Former University of Florida Professor and Researcher Charged With Fraud and Hiding China Ties

Attorney Carole C. Schriefer Headshot

CAROLE C. SCHRIEFER, J.D.

By Carole C. Schriefer, J.D.

On February 3, 2021, a former University of Florida professor was indicted on allegations of fraudulently obtaining a federal grant from the U.S. by concealing his ties with the Chinese government. He is accused of fraudulently obtaining $1.75 million in federal grant money from the National Institutes of Health (NIH). He was able to do this by concealing support he received from the Chinese government and a company that he founded in China to profit from that research, according to the U.S. Department of Justice (DOJ).

The former professor is charged with six counts of wire fraud and four counts of making false statements to an agency of the United States.

A Scheme to Defraud National Institutes of Health and the University of Florida.

According to the indictment, the ex-professor obtained a $1.75 million grant from NIH to support his development work on an imaging informatics tool for muscles known as “MuscleMiner.” Additionally, he served as the principal investigator for the grant between September 2014 and July 2019. According to prosecutors, he was required to disclose any foreign research support and any financial conflicts of interest, including financial connections to foreign companies, but he failed to do so.

The indictment alleges that he concealed the information in order to keep his job at the University of Florida and continue to receive NIH grant money. Additionally, the ex-professor signed a document from UF’s College of Engineering in 2019 that said he had no affiliation with any business, business entity, or university in China. Prosecutors said that he left the United States in August of 2019 for China and has not returned.

Each wire fraud count carries a maximum penalty of 20 years in prison and a $250,000 fine. The maximum penalty for each count of making a false statement is five years in prison and a $250,000 fine. You can read the complaint in this case here.

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

Research Fraud, Grant Application Fraud, and Scientific Misconduct Allegations Have Serious Consequences.

An accusation, even if later proven to be unfounded, may unfairly tarnish the personal and professional reputation of any scientific, medical, or clinical researcher. It can cause the researcher to lose grants, bonuses, and promotions; his or her employment may be terminated; and, as in this case, he or she may face criminal prosecution for fraud, theft, or other applicable crimes.

To learn more on clinical research fraud and misconduct, click here to visit our Areas of Practice Page on our website and read one of my prior blogs here.

Contact Health Law Attorneys Experienced in Defending Against Allegations of Clinical Research Fraud and Misconduct.

The Health Law Firm and its attorneys have experience in representing researchers, investigators, academicians, and clinicians who are the subject of clinical research fraud and misconduct allegations. The Health Law Firm and its attorneys also have experience in representing students, employees, researchers, investigators, and “whistleblowers” who report such matters including those who become the victim of reprisals and retaliation by the person against whom the report is made.

Don’t wait. Obtain the advice and counsel of experienced attorneys who are familiar with such matters and can assist you before it is too late.

If you are facing allegations of research misconduct, research fraud, medical investigation misconduct, please visit our website for more information at www.TheHealthLawFirm.com or call The Health Law Firm at (407) 331-6620 or toll-free (888) 331-6620.

Sources:

Clough, Chris. “Former Fla. Professor Charged With Fraud, Hiding China Ties.” Law360. (February 3, 2021). Web.

Swirko, Cindy. “Former Florida professor indicted for fraudulently obtaining $1.75M federal grant.” The Gainesville Sun. (February 5, 2021). Web.

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 or Toll-Free: (888) 331-6620. Its main office is in the Orlando, Florida area.

“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 © 2021 The Health Law Firm. All rights reserved.

By |2021-09-14T11:27:38-04:00March 29th, 2021|Categories: Colorado Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Former Employee Claims Disability Discrimination Against Kaiser Permanente in ADA Suit

Attorney Carole C. Schriefer Headshot

By Carole C. Schriefer, J.D.

On November 4, 2020, a former employee of Kaiser Permanente Insurance filed a class-action suit in the U.S. District Court for the Northern District of Georgia, claiming discrimination. She says the company required her to take a “competency test” to determine if she could keep her job after the Atlanta business learned of her medical disability (anxiety and depression). The suit claims that the insurance company refused to accommodate her disability and fired her after she failed.

Alleged Disability Discrimination.

The plaintiff worked for Kaiser Permanente Georgia Region between October 2010 and August 2020. According to the lawsuit that was filed, she was diagnosed with anxiety and depression in 2018 and in May 2019 but was cleared by her physician to work. According to the suit, Kaiser Permanente singled her out, forced her to disclose her anxiety and depression, and required her to take a “competency test” for a job she already held. It is worth noting that mental conditions such as “anxiety and depression,” are protected by the Americans with Disabilities Act (ADA).

In March 2019, the plaintiff requested a reasonable accommodation—i.e., a postponement of the testing until she was mentally stable enough to sit for the test. She claims her request was denied outright by Kaiser despite its knowledge of her disability. Per the complaint, the plaintiff was told that she had failed the competency test, despite never having received her scores. In August 2019, she was retested and Kaiser told her that she failed.

On November 8, 2019, the employee was terminated because she “no longer met the job requirements and was not successful at passing the second attempt of the competency test,” the complaint said.

Failure to Accommodate Under the ADA.

The former employee alleged disability discrimination, unlawful medical requests, and failure to accommodate her disabilities under the ADA. She’s seeking unspecified damages for loss of past and future income, mental anguish, and emotional distress, along with her court costs and attorney fees.

Click here to read the complaint in full.

For more information, read our prior blog on a similar case dealing with an insurance company that was sued for mental health discrimination.

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 nurses, resident physicians, mental health counselors, social workers, pharmacists, and health facilities. It also includes medical students, medical school professors, and clinical staff. We represent health 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, patient complaints, and in Department of Health investigations.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com

Sources:

Konnath, Hailey. “Kaiser Permanente Hit With ADA Suit Over Competency Tests.” Law360. (November 4, 2020). Web.

Shaak, Erin. “Singled Out: Lawsuit Claims Kaiser Permanente Denied ‘Competency Test’ Accommodation for Ex-Employee with Disability.” Newswire. (November 5, 2020). Web.

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 or Toll-Free: (888) 331-6620. Its main office is in the Orlando, Florida area.

