physicians

Update All of Your Addresses with Medicare Immediately!

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

Have You Checked Your Addresses on File with CMS/Medicare Recently?

Do you remember the last time you checked all four of the addresses you should have on file for any individual or any group/company Medicare number you may have? The consequences of not updating these addresses can be severe. In addition to your mailing (or correspondence address), and your billing address, you also should have a physical address that is complete, accurate and timely. The telephone number for that physical address should also be in the system. You must ensure that not only is the street address accurate, but also that any suite, office or apartment number on it is accurate. Check the zip code, too, just to be certain you did not transpose digits when you entered it.

Auditors, surveyors, inspectors and investigators are often sent out by Medicare and its contractors, including the Medicare Administrative Contractors (or “MACs”) and the Zone Program Integrity Contractors (or “ZPICs”), to the physical address on file. This is done as a fraud prevention tool to make sure that medical practices, durable medical equipment companies (DMEs), home health agencies (HHAs), and other businesses that receive payments from Medicare are legitimate and are actually operating.

Termination of Medicare Billing Privileges Often Results From Incorrect Addresses.

Site inspections and audits are also conducted by sending auditors on short notice or no notice to the physical address on file. If your physical address is incomplete (e.g., no suite number) or wrong (e.g., incorrect street address) or is not up to date (e.g., you moved and forgot to update it), the consequences could be severe. What we have seen most often recently is an action that terminates the Medicare billing privileges. The provider then is not allowed to reapply for a period of two (2) years from the date of termination.

Update All of Your Addresses with Medicare Immediately.

I urge you to personally and immediately go into the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and the National Plan & Provider Enumeration System (NPPES) NPI Registry and print out a copy of the existing information to check it. If your address is incorrect or incomplete, immediately submit a correction or have your administrator practice manager do this.

If anything is incorrect, including an incorrect or incomplete name for your medical group, corporation or business, immediately have this corrected, as well. Everything should be consistent, and all of your state licenses and corporation/company information on file with your Secretary of State should also contain the same information, as well.

What to Do if You Receive a Notice of Termination of Your Medicare Provider Number.

Have you received a notice of termination of your Medicare provider number? Medicare has been revoking the Medicare billing privileges of many different Medicare providers including physicians, medical groups, home health agencies (HHAs), pharmacies, and durable medical equipment (DME) providers, based on returned mail sent to old addresses which have not been updated or based on inspection team site visits to old, incorrect addresses.

Often the termination is retroactive to an earlier date when the change or move may have been determined to have occurred. Even if the mailing address is correct or was changed, the physical address of the business must have been updated, as well. It is usually an incorrect or old physical address which causes this to occur.

The effect of this termination includes:

1. You are prohibited from reapplying to Medicare for at least two (2) years.

2. You may have to pay back any monies received from the Medicare Program since the effective date of the termination (often many months prior to the notification letter).

3. Other auditing agents may be notified such as the Medicare Zone Program Integrity Contractors (ZPIC) and the state Medicare Fraud Control Unit (MFCU).

4. You may no longer contract with Medicare or anyone who does.

5. You may and probably will be terminated from the approved provider panels of health insurance companies with which you are currently contracted.

6. You may and probably will be terminated from skilled nursing facilities (SNFs) and home health agencies (HHAs) with which you have contracts.

7. You may and probably will have your clinical privileges terminated by hospitals or ambulatory surgical centers (ASCs) where you have them.

What you should not do includes:

1. Don’t bother to write letters or start e-mailing anyone, including CMS or the Medicare Administrative Contractor (or MAC) (previously called the “carrier” or “fiscal intermediary”).

2. Don’t bother to call the Centers for Medicare & Medicaid Services (CMS) or the MAC.

3. Don’t bother to file a new CMS Form 855 (application) or a CMS Form 855C (change).

4. Don’t bother to start communicating with CMS or the MAC about your situation and what you need to do about it.

5. Don’t bother to complete and file the short, one-page Corrective Action Plan (CAP) form that is on the CMS or Carrier/MAC website (unless you are close to the deadline and don’t have representation; then you must.)

What we recommend is:

1. Immediately go into the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and the National Plan & Provider Enumeration System (NPPES) NPI Registry and print out a copy of the existing information. Then update or correct any incorrect information on you or your company, if you can. Print out the information as it existed before and print out the information after you have corrected it. (Note: Medicare will act shortly after the letter to you to terminate your access to this, so it may be too late).

2. Hire an experienced health attorney immediately to assist you in putting together and submitting a comprehensive Corrective Action Plan (CAP), a Request for Reconsideration (RFR) and a request for an Appeal Hearing.

3. Note that there is a thirty (30) day deadline for submitting the CAP and a sixty (60) day deadline for requesting an appeal hearing. Do not miss these.

4. Implement formal, written internal policies and procedures to prevent a recurrence of the type of error, oversight or event that caused the termination. Train your management and staff on these.

The CAP should address every element of the applicable conditions of participation (COP) contained in the Code of Federal Regulations (CFR). It should include and be supported by all relevant documents, including but not limited to:

1. Documents showing how the error occurred or past efforts to comply.

2. Surety bond guarantees and documents (where required).

3. Insurance coverage documents showing current coverage (general liability, professional liability, vehicle/auto liability).

