Nursing Law Blog | The Health Law Firm Blog

Texas Hospital’s Vaccination Mandate For COVID-19 Upheld by Federal Court

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

As some states lift COVID-19 restrictions, the business community is still grappling with the dynamic between the COVID-19 vaccine and workplace operations. To address this, some U.S. employers have elected to adopt mandatory vaccination policies. These policies, in essence, require that, subject to a few exceptions, all employees must receive the COVID-19 vaccine as a condition of continued employment.

Not surprisingly, we see various legal challenges to mandatory COVID-19 vaccination policies across the country. On June 12, 2021, a federal court in Texas became the first to rule on the permissibility of such policies enforced by private employers. In a landmark ruling, the court stated that mandatory workplace vaccination policies are lawful under Texas and federal law and may be enforced as a condition of continued employment.

The Court’s Ruling on Mandatory Vaccination Policies.

The lawsuit, Bridges v. Houston Methodist Hospital, was initially filed on behalf of 117 employees after their employer, Houston Methodist Hospital, instituted a policy requiring employees to receive a COVID-19 vaccine as a condition of continued employment. Employees who were not vaccinated by the deadline were to be placed on a two-week unpaid suspension to allow them to comply with the policy. Under the policy, those who ultimately did not comply would be terminated.

In the law suit challenging the employer’s policy, the Plaintiffs asserted: (1) the employees whose employment was terminated as a result of this policy were wrongfully terminated in violation of Texas law, and (2) the vaccine mandate violated public policy of the state of Texas.

Texas Wrongful Termination Claim.

Under Texas law, the court found that firing an employee who is unwilling to comply with an employer’s mandatory COVID-19 vaccine policy does not constitute wrongful termination. Texas law only protects employees who are fired for refusing to commit an illegal act at the request of their employer. The court reasoned that receiving the vaccine is not an illegal act given the U.S. Supreme Court’s rulings upholding involuntary quarantines and mandatory vaccines.

Violation of Public Policy.

The court dismissed the plaintiffs’ public policy arguments because, according to the court, Texas law does not recognize a public policy exception to the at-will employment doctrine. Additionally, the court noted that a mandatory vaccine requirement is consistent with public policy. The Supreme Court has previously held that state-imposed quarantine and vaccination requirements do not violate due process of law.

The court held that the plaintiffs were not being coerced to get the vaccine but were being given a basic choice by its employer: get the vaccine so the hospital could safely continue its business of saving lives or seek employment elsewhere.

Lastly, the court also cited recent Equal Employment Opportunity Commission (EEOC) guidance in its decision. The guidance states that employers can require employees to be vaccinated, subject to the obligation to provide reasonable accommodations to employees with legitimate medical or religious reasons for not being vaccinated. Click here to view.

To view the court’s order in full, click here.

Important Takeaway From This Court Decision.

While there are sure to be future legal challenges to mandatory workplace vaccination policies, this decision provides strong support for their use and permissibility. However, even with this ruling, employers with policies need to be mindful of their obligations and potentially provide reasonable accommodations to employees with disabilities or sincerely held religious beliefs that prevent them from receiving the COVID-19 vaccine. Of course, we will see numerous legal challenges of all kinds to these decisions.

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

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations. We do NOT represent plaintiffs in COVID-19 injury suits, however.

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

Sources:

Downie, Alex. “Federal Court Upholds Employer’s COVID-19 Vaccine Mandate.” The National Law Review. (June 15, 2021). Web.

Brown, Amanda, Goldstein, Mark. “In first-of-its-kind decision, federal court rules that mandatory workplace COVID-19 vaccine policies are lawful.” Employment Law Watch. (June 16, 2021). Web.

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

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

Phony Florida Nursing Diploma Scam: Federal Criminal Indictments in “Operation Nightingale”

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

In January 2023, the U.S. Department of Justice (DOJ) announced the prosecution of a massive fake nursing diploma scheme against three Florida-based nursing schools. The investigation has now expanded to include at least eight (8) nursing schools.

The investigation has now resulted in charges against 25 people in five states and found evidence that they allegedly worked to “sell” more than 7,600 fake diplomas, along with school transcripts, between 2016 and 2021. Click here to learn more.

