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Follow These Steps to Challenge OIG Exclusion From Medicare

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

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 professional careers and future employment. Whether you are a physician, nurse, dentist, psychologist or other health professionals, if you allow yourself to be excluded from the Medicare program, devastating economic results may follow.

The administrative process by which you may challenge a proposal from the OIG for most permissive or mandatory exclusion is challenging. In most cases, you will need experienced legal representation. Below are the steps in the process you must follow to protect your career and your livelihood.

How to Challenge OIG Exclusion Actions.

1. Notice of Intent (NOI) received: If the OIG […]

The Administrative Process to Challenge OIG Exclusion Actions

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

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 professional careers and future employment. Whether you are a physician, nurse, dentist, psychologist or other health professionals, if you allow yourself to be excluded from the Medicare program, devastating economic results may follow.

The administrative process by which you may challenge a proposal from the OIG for most permissive or mandatory exclusion is challenging. In most cases, you will need experienced legal representation. Below are the steps in the process you must follow to protect your career and your livelihood.

How to Challenge OIG Exclusion Actions.

1. Notice of Intent (NOI) received: If the OIG is proposing to exclude a person or entity from […]

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Steps to Challenge OIG Exclusion Action from Medicare Program

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

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 professional careers and future employment. Whether you are a physician, nurse, dentist, psychologist or other health professionals, if you allow yourself to be excluded from the Medicare program, devastating economic results may follow.

The administrative process by which you may challenge a proposal from the OIG for most permissive or mandatory exclusion is challenging. In most cases, you will need experienced legal representation. Below are the steps in the process you must follow to protect your career and your livelihood.

The Administrative Process to Challenge OIG Exclusion Actions.

1. Notice of Intent (NOI) received: If the OIG is proposing to exclude a person […]

By The Health Law Firm|2024-03-14T10:00:12-04:00July 30, 2019|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), False Claims attorney, FCA attorney, FCA lawyer, health care fraud defense attorney, health care professional defense attorney, healthcare fraud representation, 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 Medicare and Medicaid audits, Medicare administrative law judge hearing defense attorney, Medicare administrative law judge hearing legal representation, Medicare and Medicaid audit defense attorney, Medicare audit defense attorney, Medicare audit defense legal counsel, Medicare exclusion hearing defense attorney, 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, representation for CMS investigations, representation for healthcare investigations, representation for medical overbilling, representation for submitting false claims, reviews for The Health Law Firm, The Health Law Firm attorney reviews|1 Comment

How to Challenge an OIG Exclusion Action from Medicare

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

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 professional careers and future employment. Whether you are a physician, nurse, dentist, psychologist or other health professionals, if you allow yourself to be excluded from the Medicare program, devastating economic results may follow.

The administrative process by which you may challenge a proposal from the OIG for most permissive or mandatory exclusion is challenging. In most cases, you will need experienced legal representation. Below are the steps in the process you must follow to protect your career and your livelihood.

The Administrative Process to Challenge OIG Exclusion Actions.

1. Notice of Intent (NOI) received: If the OIG is proposing to exclude a person or entity […]

By The Health Law Firm|2024-03-14T10:00:13-04:00July 9, 2019|Categories: Pharmacy Law Blog, Uncategorized|Tags: allegations of healthcare fraud, attorney legal representation for OIG notice of intent to exclude, Centers for Medicare and Medicaid (CMS), False Claims attorney, FCA attorney, FCA lawyer, health care fraud defense attorney, health care professional defense attorney, healthcare fraud representation, 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 Medicare and Medicaid audits, Medicare administrative law judge hearing defense attorney, Medicare administrative law judge hearing legal representation, Medicare and Medicaid audit defense attorney, Medicare audit defense attorney, Medicare audit defense legal counsel, Medicare exclusion hearing defense attorney, 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, representation for CMS investigations, representation for healthcare investigations, representation for medical overbilling, representation for submitting false claims, reviews for The Health Law Firm, The Health Law Firm attorney reviews|Comments Off

Genetic Testing Scams Ripping off Government Programs for Millions, 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

Several genetic testing companies have come into the spotlight for allegations of ripping off Medicare and False Claims Act (FCA) violations. Health care professionals need to be aware of these types of schemes and the dangers they may face if involved. In each of these cases, the companies agreed to a pay a settlement in the millions to resolve allegations they submitted claims for unnecessary genetic testing.