4. Current licenses and permits.

5. Certificates of good standing and latest annual reports for any corporation or limited liability company.

6. Print-outs from PECOS/NPPES Registry discussed above.

7. Accident reports, insurance claims, police reports, fire reports or other documentation showing why a relocation was required (if this was an issue).

8. Certificates of compliance training for you and your staff, if available.

9. Copies of policies and procedures that you have adopted to keep there from being a recurrence of the situation that led to the termination.

10. An authorization form for your consultant or attorney to represent you in the matter.

All copies should be clear, legible, complete, straight, no corners cut off and no handwriting on them, to the greatest extent possible.

Organize, Label and Index Professionally.

Everything should be professionally assembled, typed, indexed and labeled. It should include a table of contents or an index. Number every page. It should be submitted to the MAC (or the agency/address given in the termination letter) by two (2) reliable means that document both sending and receipt. Keep copies of everything, including postal receipts, airbills, Federal Express labels, courier receipts, etc. It must be received at the address given in the termination letter you received (usually MAC) by the deadline given above. Keep copies of online tracking reports and return receipts.

In most instances, should you show a legitimate reason for the error, show you are currently in compliance, and show what remedial measures you have taken to keep there from being a repeat, the MAC will accept your corrective action plan (CAP) and will reinstate your Medicare number, as things stand currently.

Don’t Wait Too Late; Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.

The lawyers of The Health Law Firm routinely represent physicians, medical groups, clinics, pharmacies, durable medical equipment (DME) suppliers, home health agencies, nursing homes and other healthcare providers in Medicare and Medicaid investigations, audits and recovery actions. They also represent them in preparing and submitting corrective action plans (CAPs), requests for reconsideration, and appeal hearings, including Medicare administrative hearings before an administrative law judge. Attorneys of The Health Law Firm represent health providers in actions initiated by the Medicaid Fraud Control Units (MFCUs), in False Claims Act cases, in actions initiated by the state to exclude or terminate from the Medicaid Program or by the HHS OIG to exclude from the Medicare Program.

Call now at (407) 331-6620 or (850) 439-1001 or visit our website www.TheHealthLawFirm.com.

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

Disclaimer: Please note this article is for general education and information purposes only and does not constitute legal advice or solicitation for clients. Our opinions stated herein are just that, our opinion.

By The Health Law Firm|2024-03-14T10:00:30-04:00June 1, 2018|Categories: Medicare, The Health Law Firm Blog|Tags: administrative law judge(ALJ), Centers for Medicare & Medicaid Services (CMS), clinic, corrective action plan (CAP), durable medical equipment (DME) suppliers, fraud prevention, home health agencies, investigators, Medicaid Fraud Control Unit (MFCU), medical groups, medical practices, medicare, Medicare Administrative Contractors (MAC), Medicare administrative hearing, Medicare audits, Medicare number revocation, Medicare Provider Enrollment Chain and Ownership System (PECOS), Medicare site visits, Medicare termination, National Plan & Provider Enumeration System (NPPES), NPI Registry, nursing homes and other healthcare providers, OIG special agents, pharmacies, physicians, request for reconsideration, termination of Medicare billing privileges, Zone Program Integrity Contractors (ZPIC), zpic audit, ZPIC site visit|2 Comments

Doctors’ Medicare Payment Data to be Released Spring 2014

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

For years, the Centers for Medicare and Medicaid Services (CMS) has kept private its records on Medicare claims payments made to individual physicians. However, beginning March 18, 2014, the government may disclose the payment data on a case-by-case basis. According to CMS, this directive is a push by the Obama Administration to crack down on doctors who are making a habit out of repeatedly overcharging Medicare. On January 15, 2014, CMS stated that recalcitrant providers could face civil fines and exclusion from Medicare and other federal health care programs. According to CMS, a recalcitrant provider is defined as one who is abusing the program and not changing inappropriate behavior even after extensive education to address these behaviors.

Data Made Public to Fight Healthcare Fraud.

According to The New York Times, federal officials estimate that 10 percent (10%) of payments in the fee-for-service Medical program are improper. Supporters of releasing the data say it could help identify patterns of waste and fraud. The Medicare payment data, combined with data from other sources, could be enormously useful to consumers, researchers and whistleblowers analyzing patterns of health spending.

Physician groups express caution in Medicare releasing individual payment information, saying it could lead to public misunderstanding and unintended consequences, according to The New York Times.

Click here to read the entire article from The New York Times.

Data Prohibited From Being Release for Past Thirty Years.

In 1979, a federal district judge in Jacksonville, Florida, issued an injunction that prohibited Medicare officials from releasing what Medicare pays individual doctors. The ruling, in a lawsuit filed by doctors, said such disclosure would violate the Privacy Act and constitute a clearly unwarranted invasion of personal privacy. In May 2013, the judge lifted the injunction.

According to a MedPage Today article, the decision does not require the wholesale release of Medicare payment data but allows Medicare officials and courts to consider the merits of each request.

To read the entire article from MedPage Today, click here.

Healthcare Providers Should Prepare for Possible Public Scrutiny.

Although it remains to be seen how CMS will implement its new policy, health care providers should be prepared for the possibility that their coding, billing and reimbursement patterns will become the subject of public scrutiny, particularly those providers in specialized areas including internal medicine, radiation oncology and ophthalmology.

