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Drug Enforcement Administration (DEA) Agents May Surprise You at Florida Board of Dentistry Meeting

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

At several recent Florida Board meetings, after hearings at which disciplinary cases were considered by the Board, Drug Enforcement Administration (DEA) agents approached the health professional. Even in instances where the dentist was represented by an attorney and the attorney was there, the DEA agents confronted the professional involved.

What Were the DEA Agents Trying to Do?

In the cases where The Health Law Firm’s attorneys were there representing clients, the professional received some type of discipline on his or her license. Some of these were Settlement Agreements. The DEA Agent approached the professional and urged the professional to sign a voluntary relinquishment of DEA registration.

It seems that this is happening to professionals where there is some type of serious or long-term discipline is being taken against their licenses, such as long-term probation, suspension or revocation. Also, if the charges against the health professional involved, drugs, over-prescribing, abuse of narcotics, operation of a “pill mill,” selling or illegally dispensing or prescribing narcotics, drug diversion or abuse, being impaired from use of drugs, and other similar misconduct. These are often grounds for the revocation, suspension or revocation of the DEA number.

This action by DEA agents has occurred at Board of Medicine meetings and hearings, Board of Osteopathic Medicine meetings and hearings, Board of Dentistry meetings and hearing and Board of Pharmacy meetings and hearings. If you are a professional who has a DEA registration and number, you are, apparently, fair game.

Don’t Be Surprised; Be Prepared and Don’t Make a Rash Decision.

It is unusual to see federal agents of this type “cruising” state professional board meetings like we have seen lately. But, it seems to make sense, from the DEA’s point of view. If you can take several minutes and convince, surprise or intimidate a health professional into relinquishing his or her DEA registration voluntarily, then you may save the government hundreds of hours of time and thousands of dollars in expenses in having to investigate and have a separate administrative hearing (which the health professional may win), if he or she voluntarily relinquishes the DEA registration.

Immediately consult with an experienced health law attorney who has dealt with the DEA before.

Remember Your Rights; Yes, You Have Rights!

Yes, you do have rights, Constitutional rights. Use them! That is what they are there for.

You have the right to consult with counsel before making a decision. Don’t believe it if a DEA agents tells you that you don’t.

You have the right not to sign any forms or make any statements. Don’t sign anything. Don’t make any statements except for getting the agent’s card and telling them you will have your attorney contact them.

You have the right to take time to consider the matter and consult with others. You do not have to make a decision right away.

The Consequences of Voluntary Relinquishment are Serious and Long-Lasting.

Your voluntary relinquishment are serious and long lasting. It will be treated the same as a revocation of your DEA number. We have consulted with physicians and pharmacists who have never been able to get it back after they relinquished it.

You will probably be terminated from any health insurance panels you are on if this happens.

You will probably have action taken against your clinical privileges if you have clinical privileges at any hospital, nursing home or ambulatory surgical center (ASC).

You may be terminated from the Medicare or Medicaid Program.

There are many other consequences that may result.

Therefore, you and your attorney should be aware that this may happen and you and your attorney should be prepared if it does happen.

For more tips on how to prepare, click here to read my prior blog.

Don’t Wait Too Late; Consult with an Experienced Health Law Attorney Early.

Do not wait until action has been taken against you to consult with an experienced attorney in these matters. Few cases are won on appeal. It is much easier to win your case when there is proper time to prepare and you have requested a formal hearing so that you may actually dispute the facts being alleged against you.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing dentists and dental hygienists  in investigations and at Board of Dentistry hearings.  Call now or visit our website 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: Administrative hearing attorney, representation for administrative hearings, administrative complaint defense attorney, Board of Dentistry representation, Board of Dentistry attorney, Board of Dentistry defense attorney, representation for Board of Dentistry investigations, representation for Board of Dentistry complaints, DEA hearing defense attoreny, DEA investigation attorney, DEA hearing representation, DEA investigation representation, Dentist attorney, health care professional defense attorney, representation for health care professionals, professional licensure defense attorney, professional licensure representation, licensure defense attorney, representation for licensure issues, representation for dentists, review 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 |2018-02-07T02:33:07+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.

