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NYC Doctor Gets Prison Term for Posing as Clinic Owner in $30 Million Fraud Scheme

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On August 22, 2018, a doctor received a sentence of one year and a day in prison from a New York federal court for his part in a $30 million scheme to defraud Medicare and the state Medicaid program. The doctor admitted to posing as the owner of a medical clinic and falsely claiming to have seen hundreds of patients. He pled guilty on January 11, 2018, to health care fraud and conspiracy to commit health care fraud, mail fraud and wire fraud, the U.S. Attorney’s Office said.

Lies and Cover-ups.

The New York City doctor accepted responsibility for falsely posing as the owner of two medical clinics that were actually owned by a corrupt businessman, according to the U.S. Attorney’s Office for the Southern District of New York. Under New York state law, medical clinics must be owned and operated by a medical professional. The businessman was able to evade the requirements of the law by hiring doctors to pose as the owners of each clinic.

The corrupt businessman owned and operated six medical clinics in Brooklyn between 2007 and 2013 that fraudulently billed Medicare and Medicaid. Approximately $30 million was billed for services and supplies that were not provided, according to the indictment and other documents filed in federal court, as well as statements made during the doctor’s plea proceeding and sentencing.

Additionally, the doctor fabricated false medical records to support the fraudulent reimbursement claims and wrote prescriptions and referrals for medically unnecessary tests and supplies, the U.S. attorney’s office said.

The Punishment.

U.S. District Judge Lorna G. Schofield sentenced the doctor to three years of supervised release in addition to the prison term for his role in the scheme. He was also ordered to pay restitution of approximately $1.83 million and to forfeit $269,412 in unlawful gains. The three other defendants involved in this case, a doctor, a physical therapist and an occupational therapist, are scheduled to go to trial at a later date. Click here to learn more.

“The Medicare and Medicaid programs are intended to provide essential medical services to the elderly and the needy, not to enrich corrupt doctors and other fraudsters,” U.S. Attorney Geoffrey S. Berman said in a statement. “Today’s sentence sends a strong message that those who cheat Medicare and Medicaid, including physicians who abuse their licenses and professional oaths, will be held accountable.” You can view the U.S. Attorney’s press release here.

To read about a similar case of fraud, click here to read one of my prior blogs.

This is a Dangerous Pitfall of Which all Doctors and Dentists Must Be Aware.

This is the type of situation we often see in which a doctor or dentist is victimized by dishonest and corrupt scofflaws, especially here in Florida. Most often an older physician who is retired or semi-retired is asked to become the “medical director” or “dental director” of a clinic that is owned in whole or in part by someone else. The physician may not even know who its true owners are. Later the physician or dentist is asked to serve as the “president” or as a “director” of the company and his/her name is placed on all the corporate papers. The trouble really begins, however, when the true owner(s) places the physician’s or dentist’s name on corporate papers and licensing papers as an “owner,” “shareholder” or “member” of the business, when the physician has paid nothing for the business and is not truly the owner.

If a physician or dentist becomes aware of such a scheme and gets out of it as soon as she or her finds out, the physician or dentist may be able to avoid prosecution or liability. However, if the physician or dentist continues to do business with the true owners as an “owner on paper,” “shell owner,” or “sham owner,” (they all mean the same thing, “fraudulent owner”) then he or she can be in for some serious civil and criminal liability.

There can be serious criminal penalties, such as the one reported on in this blog. For example, in Florida, it is a felony for a non-dentist (meaning a dentist not licensed in Florida) to own or control a dental clinic in Florida. It is also a criminal offense for a layperson (or a business entity owned by lay persons), to own or control a medical clinic, unless it goes through the strict health care clinic license requirements that Florida law requires. If the clinic is owned or operated illegally (even if it’s “just on paper”), then all of the bills it issue are also illegal.

Contact Health Law Attorneys Experienced in Handling Medicare and Medicaid Fraud Cases.

The Health Law Firm’s attorneys routinely represent physicians, medical groups, clinics, pharmacies, durable medical equipment (DME) suppliers, home health agencies, nursing homes and other healthcare providers in Medicare and Medicaid investigations, audits and recovery actions. They also represent them in preparing and submitting corrective action plans (CAPs), requests for reconsideration, and appeal hearings, including Medicare administrative hearings before an administrative law judge.

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

Sources:

Hanson, Joyce. “Doc Gets Year In Prison For Role In $30M Medicare Fraud.” Law360. (August 22, 2018). Web.

