STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, Petitioner, V. DOH Case No. 2017-19600 JOHN JOSEPH JANICK, M.D., Respondent. / ADMINISTRATIVE COMPLAINT Petitioner, the Florida Department of Health (the Department), hereby files this Administrative Complaint before the Florida Board of Medicine (the Board) against Respondent, John Joseph Janick, M.D. (Respondent), and in support thereof alleges: 1. | The Department is the state agency charged with regulating the practice of medicine in Florida pursuant to section 20.43, Florida Statutes, and chapters 456 and 458, Florida Statutes. 2. At all times material hereto, Respondent was a licensed physician in Florida, having been issued license number ME 27204. 3. Respondent's address of record is 1649 Tamiami Trail, Unit 1C, Port Charlotte, Florida 33948. 4. On or about May 16, 2014, Respondent married Lisa McLaren, a/k/a Lisa Janick, a/k/a Lisa McLaren-Janick. 5. On or about October 19, 2017, the United States of America charged Respondent and Lisa McLaren, by Indictment, in Case Number 8:17- cr-502, in the United States District Court for the Middle District of Florida, with: ) a. | One count of conspiracy to commit healthcare fraud and conspiracy to solicit and receive illegal remunerations (including any kickback, bribe or rebate) in violation of Title 18, United States Code, section 371; Title 18, United States Code, section 1347; and Title 42, United States Code, section 1320a-7b(b)({1)(A); and b. Eleven (11) counts of healthcare fraud in violation of Title 18, United States Code, section 1347. 6. Onor about June 8, 2018, the United States of America charged Respondent, by Superseding Information, with one (1) count of obstruction of a federal audit in violation of Title 18, United States Code, section 1516. 7. | Respondent subsequently waived prosecution by Indictment and consented to proceed by Information rather than by Indictment. DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 2 of 17 8. On or about June 11, 2018, the United States of America and Respondent entered into a Plea Agreement (the Agreement). 9. In Paragraph A.1. of the Agreement, Respondent agreed to enter a plea of guilty to Count One of the Superseding Information which charged him with obstruction of a federal audit in violation of Title 18, United States Code, section 1516. 10. In Paragraph A.3. of the Agreement, Respondent acknowledged understanding the nature and elements of the offense with which he was charged and to which he was pleading guilty. The elements of the offense with which Respondent was charged and to which Respondent plead guilty are: First: A federal auditor was in the performance of his or her official duties; Second: Those official duties related to a person, entity, or program receiving in excess of $100,000, directly or indirectly, from the United States in any one-year period under a contract, subcontract, grant, or cooperative agreement; Third: The defendant knew that an auditor [sic] was in the performance of his or her official duties; Fourth: The defendant endeavored to influence, obstruct or impede the federal auditor in DOH v. John Joseph Janick, M.D,, DOH Case Number 2017-19600 Administrative Complaint Page 3 of 17 the performance of his or her official duties; and au ce S- The defendant acted willfully, with the intent to deceive or defraud the United States. 11. Paragraph A.5. of the Agreement provided that the underlying Indictment against Respondent would be dismissed at the time of sentencing. 12. In Paragraph A.7. of the Agreement, Respondent agreed to make ‘restitution to the victim, that is, Medicare, of the offense of obstruction in violation of Title 18, United States Code, section 1516. 13. In Paragraph B.10. of the Agreement, Respondent acknowledged he was entering into the Agreement, and was pleading guilty, freely and voluntarily. 14. In Paragraph B.11. of the Agreement, Respondent acknowledged he was pleading guilty because he is in fact guilty. 