The Federal Indictment.

We have obtained a copy of the federal indictment filed against the individual owners, operators, and staff members whom the FBI alleges were committing crimes, including selling diplomas and transcripts. View the federal indictment filed in the investigation to check for any names you recognize by clicking here: https://www.thehealthlawfirm.com/uploads/Nursing%20School%20Indictment.pdf.

Additionally, you can view other helpful press releases and documents on “Operation Nightingale” on our website here.

Concerns We Have About This Investigation.

We have several concerns about this investigation based on the nurses we spoke with. As usual, the events that have resulted in this “scandal” have been going on for as many as eight years. Nothing has been done until recently, and then it is as though a tornado has just hit. We are concerned about what we view as a massive overreaction that is resulting in many babies being thrown out with the bad bath water.

What seems to have been overlooked is that these nursing schools were all accredited by the proper accreditation bodies until this happened. We have clients who contacted the Florida Board of Nursing, which affirmed that the schools were legitimate, accredited schools before our clients enrolled in them and only enrolled after being assured that they were.

In many cases, our clients and others with whom we have spoken attended other accredited nursing schools but then transferred to one of the Florida schools and received credits for their transferred courses. There was and is nothing illegal or wrong about this. We have spoken to many nurses who took all required courses to become nurses, performed their clinical, graduated, received diplomas, took the NCLEX (national nursing) examination, passed, and became licensed nurses. Some of these have been practicing for years. Some have been practicing for only days. Yet now, they are all getting letters telling them they are being investigated for possible fraud. It is devastating to many who worked so hard to become nurses.

Contact Health Law Attorneys Experienced in Investigations Against Nurses and Nursing Students.

The attorneys of The Health Law Firm provide legal representation to nurses, nursing students, and ARNPs in Department of Health (DOH) investigations, nursing board cases, Department of Health investigations, DOJ and FBI investigations, Board of Nursing investigations, formal and informal administrative hearings, emergency suspension orders, emergency restriction orders and other types of investigations of nurses and other health professionals.

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

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

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: PAlexander@TheHealthLawFirm.com or fax them to (407) 331-3030.

“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 © 2023 The Health Law Firm. All rights reserved.

Feds Charge 25 Individuals in Massive Fake Nursing Diploma Scheme in Florida

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

On January 25, 2023, the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) launched a multi-state coordinated law enforcement action to apprehend individuals engaged in a scheme to sell false and fraudulent nursing degree diplomas and transcripts. The enforcement action resulted in the execution of search warrants in Delaware, New York, New Jersey, Texas, and Florida. 25 individuals have been charged in the Southern District of Florida for their alleged participation in a fraud scheme that created an illegal licensing and employment shortcut for aspiring nurses.

The defendants include “owners, operators, and employees” of the schools who “prepared and sold the fake nursing school diplomas and transcripts, knowing that the candidates would use those false documents to sit for nursing board examinations, secure nursing licenses, and ultimately obtain nursing jobs in medical facilities not only in Florida but elsewhere across the country,” officials said. Additional defendants charged include “recruiters” to bring in would-be buyers.

Operation Nightingale.

The scheme sold fake and fraudulent nursing degree diplomas and transcripts obtained from accredited Florida-based nursing schools to aspiring Registered Nurse (RN) and Licensed Practical/Vocational Nurse (LPN/VN) candidates. The nursing schools, Siena College, Palm Beach School of Nursing, and Sacred Heart International Institute, are now closed.

Officials said nursing candidates who allegedly participated in the scheme would pay as much as $15,000 for the fraudulent diplomas.

The individuals who acquired the fraudulent nursing credentials used them to qualify to sit for the national nursing board exam. Upon completing the board exam, the nursing applicants became eligible to obtain licensure in various states to work as an RN or an LPN/VN. Once licensed, the individuals could get employment in the healthcare field. The overall scheme resulted in the distribution of more than 7,600 fake nursing diplomas and transcripts.

Each defendant faces up to 20 years in prison. Learn more about “Operation Nightingale” from the OIG here.

Dangerous Healthcare Licensing and Credentialing Shortcuts.

