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Nurse Website Files Copyright Suit, Claims Florida Blog Aggregator Stole Over 800 Articles

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

On June 28, 2018, MidLevelU, an online hub for nurse practitioners and health care professionals, filed a copyright suit in the Southern District of Florida. MidLevelU accused a subscription-based blog aggregator, ACI Information Group, of stealing and re-posting more than 800 of its articles on their website without permission or license.

Copyright Violations.

MidLevelU, is an online forum to support nurse practitioners and features helpful, informational articles to supplement a career in health care. ACI is accused of unlawfully stealing at least 823 of those articles, copying them pretty much word-for-word and then charging subscribers to access them. According to the suit, MidLevelU has copyright registrations on several dozen of the articles that the Florida-based blog aggregator copied and published without permission. In addition, ACI is accused of stealing and republishing certain photos that MidLevelU paid a third party to use on the blog posts.

After posting almost identical summaries of MidLevelU’s articles, ACI would prompt users to view the article in its entirety and then charge them monthly or yearly subscriptions to access it, according to the suit. To learn more and read the complaint in full, click here.
To learn more about MidLevelU, click here and visit their website.

Contact Health Law Attorneys Experienced in the Representation of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, 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:

Bolado, Carolina. “Nurse Practitioner Site Says Aggregator Swiped Its Articles.” Law360. (July 5, 2018). Web.

MidlevelU LLC v. ACI Information Group. Justia Docket and Filings. (July 5, 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: Legal representation for health care professionals, health law defense lawyer, representation for nurse practitioners, nurse practitioner attorney, representation for nurses, nurse attorney, representation for nursing students, health care facility representation, health care professional representation, health care 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 © 2018 The Health Law Firm. All rights reserved.

By |2018-07-12T19:14:20+00:00July 12th, 2018|Nursing Law Blog, Uncategorized|0 Comments

New Database Allows Consumers to Evaluate Nursing Homes Across the Country

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

Consumers have a new online tool to see which nursing homes are being hit with fines for poor quality, safety or maintenance. Nursing Home Inspect 2.0 is a free database that assists users in evaluating nursing homes across the country. The database was first introduced by ProPublica, a nonprofit investigative news organization, in August 2012. On December 17, 2012, the same organization introduced the 2.0 version that includes information about federal fines imposed on nursing homes in the past three years.

The website can be found at Propublica.org/nursinghomes.

According to the website, the information provided comes from government inspection reports from the Centers for Medicare and Medicaid Services (CMS).

Fines Against Nursing Homes are Handed Out Inconsistently.

On the front page the website shows colored maps of the United States. The maps break down each state’s number of deficiencies and average fine amount. From a quick glance at the maps you can see states have imposed federal fines inconsistently.

In an interview with the Orlando Sentinel, an analyst who helped develop the website said nursing homes in some states pay a steep price for misconduct, while those in neighboring states don’t. An example used in the article shows that the average fine paid by a nursing home in South Carolina in the past three years is $40,507. The average fine in Texas is $6,933. Florida sits in the middle nationally, with an average fine of a little more than $17,000.

Click here to read the article from the Orlando Sentinel.

Nursing Homes Under the Watchful Eye of the Government.

Recently the Office of the Inspector General (OIG) Department of Health and Human Services (HHS) released its annual Work Plan.  This Work Plan is an overview of how the OIG intends to carry out its mission to make the Medicare and Medicaid programs run more smoothly and efficiently.

Of particular importance to Medicare and Medicaid providers is the Work Plan’s detailing of particular areas and billing codes and practices that will be under additional scrutiny during the 2012-2013 fiscal year. Nursing Homes are on the list due to the large source of abuse of federal healthcare dollars.

To learn about several key areas in nursing homes that will be under additional scrutiny, click here.

Contact Health Law Attorneys Experienced with Nursing Home Cases.

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

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

Comments?

Would you use this new database? Do you think the way states and the CMS fine nursing homes across the country is fair ? Please leave any thoughtful comments below.

Sources:

Jameson, Marne. “New nursing home inspection website helps consumers make choices.” Orlando Sentinel. (December 17, 2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-nursing-home-inspection-website-20121217,0,171167.story

Lade, Diane. “Consumers Can Search Nursing Home’s Fines.” Sun Sentinel. (December 18, 2012). From: http://www.sun-sentinel.com/health/fl-nursing-home-inspect-20121217,0,887722.story

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

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

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

By |2018-07-12T19:06:57+00:00May 15th, 2018|ALFs, Discipline|0 Comments

Florida Bill to Expand Authority of Nurses Flatlines During 2014 Legislative Session

5 Indest-2008-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar   in Health Law

The 2014 Legislative Session ended May 2, 2014, with the death of an omnibus health bill. House Bill 7113 would have provided provisions to expand the power of nurse practitioners to work independently of physicians’ oversight. This extension of authority to nurses would no longer require them to contract with and pay a “supervising” physician. The bill died after being passed back and forth between the Florida House of Representatives and the Florida Senate numerous times. It could not be resuscitated or kept alive by artificial means.

