nursing homes | The Health Law Firm Blog

Occupational Therapists, Podiatrists, Psychologists and Optometrists Being Scrutinized in Medicare Audits

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

Our firm has recently seen an increase in the number of occupational therapists (OTs), speech therapists (STs), podiatrists, psychologists, optometrists and other licensed health professionals being scrutinized in Medicare audits and recovery actions. Often these result from claims submitted for evaluation or treatment entered in nursing homes or assisted living facilities (ALFs).

You Must Provide Complete and Detailed Documentation of Care Rendered.

In many cases, the provider may not have complete documentation of the care rendered because it has been placed in the patient’s record at the facility. Unfortunately, Medicare does not see this as an excuse […]

By The Health Law Firm|2024-03-14T10:00:45-04:00June 1, 2018|Assisted Living Facilities, Health Care Industry, Home health care facility, Medicare Audit, Medicare Fraud, The Health Law Firm Blog|

Jury Convicts Doctor and Medical Billing Company Owner for $28 Million Medicare Fraud Scheme

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

On May 1, 2017, a federal jury in Michigan found a Detroit-area doctor and owner of a medical billing company guilty of perpetrating a $28 million health care fraud scheme. The scheme involved billing Medicare for pain treatments that weren’t actually provided, the U.S. Department of Justice (DOJ) said.

Health Care Fraud Scheme.

Dr. Johnny Trotter and Elaine Lovett were both convicted after a four-week jury trial on one count of conspiracy to commit health care and wire fraud and three counts of health care fraud. In addition to the fraud scheme, both Trotter and Lovett also […]

By The Health Law Firm|2024-03-14T10:01:25-04:00May 15, 2018|Health Facilities Law Blog|

Health Care Fraud Puts Miami Man in Jail

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

4.5 Year Sentence for Role in Fraud.

A Miami Man voluntarily returned to Miami from Cuba and was immediately met with a 4.5-year long prison sentence. Jose Gerardo Gonzalez, played a role in a scheme to defraud public schools and private health care insurers of $126 million.

Gonzalez allegedly created shell companies that submitted false health care claims. The private insurers were ultimately at lose for millions of dollars. Gonzalez fled to Cuba in 2015 after being charged with conspiracy and other charges. Upon voluntary return to Florida he is sentencing was reduced.
William Barzee, Gonzalez’s attorney, states […]

By The Health Law Firm|2024-03-14T10:01:26-04:00May 15, 2018|Mental Health Law Blog|

Health Care Fraud Puts Miami Man in Jail

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

4.5 Year Sentence for Role in Fraud.

A Miami Man voluntarily returned to Miami from Cuba and was immediately met with a 4.5-year long prison sentence. Jose Gerardo Gonzalez, played a role in a scheme to defraud public schools and private health care insurers of $126 million.

Gonzalez allegedly created shell companies that submitted false health care claims. The private insurers were ultimately at lose for millions of dollars. Gonzalez fled to Cuba in 2015 after being charged with conspiracy and other charges. Upon voluntary return to Florida he is sentencing was reduced.
William Barzee, Gonzalez’s attorney, […]

By The Health Law Firm|2024-03-14T10:01:35-04:00May 15, 2018|Nursing Law Blog|

Florida’s Medicaid Program Receives Settlement Payment from Pharmaceutical Company

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

The Florida Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU), 46 other states and the federal government reached a $48 million agreement with pharmaceutical company Healthpoint Ltd., on February 25, 2013. According to the Florida AG, the settlement is in response to allegations of misrepresenting the regulatory status of an ointment used to treat skin conditions and submitting false Medicaid claims. Florida’s Medicaid program will receive almost $900,000 of the settlement.

Click here to see the press release from the AG’s office.

Pharmaceutical Company Allegedly Submitted False Claims to Medicaid.

According to the Department of Justice […]

By The Health Law Firm|2024-03-14T10:01:39-04:00May 15, 2018|Legal Defense for Pharmacists, Pharmacist, Pharmacy, Pharmacy Law, Whistleblower|

Medicare Fraud Lands More Than 30 Suspects Behind Bars in South Florida

By Dr. Thu Pham, O.D., Law Clerk

On October 4, 2012, federal authorities arrested 33 suspects in South Florida for allegedly filing fraudulent Medicare claims totaling $205 million. Payment of bribes and kickbacks, as well as payments to patient recruiters were an issue in this investigation.

To read the entire article from the Miami Herald, click here.

Feds Focus on Crackdown of Medicare Fraud Nationwide.

These arrests are part of a nationwide initiative to crack down on theft committed by individuals against Medicare. Peter Budetti, the Medicare anti-fraud czar states that the goal is to catch the fraud before the fraudsters “can successfully bill Medicare.” Previously, fraud was caught only after the funds were disbursed and spent.

[…]

By The Health Law Firm|2024-03-14T10:01:49-04:00May 15, 2018|Clinical Social Worker, Intern, Marital and Family Therapist, Medicare Audit, Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law, Psychology|

New Database Allows Consumers to Evaluate Nursing Homes Across the Country

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

Consumers have a new online tool to see which nursing homes are being hit with fines for poor quality, safety or maintenance. Nursing Home Inspect 2.0 is a free database that assists users in evaluating nursing homes across the country. The database was first introduced by ProPublica, a nonprofit investigative news organization, in August 2012. On December 17, 2012, the same organization introduced the 2.0 version that includes information about federal fines imposed on nursing homes in the past three years.

The website can be found at Propublica.org/nursinghomes.

According to the website, the information provided […]

By The Health Law Firm|2024-03-14T10:01:56-04:00May 15, 2018|ALFs, Discipline, Nursing Law Blog|