Three People Charged For Roles in $109 Million Medicare Fraud Scheme, HIPAA Violations

George F. Indest III with 30+ years of experience, is Board Certified in Health Law

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

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

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

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

Fraudulently Collecting & Using Patient Information.

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

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

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

Click here to view the criminal information in this case.

Read the DOJ’s press release for more information.

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

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

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

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

Sources:

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

Szaniszlo, Marie. “Three charged in multi-million dollar fraud scheme.” Sentinel Enterprise. (October 2, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law

DOJ Charges 345 People Involved in More Than $6 Billion in Fraud, Related to Telemedicine and Opioid Prescriptions

George F. Indest III with 30+ years experience, is board certified by the Florida Bar in Health Law.By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

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

A National Fraud Operation.

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

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

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

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

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

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

To read about a similar record-breaking telehealth fraud case in Florida, click here.

Contact Health Law Attorneys Experienced in Handling Medicare Audits, Investigations and other Legal Proceedings.

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

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

Sources:

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

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

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

 

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

 

Florida Defends Marijuana Law in High-Stakes State Supreme Court Battle

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

On May 6, 2020, in a highly-important case for the medical marijuana industry in Florida, the state defended its regulatory framework before the Florida supreme court. The case focuses on whether Florida has properly carried out a 2016 constitutional amendment that broadly legalized medical marijuana for patients. The Florida Department of Health (DOH) argues that there is no conflict between the voter-approved medical marijuana amendment and the state’s caps on providers.

Ongoing Battle in the Courts.

The case primarily centers on a requirement that the Legislature put in the 2017 law about marijuana firms allowed to operate in the state. That requirement says the companies must be able to handle all aspects of the business, including growing, processing, and distributing products. The Florida DOH appealed to the Supreme Court after lower courts sided with Florigrown, a Tampa-based company. For several years, Florigrown has unsuccessfully sought approval to become a licensed medical-marijuana operator in Florida. Click here to read my prior blog and learn more.

Arguing Over Semantics.

The key part of the case focuses on the text of the amendment in determining whether the vertical integration model is proper. The language in question is the difference in the words “or” and “and” in the amendment’s definition of a medical marijuana treatment center (MMTC).

The constitutional amendment defined MMTCs as “an entity that acquires, cultivates, possesses, processes … transfers, transports, sells, distributes, dispenses, or administers marijuana, products containing marijuana, related supplies, or educational materials.”

Meanwhile, the implementing 2017 law defines MMTCs as an entity that “cultivates, processes, transports and dispenses marijuana for medical use.”

Florigrown argues that the switch from “or” to “and” creates wording that establishes the vertically integrated system, as it establishes a need to perform all aspects of the business.

In its defense, the Florida DOH argued that the 2017 law does not directly conflict with a “proper, textual interpretation” of the constitutional amendment and directly calls for regulations on the availability and safe use of the substance.

To read more on this ongoing case and Florigrown’s lawsuit, click here to read my prior blog.

Contact Experienced Health Law Attorneys for Medical and Recreational Marijuana Concerns.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists, and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting and/or licensing, while complying with Florida law. We can also represent doctors, pharmacies and pharmacists facing proceedings brought by state regulators or agencies.

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

Sources:

Saunders, Jim. “Case challenging Florida law on medical marijuana licenses may hinge on ‘and’ vs. ‘or’.” Miami Herald. (May 6, 2020).

Bolado, Carolina. “Fla. Defends Medical Pot Regulations Before State High Court.” Law360. (May 6, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

Florida Department of Health Claims Orchid Nursery Has No Constitutional Protection In Pot Licenses

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On August 27, 2020, the Florida Department of Health (DOH) argued to the United States Eleventh Circuit Court of Appeals that a Florida nursery can’t claim the 14th Amendment to the U.S. Constitution protects its right to marijuana licenses. The DOH urged the appellate court to uphold the dismissal of Louis Del Favero Orchids’ suit because, it claimed, the U.S. Constitution doesn’t cover a property interest in a business that is illegal under federal law. This seems to be a rather hypocritical argument in that the counter-question could be “How can the state of Florida issue licenses for or control a business that is illegal under federal law?”

Is the Law Constitutionally Protected?

The would-be medical pot nursery operator has been fighting since 2016 to get one of the state’s few medical marijuana licenses. It has been involved in ongoing litigation in state court over Florida’s medical marijuana licensing process.