Currently, Florida nurse practitioners must work under direct supervision of physicians. The bill would have changed the title of nurse practitioners or advanced registered nurse practitioners. These are registered nurses with post-college education, usually a Master’s degree. The denied change would have retitled these health professionals to advanced practice registered nurses (APRNs). The bill would have also provided nurses the authority to sign documents that currently require a physician’s signature. This would have included the ability to prescribe controlled substances.

There is a total of 17 states in the United States that have adopted similar bills allowing nurse practitioners to work independently of physicians as APRNs.

To read the entire article from Modern Healthcare, click here.

Conflicting Opinions of the Bill.

Proponents of expanding nurse practitioner autonomy argue that the bill would reduce health care costs in addition to solving a critical shortage of primary care physicians. Because of the high enrollment numbers associated with the Affordable Care Act (ACA), it is anticipated that the need for physicians and health care providers will dramatically increase. Supporters also argue that northerners will be accustom to treatment by nurse practitioners because states such as Connecticut and New York have passed similar bills. They will expect the same level of care when moving to Florida during the winter months.

Opponents of the bill, led by various medical associations, argue the dangers of allocating such power to nurses. They warn that nurses should not have access to prescribing controlled substances without a doctor’s supervision. This argument is defended by highlighting Florida’s constant struggles with high numbers of pill mill busts. The medical associations opposing the bill are passionate in preserving the practice of medicine for the physician. In the end, opponents were granted their wish.

To read more on House Bill 7113, click here for a previous blog.

Even though the bill did not pass this legislative session, we expect this will not be the end of the fight to allow nurse practitioners to work independently of physicians.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent registered nurses, nurse practitioners, advanced practice registered nurses, certified registered nurse anesthetists, midwives and licensed practical nurses in Department of Health (DOH) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

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

Comments?

Is providing a trained nurse practitioner with greater authority to treat and prescribe really a controversial subject? How do you stand on the topic? What benefits or dangers could arise from providing nurses with greater independence? Please leave any thoughtful comments below.

Sources:

“Health Bill Dies in Florida Legislature.” Modern Healthcare. (May 3, 2014). From: http://www.modernhealthcare.com/article/20140503/INFO/305039930

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

The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2014 The Health Law Firm. All rights reserved.

 

 

 

 

Nurses: Don’t Work at an Illegal Health Care Clinic

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

Despite the passage of Florida’s Health Care Clinic Act over nine years ago, there are still many health practices which are violating it. Unfortunately, the violation of the Health Care Clinic Act can have serious repercussions, including conviction of a felony, loss of all fees collected, and disciplinary/licensure action against any nurses or other licensed health professionals working there.

Over the past three years we have seen the following scenarios or ones similar to these (changed factually to ensure anonymity):

Scenario 1: A health care practitioner licensed in Florida decides to sell her practice and retire. Three non-licensed business people decide to form a corporation to purchase and operate the practice. The corporation purchases the medical practice’s assets, including patient records. The corporation has not applied for or received a health care clinic license.

Results: On the day of closing or the day the practice is transferred to the new corporation, the corporation is operating illegally, in violation of Florida law. Each day of operation is a separate felony.

Scenario 2: A health care professional practices medicine through a limited liability company (LLC) which the he owns with his non-licensed wife. The health care professional dies and his wife remains sole owner of the practice, hiring a locum tenens physician to come in and treat patients.

Results: As of the date of death of the health care professional, the practice is operating illegally, in violation of Florida law. Each day of operations is a separate felony offense.

Scenario 3: A health care professional licensed in Florida operates a medical practice as a sole proprietorship. The health care professional desires to reward her practice manager, a non-licensed business person, by making him a partner in her practice. The practice continues to operate as before without a health care clinic license.

Results: The practice is operating illegally as of the day the practice manager is made a partner.

Scenario 4: A health care professional has a medical practice which he owns and operates through a business corporation which does not need or have a health care clinic license. He decides to relocate to another state. He sells the shares of stock to a medical doctor who is licensed in Georgia, but is not licensed in Florida. The new physician owner hires a medical doctor licensed in Florida to deliver all medical services in the Florida practice.

Results: The corporation, its owner, and the physician employee are operating illegally as of the date the shares in the corporation are transferred. Each day of operation constitutes a new offense.

The consequences of such actions are severe. The act provides that violating it constitutes a felony of the third degree for each day of operation. Any licensed health professional having knowledge of the unlicensed status of the practice or clinic and who does not immediately report it can be disciplined by his or her professional board. Any fees of any kind collected from any source, Medicare, Medicaid, insurers, or cash from patients, are considered illegal as a matter of law and are subject to recoupment or refund.

