though it may have a different name. The agency’s job is to ensure that the Medicaid Program was properly billed for services. Health care professionals receiving large payments from Medicaid or who practice in areas that typically see the most abuse or fraudulent billings, are the ones most likely to be audited. These include pediatricians, Ob/Gyns, family practice physicians and pediatric dentists.

A different state agency that may also conduct Medicaid audits is the state Medicaid Fraud Control Unit (MFCU). However, by definition, the MFCU is investigating allegations that there […]

By The Health Law Firm|2024-03-14T10:01:53-04:00May 15, 2018|Categories: Mental Health Law Blog|Tags: health care fraud attorney, health care fraud defense attorney, health care fraud investigation defense attorney, legal representation for fraudulent billing, legal representation for health care fraud, legal representation for health care fraud investigation, legal representation for Medicaid audits, legal representation for Medicaid fraud, legal representation for overbilling, legal representation for submitting false claims to the government, Medicaid audit defense attorney, Medicaid fraud defense attorney, reviews of The Health Law Firm, reviews of The Health Law Firm attorneys, the health law firm|Comments Off

Michigan Dentist Accused of Million Dollar Medicaid Fraud Scheme Captured in Caribbean

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

A Michigan dentist accused of Medicaid fraud was recently captured in the Dominican Republic after evading charges for months, state authorities announced. Dr. David Johnson operated the alleged scheme through Livernois Dental in Detroit, which he owned at the time but has since sold.

27 Charges.

Dr. Johnson was charged by Michigan Attorney General Bill Schuette in May 2017, after allegedly using another dentist’s information to improperly bill Medicaid $1.7 million over a three year period of time. The charges include one count of racketeering, punishable by up to 20 years in prison; 20 counts of false Medicaid claims, punishable by up to 10 years in prison; and six counts of false health care claims, punishable by up to four years in prison.

According to the Attorney General’s […]

Florida Woman Arrested for Allegedly Stealing from Disabled Adults

By Dr. Thu Pham, O.D., Law Clerk, The Health Law Firm Attorney and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A former employee of an organization that provides services to developmentally disabled adults in Alachua County, Florida, was arrested on June 15, 2012, according to the Attorney General’s (AG) Office. The woman was arrested for allegedly stealing money from 11 clients in 2010 and 2011.

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

Medicaid Fraud Control Unit’s (MFCU) Investigation Led to Arrest.

The woman was a group home manager at the organization that provides support to developmentally disabled adults. She was allegedly responsible for her clients’ money. In a Gainesville Sun article […]

By The Health Law Firm|2024-03-14T10:01:56-04:00May 15, 2018|Categories: Discipline, Patient Care|Tags: defense attorney, legal defense, Medicaid defense attorney, Medicaid Fraud Control Unit (MFCU), Medicaid fraud defense attorney, MFCU investigation, mfcu subpoena, patient abuse, patient exploitation, patient neglect|Comments Off

Florida Federal Judge Triples Award to $347 Million in Rare Whistleblower Case

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

On March 1, 2017, a Florida federal judge tripled a $115 million damages award for the government to $347 million after a jury found that the operators of 53 nursing facilities submitted false claims to Medicare and Medicaid. U.S. District Judge, Steven D. Merryday, upheld the jury’s $115 award affirming that the operators of the 53 nursing facilities had violated the False Claims Act (FCA). The case is U.S. ex rel. Ruckh v. CMC II LLC et al., case number 8:11-cv-01303, in the U.S. District Court for the Middle District of Florida.

The whistleblower in the case, Angela Ruckh, a former nurse at two of the facilities, brought the allegations against four defendants that they had submitted false claims and fraudulent records to the government. […]

Owner of Louisiana-Based Health Care Company Ordered To Pay Nearly $7 Million for Medicaid Fraud

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

On December 20, 2016, the owner of Louisiana-based Millennium Health Care Services (Millennium) was ordered to pay the state nearly $7 million in restitution and will spend 10 years behind bars for his role in a scheme to defraud the Medicaid system, according to Louisiana Attorney General Jeff Landry.

Millennium’s owner, Dwaine Woods, was ordered to pay $6,985,249 in restitution after his wife and the company were all found guilty of engaging in a criminal conspiracy to create multiple fake CPR cards for Millennium staff. The staff did not undergo training to be properly certified in CPR, Landry said.

The Dangerous Scheme.

Millennium operated from 2004 to 2010 and was solely funded by the government program Medicaid. According to Landry, the fake CPR card scheme was not […]

By The Health Law Firm|2024-03-14T10:02:00-04:00May 15, 2018|Categories: Nursing Law Blog|Tags: Colorado Medicaid Fraud defense attorney, District of Columbia (D.C.) Medicaid Fraud defense attorney, Florida Medicaid Fraud defense attorney, health care fraud defense attorney, health care fraud investigation defense lawyer, Kentucky Medicaid Fraud defense attorney, legal counsel for Medicaid audits, legal counsel for whistleblower, legal represenation for qui tam cases, legal representation for conspiracy for defraud the government, legal representation for conspiracy to commit Medicaid fraud, legal representation for Medicaid audits, legal representation for Medicaid fraud, legal representation for qui tam/whistblower investigations, legal representation for whistleblower suits, Louisiana Medicaid Fraud defense attorney, Medicaid fraud defense attorney, Medicaid investigation defense attorney, qui tam defense attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Virginia Medicaid Fraud defense attorney, whistleblower defense attorney|Comments Off