The nursery claims that the U.S. Constitution protects a property right to the licenses even if Congress has outlawed marijuana because the right itself is created by state law. In its suit, Louis Del Favero Orchids said that the property right itself originates in Florida state law, specifically, the law that legalized medical marijuana. Federal law can only determine “whether a given property interest rises to the level of a protected property interest,” the nursery argued in its brief.

According to the nursery’s brief, it sought damages and an injunction requiring the state of Florida to grant the company a hearing on its application for a medical marijuana license. You can read the nursery’s brief here.

Property Right in the “Process of” the Issuance of a Medical Marijuana License?

The Florida nursery filed its case first in federal court in June 2019. But in November 2019, the federal judge threw out the suit, deciding that the company had a property interest in the pot license under state law, but not under the 14th Amendment to the U.S. Constitution. The lower court decided that if Congress has legislated that marijuana is against the law, then it can’t be property protected by the U.S. Constitution. As a result, this decision, the nursery quickly appealed the ruling to the Eleventh Circuit.

In the brief it filed in the Court of Appeals, the Florida DOH urged the Eleventh Circuit to uphold the district court’s decision. It argued that not only is the right to a medical pot license not protected by the 14th Amendment, but there’s no property right in the process of medical marijuana licensure, the DOH told the court.

Click here to read the Florida DOH’s brief in full.

What the case does not discuss is the fact the Florida Constitution contains a provision identical to the 14th Amendment of the U.S. Constitution, in its Article 1, Section 9, which states: “Due process.—No person shall be deprived of life, liberty or property without due process of law. . . .” However, if the federal court’s decision stands, then this would be a matter solely based on Florida law and not one for the federal courts.

To learn more about their ongoing litigation in Florida involving medical marijuana issues, click here.

Click here to go to our Marijuana Law Blog page and read my prior blog on this subject to learn more.

Contact Experienced Health Law Attorneys for Medical and Recreational Marijuana Concerns.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists, and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting, and/or licensing while complying with Florida law. We can also represent doctors, pharmacies, and pharmacists facing proceedings brought by state regulators or agencies.

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

Sources:

Jones, Diana. “No Constitutional Right To Pot Licenses, Fla. Tells 11th Circ.” Law360. (August 27, 2020). Web.

Jones, Diana. “Nursery Tells 11th Circ. Pot License Constitutionally Protected.” Law360. (June 29, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

Veterans Want Federal Court To Reconsider DEA Marijuana Classification

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

On October 1, 2020, military veterans urged the U.S. Ninth Circuit Court of Appeals to reconsider the U.S. Drug Enforcement Administration’s (DEA) restrictive marijuana classification. The Iraq and Afghanistan Veterans of America (IAVA) said in an amicus curiae (friend of the court) brief that designating the drug a highly controlled substance has impeded medical research that could save lives.

Marijuana Claimed to Be a “Life-saving Treatment” for Veterans.

IAVA’s brief focused on suicide rates among returning soldiers. The group claimed the current status of marijuana on the drug schedules, listing it as a Schedule I drug, one without any medical use, under federal law inhibits studies to demonstrate its potential in the treatment of post-traumatic stress disorder (PTSD).

According to the IAVA’s brief, the Schedule I status of marijuana prevents the U.S. Department of Veterans Affairs (VA) and private practitioners from studying the benefits and risks of medical marijuana. This results in keeping life-saving treatment away from veterans suffering from PTSD who reside in states where they are not available.

The brief stated that 40% of veterans experience some form of PTSD that is not helped by treatments approved by the U.S. Food and Drug Administration. In 2019, IAVA conducted a survey showing that 20% of respondents used marijuana for medicinal purposes. Additionally, 90% of survey respondents support expanding clinical research for medical uses, and 90% would use it if it were an option.

To read IAVA’s amicus brief in full, click here.

Click here to read my recent blog on a proposed medical marijuana research bill.

Schedule I Drug.

Marijuana is listed as a Schedule I drug on the federal drug schedules. “Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse.” Some examples of Schedule I drugs include heroin, LSD, and ecstasy. Anyone viewing these drugs objectively would come to the conclusion that marijuana is simply not like the others.

It Is High Time for a Change.

Many veterans have returned from overseas combat severely affected by PTSD and other mental disorders. There is simply not enough available care through the VA to take care of them all. Moreover, many of these suffer from illnesses making them paranoid or suspicious of even seeking such care. Many are homeless. Many are able to function, some normal and some almost normally, by self-medicating with marijuana.

