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Florida Medicare And Medicaid Fraud Defense Attorney

When it comes to health care, Florida is one of the most heavily regulated states in the country. In addition to federal law, Florida health care law is fraught with nuanced regulations that apply to:

  • Primary health care providers
  • Physicians
  • Groups
  • Medicare Part B providers
  • Diagnostic imaging centers
  • Ambulatory surgical centers
  • Durable medical equipment providers
  • Other professionals

Ultimately, there are three main federal laws about which medical professionals and organizations need to be aware:

  1. The Stark Law
  2. The federal anti-kickback statute
  3. The federal false claims statute

Within all of these, one must be extremely familiar with Medicare billing regulations, provider enrollment and the use of ancillary providers including nurse practitioners and physicians assistants and 'incident to' billing. All too often these present serious costly mistakes.

On the local level, health care providers must pay attention to the Florida Patient Self-Referral Act and the Florida Patient Brokering Act.

Ultimately, it is extremely important for clients undertaking these transactions to fully understand their exposure and obligations. Many physician groups go into situations with management agreements, investing in or contracting to be medical directors for diagnostic imaging, home health, nursing homes, assisted living facilities, co-management agreements with hospitals and surgical centers.

If you or your organization is faced with any of these issues, it is critically important to understand your legal obligations and to mitigate all potential risk and costs.

Florida Medicare Fraud Defense Lawyer

We at Michael R. Lowe, P.A., are prepared to bring our experience to look at transactional agreements, medical director agreements, co-management agreements, management services agreements, in-house pharmacy or physician dispensing agreements where they want to bring an ancillary piece into their practice. We also defend allegations that physicians or clients have violated the FPBA or anti-kickback statute

We review these to ensure that when they go into them, they are compliant and will not violate any of these laws. A lot of times there are exceptions under the Stark Law that are safe harbors. We will actively do everything to promote a culture of compliance and transparency through codes of conduct, staff policies, corrective action components and internal auditing. We then try to drive transactions within the safe harbors and have extensive experience writing opinion letters, carrying out analysis and advising clients on whether they should accept the deals or go into them. This includes issues related to:

  • Space rental
  • Equipment rental
  • Personal services
  • Management contracts
    • Medical director agreements
    • Professional service agreements
    • Co-management agreements

In every case, we review the structure of transactions, write agreements and advise clients on compliance. Our attorneys also defend clients in civil litigation related to government investigations, Medicare and Medicaid audits, investigations by the Office of Inspector General and Florida Department of Health.

Additionally, we are prepared to work as co-counsel with criminal defense lawyers on fees splitting and Patient Brokering Act issues. We are also often called in to defend in PIP cases and private insurance litigation as well as health care law.

To schedule an initial consultation with one of our Orlando Medicare and Medicaid compliance lawyers, call 407-332-6353 or contact us online.

*Please note Michael R. Lowe, P.A. does not represent patients in any HIPAA, Medical Malpractice or Health Care Law Matters. Michael R. Lowe, P.A. only represents Health Care professionals and Health Care facilities. If you are a patient looking for representation please do not contact our firm, we are unable to refer you at this time and are advising you to seek counsel elsewhere. Please contact The Florida Bar Association lawyer referral service 1-800-342-8011 or online.

Recent News

1/24/2013 Practice Area Focus: Medical Malpractice Defense and Personal Counsel The Drawn Out Process of the Medical Lawsuit

Local: 407-332-6353 · Toll Free: 800-571-5208

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