“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 © 2021 The Health Law

By |2021-02-24T12:28:10-05:00March 16th, 2021|Categories: Colorado Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Florida Pediatric Group Must Face EEOC Suit for Nurses’ Retaliation Compliant Says Judge

Carole C. Schriefer, J.D., has 25+ years of experienceBy Carole C. Schriefer, J.D.

On November 4, 2020, a Florida federal court judge ruled that a Tampa-based pediatric medical group cannot escape a U.S. Equal Employment Opportunity Commission (EEOC) lawsuit, denying its attempts to dismiss the case. According to the federal agency, Pediatric Health Care Alliance unlawfully retaliated against a nurse after the nurse reported a doctor for sexual harassment. U.S. District Judge Thomas Barber denied the medical group’s motion to dismiss, saying it neglected to confront or defend against the nurse’s claim that the medical group demoted her as punishment.

The EEOC Complaint: Nurse Forced to Quit After Reporting Sexual Harassment.

On June 22, 2020, the EEOC filed an employment lawsuit in the United States District Court for the Middle District of Florida. According to the complaint, a female nurse at Pediatric Alliance reported that a doctor at the company inappropriately touched her on two different occasions. Notably, that doctor was also the Vice President (VP) of the company.

According to the suit, the nurse suffered almost immediate retaliation for filing the complaint against the VP. The EEOC alleges that Pediatric Alliance transferred her to a different location against her wishes, replaced her nursing duties with administrative ones, and docked her pay. As a direct consequence of the retaliation, the EEOC contends that the long-time employee was, in effect, forced to resign.

To read the EEOC’s press release on the lawsuit, click here.

To read the EEOC’s lawsuit, in this case, click here.

Retaliation for filing A Sexual Harassment Complaint is Unlawful, Even if it Later Turns Out the Complaint Wasn’t Valid: Title VII of the Civil Rights Act.

Under federal law (Title VII of the Civil Rights Act of 1964), employees have a legal right to raise workplace discrimination or harassment complaints. If an employee exercises this right, their company or organization is strictly prohibited from retaliating against them for doing so. Employers cannot take adverse employment action against an employee in retaliation for making a formal or informal complaint of harassment.

Adverse action occurs when an employee is penalized or punished in some form. In this case, transferring the nurse to a less desirable location, reducing salary, and taking away job duties are all examples of adverse action.

Analysis of the Ruling.

In this case, the defendant’s medical group/employer tried to get the court to dismiss the lawsuit (complaint) based on the EEOC’s earlier determination that the nurse failed to sufficiently support charges of sexual harassment. If the employer had not retaliated against the nurse, in this case, would have then been over. But that didn’t happen. The complaint asserted a claim of retaliation in violation of Title VII, not sexual harassment.

The court also noted that the medical group did not argue that the EEOC’s retaliation allegation was insufficient. Accordingly, the judge denied the motion to dismiss filed by Pediatric Alliance, the employer.

To view the court’s opinion in full, click here.

Tips for Employers to Avoid EEOC Complaints.

1. The employer should adopt a “zero tolerance” policy for discrimination and harassment.

2. Make sure your officers, supervisors, and key employees are instructed on a regular basis about what situations are considered sexual harassment or discrimination.

3. Make sure your officers, supervisors, and key employees sign a statement each year, stating that they are aware of the company’s “zero tolerance” policy and what constitutes harassment and discrimination.

4. Establish a method by which employees can submit reports of harassment and discrimination without the perpetrator becoming aware of it. This should be part of the employer’s compliance program.

5. Be sure your company or group has a good directors and officers (D&O) liability insurance and excess liability insurance policy that covers sexual harassment and discrimination claims.

6. Include an indemnification clause in the contracts of officers, supervisors, and key employees, requiring them to indemnify the employer in any case where the employer is held liable for acts of sexual harassment or discrimination.

7. Be sure that an employee who files a complaint does not have adverse employment action taken against him or her, especially based solely upon the word of the person against whom the complaint was filed. Bring a human relations expert in as early as possible to consult on the case, as well as an employment law defense attorney.

8. Make sure that all employees, including officers, supervisors, and key personnel, receive training once a year on avoiding sexual harassment and discrimination and document it in their personnel/human resources file. Hiring an outside trainer can make this less burdensome and more enjoyable. Again, this should be part of the employer’s compliance plan.

 

Don’t Wait Until It’s Too Late, Talk to an Experienced Attorney Now.

Florida workers have a right to report sexual harassment or discrimination without facing retribution, but workers often file complaints that are not valid. The EEOC advances opportunities in the workplace by enforcing federal laws prohibiting employment discrimination. Find out how The Health Law Firm can help if you are an employer that finds itself in this legal situation.

Additionally, please read one of our recent blogs dealing with a similar EEOC lawsuit.

Contact Health Law Attorneys Experienced in Representing Nurses and Other Healthcare Professionals.

The Health Law Firm’s attorneys routinely provide legal representation to nurses, physicians, medical groups, pharmacists, pharmacies, physicians, and other health providers. We provide legal representation for employers in EEOC complaints, workplace discrimination complaints, and suits involving harassment or discrimination complaints. We also provide legal representation in Department of Health, Board of Medicine, Board of Nursing investigations and complaints, DORA investigations and complaints. We provide litigation services in state and federal courts and state and federal administrative hearings. We provide legal representation across the U.S., not just in Colorado, Florida, Louisiana, Virginia, and Washington, D.C.

To contact The Health Law Firm please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Shanes, Alexis. “Fla. Pediatric Group Can’t Dodge EEOC Retaliation Suit.” Law360. (November 4, 2020). Web.

“EEOC Sues Pediatric Health Care Alliance for Retaliation Over Harassment Complaints.” U.S. Equal Employment Opportunity Commission (EEOC). (June 22, 2020). Web.

Bean, Mackenzie. “Florida practice retaliated against nurse for reporting harassment, EEOC says.” Becker’s Hospital Review. (November 9, 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 Avenue, Suite 1000, Altamonte Springs, FL 32714. Call (407) 331-6620 or Toll-Free at (888) 331-6620.

