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Almost 19% of Nurse Aides Charged with Abuse and Neglect in 2010 had Prior Criminal Records

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

A report released by the Department of Health and Human Services (HHS) Office of Inspector General (OIG) on October 5, 2012, found that nineteen percent (19%) of long-term care nurse aides who were found guilty of on-the-job abuse, neglect or property theft in 2010 had prior criminal records that would have showed up on a background check. Click here to read the entire report from the HHS OIG.

Background Check Program Initiated to Decrease Abuse Cases.

Section 6201 of the Affordable Care Act establishes a background check program. This voluntary program gives grants to states that support nursing home employee background checks. The report was released to assess the ability of the background check program to help decrease the number of neglect, abuse and misappropriation of resident property cases.

Nurse Aides Mostly Convicted for Burglary and Larceny.

Out of 1,611 nurse aides charged with abuse, neglect or property theft in 2010, 300 nurse aides had at least one prior criminal conviction. The Inspector General (IG) found the majority of disciplined nurse aides with records had been convicted of burglary, larceny or other crimes against property. Of the 300 nurse aides, 170 of them had at least one conviction prior to their date of registration as a nurse aide. The remaining 130 nurse aides, each had at least one conviction after the date of their registration. In a National Public Radio (NPR) story, a nursing professor from the University of California, San Francisco, said she is “most disturbed by the fact that nursing homes had hired some aides who’d been convicted of serious crimes.” Click here to read the NPR article.

Contact Health Law Attorneys Experienced in Representing Nurses and Nurse Aides.

The Health Law Firm’s attorneys routinely represent nurses and nurse aides in Department of Health (DOH) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida. 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 nurse, nursing aide or any other health professional, what do you think of this report? Please leave any thoughtful comments below.

Sources:

Schultz, David. “Among Disciplined Nurse Aides, Criminal Records Turn Up.” NPR. (October 11, 2012). From: http://www.npr.org/blogs/health/2012/10/11/162636910/among-disciplined-nurse-aides-criminal-records-turn-up

Wright. Stuart. “Criminal Convictions for Nurses Aides With Substantiated Findings of Abuse, Neglect, and Misappropriation.” Department of Health and Human Services Office of Inspector General. (October 5, 2012). From: http://www.thehealthlawfirm.com/uploads/Criminal%20Convictions%20for%20nurses%20aides.pdf

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.

Doctor or Nurse, Please, Please, Please: Talk to an Attorney Before You Talk to an Investigator

Despite mailing out hundreds of thousands of postcards and letters to physicians, nurses, dentists, pharmacists, and psychologists  throughout Florida, we continue to receive calls from new clients and from potential clients, after they have already spoken to and made critical harmful admissions against their own interests to investigators.  In Florida, you do not have any duty to cooperate with any investigator who is investigating you.  This extends to Department of Health (DOH) investigators (who are sometimes titled “Medical Quality Assurance Investigators” or “Medical Malpractice Investigators“), Drug Enforcement Administration (DEA) special agents, police officers, sheriff’s deputies, or criminal investigators of any type.

Let me state this as succinctly and clearly as possible.  If you are being investigated, you will not be better off making a statement.  You will not be better off explaining your side of the story.  The investigator is not your friend.  The investigator is not on your side.  All you are doing is falling for a trick and helping the government to make a case against you.

You have a right under the U.S. Constitution to not make any statement that may be used against you.  This is so important that in criminal cases government investigators are required to advise you of this by reciting to you your Miranda rights.

However, in cases where you might have your medical license revoked or have your nursing license revoked or have your DEA number revoked or lose your Medicare provider status or your Medicaid provider status, the investigator is not required to advise you of your rights.

In a criminal case, there may be ways to have your statement thrown out.  However, in a professional licensing case or other administrative case, it may be too late to avoid the damage.  You may be the best witness the government has and you may be the only witness the government needs to prove ths case against you.

In the case where you could receive a $100 criminal fine, the investigators are required to read you your constitutional Miranda rights and to be sure that you understand them before you make a statement.  However, in a case where you can lose your professional license, where you could lose your livelihood and ability to make a living, where you could lose everything you have worked so hard to obtain, they are not required to do this.  You must protect yourself.

