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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Broward Health Agrees to Pay Almost $70M to Settle False Claims Act Allegations - Whistleblower Could Receive More Than $12M

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 15, 2015, the Department of Justice (DOJ) announced that Broward Health, an operator of more than 50 health care facilities in South Florida, agreed to pay $69.5 million to settle False Claims Act allegations. Broward Health violated the Federal Stark Law and Anti-Kickback Statute by allegedly overcompensating referring physicians for services to cover up illegal kickbacks for patient refe

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Texas Medical Board Enjoined for Possible Antitrust Violations by Federal Court

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 and Shelby Root On May 29, 2015, the US District Court for the Western District of Texas granted an injunction against the Texas Medical Board (TMB). The suit was brought by a company called Teladoc, Inc. Teladoc, Inc provided medical services to patients through webchats, video chats, and other telemedicine modalities.

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New OIG Fraud Alert Focuses On Physician Contracts: What to Watch Out For

The Health Law Firm

By: Lance O. Leider, J.D., The Health Law Firm On June 9, 2015, the US Department of Health and Human Services, Office of the Inspector General issued a special fraud alert on physician compensation arrangements. The purpose of the alert was to warn physicians who enter into certain arrangements like medical directorships, department chairs, board of directors seats, and other similar positions to do so carefully.

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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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Employee Claims Wrongful Termination After Blowing the Whistle on New York Health Care Center

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 Monday, December 21, 2015, Debra Martin filed suit against former employer, Middletown Community Health Center Inc. (MCHC), in the US District Court for the Southern District of New York, claiming she was wrongfully terminated after exposing alleged illegal activities of the health center to her superiors.

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Eleventh Circuit (Once Again) Upholds Florida's "Gun Gag" Law

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 For the third time now, the Eleventh Circuit ruled on Monday, December 14, 2015, that a Florida law restricting physicians' questions about patients' gun ownership is constitutional. The ruling eliminated an injunction against enforcement and again reversed a district court's grant of summary judgment in favor of a group of physicians challenging what has become known as the "gun gag" law.

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Court Finds Qui Tam Relators Failed to Satisfy Evidentiary Requirements for Alleged Kickback Scheme of Pharmaceutical Company in Texas Case

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 December 10, 2015, US District Court for the Southern District of Texas granted defendant's partial motion for summary judgment in a qui tam case alleging violations of the Anti-Kickback Statute (AKS). The case was originally filed on June 10, 2003, by relators John King and Tammy Drummond, naming several pharmaceutical companies as defendants including Solvay Pharmaceuticals Inc.

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Chicago Husband and Wife Sentenced to Prison Terms for Misappropriation of $3 Million in Grant Funds

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 husband and wife from Chicago, Illinois, were sentenced to prison terms by US District Judge Richard Mills on Monday, December 14, 2015, for their roles in the misappropriation of $3 million in grant funds. Leon Dingle Jr. and his wife, Karen Dingle, were convicted at a one-week long jury trial in December 2014 of conspiracy, mail fraud and money laundering.

Fraud 40
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24-Year-Old May Spend Nearly a Decade Behind Bars as the Alleged Mastermind in a $21 Million Medicare 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 On Thursday, December 10, 2015, 24-year-old, Daniel Suarez, was sentenced to nine years in prison and ordered to pay nearly $21 million in restitution by US District Judge Donald Middlebrooks, for his alleged leading role in a Medicare fraud scheme in Miami, Florida.

Fraud 40
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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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Central Florida Medical Student Shot While Saving Woman in New Orleans

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 Friday, November 20, 2015, during the early morning hours in New Orleans (my home town), a Tulane University (my alma mater) medical student from Longwood, Florida, Peter Gold, was shot in the stomach as he attempted to assist a woman who was being assaulted in a botched robbery.

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Rare Occurrence: Dermatologist Acquitted of More Than 40 Counts of Health Care Fraud Following a 16-Day Trial: Part 2 of a 3-Part Series Part Two: Prosecutorial Overcharging

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 Virginia dermatologist, revered by several publications as one of the top doctors in the nation for several years running, was recently acquitted of more than 40 counts of health care fraud following an unusually lengthy 16-day trial. Dr. Amir Bajoghli was originally indicted in August 2014 on 60 counts; 53 counts of health care fraud, six counts of aggravated identity theft and one count of obstruct

Fraud 40
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Speaking of Religious Discrimination: Second Appeal to Supreme Court on Former Nursing Home Employee's Termination for Refusal to Pray with Residents

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 nursing home employee, Kelsey Nobach, a Jehovah's Witness, filed a discrimination suit against former employer, Woodland Village Nursing Center Inc. (Woodland), alleging her termination from the facility was the direct result of her religious beliefs.

