The Health Law Firm

FEBRUARY 1, 2016

Board Certified by The Florida Bar in Health Law On Friday, a Miami pharmacy owner charged in a Medicare fraud scheme, surrendered to US authorities after hiding in Cuba for over two years. Sandy De La Fe, was charged in 2013 with unlawfully pocketing $2.8 Indest III, J.D.,

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Healthcare Compliance Blog

MARCH 21, 2022

The sole owner and operator of a Kansas home healthcare company has pleaded guilty to employment tax fraud. The fraud scheme caused a tax loss to the Internal Revenue Service (IRS) of over $300,000. Issue: A check and balance system in payroll management can minimize any payroll fraud.

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Health Law Attorney

NOVEMBER 12, 2021

On November 8, 2021, the Office of Inspector General (“ OIG ”) issued multiple updates to the Health Care Fraud Self-Disclosure Protocol (“ SDP ”), incorporating legal changes made since the previous SDP revision in 2013. The OIG’s updated SDP may be accessed here. Below is an overview of the updates.

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HIPAA Journal

MAY 24, 2024

According to the Federal Bureau of Investigation (FBI) Internet Crime Complaints Center (IC3), there were 277,918 domestic and international incidents reported between October 2013 and December 2022 resulting in more than $50 billion in losses, including 137,601 incidents in the United States and more than $17 billion in reported losses.

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HIPAA Journal

JANUARY 10, 2024

As well as its payment processing activities, Stripe provides billing, identity verification, and fraud management services. However, Stripe is not HIPAA compliant because of the way it records personal data within transaction data and uses the combined data to help detect fraud. Coinbase ) or dubious privacy practices (i.e.,

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The Health Law Firm

JULY 8, 2013

Board Certified by The Florida Bar in Health Law The owner of a Lake County, Florida, medical center was arrested by the Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU) on June 27, 2013, for allegedly committing $300,000 in Medicaid fraud. Indest III, J.D.,

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The Health Law Firm

AUGUST 29, 2013

Board Certified by The Florida Bar in Health Law A therapy staffing company owner and a patient recruiter pleaded guilty on August 21, 2013, to one count each of conspiracy to commit health care fraud in connection with a $7 million Medicare fraud scheme. Indest III, J.D.,

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American Medical Compliance

JANUARY 9, 2024

This type of theft is just one example of healthcare fraud. As a result of their large size, these healthcare systems are easy targets for fraud. Through Medicare, Medicaid, and the Children’s Health Insurance Program, the federal government and state governments offer health care coverage to nearly 100 million individuals.

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The Health Law Firm

APRIL 30, 2013

As the investigation into a Central Florida mental health counselor continues, new details are emerging on the extent of the $3 million Medicaid fraud scheme. On March 27, 2013, I blogged about a registered mental health counselor arrested on charges of racketeering, Medicaid fraud and identity theft.

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Med-Net Compliance

SEPTEMBER 9, 2022

From January 13, 2013, through April 12, 2019, the ophthalmologist routinely administered vascular endothelial growth factor inhibitor injections into the eyes of patients to treat purported wet age-related macular degeneration (Wet-AMD) or other ophthalmological conditions for which treatment with such injections is indicated.

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The Health Law Firm

MAY 10, 2013

A Miami patient recruiter will spend the next 37 months in prison for his part in a $20 million Medicare fraud scheme, according to the Department of Justice (DOJ). Manuel Lozano was sentenced on May 6, 2013, in the Southern District of Florida. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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The Health Law Firm

MARCH 29, 2013

A 79-year-old Florida cardiologist was sentenced to six years in prison on March 26, 2013. He’s accused of participating in a fraud scheme involving a trust fund set up to compensate victims of the diet drug Fen-Phen. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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Hall Render

JANUARY 3, 2024

from the University of Michigan Law School in 2013. He represents clients in actions and investigations initiated under the False Claims Act and has experience working closely with state and federal authorities to resolve fraud and abuse-related matters. Liza received her J.D. Matt graduated with his J.D. Jennifer received her J.D.

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Health Law RX

NOVEMBER 9, 2021

For the first time since 2013, on November 8, 2021, the Department of Health and Human Services Office of Inspector General (“OIG”) updated its Health Care Fraud Self-Disclosure Protocol (“SDP”). The likelihood that a self-discloser would be required to pay a damages multiplier greater than 1.5

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HIPAA Journal

FEBRUARY 23, 2022

Title II: Preventing health care fraud and abuse; administration simplification; medical liability reform. The provisions related to administrative simplification are discussed below, while the provisions for medical liability reform (of which there are few) only relate to whistle blower protection for reporting fraud and abuse.

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HIPAA Journal

JULY 4, 2024

Due to concerns that the cost of the reforms would be passed onto plan members and employers, and that this would negatively impact tax revenues, Congress added a second Title to HIPAA – “Preventing Health Care Fraud and Abuse; Administrative Simplification”. Fortunately, the changes since 2013 have been limited in scale (i.e.,

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Pharmacy Law Blog

MARCH 13, 2018

The relator McKenzie Stepe, a former RS sales representative, originally filed her complaint in December 2013. fraud suit – judge.” The Relator’s FCA Suit. She accused RS and Gobea of charging Tricare, Medicare and Medicaid excessively high rates for certain compounded drugs. Florida compounding pharmacy must face U.S.

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McGuire Wood

OCTOBER 2, 2023

According to the DOJ press release, from January 2013 to July 2018, Oliver Street, doing business as U.S. If, however, an institution is concerned that its past practices have violated one of the fraud and abuse laws mentioned above, it may consider three avenues for a self-disclosure. DOJ Voluntary Self-Disclosure.