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

20 Tips to Help You Survive Facing Peer Review for Your Hospital Clinical Privileges-Part 2 of 2

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

In Part 1 of this blog I began a list of tips that should serve you well if you are notified by your hospital or medical staff that you are the subject of an internal or external peer review action. Click here to read Part 1.

20 Tips For Successful Outcome in Peer Review (Continued):

10.    If you are given the opportunity to meet with the reviewers or provide information to them, do so.  If you haven’t been offered this, ask for it in writing.

11.    Make sure any written response is provided in a typewritten letter formal not via e-mail, text or YouTube posting or handwritten note.

12.    In your written statement or response, if you use any abbreviations, spell them out completely the first time you use them and place the abbreviation after, in parentheses.  Remember, future reviews of your statement may not be physicians (e.g., a judge) or may not be in your medical specialty.

13.    It is never too early to engage experienced health car legal counsel to assist you in such matter.  But if you do, make sure you do hire an actual health law attorney who has experience with medical staff peer review actions.  This is no place for a plaintiff’s personal injury attorney, a criminal defense attorney or your tax, or business lawyer.

14.    If you find out that your matter is being sent out to an external peer review organization you should retain an experienced health law attorney immediately and obtain your own medical expert review.

15.    If the care being examined involved another physician as well as you, or if the care was of a patient referred by another physician, see if that physician supports the care you provided and will provide you a letter or statement saying that.

16.    If the allegation being reviewed involves facts that you know are not true, see if you can obtain evidence of this.  For example, I had a case where nursing staff filed a complaint against my client a male OB/GYN claiming that the mother of a minor female patient had demanded that her daughter only be examined by a female doctor.  We are able to obtain an affidavit from the mother swearing that she had never stated that.  The peer review matter was dismissed and closed.

17.    If it appears that you are being targeted for repeated peer review complaints or investigations, it is time to get out of that place.  Read the handwriting on the wall.  However , see #1 above.  Do not resign with any type of peer review pending.

18.    Remember that peer review proceedings are supposed to be confidential.  Therefore work through your legal counsel in obtaining outside reviews.  Do not discuss the matter with those outside the medical staff.

19.    Although the peer review process is confidential, it is not supposed to be “secretive.”  The person who is the subject of peer review should have access to the complaint and medical records involved.  This should not be a Star Chamber proceeding.  Make a polite written request for copies of such materials or to be allowed to review them and make notes.

20.    In many cases, you may find that you did make a mistake, violate a policy or procedure, skip a step in an algorithm, fall below the standard of care, or otherwise screw up.  Except in cases of the most egregious situations, your best course o action may be to admit this, explain how this happened, and outline steps you are taking to make sure it does not happen again.  This is especially true when it is your first “offense” and you have many years of otherwise excellent performance.  The medical staff usually wants to make sure that when a mistake occurs, the health provider has the ability to recognize it and learn from it.

Follow These Tips for The Best Results in a Peer Review Matter.

If you follow these tips, you have the best chance of coming out of the peer review without problems.  However, in a really serious case, where many records are being reviewed and the allegations appear to be very serious, then it is most important to retain an experienced health care attorney at the earliest opportunity and take that attorney’s advice.  You will be in for the fight of your professional life.

Click here to read Part 1 of this Blog
.

For more information, read one of my prior blogs on peer review, avoiding the disruptive physician label and clinical privileges.


Don’t Wait Until It’s Too Late, Contact a Health Law Attorney Experienced in the Process of Peer Reviews.

If you are the subject of a peer review proceeding, immediately retain experienced, knowledgeable health care counsel to represent you. The attorneys of The Health Law Firm have experience in most, if not all, types of “fair hearings” involving health care issues and health care providers.

At the Health Law Firm we provide legal services for physicians and other health care providers. This includes nurse practitioners, nurses, dentists, psychologists, psychiatrists, mental health counselors, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.  We also represent physicians and health care providers in complex litigation in both state and federal courts.

