The Do’s and Don’ts If You Are Under Investigation For Discipline on Your Professional License, Part 2

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

You are reading Part 2 of this blog series. To read Part 1, click here.

If you are notified that you are under investigation, DO NOT take the easy way out by immediately relinquishing your license. And DO NOT hide your head in the sand by thinking the case will just go away on its own. DO NOT think that you can just talk to the investigator, explain your side, and the case will go away. Also, DO NOT request an informal hearing or agree to a settlement agreement (consent order) in which you admit the facts alleged against you are all true.  If you do this you are, in effect, “pleading guilty.” If you are innocent of the charges, request a formal hearing and contest the charges; defend yourself.

DO immediately seek the advice of an attorney who has experience in such professional licensing matters and administrative hearings.  These attorneys are out there, but you may have to search for one.  Do this before you talk to or make any statement (oral or written) to an investigator.

DO purchase professional liability insurance that includes legal defense coverage for any professional license investigation against you, whether it is related to a malpractice claim or not.  This insurance is cheap and will provide you with needed legal assistance at the time when you may be out of a job and not have money to hire an attorney.  However, beware of the insurance policy that only covers professional license defense related to a malpractice claim.

DO NOT count on your employer to provide this type of insurance for you. In fact, most of such complaints against your license may well be filed by your employer or ex-employer.

If you are a traveling nurse or other contract or temporary type of health professional, always purchase your own insurance.

Our Advice On Professional Liability Insurance.

We strongly encourage nurses, mental health counselors, and all licensed health professionals and facilities to purchase independent insurance coverage.  Make sure it covers professional license complaint defense expenses under all circumstances.

Also, make sure you have enough coverage to actually get you through a hearing. For example, $25,000 coverage for just professional licensure defense is the absolute minimum you should purchase;   $50,000 may be adequate, but $75,000 or $100,000 may be what you need in such a situation.  You can usually buy the higher limits for a few dollars more (and I do mean only a few). If necessary, such insurance is usually cheap enough that you can actually purchase two or more different policies.

Also, I will repeat, make sure it covers your legal defense in an administrative disciplinary proceeding against your license, even if there is no malpractice claim filed against you or likely to be filed against you. We also recommend that you purchase coverage through an insurance company that allows you to select your own attorney and does not make you use one that the insurance company picks for you.

Companies we have dealt with in the past which provide an inexpensive quality insurance product for professional license defense costs include CPH & Associates Insurance, Nurses Service Organization (NSO) insurance, Healthcare Providers Organization (HPSO) Insurance, and Lloyd’s of London Insurance.

To learn more, visit our Video Q&A section on our website and watch our video titled, “Should I voluntarily relinquish my professional license because I am being investigated?” and visit our YouTube page.

Click here to read one of our prior blogs for even more information on how to fight back against adverse NPBD reports.

Don’t forget to read part one of this blog series here!

Contact Health Law Attorneys Experienced with Investigations of Healthcare Professionals.

The attorneys of The Health Law Firm provide legal representation to medical professionals in Department of Health (DOH) investigations, licensing matters and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free at (888) 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. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 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 © 2022 The Health Law Firm. All rights reserved.

FDA Releases Draft Guidance to Revamp Drug Indication and Usage Labels

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

On July 6, 2018, the U.S. Food and Drug Administration (FDA) released draft guidance outlining its recommendations for how drug companies should word the indications and usage sections on a drug’s label. The new guidance aims to increase readability and reduce redundant information on indications and usage.

Drug Indication Label.

Prescribers can expect to see revamped drug labels with clearer descriptions of the conditions and patient populations for which an FDA-approved drug is indicated. Also, described in the guidance are circumstances when it might be appropriate for an indication to be either broader or narrower than the parameters of the clinical studies that backed its approval.

In addition to suggesting what information labels should include, the draft guidance also indicates what should be omitted to avoid unnecessary clutter the label.

The FDA hopes this guidance will give health care providers more precise information on which conditions a drug is approved to treat and, therefore, help identify the correct treatment options for patients. To read the FDA’s draft guidance in full, click here.

Contact Health Law Attorneys Experienced in the Representation 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.

Sources:

Gever, John. “Drug Labels to Get FDA Revamp.” MedPage Today. (July 6, 2018). Web.

Field, Emily. “FDA Releases Draft Guidance On Drug Indication Labeling.” Law360. (July 6, 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: Food and Drug Administration (FDA) defense attorney, representation for FDA matters, legal representation for health care professionals, representation for prescribers, pharmacy representation, legal representation for pharmacies, pharmacy defense lawyer, pharmacist representation, legal representation for pharmacists, pharmacist defense attorney, health care compliance lawyer, health law defense attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“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.

