Mental Health Law Blog

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Legally Speaking: Professional Liability Insurance for Psychologists, Mental Health Counselors, Social Workers and Therapists

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

Those supervised by the Board of Psychology and the Board of Clinical Social Work, including Marriage and Family Therapy and Mental Health Counseling, psychologists, Licensed Mental Health Counselors, Clinical Social Workers and Licensed Marriage and Family Therapists are responsible for one of the most important component of patient care: mental health.

Professional Liability Insurance.

Insuring the mental health of a patient does not come without inerrant risks. For this reason, every mental health professional should carry professional liability insurance that includes professional license defense coverage (sometimes called disciplinary defense, license defense, administrative hearing coverage or broad coverage). This type of insurance coverage is included in most professional liability policies. However, if it is not, it can often be added as a rider to the insurance policy for an additional charge. Mental health professionals should be sure that coverage for professional license defense is at least $25,000 and a $50,000 increase is recommended.

“Broad form coverage” should also be requested and obtained that includes coverage of legal fees for defense of all administrative or governmental proceedings, including Medicare audits, Medicaid audits, EEOC complaints, and other types of governmental actions that could be initiated.

Though mental health may not seem like a high-risk field, if dissatisfied, patients can file complaints that can lead to serious consequences. These complaints can be initiated against a mental health professional based solely on anonymous calls to the Department of Health Hotline, newspaper reports, prior arrest reports, disgruntled patients, disgruntled insurance companies, competitors, or other sources. Once an investigation is initiated, psychologists, therapists, counselors and other mental health professionals should obtain legal representation immediately to ensure that each action on the part of the psychologist or other mental health professional will result in a more favorable outcome.

Retain a Board Certified Health Lawyer.

A board certified health lawyer experienced in representing mental health professionals will be the most qualified to handle a DOH case. A mental health professional may never face a DOH investigation or Board of Psychology or Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling administrative hearing, but it is important that every psychologist and counselor has knowledge of current legislation impacting the psychology field. The Florida Statutes have recently been updated to prohibit anyone from using the title of “social worker” unless certain requirements are met.

Additionally, there have been changes made to guidelines for treatment programs for impaired professional and psychologist reporting requirements.

Contact Health Law Attorneys Experienced in the Representation of Mental Health Counselors, Psychologists, Social Workers, and Marital and Family Therapists.

We have had mental health professionals who became victims of completely unreasonable demands from their clients/patients (house sitting, pet sitting, etc.), stalking by their clients/patients, identity theft and computer hacking by their clients/patients. Don’t become a victim yourself.

The attorneys of The Health Law Firm can assist and advise you in dealing with difficult clients/patients. We can stop stalking, cyber-stalking and harassment. We can respond to client/patient letters. We can defend you if a client/patient files a complaint against you.

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: Mental Health Counselor Law, Occupational Therapist representation, mental health representation, mental health counselor attorney, mental health attorney, Mental Health Counselor representation, legal counsel for mental health professionals, mental health defense lawyer, representation for mental health professionals, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida mental health professional representation, Florida mental health professional 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 © 2018 The Health Law Firm. All rights reserved.

By |2018-08-21T19:37:52+00:00August 21st, 2018|Mental Health Law Blog|0 Comments

Autistic Kids in Florida May Lose Care as Medicaid fraud Investigation Continues

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

On July 26, 2018, state investigators revealed that six behavioral therapists in Florida billed the state for “impossible” days of service that at times indicated they worked for more than 24 hours in a day. The six therapists, who worked with low-income children with autism, were then subsequently terminated from the Medicaid program.

The company that employed them, DRA Behavioral Health, was among four South Florida behavioral therapy companies sanctioned by the Agency for Health Care Administration (AHCA) for failing to pay fines, hiring unqualified therapists and failing to disclose required information to the state.

Is AHCA Delaying Health Care?

While AHCA continues its probe into behavior analysis services paid for by Medicaid, schools and programs say the agency is dragging out authorizations for therapy and approvals of new therapists. Thus, AHCA is effectively preventing children from getting therapy for months while reducing the costs to the state.

Advocates claim that AHCA used wrong or outdated information as a reason to suspend their therapists from Medicaid and then forced the provider to repay thousands of dollars.

In response, AHCA has urged parents of children with Medicaid to contact the agency if they are having difficulty getting behavioral analysis services as the state continues to add new providers to meet demand. For more information, click here.

