November, 2015

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University of Florida Agrees to Pay Nearly $20 Million to Settle False Claims Act Allegations

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The University of Florida (UF) has agreed to pay nearly $20 million to the federal government to settle allegations brought under the False Claims Act. The US Department of Justice (DOJ) announced the settlement Friday under allegations that it "improperly charged the US Department of Health and Human Services (HHS) for salary and administrative costs on hundreds of federal grants.

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U.S. District Court Awards Costs to Prevailing Defendants in False Claims Act Case; Whistleblower Appeals to Second Circuit

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law US District Judge Jed S. Rakoff, ordered relator, Associates Against Outlier Fraud (Associates), to pay $15,000 in costs to the prevailing defendants, Huron Consulting Group Inc. (Huron) and Empire HealthChoice Assurance Inc. (Empire), in a failed False Claims Act (FCA) suit.

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Florida HMO Owners File $1.2 Billion Lawsuit Against BankUnited for Alleged Racketeering and Fraud Scheme

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Former owners of a health maintenance organization (HMO), Haider Ali Khan and Sabiha Haider Khan, recently filed suit in Florida federal court against BankUnited Inc. and its acquired New York-based Herald National Bank. The Khans formerly operated the Tampa-based HMO, Quality Health Plans Inc.

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OIG Annual Work Plan for 2016 Series: Spotlight on OIG Investigations and Affordable Care Act Review Part Two of Two

The Health Law Firm

By Michelle Bedoya and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. The United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its 2016 Annual Work Plan (Work Plan) on November 2, 2015, with an effective date of October 1, 2015. The 2016 Work Plan identifies the new and ongoing investigative, enforcement and compliance activities that the OIG will undertake.

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The Evolution of Communication in Healthcare Settings

Healthcare communication has evolved from handwritten notes and paper charts to digital tools like EHRs, telemedicine, and AI-powered platforms. This blog explores how these advancements improve patient outcomes, streamline care delivery, and enhance provider collaboration. Learn about the role of mobile health (mHealth) apps, secure messaging, and social media in bridging communication gaps.

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Head of the DOJ's Antitrust Division Raises Concerns About Two Proposed Mega-Mergers Between Leading Health Insurers

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Assistant Attorney General, Bill Baer, head of the Department of Justice's (DOJ) Antitrust Division, recently spoke at a Yale Law School conference about competition in the health care industry. While not singling out any specific companies, Baer seemed to repeatedly reference two proposed "mega-mergers" that are currently in the balance.

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Eight Tips to Speed Up the Medicare Prepayment Review Process

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Medicare providers generally recoil at the news of an impending audit. However, being notified of a prepayment review is even worse. In a prepayment review, health care providers are required to submit documentation to a contractor for the Centers for Medicare & Medicaid Services (CMS) before ever even receiving payment.

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Florida Man Sentenced to 30 Months in Prison; Four Defendants Previously Sentenced; Two Defendants Plead Guilty in $126 Million Health Fraud Scheme

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A federal judge decided that a Florida man convicted of conspiracy to commit health fraud will spend the next 30 months behind bars. Humberto Martinez Rodriguez was the nominee owner of two clinics involved in an elaborate fraud scheme to submit $126 million in false health care claims to private insurers.

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Medical Licensing Exams to Include Questions on Military Medicine, Requiring Physicians to Know Their Veterans

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Just prior to Veteran's Day this year, an announcement was made by former US Representative and licensed clinical psychologist, Brian Baird, and his colleague, Steven Haist. Moving forward, examinations for medical students and new physicians seeking licensure will now include questions about military medicine issues.

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HCA Settlement in Shareholder Class Action Suit Over Failure to Disclose False Claims Act Cases Will Cost the Company Another $215 Million

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Just days after settling with the US Department of Justice (DOJ) agreeing to pay $16 million to resolve allegations of False Claims Act (FCA) violations, HCA Holdings, Inc. (HCA), a notable Tennessee-based health care company, announced yet another settlement, this time with its shareholders.

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3 Reasons to Retire Pagers from Healthcare Settings

Let's discuss the trusty pager—an old favorite that’s losing its shine in hospitals and clinics. While once a staple in hospitals and clinics, pagers now present significant limitations that hinder rather than facilitate communication among healthcare professionals. Healthcare professionals are constantly on the move, and they need communication tools that can keep up with their fast-paced lives.

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Federal Judge Denies Florida Cardiovascular Center's Motion to Dismiss Whistleblower Suit: Judge Rules that U.S. and Florida A.G. Did Not File "Shotgun Pleadings"

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law US District Judge for the Middle District of Florida, Roy B. Dalton, Jr., denied a motion to dismiss filed by a cardiovascular center based in Ocala, Florida, and its top physician. The case the defendants sought to dismiss is a False Claims Act (FCA) qui tam suit brought by two whistleblowers in which the United States and Florida have intervened.

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450 Hospitals Pay $250 Million in One of Nation's Largest False Claims Act Cases for Number of Defendants

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In an investigation that has spanned several years and is still ongoing, the Department of Justice (DOJ) has reached False Claims Act (FCA) settlements with more than 450 hospitals totaling $250 million over alleged improper billing of Medicare for unnecessary cardiac implants.

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Peer Review Confidentiality in Florida: Does it Exist?

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The confidentiality of peer review documents in Florida has been very questionable since a state constitutional amendment was passed in 2004. Amendment 7, found in Section 25, Article X of the Florida Constitution, restricts Section 395.0193(7), Florida Statutes, which originally established peer review confidentiality.

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Whistleblower Complaint Filed in Middle District of Florida Against Healogics, Inc. is Unsealed; Hundreds of Hospitals Also Sued

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The United States District Court for the Middle District of Florida recently unsealed a complaint filed by qui tam relators (whistleblowers) against Healogics, Inc. (Healogics) and hundreds of hospitals spanning the country alleging violations of the False Claims Act (FCA).

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15 Modern Use Cases for Enterprise Business Intelligence

Large enterprises face unique challenges in optimizing their Business Intelligence (BI) output due to the sheer scale and complexity of their operations. Unlike smaller organizations, where basic BI features and simple dashboards might suffice, enterprises must manage vast amounts of data from diverse sources. What are the top modern BI use cases for enterprise businesses to help you get a leg up on the competition?

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OIG Opinion States Health System May Legally Provide Free Shuttle Service for Patients

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A medical center, a community hospital and a multi-specialty clinic comprising an integrated health care system (System) (collectively known as Requestors), requested an advisory opinion from the Office of Inspector General (OIG) about a plan to offer free shuttle service to patients of the System (Proposed Arrangement).

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Millennium Health Pays $256 Million in Settlement with DOJ Involving False Claims Act Allegations: Omni Healthcare of Melbourne, Florida, Receives Millions as One of Eight Whistleblowers

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Millennium Health (Millennium), formerly Millennium Laboratories, Inc., entered into a settlement with the Department of Justice (DOJ) on Monday, October 19, 2015, agreeing to pay $256 million to resolve allegations of False Claims Act (FCA) violations. The allegations include billing Medicare, Medicaid and other federal health care programs for medically unnecessary urine tests and for providing kickb

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Subsidiary of Global Healthcare Company Agrees to Pay $390 Million in Whistleblower's False Claims Act Suit

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Novartis Pharmaceuticals Corp. (Novartis), a subsidiary of Novartis AG, an international pharmaceutical company headquartered in Switzerland, agreed to pay a whopping $390 million as a "settlement in principle" to resolve a False Claims Act (FCA) suit. The lawsuit, brought by whistleblower David Kester, former Novartis sales manager, alleged improper kickbacks to pharmacies to boost the sales of severa

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