11th Circuit Court of Appeals Rejects Florida Eye Doctor’s Request for New Medicare Fraud Trial

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

On July 31, 2020, a panel of U.S. Eleventh Circuit Court of Appeal judges upheld a 17-year prison sentence for a Florida ophthalmologist found guilty of Medicare fraud. The three-judge panel rejected an appeal in which Salomon Melgen claimed prosecutors mishandled his 2017 criminal trial.

It upheld the conviction on all 67 counts, deemed the 17-year-sentence to be even-handed, and denied him a new trial.

Details of the Case and Why the Former Ophthalmologist Requested a New Trial.

To understand how the panel reached their decision, it helps to understand the details of the scheme and the accusations. Back in April 2017, a jury in the Southern District of Florida convicted Melgen of carrying out systemic billing fraud at his South Florida medical offices. He stood accused of routinely administering unnecessary, invasive treatments and profiteering off the macular-degeneration drug Lucentis.

Additionally, he was charged with running millions of dollars’ worth of unnecessary diagnostic tests, often using outdated technology that allowed him to bill at higher rates.

According to the opinion, Melgen presented a list of perceived reasons for reversal, including the sufficiency of the evidence and reasonableness of his sentence. He argued that charts comparing his billing rates to his peers were not covered by Federal Rule of Evidence 1006 and, therefore, amounted to inadmissible hearsay in violation of the Confrontation Clause of the U.S. Constitution. To learn more, click here to view his appeal.

Unfortunately for the doctor, the alleged errors in the trial did not persuade the judges.

Other Alleged Errors and How the 11th Circuit Judges Came to Their Decision.

One issue was whether any of the witnesses’ communications with others had tainted their testimony at the trial. In the opinion, the appellate panel stated that Melgen failed to show that the witness interactions affected testimony. The trial court did not abuse its discretion by continuing the trial after the witness intimidation came to light. Lastly, the sentence length the district court imposed was “more than reasonable,” the panel stated.

U.S. Circuit Judge Britt C. Grant, said on behalf of the panel, “The scope of the scheme was easily enough for the jury to conclude that Melgen had engaged in systematic fraud, rather than committing isolated mistakes. We find the evidence sufficient to uphold the jury’s verdict.” You can read the opinion in full here.

Contact Health Law Attorneys Experienced with Investigations of Optometrists and Ophthalmologists.

The attorneys of The Health Law Firm provide legal representation to optometrists, ophthalmologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Kapnick, Izzie. “11th Circuit Upholds Doctor’s Massive Fraud Conviction.” Courthouse News. (July 31, 2020). Web.

Jarvis, Sarah. “11th Circ. Won’t Grant Menendez-Linked Doc New Fraud Trial.” Law360. (July 31, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

 

 

 

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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 evidence needed to support a disclosure.

Per the 2018 update, the list of reportable adverse actions includes: felony and misdemeanor convictions within the last 10 years; current or past suspensions/revocations of a medical license or an accreditation; current or past suspensions or exclusions imposed by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG); current or past debarments for participation in any Federal Executive Branch procurement or non-procurement program; Medicaid exclusions, revocations, or terminations; and current or past federal sanctions of any type.

New Guidance for MACs.

The second part of the update to the Manual provides additional guidance concerning how MACs will review applications and process the disclosure of final adverse actions. The update also covers how MACs should handle both reported and unreported adverse actions. MACs are now required to use either the Provider Enrollment, Chain and Ownership System (PECOS) or the System for Award Management (SAM) to research whether individuals with ownership interest of the applicant entity are excluded.

To view all the language in Transmittal 797, which outlines the updated Section 15.5.3, click here.

For more information, visit CMS’ website.

Click here to view another recent update issued by CMS.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, skilled nursing facilities (SNF’s) durable medical equipment (DME) suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative
hearings at both the state and the federal level. We represent health providers in Medicare and Medicaid audits and disputes on a routine basis.

To contact The Health Law Firm, please call (407) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

King & Spalding. “CMS Updates Rules for Reporting Adverse Legal Action.” JD Supra. (August 25, 2018). Web.

Dhillion, Megan. “Update to the Medicare Program Integrity Manual: New Requirements Related to Disclosing and Processing Final Adverse Actions.” AHLA. (August 24, 2018). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Centers for Medicare & Medicaid Services (CMS) representation, CMS defense attorney, representation for medicare issues, representation for Medicaid issues, Medicare defense lawyer, Medicaid defense lawyer, Medicare audit defense attorney, Medicaid audit defense attorney, CMS investigation representation, CMS defense representation, health care fraud representation, healthcare professional representation, representation for physicians, representation for physician reimbursement, professional license defense attorney, medical license defense attorney, professional license representation, licensure defense representation, representation for health care professionals, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Florida health law defense lawyer, AHCA audit defense lawyer, ZPIC audit defense attorney, RAC audit defense lawyer, Trust Solutions audit defense attorney, First Coast Service Options audit defense attorney, SafeGuard Services audit defense lawyer, Cahaba Safeguard Administrators audit defense lawyer, Noridian NCI audit defense attorney, Health Integrity audit defense lawyer

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2018 The Health Law Firm. All rights reserved.