“NYC Doctor Gets Prison Term for Role in $30M Fraud Scam.” Bloomberg Law. (August 22, 2018). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Medicare and Medicaid fraud representation, false claims attorney, false claims representation, representation for overbilling, representation for DOJ investigations, fraud defense attorney, representation for medicare issues, representation for Medicaid issues, Medicare lawyer, Medicaid lawyer, health care fraud investigation representation, health care fraud defense representation, Medicare fraud representation, health care professional representation, representation for physicians, representation for physician reimbursement, licensure defense attorney, professional license representation, licensure defense representation, representation for health care professionals, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Florida health law defense lawyer, owner on paper, shell owner, or sham owner, paper owner, Florida dental clinic ownership, health care clinic license

“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 © 2018 The Health Law Firm. All rights reserved.

 

CMS Memorandum for Texting Patient Information Among Healthcare Providers

George F. Indest III headshot

June 21, 2018

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Centers for Medicare & Medicaid Services (CMS) released a Memorandum in an effort to clarify their stance and guidelines on texting between healthcare providers and staff.

Texting Patient Orders is Not Permitted.

CMS does not permit  health care providers to text patient orders to a care team member on any platform. Therefore, texting patient orders from a health care provider is not in compliance with the Conditions of Participation (CoPs) or Conditions for Coverage (CfCs).

Texting Patient Information on Secure Platforms.

Patient information that is sent via text messages  is permissible if accomplished through a secure platform only. However, Computerized Provider Order Entry (CPOE) is the preferred method of order entry. CMS holds to the long-standing practice that a physician should enter patient orders into the medical record via a hand written order or CPOE.

Compliance Plans.

Furthermore, in order to be compliant, all healthcare providers must utilize and maintain platforms that are secure, encrypted, and minimize the risks to patient privacy. It is expected that providers/organizations will implement procedures that routinely assess the security and integrity of the texting platforms that are being utilized. This is to ensure patient confidentiality and to avoid negative outcomes that could compromise the overall care of patients.

Using secure texting platforms, has the potential for healthcare organizations to streamline contact and improve patient outcomes. Click here to visit our website and read the CMS Memorandum in full.

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

The attorneys of The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other health care providers and institutions in investigating and defending alleged HIPAA complaints and violations and in preparing Corrective Action Plans (CAPs).

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 (850) 439-1001. Be sure to check The Health Law Firm Blog for regular updates.

Source: Center for Clinical Standards and Quality/Survey & Certification Group . “Texting of Patient Information among Healthcare Providers.” Centers for Medicare and Medicaid Services (CMS). (December 28, 2017). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Centers for Medicare and Medicaid Services (CMS), representation for CMS matters, CMS attorney, representation for health care investigations, representation for patient privacy issues, HIPAA lawyer, HIPAA representation, representation for health care compliance, health care compliance lawyer, CMS investigation representation, cyber-security representation, cyber-security attorney, data breach representation, HIPPA violation representation, HIPAA violation attorney, Medicare attorney, Medicaid attorney, representation for health care professionals, representation for health care facilities, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“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 © 2018 The Health Law Firm. All rights reserved.

By |2018-06-21T20:52:13+00:00June 21st, 2018|Dental Law Blog|0 Comments

Administrative Final Orders Must State Findings of Fact Based on the Evidence Presented

Attorney George F. Indest III HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law

Following is a summary of a recent appellate case on an issue relevant to health law:

Borges v. Dep’t of Health, 143 So. 3d 1185 (Fla. 3d DCA 2014).
Gustavo Borges (Borges) appealed a final order of the Florida Board of Dentistry that revoked his license to practice dentistry based on a conviction of the knowing receipt of child pornography under a federal statute.

At hearing, eight lay witnesses and four expert witnesses testified. In the recommended order’s discussion of the evidence presented, which was the basis for the Board’s final order, the administrative law judge (ALJ) discussed the testimony of only one witness-Borges-after concluding that a statement by Borges constituted a concession that established that his conviction was related to his ability to practice dentistry. No other testimony was discussed in the order, or even acknowledged.

On appeal, the appellate court concluded that the ALJ’s recommended order adopted by the Board did not comply with one of the requirements of section 120.57, Florida Statutes-that an ALJ’s order must contain “express findings of fact.” The court was quick to point out that, while the findings of fact did not have to address the testimony of every witness (i.e., all twelve here), the order must at least address the factual controversies at issue to the extent they are relevant to the disposition, or address why the testimony is irrelevant. Having failed to do so in this case, the appellate court reversed and remanded.

The case summary above was originally published in the Administrative Law Section Newsletter, Vol. 34, No. 2 (Dec. 2014), a publication of The Administrative Law Section of The Florida Bar.

