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EEOC Sues Yale Teaching Hospital For Age, Disability Discrimination

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On February 11, 2020, the U.S. Equal Employment Opportunity Commission (EEOC) sued Yale-New Haven Hospital (YNNH), accusing the university’s hospital of discriminating against older doctors. The lawsuit was filed in the U.S. District Court for the District of Connecticut, accusing the teaching hospital of the Yale School of Medicine of violating federal anti-discrimination laws. The hospital allegedly violated federal law by adopting and implementing a discriminatory “Late Career Practitioner Policy,” according to the complaint filed by EEOC officials.

Yale’s Late Career Practitioner Policy.

The EEOC stated that it appeared that Yale violated federal laws by forcing physicians over age 70 to take neuropsychological and eye exams in order to gain or keep their medical staff privileges. Younger doctors were not subject to this “Late Career Practitioner Policy,” the EEOC claimed.

By subjecting doctors, dentists, and podiatrists to screening evaluations based solely on their age, without regard to any particular suspicion about their mental ability or eyesight, the hospital’s policy violates the Age Discrimination in Employment Act (ADEA), the EEOC alleges in its complaint. You can view the complaint in full on our website.

Additionally, the suit alleges that the policy violates the Americans with Disabilities Act (ADA), which specifically prohibits subjecting employees to medical examinations that are not job-related and consistent with business necessity.

The EEOC is seeking compensatory and punitive damages and injunctive relief against Yale, which includes the elimination of the policy, according to its press release. Read the full statement and press released issued by the EEOC here.

To read about a similar case dealing with an age discrimination suit among nurses, click here to read my prior blog.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals.  This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical student professors and clinical staff. We represent facilities, individuals, groups and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, in patient complaints and in Department of Health investigations.

To contact The Health Law Firm, please call (407) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Stawicki, Kevin. “EEOC Sues Yale Hospital For Making Older Docs Take Tests.” Law360. (February 11, 2020). Web.

“EEOC Sues Yale New Haven Hospital for Age and Disability Discrimination.” JD Supra. (February 12, 2020). Web.

Steinberg, Julie. “EEOC Sues Yale New Haven Hospital for Age Bias Over Exam Policy.” Bloomberg Law. (February 11, 2020).

Stempniak, Marty. “Yale accused of age discrimination for subjecting older radiologists, other docs to competency testing.” Radiology Business. (February 12, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

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The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law

Nursing Student Files Sexual Harassment, Retaliation Lawsuit Against UNC Greensboro

Attorney George F. Indest Headshot By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On November 29, 2019, a former University of North Carolina nursing student sued the school’s Greensboro campus, saying it improperly dismissed from her a program a month before graduation. She filed two separate suits. She claims she was forced to endure sexual harassment as a student for years. Then, when she accused a supervisor of misconduct, she was gradually pushed out of the nursing program, according to the lawsuit.

She is suing the University of North Carolina’s Greensboro nursing department in state court and UNC’s Board of Directors along with the Raleigh School of Nurse Anesthesia in federal court.

Lawsuit Describes Alleged Harassment, Retaliation.

According to the suit, the harassment began less than a year after she enrolled in the Doctor of Nursing Program at UNCG in August 2015, with hopes of becoming a nurse anesthesiologist. She was put under the supervision of a male certified registered nurse anesthetist, or CRNA. In her suit, she alleges that her supervisor began acting inappropriately almost immediately.

When she reported the harassment in July 2016, that’s when the retaliation started, claims the lawsuit. “They started trying to find things,” she reportedly said. She claims that one supervisor told her “If I can’t get you for this, I can get you for something else.” A few months later, on October 31, 2016, she states she was given additional clinical work and reassigned to work with the same CRNA she had previously reported for harassment, according to court documents.

In June 2018, a month before she was to graduate, she was dismissed from the program for what the school said were unsafe nursing practices. She appealed and UNCG allowed her to re-enroll in January 2019 for a tuition of $10,000. However, a month later, she was dismissed again for unsafe nursing practices. UNCG then refused any further appeals and upheld her dismissal in May 2019.

The nursing student is seeking unspecified damages, including loss of income and repayment of tuition, according to the lawsuit.

To read one of my prior blogs on a similar case dealing with a harassment lawsuit at Rutgers University, click here.

Contact Experienced Health Law Attorneys Representing Medical Students, Residents and Fellows.

