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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.

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

Phony Dentist Charged with Child Abuse After Injuring Teen During Procedures

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

A Miami man, his wife and their daughter have been charged with child abuse following two alleged dental procedures that left a 14-year-old girl permanently disfigured. According to a number of sources, the three were arrested on September 12, 2012, at their home-operated dental office.

Click here to see the man’s arrest affidavit from the Miami Police Department.

14-Year-Old Patient Left in Pain and Disfigured.

According to the Miami Herald, when the 14-year-old girl broke a front tooth, she and her mother went to the man, who claimed to be a dentist when he lived in Cuba. He offered to perform the dental work in the back room of his home office for $500. Instead of fixing the tooth, the article states the man filed all four of the girl’s front teeth down to the gums. He then allegedly fit her with a permanent bridge, which the mother described as an “iron bridge painted white with the form of teeth.”

The victim was allegedly left with swollen and blackened gums, according to the Miami Herald. She is now under the care of a licensed dentist at the University of Miami.

To read the entire article from the Miami Herald, click here.

All Three Family Members Face Charges of Child Abuse.

The fake dentist and his wife, who apparently witnessed the procedures, face charges of child abuse, child negligence and performing dental services without a license. The couple’s daughter faces a charge of child negligence.

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. Hint: If they don’t have a license, they ain’t a legitimate health professional.

This case was investigated by the Miami Police Department, the DOH and a Miami-Dade County team that fights pharmaceutical crime. Detectives suspect more victims will soon come forward.

Miami Seems to Be a Hot Spot for Phony Health Care Professionals.

We have seen many reports on phony doctors, dentists, nurse practitioners and others practicing in the Miami area over the past decade. Many of these operate surreptitiously and prey on immigrants and foreign nationals. Others operate blatantly and publicly advertise.

Plastic surgery and cosmetic procedures appear to be the most likely area to be “practiced” by the imposters. We have seen or heard reports of physicians performing surgery in hotel rooms. We have read reports of walk-in plastic surgery offices where animal sedatives were used to sedate the patient and plastic knee replacements were used as breast implants.

More Stories on Fake Physicians and Other Health Professionals to Come.

In the near future on this blog, we will include additional articles on fake doctors and health professionals, some old, some new.

To see a recent blog on a Florida teen impersonating a physician’s assistant (PA), click here. You can also read the story of a fake plastic surgeon in New York by clicking here.

Contact Health Law Attorneys Experienced in Representing Health Care Providers in DOH Cases.

The Health Law Firm represents dentists, pharmacists, pharmacies, physicians, nurses, and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the Drug Enforcement Agency (DEA), Department of Health (DOH), and other law enforcement agencies.

If you are aware of an investigation of you or your practice, or if you have been contacted by the DEA or DOH, contact an experienced health law attorney immediately.

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

Sources:

Sanchez, Melissa. “Little Havana Man Accused of Injuring Girl with Illegal Dental Work.” Miami Herald. (September 12, 2012). From: http://www.miamiherald.com/2012/09/12/2999610/little-havana-man-accused-of-injuring.html

CBS Miami. “Girl Leaves Dental Dungeon With Mangled Teeth; 3 Charged With Child Abuse.” CBS Miami. (September 12, 2012). From: http://miami.cbslocal.com/2012/09/12/girl-leaves-dental-clinic-with-disfigured-teeth-3-charged-with-child-abuse/

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.

Dentists Targeted for Billing Medicaid for Dead Patients; Okay to Treat Dead Patients, You Just Can’t Bill for It

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Two South Florida dentists are at the center of a fraud investigation after, among other things, allegedly billing Medicaid for unnecessary dentures for their patients, according to the Florida Attorney General’s Office. Married couple Marino Vigna and Beth Reinstein operate Sunrise Dental Clinic in Fort Lauderdale. They have not yet been arrested or charged, however, their billing practices are reportedly under investigation. According to the South Florida Sun Sentinel, the office of Florida’s Attorney General is focusing on the clinic’s submission of Medicare claims dating back to Jan. 1, 2010.

Hundreds of Elderly Patients Affected.

Vigna and Reinstein allegedly billed Medicaid for dentures for patients who had no need for false teeth. According to investigator Alexander Perez, many of the couple’s patients were “already deceased or unable to be interviewed due to physical and/or psychological disabilities.” Other alleged patients suffered from dementia and could not recall if they had previously received any services from Dr. Vigna.