 

Georgia Doctors and Nurses Losing Licenses to Practice Due to Immigration Law

10 Indest-2008-7By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Hundreds of Georgia health providers are without a professional license to practice, because a new immigration law is causing massive backups in paperwork, according to a number of sources. The Illegal Immigration Reform and Enforcement Act of 2011 or House Bill 87 went into effect on January 1, 2012, and requires every person to prove his or her citizenship or legal residency when the individual renews his or her license.

To read House Bill 87 in its entirety, click here.

With all of the extra paperwork required and too few staff members at the reviewing state agencies, many licenses are expiring before they can be renewed. Shortages of staff are being reported at the Georgia Secretary of State’s office and Georgia’s Medical Board. Licenses being affected include licenses for doctors, nurses, pharmacists and other health providers are falling through the cracks and expiring. According to a Kaiser Health News story released November 12, 2012, there’s not much that can be done to speed up the process.

Requirements are Confusing to Professionals.

Georgia House Bill 87 was aimed at blocking illegal immigrants from getting benefits but instead has created lots of confusion, according to an article in the Atlanta Journal-Constitution. For example, when people are confused about the requirements and fail to not submit copies of acceptable identification, then their professional licenses expire and they are not legally allowed to practice.

It is reported that some individuals, instead of forwarding copies of photo identification, are sending photos of animals or pornography into the state’s online system. Officials believe this is either a form of protest or a joke, either way it slows down the review process.

To read the article from the Atlanta Journal-Constitution, click here.

Providers Be Aware of Medicare Conditions of Participation.

Providers need to be forewarned that if their licenses are expired Medicare conditions of participation (COPs) prohibit billing for services provided. If a service was provided while the license was expired, be prepared to refund the overpayments.

Lengthy Processing Time Has Caused More Than 1,000 Health Professionals to Lose Their Ability to Practice.

Last year, the secretary of state’s office received more than 49,000 new applications for licenses and since 2008 the state licensing division has lost almost 40 staff members.

According to the Atlanta Journal-Constitution, the average time it takes for the state to process new license applications has jumped from 60 days to 70 days. The same goes for renewal applications. It used to take two days to renew a license, but now it takes 10 days.

According to Kaiser Health News, it’s estimated that 1,300 doctors, nurses and other health professionals have lost their ability to work either because they did not send in the correct paperwork, or they are stuck in the backlog of work.

The same article stated so far the new document requirements have yet to find any illegal immigrants.

Click here to read the entire article from Kaiser Health News.

Health Professionals Encouraged to Renew Licenses A.S.A.P.

The Georgia Nursing Association and the Georgia Pharmacy Association are monitoring this situation closely. The pharmacy association has been informing members about the new identification requirements and urging them to not put off applying for their licences.

Click here to see a warning about the process from the Georgia Pharmacy Association.

Contact Health Law Attorneys With Experience Handling Licensing Issues.

If you have had a license suspended or revoked, or are facing imminent action against your license, it is imperative that you contact an experienced healthcare attorney to assist you in defending your career.  Remember, your license is your livelihood, it is not recommended that you attempt to pursue these matters without the assistance of an attorney.

The Health Law Firm routinely represents physicians, dentists, nurses, pharmacists, medical groups, clinics, and other healthcare providers in personal and facility licensing issues all over the country.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

As a health professional what   do you think about this new law in Georgia? Do you think it is ridiculous or a necessary process? Please leave any thoughtful comments below.

Sources:

Burress, Jim. “Doctors’ And Nurses’ Licenses Snagged By New Immigration Law In Georgia.” Kaiser Health News, WABE, Atlanta and NPR. (November 12, 2012). From: http://www.kaiserhealthnews.org/Stories/2012/November/12/Georgia-immigration.aspx

Redmon, Jeremy. “New ID Law Gums Up Licensing Process.” The Atlanta Journal-Constitution. (October 15, 2012). From: ttp://www.ajc.com/news/news/new-id-law-gums-up-licensing-process/nSc6g/

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Shortage of Florida Physicians Approved to Recommend “Green Leaf Relief” for Patients

George F. Indest III, Board Certified by The Florida Bar in Health Law

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

Florida may be “going green” in a big way come November 2016; and I’m not talking about recycling.  The Florida Right to Medical Marijuana Initiative, or Ballot Initiative Amendment 2, has undergone revisions, and will likely be making its second run with voters since its marginal loss in 2014.  Promoters of the Constitutional Amendment predict success; hopefully this isn’t just a pipe dream.

However, the Florida Compassionate Medical Cannabis Act of 2014, currently allows low-THC cannabis to be utilized only by qualifying patients for certain medical ailments.  A licensed physician, as outlined in Chapter 458 or 459 of Florida Statutes, is required to qualify patients for the use of medical marijuana.

For FAQ’s on low-THC cannabis issued by the Florida Department of Health (DOH), click here.