KeyWords: Equal Employment Opportunity Commission (EEOC) investigation defense, discrimination harassment complaint defense attorney, legal representation for physicians, medical group defense attorney, complex health care litigation attorney, complex civil litigation attorney, complex medical litigation lawyer, medical staff peer review defense attorney lawyer, federal administrative hearing defense attorney, hospital complaint investigation defense, peer review defense attorney, medical staff investigation defense lawyer, medical staff clinical privileges defense legal representation, hospital medical staff fair hearing defense attorney lawyer, hospital medical staff fair hearing defense legal counsel, legal representation for healthcare business litigation matters, The Health Law Firm, reviews of The Health Law Firm Attorneys, The Health Law Firm attorney reviews, representation for EEOC complaints, workplace retaliation defense lawyer, healthcare employment law defense lawyer, nurse attorney, legal representation for nurses, legal representation for complaints against nurses

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 © 2021 The Health Law

 

 

10 Biggest Mistakes Dentists Make That Cause DOH Complaints

By Carole C. Schriefer, J.D.

In representing dentists in complaints against their licenses, we see similar cases over and over again. The dentists could have avoided many Department of Regulatory Affairs (DORA) complaints that may wind up before the Board of Dentistry.

These are the ten biggest mistakes we see dentists make, leading to DORA complaints being filed and investigations being opened against them.

1.  Requiring patients to pay an outstanding dental bill before releasing a copy of their dental records. This is prohibited by law. However, the patient can be charged for the copy of the record, up to $1.00 per page for the first 25 pages, ($.25 per page after that), and actual costs of reproduction for other forms of dental records (X-rays, CD’s photographs).

2.  Not having the original patient x-rays or a good digitized copy. Believe it or not, many dentists we have represented either gave their x-rays to the patient or sent them to a subsequent treating dentist. Always release copies (for which you may charge). Always keep the originals. (Not having them when needed). With the expanding use of digital x-rays stored in an electronic dental record, this is not so problematic as it was in the past.

3.  Accepting a new patient who has had more than one other primary dentist within the prior five years (when the patient hasn’t relocated to a new geographical area). Unhappy, disgruntled, unrealistic patients will change dentists often. Identify these patients early and refuse to accept them as your patients or terminate them as patients as soon as you identify them. Closely related to this is accepting or failing to terminate the “disgruntled” patient. If a patient is a chronic complainer or threatens to sue or file a complaint, this is a patient who will, most likely, never be satisfied. Terminate this patient immediately.

4.  Failing to fully inform the patient of possible less-than-desirable outcomes (documenting this in writing, preferably signed by the patient). This includes but is not limited to the fact that there may be subsequent pain or infection, that the bite may be less than perfect and may have to be adjusted, that a bridge or other fixture may not fit correctly and may need to be adjusted, etc.

5.  Failing to have and use appropriate consent forms including, but not limited to:

a.  Refusal of a treatment consent form

b.  Consent for less than optimal dental treatment (to use when a patient refuses to follow dentist’s recommended treatment plan). This is also called “Refusal of Recommended Treatment.”

c.  Root Canal consent form

d.  Tooth Extraction

e.  Endodontic procedures

f.  Dentures and bridges

6.  Failing to refund dental fees when complaining patients demand it. We do not routinely recommend that you refund dental fees based solely on a patient’s demand that you do so. In many cases, the patient will have benefited from the treatment, procedure, or appliance, and should pay for it. However, in many instances, this must be a business decision based on risk management principles. It is always a good idea to weigh the amount in attorney’s fees, time, and aggravation, mental anguish, or increase in insurance premiums that will result if you fail to refund demanded fees. Base your decision on a calculation of how likely it is that a complaint will result.

7.  Failing to have good, legible, comprehensive treatment records on the patient. A documented, comprehensive written treatment plan signed by the patient is mandatory in all cases except emergency cases and specialty consults. This also includes failing to prepare and maintain a periodontal chart on a patient. If you are going to treat and follow a patient for more than an emergency visit or a specialty consultation, you should perform a periodontal exam. Just as important, the Board of Dentistry will expect you to chart this on a periodontal chart.

8.  Failing to document the type of and amount of a drug administered, a sedative used, a compound used, etc. Be sure this is accurately stated in your chart. Be sure this is accurately billed with the correct billing code.

9.  Failing to give patients a copy of their dental chart within a reasonable period of time after requested. (The courts usually define “reasonable” as 14 calendar days or ten business days; however, the Board of Dentistry allows up to 30 days. If you can reasonably provide it earlier, do so, documenting the date.

10.  Producing only part of the complete dental chart to the patient, subsequent treating dentist, or DORA investigator when requested. This has become more problematic as dentists’ convert more and more into electronic dental records. Be sure to print out and produce all treatment plans, histories, physical exams, family history questionnaires, medical history questionnaires, informed consent forms, photographs, treatment plans, x-rays, periodontal charts, progress notes, daily journal entires, bills, correspondence with health insurers or other third-party payers. Also included are prior dentists’ records received, operative reports, or any other documents you have relating to the patient’s treatment.

These are not hard and fast rules. We cannot assure you that you will never receive a DORA complaint, a patient complaint, a grievance, or a lawsuit if you follow them. However, if you follow them, you will probably find your patients happier, your practice calmer and more productive, and your risks of having a complaint filed significantly reduced or eliminated.

Click here to read one of my prior blogs about DORA complaints and investigations.

Contact Health Law Attorneys Experienced with Investigations of Dentists and Health Professionals Today.

The attorneys of The Health Law Firm provide legal representation to dentists, dental hygienists, physicians, nurses, nurse practitioners, CRNAs, pharmacists, psychologists and other health providers in Department of Regulatory Affairs (DORA), Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid 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.

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 or Toll-Free: (888) 331-6620. 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 © 2021 The Health Law Firm. All rights reserved.

Military Non-judicial Punishments or Article 15 Proceedings Are Not Criminal Convictions–Military Physicians, Dentists and Nurses Should Know This

Attorney Carole C. SchrieferBy Carole C. Schriefer, J.D.

Our firm represents many military and former military health professionals. We are often asked how a non-judicial punishment or Article 15 proceeding will be treated for license applications, clinical privileges applications, and background screenings.