Be sure to check our Mental Health Law Blog regularly for updates.

Contact Health Law Attorneys Experienced in the Representation of Mental Health Counselors, Psychologists, Social Workers, and Marital and Family Therapists.

We have had mental health professionals who became victims of completely unreasonable demands from their clients/patients (house sitting, pet sitting, etc.), stalking by their clients/patients, identity theft and computer hacking by their clients/patients. Don’t become a victim yourself.

The attorneys of The Health Law Firm can assist and advise you in dealing with difficult clients/patients. We can stop stalking, cyber-stalking and harassment. We can respond to client/patient letters. We can defend you if a client/patient files a complaint against you.

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

Sources:

Chang, Daniel. “Autistic kids could lose care as Florida cracks down on Medicaid fraud.” Miami Herald. (July 26, 2018). Web.

Viteri, Amy. “Autistic children caught up in Medicaid fraud investigation.” (August 7, 2018). Web.

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

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

By |2018-08-10T18:57:51+00:00August 10th, 2018|Mental Health Law Blog|0 Comments

Massachusetts Insurance Company Sued in Mental Health Discrimination Suit

Geroge 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 July 20, 2018, a Massachusetts federal judge allowed a woman to move forward with a proposed class action against Harvard Pilgrim Health Care Insurance Company (Harvard Pilgrim). The woman is claiming that Harvard Pilgrim, which covers medical expenses at nursing homes, must also cover mental health care at her son’s behavior-correcting summer camp.

Mental Health Parity Act.

U.S. District Judge Denise J. Casper denied a motion to dismiss from the insurer, saying that the plaintiff adequately equated the two types of health settings in a lawsuit. In the suit, the insurer is accused of violating the Mental Health Parity Act when it denied coverage for behavioral services at wilderness programs. Its blanket exclusion for services rendered at wilderness treatment programs is a separate treatment limitation applicable only to mental health benefits and thus violative of the Parity Act.

The statute generally requires insurers to cover mental health treatments on the same terms that they cover medical and surgical care. As a result of this violation, the plaintiff was forced to pay more than $16,000 out of pocket for her teenage son, the lawsuit alleges.
Click here to view the complaint in full.

The Defendant’s Arguments.

In response, Harvard Pilgrim argued that it excludes wilderness-like medical benefits such as diabetes camps, so excluding wilderness mental health care is not differential. In addition, in court documents it insisted that the correct comparison was whether both types of treatment, physical and cognitive, would be excluded if offered through a wilderness program.

Despite the arguments, Judge Casper stated that the First Circuit has held that a plan administrator, in terminating or denying benefits, may not rely on a theory for its termination or denial that it did not communicate to the insured prior to litigation. To read Judge Casper’s order in full, click here.

Contact Health Law Attorneys Experienced in the Representation of Mental Health Counselors, Psychologists, Social Workers, and Marital and Family Therapists.

We have had mental health professionals who became victims of completely unreasonable demands from their clients/patients (house sitting, pet sitting, etc.), stalking by their clients/patients, identity theft and computer hacking by their clients/patients. Don’t become a victim yourself.

The attorneys of The Health Law Firm can assist and advise you in dealing with difficult clients/patients. We can stop stalking, cyber-stalking and harassment. We can respond to client/patient letters. We can defend you if a client/patient files a complaint against you.

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

Sources:

Wille, Jacklyn. “Harvard Pilgrim Sued Over Wilderness Therapy Coverage.” Bloomberg Law. (July 24, 2018). Web.

Noon, Alison. “Harvard Pilgrim Must Face Mental Health Discrimination Suit.” Law360. (July 24, 2018). Web.

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

KeyWords: Mental Health Counselor Law, Occupational Therapist representation, mental health representation, mental health counselor attorney, mental health attorney, Mental Health Counselor representation, legal counsel for mental health professionals, mental health defense lawyer, representation for mental health professionals, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida mental health professional representation, Florida mental health professional 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 © 2018 The Health Law Firm. All rights reserved.

