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Florida Psychiatric Hospital Accused of Cashing in on Baker Act Patients

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

In September 2019, a report on an investigation by The Tampa Bay Times stated that a North Tampa psychiatric hospital might be more harmful than helpful to its patients. The Tampa Bay Times claimed the health facility exploited patients held under the state’s mental health law known as the Baker Act. The Baker Act allows the involuntary confinement of a person in a mental health facility for a limited period of time if that person presents a threat to himself or to others; however, there are many limitations on this and rights that such persons have. The center has routinely held patients inappropriately against their will, making millions of dollars in the process, the newspaper reported.

After analyzing hospital records, police reports, court records, and interviews with former patients, the Tampa Bay Times was able to show that the hospital tricked or used coercive methods to keep patients locked up. Additionally, some patients described getting virtually no psychiatric treatment while admitted, according to the story.

Violations of The Baker Act.

Patients are often checked in for 72 hours the Baker Act, the Florida law that allows mental health centers to detain patients who are at risk of self-harm. The 72 hour period is to allow time for psychiatrists to evaluate the patient to see if the patient meets criteria to be confin3ed beyond the 72 hours. After 72 hours, unless a psychiatrist has found otherwise, facilities cannot legally hold patients against their will.

Despite the law, the Florida psych hospital allegedly used loopholes in the statute to hold patients longer than the law permits, thereby running up their hospital treatment bills, according to the report. The investigation exposed that the hospital uses a variety of tactics to keep patients beyond 72 hours. Some patients were tricked into thinking they had waived their right to leave the facility. Others were forced to wait around for court hearings that never happened. The extended stays were proven to be very lucrative to the facility named in the news report. It reportedly had the fourth-highest profit margin of any Florida psychiatric hospital in 2017.

Following the investigation by the Tampa Bay Times, Florida lawmakers are now calling for government regulators to further investigate the facility. Click here for more information, including a letter sent by a state representative to the Centers for Medicare and Medicaid Services (CMS).

For more information on the Baker Act law, click here to read one of my prior blogs.

Click here to visit our Areas of Practice page on our website and learn more about specific Baker Act cases and how we can assist you in these matters.

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.

Sources:

Bedi, Neil. “How one Florida psychiatric hospital makes millions off patients who have no choice.” Tampa Bay Times. (September 18, 2019). Web.

Harnes, Anna. “Florida Psych Hospital Holds Patients Captive To Make Millions In ‘Shocking’ Report.” Inquisitr. (September 21, 2019). Web.

Bedi, Neil. “Lawmakers call for investigations into Wesley Chapel psychiatric hospital.” Tampa Bay Times. (October 7, 2019). 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: Baker Act defense attorney, legal representation for Baker Act cases, legal representation for involuntary Baker Act confinement, legal representation for involuntary confinement, 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, Florida Baker Act lawyer, mental health lawyer, mental health representation, legal representation for Baker Act law, representation for mental health facilities, representation for mental health professionals, psychologist defense counsel and legal representation, social worker legal counsel and mental health counselor defense attorney, 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 © 2019 The Health Law Firm. All rights reserved.

Changes to Certificate of Need Law Eliminate CONs for Florida Hospitals

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

On June 3, 2019, Tallahassee healthcare regulators began the complex process of reshaping the state’s certificate of need (CON) program. Florida regulators are moving ahead to eliminate the certificate of need program for hospitals and to focus it on nursing homes, hospices, and institutions for individuals with developmental disabilities.

Proposed Changes to Florida’s Hospital CON Laws.

In May 2019, the Florida Legislature eliminated certificate of need program requirements for general acute care hospitals and tertiary services. The new law keeps CON requirements for specialty hospitals in place only until July 1, 2021. Click here to read more.

Rules being proposed to implement the legislative changes would maintain the four review cycles but split them into two different categories. One category would deal with applications for hospital facilities and hospices. The other category would be dedicated to nursing homes and intermediate-care facilities for individuals with disabilities.

Florida’s Certificate of Needs Programs.

Opponents of the CON program argue that it limits the ability to create new healthcare services and to build new facilities (in other words, “competition is good”). Advocates for CONs have argued that geographic areas where hospital and other health facilities are overbuilt can actually lead to increased healthcare costs and reduced services (in other words, “competition is bad”).

Critics of CONs argue that they limit the free market and, because CONs stifle competition, lead to increased costs. They have long argued that the requirements to maintain CONs can be shifted from certificates of need to simple licensing requirements.