Editor’s Comments on Case Summary.

This case demonstrates an important concept in administrative law. This is, an administrative law judge is required to discuss the evidence presented at the hearing and make specific findings of fact based on that evidence. Failing to do this in the recommended order (RO) can lead to reversal by an appellate court.


Comments?

Do you think the appellate court should have reversed? Do you think it was important to discuss all testimonies in this case? Please leave any thoughtful comments below.


Contact Health Law Attorneys Experienced in Handling Licensure Matters.

If you have been arrested, it is strongly recommended that you retain an experienced healthcare attorney who can advise you as to the effects a potential outcome could have on your license.

The attorneys of The Health Law Firm routinely represent physicians, pharmacists, nurses, and other healthcare practitioners in licensure matters. We frequently consult with criminal defense attorneys regarding defense strategies tailored to minimizing criminal sanctions while preserving the practitioner’s license.

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: Criminal law, license, defense attorney, health law, health care attorney, health care lawyer, health investigation, medical license, conviction, desntist, dentist criminal charges, Department of Health, DOH, professional license, federal statutes, license disciplined, license revoked, health attorney, finding of guilt, adjudication withheld, diversion program, DOH conviction, adjudication, discipline, criminal trial, defense lawyer, ALJ, administrative law judge, administrative law, appellate court, administrative orders, Florida Board of Dentistry, Board of Dentistry, dentistry, statutes, testimony

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2015 The Health Law Firm. All rights reserved.

Florida Dentist Performs Disappearing Act With Patients’ Money

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Pensacola, Florida, dentist has disappeared, with his patients’ cash, and now the Escambia Sheriff’s Office is looking for both, according to a number of news sources. According to the Pensacola News Journal, the dentist closed his practice months ago without alerting his patients or performing services for which they had already paid. On January 23, 2014, the sheriff’s office sent out a request for former patients of the dentist to come forward.

Click here to read the Pensacola News Journal article.

Dentist’s Checkered Past.

According to the Florida Department of Health (DOH), in 2003 and 2006, the dentist had disciplinary actions taken against him by the Florida Board of Dentistry. The Board ruled that the dentist was negligent and failed to meet minimum standards of dental performance for misdiagnosing a patient and failing to correct the patient’s dental issues. The Board also ruled that the dentist misrepresented himself as an orthodontic specialist, when he was a general practice dentist practicing in the area of orthodontics. Click here to view the discipline cases.

Currently, the DOH website lists the dentist’s license as active.

Victims Paid for a Number of Services Never Performed.

According to the Escambia Sheriff’s Office, a number of former patients have already come forward. They claim they paid for braces, dentures and other orthodontic work that was never performed. The sheriff’s office is looking for other former patients. The ABC station in Pensacola is reporting that these victims are organizing themselves on a Facebook group.

Click here to watch the news story.

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in 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 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 http://www.TheHealthLawFirm.com.

Comments?

What do you think of this story? Please leave any thoughtful comments below.

Sources:

Robinson, Kevin. “ECSO: Investigators Seeking Victims of Disappearing Dentist.” Pensacola News Journal. (January 23, 2014). From: http://www.pnj.com/article/20140123/NEWS11/140123006/ECSO-Investigators-seeking-victims-disappearing-dentist?nclick_check=1

Fernandez, Jenise. “Updated: Orthodontist Disappearance Investigation.” WEAR. (January 23, 2014). From: http://www.weartv.com/news/features/top-stories/stories/updated-orthodonist-disappearance-investigation-40700.shtml

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.

 

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999. 

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

By |2014-01-29T09:00:29+00:00May 15th, 2018|Dentists|1 Comment

Florida Dental Receptionist Charged With Stealing Thousands of Dollars From Patients

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On October 20, 2017, a receptionist at a Deltona dental clinic was arrested on charges she stole thousands of dollars in cash payments from the business’ customers since the beginning of 2016. Lucina Rodriguez was charged with two counts of grand theft in the case, which involved 30 missing bank deposits totaling more than $18,000 in cash. Rodriguez allegedly collected the cash payments from customers at Dental Care of Deltona, according to the Volusia County Sheriff’s Office.

The Alleged Theft. 

According to Volusia County sheriffs’ detectives, Rodriguez pocketed the cash deposits that were supposed to be taken to the bank. She also collected pre-payments but didn’t give receipts and failed to make a record of any payment in the patient’s file. The missing money would go undetected until months later, when the patient returned for the procedure, and the loss was written off as a “paperwork error.” In one case, a patient came to the clinic to cancel a procedure and request a refund of her $400 pre-payment. The clinic staff searched through her file and found no record of any pre-payment.

