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6 Charged In Florida Chiropractic PIP Insurance Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On October 4, 2017, federal prosecutors charged six Florida residents with running a multi-million dollar insurance fraud scheme through a dozen chiropractic clinics. The alleged scheme involved paying kickbacks to chiropractors and tow truck companies to refer accident victims and then fraudulently billing insurers for services the victims did not need. An indictment unsealed in Fort Lauderdale charge...

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10/13/2017 Comments(0)

CMS Woes: Zone Program Integrity Contractors (ZPICs) Criticized for Oversight in Fraud Investigations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Zone Program Integrity Contractors ZPIC are private companies or business entities, that have contracted with the Centers for Medicare and Medicaid Services CMS . Their purpose is to carry out certain functions related to auditing for possible fraud, that Medicare regional carriers now called Medicare Administrative Contractors or "MACs" performed in the past. They are specifically charged by CMS to da...

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10/5/2017 Comments(0)

Miami Woman Gets 4 Years in Prison for Illegal Silicone Injection Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 20, 2017, a Florida federal judge sentenced a Florida woman to more than four years in prison for her part in a conspiracy to inject non-medical silicone into the buttocks of hundreds of spa customers. U.S. District Judge Kathleen M. Williams handed down the sentence to Magaly Del Rosario, who pled guilty for her part in the scheme to purchase misbranded silicone from Colombia and inject i...

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10/2/2017 Comments(0)

Concierge Medical Services Bring Cash With Few Hassles to Physicians

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law What is concierge medical services? A concierge medical service or practice is a similar to having a primary care provider such as a family practice physician. However, concierge practices are marked by a promise, explicit or implied, that they provide appointments quickly and give a greater degree of personal attention to patients and their problems. The physician works directly with a family, an indi...

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9/21/2017 Comments(0)

Embezzling Administrator of Pediatric Clinic Faces Health Care Fraud Sentencing

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law An administrator of a Louisiana pediatric clinic has recently pleaded guilty in a health care fraud case. She faces up to 10 years in prison and over $200,000 in fines. The charges allege embezzling more than $500,000 of the clinic's money and diverting it to her personal account, from approximately August through September of 2014. She allegedly used this massive amount of money to purchase luxury ite...

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9/18/2017 Comments(0)

Recommendations For Physicians Who Receive Notice of Investigation From the ABIM

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In 2010, the American Board of Internal Medicine ABIM sanctioned 139 physicians for seeking out and sharing board examination questions with a testing preparation company. For the physicians involved in that cheating scandal, disciplinary action taken by the ABIM included revocation of board certification or suspension of certification for one to five years, depending on the severity of the offense. Th...

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9/7/2017 Comments(0)

Florida Department of Health and Law Enforcement Investigate School Providing Nurse Practitioner Courses

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A subpoena purportedly issued by the Clerk of Court for Seminole County, Florida, recently requested academic records on advanced registered nurse practitioner ARNP students, including preceptorship agreements for clinical courses they had taken. A follow-up inquiry revealed that the Florida Department of Health was behind the subpoena, seeking evidence concerning possible fraudulent practices involvin...

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9/6/2017 Comments(0)

First Medical Marijuana Dispensary in Hawaii Gets Green Light From DOH

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 8, 2017, after waiting 17 years, Hawaii will begin dispensary sales of medical marijuana to patients. Maui Grown Therapies got the green light from the Hawaii Department of Health DOH to begin selling medical cannabis. I know from reliable sources, that is that Hawaiian grown marijuana has always been a favorite with the connoisseur. Maui Grown Therapies. The Maui dispensary has been pre-regi...

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8/31/2017 Comments(0)

OIG Report Reveals VHA Improperly Billed For Service Conditions

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On August 9, 2017, the U.S. Department of Veterans Affairs VA Office of Inspector General OIG reported that the Veterans Health Administration VHA improperly issued close to 1.7 million bills to veterans and third-party payers. Of the estimated 15.4 million bills issued by the VHA’s Consolidated Patient Account Centers in 2015, an estimated 1.66 million were improper bills for treatment of servic...

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8/23/2017 Comments(0)

CONTRACTS: Breach-of-Contract Claims in Medical Malpractice Cases Require Breach of Additional Promise

Our guest author of this is article is Emily Abel , a legal research attorney with National Legal Research Group in Charlottesville, Virginia. This article was originally published in The Lawletter Vol 42 No 6 . On March 17, 2017, in Heneberry v. Pharoan , 232 Md. App. 468, 158 A.3d 1087 2017 , the Maryland Court of Special Appeals addressed the issue of what is required to prevail on a breach-of-contract claim in a medical malpractice action. The plaintiff, Valerie Heneberry "Heneberry" who was...

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8/15/2017 Comments(0)