We expect our healthcare professionals to be who they claim they are. We expect that they’ve had the proper training and credentialing. “Specifically when we talk about a nurse’s education and credentials – shortcut is not a word we want to use,” said U.S. Attorney for the Southern District of Florida Markenzy Lapointe. “When we take an injured son or daughter to a hospital emergency room, we don’t expect that the licensed practical nurse or registered nurse training our child took a shortcut.” The scheme enabled these nursing candidates allegedly buying the fake diplomas “to avoid hundreds, if not thousands, of hours of clinical training countless hours getting that experience,” Lapointe said. “These people didn’t go through that. That part was completely skipped.”

This fraud scheme is a public safety concern and tarnishes the reputation of nurses who complete the demanding clinical work required to obtain their professional licenses and employment. Additionally, it can erode public trust in our healthcare system. The alleged selling and purchasing of nursing diplomas and transcripts to willing but unqualified individuals is a serious crime that can endanger the health and safety of patients.

Click here to view the U.S. Department of Justice press release.

Contact Health Law Attorneys Experienced in Investigations Against Nurses and Nursing Students.

The attorneys of The Health Law Firm provide legal representation to nurses, nursing students, and ARNPs in Department of Health (DOH) investigations, licensure defense representation, investigation representation, Department of Health investigations, DOJ investigations, Board of Nursing investigations, formal and informal administrative hearings, emergency suspension orders, emergency restriction orders and other types of investigations of health professionals and providers.

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

Sources:

Pezenik, Sasha. “Feds announce massive takedown of fraudulent nursing diploma scheme.” ABC News. (January 27, 2023). Web.

D’Angelo, Bob. “Operation Nightingale: 25 charged in fake nursing diploma scheme in Florida.” Cox Media Group. (January 27, 2023). Web.

U.S. Department of Health and Human Services. “2023 Operation Nightingale Enforcement Action.” (January 26, 2023). Web.

“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 © 2023 The Health Law Firm. All rights reserved.

New Jersey Appeals Court Says Plaintiffs Don’t Need Presuit Affidavits to Sue LPNs in Medical Malpractice Cases

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

In a possibly precedent-setting case, on November 9, 2022, for the first time, an appeals court in New Jersey ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit to file claims against a licensed practical nurse (LPNs). The Superior Court of New Jersey, Appellate Division, said that an LPN is not included in the “licensed person” definition under the state’s affidavit of merit statute.

Additionally, the court’s ruling stated that an LPN could not use the absence of such an affidavit to avoid a medical malpractice suit. In this case, the malpractice suit was brought by a widower who says his wife died as a result of bad medical advice given by her LPN.

Allegations Made in the Lawsuit.

The plaintiff claimed that the defendant (an LPN) responded to his complaints about his wife being in pain and unable to eat following her colon surgery by blaming the issue on “post-operative gas.” After allegedly ignoring numerous messages he left regarding her condition, the LPN allegedly told the husband to give his wife, Pepto Bismol. The following day, his wife died, according to the lawsuit.

In July 2020, the plaintiff filed a medical malpractice claim on behalf of himself as the administrator of his wife’s estate. The lawsuit originally named the doctor, Virtua Surgical Group, and an unknown nurse. Following discovery, the plaintiff dismissed the claims against the doctor and Virtua Surgical Group, and proceeded against only the LPN. According to the opinion, the plaintiff alleged that the LPN was negligent in providing medical advice and in failing to consult with her doctor.

You can view the court’s opinion in full here on our website.

Is a Licensed Practical Nurse a “Licensed Person” Covered by the AOM Statute?

In New Jersey professional negligence cases, plaintiffs must file an “affidavit of merit,” or AOM, signed by a licensed medical professional, before they are allowed to sue those [professionals for malpractice. This results from a tort reform package passed by the state government in 1995.

Why there hasn’t been a case similar to this one, or lobbying by LPNs to sew up the legal “loophole” before now, is unclear.

Like many similar state statutes passed around the same time, the New Jersey statute was designed to balance between reducing frivolous lawsuits and permitting injured plaintiffs recovery for meritorious claims. According to the court’s decision, a plaintiff claiming “malpractice or negligence by a licensed person” must file an “affidavit of an appropriate licensed person” who can attest that there is a “reasonable probability” that defendant’s conduct “fell outside acceptable professional or occupational standards or treatment practices.”