Many health professionals, when confronted by an investigator, who will usually call at a very inconvenient time (to catch you by surprise) and will usually flash a badge (to intimidate you), will refuse to acknowledge the seriousness of the matter and will fall for the bait to “tell their side of the story.”  This can be fatal to your defense and fatal to your license.

In the absence of a statement by the suspect (in this case, let’s assume this is YOU), the government may have a very difficult time of proving that you have committed any offense.  It may have other witnesses (who may not be around at the time of any hearing or trial).  It may have a lot of physical evidence or documents.  But it may be impossible for the government investigators to make any link between you and the evidence, unless you help the investigators do this.  You would be surprised at how many health professionals believe that they can just talk their way out of the situation;  in reality, they are just giving evidence that is used to make the case against them.

Any evidence at all, just admitting that you were there, admitting that the documents are yours, admitting that the patient was yours, admitting that you worked at the clinic, admitting that you wrote the prescription, admitting that the property is yours, admitting that you were on duty at the time, admitting that you have taken a drug, admitting that you signed the form, can be a crucial piece of evidence that could not otherwise be proven without your own testimony.

Remember, this is the investigators’ job and profession.  This is what they do full time, every day.  And they are very good at it.  They are 1,000 times better at getting you to admit the crucial elements of a disciplinary infraction than you are in “talking your way out of it.”  They will not be convinced by any excuses you make.  They do not have to be. They will not be the ones making the final decision against you.  Theirs is the job of putting together the case against you.  You will help them by talking to them, explaining why your decisions are correct, explaining why what you did is excusable, etc.  It will not work.  You will merely be giving them enough rope to hang you with.

Hint: If it is a Medicaid Fraud Control Unit (MFCU) special agent (investigator), you are probably under investigation for Medicaid fraud.

Hint: If it is an “auditor,” “surveyor” or “investigator” from an agency or company with “integrity” or “program integrity” in its name, they are probably investigating you for “lack of integrity,” i.e., false claims or fraud.

Hint: If it is a Drug Enforcement Administration (DEA) special agent (investigator) they are probably investigating you to prosecute you or to revoke your DEA registration for drug or prescribing violations.

Hint: If it is an Office of the Inspector General (OIG) special agent (investigator), you are probably under investigation for Medicare fraud or Medicare false claims.

Hint: If it is a Department of Health Quality Assurance Investigator or Medical Malpractice Investigator, they are probably only investigating possible disciplinary action against your license that could result in large administrative fines or revocation of your license.

Do not believe for a second that you are smarter than the investigator.  Do not believe for a second that you will convince the investigator (or anyone else) that there is a legal or medical justification for what you did or what they allege.  If it were as simple as that, then why would there be an investigation and why would you be the one being investigated?

Additionally, do not believe for a second that you can lie your way out of it, either.  Remember, if the government cannot prove the basic offense that it is investigating against you, it may be able to prove that you have committed perjury or lied to an investigator.  In the case of a federal official or a federal investigation, merely making a false statement (oral or written) to an investigator is a criminal act.  This is what Martha Stewart and many others have served time for in federal prisons.

These investigators are lied to all the time.  They are usually better at detecting lies than a polygraph expert is.  Furthermore, in most cases, you will be the very last person to be interviewed.  Therefore, they will already know just about everything that can be used against you.  If your statement contradicts in any way what others have told them, they will know you are the one who is lying.  However, knowing something or suspecting something does not mean it will be something that can be proven in court or in an administrative hearing.

It is much better to make no statement at all.  Blame it on your attorney.  Tell the investigator that your attorney will kill you if you were to talk to the investigator without your attorney being there ahead of time.  “Speak to my attorney.”  “My attorney can help you, I can’t.”

All you have to do is state “I must talk to my lawyer before I say anything.”  “I will have my lawyer contact you.”  “I cannot say anything until I talk to my lawyer.”  “I want a lawyer.”

If you are not the one being investigated, then there is no good reason why the investigator would want you to make a statement before you consulted with your attorney.  What is the rush?