The Health Law Firm routinely represents medical students, residents, and fellows who run into difficulties and have disputes with their medical schools or programs. We also represent other health providers in investigations, regulatory matters, licensing issues, litigation, inspections, and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Lawsuit describes harassment, retaliation at UNCG nursing school.” Greensboro News & Record. (December 3, 2019). Web.

Waggoner, Martha. “Lawsuit describes harassment, retaliation at Nursing School.” The Washington Post. (December 3, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

One of 2019’s Largest Healthcare Fraud Case Ever: No Surprise, Florida Wins!

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making Florida, once again, the leader in fakes and frauds. Often joked and written about by Florida novelists such as Carl Hiassin and Tim Dorsey, this case serves to highlight why the “Debtor’s Haven” state often excels in cases of healthcare fraud.

In April 2019, after decades of alleged schemes, illegal kickbacks and money laundering in connection with fraudulent claims to Medicare and Medicaid, Phillip Esformes was sentenced to 20 years in prison. He was also ordered to pay $44.2 million in money forfeitures and restitution, and forfeiture of his ownership interests in several skilled nursing homes.

A federal district judge sentenced the South Florida health care facility owner after he was found guilty in the largest health care fraud scheme ever charged by the U.S. Justice Department (DOJ).

A Case of “Epic” Fraud.

The nursing home mogul was accused of paying bribes and receiving kickbacks in a massive $1 billion Medicare fraud case touted by federal prosecutors as the largest in the nation. During an eight-week jury trial, prosecutors argued that Esformes himself made $38 million from Medicare and Medicaid payments between 2010 and 2016. Additionally, his South Florida network received more than $450 million through bribes and though services that weren’t medically necessary or which were never provided, according to the prosecution’s case.

To learn more about this case, click here to read one of my prior blogs.

Convicted, But Not of Healthcare Fraud.

The shocker, in this case, is that the federal jury convicted Esformes on 20 counts of conspiracy to defraud the taxpayer-funded Medicare program. The lack of a conviction for healthcare fraud itself was puzzling. Many of his alleged co-conspirators had already pled guilty to health care fraud and some had even testified against him at trial. To learn more, click here to read one of my prior blogs on another individual involved in the case.

Despite being billed as the largest healthcare fraud case prosecuted in U.S. history, it is also a stark reminder to prosecutors of how tricky it can be to secure a conviction on any particular charge.

To read the DOJ’s press release about this case in full, click here.

Contact Health Law Attorneys Experienced in Handling Medicare Audits, Investigations and other Legal Proceedings.

The attorneys of The Health Law Firm represent healthcare providers in Medicare and Medicaid audits, and in ZPIC and RAC audits throughout Florida and across the U.S. We also represent health providers in civil and administrative litigation by government agencies and insurance companies attempting to recoup claims that have been paid. Our attorneys also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, recovery actions and administrative actions seeking termination from Medicare and Medicaid Programs.

The Health Law Firm’s attorneys routinely represent physicians, dentists, pharmacists, psychotherapists, medical groups, clinics, pharmacies, assisted living facilities (ALFs), home health agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


Sources:

Weaver, Jay. “Miami healthcare exec Esformes sentenced to 20 years in biggest Medicare fraud case.” Miami Herald. (September 12, 2019). Web.

Hale, Nathan. “The Biggest Stories In Florida Legal News Of 2019.” Law360. (December 20, 2019). Web.

Jackson, David. “Nursing home mogul Philip Esformes sentenced to 20 years for $1.3 billion Medicaid fraud.” Chicago Tribune. (September 13, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2019/2020 The Health Law Firm. All rights reserved.

By |2019-12-30T19:35:03-05:00February 10th, 2020|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Finding a Healthcare Providers Service Organization (HPSO) Insurance Attorney to Defend you in a Complaint Against Your Pharmacist or Pharmacy License

Carole C. SchrieferBy Carole C. Schriefer, J.D.
Many pharmacists or their pharmacies carry professional malpractice insurance through Healthcare Providers Service Organization (HPSO) or one of the other similar professional liability insurance companies. What they may not realize is that this insurance will pay for their legal defense expenses if there is a complaint filed against their pharmacist license or the pharmacy’s license. It will also pay for legal defense expenses if they receive a subpoena for records, if they are required to attend a deposition, or if they are accused of violating HIPAA or a client’s medical confidentiality.

