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Attorney Andrew S Feldman Discusses Health Care Fraud and Abuse Laws at Annual Osteopathic Winter Seminar

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Attorney Andrew S Feldman Discusses Health Care Fraud and Abuse Laws at Annual Osteopathic Winter Seminar

Recently, health care fraud and abuse defense attorney Andrew S. Feldman was honored as a speaker at the Annual Osteopathic Winter Seminar sponsored by the Pinellas County Medical Society in Clearwater Beach, Florida. During the presentation, Mr. Feldman discussed federal and Florida laws impacting health care providers. More specifically, Mr. Feldman spoke to the 400 attendee physicians and doctors of osteopathy about medical ethics emphasizing the Florida and federal fraud and abuse laws including Stark, the Anti-Kickback Statute, the False Claims Act, the Florida Patient Self-Referrral Act, the Florida Patient Brokering statute, and the health care fraud statute which all impact physician practices.  Mr. Feldman used a variety of hypothetical situations during the presentation to demonstrate the intersection between ethical pitfalls and fraud and abuse laws affecting physician practices in Florida and nationwide. Attendees at the conference were able to interact with the speaker, Mr. Feldman, and to provide their comments regarding the hypothetical scenarios. Following the presentation, attendees were also eager to address some of the hypothetical examples raised during the presentation.

The three day Winter conference was attended by physicians statewide.

Health care fraud attorney, Mr. Feldman, is a frequent speaker on health care fraud and abuse issues and represents physicians, pharmacists, pharmacies, home health agencies, managers of assisted living facilities, and sales and marketing professionals in matters involving allegations of health care fraud and abuse, violations of the Anti-Kickback Statute, pharmacy practice violations, and violations impacting compounding pharmacies.

If you are a doctor or a pharmacy under investigation, it is critical that you retain adequate and competent counsel.

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Indicting Doctors for Medical Malpractice

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Indicting Doctors for Medical Malpractice in Florida and Nationwide

The Florida Bar Health Law Section recently included an article written by Andrew S. Feldman in the October Edition of Health Law Updates. The article focuses on the Department of Justice’s increasing commitment to prosecuting doctors including cardiologists, surgeons, dermatologists, and ophthalmologists based on allegations that the doctor has performed medically unnecessary services to defraud Medicare, Medicaid, or private insurance companies. A link to the article on health care fraud and abuse can be found here and the article is below. 

Recently, the Criminal Division of the Department of Justice has bulked up on its health care fraud indictments against physicians and dermatologists for performing medically unnecessary surgeries or procedures. Indeed, Assistant Attorney General Leslie Caldwell reinforced during the ABA’s National Institute on Health Care Fraud and Abuse in May of this year that the Department is committed to aggressively prosecuting fraud that compromises patient safety. So far, the list of defendants includes interventional cardiologists, dermatologists, and spinal surgeons.

Nonetheless, more doctors turned defendants are forcing the government to prove their guilt beyond a reasonable doubt at trial in these cases. In September, esteemed ophthalmologist, Dr. David Pon, was convicted of 20 counts of health care fraud following a month long trial in Jacksonville, Florida. The evidence adduced at trial demonstrated that Pon intentionally misdiagnosed more than 500 Medicare beneficiaries as suffering from wet macular degeneration, a degenerative and incurable disease, and then used his false diagnoses to bill the Medicare program for unnecessary diagnostic testing and unwarranted laser treatments.

Similar to Dr. Pon, last month, cardiologist, Dr. Harold Persaud was also convicted of multiple counts of health care fraud based on evidence at trial demonstrating that Dr. Persaud falsely diagnosed patients and falsified documentation in order to implant cardiac stents in patients when stents were unnecessary. Significantly, at trial, Dr. Persaud asserted that he had a “good faith” defense to the health care fraud accusations reasoning that any surgeries were performed through mistakes or carelessness and were not performed to cheat or deceive the Medicare program and draining U.S. tax dollars.

The above physicians are not alone though. Future medical necessity prosecutions abound, including a health care prosecution targeting a South Florida ophthalmologists’ use of Lucentis injections to treat macular degeneration, and a prosecution of a dermatologist premised on the performance of alleged unnecessary Mohs surgeries. Both cases are set for trial in 2016.

Thus, in 2016, it is anticipated that the Department will continue to investigate and prosecute fraud in connection with the performance of unnecessary surgeries or procedures.

Feldman Firm has experience representing physicians and health care practitioners in health care fraud investigations and prosecutions. Contact the Feldman Firm if you have been accused of or are under investigation for health care fraud and abuse.