Drug Enforcement Administration Agents Raid Central Florida Pain Management Clinic

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

Drug Enforcement Administration (DEA) agents along with local police and sheriffs’ deputies raided a Longwood, Florida, pain management clinic on June 14, 2013. According to the Orlando Sentinel, agents searched for evidence at the clinic associated with multiple doctors. DEA agents stated the clinic was operating as a “pill mill” and allegedly diverting legal prescriptions for illegal purposes. No one was arrested during the raid. Longwood is a suburb of Orlando.

Investigation Spreads to South Florida.

According to WESH-TV, during the raid agents took everything from the clinic that could help them build a criminal prosecution. This included paper records, computer equipment and prescription drugs. DEA agents would not say how many people they were investigating, but they did say this raid was the result of a two-year long investigation.

In addition to the Longwood pain clinic, DEA agents said they are also searching locations in Brevard County, Florida, where associates of the Longwood clinic allegedly live.

To watch the WESH-TV report, click here.
Two Doctors Associated With the Longwood Clinic Allegedly “Blacklisted” by Pharmacy.

According to the Orlando Sentinel, two doctors associated with the Longwood clinic were allegedly “blacklisted” in 2011, by CVS Pharmacy. This means that CVS notified those physicians that the pharmacy chain would no longer fill prescriptions they wrote for certain drugs such as oxycodone, due to suspiciously high prescribing rates. To read a previous blog on the CVS blacklist, click here.

Click here to read the entire Orlando Sentinel article.

The Longwood pain clinic is currently closed. Whether this will be temporary or permanent is unknown at this time.

Different Clinic, Similar Storyline.

This raid on the Longwood clinic is just one of the many we’ve recently seen in Florida. DEA agents and local law enforcement officials are not slowing down in their fight against illegal pill mills, and illegal prescribing and dispensing practices. To read a blog on two Orlando-area pharmacists recently arrested on charges of alleged drug trafficking, click here. Even the biggest pharmacy chains are not immune to investigations. Walgreens just agreed to pay $80 million to settle a DEA investigation into the chain’s dispensing practices of prescription drugs. To read more, click here.

Contact Health Law Attorneys Experienced with DEA Cases and Licensing Actions.

The Health Law Firm represents physicians, 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.
If you are aware of an investigation of you or your practice, or if you have been contacted by the DEA or DOH, contact an experienced health law attorney immediately.

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 of these raids on pharmacies and pain clinics? Please leave any thoughtful comments below.

Sources:

McDaniel, Dave. “Agents Raid Longwood Pain Clinic.” WESH-TV. (June 14, 2013). From: http://www.wesh.com/news/central-florida/seminole-county/agents-raid-longwood-pain-clinic/-/17597106/20572512/-/item/0/-/afpnwwz/-/index.html

Pavuk, Amy. “Agents Raid Longwood Pain Clinic.” Orlando Sentinel. (June 14, 2013). From: http://www.orlandosentinel.com/news/local/breakingnews/os-professional-pain-care-raid-20130614,0,3826330.story#tugs_story_display
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.

New Details Released on Drug Enforcement Administration’s Investigation of Central Florida Pain Management Clinic

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

The Drug Enforcement Administration’s (DEA) investigation into a Longwood, Florida, pain management clinic continues. More details are being revealed about the case. DEA agents along with local police and sheriffs’ deputies raided the pain management clinic on June 14, 2013. Agents believe the evidence they have gathered suggests the clinic was operating as a “pill mill,” according to the Orlando Sentinel. Officials allegedly seized evidence at the clinic associated with at least ten (10) doctors and other clinic employees. No one has been arrested yet, but documents filed in federal court in Orlando suggest charges could be coming.

I previously blogged about this raid. Click here to read that blog.

Details of the Investigation.

According to the Orlando Sentinel, the DEA began surveying the alleged pill mill in January 2011, while investigating a doctor shopper. From July 2011 through May 2013, agents monitored the clinic. During the investigation, agents observed long lines outside the clinic, out-of-state license plates and groups of “patients” arriving at the clinic together. All of this behavior, according to authorities, is associated with pain clinics.

More concrete evidence against the pain management clinic, according to police officials, includes:

–  Patients stating that employees discussed selling pain pills and fake MRIs;

–  DEA agents observing drug deals made by patients coming from the clinic, in the vicinity of the clinic;

–  Used needles were found in nearby parking lots; and

–  Two of the clinic’s patients allegedly died from overdoses during the investigation.