As detectives conducted interviews and inspected records, it became clear that she was the common link in the missing deposits.

From January 2016 to September 2017, she made close to $15,000 in cash deposits to her personal bank accounts. After she was fired on September 19, 2017, money stopped disappearing from the dental clinic.

The Consequences.

Rodriguez was charged with one count of grand theft ($10,000-$20,000) for the stolen cash deposits and an additional count of grand theft ($300-$5,000) for stealing the $400 pre-payment one victim wanted refunded. To read the press release in full from the Volusia County Sheriff’s Office, click here.

Unfortunately, this isn’t the first time a health professional has stolen from an employer. To learn more on how to stop employee embezzlement, click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals in Criminal Matters and Professional Licensing Matters.

If you have been arrested, it is strongly recommended that you retain an experienced attorney who can advise you on the criminal proceeding, your rights and how it may affect you. Most important to a physician, dentist, nurse, pharmacist or other health professional are what consequences may follow this. Consequences may include loss or suspension of hospital privileges, loss or suspension of your professional license, exclusion from the Medicare Program, termination from the state Medicaid Program, termination from health care insurance panels and other severe consequences.

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

“Deltona dental clinic worker charged with stealing $18,000.” The Daytona Beach News Journal. (October 20, 2017). Web.

Padró Ocasio, Bianca. “Dental clinic employee stole thousands of dollars from patients, authorities say.” Orlando Sentinel. (October 20, 2017). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for health care professionals, criminal defense attorney for health care professionals, legal representation for criminal matters against health professionals, licensure defense attorney, legal representation for employee embezzlement, legal representation for employee theft, dental defense attorney, legal representation for dentists, legal representation for dental receptionists, legal representation for dental clinics and facilities, defense attorney for dentists, health law defense attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, The Health Law Firm

“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 © 2017 The Health Law Firm. All rights reserved.

 

By |2017-11-06T21:13:31+00:00May 15th, 2018|Dental Law Blog|0 Comments

30 Major Mistakes Dentists Make After Being Notified of a Department of Health Investigation- Part 1

5 Indest-2008-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The investigation of a Department of Health (DOH) complaint which could lead to the revocation of the dentist’s license, usually starts with a simple letter from the DOH.  This letter should not be ignored. This is a very serious legal matter and it should be treated as such by the dentist who receives it.  Yet, in many cases, we are consulted by dentists after the entire investigation is over. The case has been presented to the Probable Cause Panel and formal charges have been filed against them.  They have attempted to represent themselves throughout the case unsuccessfully and the damage has already been done.  Often, the mistakes that have been made severely compromise our ability to achieve a favorable result for the dentist.

This is part one in a two part blog series.

These are the 30 major mistakes we see in the cases we are called upon to defend after a DOH investigation has been initiated against a dentist:

1. Failing to keep a current, valid address on file with the DOH (as required by law), which may seriously delay the receipt of the Uniform Complaint (notice of investigation), letters, and other important correspondence related to the investigation.

2. Contacting the DOH investigator and providing him/her an oral statement or oral interview.  Note:  There is no legal requirement to do this.  We recommend that you never do this.  Anything that you state may be used to help the state prove its case against you.  The DOH investigator is the equivalent of a police investigator attempting to make a case against you.  Don’t help them.

3. Making a written statement in response to the “invitation” extended by the DOH investigator to do so.  (Note:  There is no legal requirement to do this.  See above.)

4. Failing to carefully review the complaint to make sure it has been sent to the correct dentist.  (Note:  Check the name and license number, especially if you have a common name.)

5. Failing to ascertain whether or not the investigation is on the “Fast Track” which may then result in an emergency suspension order (ESO) suspending the physician’s license until all proceedings are concluded.  (Note:  This will usually be the case if there are allegations regarding drug abuse, alcohol abuse, sexual contact with a patient, mental health issues, failure to comply with PRN instructions, or default on a student loan.)

6. Providing a copy of the physician’s curriculum vitae (CV) or resume to the investigator because the investigator requested them to do so.  Note:  There is no legal requirement to do this.  We have actually had information from the dentist’s CV used against him in the case presented against the dentists.

7. Believing that if they “just explain it,” the investigation will be closed and the case dropped.  This never happens.  Every case is presented the Probable Cause Panel of the Board of Dentistry.

8. Failing to submit a timely objection to a DOH subpoena when there are valid grounds to do so.  If there are valid grounds for objecting to a subpoena issued by a DOH Investigator (or by an Order from the Surgeon General to do so) then it can and should be made.  The Department of Health does not have any authority to enforce subpoenas.