Contact Health Law Attorneys Experienced with Healthcare Fraud Cases.

Attorneys with The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program. We also handle Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S.

Our attorneys also represent health care professionals and health facilities in qui tam or whistleblower cases both in defending such claims and in bringing such claims. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

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 the decision to release payment data for physicians? How will this effect health care providers? Please leave any thoughtful comments below.

Sources:

Pear, Robert. “Doctors Abusing Medicare Face Fines and Expulsion.” The New York Times. (January 25, 2014). From: http://nyti.ms/1cpIaOg

Pittman, David. “Medicare to Release Doc Pay Data This Spring.” MedPage Today. (January 14, 2014). From: http://bit.ly/1ndaCHu

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.

By The Health Law Firm|2024-03-14T10:00:54-04:00June 1, 2018|Categories: Health Care Industry, Medicare, The Health Law Firm Blog|Tags: Centers for Medicare and Medicaid, CMS, defense attorney, defense lawyer, doctor attorney, doctor lawyer, doctor payment information, doctors, exclusion from Medicare, expelled from Medicare, health law firm, improper payments, internal medicine, medically necessary claims, medically unnecessary claims, medicare, Medicare abuse, Medicare doctor services, Medicare fraud, Medicare payment data, Medicare payments, Medicare physician services, ophthalmology, overcharge Medicare, physician attorney, physician lawyer, physician payment information, physicians, radiation oncology, Recalcitrant providers, the health law firm|Comments Off

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

Two South Florida doctors, one Miami-area therapist, and two other individuals were convicted by a federal jury for their participation in a Medicare fraud scheme. The scheme allegedly involved more than $205 million in fraudulent billings by American Therapeutic Corporation (ATC), a corporation which provided mental health care services. The jury reached a decision on June 1, 2012. To see the Department of Justice press release, click here.

The two doctors and the therapist were each found guilty of one count of conspiracy to commit health care fraud. The other two individuals were each found guilty of one count of health care kickbacks. Sentencing has not yet been scheduled. The maximum penalty for each conspiracy count and each count of health care fraud is ten years in prison plus a fine. The maximum penalty for each count of health care kickbacks is five years in prison plus a fine.

Doctors, Therapist, and Others Allegedly Created False Documents for Medicare Reimbursements.

One of the federal indictments charged more than 14 separate defendants with criminal violations. To see this indictment click here.

Allegedly, ATC billed Medicare for hundreds of millions of dollars in services, for thousands of patients who were not qualified. The charges alleged fraudulent documents were created by the doctors and others associated with ATC. The doctors allegedly would sign patient documents without having seen or treated the patients.

ATC operated partial hospitalization programs (PHPs) throughout Florida and would allegedly bill Medicare for PHP treatments for patients in the names of the doctors. Included in these submissions to Medicare were claims for patients who were allegedly ineligible for PHP treatments. ATC allegedly did not provide legitimate PHP treatment, but illegally changed patient medical records to justify claims that were submitted.

ATC Executive Sentenced to 50 Years in Prison.

Since ATC was shut down nearly two years ago, 35 defendants have faced charges relating to the alleged fraud scheme. The majority of the defendants have pleaded guilty. Last year a third doctor pleaded guilty, accepting responsibility for more than $19 million of false claims submitted by the clinics.

Four ATC executives were sentenced to 50 years, 35 years, 35 years, and 91 months in prison, respectively, for their roles in the fraud scheme.

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

The Health Law Firm’s attorneys routinely represent physicians, medical groups, clinics, pharmacies, durable medical equipment (DME) suppliers, home health agencies, nursing homes and other healthcare providers in Medicare and Medicaid investigations, audits and recovery actions. They also represent them in preparing and submitting corrective action plans (CAPs), requests for reconsideration, and appeal hearings, including Medicare administrative hearings before an administrative law judge.

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:

U.S. Department of Justice, Office of Public Affairs. “Doctors, Therapist, and Recruiters from Miami-Area Mental Health Care Corporation Convicted for Participating in $205 Million Medicare Fraud Scheme.” FBI. (June 01, 2012). Press Release. From:
http://www.fbi.gov/miami/press-releases/2012/doctors-therapist-and-recruiters-from-miami-area-mental-health-care-corporation-convicted-for-participating-in-205-million-medicare-fraud-scheme

Weaver, Jay. “Two South Florida Doctors, 3 Others Convicted on Medicare Fraud Charge.” Miami Herald. (June 01, 2012). From
http://www.miamiherald.com/2012/06/01/2827660/miami-medicare-fraud-jurors-tell.html#storylink=misearch/

What Happens in the VA System Has Implications for all Health Care Professionals; FBI Investigates VA

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

The Veterans Administration healthcare system is at a crossroads. After the recent revelations about long wait times for veterans and systematic cover-ups, it is clear that reforms in the Veterans Health System are needed.