Pain Management Clinic Physicians Made Millions.

It’s reported that the pain management clinic hired ten (10) doctors to write illegal prescriptions and employed others to falsify documents. For their willingness to participate in the illegal activity, the physicians allegedly made millions of dollars.

According to the Orlando Sentinel, the bank accounts of the clinic managers were analyzed as part of the investigation. From 2011 to 2013, more than $5.5 million in cash was deposited into the bank accounts of the clinic managers and physicians.

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

Keep in mind, at this point, these are just allegations made against the clinic and its employees and nothing has been proven by the state or federal government.

Be Mindful of the Prescription Drug Monitoring Database.

DEA agents used Florida’s prescription drug monitoring database to find out what types of pills and how many pills physicians at the Longwood pain clinic were prescribing. The prescription database was not intended to be used for criminal prosecution or law enforcement purposes. Yet it is routinely being used to prosecute physicians, pharmacists and pharmacies among others.

If You are a Health Care Professional Involved with Pain Management, Keep These Tips Handy.

The raid on the Longwood clinic is just one of the many we’ve recently seen in Florida. DEA agents and local law enforcement officials are not slowing down in their fight against illegal pill mills, and illegal prescribing and dispensing practices. I have represented a number of physicians who have been accused of “overprescribing.”  Some of these were criminal investigations by local law enforcement authorities, such as a county sheriff’s office. Some were investigations by the DEA. Some were investigations by the state licensing agency, such as the Florida Department of Health (DOH).

It is important physicians know how to protect themselves and their licenses from drug-seeking patients.  Click here to read tips I give to physicians I advise on this issue.

Contact Health Law Attorneys Experienced with DEA Cases and Licensing Actions.

The Health Law Firm represents physicians, 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.
If you are aware of an investigation of you or your practice, or if you have been contacted by the DEA or DOH, contact an experienced health law attorney immediately.

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 of these raids on pharmacies and pain clinics? Please leave any thoughtful comments below.

Sources:

Pavuk, Amy. “Rx for Danger: Pain Clinic Owners Made Millions, Hired 10 Doctors to Write Illegal Scripts, Feds Say.” Orlando Sentinel. (June 24, 2013). From: http://www.orlandosentinel.com/health/os-professional-pain-care-longwood-20130624,0,1172890.story

Indest, George. “Drug Enforcement Administration Agents Raid Central Florida Pain Management Clinic.” The Health Law Fir. (June 17, 2013). From: http://thehealthlawfirmblog.wordpress.com/2013/06/17/drug-enforcement-administration-agents-raid-central-florida-pain-management-clinic/

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.

Former Pharmaceutical Sales Rep to Serve 70 Months in Prison for Part in $13M Oxycodone Scheme

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On March 24, 2017, a federal judge in the U.S. Southern District of Florida in Miami sentenced a former pharmaceutical salesman to nearly six years in prison for his part in a $13 million money laundering scheme. The scheme involved more than two million oxycodone pills, which the salesperson allegedly helped supply to pain clinics by falsely telling pharmaceutical wholesalers that the clinics weren’t “pill mills.”

U.S. District Judge Beth Bloom, sentenced Jonathan Sendor to 70 months in prison after he pled guilty in January 2017 to one count of conspiracy to commit money laundering. Sendor was essentially working as a broker between wholesale pharmaceutical suppliers and pain clinics attempting to procure a supply of oxycodone for patients of pill mills.
The Scheme.

According to prosecutors, Sendor and two co-conspirators operated six pain clinics in Florida between March 2010 and June 2011. The co-conspirators operated the clinics to ensure that the maximum amount of oxycodone would be prescribed without a legitimate medical need, and purely for the sake of profit. The six clinics dispensed and distributed more than two million oxycodone pills before they were caught and shut down in 2011. The clinics made roughly $13.5 million from the unlawful prescriptions, according to the U.S. Department of Justice.

Sendor helped the pain clinics receive a steady supply of the drug through the wholesalers, prosecutors alleged. For his part in the scheme, Sendor allegedly created multiple companies, building on the connections he had formed as a pharmaceutical salesman. He then proceeded to act as a “quasi-broker” between the doctors of the pain clinics needing the oxycodone and the wholesalers distributing the drug.