9. Forwarding only a portion of or failing to forward a complete copy of the patient’s dental record when subpoenaed by the DOH investigator as part of the investigation, when no objection is going to be filed.  We have seen this, especially with electronic dental records such as those maintained using the Dentrix system.   If you do provide a copy of the patient’s dental record (whether to the DOH investigator or to your attorney) you must be ceratin you produce each and every part of it.  This includes, daily journal entries, progress notes, periodontal charts, bills, treatment plans, x-rays, photographs, history & physical, informed consent forms, notes and telephone messages, correspondence, insurance company bills and EOBs.

10. Delegating the task of providing a complete copy of the patient medical record to your office staff, resulting in an incomplete or partial copy being provided.

11. Signing a “certificate” or “affidavit” that the copy of the record you have provided to the DOH investigator is complete.  There is no legal requirement of which we are aware that requires this.  Furthermore, we have seen this used against the dentists in a number of cases when he later discovers additional records (from another office or another source) that he had but did not include in the initial production.

12. Not being knowing or being able to tell that the investigation against them is a “fast track” or “Priority 1” investigation which is likely to be submitted to the Surgeon General for an Emergency Suspension s Order (ESO).

13. Failing to keep an exact copy of any dental records, documents, letters or statements provided to the investigator.

14. Believing that the investigator has knowledge or experience in dental procedures, medical procedures or the health care matters or the specific care or procedures investigated.

15. Believing that the investigator is merely attempting to ascertain the truth of the matter and this will result in the matter being dismissed.
Not every case will require submission of materials to the Probable Cause Panel after the investigation is received and reviewed.  There will be a few where the allegations made are not “legally sufficient” and do not constitute an offense for which the physicians may be disciplined.  However, only an attorney who has handled a large number of dentistry cases will be able to tell which cases these are.

In other cases, an experienced health care attorney may be successful in obtaining a commitment from the DOH (prosecuting) attorney to recommend a dismissal to the Probable Cause Panel.  In still other cases (usually the most serious ones), for tactical reasons, the experienced health care attorney may recommend that you waive your right to have the case submitted to the Probable Cause Panel and that you proceed directly to an administrative hearing.  The key to a successful outcome in all of these cases is to obtain the assistance of a health care lawyer who is experienced in appearing before the Board of Dentistry in such cases and does so on a regular basis.


Contact Health Law Attorneys Experienced with Department of Health Investigations of Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) 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.

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: Legal representation for dentists, dentist attorney, dentist defense attorney, legal representation for DOH investigations, legal representation for DOH investigations against dentists, DOH defense attorney, DOH investigation attorney, legal representation for DOH complaints, legal representation for complaints against dental license, legal representation for health care professionals, health law defense attorney, legal representation for revocation of license, legal representation for Probable Cause Panel issues, legal representation for Probable Cause Panel investigations, legal counsel for Probable Cause Panel investigations, The Health Law Firm, reviews of The Health Law Firm, The Health Law Firm attorney reviews
“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 © 2017 The Health Law Firm. All rights reserved.

 

By |2018-02-19T22:15:01+00:00May 15th, 2018|Dental Law Blog|1 Comment

Illegal Dentistry a Problem in Central Florida’s Minority Communities

Attorney George F. Indest III HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Officials with the Florida Department of Health and the Metropolitan Bureau of Investigation (MBI) recently raided an Orange County, Florida, home and discovered an elaborate unlicensed dentist’s office. The accused illegal dentist allegedly had everything from an old X-ray machine to a full dental lab with orthodontic equipment. But what she didn’t have was a license to practice dentistry in Florida.

According to the Orlando Sentinel, the dentist was a licensed dental hygienist in Florida and claimed to be licensed as a dentist in her native Brazil. Investigators couldn’t verify this, according to the reports. She faces charges of practicing unlicensed dentistry and operating an unregistered dental lab.

Minority Areas a Hot Spot for Unlicensed Dentists.

Unlicensed dentists typically seen in South Florida and in minority communities are becoming a bigger issue in Central Florida, according to a liaison officer from the Florida Department of Health. This seems to be caused by an influx of foreign health professionals into immigrant communities around the Central Florida region. According to data released by the Department of Health, the statewide number of unlicensed dental investigations has remained moderately steady: 47 during 2011-12, 50 during 2012-13, and 44 during 2013-14. Most unlicensed dentists claim to be licensed in their (primarily) South American home countries, according to the Florida Department of Health. After coming to Florida, they may be unable to obtain a state license to practice dentistry due to factors like money and language barriers.