If you are a nurse or other licensed health professional, be sure you know who the actual owners of the medical practice are. If any are not licensed in Florida, inquire as to the existence of a current, valid health care clinic license from the Agency for Health Care Administration. If any doubt or suspicion, consult with an experienced health care attorney.

Don’t Wait Too Late;  Consult with an Experienced Health Law Attorney At the Onset of Any Issue

Do not wait until action has been taken against you to consult with an experienced attorney in these matters. It is much easier to win your case when there is proper time to prepare.

The attorneys of The Health Law Firm are experienced in representing nurses, nurse practitioners, and CRNAs in investigations, IPN matters and at Board of Nursing hearings.  Call now or visit our website www.TheHealthLawFirm.com.

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

By |2012-05-24T13:17:25+00:00May 15th, 2018|Defense, Nurse License|0 Comments

The 25 Biggest Mistakes Nurses Make After Being Notified of a Department of Health Complaint

By Lance Leider, J.D.

The investigation of a complaint which could lead to the revocation of a nurse’s license to practice and the assessment of tens of thousands of dollars in fines, usually starts with a simple letter from the Department of Health (DOH). This is a very serious legal matter, and it should be treated as such by the nurse who receives it. Yet, in many cases, attorneys are consulted by nurses after the entire investigation is over, and they have attempted to represent themselves throughout the case. Often, the mistakes that have been made severely compromise an attorney’s ability to achieve a favorable result for the nurse.

These are the 25 biggest mistakes we see in the nursing cases we are called upon to defend after a DOH investigation has been initiated:

1. Failing to keep a current, valid address on file with the DOH (as required by law), which may seriously delay the receipt of the Uniform Complaint (notice of investigation), letters, and other important correspondence related to the investigation.

2. Contacting the DOH investigator and providing him/her an oral statement or oral interview. (Note: There is no legal requirement to do this.)

3. Making a written statement in response to the “invitation” extended by the DOH investigator to do so. (Note: There is no legal requirement to do this.)

4. Failing to carefully review the complaint to make sure it has been sent to the correct nurse. (Note: Check name and license number).

5. Failing to ascertain whether or not the investigation is on the “Fast Track” which may then result in an emergency suspension order (ESO) suspending the nurse’s license until all proceedings are concluded. (Note: This will usually be the case if there are allegations regarding drug abuse, alcohol abuse, sexual contact with a patient, mental health issues, or failure to comply with PRN instructions.)

6. Providing a copy of the nurse’s curriculum vitae (CV) or resume to the investigator because the investigator requested them to do so. (Note: There is no legal requirement to do this.)

7. Believing that if they “just explain it,” the investigation will be closed and the case dropped.

8. Failing to submit a timely objection to a DOH subpoena when there are valid grounds to do so.

9. Failing to forward a complete copy of the patient medical record when subpoenaed by the DOH investigator as part of the investigation, when no objection is going to be filed.

10. Delegating the task of providing a complete copy of the patient medical record to office staff, resulting in an incomplete or partial copy being provided.

11. Failing to keep an exact copy of any medical records, documents, letters or statements provided to the investigator.

12. Believing that the investigator has knowledge or experience in hospital procedures, medical procedures or the health care matters or procedures being investigated.

13. Believing that the investigator is merely attempting to ascertain the truth of the matter and this will result in the matter being dismissed.

14. Failing to check to see if their medical malpractice insurance carrier will pay the legal fees to defend them in this investigation.

15. Talking to DOH investigators, staff or attorneys, in the mistaken belief that they are capable of doing so without providing information that can and will be used against them.

16. Believing that because they haven’t heard anything for six months or more the matter has “gone away.” The matter does not ever just go away.

17. Failing to submit a written request to the investigator at the beginning of the investigation for a copy of the complete investigation report and file and then following up with additional requests until it is received.

18. Failing to wisely use the time while the investigation is proceeding to interview witnesses, obtain witness statements, conduct research, obtain experts, and perform other tasks that may assist defending the case.

19. Failing to exercise the right of submitting documents, statements, and expert opinions to rebut the findings made in the investigation report before the case is submitted to the Probable Cause Panel of your licensing board for a decision.

20. Taking legal advice from their colleagues regarding what they should do (or not do) in defending themselves in the investigation.

21. Retaining “consultants” or other non-lawyer personnel to represent them.

22. Believing that the case is indefensible so there is no reason to even try to have it dismissed by the Probable Cause Panel.

23. Attempting to defend themselves.

24. Believing that because they know someone with the Department of Health or a state legislator, that influence can be exerted to have the case dismissed.

25. Failing to immediately retain the services of a health care attorney who is experienced in such matters to represent them, to communicate with the DOH investigator for them, and to prepare and submit materials to the Probable Cause Panel.

Bonus Point: 26. Communicating with the Department of Health about the pending case.

