Tag Archives: quality assurance

California Doctor To Pay $562,500 Fine and Spend 5 Days in Jail for Balance Billing Patients Covered by Managed Care Plans

MLS Blog Label 2By Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A California doctor was fined $562,500 and ordered to spend five days in jail for illegally balance billing patients covered by health plans, according to a Los Angeles Times posted in December 2013. The doctor, Jeannette Martello, M.D., is a plastic and reconstructive surgeon practicing in the Los Angeles area. She was accused of balance billing patients covered by managed care health plans that were provided emergency treatment in several hospitals in Los Angeles. The doctor had very aggressive collection practices and allegedly sued her patients frequently to collect the fees not covered by the managed care health plans.

Click here to the entire Los Angeles Times article.

What is Balance Billing?

Balance billing is the practice of doctors charging the patient the difference between what the managed care plan pays and doctor’s regular charges. A physician who is in-network is usually prohibited from balance billing patients by the health plan’s contract with the physician. The problem of balance billing arises most often in the context of emergency services where the patient may go to an in-network hospital, but the specialist physician providing services to the patient may be out-of-network. Most states require the managed care plan to pay the out-of-network physician a “reasonable fee” for the services. The physicians and the managed care plans rarely agree on the “reasonable fee” for a particular service. This often results in litigation between the physician and the health plan. The situation also arises when a patient goes to an in-network hospital for surgery, but the anesthesiologist is not in-network.

Doctor Plans to Appeal.

According to the Los Angeles Times article, Dr. Martello plans to appeal the ruling. Dr. Martello and her attorney claim the prohibition on balance billing did not apply to her patients because the patients were in stable condition.

Court Previously Entered Injunction Prohibiting Illegal Billing.

In 2012, The Los Angeles Superior Court entered an injunction ordering Dr. Martello to cease all illegal billing practices, according to the Department of Managed Health Care. Dr. Martello continued the billing practices, which is why the judge ordered Dr. Martello to serve five days in jail. The judge also issued a permanent injunction prohibiting Dr. Martello from illegally billing patients in the future.

To read the press release from the Department of Managed Health Care, click here.

The Medical Board of California also placed Dr. Martello on probation for five years for her illegal billing practices in August 2013.

Balanced Billing Could be Considered a Matter of Contract Law.

It is usually sound legal advice that if a court orders you to do something or to stop doing something, comply with the court’s order. It is hard to imagine legal advice to the contrary, unless the parties desire to have a test case to challenge the law or challenge such rulings.

Balance billing in such cases is usually a matter of contract law. The provider agreement between the physician and the health plan is the contract at issue. This, then, would be a breach of contract action and not a criminal matter.

However, in certain instances, such as for Medicare or Medicaid patients, laws may prohibit balance billing. It is always best to check with your experienced health attorney first.

Contact Health Law Attorneys Experienced with Investigations of Doctors.

The attorneys of The Health Law Firm provide legal representation to doctors and other healthcare providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers. The Health Law Firm also represents providers in billing disputes with third-party payers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Have you ever heard of balance billing patients? Do you think the doctor received a far punishment for her billing practices? Please leave any thoughtful comments below.

Sources:

Terhune, Chad and Brown, Eryn. “Doctor Gets Jail Time, $562,500 Penalty in Improper-Billing Case” Los Angeles Times. (December 6, 2013). From: http://articles.latimes.com/2013/dec/06/business/la-fi-mo-doctor-balance-billing-case-20131205

Green, Marta. “Department of Managed Care Director Brent Barnhart Issues Statement on Preliminary Injunction Granted in People v. Martello.” Department of Managed Health Care. (June 13, 2012). From: http://www.dmhc.ca.gov/library/reports/news/pr061312.pdf

The Pathology Blawg. “Dr. Jeannette Martello Gets Five Years Medical Probation for Aggressive Balance Billing.” The Pathology Blawg. (August 20, 2013). From: http://pathologyblawg.com/medical-news/balance-billing/jeannette-martello-five-years-medical-probation-aggressive-balance-billing/

About the Authors: Michael L. Smith, R.R.T., J.D., is Board Certified by The Florida Bar in Health Law. He is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Dentists, Talk to an Attorney Before You Talk to an Investigator

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In Florida, You DO NOT Have to Speak to an Investigator!