As more and more states authorize medical marijuana, the federal government should acknowledge that there is some benefit to its use and reclassify it. It is simply common sense. Too long has the public labored under the unjust and unsupportable assumption that incorrectly categorizes it as a Schedule I drug. It needs to be moved to Schedule V or Schedule IV. Medical bills would go down, drug bills would go down, and legitimate physicians, even federal physicians, would be allowed to prescribe it.

Contact Experienced Health Law Attorneys for Medical Marijuana Regulatory Matters and Other Health Care Licensing Matters.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists, and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting, and/or licensing while complying with Florida law. We can also represent doctors, pharmacies, and pharmacists facing proceedings brought by state regulators or agencies. We represent health-related businesses and medical professionals in all types of licensing and regulatory matters, including state and federal administrative hearings.

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

Sources:

Reisman, Sam. “Veterans Urge 9th Circ. To Hear Challenge To DEA’s Pot Status.” Law360. (October 7, 2020). Web.

Jeager, Kyle. “Military Veterans Group Asks Federal Court To Hear Marijuana Case Challenging DEA Classification.” Marijuana Moment. (October 8, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

 

New Sweeping Privacy Legislation Announced: The SAFE DATA Act

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

On September 17, 2020, Republican members of the Senate Commerce Committee introduced sweeping federal privacy legislation. The proposed law is called the Setting an American Framework to Ensure Data Access, Transparency, and Accountability (SAFE DATA) Act. The Act is a combination of bills previously introduced in the Senate: the Consumer Data Protection Act, Filter Bubble Transparency Act, and the Deceptive Experiences to Online Users Reduction Act. It hasn’t passed, yet, so let’s wait and see.

HAH! You thought you had learned all of the acronyms and abbreviations because you know what HIPAA, HITECH, FERPA, USCDPA, and FOIA mean. Let’s see how long it takes you to remember what this one stands for.

Details of the SAFE DATA Act.

This proposed legislation has three main components if passed into actual law. It:

1. Provides consumers with more choice and control over their data (allegedly),
2. Directs business to be more transparent and accountable (allegedly), and
3. Strengthens the FTC’s enforcement power (allegedly).

The Act would provide consumer rights, such as access, notice, deletion, opting-out, correction, and a right to data portability. It also prohibits covered entities from discriminating against consumers who utilize some of the proposed rights. It will prohibit organizations from denying goods or services to individuals because they have exercised any of their rights as set forth in the bill.

Implementation of the bill would be financed through a $100 million appropriation to the Federal Trade Commission (FTC) to enforce its provisions. Therefore, the FTC would gain the authority to obtain injunctions and impose other sanctions for violations.

Integrating Other Privacy Bill Provisions.

The SAFE DATA Act incorporates three main bill provisions into the proposal.

First, it includes the Filter Bubble Transparency Act (don’t ask). It requires a notice on public-facing websites that use algorithmic ranking systems

Second, it contains provisions from the Deceptive Experiences To Online Users Reduction (“DETOUR”) bill (ouch!). This provision makes it unlawful for an online service with more than 100 million authenticated users to use a user interface to impair user autonomy.

Third, like the United States Consumer Data Privacy Act (CDPA), the proposal requires companies to obtain affirmative, express consent from the customer before processing or transferring individuals’ sensitive data.

According to Julie Brill, former Commissioner of the FTC, a comprehensive privacy law would also address consent and collection issues related to COVID-19 health data, while at the same time promoting racial equality and prohibiting data discrimination. Boy, that’s great; who knew this was likely to be accomplished in our lifetimes.

View the proposed Safe Data Act in full.

You may also read one of my prior blogs to learn more about HIPAA privacy rights violations and medical confidentiality.


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 healthcare 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 toll-free (888) 331-6620.

Sources:

Cox, Ayeisha. “Lawmakers Introduce the SAFE DATA Act.” American Health Lawyers Association (AHLA). (October 2, 2020). Web.

Traylor. Christian. “Federal Data Privacy Legislation: Will it Help the US Remain Competitive in the Global Marketplace?” JD Supra. (September 29, 2020). Web.

Panakal, Dominic Dhil. “Senate Republicans Stitch Together Safe Data Ideas into New Bill.” The National Law Review. (September 24, 2020).