By |2018-07-25T17:08:01+00:00July 25th, 2018|Mental Health Law Blog|0 Comments

New Mexico’s Largest Mental Health Providers Accused of Defrauding Medicaid Out of $36 Million

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

For months now, 15 New Mexico behavioral health agencies have been the subject of a Medicaid fraud investigation. The state’s largest mental health providers had their Medicaid funding frozen by the New Mexico Human Services Department (HSD) due to credible allegations of fraud, according to KUNM News. The behavioral health agencies are accused of collectively defrauding Medicaid of $36 million over three years. The findings in an audit conducted in 2012, by OptumHealth, the contractor that handles Medicaid payments for New Mexico’s behavioral health system, alarmed state officials to the point that they hired Public Consulting Group (PCG), a firm that specializes in Medicaid fraud, to conduct another audit in June 2013.

These behavioral health agencies provided services to approximately 30,000 patients. According to KUNM News, Arizona companies have been hired to step in to help patients needing treatment.

Click here to read the KUNM News article.

Audits and Whistleblower Claims Uncover Serious Accusations.

The reason for the Medicaid funding freeze, according to the HSD, was the initial audit conducted by OptumHealth, the company that manages Medicaid dollars for New Mexico’s behavioral health agencies. OptumHealth allegedly found problems with billing by the agencies in question. Then a second audit by PCG allegedly uncovered widespread overpayments for services that had never been provided. According to the New York Times, a quarter of patients’ claims were processed with mistakes.

During the PCG audit, whistleblowers also came forward with their own accusations, according to the New York Times. In one case, an employee was allegedly ordered not to inform the state that a patient had died. In another, an ex-employee at an agency reported being fired after refusing to overbill for services.

Click here to read the entire New York Times article.

To learn more on whistleblower cases, read our two-part blog. Click here for part one, and click here for part two.

Mental Health Providers Fight for Funding.

New Mexico officials state that they were obligated under federal law. Under the Affordable Care Act, states have more power to suspend payments when there is credible evidence that Medicaid dollars are being misused. All 15 mental health providers sought exceptions from the state so their Medicaid funding could be restored while the investigation continues. Only three exceptions were granted, according to the New York Times.

Mounting Pressure to Root Out Medicare and Medicaid Fraud.

Just this year, we’ve noticed the government become more aggressive in its anti-fraud and recovery efforts. The Affordable Care Act also gives investigators and prosecutors new tools to crack down on abuse. Now that the government is collecting more money, you can expect their efforts to get worse.

Since whistleblowers stand to receive up to thirty-five percent (35%) of a recovery made by the government, plus attorney’s fees and costs, you can expect more whistleblower lawsuits to be filed. Therefore, it is now more important than ever to verify accurate billing and coding.

Most Qui Tams Filed by Doctors, Nurses and Employees.

From our review of qui tam cases that have been unsealed by the government, it appears most of these are filed by physicians, nurses or hospital staff employees who have some knowledge of false billing or inappropriate coding taking place. Normally the government will want to see some actual documentation of the claims submitted by the hospital or other institution. Usually physicians, nurses or staff employees have access to such documentation. Whistleblowers are urged to come forward as soon as possible. In many circumstances, documentation that shows the fraud “disappears” or cannot be located once it is known that a company is under investigation.

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

Attorneys with The Health Law Firm also represent health care professionals and health facilities in qui tam or whistleblower cases both in defending such claims and in bringing such claims. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

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

Comments?

Individuals working in the health care industry often become aware of questionable activities. Often they are even asked to participate in it. In many cases the activity may amount to fraud on the government. Has this ever happened to you? Please leave any thoughtful comments below.

Sources:

Frosch, Dan. “Fraud Investigation Unsettles Mental Health Care in New Mexico.” New York Times. (September 16, 2013). From: http://www.nytimes.com/2013/09/14/us/fraud-investigation-unsettles-mental-health-care-in-new-mexico.html?pagewanted=all&_r=0

Ahtone, Tristan. “A Timeline of NM’s Shakeup of Behavioral Health Providers.” New Mexico In Depth. (September 13, 2013). From: http://www.nmindepth.com/2013/09/13/a-timeline-of-nms-shakeup-of-behavioral-health-providers/#

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.

Look Professional In Your Correspondence. Don’t Diminish Your Professional Reputation: 30 Tips (Part 1 of 3)

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

I review many letters, e-mails, memoranda, and other types of correspondence prepared by my physician and nurse clients during the course of my legal representation of them.  Often this is the result of a dispute with a hospital, a dispute with their peers or the medical staff, a dispute with an insurance company, a law suit filed by a patient, a complaint being investigated by the licensing agency, or another serious legal matter.