To read my prior blog dealing with a certificate of needs case, click here.

Consult With A Health Law Attorney Experienced in the Representation Health Care Professionals.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in academic disputes, contract negotiations, license applications, board certification applications, credential hearings and civil and administrative litigations and hearings. We also have experience in representation for health care investigations by the Agency for Healthcare Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS).

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

Sources:

Sexton, Christine. “Florida regulators float new rules in hospital wars.” Sun-Sentinel. (July 5, 2019). Web.

“State Regulators Float New Rules in Hospital War Battles.” Law.com. (July 6, 2019). Web.

About the Authors: 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., 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 © 2019 The Health Law Firm. All rights reserved.

The Administrative Process to Challenge OIG Exclusion Actions

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

Many health professionals don’t understand the significant repercussions that an exclusion action by the Office of the Inspector General (OIG) can have on their professional careers and future employment. Whether you are a physician, nurse, dentist, psychologist or other health professionals, if you allow yourself to be excluded from the Medicare program, devastating economic results may follow.

The administrative process by which you may challenge a proposal from the OIG for most permissive or mandatory exclusion is challenging. In most cases, you will need experienced legal representation.  Below are the steps in the process you must follow to protect your career and your livelihood.

How to Challenge OIG Exclusion Actions.

1.    Notice of Intent (NOI) received: If the OIG is proposing to exclude a person or entity from Medicare, it will send out a letter called a “Notice of Intent” or “NOI.” This will contain the reasons for the exclusion and will detail hearing or appeal rights.  It is very important to make sure that your state licensing board and Medicare have your correct current address on file because the address which Medicare has will be where the NOI is mailed.  (Note:  the OIG may not send a NOI for mandatory exclusions which carry a 5-year minimum exclusion period.)  You will not have a second chance. Regardless, you usually only have 30 days to submit a written response requesting a hearing and containing information the OIG will consider in making its decision.  In some cases, providers may have the opportunity to present oral arguments before OIG officials. You must make sure that your request is received by the deadline, not just mailed by the deadline.  Send your request by a fast, reliable means (such as Federal Express or U.S. express mail) that you can track; or register for and file it electronically online.  Read the instructions in the letter and follow them. Be sure you get a receipt when you file.

2.    Notice of Exclusion (NOE): Sometimes the OIG will send a “Notice of Exclusion” or “NOE” if it decides to exclude a provider regardless of the response provided to a NOI or in certain cases of mandatory exclusions or certain permissive exclusions where no NOI is ever sent. Medicare exclusions usually take effect 20 days after the NOE is mailed. In cases involving fraud, kickbacks and other prohibited activities, a Notice of Proposal to Exclude or NOPE may be sent instead.

3.    Administrative Law Judge (ALJ) Hearing: Providers have the right to appeal a proposed exclusion by requesting an administrative hearing (similar to a trial) before an “Administrative Law Judge” or “ALJ.” ALJ’s are part of the Department of Health and Human Services (HHS). If you wish to request an ALJ hearing, you must do so within 60 days of receiving the Notice of Exclusion (or according to the instructions), and you must be prepared to raise all of your arguments over issues regarding the decision itself, the proposed exclusion period, mitigating factors or other aspects of the action.

4.    Department Appeals Board (DAB): If you disagree with the ALJ hearing decision, you can further appeal to the HHS “Departmental Appeals Board” or “DAB.” This is a written appeal which will be required to set forth legal errors which were made in the ALJ hearing.

5.    Judicial Review: If you disagree with the decision made by the DAB, your only option is to challenge the final decision in a U.S. District Court.

MOST IMPORTANT, consult a health law attorney experienced in such matters. The consequences of  Medicare exclusion, even a permissive exclusion for one year or three years, are severe. Most people do not realize this until it is too late; then it is too late (in many, but not all, cases).

To learn more about the consequences of OIG exclusion, click here to read one of my prior blogs.

Contact Attorney Experienced in Defending Against Action to Exclude an Individual or Business from the Medicare Program.

The attorneys of The Health Law Firm have experience in dealing with the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS), and defending against action to exclude an individual or business entity from the Medicare Program, in administrative hearings on this type of action, in submitting applications requesting reinstatement to the Medicare Program after exclusion, and removal from the List of Excluded Individuals and Entities (LEIE).