Physician Requirements for Qualifying Patients and Ordering.

For a patient to qualify to obtain and use THC, a previously approved physician must examine and currently be treating a patient for a debilitating illness.  Such illnesses include cancer or any physical medical condition or ailment that produces chronic seizures or severe and persistent muscle spasms (such as epilepsy or multiple sclerosis).  Furthermore, the physician must have tried all other options of treatment without satisfactory results.  Medical marijuana must be a last resort alternative.  Section 381.986(2), Florida Statutes (2015).

One of the physician ordering requirements is that the doctor must “register as the orderer of low-THC cannabis for the named patient on the compassionate use registry maintained by the department [of health] and update the registry to reflect the contents of the order.”  Section 381.986(2)(c), Florida Statutes (2015).

In order to become registered in Florida, licensed physicians must successfully complete an 8-hour course, offered by either the Florida Medical Association (FMA) or the Florida Osteopathic Medical Association (FOMA).  It is necessary for the physician to satisfactorily pass an examination upon completion of the course.  Section 381.986(4), Florida Statutes (2015).

Currently, only 42 doctors varied throughout Florida in areas to include Orlando, Pensacola, Tallahassee and Jacksonville, have signed up for authorization.

Why the Lack of Physicians?

Several theories may account for the lack of physician involvement in the program in Florida.

One of the theories that may explain why physicians are hesitant to jump on board with this new-age line of treatment, is the lack of scientific research conducted in the United States to back the medical efficacy of medical marijuana.  Scientists are reluctant to answer even the most basic questions about the use of medical marijuana including the long-term risks, actual benefits and the overall effect of legalization.

Many physicians may be concerned that the use of medical marijuana is supported more by popular opinion than on actual medical research.

However, a primary reason for insignificant research may be due to the unavailability of the drug for scientific study due to its illegal status.  The federal government entirely restricts the authorization to use marijuana for medical research.  The media is replete with stories on this.  As the debate over marijuana and its legalization for medical use becomes more widespread and pertinent, the drug has concurrently become more available for research.

For more information on current medical marijuana research efforts as reported by U.S.A. Today, click here.

Who Will Dispense the Marijuana?

Another hold-up in support from physicians may be due to the fact that the Department of Health (DOH) is still in the process of selecting the five dispensing organizations throughout Florida that will be developing and dispensing the drug.

As originally proposed, this requires an arduous application process presently consisting of proposals from 24 competing companies.  A dispensing organization must have the ability to meet several requirements as set forth in the statues, including the financial ability to post a $5 million performance bond upon approval.  Section 381.986(5)(b), Florida Statutes (2015).

Many physicians are still waiting to know where the drugs will be dispensed, what the dosages will be, what forms they will be available in and how much they will cost.  These are all important factors to consider in determining whether or not medical marijuana may be beneficial to certain patients.

Penalties for Misuse.

A final reason for physician avoidance of marijuana is fear of criminal prosecution and discipline by their boards, given the lingering gray areas of the law.

To read one of our previous blogs regarding a federal judge’s challenge of the DOJ’s incorrect interpretation of federal law on medical marijuana prosecutions and a win for medical marijuana advocates across the nation, click here.

It is undisputed that the use of medical marijuana is on the rise.  Therefore, any licensed physician who is contemplating or has already signed up for the program, needs to be sure they are in strict compliance with Florida law.

A physician is committing a misdemeanor, which may result in criminal penalties, if he or she orders low-THC cannabis for a patient without possessing a reasonable belief that the patient is suffering from one of the debilitating medical conditions as described in Section 381.986(3)(a)(1) and (2), Florida Statutes.

It is one of the ongoing duties of the dispensing organizations established by the Department to “monitor physician registration and ordering of low-THC cannabis for ordering practices that could facilitate unlawful diversion or misuse of low-THC cannabis and take disciplinary action as indicated.”  Section 381.986(5)(b)(7)(c), Florida Statutes (2015).

Therefore, a physician interested in obtaining authorization to order medical marijuana for his or her patients, should contact an experienced health attorney as a safeguard to ensure he or she complies fully with the law.

Comments?

Why do you believe there is a lack of physician involvement in Florida in the medical marijuana program?  What are your thoughts on the availability of medical marijuana in Florida?

Contact Experienced Health Law Attorneys for Medical Marijuana Concerns.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting and/or licensing, while complying with Florida law. We can also represent doctors, pharmacies and pharmacists facing proceedings brought by state regulators or agencies.

To contact The Health Law Firm please call (407) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

Sources:

Powers, Scott.  “Medical-pot backers unfazed only 42 doctors in program.”  Orlando Sentinel 20 August 2015: Final.  Print.

Caputo, Mark.  “Medical marijuana supporters unveil new proposal for 2016.”  Miami Herald.  8 January 2015.  Web.  27 August 2015.