Article 15 Non-judicial Punishment Is Not the Same as a Court-martial or a Criminal Proceeding.

Under Article 15 of the Uniform Code of Military Justice (UCMJ), which is also codified in 10 U.S.C. § 815, a commanding officer may issue an administrative punishment to enlisted or officer personnel under her command. These are not considered criminal convictions for any purpose, hence their other name, “non-judicial punishment.” These are usually for minor offenses and may be considered similar to civilian non-criminal traffic offenses.

An Article 15 non-judicial proceeding is less judicial in nature than a summary court-martial. In addition, the permissible range of punishments resulting from an Article 15 proceeding is more restrictive. The less serious Article 15 non-judicial proceeding cannot amount to a criminal prosecution or proceeding. What is most important is that there is no right to “due process of law” in a NJP as there would be in a judicial proceeding.

The NJP does not have to be reported as a “conviction” or “charge” and it should not come up on any background checks. If it does, you will need to seek assistance to have it removed from your record or explain it in sufficient detail. Always consult an experienced health lawyer with knowledge of the military if you have any questions about how to respond to questions on an application.

Cases That Have Ruled That NJPs Are Noncriminal Proceedings.

In Middendorf v. Henry, 425 U.S. 25, 31-32, 96 S. Ct. 1281, 47 L. Ed. 2d 556 (1976), even the dissenting opinion (which would have held that a summary court-martial is a criminal proceeding), agreed that the less serious Article 15 non-judicial punishment is not a criminal conviction for the purposes of the Fifth or Sixth Amendment. 425 U.S. at 58 (Marshall, J., dissenting). The dissenters noted that an Article 15 non-judicial punishment can be speedily imposed by a commander and does not carry with it the stigma of a criminal conviction. 425 U.S. at 58-59.

Numerous federal cases have held that an Article 15 non-judicial proceeding is not a criminal prosecution. See e.g., United States v. Marshall, 45 M.J. 268, 271 (C.A.A.F. 1996); Varn v. United States, 13 Cl. Ct. 391, 396 (1987); Dumas v. United States, 223 Ct. Cl. 465, 620 F.2d 247, 253 (1980) (“Article 15 proceedings clearly are not criminal prosecutions within the meaning of the rights plaintiffs claim under [the Fifth and Sixth] Amendments”); Bowes v. United States, 227 Ct. Cl. 166, 645 F.2d 961 (1981); Cole v. States, 228 Ct. Cl. 890 (1981); Cochran v. United States, 1 Cl. Ct. 759, 764 (1983), aff’d, 732 F.2d 168 (1984); Cappella v. United States, 224 Ct. Cl. 162, 624 F.2d 976, 980 (1980).

Fewer Rights at a NJP Means Increased Authority to Commanders and, Therefore, Less Stigma Associated With the Discipline.

The legislative history accompanying 10 U.S.C. § 815 states that Article 15 non-judicial punishment is non-criminal in character. The legislative history explains the purpose of the 1962 amendments to Article 15:

“The purpose of the proposed legislation was to amend article 15 of the Uniform Code of Military Justice to give increased authority to designated commanders in the Armed Forces to impose non-judicial punishment. Such increased authority [enables] them to deal with minor disciplinary problems and offenses without resort to trial by court-martial.”

The Legislative History Supports this Interpretation.

“Under existing law, article 15 of the Uniform Code of Military Justice provides a means whereby military commanders deal with minor infractions of discipline without resorting to criminal law processes. Under this article, commanding officers can impose specified limited punishments for minor offenses and infractions of discipline. This punishment is referred to as ‘non-judicial’ punishment. Since the punishment is non-judicial, it is not considered as a conviction of a crime and in this sense has no connection with the military court-martial system. . . . It has been acknowledged over a long period that military commanders should have the authority to impose non-judicial punishment as an essential part of their responsibilities to preserve discipline and maintain an effective armed force.”

The legislative history also emphasizes Congress’s intent to make Article 15 a non-criminal proceeding for the protection of service personnel:

“The Department of Defense has stated that problems adversely affecting morale and discipline have been created in the Armed Forces because of the inadequate powers of commanding officers to deal with minor behavioral infractions without resorting to the processes of the military court-martial system. . . . At the same time, the increased non-judicial authority should permit the services to reduce substantially the number of courts-martial for minor offenses, which result in stigmatizing and impairing the efficiency and morale of the person concerned.”

One court noted: “In light of the foregoing, it is clear that an Article 15 military proceeding for non-judicial punishment does not amount to a “criminal prosecution.” . . . Article 15’s legislative history demonstrates that Congress did not consider non-judicial punishment to be a conviction of a crime. Furthermore, federal courts have construed such proceedings to be non-criminal in nature. Accordingly, state prosecution . . . for the same offense is not barred by our double jeopardy statutory scheme.”
State v. Myers, 100 Haw. 132, 135-36, 58 P.3d 643, 646-47 (2002)

Other Courts Have Held Similarly.

Other Courts have quoted Myers with approval or have come to the same conclusion.

For example, the U.S. District Court for the Eastern District of Virginia in United States v. Trogden, 476 F. Supp. 2d 564, 569 (E.D. Va. 2007), stated:

“‘Supreme Court, other federal court, and state court precedent support the finding that NJP is not criminal. The Supreme Court has expressly stated that “Article 15 punishment, conducted personally by an accused’s commanding officer, is an administrative method of dealing with the most minor offenses.’ Middendorf v. Henry, 425 U.S. 25, 31-32, 96 S. Ct. 1281, 47 L. Ed. 2d 556 (1976) (emphasis added); see United States v. Gammons, 51 M.J. 169, 177 (C.A.A.F. 1999) (confirming this Supreme Court precedent in stating that ‘[m]ost punishments that may be imposed in a NJP proceeding affect the noncriminal field of military personnel administration’). Lower courts have further held that NJP is a non-adversarial proceeding that is regarded as noncriminal in nature. Fairchild v. Lehman, 814 F.2d 1555, 1558 (Fed. Cir. 1987); see Wales v. United States, 14 Cl. Ct. 580, 587 (1988); Cochran, 1 Cl. Ct. at 764, 767; Dumas, 620 F.2d at 251; Gammons, 51 M.J. at 174; United States v. Marshall, 45 M.J. 268, 271 (C.A.A.F. 1996); Dobzynski v. Green, 16 M.J. 84, 85-86 (C.A.A.F. 1983); Myers, 100 Haw. at 135, 58 P.3d at 646. Accordingly, in light of Article 15’s text, implementing manual, legislative history, and evaluation in case law, this court finds that Congress did not intend for NJP to be considered as criminal punishment for double jeopardy purposes, and this congressional intent is ‘entitled to considerable deference.’ SEC v. Palmisano, 135 F.3d 860, 864 (2d Cir. 1998).”