Under this type of policy, the insurance company will pay the legal fees and other costs related to your defense or legal representation. However, you will be required to locate and retain the appropriate attorney to represent you in the matter.

What to Look For When Retaining an Attorney to Defend You.

1. The primary qualification for any attorney you hire to represent you should be his or her experience in working with health professionals in the same field. If the attorney is not familiar with your area of health practice, with the type of legal proceeding you have, or with your professional licensing board, it may be difficult for that attorney to represent you properly.

2. If consult with an attorney who states that she or he will help you make a statement to the investigator or assist you in the investigation, but will not agree to appear and represent you in hearings, then this is the wrong attorney. You need an attorney that can represent you from start to finish.

3. Seek and retain an attorney who accepts the insurance that you have, whether it is HPSO Insurance, CPH & Associates Insurance, Philadelphia Insurance, Pharmacist Mutual Insurance Company (PMIC), Trust Management Services, Philadelphia Insurance, Firemans Fund, or another national company. This will ensure that you have an attorney who will give you the lower rates the insurance company has negotiated and will have a good working relationship established with your insurance company. If an attorney with our firm cannot represent you, we will try to find you an attorney who will.

4. You also want to retain the services of an attorney who has appeared before your professional board or professional licensing authority in investigations and hearings, especially in formal administrative hearings.

5. Often you will come across an attorney who only wants you to accept a consent order, stipulation, or settlement agreement. Remember that these are all merely plea bargains and you will be pleading guilty to whatever offenses are charged. This is teh easy way out and often the easy way is not the right way. IF you plead guilty then, from that point on, you are guilty. In most cases, however, you will actually be innocent of the charges and will need a formal administrative hearing in order to prove this.

6. You don’t necessarily need an attorney who resides in your city, state, or location. Almost all the work on the case will be done by telephone and e-mail. You usually have only one meeting or hearing and, depending on what type of hearing it is, it could be located in many different locations. Our attorneys will travel to those locations for meetings and hearings.

7. Beware of attorneys who hold themselves out in Internet advertising as health attorneys or professional license defense attorneys but are really some other type of attorneys. We see this a lot from medical malpractice attorneys, criminal defense attorneys and attorneys who sue insurance companies. Be sure you get an attorney who concentrates his or her practice in defending those in the specialty of pharmacy and in board of pharmacy complaints, investigations, and hearings.

8. If you can’t find an attorney to meet your immediate needs through our firm or an Internet search, you may contact your insurance company or professional association and ask if they have a list of attorneys that can do the legal work you require.

For example, you may reach Healthcare Providers Service Organization (HPSO) at (800) 982-9491; you can reach Nurses Service Organization (NSO) at (800) 247-1500; you can reach CPH & Associates at (800) 875-1911 or (312) 987-9823; you can reach Pharmacists Mutual Insurance Company (PMIC) at (800) 247-5930.

Contact Health Law Attorneys Experienced Investigations of Pharmacists and Pharmacies.

The attorneys of The Health Law Firm provide legal representation to pharmacists, pharmacies, prescribing physicians, dispensing physicians and nurse practitioners, and other health providers in pharmacy board complaints and investigations, Department of Health (DOH) investigations, Colorado DORA investigations, Drug Enforcement Administration (DEA) investigations, Medicare and Medicaid audits, Medicaid Fraud Control Unit (MFCU) investigations, and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: Carole C. Schriefer is an attorney and former registered nurse. She practices with The Health Law Firm, which has a national practice. Its regional office is in the Northern Colorado, area. www.TheHealthLawFirm.com The Health Law Firm, 155 East Boardwalk Drive, Fort Collins, Colorado 80525. Phone: (970) 416-7456. Its main office is in the Orlando, Florida area.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

By |2020-02-04T16:56:51-05:00February 4th, 2020|Categories: Colorado Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Finding a Healthcare Providers Service Organization (HPSO) Insurance Attorney to Defend you in a Complaint Against Your Pharmacist or Pharmacy License

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Many pharmacists or their pharmacies carry professional malpractice insurance through Healthcare Providers Service Organization (HPSO) or one of the other similar professional liability insurance companies. What they may not realize is that this insurance will pay for their legal defense expenses if there is a complaint filed against their pharmacist license or the pharmacy’s license. It will also pay for legal defense expenses if they receive a subpoena for records, if they are required to attend a deposition, or if they are accused of violating HIPAA or a client’s medical confidentiality.