This is part one of a two part blog series. Click here for part two.

The Details.

On February 11, 2019, the Department of Justice (DOJ) announced that GenomeDx Biosciences Corp. (GenomeDx) agreed to pay $1.99 million to resolve FCA […]

Miami Man to Remain Jailed for Trial in Nation’s Largest Medicare Fraud Case

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

On December 3, 2018, a Florida judge ruled that a Miami businessman who has been jailed for more than two years on $1 billion health care fraud charges, must remain in custody through his trial next year. U.S. District Judge Robert N. Scola Jr. found no violation of his due process rights and denied Philip Esformes’ motion to dismiss several money laundering charges.

Trial Date is Set.

A February 11, 2019, trial date has been set for one of the nation’s biggest Medicare fraud cases that Esformes allegedly orchestrated through nursing homes and assisted living facilities he owned. According to the government, the scheme resulted in $1 billion in false billing and at least $464 million in improper reimbursement payments from Medicare and Medicaid.

Esformes, has been in federal […]

Walgreens Agrees to Pay $269 Million to Settle Two FCA Suits

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

On January 22, 2019, Walgreens agreed to pay more than $269 million to settle allegations of False Claims Act (FCA) violations for overbilling of various drugs. The deals are some of the largest pay-outs ever by a retail pharmacy, according to the United States Department of Justice (DOJ).

The Two Settlements.

There were two separate complaints involving Walgreens to settle federal and state lawsuits that accused the pharmacy of overbilling federal healthcare programs. Both were unsealed by U.S. District Court judges in Manhattan, according to the DOJ.

In the first settlement, Walgreens agreed to pay $209.2 million to the U.S. and several state governments for improperly billing Medicare, Medicaid and other federal healthcare programs. The pharmacy […]

DOJ Announces $2.8 Billion Recovered Funds From Healthcare Cases in 2018

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

On December 21, 2018, the U.S. Department of Justice (DOJ) announced that it recovered more than $2.8 billion from False Claims Act (FCA) (also known as “qui tam” or “whistleblower cases”) cases in 2018. Of the $2.8 billion in settlements and judgments that the government obtained during the year through FCA cases, more than $2.5 billion involved health care fraud. These cases included drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.

Health Care Fraud.

The DOJ’s largest recoveries involving the health care industry in 2018 came from the drug and medical device industry. In one example, AmerisourceBergen Corporation paid a whopping $625 million to settle charges filed under the whistleblower provisions of the FCA. The charges alleged that it illegally distributed […]

DOJ Announces $2.8 Billion Recovered From Healthcare FCA Cases in 2018

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

On December 21, 2018, the U.S. Department of Justice (DOJ) announced that it recovered more than $2.8 billion from False Claims Act (FCA) (also known as “qui tam” or “whistleblower cases”) cases in 2018. Of the $2.8 billion in settlements and judgments that the government obtained during the year through FCA cases, more than $2.5 billion involved health care fraud. These cases included drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.

Health Care Fraud.

The DOJ’s largest recoveries involving the health care industry in 2018 came from the drug and medical device industry. In one example, AmerisourceBergen Corporation paid a whopping $625 million to settle charges filed under the whistleblower provisions of the FCA. The charges alleged that it illegally distributed […]

Florida Pharmacist Gets More Than Six Years in Prison For Role in Compounding Fraud Scheme

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

On November 29, 2018, a Florida pharmacist was sentenced to six and a half years in prison and ordered to pay $3.4 million, for her role in a scheme to defraud the government. Marjorie Robinson pled guilty one count of conspiracy to commit health care fraud for submitting fraudulent claims to Tricare, Medicare and private insurance programs for compounded creams that were not necessary.

The Fraud Scheme.

According to the U.S. Department of Justice (DOJ), Robinson was one of three owners of ASC Pharmacy Inc., a now defunct compounding pharmacy in Miami. Under her direction, the pharmacy made compounded creams that were made to maximize reimbursement from government and private insurance programs, not for patients needs, according to the plea deal. Click […]