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

Florida Dentist’s COVID-19 Interruption Insurance Claim Dismissed by Judge

George Indest Headshot

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

On September 3, 2020, a Florida federal judge dismissed a suit for business interruption insurance payments by a Florida dentist. The dentist claimed he sustained damages caused by the COVID-19 pandemic and related civil authority shutdowns of dental services. The dismissal freed Allied Insurance Company of America from having to pay the dentist’s for COVID-19 related losses, holding that the policy’s “virus exclusion” barred coverage of the insurance claim made.

Insurance Coverage for COVID-19 Related Losses.

The dentist sued his insurance carrier for damages that he argued were “caused by or result[ing] from a Covered Cause of Loss.” The causes of the alleged loss, he maintained, included the COVID-19 virus’s impact on his dental practice and the Florida governor’s emergency declaration that limited dental services during a period of time. Specifically, he claimed that he incurred costs to decontaminate his dental office and lost valuable income because of the governor’s dental services limitation. The dentist alleged that Allied breached the insurance contract by denying coverage in April.

Allied’s insurance policy provides coverage “for direct physical loss or damage to covered property at the [plaintiff’s] premises” that is “caused by or result[s] from any Covered Cause of Loss.” Allied argued that there was no direct physical loss or damage to covered property at the clinic due to appointment cancellations or the closure of the dental practice.

Dismissal of the Law Suit.

U.S. District Court Judge John Badalamenti, for the Middle District of Florida, dismissed the case. He found that the dental practice’s loss or damage asserted was “not due to a covered cause of loss.” More importantly, he found that the policy contained an exclusion for loss or damage caused “directly or indirectly,” by “[a]ny virus, bacterium or other microorganisms that induces or is capable of inducing physical distress, illness or disease.”

According to the judge’s order, in order for the insurer to provide coverage, losses from business suspension must be caused by direct physical loss or damage. He ruled that the dentist failed to demonstrate what the policy required in order to be a covered loss. To read the order in full, click here.

With such a specific exclusion as this policy contained, it was difficult for the judge in the case to rule any other way.

Litigation on Whether Insurance Policies Should Cover Losses Due to Coronavirus Closures.

This recent Florida dismissal is another in a string of cases where insurers have prevailed in Coronavirus business loss cases, because of similar exclusions in their policies. In a similar case, a Michigan federal judge sided with the insurance company saying it didn’t have to cover a chiropractic office’s COVID-19 claimed losses. Like the case above, the judge said the business failed to allege physical loss and, therefore, the policy’s virus exclusion barred coverage. Click here to read the judge’s order in this case.

According to insurance experts and regulators, most businesses and professionals will probably find it difficult to obtain an insurance payout because of policy changes made after the 2002-2003 SARS outbreak. SARS, which infected 8,000 people, led to millions of dollars in business-interruption insurance claims. As a result, many insurers added exclusions to standard commercial policies for virus losses. The added policy language potentially allows insurance companies to avoid hundreds of billions of dollars in business-interruption claims because of the Covid-19 pandemic.

Since a wide-scale virus outbreak is such a rare event, most policy purchasers overlooked this exception. There certainly wasn’t any concerted effort to make insureds aware of the exclusion nor to offer them the opportunity to purchase specific virus outbreak insurance coverage.

A global pandemic presents unique problems for insurance companies. After the SARS outbreak at the beginning of this millennium, many insurance companies realized they would not be able to cover such a broad-scale event causing massive losses. Such an event could have damages greater than those sustained in the largest hurricane to strike the U.S. The insurance industry argued to state regulators that such policy exclusions were necessary, considering the overwhelming number of claims that might arise from a single disease outbreak.

This foresight on the part of the insurance companies saved their shareholders billions, if not trillions, of dollars. Unfortunately business and professionals have had to shoulder the losses.

So, it begs the question: Did insurers actually know the potential damage a viral pandemic could wreak on businesses and, therefore, purposefully exclude coverage? Disputes over the precise wording of business insurance policies will most likely continue to generate court battles like those discussed above.

Read my prior blog on this subject to learn more.

Recommendation for the Future.

There are several options that businesses and state insurance regulators should consider to try to prevent such massive losses from going uncompensated in the future.

First would be to create and provide virus damage insurance similar to that provided for flood insurance by the National Flood Insurance Program (NFIP). The biggest problem would be that losses could easily exceed the largest hurricane that one could imagine. However, the NFIP has shown this type of plan works.

Second would be similar programs provided at the state level. At the present time, many states, have captive insurance companies to fund losses from wind damage caused by storms. In Florida, the Citizens Property Insurance Corporation (CPIC) provides such coverage.