The defendant in this case argued that since the nursing portion of the statute defines “the practice of nursing” for “a registered professional nurse,” the Legislature intended for licensed practical nurses to be included. However, the New Jersey appeals court held that the tort reform package would not protect the LPN from the lawsuit because she was a different kind of nurse from a registered nurse.

In his written opinion for the court, New Jersey Superior Court Judge Robert J. Gilson considered whether a licensed practical nurse is a “licensed person” covered under the AOM statute. “The AOM statute expressly uses the term ‘a registered professional nurse.’ Yet, nowhere in that definition of a registered professional nurse is there a reference to a licensed practical nurse,” he added.

Gilson stated in the court’s opinion that the Legislature was aware that it had separately defined the two types of nurses. In other words, if it had wanted to protect LPNs at the same time as it was protecting RNs, it could have done so. Therefore, the plaintiff was allowed to pursue claims without an AOM. However, the plaintiff would still be required to prove the defendant’s negligence to succeed.

Click here to view the opinion in full.

Click here to read one of our related blogs about legal issues LPNs often face.

Who Is a “Professional” and What Is “Malpractice”?

“Malpractice” is usually defined as the negligence of or the breach of a professional duty by a professional. In other words, professional negligence.

How do we determine who is a “professional” then? The simple rule of thumb is that anyone who is required to have a license in order to perform his or her occupation is a professional. Thus, under this definition, we have attorneys, dentists, accountants, architects, engineers, funeral directors, teachers, all are required to have licenses, depending upon what state they are in. Thus there can be accounting malpractice, engineering malpractice, architectural malpractice and, yes, even legal malpractice. Under this definition, a licensed practical nurse would be considered a professional who could commit nursing malpractice.

However, if the wording of law limits coverage to only certain listed professions, and other professions are left out, then only the ones specifically listed will be covered by its application.

Is the Decision Limited or Possibly Widespread?

The decision appears to be a correct one based on the wording of the New Jersey statute. If “licensed practical nurses” was not a category of licensed professionals included by the Legislature in the New Jersey statute, then the courts should not “read them into” coverage by the statute. Unfortunately, this was probably merely an oversight on the part of whatever bill drafter and committee proposed the legislation in the first place. Licensed practical nurses and their professional associations should immediately lobby the Legislature of New Jersey to have the “loophole” filled.

Whether similar results are possible in other states will depend on the wording of the similar laws in those states. For example, Florida has a somewhat similar statute, but it does not actually name the specific category of medical provider covered by the act (e.g., “medical doctor,” “chiropractor”). Instead, the Florida Law, Section 766.202, Florida Statutes, refers to those covered by the medical malpractice statute as “any person licensed under part I of chapter 464, Florida Statutes. . . .[etc.]” Registered nurses, licensed practical nurses and advanced nurse practitioners are all licensed under that part and chapter of the Florida law. So a problem similar to the one in New Jersey never arises.

Contact Health Law Attorneys With Experience Representing Nurses and Handling Licensing Issues.

If you are applying for a nursing or healthcare license, have had a license suspended or revoked, or are facing imminent action against your license, you must contact an experienced healthcare attorney to assist you in defending your career. Remember, your license is your livelihood; it is not recommended that you pursue these matters without the assistance of an attorney. The Health Law Firm routinely represents nurses, physicians, dentists, medical groups, clinics, and other healthcare providers in personal and facility licensing issues.

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

Sources:

Karpan, Andrew. “No Affidavit Needed To Sue ‘Practical’ Nurses, NJ Court Says.” Law360. (November 9, 2022). Web.

Murphy, Colleen. “NJ Appeals Court: No Affidavit of Merit Needed for Negligence Claim Against Licensed Practical Nurse.” Law.com. (November 10, 2022). Web.

“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 © 2023 The Health Law Firm. All rights reserved.

9th Circuit Says Former Federal Nurse Can Proceed With Medical Malpractice Suit Against VA Hospital

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

On September 29, 2021, the U.S. Court of Appeals for the Ninth Circuit ruled that a former federal employee can sue the United States under the Federal Tort Claims Act (FTCA). The suit alleges medical negligence that occurred during psychiatric treatment for a non-workplace-related injury.

