By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The road to becoming a physician is paved with many unique challenges. The long, exhausting journey begins and students are faced with the first battle: rigorous undergraduate course work, followed by the MCAT and medical school applications. During medical school, and for some, after graduation, the USMLE (United States Medical Licensing Examination) and its STEP 1, STEP 2, and STEP 3 exams provide another hurdle in the uphill battle ..read more

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are constantly being contacted by physicians, nurse practitioners and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports. Often, we find that an adverse report has been made when the matter should not have been. Federal regulations and NPDB guidelines establish the types of incidents that are authorized to be reported to the NPDB. When an employer or other organization makes an improper report, it should be challenged and removed. Types of ..read more

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law If you have received a letter from the United States Medical Licensing Examination (USMLE) Secretariat or the Educational Commission for Foreign Medical Graduates (ECFMG) accusing you of "irregular behavior," this is very serious stuff. You need an experienced lawyer to assist you. But how do you find one? This blog will provide several tips on how to locate an experienced effective attorney who will really provide the legal assistance you need. You Don't Need a Philadelphia Attorney to Represent You ..read more

By George F. Indest III, J.D., M.P.A., LL.M., Certified by The Florida Bar in Health Law Have you received a letter or e-mail from the United States Medical Licensing Examination (USMLE) organization accusing you of "Irregular Behavior" on a Step Exam? The USMLE Secretariat, the National Board of Medical Examiners (NBME) and the Educational Commission for Foreign Medical Graduates (ECFMG), have recently been contacting many different applicants who have taken a Step examination and, without good cause (in our opinion) accused them of participating in "Irregular Behavior" in taking the examinat ..read more

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one hundred million dollars. At the December 2022 trial of the Florida man, the jury convicted the Florida Man of all ten counts against him, including health care fraud, payment of kickbacks, and conspiracy to commit money laundering. He was ordered to pay $187 million in r ..read more

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are constantly being contacted by physicians, nurse practitioners and other licensed health professionals seeking to appeal adverse National Practitioner Data Bank (NPDB) reports. Often, we find that an adverse report has been made when the matter should not have been. Federal regulations and NPDB guidelines establish the types of incidents that are authorized to be reported to the NPDB. When an employer or other organization makes an improper report, it should be challenged and removed. Types of ..read more

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule (PFS). However, the final rule increased payment rates for outpatient services and expanded telehealth services. The rule went into effect on January 1, 2024. Physician Fee Schedule Rate Reductions. The overall payment rates under the 2024 PFS will be reduced by 1.25 ..read more

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm In August 2023, a Spring Hill, Florida, pharmacy agreed to pay $800,000 in a settlement agreement that resolved allegations that it fraudulently billed for prescriptions that were either not ordered by a licensed healthcare provider or were never delivered to federal insurance beneficiaries. The Fraud Allegations ..read more

By Michelle E. Missigman, J.D. On November 6, 2023, the US Department of Health and Human Services (HHS), Office of the Inspector General (OIG), released 91 pages of "General Compliance Program Guidance" (GCPG) on its website. This is the first compliance program guidance the OIG has released since 2008. The GCPG provides general compliance guidance, tools, and references for use by federal health care program providers. This new guidance brings together many resources and links, making it a valuable and easy to read tool to keep on hand for any professional working within the health care indu ..read more

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one hundred million dollars. At the December 2022 trial of the Florida man, the jury convicted the Florida Man of all ten counts against him, including health care fraud, payment of kickbacks, and conspiracy to commit money laundering. He was ordered to pay $187 million in r ..read more