Keywords: medical marijuana lawyer, marijuana attorney, low-THC cannabis, medical cannabis, complaint against physician, Florida law, health attorney, doctor defense attorney Department of Health, Compassionate Medical Cannabis Act, disciplinary action for prescribing, medical marijuana regulations, prescribing controlled substances, physicians recommending marijuana, health regulation lawyer, medical license defense attorney, The Health Law Firm, health law attorney, DEA defense lawyer, medical marijuana ordering physician, compassionate-use in Florida, physician certifications for medical marijuana, cannabis for treatment of debilitating medical condition

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

Florida Gets a Green Light on First Five Growers as Medical Marijuana Program Expands: Five Pot Growers Hit Jackpot

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

The Florida Department of Health (DOH) awarded the state’s first licenses to five nurseries, allowing them to legally grow and cultivate marijuana for medical purposes. The nurseries selected are Costa Nursery Farms in Miami, Alpha Foliage of Homestead, Knox Nursery of Winter Garden, Hackney Nursery Company in Tallahassee and Chestnut Hill Tree Farm of Alachua.

Compassionate Use in Florida.

With these licenses, the five nurseries are permitted to grow Charlotte’s Web, a liquid form of cannabis low in THC, the chemical that gives a euphoric feeling. It is intended to treat patients with epilepsy and advanced stages of cancer. For patients to qualify for the treatment, they must obtain permission from a qualified doctor and be added to the Compassionate Use Registry. Compassionate use is the experimental use of a medical product that has not been approved by the Food and Drug Administration (FDA). To read more about compassionate use and the registry from The DOH, click here.


Applicant Rules and Guidelines.

The five nurseries were selected out of a pool of 28 applicants with businesses in Florida for at least 30 years that grow a minimum of 400,000 plants. Each of the growers now have 10 business days to post a $5 million performance bond to prove they are serious about the license. Several nurseries that were selected have partnered with consultants, investors, security firms and out of state marijuana growers to help develop plans and secure the performance bond.

Expanding the Medical Marijuana Program.

Medical Marijuana is well on its way to Florida and these first five growers are just the beginning. A Florida House Panel recently approved House Bill 307, to expand the small medical marijuana program. Under this Bill, terminally ill patients can purchase marijuana from a licensed grower with approval from two doctors. Not only did the House Justice Subcommittee approve House Bill 307 by a 9-4 vote, they tacked on new language to increase the number of growers to 20. The bill passed its first hurdle and moves next to the House Health Care Appropriations Subcommittee. To find out more details on House Bill 307, click here.

To read further on Medical Marijuana legislation in Florida, read one of our past blogs here.

Serious Questions Regarding Monopolistic Actions.

I have some very serious questions as to whether or not the state is unfairly limiting the number of medical marijuana growers. Surely there is a need for more than five of them. This has got to be perceived as capricious and arbitrary by any court reviewing it.

If the proposed Florida constitutional amendment passes during the next election, as many predict it will, then such an artificial limitation on the number of growers may well be determined to violate the intent of the amendment. With all of the scrutiny being focused on state medical agencies by the Federal Trade Commission (FTC) and the Department of Justice (DOJ) for anti-competitive practices, the artificially low number of permitted growers is found to invite future litigation from pateints and from competing growers who were shut out of the market.

Comments?

What are your thoughts on the availability of medical marijuana in Florida? Do you agree with the expansion of the medical marijuana program? Please leave any thoughtful comments below.

Contact Experienced Health Law Attorneys for Medical Marijuana Concerns.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting and/or licensing, while complying with Florida law. We can also represent doctors, pharmacies and pharmacists facing proceedings brought by state regulators or agencies.

To contact The Health Law Firm please call (407) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Sources:

Auslen, Michael. “Florida medical marijuana plan expanded to 20 growers.” Bradenton Herald. 17 Nov. 2015. Web.

Klas, Mary Ellen. “Florida approves 5 nurseriers to grow medical marijuana.” Miami Herald. 24 Nov. 2015. Web.

Powers, Scott. “5 growers get state’s 1st pot license.” Orlando Sentinel. 24 Nov. 2015. Print.

KeyWords: Florida medical marijuana, medical marijuana growers, medical marijuana cultivation, medical marijuana license, Charlotte’s Web, House Bill 307, medical marijuana lawyer, marijuana attorney, low-THC cannabis, medical cannabis, Department of Health (DOH), Compassionate Medical Cannabis Act, medical marijuana regulations, medical license defense attorney, The Health Law Firm, health law attorney, cannabis for treatment of debilitating medical condition

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

Virginia Medical Board Wins Appeal Concerning Doctor’s Revoked Medical License

Headshot of The Health Law Firm's attorney George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On March 21, 2017, a Virginia appellate court ruled that a doctor’s state medical license was properly revoked for various reasons including allowing medical students to perform unauthorized medical procedures. The appellate court said the doctor’s due process rights weren’t violated because he had three months to prepare for an administrative hearing before the Virginia Board of Medicine.

Medical License Was Properly Revoked.

When the doctor originally presented his case in the trial court, the trial judge ruled that Dr. John Hagmann’s constitutional rights were violated. The trial court decided that when the Virginia Board of Medicine denied the doctor’s second request for a postponement of an administrative proceeding it erred. The trial court judge reversed the Virginia Board of Medicine’s decision revoking his license.