15. In Paragraph B.11. of the Agreement, Respondent admitted that the facts set forth in Paragraph B.11. of the Agreement were true, and were the case to go to trial, the United States would be able to prove those specific facts and others beyond a reasonable doubt. DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 4 of 17 16. The facts set forth in Paragraph B.11. of the Agreement are as follows: On December 20, 1978, the defendant, John Janick, M.D. (Dr. Janick), formed John Joseph Janick, M.D., P.A. (d/b/a Janick Medical Group). Dr. Janick was the president, sole director, and registered agent of this medical practice, which conducted business in Charlotte County, Florida. Dr. Janick provided services as an endocrinologist and general health practitioner in the Charlotte County area, through Janick Medical Group, from late 1978 through the . present. The entity referred to herein as HHA #1 was a home health agency, which provided home health services to eligible Medicare beneficiaries, and which received through a contract more than $100,000 from Medicare from January 1, 2014, to January 2, 2015. HHA #1 operated several home health agencies throughout the state of Florida, one of which was located in Sarasota, Florida. At times relevant to the Superseding Information, the Medicare Program (Medicare) was a federally funded program that provided free or below-cost health care benefits to certain individuals, primarily the elderly, blind, and disabled. Medicare was administered by the United States Department of Health and Human Services (HHS) through its agency, the Centers for Medicare & Medicaid Services (CMS). Medicare programs covering different types of benefits were separated into different program “parts.” Medicare Part A covered medical services provided by a Medicare-certified home health agency (HHA) to “homebound” beneficiaries. DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 5 of 17 CMS contracted with companies in order to review HHAs’ claims data. CMS contracted with SafeGuard Services, a Zone Program Integrity Contractor, which safeguarded the Medicare Trust Fund by reviewing HHAs’ claims for potential fraud, waste, and abuse. SafeGuard Services routinely obtained records from authorized Medicare providers for these audits. “Part A” of the Medicare Program covered certain eligible home health care costs for medical services provided by an HHA to persons who already qualified for Medicare and who additionally required home health services because of an illness or disability that caused them to be homebound. Part A reimbursed 100% of the allowable charges for a participating HHA only if the patient qualified for home health benefits. In order to qualify for home health benefits, the beneficiary had to: a. be confined to the home (also referred to as homebound); b. be under the care of a physician who specifically determined there was a need for home health care and established a Plan of Care (a Plan); and c. have a physician-signed certification statement specifying that the beneficiary needed intermittent skilled nursing, physical therapy, speech therapy, or a continued need for occupational therapy; the beneficiary was confined to the home; that a Plan for furnishing services was established and periodically reviewed; and that the services were furnished while the beneficiary was under the care of the physician who established the Plan. In other words, in order for Medicare to pay for services provided by an HHA, DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 6 of 17 the beneficiary had to have a referral from his or her physician. In late 2013, Dr. Janick began a romantic relationship with Lisa McLaren. At the time, Lisa McLaren had no experience in medical marketing, and no experience in marketing home health care services specifically. On February 26, 2014, Dr. Janick and Lisa McLaren each signed contracts with HHA #1. Lisa McLaren signed a contract to be a “Community Liaison” for HHA #1 in exchange for an annual salary of $80,000, and an initial bonus of $3,000, to begin immediately. Dr. Janick signed a contract to be the medical director of HHA #1's Sarasota office from April 5, 2014, through April 5, 2015. He was entitled to receive up to $3,000 per month. Both Dr. Janick’s and Lisa McLaren’‘s agreements with HHA #1 provided a list of services that Dr. Janick and Lisa McLaren would perform to earn their respective fees. The agreements also required that Dr. Janick and Lisa McLaren submit invoices/timesheets documenting the performance of these services. There is no evidence that either Dr. Janick or Lisa McLaren performed the duties and_ services enumerated in their agreements. Between March 2014 and April 2015 — when Dr. Janick and Lisa McLaren ended their relationship with HHA #1 — Dr. Janick made 197 referrals for 115 beneficiaries to HHA #1’s Sarasota office, and 13 beneficiaries to other HHA #1 offices. Janick Medical Group also filed its own claims for reimbursement relating to the home health service referrals generated by Dr. Janick. DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 7 of 17 HHA #1 paid