In many cases, way too many cases, such correspondence is unprofessional and defeats the purpose of the reason you are sending the correspondence.  Sometimes it is so bad, it will be disregarded by the reader to whom it was directed. I have seen this from doctors, nurses, dentists, psychologists, owners of health care businesses, and many, many other highly educated professionals who really should know better.

When such documents are dictated and transcribed by a professional medical transcriptionist, they are usually properly formatted and many of the errors I note are avoided.  However, when the health professional types his or her own document, that is when I see the most errors.

To avoid these errors that make your correspondence and professional communications look unprofessional, follow these tips.

Remember Why You Are Writing.

Remember, the basic purpose of your correspondence is to communicate ideas effectively.  In many cases, it will be to invoke your legal rights in certain situations (such as an appeal or a hearing request).  Sometimes it will be to attempt to persuade your hospital, your peers, or your employer to take certain action or to refrain from certain action.  Remember that your correspondence is often the first impression that the other side will have of you.  Do you want it to be an impression that you are sloppy, lazy, unprofessional, not knowledgeable, uneducated, or confused?

Whether you are communicating in a letter or via e-mail, these rules hold true.  In many (if not all) situations involving legal proceedings or legal issues, it is probably best to communicate via a letter sent by U.S. mail or some other reliable service (e.g., Federal Express, Airborne Express, DHL, etc.).  Even if you are transmitting your information via an e-mail, it is my suggestion to prepare it in the form of a paper letter (if your e-mail is not set up to insert your letterhead) and then scan it in and send it electronically.

I discourage legal communications via e-mail in serious matters because they are often difficult to obtain, isolate, and authenticate when you need them for hearings.  Additionally, they are rarely secure, often available to many others who shouldn’t see them and easily susceptible to being accidentally sent to others who should not see them at all.

Horror Stories of Unprofessional Correspondence.

Why do I feel this blog is necessary?  Because of all the horrible correspondence I have seen written by allegedly highly educated professionals, mostly physicians and nurses.  That’s why.

Here are just a few:

Physician never wrote a separate response to any charges or allegations made against him on any peer review documents.  He would just hand write (scribble, actually) his remarks on the bottoms and in the margins of whatever document he was sent to him and then send it back.

Nurse practitioner was required to respond to serious charges of negligence resulting in an adverse outcome to a patient.  She hand wrote, on unlined paper, a response letter that was not addressed to anyone, not dated, not signed and did snot state who was sending it.

The physician was required to provide his analysis of a patient’s case for peer review purposes.  His typed letter of three pages, single spaced, contained one long paragraph.  I used to work for a Medical Corps Admiral when I was a Navy JAG Corps officer.  He would just glance at such correspondence and state:  “I can tell this doctor doesn’t have any idea what he is talking about.”  Failing to follow good correspondence procedures will show others your thoughts lack organization and cohesion.

A health professional was required to complete an application for clinical privileges.  He wrote all of the answers by hand, not even staying within the lines on the form, writing over the questions and around in the margins of the application.  This is what he signed and turned in.  Believe me, this did not look very professional.

Physician was requested to respond to a medical staff inquiry from the hospital.  Her response came back typed in 22 characters per inch (cpi) size type font, almost too small to read.  Perhaps she was just trying to save a sheet of paper.  But many of us would have had to pull out a magnifying glass to be able to read it.  If you are actually trying to communicate your ideas, make your correspondence easier to read, not harder to read.

A dentist was notified of a pending complaint investigation being opened against her dental license.  She wrote her response to the charges back to the investigator, without using any business address or title, and began her response statement “Dear Sharon,”.  Do not treat others informally, especially in professional or formal situations.  You will be deemed to be unprofessional when you do so.

Tips for Good Professional Correspondence.

Here are some pointers on professional communications that should be followed in all of your professional written communications about business, professional or legal matters, even in e-mails. Please note, the terms below in quotation marks have certain defined meanings.  If you don’t know what these terms mean, look them up.

1. Always remember that the reason you are sending the correspondence is to attempt to effectively and accurately communicate your position and ideas.  If you are trying to make your message indecipherable or difficult to understand, ignore these tips.  If you are trying to come across as someone who doesn’t give a damn about how he or she is perceived, ignore these tips.  If you want to come across as unprofessional, ignore these tips.