Despite mailing out hundreds of thousands of postcards and letters to dentists, throughout Florida, we continue to receive calls from new clients and from potential clients, after they have already spoken to and made critical harmful admissions against their own interests to investigators. In Florida, you do not have any duty to cooperate with any investigator who is investigating you. This extends to Department of Health (DOH) investigators (who are sometimes titled “Medical Quality Assurance Investigators” or “Medical Malpractice Investigators”), Drug Enforcement Administration (DEA) special agents, police officers, sheriff’s deputies, or criminal investigators of any type.

Investigators are NOT There to Help You.

Let me state this as succinctly and clearly as possible. If you are being investigated, you will not be better off making a statement. You will not be better off explaining your side of the story. The investigator is not your friend. The investigator is not on your side. All you are doing is falling for a trick and helping the government to make a case against you.

Protect Your License and Your Livelihood.

You have a right under the U.S. Constitution to not make any statement that may be used against you. This is so important that in criminal cases government investigators are required to advise you of this by reciting to you your Miranda rights.

However, in cases where you might have your dental license revoked or have your DEA number revoked or lose your Medicare provider status or your Medicaid provider status, the investigator is not required to advise you of your rights.

In a criminal case, there may be ways to have your statement thrown out. However, in a professional licensing case or other administrative case, it may be too late to avoid the damage. You may be the best witness the government has and you may be the only witness the government needs to prove ths case against you.

In the case where you could receive a $100 criminal fine, the investigators are required to read you your constitutional Miranda rights and to be sure that you understand them before you make a statement. However, in a case where you can lose your dental license, where you could lose your livelihood and ability to make a living, where you could lose everything you have worked so hard to obtain, they are not required to do this. You must protect yourself.

Many dentists, when confronted by an investigator, who will usually call at a very inconvenient time (to catch you by surprise) and will usually flash a badge (to intimidate you), will refuse to acknowledge the seriousness of the matter and will fall for the bait to “tell their side of the story.” This can be fatal to your defense and fatal to your license.

If You Anything You Run the Risk of Ruining Your Defense.

In the absence of a statement by the suspect (in this case, let’s assume this is YOU), the government may have a very difficult time of proving that you have committed any offense. It may have other witnesses (who may not be around at the time of any hearing or trial). It may have a lot of physical evidence or documents. But it may be impossible for the government investigators to make any link between you and the evidence, unless you help the investigators do this. You would be surprised at how many dentists believe that they can just talk their way out of the situation; in reality, they are just giving evidence that is used to make the case against them.

Any evidence at all, just admitting that you were there, admitting that the documents are yours, admitting that the patient was yours, admitting that you worked at the clinic, admitting that you wrote the prescription, admitting that the property is yours, admitting that you were on duty at the time, admitting that you have taken a drug, admitting that you signed the form, can be a crucial piece of evidence that could not otherwise be proven without your own testimony.

Remember, this is the investigators’ job and profession. This is what they do full time, every day. And they are very good at it. They are 1,000 times better at getting you to admit the crucial elements of a disciplinary infraction than you are in “talking your way out of it.” They will not be convinced by any excuses you make. They do not have to be. They will not be the ones making the final decision against you. Theirs is the job of putting together the case against you. You will help them by talking to them, explaining why your decisions are correct, explaining why what you did is excusable, etc. It will not work. You will merely be giving them enough rope to hang you with.

Why are You Being Investigated?

Hint: If it is a Medicaid Fraud Control Unit (MFCU) special agent (investigator), you are probably under investigation for Medicaid fraud.

Hint: If it is an “auditor,” “surveyor” or “investigator” from an agency or company with “integrity” or “program integrity” in its name, they are probably investigating you for “lack of integrity,” i.e., false claims or fraud.

Hint: If it is a Drug Enforcement Administration (DEA) special agent (investigator) they are probably investigating you to prosecute you or to revoke your DEA registration for drug or prescribing violations.

Hint: If it is an Office of the Inspector General (OIG) special agent (investigator), you are probably under investigation for Medicare fraud or Medicare false claims.

Hint: If it is a Department of Health Quality Assurance Investigator or Medical Malpractice Investigator, they are probably only investigating possible disciplinary action against your license that could result in large administrative fines or revocation of your license.

Talking to the Investigator May Make It Worse.

Do not believe for a second that you are smarter than the investigator. Do not believe for a second that you will convince the investigator (or anyone else) that there is a legal or medical justification for what you did or what they allege. If it were as simple as that, then why would there be an investigation and why would you be the one being investigated?