The biggest problem I see with both of the above is that short-sighted and selfish people don’t want to purchase such insurance and, thereby, make it less expensive for all involved. They figure that the government will bail them out anyway in such an event, so why should they pay. Therefore, either making it paid for completely with taxpayer money or a requirement of obtaining a business license or professional license or some combination, may be a way to finance it.

Creating a trust fund with assessments to employers and employees, similar to what is currently done for social security, would be another option. Creating a large trust fund that could cover such tragic events might work best. However, this would have to be made “raider safe” so that Congress does not come back and raid these funds and use them for other purposes like it has done to the United States Postal Service (USPS).

At the very least, some type of universal virus pandemic business loss insurance should be mandated by law or, at least, partially funded by the government. Making it mandatory means making it cheaper and making it work.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

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

Sources:

Zhang, Daphne. “Fla. Dentist’s Bid For COVID-19 Loss Coverage Axed.” Law360. (September 3, 2020). Web.

Zhang, Daphne. “State Farm Needn’t Cover Chiropractor’s COVID-19 Losses.” Law360. (September 3, 2020). Web.

Frankel, Todd. “Insurers knew the damage a viral pandemic could wreak on businesses. So they excluded coverage.” The Washington Post. (April 2, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

KeyWords: healthcare employment law representation, legal representation for physicians, doctor defense legal representation, legal representation for healthcare professionals, complex health care litigation attorney, complex civil litigation attorney, complex healthcare litigation lawyer, complex medical litigation lawyer, representation for complex medical litigation, representation for healthcare business litigation matters, business insurance representation, business interruption insurance claims defense, COVID-19 business insurance claim representation, The Health Law Firm, reviews of The Health Law Firm Attorneys, The Health Law Firm attorney reviews, legal representation for physicians and health care professionals, attorney for physician suits against insurers, complex medical business litigation against health insurers

“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 © 2020 The Health Law Firm. All rights reserved.

 

Laws Governing ESAs and Service Animals, Part 3 of 3

By Amanda I. Forbes, J.D.

This is part 3 of 3 in a blog series regarding the differences between Service Animals and Emotional Support Animals. Read part 1 and part 2.

The Fair Housing Act (FHA) is a federal law that “prohibits discrimination in housing because of: race or color, national origin, religion, sex, familial status, and disability.” (Emphasis added). It applies to both emotional support animals and service animals. (“emotional illness.”)
Click here to learn more.

In addition, the FHA states it is unlawful to:

[D]iscriminate in the sale or rental, or to otherwise make unavailable or deny, a dwelling to any buyer or renter because of a handicap.

42 U.S.C. Section3604(f)(1).

It also prohibits discrimination:

[A]gainst any person in the terms, conditions, or privileges of sale or rental of a dwelling, or in the provision of services or facilities in connection with such dwelling, because of a handicap . . .

42 U.S.C. Section 3604(f)(2).

For purposes of the FHA, discrimination includes a refusal to make:

[R]easonable accommodations in rules, policies, practices, or services, when such accommodation may be necessary to afford such person equal opportunity to use and enjoy a dwelling.

42 U.S.C. Section 3604(f)(3)(B).

The FHA is applicable to virtually all forms of housing. However, there are some exemptions:

1) Owner-occupied buildings with no more than four units, single-family housing sold or rented without the use of a broker, and housing operated by organizations and private clubs.
2) Single-family housing sold or rented without the use of a broker.
3) Housing operated by organizations and private clubs that limit occupancy to members.

The Department of Justice (DOJ) and the Department of Housing and Urban Development (HUD) have the power to enforce the Fair Housing Act. Generally, an individual with a disability may have a “reasonable accommodation” to a landlords “no pets policy”

According to the U.S. Department of Housing and Urban Development a “reasonable accommodation” is:

A reasonable accommodation is a change, exception, or adjustment to a rule, policy, practice, or service that may be necessary for a person with a disability to have an equal opportunity to use and enjoy a dwelling, including public and common use spaces . . . . The Act makes it unlawful to refuse to make reasonable accommodation to rules, policies, practices, or services when such accommodations may be necessary to afford persons with disabilities an equal opportunity to use and enjoy a dwelling.
To show that a requested accommodation may be necessary, there must be an identifiable relationship, or nexus, between the requested accommodation and the individual’s disability.

To learn more about reasonable accommodation, click here.

The American With Disabilities Act (ADA).

Under the ADA, in situations where it may not be readily apparent that an animal is a service animal the individual may be asked two questions by an establishment’s employees:

1) Is the service animal a requirement due to a disability?
2) What work has the animal been trained to perform?