2. Make sure you include your complete and correct “return address” and contact information.  This includes your physical or mailing address, telephone number, telefax number and e-mail address, so that the other party knows exactly how to reach you.  In cases where you already have this on your letterhead, be sure to use your letterhead.  Also, it appears more professional to create a letter head with the information in it and to use your new letterhead instead of having a professional business letter with a typed “return address.”  However, a typed “return address” is better than none.

3. Don’t use someone else’s letterhead.  Don’t use your hospital, medical group or institutional letterhead for your own personal communications, unless you are the owner.  Use your personal letterhead (see above), instead.  If you are being accused of poor utilization review, unprofessional conduct, or personal use of hospital (or company) property, then using someone else’s letterhead just helps prove the charge against you.

4. Date your correspondence.  Date your correspondence.  Date your correspondence.  Nothing shows a lack of professionalism and lack of attention to detail as sharply as undated correspondence.  It will certainly be difficult to prove when your letter or document was sent if you do not have a date on it.  A year or two later, it may be completely impossible to do so.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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

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

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“The Health Law Firm” is a registered fictitious business name of 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 |2018-07-09T20:05:55+00:00May 15th, 2018|Mental Health Law Blog|0 Comments

Pennsylvania Nursing Home Settles Wrongful Death Suit, Agrees to Pay $800,000

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

On December 21, 2017, the Devereux Foundation in Philadelphia, agreed to pay $800,000 to end a wrongful death suit against staff at The Devereux Pocono Center. The suit accused staff at the organization’s residential behavioral health facility in northeast Pennsylvania of failing to recognize symptoms of an infection in a developmentally disabled resident.

Details of the Wrongful Death Suit.

The family of Megan Ramsey, who died in the care of the Devereux Pocono Center in July 2014, asked a Pennsylvania federal judge to sign off on the settlement to end allegations that staff failed to detect symptoms of a perforated bowel and infection. According to court records, the patient had suffered from a rare genetic disorder known as Cornelia de Lange syndrome. Her symptoms included slow growth, small stature, gastroesophageal reflux disease, and issues with behavior and communication.

In July 2014, Ramsey complained of shoulder pain, a symptom of bowel perforation, according to the complaint. She was administered a pain reliever and observed to be uncharacteristically irritable and aggressive and was treated with doses of an anti-anxiety medication, the suit said. Ramsey asked staff members to be taken to the hospital. A residential manager at the facility, however, said only to monitor her closely, offer her fluids, and advise nursing staff of any worsening of her symptoms.

She was found dead the next morning.

The Settlement.

The patient’s family filed a pretrial memorandum in September 2017, in which investigations by state agencies resulted in findings of neglect, intentional or reckless failure to provide treatment, and intentional use of a chemical restraint or isolation.

The settlement of $800,000 includes fees for the plaintiff’s counsel of just under $267,000, the filing said. Click here to read the settlement in full.

To read one of my prior blogs about a similar case involving 14 deaths at a Florida nursing home, click here.

Contact Health Law Attorneys Experienced with Nursing Home Cases.

The Health Law Firm and its attorneys represent nursing homes, nursing home employees, mental health facilities and mental health professionals, including psychologists, social workers and mental health counselors, in a number of different matters including incorporation, preparing contracts, defending the facility against malpractice claims, licensing and regulatory matters, administrative hearings, and routine legal advice.

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

Sources:

Fair, Matt. “Pa. Nursing Home Settles Patient Death Suit.” Law360. (December 21, 2017). Web.

The Meyer Law Firm. “Wrongful Death in Nursing Homes.” NursingHomeAbuseGuide.org. (December 22, 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.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2018 The Health Law Firm. All rights reserved.

By |2018-07-09T20:08:00+00:00May 15th, 2018|Mental Health Law Blog|1 Comment

Gunman Accused of Killing Two at Titusville Hospital Was Waiting For Mental Health Evaluation

10 Indest-2008-7By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
The gunman accused of shooting and killing two women at a Titusville hospital on July 17, 2016, was awaiting a court-ordered mental evaluation, according to authorities. The gunman, David Owens, had a long history of mental health problems and it is believed that he sought help over eight times. That exam was still pending when he shot and killed two people at Parrish Medical Center.

Long-Term Care for Mentally Ill.