On June 11, 2014, the Federal Bureau of Investigation (FBI) announced it has opened a criminal investigation of the Department of Veterans Affairs (VA). The investigation stems from allegations that officials with the VA have been manipulating medical waiting lists and delaying care for thousands of veterans. On the same day, the U.S. Senate approved a bill that would allow veterans who experience long delays for appointments or live far away from a VA facility to get care at nearby private hospitals and medical facilities. In addition the bill would provide money for the VA to hire more doctors and nurses. According to Modern Healthcare, it is believed a compromise version of the bill will soon make its way to President Barack Obama’s desk for signature.

Click here to read more from Modern Healthcare.

What few people understand is that any false statement of any kind made to a federal official is a crime under the United States code.

The Alleged Scandal that Rocked the U.S.

Last month, it was revealed that a VA clinic in Phoenix was delaying treatment for veterans waiting to see a doctor. The clinic is accused of making official lists that showed patients were getting timely care, while covering up secret waiting lists showing it took much longer. As many as 40 military veterans may have died waiting for treatment. Due to these allegations the head of the VA stepped down. The investigation is being led by the FBI’s field office in Phoenix, the location of the primary focus of the allegations.

To read more on the FBI’s investigation, click here.

AMA Volunteers to Provide Help.

While waiting for a solution, the American Medical Association (AMA) states that it will seek the help of private sector physicians to provide health care for veterans still waiting for care. The AMA is proposing that state and local medical societies formulate registries of physicians who are ready and willing to provide care for veterans, according to an AMA press release.

Click here to read the press release from the AMA.

What This Means for Private Sector Health Providers.

Few would disagree that the VA needs help. Specifically, the VA needs to improve access to care for the growing numbers of new veterans joining the system. However, there is a bigger issue regarding whether the VA has even been given proper resources to do its job.

Until a permanent resolution is agreed upon, private sector healthcare providers that take military insurance such as TRICARE can expect to see an influx of VA patients. Note, there may be a delay in receiving reimbursement payments. There are also concerns as to how long it would take a private healthcare provider to obtain the medical records of a patient from the VA for follow up treatment. The shortage of VA administrative staff affects this, as well.

When seeing VA patients, keep in mind, the logistics of care are different in the private sector. VA patients will not be used to having labs, x-ray centers, pharmacies, etc., in different places and transportation may be more difficult. Providers should be aware of these challenges and have policies and procedures in place to ensure their veteran patients receive complete care. Having an open line of communications with these patients about their care will be essential.

The VA Needs More Resources, Congress!

The most important issue is that the VA needs more resources. It needs more physicians. It needs more ancillary health care professionals. It needs more administrative staff. It’s all good and fine for Congressional members to weep and gnash their teeth about VA shortcomings and failures. But Congress needs to put up the money the VA actually needs to provide the amount of care our existing veterans need.

Until Congress gets off the dime and funds the VA properly this type of situation, or worse, is bound to happen over and over. Republican governors can make idle threats against the VA, posturing for re-election. Congressmen and Senators can kowtow to Tea Party dogma. But if they aren’t going to fund the VA properly, it’s Congress’s fault and no one else’s.

Comments?

What do you think about the VA scandal? As a private sector healthcare provider, do you think you will see more VA patients in your office? Please leave thoughtful comments below.

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, NPDB actions, inspections and audits involving the Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), 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:

Kahn, Randi. “AMA Encourages the Federal Government to Utilize Private Sector Physicians to Help Solve VA Crisis.” American Medical Association. (June 10, 2014). From: http://www.ama-assn.org/ama/pub/news/news/2014/2014-06-10-private-sector-physicians-va-crisis.page

Kizer, Kenneth and Jha, Ashish. “Restorying Trust in VA Health Care.” New England Journal of Medicine. (June 11, 2014). From: http://www.nejm.org/doi/full/10.1056/NEJMp1406852

The New York Times. “F.B.I. Begins Criminal Inquiry in V.A. Scandal.” The New York Times. (June 11, 2014). From: http://nyti.ms/UwTXow

$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

By The Health Law Firm|2024-03-14T10:00:31-04:00June 1, 2018|Categories: Medicaid, The Health Law Firm Blog|Tags: Centers for Medicare & Medicaid Services (CMS), civil recovery for criminal actions, dental practice, dental services, dentist, dentist Medicaid fraud, Department of Health and Human Services, false claims act defense, fraud prevention, legal defense, medicaid, Medicaid exclusion, Medicaid fraud, Medicaid fraud defense attorney, medical groups, medical practices, medicare, Medicare defense attorneys and lawyers, Medicare exclusion, Medicare fraud, nurse, nursing, OIG exclusion, permanent exclusion, physicians, qui tam, state healthcare programs, whistle-blower|Comments Off

Federal Health Officials Propose Medicare Paying Doctors to Discuss End-of-Life Issues

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

The Centers for Medicare and Medicaid Services (CMS) released a new plan for doctors to discuss end-of-life issues with their patients. The plan is part of the CMS annual Medicare physician payment rule. This comes six years after the original controversy when President Obama first announced his health care legislation.

Doctors Will Be Paid for Discussing Treatment Options with Elderly Patients.

In what can only be described as welcomed and needed relief, the rule would reimburse doctors for discussing living wills and end-of-life medical treatment options with older patients. The medical discussions include long-term treatment options, like heart transplants. It also handles advance care planning, including a patient who desires treatment for a condition that affects his or her decision-making. These are conversations already taking place, but physicians are not currently paid for them.