“Neither party has argued that the non-judicial punishment proceedings at issue were criminal in nature. See State v. Myers, 100 Haw. 132, 58 P.3d 643, 646-47 (Haw. 2002) (‘Numerous federal cases have held that an Article 15 non-judicial proceeding is not a criminal prosecution.’). Quoted with approval in Sasen v. Mabus, Civil Action No. 16-cv-10416-ADB, 2017 U.S. Dist. LEXIS 44436, at *33-34 (D. Mass. Mar. 27, 2017).

The Ninth Circuit Court of Appelas in United States v. Reveles, 660 F.3d 1138, 1141-42 (9th Cir. 2011), stated:

“The Armed Forces Court of Appeals has stated that ‘the title of the [NJP] legislation—”Commanding officer’s non-judicial punishment”—underscores the legislative intent to separate NJP from the judicial procedures of the military’s criminal law forum, the court-martial.’ United States v. Gammons, 51 M.J. 169, 177 (C.A.A.F. 1999). Similarly, the United States Court of Claims has held that ‘non-judicial punishment, unlike the general and special court-martial, is not a formal adversary criminal proceeding, but is regarded as non-criminal in nature.’ Wales v. United States, 14 Cl. Ct. 580, 587 (1988) (citing Fairchild v. Lehman, 814 F.2d 1555, 1558 (Fed. Cir. 1987)); see also Cochran v. United States, 1 Cl. Ct. 759, 764 (1983); Dumas v. United States, 620 F.2d 247, 251-52, 223 Ct. Cl. 465 (Ct. Cl. 1980); United States v. Trogden, 476 F. Supp. 2d 564, 568 (E.D. Va. 2007); State v. Myers, 100 Haw. 132, 58 P.3d 643, 646 (Haw. 2002); but see United States v. Volpe, 986 F. Supp. 122 (N.D.N.Y. 1997); Arriaga, 49 M.J. at 12; Ivie, 961 P.2d at 945.”

Consult a Health Law Attorney Who Is Familiar with Army, Navy, and Air Force Health Care Professionals and Their Problems.

The attorneys of The Health Law Firm have represented physicians, nurses, dentists, and other health professionals in the Army, Navy, and Air Force, active duty and retired, as well as physicians, nurses, and other health professionals working for the Veterans Administration (VA) in the U.S. and around the world. Representation has included disciplinary action, investigations, peer review investigations, clinical privileges actions, fair hearings, National Practitioner Data Bank (NPDB) actions, and appeals.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free (888) 331-6620 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 or Toll-Free: (888) 331-6620. Its main office is in the Orlando, Florida area.

“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 © 2021 The Health Law Firm. All rights reserved.

Three Charged For $109 Million Medicare Fraud Scheme and HIPAA Violations

Attorney Carole C. Schriefer

By Carole C. Schriefer, J.D.

In October 2020, Massachusetts federal prosecutors charged three individuals for their alleged roles in a multi-million dollar plot to defraud Medicare. Two individuals allegedly collected patient health data and sold it to the purported mastermind, who then used it to submit $109 million in false Medicare claims.

Both individuals obtaining the personal health information were located in Florida, wouldn’t you know it. Each was charged with one count of receiving more than $1.6 million kickbacks in connection with a federal health care program. Prosecutors charged the third individual with criminal violations of the Health Insurance Portability and Accountability Act (HIPAA).

Stealing and selling personal health information is one of those HIPAA violations that will really, really get you in trouble. Very few people even know that such a HIPAA violation can be prosecuted as a federal felony crime.

Fraudulently Collecting & Using Patient Information.

According to court documents, both individuals in Florida owned marketing companies that enlisted foreign call centers to contact Medicare beneficiaries (which, I believe, I have received a number of). Using a prepared script, they allegedly asked if patients would be interested in receiving durable medical equipment (DME) such as knee braces or compression sleeves “at little to no cost.” (Does: “We are calling because of your back pain,” sound familiar?)

The call centers would then collect information including the Medicare patient’s name, address, insurance number, and doctor’s name and address, prosecutors said. The information was then sold to the third individual, who used it to file fraudulent Medicare claims for the DME that was never prescribed by a legitimate physician and was not medically necessary.

According to court records, the alleged co-conspirators used the same patients’ information repeatedly through a different shell company each time. More than 1,000 of the claims were made under the names of deceased beneficiaries. (Click here if you are deceased).

Click here to view the criminal information in this case.

Read the DOJ’s press release for more information.

Also, read one of my prior blogs on a similar case in Florida.

Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare and Health care Fraud Issues Now.

The attorneys of The Health Law Firm represent physicians, durable medical equipment (DME) suppliers, and other health care providers in Medicare audits, investigations and subpoenas, ZPIC audits, subpoenas and investigations, MAC audits, RAC audits, Department of Health (DOH) subpoenas and investigations, Department of Health and Human Services (DHHS) subpoenas and investigations, Medicaid Fraud Control Unit (MFCU) subpoenas, audits and investigations, OIG subpoenas, audits and investigations, and Department of Regulatory Agencies (DORA) subpoenas, audits, and investigations, in Florida, Colorado, Louisiana, the District of Columbia, Virginia, and throughout Florida and across the U.S. They also represent DME suppliers, physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals, and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions, termination from the Medicare or Medicaid program, and state and federal administrative hearings and litigation.

For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or toll-free (888) 331-6620.

Sources:

Sinay, Reenat. “Feds Charge 3 In Alleged $109M Medicare Fraud Scheme.” Law360. (October 2, 2020). Web.