As a result, the three-judge panel of the appeals court said that U.S. Navy veteran and VA nurse S.H.s’ lawsuit against a Seattle VA hospital can proceed. (Please note: we are not providing the nurse’s name out of respect for her privacy.)

In 2019, the district court dismissed S.H.’s federal tort lawsuit because the alleged malpractice occurred when doctors were treating an injury she said she sustained at her workplace. The district court reasoned that all existing or exacerbated injuries stemming from a federal workplace injury must be dealt with through the Federal Employees Compensation Act (FECA), even malpractice claims.

Click here to view the district court’s order for the motion to dismiss in full.

Background Details.

The plaintiff in the suit is a veteran of the U.S. Navy who suffered a mental breakdown at work in October 2011. She sought follow-up psychiatric care at a VA hospital, where she allegedly received negligent treatment. At the time the treatment was sought, she was an employee of the federal government. She claimed years of workplace bullying and harassment by her supervisor caused her mental breakdown. She sued in 2016.

The FTCA authorizes plaintiffs to sue the U.S. for “personal injury or death caused by the negligent or wrongful act or omission of any employee of the Government while acting within the scope of his office or employment, under circumstances where the United States, if a private person, would be liable to the claimant in accordance with the law of the place where the act or omission occurred.” 28 U.S.C. § 1346(b)(1). Any individual employee of the government acting within the course and scope of her job duties is immune from liability; the United States is substituted for that person in the suit.

The Big Question: Does the FTCA Authorize Suit by a Plaintiff in This Set of Circumstances?

Two factors complicate the answer in this case. First, when the plaintiff sought treatment, she was an employee of the federal government, working as a registered nurse at the VA hospital. Second, she claimed that her mental breakdown, the event that prompted her to seek medical care, was caused by workplace bullying and harassment at the hands of her supervisor. Hence, this would qualify as a work-related injury.

These facts bring into play another federal statute: the Federal Employees’ Compensation Act. FECA establishes a workers’ compensation blueprint that covers most federal employees. It is similar to state workers’ compensation laws.

When an employee sustains an injury covered by FECA, the remedy is to seek compensation under the act; they may not sue for damages under any other provision of law, including the FTCA. Therefore, had the plaintiff sued the U.S. under the FTCA to recover damages for workplace bullying and harassment, the district court would have been required to dismiss the action as barred by FECA.

In this case, however, the plaintiff is not suing for the injuries caused by workplace bullying and harassment. Instead, she is seeking to recover damages for the alleged medical malpractice by the individual doctors treating her.

Based on these facts, the appellate court reversed the district court’s judgment against the plaintiff in her Federal Tort Claims Act action. It held that the district court erred in dismissing the action on the grounds that it was barred by the FECA.

To view the ninth circuit court’s opinion in full, click here.

Consult a Health Law Attorney Who Is Familiar with Army, Navy, and Air Force Health Care Professionals and Their Problems.

The attorneys of The Health Law Firm have represented federal physicians, nurses, dentists, and other health professionals in the Army, Navy, and Air Force, active duty and retired, as well as physicians, nurses, and other health professionals working for the Veterans Administration (VA) in the U.S. and around the world. They represent physicians and other health professionals with the Indian Health Service (IHS) and the Public Health Service (PHS). Representation has included disciplinary action, investigations, peer review investigations, clinical privileges actions, fair hearings, National Practitioner Data Bank (NPDB) actions, and appeals.

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

Sources:

Capriel, Jonathan. “9th Circ. Revives Psychiatric Med Mal Suit Against VA Hospital.” Law360. (September 29, 2021). Web.

Pazanowski, Mary Ann. “Former Federal Nurse Gets New Shot at Injury Suit Against US.” Bloomberg Law. (September 29, 2021). Web.

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

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

Humana Agrees To Pay $11.2 Million to End Nurses’ Overtime Suit

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

On September 27, 2021, Humana agreed to pay $11.2 million to end claims that the health insurance company denied a group of nurses overtime pay by misclassifying them as exempt employees. A Wisconsin federal judge approved the deal with Humana, and a group of more than 200 nurses reached, securing a $36,000 average payment for each nurse involved in the suit.