The Pressure is on Medicare.

Medicare reimbursement is extremely important for elderly and disabled persons. As the second-largest insurer, many private insurers also follow the same rules Medicare adopts. Their place in the end-of-life care has long been debated. Whether or not health care professionals should be reimbursed for hospice and end-of-life treatment talks has been the center of debate. Physician groups and patient advocates have been pushing the health program to pay doctors for these consultations.

Many advocacy groups, including the American Medical Association (AMA), support the proposal. The AMA believes it’s the patient’s choice to plan advance-care decisions. Research has shown that there are great benefits to elders in advance-care planning and having their end-of-life wishes known to others. Receiving timely knowledge from physicians and health professionals can result in better decisions and ease of mind.

Rules Previously Criticized as “Death Panels” by Ignoramuses.

Sarah Palin, the towering mountain of medical knowledge and intellectual analysis, who dragged down John McCain into defeat during the elections of 2008, previously denounced similar payment provisions in the past. Sparking a great deal of unnecessary controversy, Palin claimed the health care reform legislation would create “death panels.” As a result of these and other similar accusations, the provision was removed from the final Affordable Care Act legislation. This deprived elders of useful knowledge and deprived health care providers of payment for their services. To read more about the “death panel” controversy, click here.

Comments?

What do you think of end-of-life discussions? Do you think they should be in place? Should physicians be reimbursed? Please leave any thoughtful comments below.

Sources:

Grier, Peter. “ ‘Death Panel’ Controversy Very Much Alive.” The Christian Science Monitor. (Aug. 21, 2009). From: http://www.csmonitor.com/USA/Politics/2009/0821/death-panel-controversy-remains-very-much-alive

Sun, Lena H. “Medicare Proposes to Pay Doctors to Have End-of-Life Care Discussions.” The Washington Post. (July 8, 2015). From:
http://www.washingtonpost.com/national/health-science/medicare-proposes-to-pay-doctors-to-have-end-of-life-care-discussions/2015/07/08/1d7bb436-25a7-11e5-aae2-6c4f59b050aa_story.html

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

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

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“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 © 1996-2015 The Health Law firm. All rights reserved.

By The Health Law Firm|2024-03-14T10:01:00-04:00June 1, 2018|Categories: In the News, The Health Law Firm Blog|Tags: ACA, Affordable Care Act, American Medical Association, CMS, death panel, death panel controversy, elderly healthcare, end-of-life issues, federal health, health care, health care attorney, health care lawyer, health care legislation, health law, health law attorney, health law lawyer, healthcare, medicaid, Medicaid investigations, medicare, Medicare investigations, medicine, physician attorney, physicians, senior health care, The Centers for Medicare and Medicaid Services (CMS), the health law firm|Comments Off

July Issue of Medical Economics Features Article by George F. Indest III

By Cori Pope, The Health Law Firm

The July 25, 2012, issue of Medical Economics features an article written by George F. Indest III, President and Managing Partner of The Health Law Firm. The article, “Beware Legal Ramifications of Unnecessary Tests,” discusses lists that were recently released by nine medical specialty societies on medical tests and procedures patients and physicians should question or avoid.

What Patients and Doctors Need to Know about These Lists.

In the article Mr. Indest provides his insights into what these lists of questionable procedures may mean for patients and doctors.

Patients now have access to some of the same information as their doctors and can ask whether a test or procedure is warranted. This ability allows shared decision-making between patients and physicians and can result in less uncertainty by patients about the medical care they are receiving.

For doctors, health care clinics and hospitals, these lists could mean additional litigation for ordering “unnecessary” tests and procedures for their patients.

To read the entire article, click here.

About the Author.

Mr. Indest is a well-known attorney specializing in the representation of health professionals and healthcare providers throughout Florida. He is Board Certified by The Florida Bar in the legal specialty of Health Law. His practice encompasses all aspects of health law, including malpractice defense, qui-tam or “whistle-blower” and false claims, defense of professional licensing cases, representation in investigations, defense in credentialing matters, Medicare and Medicaid audits, formation of corporations and limited liability companies (LLCs), Board of Medicine hearings, peer review actions, clinical privileges hearings, representation of medical students, and other matters of healthcare law and legal representation of healthcare professionals.

In 1999, Mr. Indest started The Health Law Firm, which has three Florida offices located in Altamonte Springs, Orlando, and Pensacola. A former Navy JAG Corps attorney, he has practiced law for more than 30 years.

For more information about The Health Law Firm, visit http://www.thehealthlawfirm.com.

Contact Health Law Attorneys Experienced in the Representation of Health Care Providers and Professionals.

At the Health Law Firm we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers (DMEs), medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider.

The services we provide include reviewing and negotiating contracts, business transactions, professional license defense, representation in investigations, credential defense, representation in peer review and clinical privileges hearings, opinion letters, 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.

