Many Adverse NPDB Actions Are Reported That Should Not Be;  Here Are Examples

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

We are constantly being contacted by physicians, nurse practitioners, and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports.  Often, we find that an adverse report has been made when the matter should not have been.  Federal regulations and NPDB guidelines establish the types of incidents authorized to be reported to the NPDB.  When an employer or other organization makes an improper report, it should be challenged and removed.

Types of Matters That Are Not Authorized for NPDB Reports.

Following are some of the incidents for which we have seen adverse NPDB reports that were improperly made:
–Physician or nurse practitioner employed by hospital fired.
–Physician’s contract with a medical group or […]
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Supreme Court of Pennsylvania Says Serial Killer Cannot Sue Psychiatrist for Medical Malpractice

Author headshot standing in dark suit with red tie against a dark grey backgroundBy: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On November 22, 2023, the Supreme Court of Pennsylvania unanimously decided that a serial killer cannot sue his psychiatrist for gross negligence because the action is barred by the Pennsylvania state law that prohibits criminals from benefitting from their crimes.

The Murderer’s Mental Health History.

In February 2016, Cosmo DiNardo was diagnosed with a major depressive disorder. Three months later, DiNardo was in an ATV accident in which he sustained head injuries. His mother reported that he began acting bizarrely a month after the accident. Additionally, DiNardo was also diagnosed with bipolar disorder and schizophrenia. He was prescribed strong antidepressants and antipsychotics.

DiNardo also had a violent […]

Under Medical Peer Review from the Military or the VA? Get Experienced Legal Representation Now

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Our firm is often consulted by military physicians, Veterans Administration (VA) physicians, and former military and VA physicians concerning matters involving peer reviews of their care. In the military, whether Army, Navy, or Air Force, peer review for all physicians is now governed by one general department. The Department of Defense (DOD) Regulation, that is, Defense Health Agency Procedures Manual (abbreviated DHA PM) 6025.13, became effective October 1, 2019. VA physicians have different, but somewhat similar regulations that apply to them.
We are often consulted by these physicians, who no longer serve with those agencies, or after action has already been taken to report them to the National Practitioner Data Bank (NPDB) for allegedly substandard care. Such reports go into the NPDB for fifty (50) years and […]

Many Adverse NPDB Actions Are Reported That Should Not Be; Here Are Examples

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
We are constantly being contacted by physicians, nurse practitioners and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports.  Often, we find that an adverse report has been made when the matter should not have been.  Federal regulations and NPDB guidelines establish the types of incidents that are authorized to be reported to the NPDB.  When an employer or other organization makes an improper report, it should be challenged and removed.
Types of Matters That Are Not Authorized for NPDB Reports.
Following are some of the incidents for which we have seen adverse NPDB reports that were improperly made:
–Physician or nurse practitioner employed by hospital fired.
–Physician’s contract with a medical group or hospital terminated for cause.
–Hospital medical staff takes action against a physician […]
By |2024-03-14T09:59:10-04:00March 4, 2024|Categories: Massage Law Blog, Nursing Law Blog, The Health Law Firm Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Many Adverse NPDB Actions Are Reported That Should Not Be; Here Are Examples

Esformes Reaches Plea Deal in Major Nursing Home Medicare Fraud Scheme

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

On February 1, 2024, the District Court for the Southern District of Florida announced that Florida nursing home mogul Phillip Esformes had reached a plea deal on pending conspiracy to commit healthcare fraud charges.

Esformes, who then owned more than 30 Miami-area nursing and assisted living facilities, was first charged in July 2016 with what the Department of Justice (DOJ) called a $1 billion, decades-long Medicare fraud and money-laundering scheme. Click here to read the DOJ’s press release. (https://www.justice.gov/opa/pr/three-individuals-charged-1-billion-medicare-fraud-and-money-laundering-scheme)

The Fraudulent Health Care Scheme.