Employees are not allowed to ask for documentation for the service animal or require the animal to demonstrate its function or inquire about the nature of the owner’s disability.

Under the ADA, 29 CFR Part 1630.2(k)(3), a “reasonable accommodation” is:

An individual with a record of a substantially limiting impairment may be entitled, absent undue hardship, to a reasonable accommodation if needed and related to the past disability. For example, an employee with an impairment that previously limited, but no longer substantially limits, a major life activity may need leave or a schedule change to permit him or her to attend follow-up or “monitoring” appointments with a health care provider.

29 CFR Part 1630.2(k)(3)

Emotional support animals are not considered service animals under the ADA.

The Air Carrier Access Act (ACAA).

The ACAA requires that airlines allow both service animals as well as emotional support animals to accompany their owners in the cabin of the aircraft.

Similar to the ADA, if an air carrier’s employee is not sure if an animal is a service animal they may “ask to see identification cards, written documentation, presence of harnesses or tags, or ask for verbal assurances” from the owner. Click here for more information on service animals.

In addition, you may be asked one of the following:

1) What tasks or functions does your animal perform for you?
2) What has your animals been trained to do for you?
3) Would you describe how the animal performs this task for you?

Regarding individuals who have emotional support animals and want their ESA to accompany them in the aircraft cabin the ACAA states the following:

e) If a passenger seeks to travel with an animal that is used as emotional support or psychiatric service animal, you are not required to accept the animal for transportation in the cabin unless the passenger provides you current documentation (i.e., no older than one year from the date of the passenger’s scheduled initial flight) on the letterhead of a licensed mental health professional (e.g., psychiatrist, psychologist, licensed clinical social worker, including a medical doctor specifically treating the passenger’s mental or emotional disability) stating the following:

(1) The passenger has a mental or emotional disability recognized in the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM IV);

(2) The passenger needs the emotional support or psychiatric service animal as an accommodation for air travel and/or for activity at the passenger’s destination;

(3) The individual providing the assessment is a licensed mental health professional, and the passenger is under his or her professional care; and

(4) The date and type of the mental health professional’s license and the state or other jurisdiction in which it was issued.

14 CFR Section 382.117(e) and (f). (Emphasis added).

Therefore, it would be wise to advise your clients that they should contact that airline well in advance of their flight in order to find out what documentation is required for their ESA to travel with them. Particularly, if the ESA is of the exotic variety.

On the topic of exotic ESAs or service animals, the ACAA states:

(f) You are never required to accommodate certain unusual service animals (e.g., snakes, other reptiles, ferrets, rodents, and spiders) as service animals in the cabin. With respect to all other animals, including unusual or exotic animals that are presented as service animals (e.g., miniature horses, pigs, monkeys), as a carrier you must determine whether any factors preclude their traveling in the cabin as service animals (e.g., whether the animal is too large or heavy to be accommodated in the cabin, whether the animal would pose a direct threat to the health or safety of others, whether it would cause a significant disruption of cabin service, whether it would be prohibited from entering a foreign country that is the flight’s destination). If no such factors preclude the animal from traveling in the cabin, you must permit it to do so. However, as a foreign carrier, you are not required to carry service animals other than dogs.

It is also important to note that:

(g) Whenever you decide not to accept an animal as a service animal, you must explain the reason for your decision to the passenger and document it in writing. A copy of the explanation must be provided to the passenger either at the airport or within 10 calendar days of the incident.

14 CFR Section 382.117(g). (Emphasis added).

Additionally, the airline cannot charge you for your reasonable accommodation of an ESA or a service animal.

According to 14 CFR Section 382.31(a):

Except as otherwise provided in this part you must not, as a carrier, impose charges for providing facilities, equipment, or services that this rule requires to be provided to passengers with a disability. You may charge for services that this part does not require.

14 CFR Section 382.31(a)

Florida Specific Law.

In Florida, a new law SB 1084 was enacted on June 23, 2020, and became effective on July 1, 2020. SC 1084 establishes what can be considered reliable information for an ESA it also creates a civil penalty for falsification of documentation used to support the need for an ESA.

In addition, it defines an “Emotional Support Animal” as:

An animal that does not require training to do work, perform tasks, provide assistance, or provide therapeutic emotional support by virtue of its presence which alleviates one or more identified symptoms or effects of a person’s disability.

SB 1084. Emphasis added.