Under this type of policy, the insurance company will pay the legal fees and other costs related to your defense or legal representation. However, you will be required to locate and retain the appropriate attorney to represent you in the matter.

What to Look For When Retaining an Attorney to Defend You.

1. The primary qualification for any attorney you hire to represent you should be his or her experience in working with health professionals in the same field. If the attorney is not familiar with your area of health practice, with the type of legal proceeding you have, or with your professional licensing board, it may be difficult for that attorney to represent you properly.

2. If consult with an attorney who states that she or he will help you make a statement to the investigator or assist you in the investigation, but will not agree to appear and represent you in hearings, then this is the wrong attorney. You need an attorney that can represent you from start to finish.

3. Seek and retain an attorney who accepts the insurance that you have, whether it is HPSO Insurance, CPH & Associates Insurance, Philadelphia Insurance, Pharmacist Mutual Insurance Company (PMIC), Trust Management Services, Philadelphia Insurance, Firemans Fund, or another national company. This will ensure that you have an attorney who will give you the lower rates the insurance company has negotiated and will have a good working relationship established with your insurance company. If an attorney with our firm cannot represent you, we will try to find you an attorney who will.

4. You also want to retain the services of an attorney who has appeared before your professional board or professional licensing authority in investigations and hearings, especially in formal administrative hearings.

5. Often you will come across an attorney who only wants you to accept a consent order, stipulation, or settlement agreement. Remember that these are all merely plea bargains and you will be pleading guilty to whatever offenses are charged. This is teh easy way out and often the easy way is not the right way. IF you plead guilty then, from that point on, you are guilty. In most cases, however, you will actually be innocent of the charges and will need a formal administrative hearing in order to prove this.

6. You don’t necessarily need an attorney who resides in your city, state, or location. Almost all the work on the case will be done by telephone and e-mail. You usually have only one meeting or hearing and, depending on what type of hearing it is, it could be located in many different locations. Our attorneys will travel to those locations for meetings and hearings.

7. Beware of attorneys who hold themselves out in Internet advertising as health attorneys or professional license defense attorneys but are really some other type of attorneys. We see this a lot from medical malpractice attorneys, criminal defense attorneys and attorneys who sue insurance companies. Be sure you get an attorney who concentrates his or her practice in defending those in the specialty of pharmacy and in board of pharmacy complaints, investigations, and hearings.

8. If you can’t find an attorney to meet your immediate needs through our firm or an Internet search, you may contact your insurance company or professional association and ask if they have a list of attorneys that can do the legal work you require.

For example, you may reach Healthcare Providers Service Organization (HPSO) at (800) 982-9491; you can reach Nurses Service Organization (NSO) at (800) 247-1500; you can reach CPH & Associates at (800) 875-1911 or (312) 987-9823; you can reach Pharmacists Mutual Insurance Company (PMIC) at (800) 247-5930.

Contact Health Law Attorneys Experienced Investigations of Pharmacists and Pharmacies.

The attorneys of The Health Law Firm provide legal representation to pharmacists, pharmacies, prescribing physicians, dispensing physicians and nurse practitioners, and other health providers in pharmacy board complaints and investigations, Department of Health (DOH) investigations, Colorado DORA investigations, Drug Enforcement Administration (DEA) investigations, Medicare and Medicaid audits, Medicaid Fraud Control Unit (MFCU) investigations, and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Healthcare Providers Service Organization (HPSO) Insurance defense attorney, HPSO defense lawyer, Florida HPSO defense attorney lawyer, Colorado HPSO defense attorney lawyer, legal representation for HPSO matters in Colorado, legal representation for HPSO matters in Florida, representation for professional liability insurance cases, Louisiana HPSO defense attorney lawyer, legal representation for HPSO matters in Louisiana, HPSO deposition defense coverage, representation for licensed mental health counselors (LMHCs), pharmacist defense lawyer, pharmacy defense attorney lawyer, medical prescriber legal representation, pharmacist complaint cases, pharmacy complaint cases, Florida Colorado Louisiana pharmacy complaint cases, defense lawyer for pharmacists, Florida health law defense attorney, medical license defense, Florida Department of Health (DOH) attorney, representation for Louisiana and Florida Department of Health (DOH) complaint investigations, Louisiana and Florida Department of Health (DOH) defense lawyer, Colorado Division of Regulatory Agencies (DORA) defense attorney, representation for Florida Colorado Division of Regulatory Agencies (DORA) complaint investigations, Colorado Division of Regulatory Agencies (DORA) defense lawyer, Lousiana LPC Board defense attorney lawyer, Board of Pharmacy defense, Board of Pharmacy complaints, representation for Board of Pharmacy investigations, Florida Board of Pharmacy defense lawyer, Colorado Board of Pharmacy defense lawyer, Health Law Firm reviews, reviews of The Health Law Firm attorneys, administrative complaint defense lawyer, administrative complaint defense attorney, administrative hearing defense lawyer, administrative hearing defense attorney, administrative hearing defense legal counsel, Drug Enforcement Administration (DEA) investigation defense attorney lawyer, Medicare and Medicaid audit defense attorney lawyer, Medicaid Fraud Control Unit (MFCU) investigation defnse attorney lawyer