The court of appeals later decided that the trial judge’s decision was erroneous and reversed it. The appellate court based its ruling on the fact that Dr. Hagmann had already received one continuance and had more than three months to prepare for his hearing. According to the appellate court, the medical board’s denial of a second continuance didn’t violate Dr. Hagmann’s due process rights.

While teaching courses at a federal military school in 2012 and 2013, Dr. Hagmann allegedly allowed the students to perform invasive medical procedures on himself and on each other. These medical procedures were allegedly unapproved and had no medicinal or therapeutic purposes, according to the medical board.

According to the court’s opinion, Dr. Hagmann was also accused of encouraging students to use alcohol and various drugs in unapproved and dangerous ways. It indicated that he also provided medical treatment, including writing prescriptions, without keeping adequate records.

To read the court’s opinion in full, click here.

Conclusion.

The Virginia appellate court decided that the circuit court, the lower court in the case, erred by substituting its discretion for the Board’s discretion. However, the court of appeal also held that the circuit court did not err in rejecting Dr. Hagmann’s claims that the Board violated his due process rights.

Therefore, the court of appeal reversed the circuit court’s ruling and remanded with directions that the decision of the Medical Board revoking Dr. Hagmann’s license to practice medicine should be reinstated.

To learn more about the consequences of having your professional medical license revoked, click here to read one of my prior blogs.

Author’s Comments:

The problem I have with this decision is that the board of medicine usually takes years to investigate such cases. Once the charges are filed, they want to rush to a hearing, often without giving the defense adequate time to prepare. I have experienced this time and time again. It behooves the defense to make a clear record of the time that the port of medicine has had to prepare, the prejudice that will occur to the defense, and the lack of prejudice to the board.

Additionally, since there was a trial in a trial court decision, the trial court judge was in a much better position to weigh the credibility of the witnesses and make the decisions that were made. In a case where there is only been one prior continuance granted, for the appellate court to reverse the trial court judge, seems unfair to me, especially since the result is the revocation of the Doctor’s license. I often refer to this as the “death sentence” for the Doctor’s career. There isn’t a harsher sentence that a board of medicine can give.

Contact Health Law Attorneys With Experience Handling Licensing Issues.

If you have had a license suspended or revoked, or are facing imminent action against your license, it is imperative that you contact an experienced healthcare attorney to assist you in defending your career. Remember, your license is your livelihood, it is not recommended that you attempt to pursue these matters without the assistance of an attorney.

The Health Law Firm routinely represents physicians, dentists, nurses, medical groups, clinics, and other healthcare providers in personal and facility licensing issues. To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Kang, Peter. “Va. Med Board Wins Appeal Over Doc’s License Revocation.” Law360. (March 21, 2017). Web.

 

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

 

KeyWords: Legal representation for licensing issues, medical license defense attorney, legal representation for revoked license, legal representation for Board of Medicine investigation, Board of Medicine investigation defense attorney, medical board appeals, legal representation for administrative law hearing, administrative hearing defense attorney, legal counsel for Board of Medicine hearing, legal representation for Department of Health investigations, Department of Health investigation defense attorney, appeal of revocations, legal representation for Administrative Law Judge (ALJ) Hearings, administrative litigation defense attorney, legal representation for Federal Administrative Hearings, legal representation for Formal Administrative Hearings and Informal Administrative Hearings, legal representation for revocation hearings, The Health Law Firm reviews, reviews of The Health Law Firm

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

Alabama Doctor and 3 Nurse Practitioners Charged With Running Fraudulent Pill Mill

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

On December 6, 2017, three nurse practitioners and a doctor were arrested following an Alabama federal grand jury indictment accusing them of operating a “pill mill.” According to the U.S. Department of Justice (DOJ), all four allegedly dispensed controlled substances inappropriately, unlawfully and for non-medical reasons.

The Alleged Pill Mill.

The nurse practitioners and physician allegedly prescribed opioids including fentanyl, hydrocodone, oxycodone, methadone and hydromorphone on a monthly basis for years, according to the indictment. They then allegedly billed health care providers for related unnecessary patient examinations.

“[The four defendants] did knowingly and intentionally conspire to distribute and dispense and cause to be distributed and dispensed mixtures and substances containing detectable amounts of controlled substances by issuing and causing prescriptions for those substances outside the usual course of professional medical practice and for no legitimate medical purposes, through the operation of a pill mill,” the indictment stated.

Prosecutors alleged the medical personnel diagnosed patients at the Alabama practice with “vague, unsubstantiated medical conditions,” and prescribed controlled substances in 30-day quantities.

Additionally, prosecutors allege that they required the patients to have a follow-up appointment involving a physical examination that was “medically unnecessary.” They would then bill health care benefit programs for the patients’ visits, usually in the amount of $75, under allegedly false and fraudulent pretenses.

The alleged scheme earned the defendants more than $10,000. If convicted, each defendant faces a maximum sentence of 20 years in prison on the drug conspiracy and distribution counts. They face maximum sentences of 10 years in prison on the health care fraud counts.