By The Health Law Firm|2024-03-14T10:00:34-04:00June 1, 2018|Categories: Health Care Industry, In the Know, In the News, The Health Law Firm Blog|Tags: Board Certified, clinical privileges hearings, defense attorney, defense in credentialing matters, defense of professional licensing cases, doctors, florida bar, health law, Health Law expert, malpractice defense, Medical Economics, opinion letters, peer review actions, physicians, representation in investigations, representation of health professionals and healthcare providers|Comments Off

Human Body Parts Discovered in Self-Storage Facility that Belonged to a Former Medical Examiner

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

A former medical examiner, who is accused of keeping the body parts of more than 100 people in his Pensacola storage facility, was arrested September 7, 2012. He now faces a felony charge of improper storage of hazardous waste, a misdemeanor charge of “nuisance injurious to public health” and driving with a suspended license, according to a number of sources.

To see the case against the former medical examiner, click here.

It is reported that he had previously been fired as a medical examiner in Jackson County, Missouri. His medical license was allegedly revoked in Missouri. A check of the Florida Department of Health (DOH) licensing website lists his license as null and void. To see his license verification, click here. He could also have some serious points added to his driving license, making his auto insurance premiums go up (if convicted of the traffic offense).

Livers, Brains and Hearts Allegedly Found in Storage Facility.

According to an article in the Pensacola News Journal, the former medical examiner rented the self-storage unit for about three years. On August 22, 2012, he defaulted on his payments, and the unit was auctioned off.

When the storage facility was auctioned off, the new purchaser allegedly discovered 10 cardboard boxes containing human remains stored in a liquid. Garbage bags containing human remains packaged in soda cups and plastic food containers were also found.

This is one auction I doubt you are going to see on “Auction Hunters” or “Storage Wars” on television.

According to a related Associated Press article, the District 1 Medical Examiner’s Office in Pensacola said that the remains appear to have come from private autopsies that were performed between 1997 and 2007 at funeral homes in the Florida Panhandle and in Tallahassee. Allegedly 111 containers filled with body parts, including hearts, brains, a liver, and a lung were found.

Although there were lots of brains found, there were no “Abbie Normal” brains reportedly found.

For a related story regarding zombie outbreaks in Florida and the Florida Legislature’s effort to control them by banning bath salts, click here.

Former Medical Examiner Fired from Medical Examiner’s Office in Pensacola.

The former medical examiner reportedly worked at the District 1 Medical Examiner’s Office in Pensacola from 1997 to 2003. He was fired for allegedly having a large backlog of cases and failing to complete autopsy reports in a timely manner.

Investigation Continues.

Right now, the former medical examiner faces a felony charge of improper storage of hazardous waste, a misdemeanor charge of “nuisance injurious to public health” and driving with a suspended license. These charges alone could land him in prison for more than five years.

The District 1 Medical Examiner’s Office in Pensacola is contacting all the family members of the decedents whose body parts were found. If the family did not give permission to the former doctor, more charges could be coming. Exactly how these body parts are being identified has not been made clear.

Click here to read the entire Pensacola News Journal article.

Your Thoughts?

Tell us below what you think of this story. We would love to hear from you.

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, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, license complaints, administrative hearings, business and commercial litigation, 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:

Heisig, Eric. “Charges Filed Against Doctor in Body Parts Cases.” Pensacola News Journal. (September 9, 2012). From: http://www.pnj.com/apps/pbcs.dll/article?AID=2012309080010

Associated Press. “Ex-Medical Examiner Charged After Human Organs Found in Storage Unit.” Associated Press (September 8, 2012). From: http://articles.orlandosentinel.com/2012-09-08/news/os-human-organs-storage-unit-florida-20120908_1_human-organs-storage-unit-medical-examiner

“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.

By The Health Law Firm|2024-03-14T10:00:36-04:00June 1, 2018|Categories: In the News, The Health Law Firm Blog|Tags: administrative action, defense attorney, doctor felony, doctors, licensing and regulatory, licensing issues, licensure cases, medical license, physician felony, physicians|1 Comment

The Collateral Effects of Voluntary Relinquishment with Investigation Pending or other Discipline on Your Massage Therapy License

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

Many massage therapists are unaware of the drastic long-term effects that discipline on their massage therapist license could have. This includes submitting a voluntary relinquishment of the massage therapist’s license while there is an investigation pending or while there are charges pending. Although this particular article is being prepared specifically for massage therapists, similar principles apply to physicians, nurses, pharmacists, psychologists, dentists, mental health counselors and other licensed health professionals.

A voluntary relinquishment of the license after notice of the opening of an investigation or while a charge is pending is treated the same as a disciplinary revocation of the license. It is reported out the same and is treated the same. In some cases it may even be worse, if the agreement to voluntarily relinquish also includes an agreement to never apply for another license again.

Even discipline on the massage therapy license such as a suspension, probation, restrictions, etc., can have far-lasting adverse repercussions. Most people do not understand what else can happen as a result of a discipline, revocation or even voluntary relinquishment (under these circumstances).

Reports to National Organizations on the Discipline.

First and foremost, the discipline (including voluntary relinquishment) will be a public record. It will also be reported out to national reporting agencies, including the National Practitioner Data Bank (NPDB) and the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB).

As a result of the report to the NPDB, the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) will probably start action to exclude the disciplined therapist from the Medicare Program and place him or her on the OIG’s List of Excluded Individual’s and Entities (LEIE). This will bar you from the Medicare Program or working for or contracting with anyone else who does (including insurer’s medical clinics and most health care providers). This by itself will also have many negative consequences. For example, if you are excluded from the Medicare Program you are automatically placed on the U.S. General Services Administration (GSA) “debarred” list. You are automatically excluded from working for or contracting with, in any capacity, any organization, individual or agency that has any government contracts or accepts any federal funding. This act can bar you from working for a public school, working as a real estate agent, or many other jobs.