Not every case will require submission of materials to the Probable Cause Panel after the investigation is received and reviewed. There will be a few where the allegations made are not “legally sufficient” and do not constitute an offense for which the nurse may be disciplined.

In other cases, an experienced health care attorney may be successful in obtaining a commitment from the DOH attorney to recommend a dismissal to the Probable Cause Panel. In other cases (usually the most serious ones), for tactical reasons, the experienced health care attorney may recommend that you waive your right to have the case submitted to the Probable Cause Panel and that you proceed directly to an administrative hearing. The key to a successful outcome in all of these cases is to obtain the assistance of a health care lawyer who is experienced in appearing before the Board of Medicine in such cases and does so on a regular basis.

Contact Health Law Attorneys Experienced with Department of Health Investigations of Nurses.  

The attorneys of The Health Law Firm provide legal representation to nurses and nurse practitioners in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations and other types of investigations of health professionals and providers.   To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: Lance O. Leider, J.D. is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

OIG Alert Warns of Improper Conduct Involving Home Health Agencies and Physicians

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

On June 22, 2016, the United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) published a fraud alert regarding improper arrangements and conduct involving home health agencies (HHAs) and physicians. The alert comes as a result of recent investigations and studies, where it has been found that home health fraud in Medicare continues to warrant scrutiny and attention from the OIG, its law enforcement partners, and the Centers for Medicare & Medicaid Services (CMS).

According to the alert, in the past year, home health agencies, individual physicians, and home-visiting physician companies have faced criminal conviction and civil settlements for defrauding Medicare because they have:

1) made or accepted payments for patient referrals;
2) falsely certified patients as homebound; or
3) billed for medically unnecessary services or for services that were
not rendered.

Payments in Return for Referrals of Beneficiaries.

Home health agencies were alleged to have violated the Federal anti-kickback statute (AKS) by directly or indirectly paying physicians in return for referrals of Medicare beneficiaries to home health agencies.

In turn, physicians were alleged to have violated the AKS because they directly or indirectly, either solicited or received payments from home health agencies in exchange for referring Medicare beneficiaries to those home health agencies.

These payments, between home health agencies and physicians, were sometimes disguised as compensation agreements for services provided. For example, a Medical Director agreement, which purportedly based compensation of a physician for services rendered as Medical Director of a home health agency, would act as a front of validity. According to the OIG, these agreements were actually mere guises for illegal payments for referrals of Medicare beneficiaries.

A Valid Compensation Agreement.

A valid compensation agreement for services, between home health agencies and physicians, must comprise of arrangements and payments that are commercially reasonable and at fair market value.

According to the OIG, payments that are made or received to induce referrals, raise the following concerns:

1) corruption of medical judgement;
2) patient steering;
3) overutilization;
4) unfair competition; and
5) increased costs to Federal health care programs.

Other Federal Law Violations.

According to the alert, the government also alleged that home health agencies, individual physicians, and home-visiting physician companies violated other federal laws such as the health care fraud statute and the statute that prohibits false statements relating to health care matters.

Conclusion.

Entities or individuals that are engaged in fraudulent activities involving federal health care programs, such as Medicare and Medicaid, are potentially subject to criminal, civil, and administrative sanctions.

Home health agencies and physicians should rely on experienced legal counsel for guidance in proper compensation agreements to ensure compliance with federal laws.

Comments?

What do you think of the OIG’s alert? Leave your comments below.

Contact an Experienced Health Care Attorney.

The attorneys of The Health Law Firm represent health care providers 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.

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

Source:

“Alert: Improper Arrangements and Conduct Involving Home Health Agencies and Physicians.” U.S. Department of Health and Human Services: Office of Inspector General, 2016.

About the Authors: Michelle L. Bedoya, J.D., is an attorney with The Health Law Firm and a long-time consultant to home health agencies. 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 Avenue, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Home health agency (HHA) lawyer, Florida health fraud defense attorney, health law defense lawyer, health professional attorney, nursing board defense attorney, home health agency defense lawyer, Medicare fraud defense attorney, Office of the Inspector General (OIG) investigation defense lawyer, OIG exclusion attorney, Medicaid fraud defense attorney, Medicare Fraud Strike Force attorney, home health agency (HHA) defense attorney, Zone Program Integrity Contractor (ZPIC) audit defense attorney lawyer, review of The Health Law Firm attorneys, The Health Law Firm, The Health Law Firm reviews, Nursing Service Organization (NSO) insurance defense attorney lawyer, Healthcare Providers Service Organization (HPSO) insurance defense attorney lawyer, Recovery Audit Contractor (RAC) audit defense attorney lawyer, Florida health attorney, Medicare fraud defense lawyer, Health care fraud statute, Medical Director agreements

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2016 The Health Law Firm. All rights reserved.

By |2016-09-19T07:51:37+00:00May 15th, 2018|Nursing Law Blog|0 Comments

Florida’s Baker Act: What You Need to Know – Part 2

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

Our firm is frequently retained to act to obtain the release of individuals erroneously confined and held involuntarily under the Baker Act. We hope to share some of the lessons we have learned in representing such individuals and obtaining their release.