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

By |2020-02-04T16:39:04-05:00February 4th, 2020|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Hospital Countersues Whistleblower for Failing to Report Information Internally in FCA Suit

George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the whistleblower/relator in the lawsuit, breached his fiduciary duty to the company by failing to report the unlawful conduct internally, first. Instead, he used the information as the basis for his whistleblower claim. In the countersuit filed in the U.S. District Court for the Northern District of West Virginia, the Hospital accuses the former executive-turned-whistleblower of attempting to ‘extort a settlement’ and filing the FCA whistleblower suit as an act of revenge.

The Whistleblower’s Complaint.

The whistleblower, a former accountant, and senior executive at Wheeling Hospital, was discharged in August 2015. In December 2017, he filed a complaint under the qui tam provisions of the False Claims Act (FCA). He alleged the hospital violated the federal Anti-Kickback Statute (AKS) by paying kickbacks to physicians for patient referrals to the Hospital. Based on this, it is alleged, the claims for the services the hospital provided to the referred patients were false claims, subject to recoupment by the government.

The Hospital’s Countersuit.

In an unusual strategy, the Hospital filed a counter-suit against the whistleblower, alleging that he breached his fiduciary duty to the Hospital and abused the legal process. The Hospital’s case asserts that instead of carrying out his duty to the Hospital, instead, he capitalized on his alleged knowledge of the conduct to “extort a settlement” through a “false and frivolous” FCA suit as an act of revenge.

Additionally, the Hospital alleges that “at no time during his employment, or in his role as a partner at Deloitte, did he report any suspicions of fraud or violations of federal regulations to Wheeling Hospital’s compliance officer.”

You can read Wheeling Hospital’s countersuit against the whistleblower on our website in full.

The Significance of This Case: Unique Defense Strategy for Defending a Whistleblower Suit.

This case shows a unique, but legally valid, defense strategy that might be used in other future whistleblower cases. Often the information about false claims is produced by a high-ranking hospital or institutional employees whose job duties may have required them to report what they knew to the company as part of their job. The company should then have the opportunity to investigate and correct any improper billing or other misconduct that an errant employee might be carrying out on his own. By failing to do this, the employee may breach his duties to the company, may violate his employment contract, and may be subject to a suit or counter-suit over this. To the extent that the actions of the ex-employee cause the employer damages, the employer may be entitled to indemnification from the ex-employee.

However, the other side of the story is when an employee does make his or her superiors aware of suspected misconduct and false claims within the company and the company does nothing about it. This is often the case that we have when potential blowers contact us about filing a False Claims Act case. Often the whistleblower attempts to do the right thing by reporting it within the company and is stymied by his or her superiors. To us, this opens the door to legitimate whistleblower suits.

To read one of my prior blogs about South Florida Hospital reaching a settlement for similar FCA
claims, click here.

Click here to learn more about who can file a whistleblower/qui tam lawsuit and the reward programs for coming forward with a false claim.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities that have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Pearlman, Steve and Freeman, Meika. “Top 10 Whistleblowing And Retaliation Events Of The Year.” Law360. (December 20, 2019). Web.

Goldberg, Pinchos. “Hospital Sues Whistleblower for Failing to Report Information And Choosing Instead to Use As Basis for Claim.” JD Supra. (May 8, 2019). Web.