Of particular note, SB 1084 states:

A person with a disability or a disability-related need is liable for any damage done to the premises or to another person on the premises by his or her emotional support animal.

Check with your state and local laws in order to ensure you are in compliance with your state’s laws regarding emotional support animals and service animals. Don’t forget to read part 1 and part 2 in this blog series.

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

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, social workers, and family therapists in Department of Health (DOH) investigations, FBI investigations and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

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

About the Author: Amanda I. Forbes, practices health law with The Health Law Firm in its Altamonte Springs, Florida, office. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or toll-free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

By |2021-03-04T10:33:19-05:00December 22nd, 2020|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Emotional Support Animals and Protecting Your License, Pitfalls and Tips, Part 2 of 3

Amanda I. Forbes, J.D.By Amanda I. Forbes, J.D.; and George F. Indest III, J.D., M.P.A., LL.M., Board Certified in Health Law

This is part 2 of 3 in a blog series regarding Emotional Support Animals (ESA) support letters being prepared by counselors and therapists. There are serious pitfalls that exist for the unwary mental health professional and, in part 1, we provided a number of tips on how to avoid these. Click here to read part 1. Don’t forget to read part 3!

The ACA has identified specific potential risks to animals, clients, the public, and counselors which everyone involved in this area of practice should be familiar with.

Potential Risks to Animals:

1. Neglect or other abuse; poor mental health on the part of the client may prevent adequate animal care or may promote neglect or abuse.

2. Undue stress may occur to the animal from constant work during accompaniment, including being placed in stressful environments.

3. The animal may suffer undue stress from being handled by a person who does not have specialized training.

4. The animal may suffer an illness, undue stress, or injury from public interactions.

Possible Risks to Clients:

1. Inadequate treatment of a mental health disorder.

2. Injury or property damage from an inadequately trained or socialized animal.

3. Zoonotic infection or disease.

4. Animal allergies in the client, the client’s family, and the client’s associates.

5. Potential fraud or legal concerns if an ESA is misrepresented as a service animal.

6. Financial and emotional burdens due to potential behavior problems associated with inadequately trained and socialized companion animals.

7. Misconception that a relationship with an ESA replaces or substitutes for professional mental health care or human relationships (especially the latter).

Potential Risk to the Public:

1. Injury or emotional damage from inadequately trained animals.

2. Untrained or improperly socialized animals may be more likely to be stressed out or aggressive in public.

3. Unsocialized animals may be disruptive and interfere with normal activities such as group functions, public travel, public dining.

4. Maladaptive interactions with other animals (especially toward service animals)

5. Zoonotic infection or disease from animals.

6. Animal allergies and phobias (yes, some regular people have phobias against dogs, cats, snakes, weasels, alligators, and monkeys).

7. They may contribute to public skepticism, which hurts those with valid helper animals (e.g., someone who has a full-size alligator that she claims is her emotional support animal and takes it everywhere she goes).

8. The more unsuitable the animal, the greater the risk (i.e., exotic pet, undomesticated or wild animal).

9. When more fraudulent animals have greater public access, the more public risk is incurred.

Risks to the Counselor Who Certifies or Approves an Emotional Support Animal:

1. Liability for adverse client outcomes due to inadequate or substandard treatment.
2. Potential provider role conflicts: Forensic v. Counseling.
3. Potential liability for injury/illness caused by the animal to the client or others.
4. Potential charges of fraud if an inadequate evaluation is done to demonstrate the need for the animal, or if performed in the absence of actual supporting facts, or if performed for a fake client who is just making up everything.
5. Disciplinary action taken against your professional license by your licensing board for any of the above.
6. Ethical considerations for inadequate education about ESAs and their role in comprehensive treatment. Potential to be called to testify if the ESA is challenged or if an incident occurs.

Click here for more information.

An additional potential risk that the ACA did not address was the possibility of disciplinary action against your license by your professional board. The reasons for such an action could possibly be from a failure to establish a proper client relationship prior to writing an ESA recommendation letter. It is important to keep these potential risks in mind when determining whether to write an ESA recommendation letter.

Don’t forget to read part 1 and part 3 of this blog series for more information.

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

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, social workers, and family therapists in Department of Health (DOH) investigations, FBI investigations, and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

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

About the Authors: Amanda I. Forbes, practices health law with The Health Law Firm in its Altamonte Springs, Florida, office. George F. Indest III, J.D., M.P.A., LL.M., is Board Certified in Health Law by The Florida Bar and is licensed in Louisiana, Florida, and the District of Columbia. He is President and Managing Partner of The Health Law Firm. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll Free: (888) 331-6620.