This is Part 2 of our blog on Florida’s Baker Act. To read Part 1 of this blog, click here.

Selected Examples of Some of Our Prior Cases.

Here are examples of actual cases in which we have been retained to obtain the release of a Baker Act patient. We have changed the facts somewhat to protect the identities of the individuals and the facilities involved.

Case #1: An independent elderly woman who still worked and was completely independent tripped and fell in her apartment, injuring herself. Her roommate took her to the local hospital emergency room to be examined and treated for the physical injury. The emergency room staff had her involuntarily confined in the hospital’s Baker Act unit and would not release her. She was not a danger to herself or to others. She was completely independent and held a good paying job. Her roommate drove her around and to medical appointments. She had never been diagnosed with a mental illness before and had never been Baker Acted before. Because of the Baker Act confinement, she missed several of her regular medical appointments which she had scheduled.

Case #2: The president of a medium-sized manufacturing company in another state came to Florida for a business conference at which his company had a display. On the last night of the conference, he partied late, drank too much and a friend took him to a hospital emergency room. He had a plane ticket to leave the next day. The hospital emergency room staff diagnosed him with depression and had him involuntarily confined under the Baker Act. He missed his flight home, and one of his company officials had to come to Florida to try to get him released.

Case #3: The fairly new wife of a businessman who worked a lot and who already had two small children, delivered twins. About six months later, the nanny quit at during the same week that they were supposed to move to a new home. The wife went to her OB/GYN for her routine follow-up visit. She was tired and run down from the loss of her nanny, getting ready to move, taking care of all of the small children, etc. Questioning by her OB/GYN indicated that she may have been depressed. The OB/GYN had his two nurses from his office walk her over to the hospital emergency room (which was next door) to be Baker Acted. Her husband and kids were then at home without a nanny and without mom. Mom was angry and upset because she was not suicidal, felt that she had been betrayed by her doctor and was not a threat to herself, her children or anyone else. She felt she was a prisoner, confined without any rights.

Case #4: A 14-year-old girl in high school broke up with her best friend around Christmas time. She was somewhat depressed and wrote down her thoughts about “ending it all.” Several months later, at the end of the school semester someone found the anonymous note (it had been inside her textbook) and turned it into the teacher. The teacher and principal are eventually able to identify the handwriting and confront the teenager. She admitted that it was her note but denied any suicidal thoughts. The principal called the sheriff’s department and sheriff’s deputies came and took her away to a Baker Act facility over her parents’ protests. She was then involuntarily confined there.

Case #5: A happily married mother of three young adults (who were in college and lived with their mother and father) had a long history of depression for which she saw her own psychiatrist on a regular basis (for more than ten years) and received prescription medication to control it. Her psychiatrist routinely adjusted her medications as needed. Her psychiatrist had recently adjusted her medication, but then was out of town on vacation for two weeks. She had a reaction to the medication adjustment. She telephoned her psychiatrist’s office and was instructed to go to the nearest hospital emergency room to have her medications adjusted. She did this. Instead of getting her medications adjusted, she was involuntarily confined in the hospital’s behavioral health unit under the Baker Act, Her husband (a professional) and her children, who live with her and depend on her, are distraught and could not convince the hospital or its medical staff to release her.

The cases above are all based on actual cases in which we were retained by the individual or the family. We were able to obtain the individual’s prompt release from the Baker Act facility.

Serious Problems We See Over and Over Again.

– The staff and treating physician constantly pressure the patient to convert their involuntary confinement (which may be expiring shortly, or there may be no grounds to renew it) to a voluntary admission. If this occurs, then they can keep the person as long as they desire. However, they threaten that if the patient attempts to leave, even though the patient is now there voluntarily, then they will have the patient involuntarily confined under the Baker Act.

– The patient is angry and upset at being imprisoned when he or she came to the hospital voluntarily for help. As a result, he or she rants and raves and threatens the doctors and staff with litigation or refuses to talk to them. This may serve to reinforce the doctor and staff’s concerns that the patient is mentally ill or irrational.

– Some of our clients have expressed concerns that because they have excellent health insurance, Medicare, Medicaid, or TRICARE coverage (all of which cover hospitalizations), that they are being held involuntarily against their will when they should not be, while indigents who really have serious mental health issues are discharged immediately. They express concerns that they are being held involuntarily solely because the hospital and physician are getting paid to keep them.

– Individuals who have medical problems, but are successfully living independently and obtaining regular medical treatment for their ailments, may not receive the appropriate type of medical care they need when they are being confined in a psychiatric facility. Their prescription medications are at home, and they are not able to take their prescribed medications. Their regular treating physicians are not called or consulted. Their continuity of care is interrupted by the confinement.