To read the indictment in full, click here.
Law Enforcement Raids on Physicians, Pharmacists, Nurses and Other Health Providers Will Continue.

According to the U.S. Drug Enforcement Administration (DEA), investigations against pill mill operations are ongoing. Additional arrests of co-conspirators, including other doctors and health providers, are forthcoming, according to the DEA. If you are a physician, pharmacist, nurse, or other health provider, ensure you are taking measures to protect yourself and your practice.

To see a prior blog I wrote on the steps pain management physicians can take to stay out of trouble, click here.
Contact a Health Law Attorney Experienced in DEA Cases.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, health care clinics, pain management clinics, pharmacists, pharmacies, and any other health care provider. We defend pain management physicians, clinics and pharmacists in state license investigations, in administrative hearings, and in DEA actions, including Show Cause Orders (SCOs) . The services we provide include reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, advice on setting aside or voiding contracts, litigation of contracts (in start or federal court), business transactions, professional license defense, opinion letters, representation in investigations, fair hearing defense, representation in peer review and clinical privileges hearings, litigation of restrictive covenant (covenants not to compete), Medicare and Medicaid audits, commercial litigation, and administrative hearings. It includes defense in federal or state court and defense in federal or state administrative hearings.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Robinson, Carol. “Alabama doctor, 3 nurse practitioners federally indicted in pill mill case.” AL.com (Alabama News). (December 5, 2017). Web.

Narea, Nicole. “Doctor, 3 Nurse Practitioners Charged With Running ‘Pill Mill’.” Law360. (December 5, 2017). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for pain management clinic, pain management clinic defense attorney, Show Cause Order (SCO) defense attorney, Show Cause Order (SCO) defense legal counsel, Show Cause Order (SCO) defense lawyer, legal representation for over-billing, legal representation for submitting false claims, False Claims Act (FCA) defense attorney, medical license defense attorney, nursing license defense attorney, Drug Enforcement Administration (DEA) defense attorney, Drug Enforcement Administration (DEA) defense counsel, Drug Enforcement Administration (DEA) defense lawyer, board of medicine attorney, board of pharmacy attorney, legal representation for Department of Health investigations, legal representation for allegations of over-prescribing, legal representation for U.S. Department of Justice (DOJ) investigations, DOJ investigation defense attorney, The Health Law Firm reviews, reviews of The Health Law Firm, The Health Law Firm attorney reviews, formal and informal administrative hearing defense attorney, formal and informal administrative hearing defense lawyer, formal and informal administrative hearing defense legal counsel

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2018 The Health Law Firm. All rights reserved.

 

Alabama Doctor and 3 Nurse Practitioners Charged With Running Fraudulent Pill Mill

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 6, 2017, three nurse practitioners and a doctor were arrested following an Alabama federal grand jury indictment accusing them of operating a “pill mill.” According to the U.S. Department of Justice (DOJ), all four allegedly dispensed controlled substances inappropriately, unlawfully and for non-medical reasons.

The Alleged Pill Mill.

The nurse practitioners and physician allegedly prescribed opioids including fentanyl, hydrocodone, oxycodone, methadone and hydromorphone on a monthly basis for years, according to the indictment. They then allegedly billed health care providers for related unnecessary patient examinations.

“[The four defendants] did knowingly and intentionally conspire to distribute and dispense and cause to be distributed and dispensed mixtures and substances containing detectable amounts of controlled substances by issuing and causing prescriptions for those substances outside the usual course of professional medical practice and for no legitimate medical purposes, through the operation of a pill mill,” the indictment stated.

Prosecutors alleged the medical personnel diagnosed patients at the Alabama practice with “vague, unsubstantiated medical conditions,” and prescribed controlled substances in 30-day quantities.

Additionally, prosecutors allege that they required the patients to have a follow-up appointment involving a physical examination that was “medically unnecessary.” They would then bill health care benefit programs for the patients’ visits, usually in the amount of $75, under allegedly false and fraudulent pretenses.

The alleged scheme earned the defendants more than $10,000. If convicted, each defendant faces a maximum sentence of 20 years in prison on the drug conspiracy and distribution counts. They face maximum sentences of 10 years in prison on the health care fraud counts.

To read the indictment in full, click here.
Law Enforcement Raids on Physicians, Pharmacists, Nurses and Other Health Providers Will Continue.

According to the U.S. Drug Enforcement Administration (DEA), investigations against pill mill operations are ongoing. Additional arrests of co-conspirators, including other doctors and health providers, are forthcoming, according to the DEA. If you are a physician, pharmacist, nurse, or other health provider, ensure you are taking measures to protect yourself and your practice.