The NCBTMB will also take action to revoke your national certification given by the NCBTMB. This will exclude you from being licensed in any other state.

Summary of Adverse Consequences of Revocation or Other Discipline.

To summarize, the most important adverse problems that may be caused as a result of discipline on your license, may include the following:

1. May cause discipline to be commenced against any other health professional license you have, such as a nurse, acupuncture physician, chiropractic assistant, nurse’s aide, home health assistant, etc.

2. Will prevent you from obtaining any health professional license in the future.

3. May cause discipline to be commenced against any massage therapy establishment license for a massage therapy establishment you own in whole or in part.

4. Any other states or jurisdictions in which you have a license will also initiate action against him or her in that jurisdiction.

5. The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) will also take action to revoke your national certification given by the NCBTMB. This will exclude you from being licensed in any other state and will cause any other state in which you are licensed to take action against you.

6. Mandatory report to the National Practitioner Data Base (NPDB)), which remains there for 50 years. (Note: Healthcare Integrity and Protection Data Bank or HIPDB recently folded into NPDB.)

7. The OIG of HHS will take action to exclude the provider from the Medicare Program. If this occurs, (and most of these offenses require mandatory exclusion) the provider will be placed on the List of Excluded Individuals and Entities (LEIE) maintained by the OIG HHS.

8. If the above occurs, the provider is also automatically “debarred” or prohibited from participating in any capacity in any federal contracting and is placed on the U.S. General Services Administration’s (GSA’s) debarment list.

9. Third party payors (health insurance companies, HMOs, etc.) will terminate the professional’s contract or panel membership with that organization.

10. Regardless of any of the above, any facility licensed by AHCA (hospitals, skilled nursing facilities (SNFs), public health clinics, group homes for the developmentally disabled, etc.) that are required to perform background screenings on their employees will result in AHCA notifying the facility and the professional that he or she is disqualified from employment.

What Can be Done?

If you have submitted a voluntary relinquishment without understanding the consequences, and the Board of Massage Therapy (“Board”) has not acted to accept it, you may withdraw it. What we do is submit a letter to the Executive Director of the Board stating it was submitted by mistake without fully understanding the consequences, and the massage therapist desires to withdraw the voluntary relinquishment. We submit this immediately (keeping a copy, of course) and by certified mail, return receipt requested, so we have proof of sending and proof of receipt.

However, you must also ask for a formal hearing to dispute the facts in your case, as well. We usually do this at the same time and by the same method. If you fail to request a formal hearing, then you are waiving your rights to challenge your guilt or innocence.

If you have requested an informal hearing, you have made a big mistake. For an informal hearing, you admit that everything stated in the complaint against you is true. You have admitted that all of the charges against you are correct, so you are pleading guilty to the charges. You are then giving up the right to have a hearing to determine whether you are really guilty or innocent. All you are going to be arguing about is the punishment you will receive. You will not be allowed to testify on or introduce any evidence on your guilt or innocence.

If you have submitted a request for an informal hearing, not realizing this, then what we usually do is to submit an immediate request to have the hearing changed over to a formal administrative hearing where you are allowed to dispute the facts against you and prove your innocence. In such a case, it is necessary to submit a Petition for a Formal Administrative Hearing and to specify which facts are contested or disputed and why.

The case is then sent to a neutral administrative law judge (ALJ) to hold a hearing on the case. The state Department of Health (DOH) (the parent agency over the Board of Massage Therapy) is then required to prove the facts against you by clear and convincing evidence. In fact, you do not even have to introduce any evidence or testimony, the burden of proof is on the DOH to prove the case against you.

Emergency Suspension Orders (ESOs), Appeals and Election of Rights (EOR) Forms.

In Florida, if you have an Emergency Suspension Order (ESO), you can appeal it to a court of appeal. The problem with this is that it is very technical to do so and is very costly. Call an attorney who specializes in appeals or appellate law and ask. Additionally, the court of appeal only rules on the law and not the facts. The appeal court will be required to accept everything that is stated in the ESO as true. There is no fact hearing, there are only legal arguments. Your basic case will be delayed while this takes place, and you will probably lose on appeal. This may not be the correct choice for you.

However, if there is an ESO, you also have the right to an expedited fact hearing on it. This may be the best course of action if you have documents and facts to show you are not guilty of the charges.

Furthermore, there will also be an additional document served on you, an administrative complaint (AC). When you receive the AC, it will probably say just about the same thing as the ESO. You will be given your hearing rights when this occurs (called an “Election of Rights” form or “EOR”). As we indicated above, you will almost always want to select a formal administrative hearing in which you dispute (challenge or contest) the allegations (charges) made against you. This is the only way you will have the right to have a full and fair hearing on your innocence of the charges. Make sure it is submitted in plenty of time to be received within the 21 days given. Seek legal advice in completing it. Do not admit to anything; you don’t have to as the state DOH has the burden of proof.

The Need for an Experienced Health Law Attorney.

