physicians | The Health Law Firm Blog

Two South Florida Doctors Convicted of Fraudulently Billing American Therapeutic Corporation (ATC)

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

A federal jury convicted two South Florida doctors, one Miami-area therapist, and two other individuals 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 […]

Medicare and Medicaid Audits of Psychologists and Other Mental Health Professionals – Part 1

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

Over the past year I have observed an increasing number of Medicare and Medicaid audits being initiated against psychologists and other mental health professionals.

I have recently seen a number of audits initiated against psychologists and mental health professionals who treat assisted living facility (ALF) and skilled nursing facility (SNF) residents. Most often these are audits by the Medicare Administrative Contractor (MAC), because this area of medical practice has been identified as one fraught with fraud and abuse. Sometimes these are only “probe” audits, initial audits requesting one (1) to five (5) medical records. Other times the MAC has been requesting anywhere from 120 to 375 records.

This blog is the first part of my two-part series on Medicare and Medicaid […]

Cancer Patients Must Provide DOH Approval for Seizures and Muscle Spasms, or May Be Unqualified for Low-THC Medical Marijuana

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

Barnhart v. Dep’t of Health, Div. Admin. Hearings, Case No. 15-1271RP (Final Order April 10, 2015).

Following is a summary of a recent Division of Administrative Hearings case summary, taken from The Florida Bar Administrative Law Section Newsletter, Vol. 36, No. 4 (June 2015).

FACTS: On February 6, 2015, the Department of Health (“DOH”) published a notice of proposed rule-making setting forth the text of six proposed rules to implement the Compassionate Medical Cannabis Act of 2014 (“the Act”). The Act provides in part that certain physicians treating patients suffering from cancer or a condition that chronically produces seizures or severe muscle spasms may order low-THC cannabis for those patients’ treatment.

The Petitioner filed a Petition asserting that one of the proposed rules (64-4.002) is an invalid exercise of […]

By The Health Law Firm|2024-03-14T10:01:06-04:00May 15, 2018|Categories: Marijuana Law Blog, Medical Marijuana|Tags: Administrative Hearing, administrative law judge, ALJ, brain tumor, cancer, cancer patients, cannabis, Compassionate Medical Cannabis Act, defense attorney, department of health, doh, florida, Florida marijuana, Florida medical marijuana, health attorney, health care attorney, health care lawyer, health conditions, health investigation, health law, license, marijuana, marijuana defense attorney, marijuana law, medical cannabis, medical license, medical marijuana law, medical marijuana lawyer, medical marijuana license, medical THC, Office of Compassionate Use, petition for rule challenge, petitions, physicians, recreational cannabis, recreational marijuana, THC|Comments Off

Medicare and Medicaid Audits of Psychologists and Other Mental Health Professionals – Part 2

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

Over the past year I have observed an increasing number of Medicare and Medicaid audits being initiated against psychologists and other mental health professionals.

I have recently seen a number of audits initiated against psychologists and mental health professionals who treat assisted living facility (ALF) and skilled nursing facility (SNF) residents. Most often these are audits by the Medicare Administrative Contractor (MAC), because this area of medical practice has been identified as one fraught with fraud and abuse. Sometimes these are only “probe” audits, initial audits requesting one (1) to five (5) medical records. Other times the MAC has been requesting anywhere from 120 to 375 records.

This blog is party two in my series on Medicare and Medicaid audits […]

By The Health Law Firm|2024-03-14T10:01:49-04:00May 15, 2018|Categories: Medicaid audit, Medicare Audit, Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law, Psychology|Tags: assisted living facility (ALF), fraud prevention, mac, medicaid, Medicaid Audits, Medicaid fraud, medical groups, medical practices, medicare, Medicare Administrative Contractor, Medicare audits, Medicare fraud, mental health professionals, physicians, psychiatrists, psychologists, review contractors, Skilled Nursing Facility (SNF), Zone Program Integrity Contracts, zpic, zpic audit|Comments Off