Dr. Janick a total of $26,500 between April 30, 2014, and April 15, 2015. Throughout his tenure as Medical Director and McLaren’s tenure as a community liaison, Dr. Janick felt pressure to refer patients to HHA #1 without confirming the medical necessity of said services in order to maintain Lisa McLaren’s job. In order to facilitate the referrals required by her position, Lisa McLaren maintained an office with Janick Medical Group and accessed sensitive and protected Janick Medical Group patient records to identify potential Medicare beneficiary referrals to HHA #1, which referrals were induced by the payments made to her by HHA #1. On or about March 10, 2015, Safeguard [sic] Services went to Janick Medical Group to conduct an audit relating to beneficiaries referred by Dr. Janick to HHA #1 for home health services. The auditor was concerned about the relationship between Dr. Janick, HHA #1, and Lisa McLaren, as well as whether the beneficiaries referred by Dr. Janick actually qualified for home health services. Among other questions, the Safeguard [sic] Services auditor asked Dr. Janick about Lisa McLaren having an office at Janick Medical Group when she was purportedly an employee of HHA #1. Dr. Janick endeavored to influence, obstruct, and impede the Safeguard [sic] Services auditor, and willfully acted with the intent to deceive, by falsely stating to the federal auditor that HHA #1 paid to lease office space from Janick Medical Group for use by Lisa McLaren, who was an employee of both HHA #1 and Janick Medical Group, knowing that HHA #1 did not in fact lease this space. 17. On or about July 17, 2018, the presiding judge accepted Respondent's plea of guilty and adjudged Respondent guilty. DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 8 of 17 18. Onor about July 9, 2018, the United States of America and Lisa McLaren also entered into a Plea Agreement (the McLaren Agreement). 19. In Paragraph A.1. of the McLaren Agreement, Lisa McLaren agreed to enter a plea of guilty to Counts Five and Six of the Indictment which charged her with healthcare fraud in violation of Title 18, United States Code, section 1347. 20. In Paragraph A.3. of the McLaren Agreement, Lisa McLaren acknowledged understanding the nature and elements of the offense with which she was charged and to which she was pleading guilty. The elements of the offense with which Lisa McLaren was charged and to which Lisa McLaren plead guilty are: First: That the defendant knowingly executed, or attempted to execute, a scheme to defraud a health care benefit program, or to obtain money or property owned by, or under the custody or control of, a health care benefit program, by means of false or fraudulent pretenses, representations, or promises; Second: The health care benefit program affected interstate commerce; Third: The false or fraudulent pretenses, representations, or promises related to a material fact; DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 9 of 17 Fourth: The defendant acted willfully and intended to defraud; and Fifth: The defendant did so in connection with the delivery of or payment for healthcare benefits, items, or services. 21. Paragraph A.4. of the McLaren Agreement provided that the remaining counts against Lisa McLaren, namely Counts One through Four and Seven through Twelve, would be dismissed at the time of sentencing. 22. In Paragraph A.6. of the McLaren Agreement, Lisa McLaren agreed to “make full restitution to the Medicare Program to be paid jointly and severally with her co-conspirators.” 23. In Paragraph B.10. of the McLaren Agreement, Lisa McLaren acknowledged she was entering into the Plea Agreement, and was pleading guilty, freely and voluntarily. 24. In Paragraph B.11. of the McLaren Agreement, Lisa McLaren acknowledged she was pleading guilty because she is in fact guilty. 25. In Paragraph B.11. of the McLaren Agreement, Lisa McLaren admitted that the facts set forth in Paragraph B.11. of the Plea Agreement were true, and were the case to go to trial, the United States would be able to prove those specific facts and others beyond a reasonable doubt. DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 10 of 17 26. The facts set forth in Paragraph B.11. of the McLaren Agreement are as follows: During the period relevant to the indictment, the Medicare Program (Medicare) was a federally-funded program that provided free or below-cost health care benefits to certain individuals, primarily the elderly, blind, and disabled. Medicare Part A covered certain eligible home health care