KeyWords: Representation for healthcare professionals, representation for healthcare compliance, representation for healthcare facilities, healthcare facility defense lawyer, healthcare compliance defense attorney, healthcare license defense attorney, Complex Healthcare Litigation, complex healthcare litigation defense lawyer, Complex Business Litigation, Complex Commercial Litigation, Class Action Litigation, medical regulatory defense lawyer, representation for licensed mental health counselors (LMHCs), mental health counselor defense lawyer, licensed professional counselor (LPC) defense attorney lawyer, mental health counselor legal representation, licensed professional counselor (LPC) legal representation, social worker defense lawyer, representation for social workers, social worker defense attorney, social worker complaint cases, Florida Colorado Louisiana mental health counselor complaint cases, defense lawyer for psychologists, Florida health law defense attorney, medical license defense, Florida Department of Health (DOH) attorney, representation for Louisiana and Florida Department of Health (DOH) complaint investigations, Louisiana and Florida Department of Health (DOH) defense lawyer, Colorado Division of Regulatory Agencies (DORA) defense attorney, representation for Florida Colorado Division of Regulatory Agencies (DORA) complaint investigations, Colorado Division of Regulatory Agencies (DORA) defense lawyer, Lousiana LPC Board defense attorney lawyer, Health Law Firm reviews, reviews of The Health Law Firm attorneys, administrative complaint defense lawyer, administrative complaint defense attorney, administrative hearing defense lawyer, administrative hearing defense attorney, administrative hearing defense legal counsel, representation for health care professionals

“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 © 2020 The Health Law Firm. All rights reserved.

By |2021-03-04T10:32:51-05:00October 5th, 2020|Categories: In the News, Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

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

Attorney Amanda I. ForbesBy Amanda I. Forbes, J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified in Health Law

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Guidance from the American Counseling Association:

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

In that position paper the ACA stated:

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

Click here to read the ACA letter in full.

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

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

Click here to learn more.

The ACA also cautions:

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

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

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

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

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, social workers, and family therapists in Department of Health (DOH) investigations, FBI investigations and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 or Toll-Free: (888) 331-6620, and visit our website at www.TheHealthLawFirm.com.

GEORGE F. INDEST III, J.D., M.P.A., LL.M.About the Authors: Amanda I. Forbes, practices health law with The Health Law Firm in its Altamonte Springs, Florida, office. George F. Indest III, J.D., M.P.A., LL.M., is Board Certified in Health Law by The Florida Bar and is licensed in Louisiana, Florida, and the District of Columbia. He is President and Managing Partner of The Health Law Firm. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll Free: (888) 331-6620.

KeyWords: Representation for healthcare professionals, representation for healthcare compliance, representation for healthcare facilities, healthcare facility defense lawyer, healthcare compliance defense attorney, healthcare license defense attorney, Complex Healthcare Litigation, complex healthcare litigation defense lawyer, Complex Business Litigation, Complex Commercial Litigation, Class Action Litigation, medical regulatory defense lawyer, representation for licensed mental health counselors (LMHCs), mental health counselor defense lawyer, licensed professional counselor (LPC) defense attorney lawyer, mental health counselor legal representation, licensed professional counselor (LPC) legal representation, social worker defense lawyer, representation for social workers, social worker defense attorney, social worker complaint cases, Florida Colorado Louisiana mental health counselor complaint cases, defense lawyer for psychologists, Florida health law defense attorney, medical license defense, Florida Department of Health (DOH) attorney, representation for Louisiana and Florida Department of Health (DOH) complaint investigations, Louisiana and Florida Department of Health (DOH) defense lawyer, Colorado Division of Regulatory Agencies (DORA) defense attorney, representation for Florida Colorado Division of Regulatory Agencies (DORA) complaint investigations, Colorado Division of Regulatory Agencies (DORA) defense lawyer, Lousiana LPC Board defense attorney lawyer, Health Law Firm reviews, reviews of The Health Law Firm attorneys, administrative complaint defense lawyer, administrative complaint defense attorney, administrative hearing defense lawyer, administrative hearing defense attorney, administrative hearing defense legal counsel, representation for health care professionals

“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 © 2020 The Health Law Firm. All rights reserved.

By |2021-02-17T11:16:34-05:00September 28th, 2020|Categories: In the News, Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments
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