Szaniszlo, Marie. “Three charged in multi-million dollar fraud scheme.” Sentinel Enterprise. (October 2, 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 the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

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 © 2021 The Health Law

CVS Fined for Prescription Errors and Poor Staffing at Oklahoma Pharmacies

Attorney 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 July 16, 2020, the Oklahoma State Board of Pharmacy fined CVS, the nationwide pharmacy chain, $125,000, after auditors found safety issues and “chaotic” scenes at four of its pharmacies. State regulators in Oklahoma cited and fined the nation’s largest retail pharmacy chain for conditions including inadequate staffing and errors made in filling prescriptions. Hopefully, this was isolated to the few stores involved.

Pharmacy Complaints.

In four separate administrative orders, the Oklahoma State Board of Pharmacy said that auditors responded to complaints at each of the pharmacies for issues including long waiting times, wrong information on prescription refills, and dosage mistakes. The state board inspected the four pharmacies from mid-2019 to early 2020. In one case, the complaint said the pharmacy had put someone on hold on multiple occasions, sometimes as long as an hour. In another case, a woman said that when she got her medication refilled, the name and other information on the bottle she received was for someone else.

The pharmacy chains have pushed back on customer and employees’ complaints, saying staffing is sufficient and errors are rare.

Pharmacy Audits.

On multiple occasions, state auditors visiting the pharmacies said they found understaffed facilities, with the phone continuously ringing, employees working around unopened (and, we assume, un-inventoried) delivery boxes, and long lines at the drive-through windows. According to the orders, one pharmacy stated that it was normal for them to be as much as two weeks behind in filling prescriptions as a result of understaffing. It should be noted that the audits took place predominantly before the COVID-19 crisis.

Additionally, in letters to state pharmacy boards and in interviews, pharmacists working for CVS allegedly admitted that they struggled to keep up with an increasing number of tasks including filling prescriptions, giving flu shots, tending the drive-through window, answering phones, and calling patients. According to the orders, many said they also struggled to meet corporate performance metrics that they characterized as excessive and unsafe.

As a routine customer of CVS Pharmacy (not in Oklahoma, of course), I can sympathize with the pharmacists, pharmacy technicians, and clerks. In many places, pharmacists are now being required to administer a laundry list of vaccinations (literally, ten different vaccinations), practice medicine to a limited scope, contact prescribing physicians, constantly order out-of-stock drugs, order diagnostic tests, and answer all sorts of customer questions. Now, with the COVID-19 pandemic, there is a steady flow of coronavirus tests to administer to customers at the drive-through window. I see first-hand how difficult it is for these front-line healthcare professionals to keep up on a daily basis.

The Oklahoma Board said it “strongly recommended” that CVS follow through on nearly a dozen recommendations for all of its Oklahoma pharmacies, including increased training for technicians and changes to how staffing needs were determined. Additionally, the Oklahoma Board advised eliminating tasks that might overburden pharmacists and removing some metrics they are required to meet. For example, phone calls pharmacists often must make could be outsourced to a corporate call center.

In a statement, CVS Pharmacy said it agreed with the Board to settle the matter to avoid the lengthy and costly hearing process. The orders specify that CVS neither admits to nor denies the violations. The company agreed to pay the fines and to make other efforts to address the problems without contesting the allegations.

While the fine of $125,000 is relatively small for CVS, as it’s the country’s fifth-largest company, the move did validate the concerns raised at multiple drugstore chains by pharmacists who say workplaces are putting the public at risk.

You can read all four orders in this case here: CVS Order – Bartlesville, CVS Order – Choctaw, CVS Order – Moore, and CVS Order – Owasso.

Visit our Areas of Practice page on our website to learn more about Board of Pharmacy Representation and how we can assist Pharmacists and Pharmacies in these types of cases.

 

Consult With A Health Law Attorney Experienced in the Representation of Pharmacists and Pharmacies.

We routinely provide defense for pharmacists, pharmacies, and pharmacy technicians; defense to complaints filed against their licenses; defense to complaints filed by patients; defense in litigation against pharmacists, pharmacies, and technicians; legal representation and defense to DEA and Board of Pharmacy audits, investigations, and subpoenas; legal representation in depositions in criminal cases, negligence cases, civil cases, or disciplinary cases involving other health professionals. We have experience in dealing with HIPAA privacy complaints, audits, and investigations. We have experience in defending in Medicare, Medicaid, Tricare, and health insurance audits. We accept most professional liability insurance that pharmacists carry.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians, physician assistants, and other health professionals in investigations and at Board of Pharmacy hearings. Call our office now at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website www.TheHealthLawFirm.com.

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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“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 © 2021 The Health Law Firm. All rights reserved.

Certifying Emotional Support Animals and Protecting Your License, Part 1 of 2

Attorney Amanda I. ForbesBy Amanda I. Forbes, J.D., and Carole C. Schriefer, J.D.

In today’s stress-filed world if you are a mental health counselor or other professional counselor, it is likely that you will encounter a client seeking to obtain an Emotional Support Animal (ESA)
designation letter from you. Providing such a letter may cause you to face complaints, licensing, and disciplinary actions driven by hostile landlords, homeowners associations, and business establishments that do not want any sort of animals on their premises. Often cases wind up in civil litigation. The client may also try to retaliate against you, should the client be the victim of legal problems because of attempting to keep an ESA and not understanding the legal ramifications.

However, you, as an experienced, licensed mental health professional must know what to do and not to do to protect your license and your career.

This is part 1 of 2 in a blog series regarding Emotional Support Animals. Click here for part two. We also intend to do a follow-up blog series on working animals and how they are legally distinguished from ESAs.

Here are some tips to keep in mind should you decide to provide an ESA recommendation letter:

1. You must develop and document a properly established therapist-client relationship with the client prior to writing a recommendation–do whatever you would normally do for any other client seeking your help who walks in the door.

2. Confirm the actual, true identity of the client to be sure you know with whom you are dealing. Request and obtain at least two different forms of photo ID, one including a driver’s license for the equivalent. Check and verify the name and address on the Internet or with directory assistance. (I have a personal rule of thumb: “If you can’t find a person on the Internet, then he is a fake and does not exist”).