– The regular treating physicians of those confined may not visit or see them while they are confined in a different hospital from the one(s) in which the treating physician has approved clinical privileges.

We Work to Get Victims Out Quickly.

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 a victim, 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 the victim 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.

Contact Health Law Attorneys Experienced in Handling Victims of Involuntary Confinement Through the Baker Act 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 quickly. We act immediately to begin our representation, to make the hospital and its physicians aware that we are representing the victim, 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 the victim brought before the judge for an emergency release hearing. These cases can be time intensive, require a great deal of immediate work, but can yield fast results in most cases.

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

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

KeyWords: Legal representation for Baker Act cases, Baker Act defense attorney, legal representation for involuntary Baker Act confinement, legal representation for involuntary confinement in hospital, legal representation for confinement in Baker Act facility, legal representation for mental health confinement, petition for Writ of Habeas Corpus, Baker Act attorney, Baker Act defense lawyer, Florida Baker Act defense attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, 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 © 2017 The Health Law Firm. All rights reserved.

By |2017-07-27T07:48:46+00:00May 15th, 2018|Nursing Law Blog|0 Comments

How Disciplinary Actions are Initiated Against a Florida Nurse

There are many possible grounds for which disciplinary action may be initiated against a nurse in Florida.  It is important to be familiar with these so that you can avoid them.

You should review and be very familiar with all of the Florida laws and the Florida Board of Nursing’s Rules that appear in the Florida Administrative Code (F.A.C.).  These may all be accesses through the Florida Board of Nursing’s website:  www.doh.state.fl.us/mqa/nursing/.  Look for the menu item “Laws and Rules” and click on this.

The laws which set forth various grounds for discipline include:

Chapter 456, Florida Statutes (which applies to all licensed health professionals).

Chapter 464, Florida Statutes (the Nurse Practice Act).

Chapter 64B9, Florida Administrative Code (Rules adopted by the Board of Nursing).

Basically, a nurse may be disciplined for any violation of the Nurse Practice Act, for any violation of Chapter 456, Florida Statutes, for violation of any Rule of the Board of Nursing (Chapter 64B9, F.A.C.), for violation of any law applicable to nurses or nursing, or for violation of any final order of the Board of Nursing or Department of Health.  The most ambiguous of these tends to be actions of the nurse which fail to meet “minimal standards of acceptable and prevailing nursing practice” (sometimes called “falling below the standard of nursing practice” or “substandard performance”), as stated in Section 464.018, Florida Statutes.

Acts that Result in Disciplinary Action Against a Nursing License

Disciplinary action may be taken against the nurse’s license, through administrative proceedings, under the following circumstances, as provided by Section 464.018, Florida Statutes:

1. Procuring, attempting to procure, or renewing a license to practice nursing by bribery, by knowing misrepresentations, or through an error of the department or the board;

2. Having a license to practice nursing revoked, suspended, or otherwise acted against, including the denial of licensure, by the licensing authority of another state, territory, or country;

3. Being convicted or found guilty of, or entering a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiction which directly relates to the practice of nursing or to the ability to practice nursing;

4. Being found guilty, regardless of adjudication, of any of the following offenses:

  • A forcible felony as defined in Chapter 776, Florida Statutes;
  • A violation of Chapter 812, Florida Statutes, relating to theft, robbery, and related crimes;
  • A violation of Chapter 817, relating to fraudulent practices;
  • A violation of Chapter 800, relating to lewdness and indecent exposure;
  • A violation of Chapter 784, Florida Statutes, relating to assault, battery, and culpable negligence;
  • A violation of Chapter 827, Florida Statutes, relating to child abuse;
  • A violation of Chapter 415, Florida Statutes, relating to protection from abuse, neglect, and exploitation; and
  • A violation of Chapter 39, Florida Statutes, relating to child abuse, abandonment, and neglect.

5. Having been found guilty of, regardless of adjudication, or entered a plea of nolo contendere or guilty to, any offense prohibited under Section 435.03, Florida Statutes, or under any similar statute of another jurisdiction; or having committed an act which constitutes domestic violence as defined in Section 741.28, Florida Statutes;

6. Making or filing a false report or record, which the licensee knows to be false, intentionally or negligently failing to file a report or record required by state or federal law, willfully impeding or obstructing such filing or inducing another person to do so. Such reports or records shall include only those which are signed in the nurse’s capacity as a licensed nurse;

7. False, misleading, or deceptive advertising;

8. Unprofessional conduct, as defined by board rule;

9. Engaging or attempting to engage in the possession, sale, or distribution of controlled substances as set forth in chapter 893, for any other than legitimate purposes authorized by this part;

10. Being unable to practice nursing with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, or chemicals or any other type of material or as a result of any mental or physical condition;

11. Failing to report to the department any person who the licensee knows is in violation of this part or of the rules of the department or the board; however, if the licensee verifies that such person is actively participating in a board-approved program for the treatment of a physical or mental condition, the licensee is required to report such person only to an impaired professionals consultant;