Additionally, do not believe for a second that you can lie your way out of it, either. Remember, if the government cannot prove the basic offense that it is investigating against you, it may be able to prove that you have committed perjury or lied to an investigator. In the case of a federal official or a federal investigation, merely making a false statement (oral or written) to an investigator is a criminal act. This is what Martha Stewart and many others have served time for in federal prisons.

These investigators are lied to all the time. They are usually better at detecting lies than a polygraph expert is. Furthermore, in most cases, you will be the very last person to be interviewed. Therefore, they will already know just about everything that can be used against you. If your statement contradicts in any way what others have told them, they will know you are the one who is lying. However, knowing something or suspecting something does not mean it will be something that can be proven in court or in an administrative hearing.

Talk to a Lawyer Prior to Making a Statement.

It is much better to make no statement at all. Blame it on your attorney. Tell the investigator that your attorney will kill you if you were to talk to the investigator without your attorney being there ahead of time. “Speak to my attorney.” “My attorney can help you, I can’t.”

All you have to do is state “I must talk to my lawyer before I say anything.” “I will have my lawyer contact you.” “I cannot say anything until I talk to my lawyer.” “I want a lawyer.”

If you are not the one being investigated, then there is no good reason why the investigator would want you to make a statement before you consulted with your attorney. What is the rush?

Then you must also avoid the old trick of the investigator telling you “If you don’t have anything to hide, why would you need a lawyer?” Please don’t fall for this trick, either. This is America. Smart people and rich people spend a lot of money on attorneys and other professionals to represent them and advise them. There is a good reason why they do this.

Far too often the doctor only calls us after he has given a statement. This is usually too late to avoid much of the damage that will have been be caused.

Everything above applies to oral statements or written statements. Do not make either. Contact a lawyer as soon as possible, preferably before making any statement, no matter how simple, defensive, self-serving or innocuous you may think it to be.

Think of this as an intelligence test. Are you smart enough to follow this guidance and avoid this type of mistake?

Contact Health Law Attorneys Experienced with Investigations of Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

 

Nurse Accused of Illegally Writing Herself Prescriptions for Painkillers

10 Indest-2008-7By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Central Florida nurse is in trouble with the law for allegedly writing fake prescriptions and illegally obtaining painkillers for herself, according to the Orlando NBC affiliate, WESH television. The nurse was allegedly arrested during the week of December 31, 2012. She is accused of trafficking in oxycodone and trying to fill forged prescriptions.

Click here to read the WESH article.

Pharmacist Did Not Fall for Fake Prescriptions.

According to an Orlando Sentinel article, a pharmacist, who was suspicious of one of the prescriptions the nurse tried to fill, called the doctor listed on the prescription. The doctor informed the pharmacist that she (the doctor) was the nurse’s employer, and the nurse was not a patient. It was then discovered that the nurse used the names of two doctors at her place of employment. She had stolen the prescriptions to obtain painkillers for herself.

A search of Florida’s Prescription Drug Monitoring Database allegedly showed that the nurse had obtained dozens of prescriptions for controlled substances for herself in the past year.

To read the article from the Orlando Sentinel, click here.

Nurse’s License is Currently Suspended.

According to the Department of Health (DOH) the nurse’s license is currently suspended. A complaint on the nurse’s record also shows that in December 2009, the nurse admitted to stealing pain medication from her patients. Click here to read the entire complaint from the DOH.

Useful Tips on How to Prevent Employees from Stealing.

I recently wrote an article for Medical Economics on how to prevent or detect employee embezzlement in the medical or dental office. It contains valuable information for any small health care practice owner. Topics discussed in the article include: how to recognize embezzlement warning signs, steps to take to safeguard your assets, and the proper way to take action against a suspected embezzler. To read it in its entirety, click here.

I have also written a number of blogs on abuses with narcotics. See my blog on a fake prescription ring busted in Osceola County, and a Drug Enforcement Administration (DEA) arrest of a doctor allegedly on crack cocaine charges, for example.

 

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, Department of Justice (DOJ) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

 

Comments?

As a health professional how do you keep tabs on your important office supplies? How would you handle an employee stealing from your office? Please leave any thoughtful comments below.