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 peer review, peer review defense attorney, medical staff peer review confidentiality, medical staff fair hearing legal representation, medical staff fair hearing attorney, clinical privileges hearing defense attorney, clinical privileges hearing legal representation, clinical privileges hearing attorney, legal counsel on peer review process, legal representation for physician defamation, health law defense attorney, economic credentialing, sham peer review attorney, health law peer review attorney, legal representation for peer review investigations, health care litigation legal counsel, complex health care litigation attorney, legal representation for health care employment issues, disruptive physician representation, legal representation for disruptive physicians,  health care employment defense attorney, The Health Law Firm reviews, reviews of The Health Law Firm Attorneys

“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 |2018-05-14T19:05:41+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

In Colorado, Are Threatening Statements Protected by Psychologist-Patient Privilege?

5571 darken lighten center w skin softBy Carole C. Schriefer, R.N., J.D., The Health Law Firm

Mental health providers and patients share a sacred bond. But is that sensitive relationship tarnished when a doctor testifies against patients?

That was the question posed to the Colorado Supreme Court in People v. Kailey. The state’s high court had to decide if a patient makes threatening statements during a therapy session, and the doctor reports these statements, can the doctor’s testimony against a patient be used in court?

Click here to read the entire case.

Case Background.

Randy Kailey was serving a 32-year sentence at a correctional facility in Colorado when he met with Brian Willson for a therapy session. Willson was a psychologist candidate working for the Colorado Department of Corrections (DOC). During the session, Kailey allegedly spoke threateningly about witnesses who testified against him during his trial. Willson considered these statements to constitute serious threats of violence.

According to Willson’s duty to warn, he submitted an incident report to the Colorado DOC. Based on that report and testimony from Willson, the State of Colorado charged Kailey with retaliation against a witness.

Kailey moved to exclude the doctor’s testimony, contending that Kailey’s statements should be protected by the psychologist-patient privilege. After a hearing, a trial court sided with Kailey, ruling that even after a mental health provider notifies law enforcement about the threatening statements, those statements remain privileged.

Colorado Supreme Court’s Dilemma.

All jurisdictions acknowledge some form of the duty to warn. However, there are disagreements in various jurisdictions over whether mental health providers can testify on threatening statements made by their patients when these statements have already been disclosed.

In the case discussed above, Willson’s testimony was critical to the prosecutor’s case. The suppression of evidence due to the psychologist-patient privilege would have significantly impeded Colorado’s ability to prosecute Kailey.

Colorado Supreme Court Decision.

In the end, the Colorado Supreme Court held that if a mental health provider believes that statements made by a patient during a therapy session threaten imminent physical violence against a specific person, and thus triggering the provider’s legal duty to warn, the patient’s threatening statements are not protected by the psychologist-patient privilege. Consequently, the Colorado Supreme Court held that the trial court erred when it excluded threatening statements made by Kailey to Willson on the grounds that the statements were protected by the psychologist-patient privilege.

FYI on Psychologist-Patient Privilege.

Psychologist-patient privilege is a privilege whereby a person can prevent the disclosure of a confidential communication made in the course of diagnosis or treatment of a mental or emotional condition by or at the direction of a psychologist. The requirements of this privilege are:

1. The communications must be confidential;
2. The therapist must be a licensed psychologists; and
3. The communications must occur in the course of diagnosis or treatment.

Almost all the states in the United States have specific laws on psychologists-patient privilege. The state laws vary with regard to the types of therapy relationships protected and the exceptions recognized. The privilege can be overcome under certain conditions, such as when the examination is ordered by a court. Be sure to consult with your own state for its specific statutes on the psychologist-patient privilege. If you have any question be sure to contact an experienced health law attorney.

Comments?

Do you agree or disagree with the Colorado Supreme Court’s ruling? Please explain your opinion.

Contact A Lawyer Experienced in the Representation of Psychiatrists, Mental Health Counselors, Social Workers, Licensed Marriage and Family Therapists and Other Mental Health Professionals.

We routinely provide deposition coverage to psychiatrists, mental health counselors, social workers, licensed marriage and family therapists and other mental 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 psychiatrists, mental health counselors, social workers, licensed marriage and family therapists and other mental health professionals in investigations at the Board of Medicine, Board of Psychology, or the Board of Clinical Social, Marriage and Family, and Mental Health Counseling. 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 © 1996-2014 The Health Law Firm. All rights reserved.

 

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

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
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