Then you must also avoid the old trick of the investigator telling you “If you don’t have anything to hide, why would you need a lawyer?”  Please don’t fall for this trick, either.  This is America.  Smart people and rich people spend a lot of money on attorneys and other professionals to represent them and advise them.  There is a good reason why they do this.

Far too often the health professional only calls us after he has given a statement.  This is usually too late to avoid much of the damage that will have been be caused.

Everything above applies to oral statements or written statements.  Do not make either.  Contact a lawyer as soon as possible, preferably before making any statement, no matter how simple, defensive, self-serving or innocuous you may think it to be.

Think of this as an intelligence test.  Are you smart enough to follow this guidance and avoid this type of mistake?

For more information about investigations and other legal matters, visit www.TheHealthLawFirm.com.

Most Physicians Not Using the Prescription Drug Monitoring Program

By Danielle M. Murray, J.D.

The Florida Prescription Drug Monitoring Program is apparently collecting dust as physicians are choosing not to use it. The Tampa Bay Times reported on October 5, 2012, that as few as one in twelve doctors have ever used the database. That is about eight percent (8%) of all physicians. Approximately fourteen percent (14%) of physicians are registered for the database.

Click here to read the entire story from the Tampa Bay Times.

Physicians Don’t Want to Use the Database.

Physicians interviewed for the article said the problem is that database use is not mandatory. Physicians are not required to review the database prior to accepting a new patient, or prior to giving out a prescription.  Some physicians said they would ask the pharmacy or check the local arrest records if they had a suspicion that the patient was abusing drugs or “doctor shopping.”

One potential reason that physicians may not check the database is simply that they don’t want to know.  If they know a patient is abusing prescription drugs, then that patient has to be sent away, and that is a loss of business. Another reason could be some doctors may not know the database exists, and other doctors may simply be too busy to bother.

In Some States the Database Is Mandatory.

The prescription drug database in Kentucky had a similar usage problem until the state made it mandatory for physicians to check the database.  A mandatory law in Ohio resulted in shock when physicians saw the reality of the large number of prescription drug abusers in their practices.

For the foreseeable future, using the database will not be mandatory for physicians. However, physicians should consider using the database, or otherwise remaining vigilant to avoid being labeled an overprescriber.

For legal tips for working with pain patients, click here.

Does the Database a Make it Easier to Prosecute?

From my perspective, I have seen the database in Florida used mostly as a tool for prosecution of pain management physicians and pharmacists. Even in cases where the pharmacist has been the one to notify the authorities of suspected forged prescriptions and where the pharmacist has cooperated in prosecuting the criminals, I have seen this database cited as evidence against him or her. I do not believe this is what the legislation intended.

Contact an Attorney Experienced in Department of Health (DOH) and Drug Enforcement Administration (DEA) Investigations.

As a health care professional, you may one day be charged with overprescribing narcotics or even criminally charged in the death of a patient due to their drug habits. If you are contacted by the Department of Health (DOH) or the Drug Enforcement Administration (DEA), do not sign anything or make any statements to anyone. Call an experienced health law attorney to learn about your rights in such a case.

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 physician, do you use the Florida Prescription Drug Monitoring Program? Why or why not? Please leave any thoughtful comments below.

Source:

Cox, John Woodrow, “Florida Drug Database Intended to Save Lives is Barely Used by Doctors.” Tampa Bay Times. October 7, 2012. http://www.tampabay.com/news/health/florida-drug-database-intended-to-save-lives-is-barely-used-by-doctors/1255062

About the Author: Danielle M. Murray is an attorney with 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.

Central Florida Has Been Invaded By Zombies – No Twinkies Means No Food Source

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

You are already aware of Floridians’ fear of zombies, as shown by recent legislation against bath salts. Despite this, there continue to be reports of rampant zombie outbreaks across the Sunshine State. The zombie apocalypse has hit Central Florida, hard. As a citizen of Florida, you know you are not safe; not from zombies, not from British tourists, not from inability to count (notes in an election) and not from the state legislature. To make matters worse, Twinkies, the only food known to mankind that can survive a post-apocalyptic zombie outbreak (reference: Zombieland 2009) or a nuclear holocaust (reference: Family Guy, second season, third episode Dec. 26, 1999), may soon be out of production. Everyone knows Twinkies have a shelf life of 246 years.

