Ari H. Gerstin

Subscribe to all posts by Ari H. Gerstin

Medical Marijuana’s Florida Debut: A Process Fraught with Constraints

Florida’s limited medical marijuana program is finally almost ready to go live. For those who have been sitting on the sidelines waiting for the right moment to learn about the program, now is that moment. Recently, the Florida Department of Health (DOH) hosted a webinar highlighting some of the key features, as well as limitations … Continue Reading

Federal Appeals Court Reverses Conviction of Mental Health Program Director

In a recently released decision, the United States Court of Appeals for the Eleventh Circuit reversed the conviction of a former community mental health program director who was convicted after trial of conspiring to commit health care fraud at American Therapeutic Corporation (ATC).  According to the government, ATC, which was headquartered in Miami and had multiple … Continue Reading

Department of Health and Human Services Office of Inspector General’s FY 2014 Work Plan Identifies Security of EHR Technology as New Focus

On January 31, 2014, the U.S. Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) released its annual work plan.  Not surprisingly, issues relating to Electronic Health Records (“EHRs”) continue to receive significant attention. Pursuant to the American Recovery and Reinvestment Act of 2009, OIG received funding to evaluate whether funds received … Continue Reading

“Meaningful” Errors Require Hospital System to Refund $31M

In what is reported to be the largest repayment to date involving “meaningful use” incentive payments, Naples, Florida-based Health Management Associates, Inc. (“HMA”), with 71 inpatient facilities in 15 states, including Florida, recently voluntarily notified the Centers for Medicare and Medicaid Services (“CMS”) that it erroneously certified its electronic health record (“EHR”) technology in the … Continue Reading

PODs Continue to Attract Scrutiny from OIG and Congress

In the wake of a recent U.S. Department of Health and Human Services Office of Inspector General (“OIG”) investigation, physicians with ownership interests in medical device distributorships and hospitals should prepare for an uptick in the scrutiny of physician-owned distributorships (“PODs”). The OIG investigation generated a report, Physician-Owned Distributors of Spinal Devices: Overview of Prevalence … Continue Reading

Meaningful Use Attestation Deadline Approaching: What You Need To Know

As the end of the federal fiscal year rapidly approaches, so does the attestation deadline for hospitals participating in the Medicare Electronic Health Record (EHR) Incentive Program. Each year, hospitals are required to show that they are “meaningfully using” their EHRs in order to receive their incentive payment and avoid any adjustment. They demonstrate such … Continue Reading

EHR Meaningful Use Audits Come to Florida

As previously reported, the Office of Inspector General (OIG) for the Department of Health and Human Services (HHS) plans to audit healthcare providers that received incentive payments to adopt electronic health record (EHR) technology. We have now received reports confirming that certain provider entities have been audited in Florida regarding these EHR incentive payments.  The … Continue Reading

Tuomey Standing Firm in Face of “Stark” Penalties

The next round in United States ex. rel. Drakeford v. Tuomey Healthcare System, Inc., is underway and Tuomey Healthcare keeps fighting.  As previously reported, on May 8, 2013, a federal jury found that Tuomey Healthcare System, a non-profit system in South Carolina, violated the Stark law and the False Claims Act in connection with its … Continue Reading

Jury Returns Mixed Verdict in Complicated Medicaid Fraud Trial

Over five years after law enforcement agents raided the Tampa, Florida headquarters of WellCare Health Plans, a federal jury delivered a mixed verdict in the criminal trial of the company’s former top executives. The verdict, which was delivered on Monday, came after a nearly two and a half month trial and lengthy jury deliberations that … Continue Reading

Health Care Solution Network Inc. Fraud Case Continues to Generate Lengthy Prison Terms

Healthcare providers continue to receive lengthy sentences from federal district court judges in the Sothern District of Florida in the wake of the Health Care Solutions Network Inc. (HCSN) community mental health center fraud. From 2004 to 2011, HCSN billed Medicare and the Florida Medicaid program approximately $63 million for purported mental health services. Fifteen … Continue Reading

Second Time Around Tuomey Healthcare System is Found to Have Violated Stark Law and False Claims Act; Faces Penalties of up to $357 Million

In the ongoing saga of U.S. ex. rel. Drakeford v. Tuomey Healthcare System, Inc., on May 8, 2013, a South Carolina jury found that Tuomey violated the Stark Law and the False Claims Act.  The jury determined that Tuomey submitted over 21,000 improper claims, totaling $39 million. When penalties and treble damages of up to … Continue Reading

EMR Market Continues to Grow While Practitioner Satisfaction Decreases

According to a new report from healthcare market research firm Kalorama Information, the market for Electronic Medical Records (EMRs) was $20.7 billion in 2012, up 15 percent from $17.9 billion in 2011. The EMR market includes revenues from EMR and Computerized Physician Order Entry (CPOE) systems as well as directly-related services such as installation, training, … Continue Reading

Florida Physician to Pay $26.1 Million to Settle False Claims Allegations

On February 11, 2013, the U.S. Department of Justice (DOJ) announced the largest settlement ever reached with an individual under the False Claims Act (FCA) in the United States District Court for the Middle District of Florida. The settlement is also one of the largest with an individual under the FCA in U.S. history. According … Continue Reading