To see a prior blog I wrote on the steps pain management physicians can take to stay out of trouble, click here.
Contact a Health Law Attorney Experienced in DEA Cases.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, health care clinics, pain management clinics, pharmacists, pharmacies, and any other health care provider. We defend pain management physicians, clinics and pharmacists in state license investigations, in administrative hearings, and in DEA actions, including Show Cause Orders (SCOs) . The services we provide include reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, advice on setting aside or voiding contracts, litigation of contracts (in start or federal court), business transactions, professional license defense, opinion letters, representation in investigations, fair hearing defense, representation in peer review and clinical privileges hearings, litigation of restrictive covenant (covenants not to compete), Medicare and Medicaid audits, commercial litigation, and administrative hearings. It includes defense in federal or state court and defense in federal or state administrative hearings.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Robinson, Carol. “Alabama doctor, 3 nurse practitioners federally indicted in pill mill case.” AL.com (Alabama News). (December 5, 2017). Web.

Narea, Nicole. “Doctor, 3 Nurse Practitioners Charged With Running ‘Pill Mill’.” Law360. (December 5, 2017). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for pain management clinic, pain management clinic defense attorney, Show Cause Order (SCO) defense attorney, Show Cause Order (SCO) defense legal counsel, Show Cause Order (SCO) defense lawyer, legal representation for over-billing, legal representation for submitting false claims, False Claims Act (FCA) defense attorney, medical license defense attorney, nursing license defense attorney, Drug Enforcement Administration (DEA) defense attorney, Drug Enforcement Administration (DEA) defense counsel, Drug Enforcement Administration (DEA) defense lawyer, board of medicine attorney, board of pharmacy attorney, legal representation for Department of Health investigations, legal representation for allegations of over-prescribing, legal representation for U.S. Department of Justice (DOJ) investigations, DOJ investigation defense attorney, The Health Law Firm reviews, reviews of The Health Law Firm, The Health Law Firm attorney reviews, formal and informal administrative hearing defense attorney, formal and informal administrative hearing defense lawyer, formal and informal administrative hearing defense legal counsel

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2018 The Health Law Firm. All rights reserved.

 

Virginia Medical Board Wins Appeal Concerning Doctor’s Revoked Medical License

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

On March 21, 2017, a Virginia appellate court ruled that a doctor’s state medical license was properly revoked for various reasons including allowing medical students to perform unauthorized medical procedures. The appellate court said the doctor’s due process rights weren’t violated because he had three months to prepare for an administrative hearing before the Virginia Board of Medicine.

Medical License Was Properly Revoked.

When the doctor originally presented his case in the trial court, the trial judge ruled that Dr. John Hagmann’s constitutional rights were violated. The trial court decided that when the Virginia Board of Medicine denied the doctor’s second request for a postponement of an administrative proceeding it erred. The trial court judge reversed the Virginia Board of Medicine’s decision revoking his license.

The court of appeals later decided that the trial judge’s decision was erroneous and reversed it. The appellate court based its ruling on the fact that Dr. Hagmann had already received one continuance and had more than three months to prepare for his hearing. According to the appellate court, the medical board’s denial of a second continuance didn’t violate Dr. Hagmann’s due process rights.

While teaching courses at a federal military school in 2012 and 2013, Dr. Hagmann allegedly allowed the students to perform invasive medical procedures on himself and on each other. These medical procedures were allegedly unapproved and had no medicinal or therapeutic purposes, according to the medical board.

According to the court’s opinion, Dr. Hagmann was also accused of encouraging students to use alcohol and various drugs in unapproved and dangerous ways. It indicated that he also provided medical treatment, including writing prescriptions, without keeping adequate records.

To read the court’s opinion in full, click here.

Conclusion.

The Virginia appellate court decided that the circuit court, the lower court in the case, erred by substituting its discretion for the Board’s discretion. However, the court of appeal also held that the circuit court did not err in rejecting Dr. Hagmann’s claims that the Board violated his due process rights.

Therefore, the court of appeal reversed the circuit court’s ruling and remanded with directions that the decision of the Medical Board revoking Dr. Hagmann’s license to practice medicine should be reinstated.

To learn more about the consequences of having your professional medical license revoked, click here to read one of my prior blogs.

Author’s Comments:

The problem I have with this decision is that the board of medicine usually takes years to investigate such cases. Once the charges are filed, they want to rush to a hearing, often without giving the defense adequate time to prepare. I have experienced this time and time again. It behooves the defense to make a clear record of the time that the port of medicine has had to prepare, the prejudice that will occur to the defense, and the lack of prejudice to the board.

Additionally, since there was a trial in a trial court decision, the trial court judge was in a much better position to weigh the credibility of the witnesses and make the decisions that were made. In a case where there is only been one prior continuance granted, for the appellate court to reverse the trial court judge, seems unfair to me, especially since the result is the revocation of the Doctor’s license. I often refer to this as the “death sentence” for the Doctor’s career. There isn’t a harsher sentence that a board of medicine can give.

Contact Health Law Attorneys With Experience Handling Licensing Issues.

If you have had a license suspended or revoked, or are facing imminent action against your license, it is imperative that you contact an experienced healthcare attorney to assist you in defending your career. Remember, your license is your livelihood, it is not recommended that you attempt to pursue these matters without the assistance of an attorney.