3. Obtain the client’s complete mental health history and medical history, requesting and obtaining other treater’s records just as you would do for any other client/patient.

4. If the client has been referred to you by another provider, especially one in a different medical or health specialty, request a written referral documenting the need for the referral to you.

5. Adequately and thoroughly make and document any decision that an ESA will benefit the client and help in treating any mental health symptoms. Be thorough and document it.

6. Assign a code from the Diagnostic and Statistical Manual, ed. 5 (DSM-5 ), to the patient, or obtain one from the patient’s regular treating psychiatrist, psychologist, or mental health therapist.

7. The most important element involved is to show that there is an actual medical necessity for the client to have an ESA or that there will be a therapeutic benefit for the client to have the ESA. If you cannot justify and document this, then do not approve the request.

8. Evaluate the ESA, preferably by an in-person meeting or tele-health conference, and determine that it will benefit the client, be sure to document this evaluation and comment on the weight, height, aggressiveness, and character of the ESA. It is most helpful to have a form the ESA’s veterinarian will complete, sign, and return to you for confirmation of this information and, perhaps, an indication that the animal is suitable in character. Keep this in your record.

9. Thoroughly document the above in your chart on the client.

10. Have a thorough knowledge of your state’s laws and professional licensing board’s regulations concerning ESAs. You might review past disciplinary cases in which counselors have received discipline relating to ESAs in your state.

Warning About Organizations that Target Mental Health Counselors, Psychoanalysts, and Professional Counselors Who Approve Emotional Support Animals.

Those mental health counselors, social workers, professional counselors, and therapists who are involved in the certification or approval of emotional support animals and working animals should be advised that there are a number of organizations and individuals out there who seek out and target those who certify or approve such animals. These organizations and individuals see many cases of abuse and improper certifications being used. They see individuals who appear to have no real medical need for such an animal “purchasing” such certifications. They view them as a merely “privileged” individual who merely buys such certification for their pet just so that can take the pet everywhere and garner attention for themselves.

Sometimes these organizations and individuals even pretend to be a patient seeking certification of an emotional support animal or a working animal. They do often contact counselors using fake names and pretending to be fake patients to see how far the therapist will go without even having a real patient. Then they file a complaint with the therapist’s professional board in an attempt to have disciplinary action taken against their license.

Therefore, it is imperative that you follow the tips mentioned in this article.

Guidance from the American Counseling Association:

The American Counseling Association (ACA) published a position paper titled: Emotional Support Animals-Human Animal Interactions in Counseling Interest Network Position Statement.

In that position paper the ACA stated:

As Licensed Professional Counselors, the assessment of DSM-5 diagnoses for human clients is within the scope of practice; however, the added practices of animal behavior, behavior assessment or Human-Animal Interventions are (most often) not. Emotional Support Animal may, in some specific circumstances, provide benefits to humans to minimize identified symptoms often associated with a DSM 5 diagnoses; however, because of the potential risks and unanticipated outcomes, the HAIC strongly suggests that counselors abstain from writing letters for persons seeking counseling or assessments for the sole purpose of obtaining an ESA recommendation letter.

Click here to read the ACA letter in full.

However, if the counselor already has an existing treating relationship with a client and the counselor is considering writing an ESA recommendation letter, then the ASA recommends:

[T]he counselor must have a thorough knowledge of the local, state, and federal laws and policies surrounding ESAs and appropriate knowledge, skills, and attitudes with the subject of therapeutic human-animal interactions before writing such a letter.

Click here to learn more.

The ACA also cautions:

The ACA’s Code of Ethics C.2.e Consultations on Ethical Obligations includes “taking reasonable steps with other counselors, the ACA Ethics and Professional Standards Department, or related professionals when they have questions regarding their ethical obligations or professional practice.” This may include working with animal trainers, behaviorists, or veterinary behaviorists to ensure that the clinician remains within their scope of practice. Since there is no overarching licensing or accrediting body for this matter, nor are there federal or state mandates at this time, the onus is on the clinician to ensure ethical practice.

https://www.unh.edu/sites/default/files/departments/student_accessibility_services_/aca.final_version_esa14556_002.pdf. (Emphasis added).

Don’t forget to read part 2 in this blog series to learn more.

Contact Health Law Attorneys Experienced Investigations of Mental Health Counselors, Psychologists, Social Workers, and Family Therapists.

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, social workers, and family therapists in Department of Health (DOH) investigations, FBI 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 or Toll-Free: (888) 331-6620, and visit our website at www.TheHealthLawFirm.com.

About the Authors: Amanda I. Forbes, practices health law with The Health Law Firm in its Altamonte Springs, Florida, office. Carole C. Schriefer is an attorney and former registered nurse.  Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll Free: (888) 331-6620.

“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 © 2021 The Health Law Firm. All rights reserved.

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Multiple Settlements with HHS for HIPAA Security Rule Violations & Data Breaches

Attorney Carole C. SchrieferBy Carole C. Schriefer, J.D.

In September 2020, the Department of Health and Human Services (HHS) announced three settlements to resolve alleged violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules. The settlements, totaling $10.6 million, stem from data breaches in which hackers were able to access and obtain individuals’ protected health information (PHI) from U.S. health providers. Combined, the three hacking incidents compromised the health information of more than 16 million patients.

Summary of the HIPAA Security Rule Settlements.

On September 21, 2020, the Office of Civil Rights, or OCR, the division of HHS which receives and investigates HIPAA complaints, announced a settlement with an orthopedic clinic in Georgia. The clinic agreed to pay $1.5 million after a 2016 hacking incident that compromised over 200,000 patient records. Part of the settlement included a Corrective Action Plan, or CAP, which the clinic agreed to adopt, to help prevent future breaches of privacy. Click here to view the resolution agreement and Corrective Action Plan (CAP).

On September 24, 2020, the OCR publicized a settlement with an information technology (IT) and health information management company. The business agreed to pay $2.3 million to settle claims of systemic security rule violations relating to a 2014 hacking incident impacting the personal health information (PHI) of more than 6 million individuals. Click here to read the settlement agreement.