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HIPAA Journal

JULY 24, 2023

The team’s roles are to investigate and audit the Department’s operations to prevent fraud, waste, and abuse within the Department, and also to audit and investigate potential crimes against the Department. Subsequent Acts of Congress increased the OIG’s regulatory authority to prevent crimes against the Department.

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The Health Law Firm

JULY 23, 2015

Thomas Philpot, a former Lake County Clerk of Court in Indiana, was sentenced to 18 months in prison in 2013 for theft and mail fraud. Conviction of Theft and Fraud. Indest III, J.D., Board Certified by The Florida Bar in Health Law and Shelby Root. Mr. Philpot, a multi-talented person, was both a podiatrist and an attorney.

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The Health Law Firm

SEPTEMBER 23, 2013

million, according to the Department of Justice (DOJ) on September 13, 2013. Indest III, J.D., Board Certified by The Florida Bar in Health Law A group of Florida radiation oncology service providers settled a whistleblower or qui tam lawsuit for $3.5

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The Health Law Firm

SEPTEMBER 20, 2013

Click here to read the Sun Sentinel article from September 18, 2013. The audit allegedly found that the home health care company was overpaid for services that were not covered by Medicaid, according to the Sun Sentinel.

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The Health Law Firm

APRIL 22, 2013

Watkins was sentenced on April 2, 2013. We blogged about this case in February 2013, when Ms. Edna Lorraine Watkins, the owner of Homecare Unlimited, LLC, in Jacksonville, Florida, has been sentenced to six years in prison for defrauding Medicaid, according to the Florida Office of the Attorney General (AG). Watkins was arrested.

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Healthcare Compliance Blog

MAY 19, 2022

The voluntary disclosure and investigation revealed that from June 1, 2013, through May 31, 2019, the hospital submitted claims to Medicare for Intensive Cardiac Rehabilitation (ICR) services provided to Medicare beneficiaries.?Before Throughout the investigation, the hospital cooperated with the above entities.

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Healthcare IT News - Telehealth

JULY 19, 2021

Unsecure telehealth connections can open the door for fraud, phishing and ransomware attacks, with serious reputational and financial consequences. Progressive Therapeutics has been using Azalea's EHR-integrated telehealth solution since 2013. "Last year, ransomware attacks cost the healthcare industry $20.8

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The Health Law Firm

AUGUST 19, 2013

million to settle civil allegations under the False Claims Act, according to the Department of Justice (DOJ) on August 16, 2013. Indest III, J.D., Board Certified by The Florida Bar in Health Law Planned Parenthood Gulf Coast recently paid $4.3

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The Health Law Firm

MARCH 12, 2013

A Central Florida chiropractor was convicted of conspiracy to commit health care fraud by a federal jury on March 1, 2013. Since 2009, the chiropractor fraudulently claimed to own a rehabilitation center in Cape Coral, Florida. To read the press release from the DOJ on the charges, click here.

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HIPAA Journal

MARCH 29, 2024

Baylor College of Medicine said the research participants’ data exposed in the attack related to breast cancer research and clinical trials at the Dan L Duncan Comprehensive Cancer Center between 1999 to 2013. The post MFA Bypassed in Cyberattack on L.A.

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C&M Health Law

APRIL 21, 2022

In 2016, Larry Bomar, a former hospital reimbursement manager in Florida filed a whistleblower suit alleging that, between October 2013 and September 2015, BayCare had allegedly made improper cash donations to the Juvenile Welfare Board (JWB) as part of a scheme to boost BayCare’s Medicaid funding.

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The Health Law Firm

FEBRUARY 21, 2014

Board Certified by The Florida Bar in Health Law A licensed speech therapist faces up to five years in prison for allegedly defrauding Medicaid during the summer of 2013. Indest III, J.D.,

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HIPAA Journal

OCTOBER 21, 2022

For example, the Administrative Requirements (Part 162) helped reduce insurance fraud and accelerated eligibility inquiries, authorization requests, and claims processing. In 2013, HHS confirmed that paper-to-paper, non-digital faxes are not covered transactions).

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The Health Law Firm

MARCH 6, 2014

In an effort to do so, the agency is temporarily blocking several home health agencies (HHAs) and ground ambulance suppliers in fraud hot spots around the country from enrolling in and receiving reimbursements from Medicare, Medicaid and the Children’s Health Insurance Program (CHIP) programs.

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The Health Law Firm

SEPTEMBER 24, 2013

Leider with The Health Law Firm will be giving a presentation on Thursday, September 26, 2013, to the members of the Medical Office Resources of Florida (MOROF) and attending health care providers. A Fraud Investigation Can Happen to You. By Cori Powers, Marketing Director, The Health Law Firm Attorneys Christopher E. until 9:00 a.m.

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The Health Law Firm

MARCH 4, 2013

A report released by the Government Accountability Office (GAO) on February 27, 2013, announced that Medicare will remain a "high-risk" program with respect to its fraud and waste vulnerability. By Lance O. Leider, J.D., The Health Law Firm.

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The Health Law Firm

JANUARY 28, 2013

A family that owns a number of South Florida pharmacies is allegedly under investigation for Medicare fraud, according to a number of sources. On January 17, 2013, federal authorities raided one pharmacy location in Naples, Florida. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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Verisys

NOVEMBER 14, 2023

Verisys’ owned and maintained Fraud Abuse Control Information System (FACIS) is a provider data supersource. Proven software and technology which continuously monitors these sources will ensure that your healthcare organization is in compliance at all times.

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Provider Trust

MAY 18, 2022

Moon , for submitting claims while excluded from March 2006 through July 2013. In addition to exclusion monitoring of individuals within your workforce and provider networks, you are responsible for ensuring your vendors are clear of any state or federal exclusion lists, such as the OIG’s List of Excluded Individuals and Entities (LEIE).

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