Sources:

Pavuk, Amy. “Nurse Charged with Stealing Scripts, Illegally Obtaining Painkillers.” Orlando Sentinel. (January 3, 2013). From: http://articles.orlandosentinel.com/2013-01-02/news/os-nurse-arrested-prescription-drugs-20130102_1_fake-prescriptions-prescription-sheets-cvs

WESH-TV. “Nurse Accused of Illegally Obtaining Painkillers.” WESH. (January 3, 2013). From: http://www.wesh.com/news/central-florida/seminole-county/Nurse-accused-of-illegally-obtaining-painkillers/-/17597106/17995906/-/dmj2se/-/index.html?absolute=true

Department of Health v. Tabetha Terry, R.N. Case Number 2010-13467. Administrative Complaint. (February 22, 2011). From: http://www.thehealthlawfirm.com/uploads/tabetha%20terry%20complaint.pdf

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Florida Dentist Hit with an Emergency Suspension Order for Allegedly Inhaling Nitrous Oxide

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Debary, Florida, dentist has been served with an emergency suspension order (ESO) by the Florida Department of Health (DOH) for allegedly inhaling nitrous oxide or laughing gas in front of patients. The administrative complaint filed against the dentist on November 2, 2012, by the Florida DOH stated a department-approved evaluator deemed the dentist unfit to practice dentistry and was recommended to undergo residential treatment.

Click here to read the full administrative complaint against the dentist.

We want to point out that these are just allegations made against the dentist at this point in time and have not been proven by the state.

Dentist Allegedly Ordered to Rehabilitation.

In June 2012, the Florida DOH ordered the dentist to be treated for alcohol and inhalant dependence. However, while in rehabilitation, she allegedly failed drug tests for alcohol, opiates and hydrocodone. She was then later reportedly caught inhaling laughing gas again.

The dentist allegedly refused another treatment plan by writing on it that she was going to drink champagne on holidays and special occasions.

ESO Means Health Professional Cannot Practice While License is Suspended.

On November 27, 2012, WFTV in Orlando reported a woman that looked to be the suspended dentist drove up to the Debary office and posted a handwritten sign on the front door that read, “Office is open.”

To see the story from WFTV, click here.

The Florida DOH states that when a licensee is served with an ESO that person may not practice in Florida while his or her license is suspended. Click here to see the status of the dentist’s license from the DOH.

Formal vs Informal Hearings.

The dentist may elect to have a formal hearing contesting the facts with the Division of Administrative Hearings (DOAH). She also may waive this right and not dispute the facts and have an informal hearing before the Board of Dentistry.  The Board will then make a final decision concerning the dentist’s license and her future working in dentistry. Be sure to check this blog for updates.

Contact Health Law Attorneys Experienced with Department of Health (DOH) Investigations of Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

What do you think of this dentist’s story? Please leave any thoughtful comments below.

Sources:

Walsh, Michael. “Dentist Gassing Up on Nitrous Oxide No Laughing Matter.” New York Daily News. (November 27, 2012). From: http://www.nydailynews.com/news/national/dentist-gassing-nitrous-oxide-laughing-matter-article-1.1209081?print

Barber, Tim. “Dentist Accused of Using Laughing Gas on Self While Working on Patients.” WFTV. (November 27, 2012). From: http://www.wftv.com/news/news/local/dentist-accused-using-laughing-gas-while-operating/nTGJd/

Department of Health v. Sharon Ann Day-Osteen, D.D.S. Case Number 2012-13461. Administrative Complaint to the Board of Dentistry. (November 2, 2012). From: http://www.thehealthlawfirm.com/uploads/doh%20v%20Day-Osteen.pdf

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Former Daytona Beach Chiropractor Will Spend More Than 15 Years Behind Bars

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A former Daytona Beach chiropractor will spend more than 15 years in federal prison for an alleged health care fraud scheme and illegally prescribing pills, according to the Federal Bureau of Investigation (FBI), Jacksonville Division. He was also ordered to pay more than $2 million in restitution to his victims. The former chiropractor was sentenced on November 29, 2012, by a United States District Judge who called his fraud scheme “sophisticated.”

Click here to read the press release from the FBI.

I previously wrote about this scheme in August 2012, when the former chiropractor was found guilty. To read that blog, click here.

Complex Scheme Involved a Number of Co-Conspirators.

According to the Daytona Beach News Journal, the former chiropractor is thought to have worked with five other doctors in a scheme. The group allegedly split the money they collected from sending inflated bills to insurance companies, including Medicare.

Former Chiropractor Allegedly Prescribed Controlled Substances to Patients.