The government initially accused The Florida Man of bribing physicians to refer patients to the nursing homes he owned in the Miami area. He would then move the patients to his assisted living facilities once he […]

Is the DEA Knocking on Your Door? What You Need to Know Right Now!

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

Is the Drug Enforcement Administration (DEA) knocking at your door or, even worse, going through your files inside your office?

This is what you need to know right now!

YES, you do have the right to call your attorney. Call your attorney right now. If you cannot, ask one of your employees or spouse to call your attorney. Get your attorney involved right now!

NO, do not sign a document to relinquish or voluntarily give up your DEA registration number. If you do so, this will probably be the biggest mistake you make of your life.

NO, do not sign a document waiving your right to a grand jury investigation before the DEA is authorized to charge you. Why would you want to voluntarily give up one […]

By |2024-03-14T09:59:11-04:00March 2, 2024|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Is the DEA Knocking on Your Door? What You Need to Know Right Now!

Centene Will Pay $19 Million to Washington State For Medicaid Fraud Allegations

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

On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, it has been reported that Centene/Sunshine Health reportedly has over $31 billion in contracts with the state of Florida alone. Click here to learn more.

The agreement with Washington State resolves allegations that it overcharged its Medicaid program for pharmacy benefit management services, Washington Attorney General Bob Ferguson announced in a press release.

Under the deal, in addition to the $19 million payment to Washington State, the federal government will receive $13.3 million related to the settlement, according to the Attorney General’s […]

By |2024-03-14T09:59:11-04:00February 23, 2024|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Centene Will Pay $19 Million to Washington State For Medicaid Fraud Allegations

When the DEA Comes Knocking: 15 Tips For a “Routine” DEA Inspection

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

As the United States continues to open back up from the COVID-19 shutdown, the Drug Enforcement Agency (DEA) is resuming on-site routine inspections.  Therefore, healthcare professionals must ensure compliance and regulatory efforts are in place.

This is part 1 of a 2-part blog series. Check back for part 2 of this blog series soon!

DEA Inspections and Site Visits:  Subpoenas.

DEA agents are often pushy, demanding, and intimidating.  They will try to use subpoenas (which are merely requests for documents that afford you at least ten days to produce the requested documents) as search warrants.  THEY ARE NOT.  They will try to use an administrative subpoena to obtain documents and get your testimony immediately. YOU DO NOT HAVE TO PRODUCE THEM RIGHT AWAY. A copy of a […]

By |2024-03-14T09:59:11-04:00February 22, 2024|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on When the DEA Comes Knocking: 15 Tips For a “Routine” DEA Inspection

Pharmacy Technicians Allowed to Administer Immunizations After New Florida Legislation

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

On July 1, 2022, Florida passed HB 1209, allowing registered pharmacy technicians to administer immunizations to patients. The new law utilizes pharmacy technicians to seek certification to provide immunizations and become “Certified Registered Pharmacy Technicians.” These pharmacy technicians will then be allowed to administer all vaccines listed by the CDC in the Adult Immunization Schedule or recommended by the CDC for international travel. Additionally, it includes vaccines authorized by the FDA under an emergency use authorization or by the Florida Board of Pharmacy in response to a state of emergency declared by the Governor.

This is a big step in medicine, once again broadening the ability of health professionals to provide more efficient and less expensive health care. In the past, properly qualified pharmacists […]

By |2024-03-14T09:59:12-04:00February 12, 2024|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Pharmacy Technicians Allowed to Administer Immunizations After New Florida Legislation

Florid Man Strikes Again–Government Asks for Life Sentence for Florida Man in $187M Medicare Fraud Case

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one hundred million dollars. At the December 2022 trial of the Florida man, the jury convicted the Florida Man of all ten counts against him, including health care fraud, payment of kickbacks, and conspiracy to commit money laundering. He was ordered to pay $187 million in restitution.

I have to say it. They need to lock up that Florida man once and for all! I see his wanton actions all over Florida, reported time and time again. Now that Tim Dorsey is deceased (bless his Florida soul) we don’t […]

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