Medicaid paid a $1,198 claim for a 100-year-old woman residing in a senior care facility. Vigna billed for the extraction of 11 teeth and upper and lower dentures. When investigators interviewed the woman’s son, it was revealed that she never had any teeth extracted by Vigna and her dentures were obtained 12 years ago in another state. Another alleged patient had no need for dentures as the patient had long been restricted to a liquid diet.

Other Fun Facts (Allegations).

The clinic reportedly billed for services provided to patients while Vigna and Reinstein were vacationing out of the country. The Bureau of Immigration and Customs Enforcement (ICE) confirmed that the couple were in the Netherlands, Bahamas, Paris and Sweden, on the dates in question. Red flags were raised as clinic employees revealed to investigators that the dental office closes when Vigna goes on vacation.

Furthermore, some patients reportedly treated by the clinic were deceased at the time of their services, yet the clinic still billed Medicaid.

How Much Did the Alleged Fraud Cost Medicaid?

At this time, an estimate of the total alleged fraud cost is not available. The Sun Sentinel revealed, however, that the clinic was reportedly paid nearly $10,000 for services provided to Medicaid patients who were allegedly treated while the couple was on vacation in 2012.

To learn more about the large crackdowns on Medicaid fraud and how it may affect you, read one of our past blogs here.

To read about the oversight of the integrity of the Medicaid program click here.

Editor’s Comments.

As I’ve always said, you can treat dead people as much as you want. Just don’t try to bill Medicare or Medicaid for the treatment.

Comments?

Do you think harsher punishments are the key to counteracting Medicaid fraud? Leave any thoughtful comments below.

Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations and Other Legal Proceedings.
Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Health Care Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.

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

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

Sources:

Alanez, Tonya. (Aug. 12, 2015). “Dentists target of false-teeth inquiry.” Orlando Sentinel.

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: dentist, dental clinic dental practice, Medicaid, Medicaid fraud, Medicaid investigation, Medicaid claims, fraudulent claims, health care fraud, Medicaid billing, Attorney General senior health care Medicaid reimbursements health law firm The Health Law Firm

“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 |2018-05-18T11:37:20+00:00May 15th, 2018|Dental Law Blog|0 Comments

Texas Federal Court Rules Dentists Can Advertise As “Specialists” in Dentistry

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

On January 21, 2016, the United States District Court for the Western District of Texas, Austin Division, ruled that the Texas State Board of Dental Examiners could not prohibit dentists from advertising themselves to the public as “specialists” in dentistry.

The court found this to be unconstitutional, as it violated the defendants’ First Amendment rights to engage in truthful, non-misleading commercial speech. As a result of the decision, dentists who have earned board certification from the Certifying Board sponsored by the American Academy of Implant Dentistry (AAID) or those of the other plaintiff organizations may now advertise that they are specialists in the state of Texas.

The Ruling.

Judge Sam Sparks ruled that a Texas Administrative Code §108.54 , that restricted specialties in Texas to only those recognized by the American Dental Association (ADA) was unconstitutional. The AAID, along with three other dental organizations and five individual Texas dentists, filed suit challenging the Texas regulation.

“This is a great victory for patients throughout the state of Texas. They now can have more information available to them to help them decide who to use for their dental needs,” said Dr. Richard Mercurio, President of AAID. “No longer will patients need to guess whether a dentist who is trained in treating gum disease or extracting teeth is also experienced in the complex and comprehensive field of implant placement and restoration. Patients will now be able to seek out specialists in implant dentistry, such as those certified by AAID’s Certifying Board, the American Board of Oral Implantology/Implant Dentistry (ABOI/ID),” he pointed out.

To read the court’s decision in this case, click here.

To find out more on how The Health Law Firm can assist you in legal issues, click here.

Consult With An Attorney Experienced in the Representation of Dentists.

We routinely provide deposition coverage to dentists, dental hygienists and other health professionals being deposed in criminal cases, negligence cases, civil cases or disciplinary cases involving other health professionals.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing dentists and dental hygienists and other health professionals in investigations and at Board of Dentistry hearings. Call now or visit our website www.TheHealthLawFirm.com.

Sources:

Davis, Michael. “United States District Court ruling sets stage for expansion of ‘dental specialties’, practitioner independence from ADA restrictions.” Dentistry IQ. (January 25, 2016). Web.