An Easy Fix.

Steering clear of illegal dentists might seem like a no-brainer, but for some minorities and lower-paid workers, it can be a popular alternative. In many cases, it may be the only alternative. According to Josephine Mercado, founder of Hispanic Health Initiatives in Orlando, the dentists have no easy way of transferring their licenses to Florida and the immigrants may lack affordable dental care, so the business thrives. Unlicensed dentists generally target clients of the same nationality and word quickly spreads around the community.

Not Worth the Risk.

It’s important to keep in mind how dangerous an unlicensed dentist can be. The chance to save money could end up costing patients a lot more in the long run. Aside from the risk of infection or permanent disfigurement, patients also run the risk of permanent nerve damage and even possible death from improper anesthesia usage.

One of the most publicized cases in recent years was a Hollywood, Florida, woman who had permanent nerve damage after being treated by an unlicensed dentist in 2012. Unlicensed dentist cases, especially ones that result in an injury, have become a top priority for the Department of Health, according to its unlicensed-activity liaison. Click here to read our prior blog about Florida’s cracking down on unlicensed activity.

The license status of almost all health care professionals can easily be checked online. In Florida, license verification for all health care professionals can be checked on the Florida Department of Health (DOH) website here. Hint: If they don’t have a license, they’re not a legitimate health professional.

Should Inexpensive Dental Care Be More Widely Available in Florida?

In my opinion, the State of Florida should be doing a lot more to promote inexpensive dental care for its citizens. The availability of affordable dental care promotes the overall health of the community as a whole, reducing health care costs. Yet the organized dental community seems to oppose measures that would increase competition, increase the number of dentists, or decrease dental expenses.

Efforts of organized dentistry have recently been slapped down by the U.S. Supreme Court in 2014 as monopolistic in the case of North Carolina Board of Dental Examiners v. Federal Trade Commission. Efforts to open additional schools of dentistry have also been torpedoed by the state legislature.

While there are many wonderful dentists who do provide an extraordinary amount of free dental care to their communities, this is the exception rather than the norm.

Florida needs more dental schools, more dentists, and more affordable care for its lower-paid citizens.

Comments?

What do you think about the illegal dentistry problem in Florida? What do you think can be done to improve this situation? Should inexpensive dental care be more widely available in Florida? Please leave any thoughtful comments below.

Contact Health Law Attorneys Experienced with Department of Health Investigations of Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) 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.

 

Sources:

Alanez, Tonya. “Arrests Shed Light On Practice of Unlicensed Dentistry in South Florida.” Sun Sentinel. (August 5, 2013). From:

http://articles.sun-sentinel.com/2013-08-05/news/fl-unlicensed-dentists-20130804_1_unlicensed-dentistry-mirta-pavon-health-problems

Allen, Stephanie. “Illegal Dentists a Danger to Central Florida Immigrant Communities, Officials Say.” Orlando Sentinel. (May 23, 2015). From:


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:
dental law, dentistry law, dentist, dentistry, Board of Dentistry Department of Health (DOH), health law, health care attorney, health care lawyer, health investigation, dental license, defense lawyer, dental practice, board of dentistry attorney, Department of Health investigation, unlicensed practice defense attorney

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2015 The Health Law Firm. All rights reserved.

By |2018-07-06T01:30:49+00:00May 15th, 2018|Dental Law Blog|1 Comment

FTC Drills Dental Software Provider For Deceptive Encryption Promises

Attorney George F. Indest III HeadshotBy: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
A leading dental office management software provider has agreed to pay $250,000 to settle the Federal Trade Commission’s (FTC) claims that it falsely advertised its product as having industry-standard encryption. This encryption would help clients meet obligations under federal health privacy law to protect patient information.

Protecting Patient Information.

The Dentrix G5 software is used by dentists to perform office tasks such as entering patient data, sending appointment reminders, submitting insurance claims and recording diagnostic information. According to the FTC, Henry Schein Practice Solutions Inc. violated  The Federal Trade Commission Act Section 5: Unfair or Deceptive Acts or Practices, by falsely claiming that its software provided adequate encryption of sensitive patient information. The FTC’s Section 5 of the Federal Trade Commission Act (FTC Act) (15 USC 45) prohibits ‘‘unfair or deceptive acts or practices in or affecting commerce.’’  PracticesHenry Schein ( or, It) also claimed that those using the product would meet regulatory obligations under the Health Insurance Portability and Accountability Act (HIPAA).

Although advertisements claimed the product would help dental providers, the product’s encryption capabilities fell short of the promises. In 2010, the company was warned that its software was “less secure and more vulnerable” than industry-standard encryption. Despite this warning, the company continued to falsely marketing its product.

