Category Archives: Licensing

Volusia County Chiropractor Pleads Guilty to Federal Charges of Illegally Prescribed Drugs, Healthcare Fraud

Joseph Wagner, a Volusia County chiropractor accused of prescribing pain killers and muscle relaxers to patients under other doctors’ names, has plead guilty to Federal charges on Tuesday.

Reports indicate that Wagner, who operated Wagner Chiropractic & Acupuncture Clinic on North Ridgewood Avenue, has been under investigation since 2009 when auto insurers began reporting the provider for billing services that were never performed.  Investigators discovered Wagner was committing insurance fraud and illegally distributing drugs by using the Drug Enforcement Administration number and name of another physician.  Wagner was not permitted to prescribe drugs as he was a chiropractor and not a licensed Florida medical doctor.

In July 2010, one of Wagner’s patients overdosed within days of being prescribed painkillers, muscle relaxers and anti-anxiety drugs.  Reports indicate that the patient did survive.   Part of Wagner’s fraud scheme involved submitting fake billings in the names of other, presumably properly licensed, doctors.  Prosecutors say that the the insurance company reimbursements were then split between those doctors and Wagner.  Wagner was indicted on 95 charges and plead guilty to three counts on Tuesday: healthcare fraud, conspiracy to distribute controlled substances and transactional money laundering.

The full article from the Orlando Sentinel is available here.

 

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Filed under Fla. Stat. 627.736 (2008), Insurance Fraud, Licensing

Owners of Sky Imaging, North Miami Beach Arrested Friday, More Than $1.5mil in Fraudulent PIP Claims

On Friday authorities arrested arrested Robbie N. Chamoun, 30, and Nazih Boulos Chamoun, 74, owners of Sky Imaging located in North Miami Beach for alleged PIP fraud.  The two are accused of operating an unlicensed accident clinic and fraudulently billing more than $1.5 million in auto-related claims to insurance companies.

Specifically the owners of Sky Imaging lacked licensing from the Agency of Healthcare Administration (AHCA) and instead enlisted a medical doctor to sign paperwork and pose as the clinic owner to qualify to bill Florida PIP insurers.

The article from the SunSentinel is available here.

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Filed under Fla. Stat. 627.736 (2008), Fla. Stat. 627.736 (2012), Insurance Fraud, Licensing

Trial Advocate Quarterly Features Article on 2012 Florida PIP Law Changes by Mark J. Rose

Trial Advocate Quarterly

Trial Advocate Quarterly, Summer 2012

The summer 2012 of the Trial Advocate Quarterly features an article by attorney and FLPIPGuide.com contributor Mark J. Rose on the recent changes to Florida’s PIP/No-Fault Law including: statutory fee schedules, the “emergency medical condition” limitation, PIP payment logs, exhaustion of benefits, explanations of benefits, examinations under oat (EUO), independent medical examinations, and fraudulent PIP claims.

The article will soon be available on the Florida Defense Lawyer Association (FDLA) website at www.FDLA.org.  Requests for full copies of the article or for more information on the recent Florida PIP law changes, please contact Mark Rose (mrose@roiglawyers.com) or Michael Rosenberg (mrosenberg@roiglawyers.com).

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Filed under Examinations Under Oath (EUO), Fla. Stat. 627.736 (2012), Independent Medical Examinations (IME), Insurance Fraud, Licensing, The Statutory "Fee Schedules"

Florida Agency for Healthcare Administration (AHCA) Issues Memo on Potential Gap in PIP Licensing Requirement

On May 8, 2012, Florida’s Agency for Healthcare Administration (AHCA) issued a memorandum in an attempt to clarify the potential “gap” in the licensing requirements under Florida’s amended PIP law, Florida Statute 627.736.

The three page memorandum finds that entities that meet the exemption standards of Florida Statute 627.736(5)(h) do not need to obtain licenses to comply with the apparent licensing requirements under the July 1, 2012 amendment to the PIP statute.

Stuart Williams, General Counsel of AHCA, concludes in the memorandum:

Consonant with applicable rules of statutory construction, the Agency believes that the Act applies the same effective date of January 1, 2013 to both the new licensure requirement and the 5(h) exemption.

The full AHCA memorandum is available here.

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Filed under Fla. Stat. 627.736 (2012), Licensing

Agency for Health Care Administration Mobile App

Yesterday the Agency for Health Care Administration (AHCA) released its mobile app allowing consumers the ability to obtain medical provider location & driving directions. AHCA says the following about the app:

“I am excited the Agency is able to make this mobile technology available,” said Secretary Liz Dudek. “The mobile facility locator will provide residents, consumers and tourists with easy access to facility information and driving directions for Florida health care facilities.”

Consumers can search for a facility by license type, county, city, proximity distance or a combination of those options.  After a facility has been selected, the mobile app will provide directions using the same directions feature on FloridaHealthFinder.gov or enter the facility address into the phone’s independent navigation application.

The app also allows the consumer to learn what type of beds and capacity the facility offers, along with the names of the facility administrator and owner. From the app, the user can link directly to the facility’s specific website, if available, to learn more. This additional resource can assist consumers in finding health care facilities that are nearby to them and fit their needs.

To download the app on Itunes click here

To download the app on Android click here

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Filed under Fla. Stat. 627.736 (2008), Licensing