Tag Archives: Rafael A. Gaitan

01 Aug

One More Week to Go: FDA’s New Tobacco Rules Go Into Effect on August 8, 2016

Retailers, manufactures and retailer/manufacturers of tobacco products should take note that compliance with the U.S. Food and Drug Administration (FDA) new tobacco rules is rapidly approaching.  Certain provisions of the final rule become effective Monday, August 8, 2016.   On May 10, 2016, the FDA issued its final rule expanding the FDA’s definition of “tobacco

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17 Sep

AHCA Increases Efforts to Collect Medicaid Overpayments

On September 16, 2014, Florida’s Agency for Health Care Administration (AHCA) issued a notice to Medicaid providers informing that “in the upcoming weeks the Agency will increase its efforts to ensure that providers are repaying overpayments”, while also reminding Medicaid providers of “their obligation to promptly refund moneys due to [AHCA], including any moneys received

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04 Mar

Hospital enters $85 million settlement for alleged Stark Law violations

Halifax Hospital agreed Monday, March 3, 2014, to settle a whistleblower case for alleged Stark Law violations with the U.S. Justice Department in the amount of $85 million — an amount so large it is more than twice the previous recors for hospital systems accused of Medicare fraud.  The Daytona Beach, Florida  hospital is accused of

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23 Aug

Suarez Gaitan Successfully Reduces a $736,305.93 Overpayment to $6,826.00

  CMS sought recovery of an alleged overpayment in excess of $730,000 from a diagnostic laboratory, upon the conclusion and recommendation of Safeguard Services (SGS) to deny all claims submitted for 3,006 Medicare beneficiaries.  Mr. Gaitan and Mr. Suarez, of our health care practice group, appealed the overpayment claim through the reconsideration (second level appeal),

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17 Apr

HHS reaches $100,000 settlement with Phoenix Cardiac Surgery for Lack of HIPAA Safeguards

Phoenix Cardiac Surgery, P.C., of Phoenix and Prescott, Arizona, has agreed to pay the U.S. Department of Health and Human Services (HHS) a $100,000 settlement and take corrective action to implement policies and procedures to safeguard the protected health information of its patients. The settlement with the physician practice follows an extensive investigation by the HHS Office for Civil Rights (OCR) for potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules. For assistance developing a HIPAA compliance program or responding to a HIPAA breach, contact Rafael A. Gaitan, Esq. Mr. Gaitan has over 15 years experience in the health care industry and regularly counsels physician practices on regulatory matters including HIPAA and the HITECH rules.

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17 Apr

Community Pharmacy Re-permitting Required Before July 1, 2012

Section 465.018, Florida Statutes was amended in 2011, by HB 7095 to require every community pharmacy that dispenses Schedule II and Schedule III controlled substances to be re-permitted by July 1, 2012. All owners, officers, and prescription department managers of the community pharmacy will need to submit fingerprints to the Department of Health as part of the permitting process; and the community pharmacy must implement written policies and procedures for preventing controlled substance dispensing based upon fraudulent representations or invalid practitioner-patient relationships. To avoid disruptions to a business, community pharmacies are advised to begin the permitting process immediately. For assistance and guidance with applying for a community pharmacy permit, developing policies and procedures for preventing controlled substance dispensing fraud and abuse, or to appeal a permit denial or revocation, contact Rafael A. Gaitan, Esq. Mr. Gaitan has over 15 years experience in the health care industry, regularly representing pharmacies and pharmacist before regulatory bodies like the Florida Department of Health, and the Board of Medicine. Mr. Gaitan can be reached via e-mail at rgaitan@gaitanmorales.com or via telephone at 305.329.1462.

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17 Jan

House subcommittee passes bill authorizing the Surgeon General to restrict the license of doctors who over-prescribe narcotics

January 17, 2012.  Today, the House Health & Human Services Quality Subcommittee passed a bill aimed at giving the Surgeon General more power to stop doctors who over-prescribe narcotics, but only after a rewrite removing the word “suspension” — a compromise worked out between the Florida Medical Association and  Department of Health. Under the rewritten version of

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09 Jan

Medicare delays RAC demonstration program intended to hold back payments to hospitals

CMS has announced that it will postpone its Recovery Audit (RAC) Prepayment Review demonstration project that would have held up payments to hospitals until the Medicare RAC reviews the claim to ensure that the provider complied with all Medicare payment rules. The Medicare RAC Prepayment Review demonstration called for the RACs to conduct prepayment review of claims for 15 procedures that historically result in high rates of improper payments. Many doctors were unhappy with the proposed program, especially cardiologists, who would be most affected since 11 of the 15 procedures identified for Medicare RAC prepayment review affect cardiologists.

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22 Dec

Revised HIPAA: Who is a “Business Associate”? What Each Business Associate Must Know?

For the purposes of HIPAA, any person or business providing particular services to a covered entity involving “protected health information” (PHI) is known as a “business associate”; in fact anyone who would have occasion to encounter PHI in the course of their work for a HIPAA-covered entity—is a “business associate” and is not only under the same duty as the covered entity to comport itself by the dictates of HIPAA, but must also have a Business Associate Agreement (BAA). At Gaitan Morales, we regularly counsel health care entities and their subcontractors on such regulatory issues as HIPAA, the HITECH rule, the Red Flag rules and numerous other laws and regulations that govern the health care industry. To protect your medical practice or associated health care business from a regulatory mishap, call Rafael A. Gaitan, Esq. today at 305.329.1462, to schedule a free initial consultation and learn more about how the law firm of Gaitan Morales can help you.

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16 Dec

More Fraud in Foreclosure Cases: Florida Investigates Process Servers Practices

The Florida Attorney General’s office (AG), along with State regulators, are investigating two process servicing companies that deliver foreclosure notices to homeowners, on civil allegations of slipshod business practices. Process servicers are persons who have been certified to administer “service”, that is the official delivery of legal papers on parties, witnesses or other people involved in a case. Failure to deliver these documents to the defendant homeowner, can result in the homeowner losing its home without the benefit of the judicial process. Attorney Rafael A. Gaitan, at Gaitan Morales, PLLC, represents homeowners at risk of losing their homes.

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