FBI investigators also accused the former chiropractor of writing prescriptions for controlled substances. Since the man could not prescribe controlled substances, he would use the names of medical doctors who most likely knew their names were being used illegally. It’s believed that there were about a dozen patients who overdosed on controlled substances prescribed by the former chiropractor, according to the Daytona Beach News Journal.

Click here to read the entire Daytona Beach News Journal article.

Effects of Voluntarily Relinquishing a Professional License.

Back in December of 2011, the former chiropractor voluntarily relinquished his license. We almost always counsel our clients to refrain from voluntarily relinquishing their licenses. A voluntary relinquishment of a license in the face of a pending investigation is treated, for all practical purposes, the same as a disciplinary revocation.

The consequences will usually include:

1. Mandatory report to the National Practitioner Data Base (NPDB) (Note:  Healthcare Integrity and Protection Data Bank or HIPDB recently folded into NPDB) which remains there for 50 years.

2. Any other states or jurisdictions in which the client has a license will also initiate action against him or her in that jurisdiction.  (Note:  I have had two clients who had licenses in seven other states).

3. Action to revoke, suspend or take other action against the clinical privileges and medical staff membership of those licensed health professionals who may have such in a hospital, ambulatory surgical center, skilled nursing facility, or staff model HMO or clinic.

4. The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) will take action to exclude the provider from the Medicare Program.  If this occurs (and most of these offenses require mandatory exclusion) the provider will be placed on the List of Excluded Individuals and Entities (LEIE) maintained by the HHS OIG.

5. If the above occurs, the provider is also automatically “debarred” or prohibited from participating in any capacity in any federal contracting and is placed on the U.S. General Services Administration’s (GSA’s) debarment list.

6. The U.S. Drug Enforcement Administration (DEA) will act to revoke the

 professional’s DEA registration if he or she has one.

7. The board certified health professional’s certifying organization will act to revoke his or her certification.

For more reasons why a health care provider should not relinquish a professional license, click here.

Innocent Until Proven Guilty.

Remember, all person are presumed innocent until convicted in a court of law. In this case, the chiropractor has been convicted in a court of law.

Contact Health Law Attorneys Experienced in Handling Medicare Audits.
Medicare fraud is a serious crime and is vigorously investigated by the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), state Medicaid Fraud Control Units (MFCUs) and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today.

The Health Law Firm’s attorneys routinely represent physicians, nurses, chiropractors, medical groups, clinics, pharmacies, home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Do you think this sentence is too steep? Do you think the doctors the former chiropractor worked with will receive the same sentence? Please leave any thoughtful comments below.

Sources:

Pavuk, Amy. “Chiropractor gets 15 Years Prison for Illegally Writing Prescriptions and Healthcare Fraud.” Orlando Sentinel. (November 28, 2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-chiropractor-painkillers-sentence-20121128,0,60766.story

Federal Bureau of Investigation. “Former Daytona Beach Chiropractor Sentenced to More Than 15 Years in Federal Prison.” FBI. (November 29, 2012). From: http://www.fbi.gov/jacksonville/press-releases/2012/former-daytona-beach-clinic-owner-sentenced-to-more-than-15-years-in-federal-prison

Longa, Lyda. “Judge Sentences Chiropractor Joseph Wagner to 15-Year Term.” Daytona Beach News Journal. (November 28, 2012). From: http://www.news-journalonline.com/article/20121128/NEWS/311289998/1025?p=2&tc=pg

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Orlando Pharmacist Accused of Filling Phony Prescriptions for Painkillers

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Sex, prescription drugs and money – sounds like the next big rock ‘n’ roll song, doesn’t it? According to a number of news sources, the owner of an Avalon Park-area pharmacist was allegedly knowingly filling phony prescriptions for painkillers. The pharmacist is also accused of exchanging sex for drugs with at least one woman, according to the Orlando Sentinel. This investigation was led by the Metropolitan Bureau of Investigation (MBI) and the Drug Enforcement Administration (DEA). Both agencies simultaneously raided the pharmacy on November 29, 2012.

Avalon Park is a community it the greater Orlando area.

DEA Agents Raided Pharmacy and Pharmacist’s Home.

According to WFTV, the owner of the pharmacy and two employees sat handcuffed outside the pharmacy as federal drug agents reportedly removed boxes of evidence from the pharmacy during the raid. Agents then moved onto the pharmacist’s nearby home.