Since Florida seems to be the only state infected with this flesh-eating disease, we are taking a poll. Should we be renamed “the Zombie State?”

A Run With the Living Dead in Clermont.

For those of your reading this blog from another state, you’re in luck. There is actual video footage of how bad the zombie outbreak has gotten in Florida. In Clermont, thousands of cardio-enthusiasts showed up to run a 5K course filled with numerous obstacles that forced participants to crawl in the sticky mud to avoid being pricked by barbed wire above and walking along an unstable beam of wood. Unfortunately, the runners were bombarded along the way by the living dead looking for a quick bite to eat. The participants had to protect their brains while running for their lives. Only the fastest survived.

To see video of attack, click here.

Zombies Take Over the University of Central Florida (UCF).

If you are in Florida and were hoping to take shelter on the campus of the University of Central Florida (UCF), you’re too late. From now until December 2, 2012, the campus will be crawling with zombies who have taken to the stage in a production called “Zombie Town: A Documentary Play.”

We’ve heard it’s not bad. Click here to read a review of the performance.

No Twinkies = No Hope.

By now you’ve heard Hostess, the maker of Twinkies, may be on its way to a complete shutdown. As you know, these delicious treats are the only food that can survive a zombie outbreak. If Hostess closes its doors, we are doomed for sure. Thank goodness Hostess and its striking union members are renegotiating. If Hostess does shut down, it’s rumored a Boca Raton, Florida, company will purchase the brand. We can only hope.

To read the latest on the Hostess debacle, click here.

Given the increasing number of zombie attacks in Florida, the price of Twinkies could soar into the hundreds of dollars each in Florida. Doomsday enthusiasts and disenchanted stock market investors are allegedly pouring funds into warehouse loads of Twinkies.

Is the Ban on Synthetic Drugs in Florida Working?

If you remember, Florida Governor Rick Scott signed House Bill 1175 on March 23, 2012. This bill outlawed more than 90 new forms of synthetic drugs. It modified Section 893.03(1)(c), Florida Statutes, by expanding the list of banned hallucinogenic substances in Schedule I of the Florida Comprehensive Abuse Prevention and Control Act. To view Florida HB 1175, click here. To read more on the ban, click here.

HB 1175 was in response to the first known zombie attack in Miami. This cannibalistic attack was allegedly because the one man was high on bath salts. It was rumored that one prominent Florida lawmaker stated that banning bath salts, smiles and other synthetic drugs should help to reduce the reported acts of cannibalism and zombie-like behavior in Florida.

And he was wrong, the walking dead are alive, sort of, and well in Florida.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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

Comments?

What do you think about all the zombies around town? What are you doing to survive? Are you stocking up on Twinkies now? Tell us, do you think we should rename Florida the Zombie state? Vote in a poll on our Facebook page.

Sources:

Armstrong, Cassie. “Zombies Invade Clermont in 5K Challenge.” Florida 360. (November 17, 2012). From: http://www.orlandosentinel.com/multimedia/os-fla360-zombies-invade-clermont-in-5k-challenge,0,110644.story

Palm, Matthew. “Theater review: ‘Zombie Town: A Documentary Play’ from Theatre UCF.” Orlando Sentinel. (November 18, 2012). From: http://www.orlandosentinel.com/community/ucf/os-zombie-town-review-ucf-20121116,0,4007008.story

Hsu, Tiffany. “Hostess, Union to Give Talks Another Chance.” Orlando Sentinel. (Novemeber 2012). From: http://www.orlandosentinel.com/la-fi-mo-twinkies-hostess-union-mediation-20121119,0,4220893.story

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.

Tightened Restrictions Placed on Pain Management Clinics in Seminole County

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

Seminole County, Florida, is the latest county to adopt tightened regulations for pain management clinics. On November 13, 2012, County Commissioners unanimously voted to adopt the ordinance enacting Chapter 186 of the Seminole County Code to establish regulations regarding pain management clinics.

Click here to read the entire Seminole County Ordinance.

County Commissioners hope these new regulations will aid law enforcement in fighting illegal pill mill operations in Florida.

