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AHCA, therapist fight over notes | Top Story | Health News Florida
Florida’s Agency for Health Care Administration has been trying to shut down Hillandale Assisted Living, a home for mentally disabled adults, for over a year — ever since The Miami Herald reported its long record of abuse and neglect.
But the Pasco County assisted-living facility (ALF) has demanded a full evidentiary hearing. The resulting legal battle has a Tampa mental-health counselor pinned in the middle.
Joanna Theiss Mulder, who counsels residents of Hillandale and other ALFs, has been ordered to testify and turn over her patient records under an AHCA subpoena. Mulder refuses.
In court papers filed on Wednesday, Mulder argued that it would actually violate the law for her to release any records without her patients’ consent.
The patients named on Muller’s subpoena “specifically object to AHCA’s effort to access their records as an invasion of their privacy,” said the papers filed in Hillsborough Circuit Court.
The irony is that both AHCA’s attorney and Mulder see themselves as protectors of the mentally-ill clients who live at Hillandale, judging from their legal arguments.
See on healthnewsflorida.org
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Doctors booted from Medicaid for massive oxy doses in Florida
The state’s most prolific prescriber of Medicaid-financed oxycodone to the poor in 2010 and 2011 has been barred from participating in the taxpayer supported health care program, one of 76 such high-volume prescribers identified in a Palm Beach Post investigation.
Four others, including West Palm physician Dr. John Christensen, are either under regulatory scrutiny or have been disciplined for their prescribing patterns.
None wrote more oxycodone prescriptions than Dr. Jorge Leal. The Tampa-area anesthesiologist and pain clinic specialist prescribed over 715,000 doses of oxycodone billed to Medicaid over two years – on average, just under 1,000 doses a day. On busy days, Leal’s oxycodone scripts were filled by the bushel: Multiple times, more than 2,000 pills a day were filled by pharmacies and billed to Medicaid; during one 24-hour period, that number topped 4,000 pills.
See on www.palmbeachpost.com
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SEC Charges Five Physicians With Insider Trading in Stock of Medical Professional Liability Insurer
The Securities and Exchange Commission last week charged five physicians with insider trading in the securities of an East Lansing, Mich.-based holding company for a medical professional liability insurer.
The SEC alleges that Apparao Mukkamala learned confidential information from board meetings and other communications about the anticipated acquisition of American Physicians Capital Inc. (ACAP) by another insurance company. Mukkamala in turn shared the nonpublic information with fellow physicians and friends Suresh Anne, Jitendra Prasad Katneni and Rao A.K. Yalamanchili as well as his brother-in-law Mallikarjunarao Anne. The five physicians each purchased ACAP stock based on confidential information about the impending sale in the months leading up to a public announcement. Collectively, they made more than $623,000 in illegal profits on their ACAP stock following the announcement.
Without admitting or denying the allegations in the SEC’s complaint, the physicians agreed to pay a combined total of more than $1.9 million to settle the SEC’s charges.
According to the SEC’s complaint filed in U.S. District Court for the Eastern District of Michigan’s Southern Division, Mukkamala is a resident of Grand Blanc, Mich., and served as a member of ACAP’s board since its formation in July 2000. He became its chairman in May 2007. At a meeting on March 12, 2010, ACAP’s board confidentially discussed whether it should consider a potential sale of ACAP and instructed company management to evaluate whether or not to continue as an independent, stand-alone company.
The SEC alleges that as ACAP’s board and management continued undertaking definite steps toward a sale, Mukkamala routinely disclosed material nonpublic information along the way to the other four physicians. Between April 30 and July 7, 2010, they illegally purchased nearly $2.2 million of ACAP stock based on the confidential information that Mukkamala shared. Mukkamala himself made a trade in the trading account of Chinmaya Mission West, a charitable organization for which he was then serving as president. On July 8, the acquisition of ACAP by Napa, Calif.-based insurer The Doctors Company was publicly announced, and ACAP shares closed approximately 28 percent higher than the previous day’s closing price.
See on www.sec.gov
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OIG’s Most Wanted Fugitives
U.S. Department of Health and Human Services Office of Inspector General Web page contains information about OIG’s most wanted health care fugitives. In all, the OIG is seeking more than 170 fugitives on charges related to health care fraud and abuse.
See more at oig.hhs.gov
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Two Charged for Medicare Fraud Schemes in Detroit Involving $8.8 Million in False Billings
USDOJ: US Attorney’s Office – Eastern District of Michigan: A federal indictment was unsealed on July 11 in Detroit charging two individuals for their participation in a series of separate Medicare fraud schemes involving home health services, United States Attorney Barbara L. McQuade announced. McQuade was joined in the announcement by Acting Special Agent in Charge Edward Hanko of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh, III of the HHS-OIG Office of Investigation.