The Repercussions of Deceptive Acts or Practices.

The FTC alleges that the company’s misrepresentation of its software caused harm to dentists by leading them to believe they were in compliance with federal health privacy laws. Failure to comply with HIPAA can result in both civil and criminal penalties. To read further on this, click here to read one of my previous blogs.

To read more on the importance of enforcing privacy and security rules, click here.

Comments?

Do you think the software provider was given a fair penalty? How can the FTC further eliminate cases such as this?

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

The attorneys of The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other health care providers and institutions in investigating and defending alleged HIPAA complaints and violations and in preparing Corrective Action Plans (CAPs).

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 (850) 439-1001.

Source:

Grande, Allison. “FTC dings dental software prover for encryption promises.” Law 360. (January 5, 2016). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Health Insurance Portability and Accountability Act (HIPAA), HIPAA compliance, data security, protected health information (PHI), Patient privacy, Federal Trade Commission (FTC), penalties for HIPAA violation, defense attorney, defense lawyer, HIPAA defense attorney, health law, The Health Law Firm, dentist defense attorney, legal representation for dentists

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2016 The Health Law Firm. All rights reserved.

By |2018-07-06T01:34:28+00:00May 15th, 2018|Dental Law Blog|0 Comments

30 Major Mistakes Dentists Make After Being Notified of a Department of Health Investigation- Part 2

Attorney George F. Indest III HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

This two part blog series discusses the seriousness of receiving a letter of investigation from the Department of Health (DOH) and the importance of consulting an experienced health law attorney. In many cases, we are consulted by dentists after the entire investigation is over. Often, the mistakes that have been made severely compromise our ability to achieve a favorable result for the dentist.

This is part two in a two part blog series. To read part one of this series, click here.

These are the major mistakes we see in the cases we are called upon to defend after a DOH investigation has been initiated against a dentist:

16. Failing to check to see if their dental malpractice insurance carrier will pay the legal fees to defend them in this investigation.  In the absence of coverage by their insurance carrier, failing to retain the services of a health care attorney experienced in dental board cases to represent them from the beginning of the investigation.

17. Talking to DOH investigators, staff or attorneys, in the mistaken belief that they are capable of doing so without providing information that can and will be used against them.  Note:  Every telephone conversation with DOH personnel is entered into their computer data base and often internal e-mails Are exchanged sharing this information afterwards.

18. Believing that because they haven’t heard anything for six months or more the matter has “gone away.”  The matter does not ever just go away.

19. Failing to submit a written request to the investigator at the beginning of the investigation for a copy of the complete investigation report and file and then following up with additional requests until it is received.

20. Failing to wisely use the time while the investigation is proceeding to interview witnesses, obtain written witness statements, conduct research, obtain experts, and perform other tasks that may assist defending the case once it has been completed.

21. Failing to exercise the right of submitting documents, statements, and expert opinions to rebut the findings made in the investigation report before the case is submitted to the Probable Cause Panel of your licensing board for a decision.

22. Taking legal advice from their colleagues regarding what they should do (or not do) in defending themselves in the investigation.

23. Retaining “consultants” or other non-lawyer personnel to represent them in the matter, instead of experienced legal counsel.

24. Believing that the case is indefensible so there is no reason to even try to have it dismissed by the Probable Cause Panel.

25. Attempting to defend themselves.

26. Believing that because they know someone on the Board of Dentistry, with the Department of Health, or a state legislator, that influence can be exerted to have the case dismissed.  This is definitely not the case.  If you do know someone on the Board of Dentistry, that person is required by law to recuse (disqualify) themself from any discussion or vote on your case.

27. Failing to immediately retain the services of a health care attorney who is experienced in such matters to represent them, to communicate with the DOH investigator for them, and to prepare and submit materials to the Probable Cause Panel.

28. Believing that if an emergency Suspension Order (ESO) is entered against them that it may be successfully appealed.  In realty, ESO’s are reviewed by the appellate courts when there is an appeal based on what is contained “within the four corners of the document.”  Nothing outside the document may be considered.  If the ESO appears to state a sufficient case for an emergency suspension (whether the facts it states are actually true or not), the court of appeal is required to uphold the emergency suspension.

29. Communicating with the Department of Health about the pending case.

30. Failing to obtain legal representation.

The key to a successful outcome in all of these cases is to obtain the assistance of a health care lawyer who is experienced in appearing before the Board of Dentistry in such cases and does so on a regular basis.

Contact Health Law Attorneys Experienced with Department of Health Investigations of Dentists. 