Officials Believe Restrictions Will Help Prevent Overprescribing.

The ordinance requires clinics to get a license, produce monthly reports on how many prescriptions are issued for controlled substances and report patient information, such as a patient’s address. This only applies to practices where doctors issue prescriptions for painkillers such as oxycodone to more than 20 patients a day. It does not pertain to hospitals and other major medical facilities.

Anyone violating the regulations can be charged with a misdemeanor and lose his or her business license.

Restrictions Have Doctors Upset.

The Orlando Sentinel interviewed a Boca Raton doctor who specializes in pain management. The doctor reportedly believes the regulations are helping to curb drug overdoses, but stated the regulations also limit legitimate board-certified medical specialists. He believes many Florida doctors are ready to move out of the Sunshine State and go to another state with fewer regulations.

To read the Orlando Sentinel article, click here.

Other Cities and Counties in Central Florida That Have Voted to Regulate Pain Management Clinics.

At the end of October 2012, Osceola County Commissioners voted to adopt a similar ordinance. I wrote previously wrote about that story, click here to read that blog.

In addition to Osceola County, Winter Park, Sanford, Oviedo and Maitland have opted to enact ordinances that regulate pain management clinics’ location and operation.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

 The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, pain management doctors, dentists, pharmacists, psychologists 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.

Comments?

As a healthcare professional, what do you think of this ordinance? Have you thought about leaving Florida due to the new regulations? Please leave any thoughtful comments below.

Sources:

Comas, Martin. “Seminole Tightens Regulations for Pain Management Clinics.” Orlando Sentinel. (November 13, 2012). From: http://www.orlandosentinel.com/news/local/seminole/os-pain-management-clinics-seminole-20121112,0,7626282.story

Seminole County Government. “Ordinance Chapter 186.” Seminole County Government. (November 13, 2012). From: http://www.thehealthlawfirm.com/uploads/Pain%20Management%20Ordinance.pdf

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.

Signing False Medicare Claims Lands Nurse Behind Bars for 30 Months

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

A Detroit-area registered nurse was sentenced on November 19, 2012, to 30 months in federal prison for his alleged part in a nearly $13.8 million Medicare fraud scheme. According to a Department of Justice (DOJ) press release, he will serve probation after being released from prison. He was also ordered to pay more than $450,000 in restitution, together with his co-defendants.

Click here to read the entire press release from the DOJ.

Nurse Signed Medical Records for Services Never Rendered.

According to the nurse’s plea agreement, from December 2008 through September 2011, he was paid to sign medical records for a home health care agency that billed Medicare for services that were allegedly never rendered. The man reportedly admitted to not seeing or treating the Medicare beneficiaries for whom he signed medical documentation. He also admitted to knowing that the documents he signed were being used for false claims. According to an article from Health Exec News, the man was paid around $150 for each fake file that he signed.

To read the article from Health Exec News, click here.

A Handful of Alleged Co-Conspirators Waiting to Be Sentenced.

Nine alleged co-defendants in this case have pleaded guilty and are waiting to be sentenced, while three others are fugitives and six more are awaiting trial, according to the DOJ. In total, the home health agency was paid close to $13.8 million by Medicare.

This case was investigated by the Federal Bureau of Investigation (FBI) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG) as part of the Medicare Fraud Strike Force.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, Department of Justice (DOJ) investigations,  in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

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

Comments?

Do you think the registered nurse received a sentence that was too harsh? Please leave any thoughtful comments below.

Sources:

Health Exec News. “Medicare Fraud Scheme: Nurse Gets Jail Time for Signing False Claims.” Health Exec News. (November 23, 2012). From: http://healthexecnews.com/nurse-medicare-fraud-scheme

Department of Justice. “Detroit-Area Nurse Sentenced to 30 Months in Prison for Role in $13.8 Million Home Health Care Fraud Scheme.” Department of Justice. (November 19, 2012). From: ttp://www.justice.gov/opa/pr/2012/November/12-crm-1389.html

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.