Commins, John. “HOSPITAL COUNTERSUES FALSE CLAIMS WHISTLEBLOWER.” Health Leaders. (May 9, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida area.  www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

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Nursing Student Files Sexual Harassment, Retaliation Lawsuit Against UNC Greensboro

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On November 29, 2019, a former University of North Carolina nursing student sued the school’s Greensboro campus, saying it improperly dismissed from her a program a month before graduation. She filed two separate suits. She claims she was forced to endure sexual harassment as a student for years. Then, when she accused a supervisor of misconduct, she was gradually pushed out of the nursing program, according to the lawsuit.

She is suing the University of North Carolina’s Greensboro nursing department in state court and UNC’s Board of Directors along with the Raleigh School of Nurse Anesthesia in federal court.

Lawsuit Describes Alleged Harassment, Retaliation.

According to the suit, the harassment began less than a year after she enrolled in the Doctor of Nursing Program at UNCG in August 2015, with hopes of becoming a nurse anesthesiologist. She was put under the supervision of a male certified registered nurse anesthetist, or CRNA. In her suit, she alleges that her supervisor began acting inappropriately almost immediately.

When she reported the harassment in July 2016, that’s when the retaliation started, claims the lawsuit. “They started trying to find things,” she reportedly said. She claims that one supervisor told her “If I can’t get you for this, I can get you for something else.” A few months later, on October 31, 2016, she states she was given additional clinical work and reassigned to work with the same CRNA she had previously reported for harassment, according to court documents.

In June 2018, a month before she was to graduate, she was dismissed from the program for what the school said were unsafe nursing practices. She appealed and UNCG allowed her to re-enroll in January 2019 for a tuition of $10,000. However, a month later, she was dismissed again for unsafe nursing practices. UNCG then refused any further appeals and upheld her dismissal in May 2019.

The nursing student is seeking unspecified damages, including loss of income and repayment of tuition, according to the lawsuit.

To read one of my prior blogs on a similar case dealing with a harassment lawsuit at Rutgers University, click here.

Contact Experienced Health Law Attorneys Representing Medical Students, Residents and Fellows.

The Health Law Firm routinely represents medical students, residents, and fellows who run into difficulties and have disputes with their medical schools or programs. We also represent other health providers in investigations, regulatory matters, licensing issues, litigation, inspections, and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Lawsuit describes harassment, retaliation at UNCG nursing school.” Greensboro News & Record. (December 3, 2019). Web.

Waggoner, Martha. “Lawsuit describes harassment, retaliation at Nursing School.” The Washington Post. (December 3, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

ADA Files Class Action Lawsuit For Antitrust Violations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On November 26, 2019, the American Dental Association (ADA) and two individual dentists filed a class-action lawsuit against the Delta Dental Plans Association, its affiliated national entities, and 39 independent Delta Dental companies. The suit alleges the provider network engaged in anticompetitive conduct and violated federal antitrust laws.

The ADA filed its lawsuit in the U.S. District Court for the Northern District of Illinois.

Details of the Suit.

The complaint alleges Delta Dental allocated territories of operation and divided the national market to restrict competition, reduce reimbursement rates, and force unfavorable coverage to dentists. “Its harm is reflected in the suppression of compensation below levels that would prevail in a competitive marketplace to dentists who are members of the Delta Dental provider network,” the suit alleges.

Hurting Both Dentists and Patients.

The complaint goes on to say that Delta’s anticompetitive acts hurt both dentists and patients by limiting the choices of dental care available. When compensation can’t cover dentists’ costs, they aren’t able to take time from commercially insured customers and serve the dental needs of other patients, like those on Medicaid, said the ADA.

Click here to view the complaint in this case in full.

To read the press release issued by the ADA, click here.

Click here to read one of my prior blogs on a similar case dealing with dentists and an antitrust case.

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in the Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

Our firm also routinely represents physicians, dentists, orthodontists, medical groups, clinics, pharmacies, home health care agencies, nursing homes and other health care providers in AHCA investigations, audits and recovery actions, as well as Medicare and Medicaid investigations, audits and recovery actions.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Cullen, Anne. “Dentists Sue Delta Dental Over Antitrust Conspiracy.” Law360. (November 27, 2019). Web.

Versaci, Mary Beth. “American Dental Association files lawsuit against Delta Dental.” ADA. (November 26, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

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The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2019 The Health Law Firm. All rights reserved. federal antitrust laws, health defense attorney, health defense lawyer, legal representation for dentists, health law firm, The Health Law Firm

2019’s Largest Healthcare Fraud Case Ever Prosecuted: No Surprise, Florida Wins!