Sendor was able to mislead wholesale pharmaceutical companies and told them that he would function as an inspector. It is alleged that he conducted fake inspection visits to the pain clinics and required the clinics’ doctors to complete a survey. When the surveys were completed, he misrepresented the results and advised the doctors, pain clinic managers, owners and other co-conspirators to lie on the survey form.

In 2010, Florida Attorney General Pam Bondi helped pass legislation banning doctors from dispensing narcotic medications out of their office. After the law changed, Sendor then assisted in the opening of two pharmacies – one in Boca Raton and another in Orlando, Florida. Patients of the six pain clinics were then directed to these pharmacies for oxycodone.

To read the DOJ’s press release in full, click here.

To learn more about the pill mill problem in Florida, click here to read one of my prior blogs.

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, dentists, pharmacists, psychologists, psychiatrists, mental health counselors, durable medical equipment suppliers (DME), medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, 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. 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.

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

Sources:

Lincoff, Nina. “South Florida pain clinics tied up in $13M money laundering conspiracy.” South Florida Business Journal. (January 17, 2017). Web.

Posses, Shayna. “Sales Rep To Serve 70 Months For $13M Oxycodone Scheme.” Law360. (March 24, 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 prescription drug abuse, Drug Enforcement Administration (DEA) cases, legal representation for DEA investigations, Prescription Drug Monitoring Program, legal representation for schemes to over-prescribe narcotics, legal representation for schemes to traffic narcotics, pill mill defense attorney, legal representation for doctor shopping, legal representation for pill mills, legal representation for pharmacists, legal representation for pharmacies pharmacy defense attorney, pharmacist defense attorney, administrative hearing attorney, DEA defense attorney, Department of Health investigations, legal representation for DOH investigations, DOH investigation defense attorney, prescription drug crackdown, Florida prescription drug abuse, prescription drug trafficking, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“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.

Kmart Agrees to Pay $32.3 million to Settle Whistle Blower’s False Claims Act Suit

PS 3 Indest-2009-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 22, 2017, Kmart Corporation agreed to pay $32.3 million to settle a whistle blower lawsuit alleging its pharmacies caused federal health programs to overpay for prescription drugs by not telling the government about discounted prices. The department store chain withheld certain information from Medicare Part D, Medicaid and Tricare, the Department of Justice (DOJ) said.

The Whistle Blower False Claims Act (FCA) Suit.

The new agreement resolves allegations arising from a 2008 lawsuit brought under the qui tam, or whistle blower, provisions of the False Claims Act (FCA). This provision permits private citizens with knowledge of fraud against the government to bring an action on behalf of the United States and to share in any recovery.

The 2008 lawsuit, which was filed by a former Kmart pharmacist, alleged that Kmart pharmacies offered discounted generic drug prices to cash paying customers through various club programs. The pharmacies then knowingly failed to disclose those prices when reporting to federal health programs. According to the suit, in one case, Kmart had sold a 30-day supply of a generic version of a prescription drug for $5 to customers of its discount program, but then filed for reimbursement from the government for $152 for that same drug for its Medicare customers.
To read more on the 2008 suit, click here.

The settlement agreement with the United States is a part of a global $59 million settlement that includes a resolution of state Medicaid and insurance claims against Kmart. The former pharmacist will receive a whistle blower award of $9.3 million. The case was heard in the U.S. District Court in the Southern District of Illinois.

To read the DOJ’s press release on this case in full, click here.

To read about a similar case of a pharmacy inflating prices to government health care programs, click here to read one of my prior blogs.

Who Knew Medicare Part D Claims Could Yield Such Big Whistle Blower Settlements?

Who knew Medicare part D claims could yield such big whistle blower settlements? I know I didn’t. I didn’t even think about such claims until I read this case. This could mean some serious compliance issues for big chain stores that have pharmacies (note that I said “could”). Walmart, Publix, Albertsons, Costco, Sam’s Club, Winn Dixie, Engel’s, and every other chain that owns and operates pharmacies, may be in jeopardy.

Contact an Experienced Health Law Attorney to Assist in Whistleblower/Qui Tam Cases.

If you have knowledge of false claims being filed against Medicare, Medicaid, TRICARE/CHAMPUS or any other type of government program, please contact us, and we will be happy to assist you. Our law firm represents health professionals and health care organizations almost exclusively. Yet, we have been involved in a number of whistleblower/qui tam cases, in which we represent the person who files the claim (the whistle blower). We have also defended health professionals and institutions in litigation of whistle blower complaints filed against them.

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

Sources:

McCausland, Phil. “Kmart to pay $32.3M to settle health care-related whistleblower case.” NBC News. (December 22, 2017). Web.