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 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 © 2019 The Health Law Firm. All rights reserved.

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Florida’s Prescription Drug Importation Plan Continues to Gain Support

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

On March 12, 2019, the Florida House of Representatives’ Health Quality Subcommittee voted 15 to 2 to approve House Bill 19 (HB 19) that would implement one of Florida Gov. Ron DeSantis’ recently announced health care proposals. In February 2019, the new Florida governor, who was criticized for not having a health care platform while he campaigned, announced the proposal that Florida start importing drugs from Canada.

HB 19 -Prescription Drug Importation Programs.

HB 19 was created for the purpose of safely importing cost-effective prescription drugs from Canada and other foreign nations under specified conditions. The proposed program would go into effect on July 1, 2019.

HB 19 provides eligibility criteria for prescription drugs and program participants; provides distribution requirements; provides annual reporting requirements; provides application and permitting requirements for certain participating entities; and provides that implementation of International Prescription Drug Importation Program is contingent on federal arrangement or obtaining federal guidance. Click here for more information on HB 19.

Two Programs, One Goal – Lowering Prescription Drug Prices.

The program will offer access to FDA-approved prescription drugs imported from Canada, allowing the drugs to be sold to Floridians at a much lower cost than they could otherwise purchase them here. “One of the biggest drivers of this country’s out of control healthcare spending is the cost of prescription drugs,” said Governor DeSantis.

According to the bill, the U.S. spends 30 to 190% more than other developed countries on prescription drugs, and up to 174% more for the exact same for prescription drugs. The proposed bill aims to lower these unnecessary high costs by establishing two different drug importation programs.

The first program would allow the state to import prescription drugs from Canada for use by the Florida Medicaid Program and prison health care system. It would be known as the Canadian Drug Importation Program. It would be run by the Florida Agency for Health Care Administration (AHCA).

The second program would be known as the International Drug Importation Program. It would be run by the Florida Department of Business and Professional Regulation and would be available to individual residents.

Despite gaining house support, both programs would still need approval from the federal government before they could be implemented in Florida.

To learn more about Gov. DeSantis’ proposal, click here to read his press release.

Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.

The Health Law Firm represents pharmacists and pharmacies in DEA, DOH and FDA investigations, qui tam and whistleblower cases, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits. The firm’s 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.

Sources:

Sexton, Christine. “DeSantis prescription drug savings plan gets early House support.” Orlando Sentinel. (March 12, 2019). Web.

News Service of Florida. “DeSantis Drug Importation Plan Wins House Support.” Sunshine State News. (March 13, 2019). Web.

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

KeyWords: Legal representation for pharmacies, representation of health care professionals, health law defense attorney, doctor attorney, nurse attorney, Legal Defense for Pharmacists, pharmacy defense attorney, representation for pharmacists, representation for pharmacies, Department of Health defense attorney, DOH investigation representation, quality assurance representation, DEA investigation, DEA attorney, DEA representation, prescription E-FORSCE representation, DEA defense lawyer, representation for overprescribing, Medicare investigation lawyer, representation for Medicaid investigation, representation for health care professionals, license defense lawyer, licensure representation, board representation attorney, representation for board investigations, whistleblower representation, qui tam representation, whistleblower attorney, whistleblower defense attorney, qui tam attorney, qui tam defense lawyer, representation for license defense, licensure defense attorney, protecting your professional license, Florida opioid crisis, Florida’s ongoing lawsuit for opioid crisis The Health Law Firm, Florida health law attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2019 The Health Law Firm. All rights reserved.

Neurosurgeon Keeps $17.5 Million Award, Despite Arrest for Soliciting Prostitute

Headshot of The Health Law Firm's attorney George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On June 25, 2019, a Washington state appeals court sided with an arbitrator’s decision to award $17.5 million to a neurosurgeon who was fired after he didn’t disclose his arrest for soliciting prostitute.

Swedish Health Services had appealed the original arbitration ruling, arguing that the neurosurgeon violated the terms of his employment contract when he failed to notify the employer that he had been arrested in a prostitution sting. However, according to the reports, the neurosurgeon claimed that in 2017 Swedish Health Services actually fired him after he complained of the practices of a different doctor. The arbitral ruled in favor of the neurosurgeon and made the monetary award. Click here to read more.