costs for medical services provided by a home health agency (HHA) to persons who qualified for Medicare and who also required home health services because of an illness or disability that caused them to be homebound. In order for Medicare to pay for services provided by a HHA, the beneficiary had to have a referral from the beneficiary’s physician, a plan of care signed by the beneficiary’s physician, and be homebound. In the fall of 2013, defendant Lisa McLaren decided that she and Dr John Janick, should market themselves to HHAs as a “package deal” be requesting that HHAs hire the defendant as a “marketer” and Dr. Janick as a “Medical Director/Consultant/Advisor,” with the intention that they would receive payments, or kickbacks, from the HHAs in exchange for home health service referrals from Dr. Janick’s practice. The defendant and Dr. Janick were successful in this endeavor with two separate HHAs in Sarasota County, Florida (HHA #1 and HHA #2). On February 26, 2014, the defendant signed a contract to be a “Community Liaison” for HHA #1, and Dr. Janick signed a contract to serve as “Medical Director” of HHA #1’s Sarasota office. The defendant’s compensation was directly tied to the number of referrals she generated for HHA #1. DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 11 of 17 During her tenure with HHA #1, the defendant, aided and abetted by Dr. Janick, falsified documents regarding face-to-face encounters with beneficiaries and plans of care, falsely stating that beneficiaries were homebound when, as the defendant knew, they were not. The defendant also knew that HHA #1 intended to bill Medicare for home health services rendered to these beneficiaries using the documents that she had falsely created to support the claims. For example, on December 29, 2014, the defendant accessed the electronic medical record of patient J.E. and used information therein to create a fraudulent referral for home health services for J.E., on which she stated, willfully and with the intent to defraud, that J.E. was homebound. On January 27, 2015, the defendant caused Dr. Janick to sign a face-to-face encounter form, which falsely and fraudulently stated that he had evaluated J.E. on January 23, 2015, and certified that J.E. was homebound due to diabetes and chronic pain. On both dates, the defendant knew that J.E. was not homebound and that HHA #1 intended to bill Medicare for medically unnecessary services rendered to J.E. On or about February 26, 2015, HHA #1 submitted a final Medicare claim for home health services rendered to J.E. for a home health episode of care running from December 31, 2014, through January 16, 2015. Medicare paid HHA #1 $334.02 for this claim. As another example, on January 15, 2015, the defendant accessed the electronic medical record of patient E.M.V. and used information therein to create a fraudulent referral for E.M.V., which stated that E.M.V. needed home health services for the purposes of diabetic management and teaching. The defendant caused Dr. Janick to sign this referral. On January 27, 2015, the defendant created a false and DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 12 of 17 fraudulent face-to-face encounter form, in which she stated that Dr. Janick had evaluated E.M.V. on January 15, 2015, and determined that E.M.V. had “uncontrolled DM [Diabetes] and require[d] assistance to leave the home due to safety at this time.” On February 12, 2015, the defendant accessed E.M.V's electronic health record again and falsely and fraudulently modified the notes to reflect an “unsteady gait” in an effort to bolster the claim for home health services. On all three of these dates, the defendant knew that E.M.V. was not homebound, that Dr. Janick had never seen E.M.V. as a patient, and that HHA #1 would use her false and fraudulent representations to make a claim for payment from Medicare for medically unnecessary — services rendered to E.M.V. On or about March 20, 2015, HHA #1 submitted a final Medicare claim for home health services rendered to E.M.V. for a home health episode of care running from January 18, 2015, through January 21, 2015. Medicare paid HHA #1 $209.75 for this claim. Between March 14 and April 2015, when the defendant and Dr. Janick ended their relationship with HHA #1, Dr. Janick made 197 referrals for 115 unique beneficiaries to HHA #1's Sarasota location, and 13 beneficiaries to other HHA #1 offices, resulting in a total loss to Medicare of greater than $250,000. HHA #1 paid the defendant $92,331.62. 