The Associated Press. “Kmart to pay $32.3 million to settle prescription drugs case.” ABC News. (December 22, 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: False Claims Act case, legal representation for whistle blower suits, legal representation of plaintiffs in whistle blower cases, legal representation of defendants in whistle blower cases, legal representation in complex health care litigation cases attorney lawyer, legal representation in federal and state courts attorney lawyer, whistle blower defense attorney, legal representation in qui tam lawsuits, qui tam defense attorney, pharmacy defense attorney, pharmacist defense attorney, pharmacy defense lawyer, pharmacist defense lawyer, pharmacy defense counsel, pharmacist defense counsel, Board of Pharmacy license defense attorney, Board of Pharmacy license defense lawyer, Board of Pharmacy license defense counsel, FCA defense attorney, legal representation for Medicare false claims, legal representation for false billing, Medicare fraud defense attorney, legal representation for Medicare fraud, legal representation for Medicare audit, complex health care litigation defense attorney, health care fraud defense attorney, complex health care litigation defense lawyer, legal representation for health care professionals, health law defense attorney, The Health Law Firm attorney reviews, reviews of The Health Law Firm, whistle blower plaintiff attorney, health care professionals defense counsel, health care professional defense lawyer, health care professional defense counsel, whistle blower defense attorney, whistle blower defense lawyer, legal representation for whistle blower suits, legal representation for qui tam suits, qui tam relator attorney, qui tam relator lawyer, qui tam relator legal counsel

 

“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.

 

2018-03-15T18:28:21-04:00May 15th, 2018|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Kmart Agrees to Pay $32.3 million to Settle Whistle Blower’s False Claims Act Suit

PS 3 Indest-2009-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 22, 2017, Kmart Corporation agreed to pay $32.3 million to settle a whistle blower lawsuit alleging its pharmacies caused federal health programs to overpay for prescription drugs by not telling the government about discounted prices. The department store chain withheld certain information from Medicare Part D, Medicaid and Tricare, the Department of Justice (DOJ) said.

The Whistle Blower False Claims Act (FCA) Suit.

The new agreement resolves allegations arising from a 2008 lawsuit brought under the qui tam, or whistle blower, provisions of the False Claims Act (FCA). This provision permits private citizens with knowledge of fraud against the government to bring an action on behalf of the United States and to share in any recovery.

The 2008 lawsuit, which was filed by a former Kmart pharmacist, alleged that Kmart pharmacies offered discounted generic drug prices to cash paying customers through various club programs. The pharmacies then knowingly failed to disclose those prices when reporting to federal health programs. According to the suit, in one case, Kmart had sold a 30-day supply of a generic version of a prescription drug for $5 to customers of its discount program, but then filed for reimbursement from the government for $152 for that same drug for its Medicare customers.
To read more on the 2008 suit, click here.

The settlement agreement with the United States is a part of a global $59 million settlement that includes a resolution of state Medicaid and insurance claims against Kmart. The former pharmacist will receive a whistle blower award of $9.3 million. The case was heard in the U.S. District Court in the Southern District of Illinois.

To read the DOJ’s press release on this case in full, click here.

To read about a similar case of a pharmacy inflating prices to government health care programs, click here to read one of my prior blogs.

Who Knew Medicare Part D Claims Could Yield Such Big Whistle Blower Settlements?

Who knew Medicare part D claims could yield such big whistle blower settlements? I know I didn’t. I didn’t even think about such claims until I read this case. This could mean some serious compliance issues for big chain stores that have pharmacies (note that I said “could”). Walmart, Publix, Albertsons, Costco, Sam’s Club, Winn Dixie, Engel’s, and every other chain that owns and operates pharmacies, may be in jeopardy.

Contact an Experienced Health Law Attorney to Assist in Whistleblower/Qui Tam Cases.

If you have knowledge of false claims being filed against Medicare, Medicaid, TRICARE/CHAMPUS or any other type of government program, please contact us, and we will be happy to assist you. Our law firm represents health professionals and health care organizations almost exclusively. Yet, we have been involved in a number of whistleblower/qui tam cases, in which we represent the person who files the claim (the whistle blower). We have also defended health professionals and institutions in litigation of whistle blower complaints filed against them.

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

Sources:

McCausland, Phil. “Kmart to pay $32.3M to settle health care-related whistleblower case.” NBC News. (December 22, 2017). Web.