The Health Law Firm routinely represents physicians, dentists, nurses, medical groups, clinics, and other healthcare providers in personal and facility licensing issues. To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Kang, Peter. “Va. Med Board Wins Appeal Over Doc’s License Revocation.” Law360. (March 21, 2017). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for licensing issues, medical license defense attorney, legal representation for revoked license, legal representation for Board of Medicine investigation, Board of Medicine investigation defense attorney, medical board appeals, legal representation for administrative law hearing, administrative hearing defense attorney, legal counsel for Board of Medicine hearing, legal representation for Department of Health investigations, Department of Health investigation defense attorney, appeal of revocations, legal representation for Administrative Law Judge (ALJ) Hearings, administrative litigation defense attorney, legal representation for Federal Administrative Hearings, legal representation for Formal Administrative Hearings and Informal Administrative Hearings, legal representation for revocation hearings, The Health Law Firm reviews, reviews of The Health Law Firm

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

Alabama Doctor and 3 Nurse Practitioners Charged With Running Fraudulent Pill Mill

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 6, 2017, three nurse practitioners and a doctor were arrested following an Alabama federal grand jury indictment accusing them of operating a “pill mill.” According to the U.S. Department of Justice (DOJ), all four allegedly dispensed controlled substances inappropriately, unlawfully and for non-medical reasons.

The Alleged Pill Mill.

The nurse practitioners and physician allegedly prescribed opioids including fentanyl, hydrocodone, oxycodone, methadone and hydromorphone on a monthly basis for years, according to the indictment. They then allegedly billed health care providers for related unnecessary patient examinations.

“[The four defendants] did knowingly and intentionally conspire to distribute and dispense and cause to be distributed and dispensed mixtures and substances containing detectable amounts of controlled substances by issuing and causing prescriptions for those substances outside the usual course of professional medical practice and for no legitimate medical purposes, through the operation of a pill mill,” the indictment stated.

Prosecutors alleged the medical personnel diagnosed patients at the Alabama practice with “vague, unsubstantiated medical conditions,” and prescribed controlled substances in 30-day quantities.

Additionally, prosecutors allege that they required the patients to have a follow-up appointment involving a physical examination that was “medically unnecessary.” They would then bill health care benefit programs for the patients’ visits, usually in the amount of $75, under allegedly false and fraudulent pretenses.

The alleged scheme earned the defendants more than $10,000. If convicted, each defendant faces a maximum sentence of 20 years in prison on the drug conspiracy and distribution counts. They face maximum sentences of 10 years in prison on the health care fraud counts.

To read the indictment in full, click here.
Law Enforcement Raids on Physicians, Pharmacists, Nurses and Other Health Providers Will Continue.

According to the U.S. Drug Enforcement Administration (DEA), investigations against pill mill operations are ongoing. Additional arrests of co-conspirators, including other doctors and health providers, are forthcoming, according to the DEA. If you are a physician, pharmacist, nurse, or other health provider, ensure you are taking measures to protect yourself and your practice.

To see a prior blog I wrote on the steps pain management physicians can take to stay out of trouble, click here.
Contact a Health Law Attorney Experienced in DEA Cases.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, health care clinics, pain management clinics, pharmacists, pharmacies, and any other health care provider. We defend pain management physicians, clinics and pharmacists in state license investigations, in administrative hearings, and in DEA actions, including Show Cause Orders (SCOs) . The services we provide include reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, advice on setting aside or voiding contracts, litigation of contracts (in start or federal court), business transactions, professional license defense, opinion letters, representation in investigations, fair hearing defense, representation in peer review and clinical privileges hearings, litigation of restrictive covenant (covenants not to compete), Medicare and Medicaid audits, commercial litigation, and administrative hearings. It includes defense in federal or state court and defense in federal or state administrative hearings.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Robinson, Carol. “Alabama doctor, 3 nurse practitioners federally indicted in pill mill case.” AL.com (Alabama News). (December 5, 2017). Web.

Narea, Nicole. “Doctor, 3 Nurse Practitioners Charged With Running ‘Pill Mill’.” Law360. (December 5, 2017). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for pain management clinic, pain management clinic defense attorney, Show Cause Order (SCO) defense attorney, Show Cause Order (SCO) defense legal counsel, Show Cause Order (SCO) defense lawyer, legal representation for over-billing, legal representation for submitting false claims, False Claims Act (FCA) defense attorney, medical license defense attorney, nursing license defense attorney, Drug Enforcement Administration (DEA) defense attorney, Drug Enforcement Administration (DEA) defense counsel, Drug Enforcement Administration (DEA) defense lawyer, board of medicine attorney, board of pharmacy attorney, legal representation for Department of Health investigations, legal representation for allegations of over-prescribing, legal representation for U.S. Department of Justice (DOJ) investigations, DOJ investigation defense attorney, The Health Law Firm reviews, reviews of The Health Law Firm, The Health Law Firm attorney reviews, formal and informal administrative hearing defense attorney, formal and informal administrative hearing defense lawyer, formal and informal administrative hearing defense legal counsel

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2018 The Health Law Firm. All rights reserved.

 

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