Charged in the indictment were Usha Shah, 63, and Deepak Shah, 63, both of West Bloomfield, Michigan. According to the indictment, the Shahs were allegedly involved in fraudulent claims submitted to Medicare totaling more than $8.8 million through their company, Miracle Home Health of Southfield, for home health care services that were medically unnecessary and/or never provided. In addition, the court documents allege that the Shahs engaged in a conspiracy to pay cash kickbacks in return for obtaining Medicare beneficiaries’ whose Medicare identifications were used to bill the Medicare program.
U.S. Attorney Barbara L. McQuade said, “Medicare fraud cheats taxpayers out of money intended to pay for health care. We want providers to know that we are scrutinizing billing records to root out fraud.” FBI Acting Special Agent in Charge Edward Hanko said, “Those who seek to steal from the medicare system and collect millions of dollars illegally must be brought to justice. These types of crimes motivated by greed will continue to be investigated vigorously by the FBI and our law enforcement partners.”
“The payment of kickbacks in exchange for the referral of Medicare beneficiaries is illegal,” said Lamont Pugh, III Special Agent in Charge of the Chicago Region of the U.S. Department of Health and Human Services, Office of Inspector General. “The OIG will continue to work with our law enforcement partners to hold those who participate in this type of illegal activity accountable.”
See more at www.fbi.gov
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New Jersey Doctor Pleads Guilty In Cash-For-Patients Kickback Scheme
USDOJ: US Attorney’s Office – District of New Jersey: New Jersey doctor practicing in Newark admitted today he took kickbacks in connection with a cash-for-patients scheme with a diagnostic facility in Orange, N.J., U.S. Attorney Paul J. Fishman announced on July 11.
Dr. William Lagrada, 52, of Edison, N.J., pleaded guilty before U.S. District Judge Claire C. Cecchi to an Information charging him with one count of violating the federal healthcare program anti-kickback statute. Lagrada will forfeit $69,880 he received in kickbacks during the years 2010 and 2011.
According to documents filed in this case and statements made in court:
On Dec. 13, 2011, Lagrada was arrested and charged with accepting cash kickback payments from Orange Community MRI (“Orange MRI”), a diagnostic facility, in exchange for patient referrals. Also on Dec. 13, 2011, 12 other New Jersey doctors and a nurse practitioner were arrested and charged in separate complaints with accepting similar cash kickback payments from Orange MRI. As revealed in the Complaints, each of the defendants was recorded taking envelopes of cash in exchange for their patient referrals. On Dec. 8, 2011, an Orange MRI executive was arrested and charged in a separate Complaint in connection with his participation in the scheme.
Starting in at least 2010, Orange MRI began making monthly cash kickback payments in exchange for patient referrals to Orange MRI for diagnostic tests. At the end of each calendar month, individuals at Orange MRI printed Orange MRI patient reports that detailed how many magnetic resonance imagings, ultrasounds, echocardiograms, computed axial tomographies, and dual-emission X-ray absorptiometries were referred. These patient reports were used to calculate the kickback payments.
See more at www.justice.gov
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
Hot Topics in Health Care Law — Saturday July 7, 2012
Today’s edition of Hot Topics in Health Care Law is available. This topic aggregator/newspaper contains articles that I think are on the cutting edge of health law.
USDOJ: GlaxoSmithKline to Plead Guilty and Pay $3 Billion to Resolve Fraud Allegations and Failure to Report Safety Data
Global health care giant GlaxoSmithKline LLC agreed to plead guilty and to pay $3 billion to resolve its criminal and civil liability arising from the company’s unlawful promotion of certain prescription drugs, its failure to report certain safety data, and its civil liability for alleged false price reporting practices, the Justice Department announced today, July 2, 2012. The resolution is the largest health care fraud settlement in U.S. history and the largest payment ever by a drug company.
See on www.justice.gov
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Oklahoma City Dentist Charged with Health Care Fraud
See on Scoop.it – Hot Topics in Healthcare Law and Regulation
ROBIN R. LOCKWOOD, 44, a dentist from Oklahoma City, has been charged with committing health care fraud. Lockwood is a dentist licensed to practice in the State of Oklahoma and was employed under contract by Ocean Dental at offices located in Oklahoma City. Ocean Dental’s dentists provided dental care to Medicaid-eligible children. Ocean Dental submitted claims to the OHCA for reimbursement of dentists’ services based on patient treatment notes created by the dentists. Ocean Dental paid Lockwood a percentage of the funds that OHCA reimbursed to Ocean Dental for services she personally rendered. Lockwood engaged in a scheme to defraud Medicaid by submitting claims for dental services that she did not provide.
See on www.justice.gov
Owner and Employee of Miami Home Health Company Sentenced to Prison in $22 Million Medicare Fraud Scheme
See on Scoop.it – Hot Topics in Healthcare Law and Regulation
The owner and an employee of a Miami home health care agency were sentenced on 6/19/12 to 108 months and 46 months in prison, respectively, for their participation in a $22 million Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services.
See on www.justice.gov
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