Swedish Health Services argued that the arbitrator unfairly limited how much it could cross-examine the fired neurosurgeon about his “illicit behaviors” before he was fired. However, the court rejected arguments that Swedish Health Services didn’t get a fair shake at the arbitration hearing. The court affirmed that his sexual activities were irrelevant to the claims about the cause of the termination.
To read the court’s opinion in full, click here.

Click here to read one of my prior blogs about a wrongful termination case involving a health care facility and a former employee and whistleblower.

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,
Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical
centers, pain management clinics, nursing homes, and any other healthcare provider. We represent
facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative
hearings and in representing physicians in investigations and at Board of Medicine and Board of
Osteopathic Medicine hearings. We represent physicians accused of wrongdoing, in patient complaints and in Department of Health investigations.

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

Sources:

Lidgett, Adam. “Doc Who Solicited Prostitute Sees $17.5M Arbitral Win Upheld.” Law360. (June 25, 2019). Web.

Baker, Mike. “Judge confirms $17.5M award for fired Swedish Health neurosurgeon.” Seattle Times. (October 23, 2017). Web.

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

KeyWords: Representation for health care professionals, legal representation for alternative dispute resolution (ADRS) proceedings, legal representation for arbitration for health providers, physician arbitration mediation legal counsel, physician mediation-arbitration attorney, legal representation for mediation-arbitration for health providers, complex health care litigation attorney, complex medical litigation legal counsel, complex medical business litigation attorney, physician employment legal representation, physician employment attorney, physician employment dispute lawyer, wrongful termination of health professionals legal representation, medical employment contract lawyer, medical employment contact representation, breach of physician employment contract lawyer, breach of physician contract representation, representation for healthcare whistleblowers, whistleblower defense lawyer, qui tam defense lawyer, representation for qui tam cases, The Health Law Firm reviews, reviews of The Health Law Firm

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2019 The Health Law Firm. All rights reserved.

Dental Clinic Owners Found Guilty of $1 Million Medicaid, Tax Scheme

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

On February 21, 2019, a federal jury found the owners of several dental clinics in Missouri guilty of a $1 million scheme to defraud the government. The owners of All About Smiles LLC, were convicted of submitting false claims to Medicaid for dentures and other services and payroll tax fraud, according to prosecutors.

Submitting False Claims.

Prosecutors alleged that the couple that owned the practice ran several schemes through the dental clinics from 2010 to 2015, including conspiring to defraud Medicaid. A main part of the scheme was to provide dentures and other services to adults who didn’t qualify for Medicaid. They would then bill the Medicaid program anyway, receiving more than $720,000, according to the DOJ.

The pair also allegedly ran a similar scheme with orthodontic equipment, racking up an estimated 241 false claims, said prosecutors. All About Smiles was paid approximately $165,700 during the the duration of the scheme.

Payroll Problems.

In addition to the fraud, the owners allegedly failed to forward payroll taxes to the Internal Revenue Service (IRS) even though the money was withheld from employee paychecks. Instead, the married pair used the almost $195,000 to cover lavish personal expenses and make payments on a variety of vehicles, said the DOJ.

Not Smiling Anymore.

Jurors found the couple guilty on all charges detailed in a 40-count indictment accusing them of fraudulently operating three All About Smiles LLC dental clinics, said the DOJ. Additionally, their legal woes continued to stack up as each was also convicted on a count of theft of public money for collecting unemployment benefits while working.

The female owner faces up to 10 years in prison on every count besides the payroll tax conspiracy charge, which comes with a maximum penalty of five years. The husband owner could get up to a decade for obtaining unemployment benefits and five years for each additional charge, prosecutors said.

Click here to read the DOJ’s press release.

To read one of my prior blogs on a similar case about a dentist defrauding medicaid, click here.

Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicaid Billing Issues Now.

The attorneys of The Health Law Firm represent dentists, oral surgeons, and other health care providers in Medicaid audits, Medicare audits, insurance billing audits, ZPIC audits, RAC audits, administrative litigation and civil litigation throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in licensure complaints and investigations, DEA investigations, Medicare and Medicaid fraud investigations, audits, recovery actions and terminations from the Medicare or Medicaid Program.

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

Sources:

“All About Smiles Owners Convicted of Fraud.” Ozark Independent. (February 21, 2019). Web.
Posses, Shayna. “Couple Found Guilty Of $1M Medicaid, Payroll Tax Scheme.” Law360. (February 21, 2019). 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 © 2019 The Health Law Firm. All rights reserved.

