September, 2016

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Community Health Exploring Options Including the Possible Sale of Its Business

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 On September 16, 2016, Community Health System Inc. (CHS), one of the largest US hospital chains, announced that it is exploring the possibility of a deal to sell the company. The struggling Tennessee-based company announced "very preliminary" discussions with advisers to consider all of its options.

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HHS Announces Hefty Increase in Civil Monetary Penalties

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 On September 16, 2016, the US Health and Human Services (HHS) announced new updates that would require health care organizations to pay heftier penalties if they violate federal regulations. HHS is seeking maximum penalties and adjustments reflects multiple years of inflation.

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CMS's Pre-Claim Review Project for Home Health Agencies Delayed Indefinitely For Florida

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 Centers for Medicare & Medicaid Services (CMS) is implementing a three-year Medicare Pre-Claim Review Demonstration for Home Health Services in the states of Illinois, Florida, and Texas Michigan and Massachusetts. The CMS Pre-Claim Review Demonstration officially began in Illinois on August 3, 2016, however, early information received from Illinois, has caused a change of plans.

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Judge Rules Against Wal-Mart For a New Trial in $16 Million Gender Bias 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 On September 16, 2016, a New Hampshire federal judge ruled against Wal-Mart’s request for a new trial after a fired store pharmacist won about $16.2 million in a gender discrimination case. The judge did however, request clarification from a state court on the company's request to limit enhanced compensatory damages to $15 million and reduce the front-pay award.

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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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Big Surprise! California Doctors And Hospitals Can’t Agree Over Role Of Nurse-Midwives

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 On August 8, 2016, a California bill was announced that would allow certified nurse-midwives (CNMs) to practice in hospitals independently. It is apparently upsetting many of teh state's physicians. The California Hospital Association and the California Medical Association (which represents doctors), agree that nurse-midwives have the training and qualifications to practice without physician supervisio

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DOJ and FTC Ask Fifth Circuit To Dismiss Antitrust Appeal

The Health Law Firm

By Miles O. Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm On September 14, 2016, the Department of Justice (DOJ) and Federal Trade Commission (FTC) filed a joint amicus brief before the United States Court of Appeals for the Fifth Circuit, arguing that the court lacks jurisdiction to hear a medical board’s appeal of an antitrust case. The central issue of the Fifth Circuit’s jurisdiction is whether it can hear an immediate appeal of a lower court’s refusal to dismiss a ca

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Former Connecticut Dentist Ordered To Pay $700k For Medicaid Billing 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 On August 11, 2016, a former dentist in Connecticut and his practice were ordered to pay more than $700,000 in restitution and civil penalties for improperly billing the state Medicaid program for pediatric dental cleanings and fluoride treatments. Connecticut Attorney General George Jepsen says a Superior Court judge ruled that Dr.

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Dentists File Class Action Lawsuit Against 3M over Faulty Dental Crown Materials

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 April and May 2016, dentists from Florida, Georgia and Texas filed a class action lawsuits. Six suits have been filed in federal court in Minnesota against the Minneapolis-based 3M Co. ([link] These have been consolidated by the federal court. Each of the complaints in these six cases alleges that 3M's Lava Ultimate restorative material used to make dental crowns chair-side by dentists was defective

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It is Always a Bad Idea For a Doctor To.

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 my 30 plus years of practice representing physicians, dentists, nurses and psychotherapists, I have defended clients involved in many different situations. Several of these seem to be problem areas which we see repeatedly. Following is a list of those problems which it would seem to be common sense for a physician or other health care professional to avoid doing.

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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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DOJ and OIG Use Complex Data Analysis To Find Medicare Fraudsters

The Health Law Firm

By Miles O. Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm Since the 1990s, the credit-card industry has successfully used predictive analytics to find suspicious patterns and protect consumers from fraudulent charges. The health care industry has found a similar success in recent years, as federal agents use data mining, predictive analytics, and other modeling approaches to catch Medicare fraud.

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Does This Drug Make People Irresponsible Zombies?

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 smoking-cessation drug Chantix has come into the spotlight and allegedly played a crucial role in a second violent crime. On August 8, 2016, a Maryland man was reported to have been found not criminally responsible for shooting his wife in their home in 2014 because he was found to be suffering from “involuntary intoxication” due to the drug Chantix.

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Early Bird Whistleblowers May Block Third Whistleblower From $18M FCA Deal

The Health Law Firm

By Miles O. Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm On August 16, 2016, two whistleblowers asked a Colorado federal court to disqualify a third whistleblower from sharing in a $18 million False Claims Act settlement award with OptumHealth. Evercare LLC (now known as OptumHealth) had allegedly submitted false Medicare claims for hospice care on behalf of patients who were not in fact terminally ill.

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Texas Jury Finds Doctor Responsible for Harassment of Nurse Despite Settlement Being Reached

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 On August 9, 2016, a licensed vocational nurse in Texas who alleged she was bullied and sexually harassed by a doctor at work was vindicated when a $440,000 settlement was reached between the parties. Patricia Hahn alleged the harassment she received from Dr.

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From Diagnosis to Delivery: How AI is Revolutionizing the Patient Experience

Speaker: Simran Kaur, Founder & CEO at Tattva Health Inc.

The healthcare landscape is being revolutionized by AI and cutting-edge digital technologies, reshaping how patients receive care and interact with providers. In this webinar led by Simran Kaur, we will explore how AI-driven solutions are enhancing patient communication, improving care quality, and empowering preventive and predictive medicine. You'll also learn how AI is streamlining healthcare processes, helping providers offer more efficient, personalized care and enabling faster, data-driven

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Ninth Circuit Upholds Whistleblower Complaint Against Health Insurance Giants

The Health Law Firm

By Miles O. Indest, J.D./M.B.A.; Law Clerk, The Health Law Firm In a David and Goliath legal battle, a whistleblower recently won a small victory against several large insurance companies accused of defrauding the Medicare Advantage Program. Ignorance Was Bliss: Medicare Payments for Over-Coded Diagnoses. On August 10, 2016, the United States Court of Appeals for the Ninth Circuit unanimously ordered United Healthcare, WellPoint, Aetna, and other health insurance providers to answer whistleblowe