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) 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.

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: Legal representation for dentists, dentist attorney, dentist defense attorney, legal representation for DOH investigations, legal representation for DOH investigations against dentists, DOH defense attorney, DOH investigation attorney, legal representation for DOH complaints, legal representation for complaints against dental license, legal representation for health care professionals, health law defense attorney, legal representation for revocation of license, legal representation for Probable Cause Panel issues, legal representation for Probable Cause Panel investigations, legal counsel for Probable Cause Panel investigations, The Health Law Firm, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“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 © 2017 The Health Law Firm. All rights reserved.

 

 

By |2018-07-06T01:36:42+00:00May 15th, 2018|Dental Law Blog|0 Comments

Colorado Unveils New Weapon in Fight Against Prescription Drug Abuse

By Carole C. Schriefer, R.N., J.D., The Health Law Firm

In the United States, Colorado ranks among the highest in prescription drug abuse. Prescribing practices have contributed to both the overuse as well as the illegal use of controlled substances. Recently, the Colorado Medical Board in collaboration with the Colorado Dental Board, Colorado Board of Nursing, Colorado Board of Pharmacy, and the Nurse-Physician Advisory Task Force for Colorado Healthcare, passed a policy for prescribing and dispensing opioids. This is the first time that all four Colorado licensing agencies have worked together to formulate a common policy for health care providers.

The new guidance sets the tone for how complaints involving prescribing and dispensing controlled substances will be viewed by these regulatory boards.

To read the new policy in its entirety, click here.

An Overview of the Prescribing and Dispensing Policy.

The new policy aims to reduce prescription drug abuse by better managing opioid prescribing and dispensing. The policy states that providers working with patients who are prescribed opioids should:

– Follow the policy for prescribing and dispensing opioids;
– Be informed about evidence-based practices for opioid use in health care and risk mitigation;
– Collaborate with the integrated health care team to decrease overprescribing, misuse and abuse of opioids;
– Use the Colorado Prescription Drug Monitoring Program (PDMP) when initially prescribing medication and with each refill;
– Use caution when dispensing to new or unknown patients, filling weekend or late day prescriptions, and when filling prescriptions issued by a provider far from the location of the pharmacy; and
– Educate patients on appropriate use, storage and disposal of opioids, risks and the potential for diversion.

Red Flags.

The new policy describes certain “red flags” health care providers should look for when prescribing and dispensing opioids. It alludes to certain prescription amounts and types that will likely be considered substandard in the absence of a compelling reason for the prescription. For example, the policy advises opioid doses greater than the equivalent of 120 mg morphine are dangerous. The policy also advises against opioid treatment that exceeds 90 days. It’s suggested that prescribers should consider discontinuing opioid therapy when:

– The underlying painful condition is resolved;
– Intolerable side effects emerge;
– The patient’s quality of life fails to improve;
– Functioning deteriorates; or
– There is aberrant medical use.

Tread Lightly When Prescribing Opioids.

Whether you are a physician, nurse, dentist, pharmacist or other health care provider practicing pain management, you should read the entire policy and strictly follow its guidance. Keep detailed records of your pain patients’ care, including copies of PDMP data. As a professional dealing with pain patients, you should also feel comfortable referring appropriate patients to addiction and pain management specialists at any sign of abuse. Failure to follow the new policy may lead to disciplinary action against your license.

For more tips to protect yourself from being accused of overprescribing, click here for a previous blog.

Comments?

What do you think of Colorado’s policy for prescribing and dispensing opioids? Do you think this new policy will make an impact on the prescription drug abuse throughout the state? As a health care provider, will you follow the new policy? Please leave any thoughtful comments below.

Contact A Lawyer Experienced in the Representation of Health Care Professionals in Pain Management Defense.

The Health Law Firm attorneys represent physicians, pharmacists, nurses, clinics, dentists, pharmacies, health facilities and other health care providers in different cases involving allegations of overprescribing narcotics and pain medications. These include criminal investigations by local police and law enforcement authorities, investigations by the U.S. Drug Enforcement Agency (DEA), complaints against professional licenses, and other types of cases. Having attorneys familiar with the medical standards of care and guidelines for prescribing narcotics and having access to expert medical and pharmacy professionals who can testify as expert witnesses in such cases is also crucial. We have represented professionals in administrative investigations and administrative hearings at both the state and federal level.

Call (970) 416-7456 now or visit our website www.TheHealthLawFirm.com.

About the Author: Carole C. Schriefer is a nurse-attorney 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.

The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1999-2014 The Health Law Firm. All rights reserved.

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