As peptides gain popularity in medicine and wellness, many wonder — are peptides legal in the U.S.? This detailed guide explores FDA regulations, approved medical uses, and compliance requirements to help healthcare professionals and consumers stay informed and legally protected.
Continue reading
DME medical services play a vital role in Florida’s healthcare industry. This 2025 guide explains everything about DME compliance, licensing, Medicare billing, and AHCA regulations to help providers operate legally and efficiently while maintaining patient care standards.
Continue reading
The Florida Board of Nursing license lookup is an essential tool for verifying nursing credentials and ensuring compliance across Florida’s healthcare industry. This detailed guide explains how to check license status, understand verification results, and maintain professional integrity while meeting regulatory requirements in 2025.
Continue reading
The DME healthcare acronym stands for Durable Medical Equipment — essential devices that aid patient recovery and long-term care. From wheelchairs to oxygen equipment, DME supports daily living while operating under strict federal and Florida healthcare compliance rules. This guide explains the meaning of DME, its role in patient care, and the legal responsibilities healthcare providers must understand to remain compliant and deliver quality care.
Continue readingYet another pharmacy owner was just convicted of unlawfully dispensing over 1.5 million doses of controlled substances, primarily oxycodone and hydrocodone.
By: Karen Davila
In my last couple of articles, I’ve focused on the controls necessary to safely operate a pharmacy and dispense appropriate prescribed medications, including controlled substances. And those of you who heed that kind of advice are likely to avoid the unwanted attention of law enforcement. However, for those who continue to think they can operate with impunity, heads’ up: the war against opioids in the U.S. is ongoing and enforcement activities are not slowing down. Below is an article about this recent case out of Texas and some lessons we can all take away from what was reported.
In this most recent case, a federal jury in Texas convicted a Texas pharmacy owner (Carr) on March 7 of one count of conspiracy to unlawfully distribute and dispense controlled substances, four counts of unlawfully distributing and dispensing controlled substances, one count of conspiracy to launder money, and two counts of engaging in transactions in property obtained from the illicit activity. Carr now faces up to 140 years in prison, among other consequences.Continue reading
Providing a high-quality and safe environment and care for vulnerable seniors is a top priority for continuing care communities (CCCs). Senior communities that provide a full continuum for seniors aging in place (including independent living, assisted living, skilled nursing, and memory care) often focus their safety concerns and resources on the licensed areas of the community, where falls and skin breakdown are the subject of lawsuits. Sometimes overlooked are the risks that arise when independent living residents bring their own personal caregivers into the community to support their needs.
Growing Use of Personal Caregivers
More and more seniors are finding safety and security in CCCs throughout the country. And, as they age in place, maintaining that independence often involves the use of personal caregivers who come into the CCCs and create additional risks. Each time a personal caregiver is allowed admittance to the CCC, real risk is created- and that risk can lead to legal liability, including:
But there are a few basic steps that a CCC can do to reduce those risks, while still allowing residents their independence. Here are some simple considerations:Continue reading
On November 8, 2021, The Department of Health & Human Services (HHS), Office of Inspector General (OIG) released a revised and renamed Provider Self-Disclosure Protocol (SDP), now known as the “Health Care Fraud Self Disclosure “protocol. The SDP was created in 1998, and the protocol can be used to voluntarily identify, disclose and resolve instances of potential fraud involving federal healthcare programs. As described on the OIG website, “Self-disclosures give persons the opportunity to avoid the costs and disruptions associated with a Government-directed investigation and civil or administrative litigation.”Continue reading
More and more seniors are finding safety and security in continuing care communities (CCCs) throughout the country. And, while they want the increased safety and security, they do not want to lose their independence. Aging in place and maintaining that independence often involves the use of various personal service providers (PSPs) who come onto the CCC campus and create new risks. PSPs go by many names and perform many functions, including housekeeping, meal preparation, assistance with activities of daily living (bathing, grooming, eating), grocery shopping, dog walking, and driving the resident to various offsite appointments.Continue reading
Medical necessity is foundational to payment by government payers (Medicare, Medicaid, Tricare, FEHBP) for health care services. If services are not medically necessary, any claims filed constitute false claims. In a recent DOJ False Claims Act (FCA) case, a civil settlement of a whistleblower action was reached in resolution of allegations that over a more than six-year period, a rehabilitation therapy contractor violated the FCA by causing the submission by 12 skilled nursing facilities (SNFs) of false claims for “medically unnecessary, unreasonable, and/or unskilled rehabilitation therapy services.” Under the Settlement Agreement, the rehabilitation therapy provider agreed to pay $8.4 million to resolve the matter.
BACKGROUND ON SNF REIMBURSEMENT
In order to understand the case, it is important to understand (at least at a basic level) SNF reimbursement. This case arises during the time period 2010-2016 when SNFs were paid by Medicare under the Resource Utilization Groups (RUGs). By way of background, RUGs are a prospective payment model which includes a system of grouping a SNF’s residents according to their clinical and functional statuses which information derives from the minimum data set (MDS) assessment for the resident. Soon after adoption, many SNFs and rehabilitation therapy providers adjusted their model of care delivery to increase the level of reimbursement. The methodology created an incentive to deliver more therapy than skilled nursing services since those RUGs were reimbursed at a higher rate.Continue reading
By: Zach Simpson
There have been a rise in cases recently, in which practices that operate under a Health Care Clinic License have been brought under scrutiny by insurance companies trying to recoup funds through any means possible. In an effort to claw back funds insurance companies are beginning to claim that medical directors are failing to meet their statutory obligations under Florida Law which in turn can have serious monetary repercussions. Due to the clinics allegedly failing to meet their statutory obligations the insurance companies are filing suit to recoup any payments made while violating the Health Care Clinic Act obligations, and to stall any future payments due until such cases are heard.
By law, a medical director must be a health care practitioner that holds an active and unencumbered Florida license as a medical physician, osteopathic physician, chiropractic physician, or podiatric physician. The type of services provided at a clinic may dictate who would be able to serve as a clinic’s medical director, because a medical director must be authorized under the law to supervise all services provided at the clinic.