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Baker Acts Are on the Rise Among Students at the University of Central 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 It's beginning to look a lot like Christmas; candy canes and toys, holly and trees, bells and carols, and. Baker Acts? You read that right. According to University of Central Florida (UCF) police Cpl. Peter Osterrieder, a rise in Baker Acts is to be expected among college students this time of year.

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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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U.S. Department of Justice's Antitrust Division Has Yet to Weigh In on Anthem/Cigna Mega-Merger Given the Go-Ahead by Shareholders

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 Thursday, December 3, 2015, shareholders of Anthem Inc. (Anthem) and Cigna Corp. (Cigna) approved a previously announced $54 billion mega-merger in an overwhelming 99 percent favorable vote. The pending acquisition of Cigna by Anthem would cover approximately 53 million medical members resulting in the formation of the nation's largest health insurance company.

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Rare Occurrence: Dermatologist Acquitted of More Than 40 Counts of Health Care Fraud Following a 16-Day Trial: Part 1 of a 3-Part Series Part One: Reviewing the Charges

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 Dr. Amir Bajoghli, of McLean, Virginia, was a dermatologist and owner of the Skin & Laser Surgery Center. Dr. Bajoghli was recognized by former Washingtonian Magazine, Northern Virginia Magazine, US News & World Report and Castle Connolly as "Top Doctor.

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Pharmaceutical Company Says Former Employee is Not "Original Source" of False Claims Act Allegations and Cannot Bring Whistleblower 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 Medco Health Solutions Inc. (Medco) asked a Delaware federal judge to dismiss a False Claims Act (FCA) lawsuit brought by former employee and vice president of the company's pharmaceutical contracting group. Paul Denis brought the qui tam suit against Medco alleging the company defrauded state and federal insurance companies by hiding discounts it was receiving on drugs.

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Former New York Assembly Speaker Convicted on Corruption Charges in Scheme for Referral Fees

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 New York Assembly Speaker, Sheldon Silver, was convicted by a jury on Monday, November 30, 2015, on federal corruption charges. Silver had spent nearly 40 years as an elected New York Assemblyman. Prosecutors say Silver was using public money to fund an asbestos disease researcher in exchange for patient referrals to Silver's colleagues and personal injury law firm, Weitz & Luxenberg PC.

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Why Every Small Business Needs an HCM Solution: A Comprehensive Guide

Managing HR tasks like payroll, compliance, and employee data can overwhelm small businesses. That’s where a Human Capital Management (HCM) solution comes in. Our eBook, Why Every Small Business Needs an HCM Solution: A Comprehensive Guide , shows how an HCM system automates tedious processes, ensuring your business stays compliant and efficient. You’ll learn how to simplify payroll, eliminate costly errors, and empower your employees with self-service tools.

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Florida Court of Appeal Says Federal Law Preempts Florida's Amendment 7; The Peer Review Privilege May Still Be Alive

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 Southern Baptist Hospital of Florida Inc. (Baptist) filed a Petition for Writ of Certiorari with the First District Court of Appeal in Florida following a Florida circuit court ruling on the compelled disclosure of certain documents. The plaintiffs in a medical malpractice case were attempting to obtain peer review documents from the hospital on their claims.

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Oncologist Falsified Data on Research Once Described as "Holy Grail" of Cancer Treatment

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 Back in 2006, Anil Potti, a cancer researcher at Duke University, claimed to identify genetic markers that would allow customized treatment for cancer patients based on the types of tumors they had. Several reports from Potti and his team claimed it could predict a patient's response to chemotherapy with up to 90 percent accuracy.

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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.

Fraud 40
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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.

Fraud 40
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Real-Life Examples of HIPAA Violations and How to Avoid Them

Speaker: Jack Clough, Chief Growth Officer

Download our 30-minute webinar where we delve into real-life examples of HIPAA violations and preventative measures every organization should know! You will learn: The critical factors that lead to HIPAA violations and how to identify them. Three compelling real-life cases of organizations that faced severe HIPAA penalties. Proven strategies to safeguard YOUR organization against HIPAA violations.

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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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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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OIG Annual Work Plan for 2016 Series: Spotlight on Medicare and Medicaid Areas of Fraud Part One 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 Work Plan describes more than 40 new investigations and strategic inquiries concerning pharmacy fraud and increased drug prices, among other topics.

Fraud 40
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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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Best Practices to Streamline Compensation Management: A Foundation for Growth

Speaker: Joe Sharpe and James Carlson

Payroll optimization can be one of the most time-consuming and complex factors of small business management. Yet, organizations that crack the code on streamlining employee compensation often discover innovative avenues for growth. With the right strategies in place, outsourcing and streamlining payroll processes can result in substantial time and resource savings.