The Health Law Firm

NOVEMBER 24, 2015

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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The Health Law Firm

NOVEMBER 25, 2015

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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The Health Law Firm

NOVEMBER 23, 2015

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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The Health Law Firm

NOVEMBER 20, 2015

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 Health Law Firm

NOVEMBER 18, 2015

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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The Health Law Firm

NOVEMBER 17, 2015

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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The Health Law Firm

NOVEMBER 17, 2015

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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The Health Law Firm

NOVEMBER 16, 2015

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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The Health Law Firm

NOVEMBER 13, 2015

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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The Health Law Firm

NOVEMBER 11, 2015

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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The Health Law Firm

NOVEMBER 11, 2015

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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The Health Law Firm

NOVEMBER 9, 2015

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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The Health Law Firm

NOVEMBER 6, 2015

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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The Health Law Firm

NOVEMBER 5, 2015

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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The Health Law Firm

NOVEMBER 4, 2015

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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The Health Law Firm

NOVEMBER 3, 2015

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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