It’s believed another person was producing fake prescriptions and asking others to get them filled at the Avalon pharmacy and others around town. The people who fill the prescriptions are nicknamed “smurfs.” They are usually hired by a drug ring. They return the pills from the prescriptions they get filled, back to the ring. Click here to read what Papa Smurf has to say about his name being used in such a manner.

According to WFTV, 230 fraudulent prescriptions were produced and 33 were filled at the Avalon-area pharmacy.

Click here to watch WFTV’s report on this raid.

Smurf Allegedly Received Drugs for Sex.

A woman, who worked as a smurf, allegedly told federal agents she had sex with the pharmacist. Afterward, the pharmacist gave her cash and oxycodone, according to the Orlando Sentinel. However, we want to make it clear that those who break the law and get caught often point the finger at innocent people, trying to divert blame from themselves.

To read the article from the Orlando Sentinel, click here.

Charges Being Faced.

The pharmacist faces up to 32 counts of trafficking in controlled substance and one count of conspiracy to traffic. Federal agents believe the pharmacist is part of a larger drug ring.

On the Florida Department of Health (DOH) website his license is still listed as clear/active. To see his license status, click here.

Remember, all who are name or discussed in our blog are innocent until proven guilty in a court of law.

Contact Health Law Attorneys Experienced with Representing Pharmacists and Pharmacies.

The attorneys of The Health Law Firm provide legal representation to pharmacists and pharmacies in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Tell us your thoughts on this story. Are federal drug agents fighting a losing battle? Please leave any thoughtful comments below.

Sources:

Barrett, Steve. “Avalon Park Pharmacy Owner Accused of Filling Fake Oxycodone Prescriptions.” WFTV. (November 30, 2012). From: http://www.wftv.com/news/news/local/dea-agents-raid-avalon-park-pharmacy/nTJbw/

Pauk, Amy. “Pharmacist Accused of Over-Dispensing Painkillers, Exchanging Pills for Sex.” Orlando Sentinel. (November 29, 2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-avalon-park-pharmacy-20121129,0,6040870.story

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Fake Pharmacist Sentenced to Prison for Working in Central Florida Pharmacies

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On November 2, 2012, a former Altamonte Springs resident was sentenced to three and a half years in federal prison for fraudulently working as a Central Florida pharmacist from 2000 to 2009, according to the Department of Justice (DOJ).

Click here to read the press release from the DOJ.

I previously blogged about this story when the fake pharmacist pleaded guilty. Click here to read that blog.

Phony Pharmacist Worked at Central Florida Pharmacies Including CVS and Walgreens.

According to an article in the Orlando Sentinel, the man worked at pharmacies throughout Central Florida, including a CVS and a Walgreens. While working at one of the pharmacies, he allegedly gave a customer the incorrect medication, causing that person to suffer a stroke.

Man Will Spend Time in Prison and Must Change His Name.

Allegedly, the man fraudulently obtained a pharmacy license in September of 2000

from the Florida Department of Health (DOH) by using the name, date of birth, Social Security number and pharmacy education information of a licensed pharmacist in Arizona. In 2004 the man actually changed his legal name by fraud to the name of the licensed pharmacist.

Along with his prison sentence, the fake pharmacist was ordered to change his name back to his legal name.

Fun with Alliteration.

Pardon my alliteration, but I just love all of those “F” sounds like I used in the title for this blog. For comparison, see my blog on Franck’s Pharmacy fungus case.

Look for More Stories on Phony and Fraudulent Health Professionals to Come.

In the near future on this blog we will include additional articles on fake doctors and health professionals, some old, some new.

To see a recent blog on a fake dentist in Miami, click here. You can also read the story of a fake plastic surgeon in New York by clicking here.

Contact Health Law Attorneys Experienced with Representing Pharmacists and Pharmacies.

The attorneys of The Health Law Firm provide legal representation to pharmacists and pharmacies in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

What do you think of all the fake health provider stories? Please leave any thoughtful comments below.

Sources:

FBI.gov. “Pharmacist Impersonator Sentenced to Prison and Ordered to Change His Name.” FBI, Tampa Division. (November 1, 2012). From Press Release: http://www.fbi.gov/tampa/press-releases/2012/pharmacist-impersonator-sentenced-to-prison-and-ordered-to-change-his-name

Pavuk, Amy. “Fake Pharmacist Sentenced to Federal Prison.” Orlando Sentinel. (November 1, 2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-fake-pharmacist-prison-20121101,0,4565731.story
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.