12. Knowingly violating any provision of this part, a rule of the board or the department, or a lawful order of the board or department previously entered in a disciplinary proceeding or failing to comply with a lawfully issued subpoena of the department;

13. Failing to report to the department any licensee under Chapter 458 or under Chapter 459, Florida Statutes, who the nurse knows has violated the grounds for disciplinary action set out in the law under which that person is licensed and who provides health care services in a facility licensed under Chapter 395, Florida Statutes, or a health maintenance organization certificated under part I of Chapter 641, Florida Statutes, in which the nurse also provides services;

14. Failing to meet minimal standards of acceptable and prevailing nursing practice, including engaging in acts for which the licensee is not qualified by training or experience; and

15. Violating any provision of this Chapter or Chapter 456, Florida Statutes, or any rules adopted pursuant thereto.

Section 456.072, Florida Statutes, which applies to nurses and all other licensed health professionals, also provides a list of grounds for disciplinary action against a nurse’s license. This information can be found here.

Contact an Experienced Health Attorney Familiar with Nursing Law Issues

The attorneys of The Health Law Firm have experience in representing nurses in both formal and informal administrative hearings and in representing nurses, nurse practitioners, and CRNAs in investigations and at Board of Nursing hearings.  Call us now at (407) 331-6620 or (850) 439-1001 or visit our website www.TheHealthLawFirm.com.

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

By |2012-05-11T14:43:27+00:00May 15th, 2018|Nursing Law Blog|0 Comments

Nursing Home Chain Reaches Record High False Claims Act Settlement With DOJ

indest1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On October 24, 2016, the U.S. Department of Justice (DOJ) announced that Life Care Centers of America will be paying $145 million to end False Claims Act (FCA) litigation that alleged the company submitted false claims to Medicare for rehabilitation therapy services that were not necessary.  This settlement is a FCA record for the nursing industry and DOJ claims it is the largest in the Department’s history.

Who Blew The Whistle?

Tammie Taylor and Glenda Martin, the two whistle blowers and former employees of Life Care, will be splitting the $29 million cut of the payout that they receive as the persons who blew the whistle and filed the initial law suit.  The deal marks the end of two whistle blower cases and a wrongful enrichment suit brought by the DOJ against Forrest L. Preston. Preston is the owner of the Tennessee-based Life Care Center that has over 200 skilled nursing facilities.

$29 million may not be very much money to you, but it is to me.  The False Claims Act and the monetary rewards it authorizes to those who come forward and report fraudulent activities, has now become the primary tool the government has to help stamp out fraud in government programs, in my opinion.

Unnecessary Treatment Alleged.

The government joined the FCA case filed by the whistle blowers in 2012, suspecting that the company was performing excessive treatment of senior patients in order to maximize their Medicare reimbursement.  The company was accused of excessive and unreasonable treatment between January 1, 2006, and February 28, 2013, so that they would qualify for the “Ultra High” reimbursement level Medicare pays.  U.S. Attorney Nancy Stallard Harr stated on Monday that the company’s actions “exploits our most vulnerable citizens.”

According to reports, Preston announced made a statement in connection with the settlement that denied that Life Care engaged in any illegal or improper conduct but was pleased to put the matter behind it.

Big Rewards for Whistle Blowers.

This cause helps show the big monetary rewards that employees and former employees of health care businesses can obtain by coming forward and reporting it when their employer is engaged in submitting false claims to the government.  If managers and supervisors condone or turn a blind eye toward its employees submitting false claims, then this is the same as knowingly committing such violations.  The business is profiting from the false claims.

What is usually missing when an employee or former employee tries to file a whistle blowers law suit is documentation of the companies submission of claims taht are actually false.  Therefore, before an employee or former employee files such a suit, he or she must have copies of the claims that were actually submitted (such as CMS forms 1500, superbills, explanation of benefits (EOBs), etc.) and other documentation.  Without such documentation that shows that false claims were actually submitted for payment, many FCA whistle blower suits are dismissed.

Also, any claims that are paid by state or federally funded healthcare programs can be the subject of such an action.  Most states have a state false claims act that is based on the federal law.  Usually this applies to the state Medicaid program,, but it can also apply to state provided employer health clinics that some cities, counties and agencies provide or to other state funded activities.  Federally funded health care programs that can result in FCA suits include not just Medicare, but also TRICARE, Veterans Administration (VA) funding, Public Health Service (PHS) funding, Indian Health Service (IHS) funding and other government health care programs.  When in doubt, call your friendly whistle blower attorney.

Contact Health Law Attorneys Experienced with Qui Tam, Whistleblower and False Claims Act Cases.

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

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

Sources:
Overly, Jeff. “Nursing Home Chain Inks Record $145M FCA Deal With DOJ.” Law360.(October 24, 2016).Web.