By |2019-04-18T18:44:05-04:00April 18th, 2019|Categories: Centers for Medicare and Medicaid Services, Dental Law Blog, Dentist Defense attorney, Health Care Fraud, Health care Law, Medicaid Fraud, Medicaid fraud|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

FL May Allow Providers to Avoid Past Mental-Health Conditions, Drug Issues on License Applications

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

Health care professionals ask patients about their medical histories every day for in treating them. But what happens when they are requested to divulge in their own history to the state as part of the licensing process? Before being licensed in the state of Florida, for example, health care providers are required to disclose if they have been treated for mental-health or substance-abuse disorders within in the past five years. However, this could be changing very soon.

Changes to Past Health Questions.

In December 2018, a committee of the Florida Board of Medicine gave preliminary approval to eliminate questions about past treatment of mental health and substance abuse from applications for medical licenses in Florida. Rather, applicants would be asked only whether they currently have any condition that impairs them from safely practicing.

Medical history questions are asked during the initial application for license, whether the applicant is a new physician or a physician from another state who is seeking a Florida license. This is true for most states. The new questions are designed to be more open-ended and lend themselves to subjective answers.

The proposal to change the initial application questions comes after several studies revealed an alarming suicide rate among physicians and medical students. According to a 2015 study published in the journal JAMA Psychiatry, between 300 and 400 physicians commit suicide each year.

Despite these numbers, the proposal still requires full board approval and faces opposition from some board members.

Click here to read one of my prior blogs about rising baker acts among college students in Florida.

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

The attorneys of The Health Law Firm provide legal representation to physicians, physician assistants, nurses, nurse practitioners, cardiologists, CRNAs, pain management doctors, 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.

Sources:

Sexton, Christine. “Florida doctors may avoid revealing past mental-health and drug-abuse issues.” Orlando Sentinel. (January 16, 2019). Web.

“Change Seeks To Remove ‘Stigma’ For Doctors.” Health News Florida. (January 16, 2019). 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 © 2019 The Health Law Firm. All rights reserved.

Virginia Doc Lands 40 Years in Prison For Running Multi-state Pill Mill

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On October 2, 2019, a Virginia doctor received a 40-year prison sentence for illegally prescribing more than half a million opioid pills over 19 months. The U.S. District Court for the Western District of Virginia handed down the sentence to Joel Smithers, who was reported to have operated a “pill mill” out of Virginia, according to authorities. In addition to prison time, he was given an $86,000 fine and will serve three years of supervised release upon the completion of his prison time, according to court documents.

The sentence is lighter than it could have been. He was facing up to life in prison and a fine of more than $200 million, according to officials at the U.S. Justice Department. Click here to view the court’s sentencing document in full.

Alleged Interstate Drug Distribution Network.

In May 2019, Smithers was convicted by a jury on more than 859 federal drug charges, including one count of possessing with the intent to distribute controlled substances and one count of maintaining a place for the purpose of unlawfully distributing controlled substances. Additionally, he was also convicted on hundreds of counts of unlawfully distributing a controlled substance without a legitimate medical purpose or beyond the bounds of medical practice.

When he opened his Virginia practice in 2015, Justice Department officials said he prescribed controlled substances to “every patient in his practice, resulting in over 500,000 Schedule II controlled substances being distributed.” Authorities say that he allegedly ran an operation that was less a medical practice and more an interstate drug distribution network.

Smithers was able to rake in over $700,000 in cash and credit card payments before the search warrant was executed at his office on March 7, 2017. Click here to read the press release issued by the U.S. Attorney’s Office in the Western District of Virginia.

To learn about a similar case involving two Florida doctors, click here.

The Problems I See.

I tell you that I take issue with many of the cases of this sort. I do not know enough about the actual facts of this physician’s case, but I can comment generally based on other similar cases I have had in the past. The government, both state and federal, has come down like a hammer on individual physicians and pharmacists in its over-zealous campaign to crack down on opioids. Many physicians and pharmacists, just trying to do a good job and legitimately treat their patients, are being caught up and persecuted. Chronic pain patients, many of whom are disabled veterans or people injured on the job, are unable to find physicians to treat them anymore or, if they can, any pharmacists willing to fill their prescriptions.