The gunman’s mother told authorities that she had been trying to get her mentally ill son long-term care for years. She claimed he talked of killing and that she felt her life, and those of others, was in danger, and begged he be sent to a mental hospital.

Reviews of State Laws.

Former chief judge and current WFTV legal analyst Belvin Perry believes there needs to be a comprehensive review of state law. “If the laws are not there, then no judge can say, ‘Let’s force him to take his meds,’” said Perry. He also said people need avenues of help much sooner than a court-mandated examination. He cited lack of funding for mental health and said, “We really need to evaluate the laws to make sure we protect the patients’ rights, get them help and protect society.”

To read more on mental health care, click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in the Representation of Mental Health Counselors, Psychologists, Social Workers, and Marital and Family Therapists.

We have had mental health professionals who became victims of completely unreasonable demands from their clients/patients (house sitting, pet sitting, etc.), stalking by their clients/patients, identity theft and computer hacking by their clients/patients. Don’t become a victim yourself.

The attorneys of The Health Law Firm can assist and advise you in dealing with difficult clients/patients. We can stop stalking, cyber-stalking and harassment. We can respond to client/patient letters. We can defend you if a client/patient files a complaint against you.

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

Source:

“Gunman accused of killing 2 at Titusville hospital was waiting for mental health evaluation.” WFTV. (July 18, 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: Mental Health Counselor Law, Occupational Therapist, Resident and doctor-patient relationship, mental health attorney, Mental Health Counselor, legal counsel for mental health professionals, long term care for mentally ill, court appointment mental evaluations, mental health defense lawyer, representation for mental health professionals, 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 |2016-07-21T19:13:28+00:00May 15th, 2018|Mental Health Law Blog|0 Comments

Florida’s Baker Act: What You Need to Know – Part 1

7 Indest-2008-4By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

At The Health Law Firm, we are frequently consulted by family members of individuals who are erroneously held under Florida’s Baker Act. An erroneous confinement under the Baker Act can occur for a number of different reasons. However, the result is that an independent citizen is confined in violation of his/her constitutional rights to liberty, privacy and the pursuit of happiness.

The Baker Act allows a licensed health professional to order an individual who is a threat to themselves or others because of a mental illness to be involuntarily held. The individual may then be held in certain designated health facilities for up to 72 hours for an initial psychiatric evaluation.

If the psychiatrist examining the confined individual feels that he or she should be held for further evaluation, then he or she can be held up to a week.

 

When to Call a Baker Act Attorney.

Over-cautious physicians, emergency room personnel, school officials, nursing home staff and other authorities may call upon the Baker Act to have those that they suspect may be a danger and have a mental problem involuntarily confined. If they are believed to be a threat, usually that individual may be legally involuntarily confined under the Baker Act. Seniors living on their own and teenagers are often the “victims” of this process.

If the individual being held under the Baker Act is not really a threat to themselves or others and the facility will not agree to release them, this is the time to call an attorney. Mistakes often occur as health personnel, school administrators and law enforcement personnel do not want to take the chance of someone committing suicide or killing others.

Factors that may indicate the person should not be held under the Baker Act include:

1. No prior history of mental illness or Baker Acts.
2. Supportive family/friends in the immediate area.
3. Acts/statements made not truly a threat to self or others.
4. Regular treating physician or health care personnel in area.
5. No current signs of mental illness.

 

Examples of abuses of the Baker Act that can occur:

1. Individuals who do not have a mental condition and do not meet the basic criteria for the Baker Act may be involuntarily confined and deprived of their freedom.

2. Children are involuntarily confined at facilities that are not really set up to take care of the medical and mental health needs of children.

3. Because of overcrowding, the person is taken to or transferred to a facility far away from his or her home, family and friends.

4. A person who has other medical problems or chronic medical problems (especially true with the elderly) is confined in a Baker Act facility and is unable to receive regular medical care or attend scheduled appointments with their regular treating physicians.

5. A person who is taking one or more prescriptions for medical problems will not be allowed to take them while confined in the Baker Act facility. This can lead to a deterioration of the person’s medical condition.

6. If the person has a regular psychiatrist or therapist, that person is not allowed to see or treat the person where he or she is confined because the therapist is not on the medical staff of the Baker Act facility.

7. If the person has a regular psychiatrist or therapist, that psychotherapist is, most often, not spoken to or consulted by the psychiatrist or staff of the Baker Act facility, even though the regular treating psychotherapist may know far more about the confined patients condition than anyone else.