27. On or about August 15, 2018, the presiding judge accepted Lisa McLaren’s plea of guilty and adjudged Lisa McLaren guilty. DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 13 of 17 COUNT I 28. The Department re-alleges and incorporates paragraphs one (1) through twenty-seven (27) as if fully set forth herein. 29. Section 456.072(1)(a), Florida Statutes (2013-2014), subjects a licensee to discipline for making misleading, deceptive, or fraudulent representations in or related to the practice of the licensee’s profession. 30. Onone or more occasions between in or around March 2014 and April 2015, Respondent made misleading, deceptive, or fraudulent representations in or related to the practice of his profession. 31. Based on the foregoing, Respondent violated section 456.072(1)(a), Florida Statutes (2013-2014). COUNT II 32. The Department re-alleges and incorporates paragraphs one (1) through twenty-seven (27) as if fully set forth herein. 33. Section 456.072(1)(c), Florida Statutes (2018), subjects a licensee to discipline for being convicted or found guilty of, or entering a plea of guilty or nolo contendere to, regardless of adjudication, a crime in any jurisdiction which relates to the practice of, or the ability to practice, a licensee's profession. DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 14 of 17 34. On or about July 17, 2018, Respondent plead guilty to, and was adjudicated guilty of, a federal crime which relates to the practice of, or the ability to practice, his profession. | 35. Based on the foregoing, Respondent violated section 456.072(1)(c), Florida Statutes (2018), COUNT III 36. The Department re-alleges and incorporates paragraphs one (1) through twenty-seven (27) as if fully set forth herein. 37. Section 456.072(1)(Il), Florida Statutes (2018), subjects a licensee to discipline for being convicted of, or entering a plea of guilty or nolo contendere to, any misdemeanor or felony, regardless of adjudication, a crime in any jurisdiction which relates to health care fraud. 38. On or about July 17, 2018, Respondent plead guilty to, and was adjudicated guilty of, a federal crime which relates to health care fraud. 39. Based on the foregoing, Respondent violated section 456.072(1)(Il), Florida Statutes (2018). WHEREFORE, the Department respectfully requests the Board enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, restriction of practice, DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 15 of 17 imposition of an administrative fine, issuance of a reprimand, placement of Respondent on probation, corrective action, refund of fees billed or collected, remedial education, and/or any other relief the Board deems appropriate. SIGNED this 19" day of October, 2018. Celeste Philip, M.D., M.P.H. Surgeon General and Secretary Geoffrey M. Christian Geoffrey M. Christian, Esq. Assistant General Counsel Florida Bar No. 0010325 Department of Health Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 FILED Telephone (850) 245-4661 DEPARTMENT Oe Facsimile (850) 245-4684 CLERK Amber og? 2018 E-mail Geoffrey.Christian@flhealth.gov Attorney for Petitioner PCP Date: October 19, 2018 PCP Members: J. Lopez, M.D.; S. Haridopolos, M.D.; Mr. A. Perez DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 16 of 17 DOH V. JOHN JOSEPH JANICK, M.D. DOH CASE NUMBER 2017-19600 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with section 120.569 and 120.57, Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. A request or petition for an administrative hearing must be in writing and must be received by the Department within twenty-one (21) days from the day Respondent received this Administrative Complaint, pursuant to rule 28-106.111(2), Florida Administrative Code. If Respondent fails to request a hearing within twenty-one (21) days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to rule 28-106.111(4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in this Administrative Complaint must conform to rule 28- 106.2015(5), Florida Administrative Code. Mediation under section 120.573, Florida Statutes, is not available to resolve this Administrative Complaint. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that the Department has incurred costs related to the investigation and prosecution of this matter. Pursuant to section 456.072(4), Florida Statutes, the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on Respondent in addition to any other discipline imposed. DOH v. John Joseph Janick, M.D., DOH Case Number 2017-19600 Administrative Complaint Page 17 of 17

Docket for Case No: 19-003391PL