“Life Care Centers of America Inc. Agrees to Pay $145 Million to Resolve False Claims Act Allegations Relating to the Provision of Medically Unnecessary Rehabilitation Therapy Services.” Department of Justice. (October 24, 2016). 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 the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords:  Whistle blower defense attorney, False Claims Act lawyer, qui tam legal counsel, reviews for the Health Law Firm, skilled nursing facility (SNF) attorney, Health Law Firm reviews, health law, health law firm, The Health Law Firm, False Claims Act whistle blower’s plaintiff attorney, False Claims Act relator’s lawyer, U.S. Department of Justice defense attorney, False Claims Act litigation attorney, False Claims Act defense attorney, consumer reports of Medicare or Medicaid fraud, whistle blower defense attorney, home health care defense attorney, nursing home lawyer, legal representation for home health agencies, attorney for home health agency, legal representation for False Claims Act of whistle blowers, attorneys for VA physicians, Tricare false claims act legal counsel, skilled nursing facility (SNF) defense lawyer, Tricare whistle blower case attorney, nurse reports false claims, defense attorneys on whistle blower, nursing law attorney, nurse attorney, lawyers for nurses

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

By |2016-10-26T15:47:35+00:00May 15th, 2018|Nursing Law Blog|1 Comment

Whistleblower Case Against Tennessee-Based Nursing Care Company

IMG_5281 fixedBy Danielle M. Murray, J.D.

The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) is investigating a Tennessee-based nursing care company. The company runs more than 200 skilled nursing homes (SNFs), assisted living facilities (ALFs), retirement living communities, home care services, and Alzheimer’s centers across the country. The nursing care company is accused of defrauding Medicare of millions of dollars for unnecessary and expensive therapy treatments from 2006 to 2011, according to the Wall Street Journal.

Click here to read the entire article from the Wall Street Journal.

Nursing Care Company Allegedly Overbilled Medicare and Tricare.

According to the federal complaint, the nursing care company is accused of encouraging its employed therapists to perform unnecessary and expensive therapy treatments that were billed to Medicare. The document mentioned specific cases of patients who allegedly didn’t need therapy or could have been harmed by it, but received it anyway.

In addition to Medicare, Tricare was also allegedly billed for high-priced nursing care performed at facilities that are affiliated with the nursing care company.

Letter on Company’s Website Defends Billing Methods.

Representatives from the nursing care company posted an open letter on its website. It calls the lawsuit an attempt by the federal government to target companies that provide rehabilitation therapy services. It also denies the allegations of fraudulent billing.

Click here to read the entire letter.


Whistleblowers Cry Foul.

Two former employees filed separate cases against the nursing care company, according to a Times Free Press article. In 2008, a former staff development coordinator working in Tennessee filed a complaint alleging Medicare fraud. In the same year, a former occupational therapist who had worked for the company in Florida, made similar complaints. The government decided to combine their lawsuits and is currently investigating. Be sure to check this blog in the future for updates to this story.

To read the Times Free Press article, click here.

More Medicare and Medicaid Audits May Be Coming to Health Professionals.

The Health Law Firm’s President and Managing Partner George F. Indest III wrote a two-part blog on the increased number of Medicare and Medicaid audits being initiated against health professionals who treat assisted living facility (ALF) and SNF residents. Most often these are audits by the Medicare Administrative Contractor (MAC), because this area of medical practice has been identified as one fraught with fraud and abuse. To learn more on the areas being targeted and how to respond to different types of audits, click here for the first blog and here for the second.

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

In addition to our other experience in Medicare, Medicaid and Tricare cases, attorneys with The Health Law Firm also represent health care professionals and health facilities in qui tam or whistleblower cases. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters.

To learn more on our experience with Medicaid and Medicare quit tam or whistleblower cases, visit our website. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Do nursing care companies need stricter oversight? Have you noticed an increase in Medicare or Medicaid audits in your practice area? Please leave any thoughtful comments below.

Sources:

Burton, Thomas. “Medicare Fraud is Charged.” Wall Street Journal. (December 3, 2012). From: http://online.wsj.com/article/SB10001424127887323717004578157640024945594.html?mod=googlenews_wsj

Harrison, Kate and South, Todd. “Probe Reveals Claims of Unnecessary Therapies at Cleveland-based Life Care Centers.” Times Free Press. (December 16, 2012). From: http://www.timesfreepress.com/news/2012/dec/16/dying-patients-unneeded-therapy-life-care-center/?print

Life Care Centers of America. “Open Letter to Life Care Associates and Medical Professionals.” Life Care Centers of America. (November 30, 2012). From: http://lcca.com/openletter/

About the Author: Danielle M. Murray is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999. Copyright © 1996-2012 The Health Law Firm. All rights reserved.

By |2013-01-03T16:02:27+00:00May 15th, 2018|ALFs, Medicare Fraud|0 Comments
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