$24 Million Medicaid Fraud Scheme Alleged by Connecticut Attorney General

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

Connecticut’s Attorney General, George Jepsen, alleges that 28 individuals, dental practices and corporations were involved in a $24 million Medicaid fraud scheme. He filed a civil action  on May 31, 2012. It is the first case the state has initiated under the Connecticut False Claims Act. The Connecticut False Claims Act gives the state the ability to seek compensation for taxpayers from those who submit false claims for reimbursements they are not eligible to receive. To view the Connecticut False Claims Act, click here.

The complaint seeks restitution, treble damages and civil penalties as well as a permanent injunction against the unlawful acts and practices alleged in the complaint. To view the complaint, click here.

Accused Individual Allegedly Found Ways to Bill Medicaid for Services, Despite Being Excluded from Medicare and Medicaid Programs.

According to the complaint, one of the individuals involved in the alleged fraud scheme was previously convicted of a felony in another state for submitting false health care claims. He was then permanently excluded by the U.S. Department of Health and Human Services (DHHS) from participation in Medicare and Medicaid, as a result of his conviction. Any entity with which he serves as an employee, administrator, operator or in any other capacity, were also excluded from state healthcare programs.

The state alleges that, despite the exclusion, he established a number of dental practices in Connecticut that were operated by practicing dentists who billed Medicaid for services.

Allegedly, the excluded individual was actively involved in managing the practices and received millions of dollars in Medicaid reimbursements. The dental providers allegedly knew of the exclusion and did not disclose it on enrollment and re-enrollment forms for the Connecticut Medical Assistance Program.

Florida Has Similar False Claims Act.

Florida has a Medicaid False Claims Act similar to the one that Connecticut has. Florida’s Medicaid False Claims Act can be found here. However, in Florida, a separate provision of the state’s Medicaid law provides an award to a whistle-blower of up to 25% of any recovery. This is in Section 409.9203, Florida Statutes. In addition, Florida has a law that allows civil recovery for criminal acts such as Medicaid fraud, which is sometimes used by the Florida Attorney General and private individuals to recover money lost as a result of certain criminal conduct. For the Florida Civil Remedies for Criminal Actions law, click here.

As a general rule state false claims acts are modeled after the federal False Claims Act used to pursue Medicare fraud. For the federal Medicare Fraud False Claims Act, 31 U.S.C. § 3729, click here.

Contact Health Law Attorneys Experienced in Handling Medicaid and Medicare Fraud Cases.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses, medical groups, clinics, pharmacies, durable medical equipment (DME) suppliers, home health agencies, nursing homes and other healthcare providers in Medicaid and Medicare investigations, audits, hearings and recovery actions. In addition The Health Law Firm represents health providers in Medicare exclusion actions and in being reinstated to the Medicare Program or being removed from the exclusion list.

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

Sources:

Rees, Nick. “Jepsen alleges $24M Medicaid fraud.” Legal Newsline. (June 4, 2012). From: http://www.legalnewsline.com/news/contentview.asp?c=236342

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.

22 New Synthetic Drugs Outlawed in Florida: Citizens Keep an Eye Out for Zombies

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

On December 11, 2012, Attorney General (AG) Pam Bondi filed an emergency rule outlawing 22 new synthetic drugs, commonly known as “bath salts,” “K2,” and “Spice.” This emergency rule modifies Section 893.03(1)(c), Florida Statutes, by expanding the list of synthetic drugs in Schedule I of controlled substances of the Florida Comprehensive Abuse Prevention and Control Act.

Click here to view a copy of the emergency rule.

I previously wrote a blog on House Bill 1175 in July 2012, which originally outlawed 90 forms of synthetic drugs. Click here to read that blog.

Authorities Having a Hard Time Staying on Top of These Drugs.

The new law puts restrictions on those who manufacture, sell or deliver synthetic substances including certain synthetic cannabinoids and synthetic stimulants. Many of the synthetic substances are also commonly known as synthetic marijuana, bath salts, K2, potpourri, and incense. According to an article in the Orlando Sentinel many of these drugs look like snacks for children. One of these drugs is even marketed as a “Scooby Snack,” another looks like cotton candy. To read the entire article from the Orlando Sentinel, click here.