8. An individual may be confined in a facility in which one or more dangerous patients are also confined. Our clients have reported assaults and sexual molestation which have occurred at such facilities when they were confined involuntarily under the Baker Act.

9. It has been reported to us by our clients that it seems if they have good health insurance (or Medicare) then they are kept longer because the insurance company (or Medicare) is paying the hospital for the inpatient stay, which can be a large amount of money.

10. Sometimes the family is located in another state and merely wants to have the person released so he or she can be taken where they are so the family is better able to support their needs.

Examples of How The Health Law Firm Can Help.

We often receive calls from the husband, wife, parents, children or friends of individuals who have been confined involuntarily to a mental facility. Often, we are called on to respond urgently to obtain the release of someone who may have been incorrectly confined to a mental institution without their consent.

Occasionally, we assist in cases in which the family may be located in another state and the patient is located here in Florida. Often, we are able to obtain a prompt release of the confined person in cases in which the basic requirements for an involuntary confinement under Florida Law do not exist and the patient should not have been confined.

We have been involved in working on an expedited basis with the hospital, mental institution or court to obtain the release of individuals who should not be confined or who desire to be released into the custody and care of their family or back to their own independence.

For a sample of an Emergency Petition for Write of Habeas Corpus we prepared with its supporting documentation, and which contains citations to the appropriate legal authorities, click here.  A Memorandum of Law (legal brief) in support of the Petition for Writ of Habeas Corpus is also included with it.

The Baker Act Is Not a Bad Thing.

We realize that the Baker Act is a good thing. Many people who may have serious mental health issues and fail to obtain treatment, should be involuntarily confined under the Baker Act. Sometimes this is the only way they will ever be treated correctly. Additionally, it is also a good thing that police, deputy sheriffs and other law enforcement officers are receiving training which is now resulting in more Baker Act hospitalizations and fewer arrests. This helps an individual to avoid a serious arrest and possible conviction of a serious offense (giving them a criminal record forever) when they may need only medical treatment for a mental condition.

Check this blog regularly for more on Florida’s Baker Act and the Marchman Act.

Contact Health Law Attorneys Experienced in Handling Victims of Involuntary Confinement Through the Baker Act and Marchman Act.

The Health Law Firm represents individuals, families and friends in challenges to and hearings related to the Florida Baker Act and Marchman Act, when the basic criteria for confinement are not met and there is no medical necessity for further confinement.

Our firm has a process we follow to make sure that a person who should not be held under the Baker Act may be released in a very short time. If the basic criteria for a Baker Act confinement are not present, the person is not required to be held and should be released. If the person has been living independently for decades, has family and a support system available, and has had no prior mental health problems, the odds are he or she should not be involuntarily confined. We act immediately to begin our representation, to make the hospital and its physicians aware that we are representing you, and to take measures to obtain release. If required, we are prepared to file an emergency Petition for Writ of Habeas Corpus with the local Circuit Court to have you brought before the judge for an emergency release hearing. These cases can be time intensive, require a great deal of immediate work, but can yield fast results in most cases.

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: Baker Act defense attorney, legal representation for Baker Act cases, legal representation for involuntary Baker Act confinement, legal representation for involuntary confinement in hospital, mental health confinement defense attorney, petition for Writ of Habeas Corpus, Baker Act attorney, Baker Act defense lawyer, legal representation for Florida Baker Act, Florida Marchman Act defense attorney, legal representation for Baker Act law, The Health Law Firm, reviews of The Health Law Firm attorneys, The Health Law Firm 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 |2017-04-20T16:17:19+00:00May 15th, 2018|Mental Health Law Blog|1 Comment

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

8 Indest-2008-5By 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 |2018-03-19T15:58:58+00:00May 15th, 2018|Mental Health Law Blog|0 Comments

Have You Received a Notice of Termination of Your Medicare Provider Number?

By Danielle M. Murray, J.D.

Have you received a notice of termination of your Medicare provider number? Medicare has been revoking the Medicare provider numbers of many different Medicare providers including psychologists and other mental health providers, based on returned mail sent to old addresses which have not been updated or based on inspection team site visits to old addresses.

Often the termination is retroactive to a much earlier date the change or move may have been determined to have occurred. Even if the mailing address is correct or was changed, the physical address of the business must have been updated, as well. It is usually an incorrect or old physical address which causes this to occur.