The Associated Press. “Kmart to pay $32.3 million to settle prescription drugs case.” ABC News. (December 22, 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: False Claims Act case, legal representation for whistle blower suits, legal representation of plaintiffs in whistle blower cases, legal representation of defendants in whistle blower cases, legal representation in complex health care litigation cases attorney lawyer, legal representation in federal and state courts attorney lawyer, whistle blower defense attorney, legal representation in qui tam lawsuits, qui tam defense attorney, pharmacy defense attorney, pharmacist defense attorney, pharmacy defense lawyer, pharmacist defense lawyer, pharmacy defense counsel, pharmacist defense counsel, Board of Pharmacy license defense attorney, Board of Pharmacy license defense lawyer, Board of Pharmacy license defense counsel, FCA defense attorney, legal representation for Medicare false claims, legal representation for false billing, Medicare fraud defense attorney, legal representation for Medicare fraud, legal representation for Medicare audit, complex health care litigation defense attorney, health care fraud defense attorney, complex health care litigation defense lawyer, legal representation for health care professionals, health law defense attorney, The Health Law Firm attorney reviews, reviews of The Health Law Firm, whistle blower plaintiff attorney, health care professionals defense counsel, health care professional defense lawyer, health care professional defense counsel, whistle blower defense attorney, whistle blower defense lawyer, legal representation for whistle blower suits, legal representation for qui tam suits, qui tam relator attorney, qui tam relator lawyer, qui tam relator legal counsel

 

“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.

 

2018-01-30T07:21:11-05:00May 15th, 2018|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Kmart Agrees to Pay $32.3 million to Settle Whistle Blower’s False Claims Act Suit

PS 3 Indest-2009-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 22, 2017, Kmart Corporation agreed to pay $32.3 million to settle a whistle blower lawsuit alleging its pharmacies caused federal health programs to overpay for prescription drugs by not telling the government about discounted prices. The department store chain withheld certain information from Medicare Part D, Medicaid and Tricare, the Department of Justice (DOJ) said.

The Whistle Blower False Claims Act (FCA) Suit.

The new agreement resolves allegations arising from a 2008 lawsuit brought under the qui tam, or whistle blower, provisions of the False Claims Act (FCA). This provision permits private citizens with knowledge of fraud against the government to bring an action on behalf of the United States and to share in any recovery.

The 2008 lawsuit, which was filed by a former Kmart pharmacist, alleged that Kmart pharmacies offered discounted generic drug prices to cash paying customers through various club programs. The pharmacies then knowingly failed to disclose those prices when reporting to federal health programs. According to the suit, in one case, Kmart had sold a 30-day supply of a generic version of a prescription drug for $5 to customers of its discount program, but then filed for reimbursement from the government for $152 for that same drug for its Medicare customers.
To read more on the 2008 suit, click here.

The settlement agreement with the United States is a part of a global $59 million settlement that includes a resolution of state Medicaid and insurance claims against Kmart. The former pharmacist will receive a whistle blower award of $9.3 million. The case was heard in the U.S. District Court in the Southern District of Illinois.

To read the DOJ’s press release on this case in full, click here.

To read about a similar case of a pharmacy inflating prices to government health care programs, click here to read one of my prior blogs.

Who Knew Medicare Part D Claims Could Yield Such Big Whistle Blower Settlements?

Who knew Medicare part D claims could yield such big whistle blower settlements? I know I didn’t. I didn’t even think about such claims until I read this case. This could mean some serious compliance issues for big chain stores that have pharmacies (note that I said “could”). Walmart, Publix, Albertsons, Costco, Sam’s Club, Winn Dixie, Engel’s, and every other chain that owns and operates pharmacies, may be in jeopardy.

Contact an Experienced Health Law Attorney to Assist in Whistleblower/Qui Tam Cases.

If you have knowledge of false claims being filed against Medicare, Medicaid, TRICARE/CHAMPUS or any other type of government program, please contact us, and we will be happy to assist you. Our law firm represents health professionals and health care organizations almost exclusively. Yet, we have been involved in a number of whistleblower/qui tam cases, in which we represent the person who files the claim (the whistle blower). We have also defended health professionals and institutions in litigation of whistle blower complaints filed against them.

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

Sources:

McCausland, Phil. “Kmart to pay $32.3M to settle health care-related whistleblower case.” NBC News. (December 22, 2017). Web.

The Associated Press. “Kmart to pay $32.3 million to settle prescription drugs case.” ABC News. (December 22, 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.

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“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.

 

2018-03-28T18:29:34-04:00May 15th, 2018|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments
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