Florida’s officials are continuously updating the list of outlawed synthetic substances because the chemical compounds in these substances are easy to change. The ease of converting these substances into illegal drugs helps drug makers, users and sellers avoid arrest and prosecution.

Click here to see the entire list of outlawed controlled substances.

Anyone with These Drugs Asked to Voluntarily Surrender Supply.

The emergency rule by the AG makes it a third-degree felony for an individual to sell, manufacture or deliver these synthetic drugs.

These drugs are widely available in smoke shops, truck stops, convenience stores and on the internet. In a press release the AG and local law enforcement reached out to people handling these drugs, asking them to voluntarily surrender the substances or face action from law enforcement.

To read the entire press release from the AG, click here.

AG Wants a Zombie-Free Holiday.

This emergency rule is evidence of Floridians’ fear of zombies and cannibal attacks allegedly linked to the misuse of the outlawed substances. Florida has been linked to both in the national news, thus scaring away many of our tourists who usually flood the state. For an update on the zombie apocalypse in Florida, click here. Of course, there are those detractor who contend that face-chewing and other alleged zombie behavior is just natural behavior for Floridians, regardless of the chemicals imbibed.

Since Florida seems to be the only state infected with these flesh-eaters, we are taking a poll. Should Florida be renamed “the Zombie State?” Let us hear from you.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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

Comments?

What do you think of this new list of outlawed synthetic drugs? Do you think sellers will voluntarily surrender their products? Will this new list keep the zombies away? Tell us, do you think we should rename Florida the Zombie state? Click here to vote in a poll on our Facebook page.

Sources:

Meale, Jenn. “Attorney General Pam Bondi Outlaws Additional Synthetic Drugs.” Office of the Attorney General. (December 11, 2012). From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/C2FED4E8849E737685257AD1006EED54

Haughney, K. “Bondi Files Emergency Rule to Outlaw Additional Synthetic Drugs.” Orlando Sentinel. (December 11, 2012). From: http://blogs.orlandosentinel.com/news_politics/2012/12/bondi-files-emergency-rule-to-outlaw-additional-synthetic-drugs.html

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.

Doctors and Nurse Practitioner Arrested in Prescription Drug Abuse Raid

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

A crackdown on prescription drug abuse by New York law enforcement has resulted in the arrests of 98 people. Two doctors and a nurse practitioner were among those charged.

A series of raids were carried out by Brooklyn federal prosecutors, the Drug Enforcement Administration (DEA), district attorney’s offices, and local law enforcement agencies. The raids began June 5, 2012 and resulted in the arrests.

To view the DEA’s press release concerning the raid, click here.

Both Doctors Accused of Overprescribing.

One of the doctors is accused of conspiring to distribute oxycodone to patients that were not legitimate. Allegedly, the doctor surrendered his DEA registration. This terminated his authority to prescribe controlled substances such as oxycodone. However, he allegedly attempted to use other health care practitioners to continue to prescribe drugs, which the government contends is illegal.

Another doctor involved in the crackdown is charged with illegal distribution of oxycodone. During the execution of a federal search warrant at his offices on March 1, 2012, the doctor voluntarily surrendered his DEA registration. However, he allegedly continued to issue prescriptions to those whom he knew were not legitimate patients.

We continually warn against “voluntarily relinquishing” DEA registrations or medical licenses with any investigation pending as this is treated the same as a revocation in most cases. For an article we have written on this, click here.

Florida Has Experienced Similar Prescription Drug Abuse Crackdowns.

Starting around two years ago, Florida health providers involved in narcotics precribing became routine targets for law enforcement. This was part of a concerted effort by state and federal officials to crackdown on “pill mill” operations. Regulations increased. Lawmakers enacted severe penalties for doctors and other health professionals accused of over-prescribing. Most physicians were banned from dispensing drugs in their offices. The governor created a Florida drug “strike force” with a mission to eliminate any pain clinics that were found to be breaking the law. The Florida Surgeon General and the Board of Medicine made announcements about the “crackdown” on “over-prescribing.”

Since the implementation of the new pain management and prescribing laws, the Florida strike force has made thousands of arrests and seized millions of pills of narcotics. This has resulted in serious concerns by those in the pain management profession.