It is very difficult to take the actions necessary yourself if you do not have any legal training. Nonlawyers make many stupid mistakes in these proceedings, including submitting written statements that can be used against them when they do not have to do so, talking to the DOH investigator or Board personnel, talking to the DOH prosecuting attorney, making admissions which can be used against them, and waiving their rights when they do not have to do so.

Most attorneys are not familiar with these types of procedures if they do not practice health law. They do not realize that the same rights which apply in criminal cases also apply to professional licensure cases. You need to find and hire an attorney experienced in this type of case. That would be a health law attorney, and preferably one who is Board Certified by the Florida Bar in Health Law.

What You Should Do.

So the bottom line is that if you are innocent and want to dispute any charges against you, you should:

1. If you have professional insurance coverage, such as HPSO Insurance, see if your insurance will cover your legal defense expenses in this type of case. Many will. We know HPSO will.

2. Act right away to request all of your rights in any matter. Make sure that anything you submit is actually received (not mailed, received) before the deadline given.

3. Do not call, write or speak to the DOH investigator, Board personnel, DOH personnel or the DOH attorney.

4. Do not make a statement, written or oral, to the DOH investigator, Board personnel, DOH personnel or the DOH attorney.

5. Contest (dispute or fight) every action that might be stated against you, including one by the NCBTMB or OIG.

6. Do not admit to anything you don’t have to as the state DOH has the burden of proof.

7. Keep copies of all forms or letters submitted, along with proof of mailing and proof of receipt (send via certified mail, return receipt requested).

8. Retain the services of a health lawyer who has experience in Board of Massage Therapy/Department of Health (DOH) cases (ask him or her how many he or she has actually done). DO THIS FIRST, NOT LAST!

Contact Health Law Attorneys Experienced with Department of Health (DOH) Investigations of Massage Therapists.
The attorneys of The Health Law Firm provide legal representation to massage therapists 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 (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

By The Health Law Firm|2024-03-14T10:00:36-04:00June 1, 2018|Categories: Department of Health, Health Care Industry, In the Know, In the News, Informal Hearings, Licensing issues, Massage Therapy, Massage Therapy License, The Health Law Firm Blog|Tags: administrative charges, administrative complaint, advanced therapy, back pain investigation, defense attorney, dentists, Department of Health (DOH), DOH investigation, election of rights (EOR), emergency suspension order (ESO), fake massage therapist, Florida Board of Massage Therapy, Florida College of Natural Health, formal hearing, human trafficking, Informal hearing, license investigation, licensed health professionals, licensed massage therapist, licensure defense coverage, massage therapist, Massage therapy, massage therapy defense, mental health counselors, neck pain investigation, neuromuscular therapy, nurses, pharmacists, physical therapy, physicians, psychologists, rehabilitation investigation, shoulder surgery investigation, sports medicine therapy, trigger point therapy|1 Comment

Posing as Physician Assistant Lands Kissimmee Teen Behind Bars for One Year

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

The Kissimmee, Florida, teen found guilty in August 2012 for impersonating a physician assistant (P.A.) faced up to 20 years in prison for two counts of impersonation and two counts of practicing without a license. On November 14, 2012, the teen was sentenced to one year in jail by an Osceola County judge.

The phony P.A. was given credit for his 264 days already served in jail, so he will only have to spend the remaining 101 days behind bars. The judge ordered the teen to receive mental health counseling, and he will also serve eight years of supervised probation, according to WESH news in Orlando.

You can click here to watch video of the sentencing from WESH news. Click here to see the Osceola County Court records from this case.

Teen Acting Like a P.A. Had Access to Patients.

In August 2011, the teen tricked emergency room doctors, nurses and patients at Osceola Regional Medical Center into thinking he was a P.A. He even allegedly administered CPR to a patient. The charade ended before anyone was hurt.

Click here to read a blog I previously wrote on what else the teen did while impersonating a P.A.

Psychologist Testified on Behalf of Teen.

During the sentencing a psychologist testified on the teen’s behalf, according to the Orlando Sentinel. The article stated that the psychologist believes the teen lost sight of the consequences of his actions as his desire to be someone else took over.

The judge warned the teen that his probation prohibits him from owning or wearing medical apparel. The teen is also not allowed to visit any hospitals. According to the Orlando Sentinel, violating any of these terms will land him in prison.

Click here to read the article from the Orlando Sentinel.

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, 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?

What do you think of the sentence? Do you think it was the hospital’s fault the teen gained access to patients? Please leave any thoughtful comment below.

Sources:

WESH-TV. “Matthew Scheidt Sentenced for Impersonating Hospital Employee” WESH-TV. (November 14, 2012). From: http://www.wesh.com/news/central-florida/Matthew-Scheidt-sentenced-for-impersonating-hospital-employee/-/11788162/17399014/-/154bbs1z/-/index.html

Pierson Curtis, Henry. “Matthew Scheidt: Teen Impostor Gets Year in Jail for Physician-Assistant Charade.” Orlando Sentinel. (November 14, 2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-matthew-scheidt-impostor-sentencing-20121114,0,6656845.story

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Human Body Parts Discovered in Self-Storage Facility that Belonged to a Former Medical Examiner

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Posing as Physician Assistant Lands Kissimmee Teen Behind Bars for One Year