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making Florida, once again, the leader in fakes and frauds. Often joked and written about by Florida novelists such as Carl Hiassin and Tim Dorsey, this case serves to highlight why the “Debtor’s Haven” state often excels in cases of healthcare fraud.

In April 2019, after decades of alleged schemes, illegal kickbacks and money laundering in connection with fraudulent claims to Medicare and Medicaid, Phillip Esformes was sentenced to 20 years in prison. He was also ordered to pay $44.2 million in money forfeitures and restitution, and forfeiture of his ownership interests in several skilled nursing homes.

A federal district judge sentenced the South Florida health care facility owner after he was found guilty in the largest health care fraud scheme ever charged by the U.S. Justice Department (DOJ).

A Case of “Epic” Fraud.

The nursing home mogul was accused of paying bribes and receiving kickbacks in a massive $1 billion Medicare fraud case touted by federal prosecutors as the largest in the nation. During an eight-week jury trial, prosecutors argued that Esformes himself made $38 million from Medicare and Medicaid payments between 2010 and 2016. Additionally, his South Florida network received more than $450 million through bribes and though services that weren’t medically necessary or which were never provided, according to the prosecution’s case.

To learn more about this case, click here to read one of my prior blogs.

Convicted, But Not of Healthcare Fraud.

The shocker, in this case, is that the federal jury convicted Esformes on 20 counts of conspiracy to defraud the taxpayer-funded Medicare program. The lack of a conviction for healthcare fraud itself was puzzling. Many of his alleged co-conspirators had already pled guilty to health care fraud and some had even testified against him at trial. To learn more, click here to read one of my prior blogs on another individual involved in the case.

Despite being billed as the largest healthcare fraud case prosecuted in U.S. history, it is also a stark reminder to prosecutors of how tricky it can be to secure a conviction on any particular charge.

To read the DOJ’s press release about this case in full, click here.

Contact Health Law Attorneys Experienced in Handling Medicare Audits, Investigations and other Legal Proceedings.

The attorneys of The Health Law Firm represent healthcare providers in Medicare and Medicaid audits, and in ZPIC and RAC audits throughout Florida and across the U.S. We also represent health providers in civil and administrative litigation by government agencies and insurance companies attempting to recoup claims that have been paid. Our attorneys also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, recovery actions and administrative actions seeking termination from Medicare and Medicaid Programs.

The Health Law Firm’s attorneys routinely represent physicians, dentists, pharmacists, psychotherapists, medical groups, clinics, pharmacies, assisted living facilities (ALFs), home health agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


Sources:

Weaver, Jay. “Miami healthcare exec Esformes sentenced to 20 years in biggest Medicare fraud case.” Miami Herald. (September 12, 2019). Web.

Hale, Nathan. “The Biggest Stories In Florida Legal News Of 2019.” Law360. (December 20, 2019). Web.

Jackson, David. “Nursing home mogul Philip Esformes sentenced to 20 years for $1.3 billion Medicaid fraud.” Chicago Tribune. (September 13, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Keywords: Medicare and Medicaid fraud defense attorney, legal representation for Medicare and Medicaid fraud defense, Medicare and Medicaid fraud defense legal counsel, Medicare and Medicaid fraud defense lawyer, defense of Medicare and Medicaid fraud charges, CMS, ZPIC and RAC audit defense attorney, CMS, ZPIC and RAC audit defense lawyer, CMS, ZPIC and RAC audit legal representation, Medicaid Fraud Control Unit (MFCU) defense attorney, health care clinic fraud audit, Medicaid Fraud Control Unit (MFCU) defense lawyer, Medicaid Fraud Control Unit (MFCU) defense legal counsel, Medicaid Fraud Control Unit (MFCU) subpoena defense attorney, Medicaid Fraud Control Unit (MFCU) subpoena legal representation, Medicaid Fraud Control Unit (MFCU) subpoena defense lawyer, OIG, HHS, DOJ and U.S. Attorney subpoena defense lawyer, OIG, HHS, DOJ and U.S. Attorney subpoena defense attorney, OIG, HHS, DOJ and U.S. Attorney subpoena legal representation, legal representation for allegations of Medicare fraud, legal representation for health care fraud, healthcare fraud defense attorney, healthcare fraud defense lawyer, reviews of the Health Law Firm, The Health Law Firm attorney reviews, Health law defense attorney, healthcare fraud defense legal representation, legal representation for submitting false claims, false claims defense lawyer, false claims legal defense representation, false claims defense attorney, Medicare and Medicaid investigation defense attorney, legal representation for Medicare and Medicaid investigations, OIG investigation defense attorney, legal representation for OIG investigations, Department of Justice (DOJ) investigation defnse, DOJ defense representation, False Claims Act (FCA) legal defense attorney lawyer, False Claims Act (FCA) defense legal representation counsel, Anti-Kickback Statute (AKS) defense attorney, AKS legal defense representation, AKS defense lawyer

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2019/2020 The Health Law Firm. All rights reserved.