Recker, Frank. “Texas U.S. District Court Sides with AAID on Specialization Lawsuit.” American Academy of Implant Dentistry. (January 25, 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: American Academy of Implant Dentistry (AAID), American Dental Association (ADA), Texas State Board of Dental Examiners, dentists advertising as specialists, First Amendment rights to engage in truthful, non-misleading commercial speech, legal representation for dentists, dental industry defense attorney, dentist defense attorney, Board of Dentistry, Board of Dentistry defense lawyer, The Health Law Firm

“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 © 2016 The Health Law Firm. All rights reserved.

By |2018-07-09T19:35:40+00:00May 15th, 2018|Dental Law Blog|0 Comments

Little Known Facts About State and DOH Investigations That Could Save Your Professional License

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

The notice that you are under investigation may seem nonthreatening. It may come in the mail, be delivered personally by an investigator or you may receive a telephone call from the investigator. This is a very serious matter for you.

Our attorneys include those who are board certified in health law by The Florida Bar, those who are nurses, and those who are themselves licensed health professionals.  Our attorneys represent health care professionals and providers at formal administrative hearings at the Division of Administrative Hearings (DOAH), in defense of administrative complaints and in informal hearings before the Department of Health (DOH).
The Following is a list of little known facts about state investigations (including DOH investigations) that could save your license:

1. You do not have to make any statement at all to an investigator.  The Fifth Amendment applies to administrative investigations that can affect your license in Florida.  We recommend you never speak to an investigator or make any statement.  Let your attorney do this for you.

2. You do not have to sign an affidavit that your health records are complete.  In fact, we strongly recommend against doing this.  Consult an experienced health lawyer in who has experience in litigating your type of case before signing anything.

3. If you receive a DOH subpoena for records, you do not necessarily have to provide them.  You may file an objection to producing them based on an invasion of the privacy of the patient, lack of relevance to the investigation, super-confidential medical information (including HIV/AIDS testing or information, drug or alcohol counseling or testing information, or mental health information) or other proper grounds.  In one case, our client received a subpoena for copies of her professional school records and when we checked the case number for the case in which it was issued, the case did not exist.

4. The Surgeon General (formerly known as the Secretary of the Department of Health) does not have the authority to enforce a subpoena or to issue a final order to you compelling you to respond to the subpoena.  Only a court of law with jurisdiction has the legal authority to compel you to produce records in response to a DOH subpoena.

5. If you have filed an objection to an administrative procedure, you cannot be legally charged with violating an order from the head of the agency to produce those records.  The Surgeon General (formerly known as the Secretary of the Department of Health) does not have the legal authority to enforce such subpoenas.

6. If you are facing an emergency suspension order (ESO) for certain types of misconduct (e.g., drug abuse, alcohol abuse, sexual misconduct, mental impairment) you may be able to submit a voluntary request/agreement to refrain from practice in the state of Florida.  This may avoid having an ESO issued, which is a public record and is published through the media.  If you have a license in another state, you may still practice in that state.

7. A voluntary relinquishment of your professional license after an investigation has begun is treated the same as a revocation of your license.  This may result in a report being made to the National Practitioner Data Bank (NPDB) or the Healthcare Integrity Procurement Data Bank (HIPDB) just the same as a revocation of your license would be (even for LPN, R.N., or ARNP).  This will then result in your exclusion from the Medicare and Medicaid Programs, and you debarment/exclusion from all government contracting or employment.

8. You do not have to report a pending DOH investigation against you to anyone.  A DOH investigation is and remains completely confidential until at least ten (10) days after there is a finding of probable cause.

9. Until there is a suspension or other final action taken against you, there is no indication on your license or in your licensure file that you are being investigated.
If you receive notice that the Department of Health (DOH) has opened an investigation against you, contact The Health Law Firm immediately, before you talk to an investigator.

To learn more about how The Health Law Firm can assist you if you find yourself in this situation, click here.

To learn more on how to protect your medical license, click here to read one of my prior blogs.

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

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in 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: 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 Department of Health (DOH) investigations, legal representation for DOH complaints, licensure defense attorney, DOH defense attorney, health law defense attorney, legal representation for health care professionals, legal representation for disciplinary actions against your license, legal representation for license revocation, licensure defense attorney, administrative complaint attorney, legal representation for administrative complaints, Board of Medicine representation, legal counsel for Board representation, The Health Law Firm, health law defense attorney, Florida health law attorney, reviews of The Health Law Firm, The Health Law Firm attorneys review

“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 |2018-07-09T19:44:48+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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