Days later, the OCR released information about a $6.85 million settlement with Premera Blue Cross, the largest health plan in the Pacific Northwest. The settlement, the second largest to date, related to a 2015 cyber-attack which exposed the health information of more than 10 million individuals. To read the resolution agreement in full, click here.

In regard to these settlements, the OCR alleged that the following security rule violations had occurred:

1. Failure to conduct an adequate and thorough risk analysis;

2. Failure to implement sufficient mechanisms to record and examine system activities;

3. Failure to enter into business associate agreements with vendors with access to electronic protected health information;

4. Failure to implement reasonable security measures to reduce risks and vulnerabilities;

5. Failure to respond to and document a known security incident;

6. Failure to implement technical policies and procedures regarding access; and

7. Failure to implement procedures to regularly review system activity logs and reports.

Readers could use the above as a compliance checklist to make sure their own systems of records are being properly protected.

Consequences of HIPAA Security Rule Noncompliance.

The HIPAA Security Rule establishes a set of national standards for confidentiality, integrity, and availability of e-PHI. HHS is responsible for administering and enforcing these standards,along with enforcement of the HIPAA Privacy Rule. Therefore, the agency may conduct complaint investigations and compliance reviews. To learn more details about the HIPAA Security Rule, click here.

HHS looks for systems failures, prior breaches, missing risk analyses, or absence of or inadequate HIPAA policies. Without question, any compliance violations will result in an enforcement action. And as these three settlements have demonstrated, enforcement can be costly.

Don’t Wait Until It’s Too Late, Protect Yourself from HIPAA Security Rule Compliance Violations.

Businesses and organizations need to acknowledge the need to act and create a HIPAA security rule compliance plan. Locating existing security policies and the last completed risk analysis is an essential step in compliance. If it’s been over a year, perform or update risk analysis to identify risks or vulnerabilities on all systems that contain any e-PHI. Security rule compliance requires regular attention and detailed records. Take steps now to help protect e-PHI from data breaches, and avoid millions of dollars in settlements or fines.

Contact a Health Law Attorney Experienced in Defending HIPAA Complaints and Violations.

The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals, and other healthcare providers and institutions to investigate and defend alleged HIPAA complaints and violations and prepare Corrective Action Plans (CAPs). Our attorneys regularly defend OCR HIPAA audits, defend in HIPAA complaint investigations, assist in preparing a HIPAA Risk Analyses, defend in federal administrative actions and administrative hearing cases, and defend in civil or administrative litigation of HIPAA/breach of medical confidentiality law suits.

For more information about HIPAA violations, electronic health records or corrective action plans (CAPs) please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or toll-free (888) 331-6620.

Sources:

Kraus, Anna and Carrier, Tara. “HHS Announces Multiple HIPAA Settlements Related to Data Breaches and the Right of Access Initiative.” Lexology. (October 6, 2020). Web.

Castricone, Dena. “The Crushing Cost Of HIPAA Security Rule Noncompliance.” Law360. (October 1, 2020). Web.

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 or Toll-Free: (888) 331-6620. Its main office is in the Orlando, Florida area.

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 © 2021 The Health Law

DOJ Charges 345 People Allegedly Involved $6 Billion in Fraud, Related to Healthcare

Attorney Carole C. SchrieferBy Carole C. Schriefer, J.D.

In September 2020, federal prosecutors charged 345 doctors, nurses, and other medical professionals allegedly involved in more than $6 billion in healthcare fraud. It is considered the largest Health Care Fraud and Opioid Enforcement Action in the Department of Justice’s history (DOJ). The schemes were related to telemedicine, illegal opioid distribution, and durable medical equipment, the DOJ said.


A National Fraud Operation.

According to the DOJ, the 345 defendants were responsible for submitting false and fraudulent claims that cost more than $6 billion to federal health care programs and private insurers. It included $4.5 billion related to telemedicine fraud, $1.5 billion connected to sober homes, and over $806 million linked to illegal opioid distribution and other forms of Medicare fraud.

Telemedicine fraud charges made up the bulk of the nationwide bust. A total of 86 defendants were telehealth executives who allegedly paid medical professionals to order unnecessary amounts of durable medical equipment, genetic tests, and pain medications.

The sober homes cases include charges against more than 12 defendants for allegedly submitting false claims for tests and treatments for patients with drug and alcohol problems. The defendants allegedly paid illegal kickbacks and bribes for the referral of hundreds of patients to substance abuse treatment facilities.

Similarly, included in the charges were health professionals and others involved in distributing more than 30 million doses of opioids and other prescription narcotics. These charges have already resulted in guilty pleas by more than 240 of the defendants.

The historic law enforcement action was put in motion in April 2020 and aimed to crack down on classic health care fraud schemes. The DOJ executes “takedowns” every year to spotlight concerns about fraud in certain areas by grouping similar schemes together. Since its establishment in 2007, it has charged more than 4,200 defendants who defrauded Medicare for more than $19 billion, the agency said.

Click here to read the press release issued by the DOJ.

To read about a similar record-breaking telehealth fraud case in Florida, 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 defending audits and investigations by the Department of Health and Human Services, the Department of Justice, The Drug Enforcement Administration (DEA), the Florida Department of Health (DOH), the Colorado Department of Regulatory Agencies, Medicaid Fraud Control Unit (MFCU), state boards of medicine, state boards of pharmacy, and state boards of nursing. They also represent health professionals and providers in administrative litigation (state and federal) and civil litigation (state and federal). They represent physicians, nurses, medical groups, nursing homes, home health agencies, pharmacies, dentists, pharmacies, assisted living facilities, and other healthcare providers and institutions in recovery actions and termination from Medicare and Medicaid Programs.

To contact The Health Law Firm please call (407) 331-6620 or (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.


Sources:

Allen, Jackie. “DOJ charges 345 people involve in more than $6 billion healthcare fraud.” USA Herald. (October 3, 2020). Web.

Stawicki, Keven. “DOJ Charges 345 In Health Fraud Schemes Topping $6B.” Law360. (September 30, 2020). Web.

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 or Toll-Free: (888) 331-6620. Its main office is in the Orlando, Florida area.

“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 © 2021 The Health Law Firm. All rights reserved.

 

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