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Andrew S. Feldman Quoted in Law 360 Discusses How to Respond to IRS

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Andrew S. Feldman Quoted in Law 360 Discusses How to Respond to IRS 

Attorney Andrew S. Feldman was recently quoted in Law 360 and discussed how to respond to IRS in  3 Tips For Responding to IRS Document Requests . The article discussed strategies for how to respond to the IRS and how to respond to an an IRS request for documents or an IRS summons.

RespondiIRSng to the IRS can be onerous and should not be done without the assistance of an experienced attorney. With the assistance of an attorney, you may evaluate which documents are relevant and, more importantly, which documents should be produced. Assessing which documents should be produced is a complicated task that you should not attempt to accomplish without the assistance of an attorney.  Hiring an attorney may also help a tax payer avoid the possibility of unknowingly or inadvertently producing documents that are potentially incriminating or contain privileged information. Further, if you decide not to produce certain documents, then the IRS may challenge your reasons for not producing those documents.

The IRS has also increased the amount of summonses (John Doe and otherwise) and document requests that they are sending to taxpayers related to foreign bank accounts and foreign assets or income. Taxpayers with unreported foreign bank accounts or foreign assets should also seriously consider contacting an experienced attorney prior to receiving a IRS request for documents or an IRS summons.

Mr. Feldman has experience with IRS investigations including responding to IRS summonses, criminal tax investigations, and investigations and audits involving foreign assets and foreign bank accounts.

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Andrew S Feldman Speaks at the Annual Meeting for the Florida Academy of Pain Medicine Discusses Patient Access to Controlled Substances

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Attorney Andrew S. Feldman Speaks at the Annual Meeting for the Florida Academy of Pain Medicine on Patient Access to Controlled Substances

During the annual meeting of the Florida Academy of Pain Medicine, Mr. Feldman participated in a panel discussion, Patient Access to Controlled Substances. During the panel, Mr. Feldman addressed the aggressive government response to opioid abuse and pharmaceutical diversion and emphasized that “if you are operating in the controlled substance universe, you are operating in a law enforcement universe.”

Mr. Feldman further underscored that the reaction to the “pill mills” era has been devastating to patients seeking treatment for pain. Similarly, costly enforcement actions against major retail pharmacies, like Walgreens and CVS, and against distributors such as Cardinal Health coupled with FDA litigation for false promotion of opioids against major pharmaceutical manufacturers, have resulted in unintended consequences to patients seeking treatment for chronic and acute pain. Likewise, Mr. Feldman noted that the Drug Enforcement Administration recently issued a final rule rescheduling hydrocodone containing products to Schedule II, “yet when you read the entire final rule and the 35 pages of the rule, DEA only included a single paragraph about patient access to care.”

Significantly, during the panel, it was also noted that, the current Drug Enforcement Administration approach to problems related to the prescription and dispensing of opioids, has created an environment where everyone is practicing scared. In doing so, the Drug Enforcement Administration appears to have frustrated relationships between pharmacists (and big box pharmacies like Walgreens and CVS) and pain physicians. This current approach has impacted patient access to drugs, caused distributors to take a more conservative approach to shipping opioids to pharmacies, and has forced physicians to prescribe alternative methods, albeit sometimes reluctantly, for the treatment of pain.

Finally, based on questions and comments from physician-attendees during the panel, there is a collective need to begin a dialogue among pain physicians, the Board of Pharmacy, and the Drug Enforcement Administration to implement policies and procedures which do not put patients at risk of not receiving their medications.

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Attorney Andrew S. Feldman Delivered Two Part Webinar on Health Care Fraud and Abuse

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Attorney Andrew S. Feldman Delivered Two Part Webinar on Health Care Fraud and Abuse

Attorney Andrew S. Feldman recently delivered a two part webinar on health care fraud and abuse which is available here (type full name and email to register and the link to the health care fraud webinar will become available) The two part webinar was part of an ABA Health Law Section Member Benefit. During the webinars, which focused on health care fraud and abuse, Mr. Feldman addressed the recent government enforcement trends and the government’s heightened focus on health care fraud and abuse in managed care, health care fraud and abuse in Medicare Part D, and improper sales and marketing arrangements.

In addition, Mr. Feldman discussed the uptick in Anti Kickback Statute prosecutions –Anti Kickback Statute criminal prosecutions and  False Claims Act whistleblower lawsuits based on Anti Kickback violations – the recent nationwide takedowns for health care fraud and abuse in the HEAT target locations, and the proliferation of medical necessity, as a prosecution theory, in criminal health care fraud cases especially in relation to dermatologists, ophthalmologists, cardiologist, and spinal surgeons.

The webinar series also addressed some of the recent False Claims Act decisions before the Supreme Court of the United States and examined and suggested various defense and mitigation strategies.

Please feel free to view the power point presentation from the two part webinar.