By |2020-01-23T17:31:06-05:00January 27th, 2020|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Nursing Student Claims Sexual Harassment, Retaliation in Lawsuit Filed Against North Carolina Lawsuit

Attorney Carole C. Schriefer Headshot By Carole C. Schriefer, R.N., J.D.
On November 29, 2019, a former University of North Carolina nursing student sued the school’s Greensboro campus, saying it improperly dismissed from her a program a month before graduation. She filed two separate suits. She claims she was forced to endure sexual harassment as a student for years. Then, when she accused a supervisor of misconduct, she was gradually pushed out of the nursing program, according to the lawsuit.

She is suing the University of North Carolina’s Greensboro nursing department in state court and UNC’s Board of Directors along with the Raleigh School of Nurse Anesthesia in federal court.

Lawsuit Describes Alleged Sexual Harassment, Retaliation.

According to the suit, the harassment began less than a year after she enrolled in the Doctor of Nursing Program at UNCG in August 2015, with hopes of becoming a nurse anesthesiologist. She was put under the supervision of a male certified registered nurse anesthetist, or CRNA. In her suit, she alleges that her supervisor began acting inappropriately almost immediately.

When she reported the harassment in July 2016, that’s when the retaliation started, claims the lawsuit. “They started trying to find things,” she reportedly said. She claims that one supervisor told her “If I can’t get you for this, I can get you for something else.” A few months later, on October 31, 2016, she states she was given additional clinical work and reassigned to work with the same CRNA she had previously reported for harassment, according to court documents.

In June 2018, a month before she was to graduate, she was dismissed from the program for what the school said were unsafe nursing practices. She appealed and UNCG allowed her to re-enroll in January 2019 for a tuition of $10,000. However, a month later, she was dismissed again for unsafe nursing practices. UNCG then refused any further appeals and upheld her dismissal in May 2019.

The nursing student is seeking unspecified damages, including loss of income and repayment of tuition, according to the lawsuit.

To read one of my prior blogs on a similar case dealing with a harassment lawsuit at Rutgers University, click here.

Contact Experienced Health Law Attorneys Representing Medical Students, Residents and Fellows.

The Health Law Firm routinely represents medical students, residents, and fellows who run into difficulties and have disputes with their medical schools or programs. We also represent other health providers in investigations, regulatory matters, licensing issues, litigation, inspections, and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Lawsuit describes harassment, retaliation at UNCG nursing school.” Greensboro News & Record. (December 3, 2019). Web.

Waggoner, Martha. “Lawsuit describes harassment, retaliation at Nursing School.” The Washington Post. (December 3, 2019). Web.

About the Author: Carole C. Schriefer is an attorney and registered nurse. She practices with The Health Law Firm, which has a national practice. Its regional office is in the Northern Colorado, area. www.TheHealthLawFirm.com The Health Law Firm, 155 East Boardwalk Drive, Fort Collins, Colorado 80525. Phone: (970) 416-7456. Its main office is in the Orlando, Florida area.

KeyWords: Legal representation for nursing students, legal representation for nurse practice students, legal representation for nurse anesthetist students, nursing student attorney, nurse practice attorney, nurse anesthetist student attorney, nursing student legal counsel, nurse practice legal counsel, nurse anesthetist legal counsel, education law attorney for health professionals, education law legal counsel for health professional students, education law lawyer for health professional students academic review hearing attorney, nursing board defense attorney, nursing board defense legal representation, nursing school attorney, nursing school lawyer, nursing school legal counsel, nursing school legal defense counsel, legal dispute with nursing school, legal representation for CRNAs, attorney for CRNAs, lawyer for CRNAs, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, board of nursing legal defense counsel, board of nursing defense lawyer, board of nursing defense attorney

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

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