All sorts of under-handed techniques are used to try to make a case against conscientious health professionals who are merely trying to do their jobs. These do include the tactic seen in the case we are reporting on, which I call “bean counting.” The government comes in and, instead of proving how many allegedly illegal prescriptions were written or how many patients the physician gave the prescriptions to, breaks these out into the number of pills. This greatly exaggerates the case and these large numbers alone make it look like the doctor (or pharmacist) is doing something wrong or extremely way out of the norm.

For example, if a patient was receiving a low dose of a pain killer, say 10 mg Oxycodone every 4 to 6 hours, prescribed for four times a day, the ordinary monthly prescription for this medication alone (and such patients rarely receive one type of medication alone) this equates to 120 pills per month. If 10 mg pills are not available and/or the prescription is filled with 5 mg pills, instead, this is 240 pills a month. A years’ worth is 1,440 pills or 2,880 pills for just one patient. If the physician has 50 similar patients, this is 72,000 pills or 144,000 pills a year that the physician is writing and a pharmacy or pharmacies are filling.

This does not seem extreme or unusual to me, at all, and these amounts are on the low side. Yet just as government agencies love to inflate the “street value” or contraband drugs they seize, they love to break down the number of opioids a physician writes so it seems to a layperson to be extraordinarily large. Furthermore, a pain management physician or any other kind of physician cannot survive with just 50 patients a month. It is far more likely for a physician to have a thousand (1,000) or more patients a month. I call this type of numerical exaggeration “bean counting.” But it has put a number of physicians and pharmacists in jail.

Judges should not allow such exaggerated numbers to be introduced into evidence in the absence of further information that places them in context. It is unfairly prejudicial to the defendant to do so.

Contact Health Law Attorneys Experienced with DEA Cases.

The attorneys of The Health Law Firm are experienced in handling Drug Enforcement Administration (DEA) cases, board of medicine cases and board of pharmacy cases regarding allegations of over-prescribing and illegal prescribing. If you are currently being investigated or facing other adverse actions by the DEA contact one of our attorneys by calling (407) 331-6620 or (850) 439-1001. You can also visit our website for more information at www.TheHealthLawFirm.com.

Sources:

Booker, Brakkton. “Doctor Gets 40 Years For Illegally Prescribing More Than Half A Million Opioid Doses.” NPR. (October 2, 2019). Web.

“Virginia doctor could get life in prison today for prescribing 500,000 opioid pills.” RTV6. (October 2, 2019). Web.

Almasy, Steve. “Virginia doctor who illegally prescribed 500,000 opioid pills sentenced to 40 years in prison.” CNN. (October 2, 2019). Web.

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

KeyWords: legal representation for pain management physicians and pharmacists, legal representation for pharmacies, pharmacy defense attorney, pain management physician defense attorney, pharmacist defense lawyer, pain management physician defense lawyer, representation for False Claims Act (FCA) investigation, False Claims Act representation, FCA defense lawyer, board representation for pharmacists, board representation for pharmacies, board representation for physicians, Board of Pharmacy investigation representation, legal representation for board investigations, Drug Enforcement Administration (DEA) defense attorney, board of medicine attorney, board of pharmacy attorney, Department of Health investigations, pain clinics, over prescribing painkillers, Drug Enforcement Administration (DEA) investigation attorney, The Health Law Firm, administrative hearing defense attorney, DEA order to show cause (OSC) defense lawyer, legal representation for administrative hearings, administrative complaint representation, Board of Medicine representation, Board of Medicine attorney, Board of Medicine defense attorney, representation for Board of Medicine investigations, representation for Board of Medicine complaints, DEA hearing defense attorney, DEA investigation attorney, DEA hearing representation, DEA investigation representation, representation for DEA investigations against physicians, representation for pill mill allegations, representation for allegations of overprescribing, representation for overbilling, DOJ defense lawyer, representation for DOJ investigations, representation for health care professionals, reviews of The Health Law Firm, The Health Law Firm attorney reviews, DEA order to show cause (OSC) defense attorney

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Copyright © 2019 The Health Law Firm. All rights reserved.

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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.

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.

KeyWords: Representation for Medicare fraud, Medicare fraud investigation representation, Medicare attorney, Medicare fraud defense lawyer, representation for AHCA investigations, AHCA attorney, representation for health care professionals, doctor lawyer, doctor attorney, representation for doctors, doctor defense attorney, health care professional defense lawyer, health law defense attorney, health care facility representation, health care law defense, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Florida health law firm, Florida health law defense attorney

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

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