Law Enforcement will Continue to Pursue Physicians, Pharmacists, Nurses and Other Health Providers.

The recent raid in New York and ongoing actions in Florida demonstrate that law enforcement will continue to pursue health professionals who prescribe large amounts of narcotics.

Contact Health Law Attorneys Experienced with Overprescribing Charges and DEA Cases.

The Health Law Firm represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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

Sources Include:

Allen, Jonathon. “Doctors Arrested in New York Prescription Drug Crackdown.” Reuters. (June 7, 2012). From http://in.reuters.com/article/2012/06/06/usa-crime-painkillers-idINL1E8H6E3J20120606

CBS News. “98 Arrested in NY Prescription Drug Sweep.” CBS News. (June 6, 2012). From http://www.cbsnews.com/8301-201_162-57448268/dozens-arrested-in-ny-prescription-drug-bust/

McKenzie-Mulvey, Erin. “U.S. Attorney Lynch, District Attorneys, DEA, Other Law Enforcement Announce Prescription Drug Initiative.” Drug Enforcement Administration. (June 7, 2012). Press Release. From: http://www.justice.gov/dea/pubs/states/newsrel/2012/nyc060712a.html

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.

Nurse Accused of Illegally Writing Herself Prescriptions for Painkillers

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

A Central Florida nurse is in trouble with the law for allegedly writing fake prescriptions and illegally obtaining painkillers for herself, according to the Orlando NBC affiliate, WESH television. The nurse was allegedly arrested during the week of December 31, 2012. She is accused of trafficking in oxycodone and trying to fill forged prescriptions.

Click here to read the WESH article.

Pharmacist Did Not Fall for Fake Prescriptions.

According to an Orlando Sentinel article, a pharmacist, who was suspicious of one of the prescriptions the nurse tried to fill, called the doctor listed on the prescription. The doctor informed the pharmacist that she (the doctor) was the nurse’s employer, and the nurse was not a patient. It was then discovered that the nurse used the names of two doctors at her place of employment. She had stolen the prescriptions to obtain painkillers for herself.

A search of Florida’s Prescription Drug Monitoring Database allegedly showed that the nurse had obtained dozens of prescriptions for controlled substances for herself in the past year.

To read the article from the Orlando Sentinel, click here.

Nurse’s License is Currently Suspended.

According to the Department of Health (DOH) the nurse’s license is currently suspended. A complaint on the nurse’s record also shows that in December 2009, the nurse admitted to stealing pain medication from her patients. Click here to read the entire complaint from the DOH.

Useful Tips on How to Prevent Employees from Stealing.

I recently wrote an article for Medical Economics on how to prevent or detect employee embezzlement in the medical or dental office. It contains valuable information for any small health care practice owner. Topics discussed in the article include: how to recognize embezzlement warning signs, steps to take to safeguard your assets, and the proper way to take action against a suspected embezzler. To read it in its entirety, click here.

I have also written a number of blogs on abuses with narcotics. See my blog on a fake prescription ring busted in Osceola County, and a Drug Enforcement Administration (DEA) arrest of a doctor allegedly on crack cocaine charges, for example.

 

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, Department of Justice (DOJ) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

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 how do you keep tabs on your important office supplies? How would you handle an employee stealing from your office? Please leave any thoughtful comments below.

Sources:

Pavuk, Amy. “Nurse Charged with Stealing Scripts, Illegally Obtaining Painkillers.” Orlando Sentinel. (January 3, 2013). From: http://articles.orlandosentinel.com/2013-01-02/news/os-nurse-arrested-prescription-drugs-20130102_1_fake-prescriptions-prescription-sheets-cvs

WESH-TV. “Nurse Accused of Illegally Obtaining Painkillers.” WESH. (January 3, 2013). From: http://www.wesh.com/news/central-florida/seminole-county/Nurse-accused-of-illegally-obtaining-painkillers/-/17597106/17995906/-/dmj2se/-/index.html?absolute=true

Department of Health v. Tabetha Terry, R.N. Case Number 2010-13467. Administrative Complaint. (February 22, 2011). From: http://www.thehealthlawfirm.com/uploads/tabetha%20terry%20complaint.pdf

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.

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