The effect of this termination includes:

1. You are prohibited from reapplying to Medicare for at least two (2) years.

2. You may have to pay back any monies received from the Medicare Program since the effective date of the termination (often many months prior to the notification letter).

3. Other auditing agents may be notified such as the Medicare Zone Program Integrity Contractors (ZPIC) and the state Medicare Fraud Control Unit (MFCU).

4. You may no longer contract with Medicare or anyone who does.

5. You may and probably will be terminated from the approved provider panels of health insurance companies with which you are currently contracted.

6. You may and probably will be terminated from skilled nursing facilities (SNFs) and home health agencies (HHAs) with which you have contracts.

7. You may and probably will have your clinical privileges terminated by hospitals or ambulatory surgical centers (ASCs) where you have them.

What you should not do includes:

1. Don’t bother to write letters.

2. Don’t bother to call the Centers for Medicare & Medicaid Services (CMS).

3. Don’t bother to call the Medicare Administrative Contractor (or MAC) (previously called the “carrier” or “fiscal intermediary”).
4. Don’t bother to file a new CMS Form 855 (application) or a CMS Form 855C (change).

5. Don’t bother to start communicating with CMS or the MAC about your situation and what you need to do about it.

6. Don’t bother to complete and file the short, one-page Corrective Action Plan (CAP) form that is on the CMS or Carrier/MAC website (unless you are close to the deadline and don’t have representation; then you must.)

What we recommend is:

1. Immediately go into the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and the National Plan & Provider Enumeration System (NPPES) NPI Registry and print out a copy of the existing information. Then update or correct any incorrect information on you or your company, if you can. Print out the information as it existed before and print out the information after you have corrected it. (Note: Medicare will act shortly after the letter to you to terminate your access to this, so it may be too late).

2. Hire an experienced health attorney immediately to assist you in putting together and submitting a comprehensive Corrective Action Plan (CAP), a Request for Reconsideration (RFR) and a request for an Appeal Hearing.

3. Note that there is a thirty (30) day deadline for submitting the CAP and a sixty (60) day deadline for requesting an appeal hearing. Do not miss these.

4. Implement formal, written internal policies and procedures to prevent a recurrence of the type of error, oversight or event that caused the termination. Train your management and staff on these.

The CAP should address every element of the applicable conditions of participation (COP) contained in the Code of Federal Regulations (CFR). It should include and be supported by all relevant documents, including but not limited to:

1. Documents showing how the error occurred or past efforts to comply.

2. Surety bond guarantees and documents (where required).

3. Insurance coverage documents showing current coverage (general liability, professional liability, vehicle/auto liability).

4. Current licenses and permits.

5. Certificates of good standing and latest annual reports for any corporation or limited liability company.

6. Print-outs from PECOS/NPPES Registry discussed above.

7. Accident reports, insurance claims, police reports, fire reports or other documentation showing why a relocation was required (if this was an issue).

8. Certificates of compliance training for you and your staff, if available.

9. Copies of policies and procedures that you have adopted to keep there from being a recurrence of the situation that led to the termination.

10. An authorization form for your consultant or attorney to represent you in the matter.

All copies should be clear, legible, complete, straight, no corners cut off an no handwriting on them, to the greatest extent possible.

Everything should be professionally assembled, typed, indexed and labeled. It should include a table of contents or an index. Number every page. It should be submitted to the MAC (or the agency/address given in the termination letter) by two (2) reliable means that document both sending and receipt. Keep copies of everything, including postal receipts, airbills, Federal Express labels, courier receipts, etc. It must be received at the address given in the termination letter you received (usually MAC) by the deadline given above. Keep copies of online tracking reports and return receipts.

In most instances, should you show a legitimate reason for the error, show you are currently in compliance, and show what remedial measures you have taken to keep there from being a repeat, the MAC will accept your corrective action plan (CAP) and will reinstate your Medicare number, as things stand currently.

Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare Issues Now.
The attorneys of The Health Law Firm represent durable medical equipment (DME) suppliers and health care providers in Medicare audits, ZPIC audits, MAC audits and RAC audits throughout Florida and across the U.S. They also represent DME suppliers, physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions, termination from the Medicare or Medicaid Program and administrative hearings.

For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Comments?

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About the Author: Danielle M. Murray is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714

“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.

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