A Violation of the Fair Labor Standards Act (FLSA).

This dispute stems from a class-action lawsuit filed in 2017 alleging that Humana misclassified its clinical nurse advisers as exempt employees and denied them overtime compensation, violating the Fair Labor Standards Act. Many professionals and supervisors or managerial employees are considered to be exempt from overtime laws.

In the suit, the company faced allegations from nurses who claimed they were never paid for overtime even though they were required to work more than 40 hours per week to meet Humana’s production goals and expectations.

The Settlement.

The settlement agreement will allocate almost $3 million to cover attorney fees and costs. Additionally, the 221 nurses that are part of the settling class will get nearly $8 million based on the number of full-time weeks the nurses worked. According to the motion, the average payment per nurse for unpaid overtime and liquidated damages will be over $36,000.

The case is O’Leary v. Humana Insurance Co., et al., case number 17-cv-1774, in the U.S. District Court for the Eastern District of Wisconsin. Click here to view the court’s brief in full.

To read about another case dealing with alleged pay discrimination in the healthcare field, click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in Representing Nurses and Other Healthcare Professionals.

The Health Law Firm’s attorneys routinely provide legal representation to nurses, pharmacists, pharmacy technicians, dentists, dental assistants, physicians, physician assistants, mental health counselors, and other health providers. We also provide legal representation for employers in EEOC complaints, workplace discrimination complaints, and suits involving harassment or discrimination complaints. We also provide legal representation in Department of Health, Board of Medicine, Board of Nursing investigations and complaints, DORA investigations and complaints. We provide litigation services in state and federal courts and state and federal administrative hearings. We provide legal representation across the U.S., not just in Colorado, Florida, Louisiana, Virginia, and Washington, D.C.

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

Sources:

Spezzemonte, Irene. “Humana To Pay $11.2M To End Nurses’ Misclassification Suit.” Law360. (September 27, 2021). Web.

Webster, Katherine. “Court OKs $11.2M Overtime Settlement Between Humana, Nurses.” Top Class Actions. (September 30, 2021). Web.

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

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

What You Need to Know Right Now If the DEA is Knocking on Your Door!

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

Is the Drug Enforcement Administration (DEA) knocking at your door or, even worse, going through your files inside your office?

If so, this is what you need to know right now!

YES, you do have the right to call your attorney. Call your attorney right now. If you cannot, ask one of your employees or spouse to call your attorney. Get your attorney involved right now!

NO, do not sign a document to relinquish or voluntarily give up your DEA registration number. If you do so, this will probably be the biggest mistake you make in your life.

NO, do not sign a document waiving your right to a grand jury investigation before the DEA is authorized to charge you. Why would you voluntarily give up one of your most important constitutional rights?

Don’t Get Fooled By What the DEA Agents Tell You.

The DEA has the reputation (and, in my experience, deservedly so) of making false statements to individuals about what will happen to them or not happen to them if they do not “Cooperate” with the DEA by giving up their rights.

Often they will handcuff the pharmacist or the physician who is the subject of their raid, search warrant, or subpoena as a method of intimidating them. Then they will threaten the person by arresting them and jailing them immediately if they do not sign a “voluntary” relinquishment of their DEA registration. Yet once you do this, your DEA registration is gone, and you will most likely never get one again.

We have even had the report from a physician recently where the DEA agents, during executing a search warrant (not an arrest warrant, by the way), of having the doctor sign a document waiving her right to having a grand jury hearing on any charges she may have been facing. The threat was that she needed to waive her rights or be arrested on the spot and taken to jail. She signed without consulting an attorney.

If you are a pharmacist or pain management physician, or you own or operate a pain management practice, or if you prescribe or dispense opioids, you must have the name and phone number of a good health lawyer and a good criminal lawyer on hand and post at all times! It is only a matter of time before you need to use it.

Have this information in your wallet and taped to every telephone and computer in your office. But use it right away. Call your attorney right away. Your attorney will come over or brief you on what to do or not do.

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, call (407) 331-6620 or toll-free (888) 331-6620 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. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620. Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

Centene Agrees to Pay $19 Million to Washington State For Medicaid Fraud Allegations

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

On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, it has been reported that Centene/Sunshine Health reportedly has over $31 billion in contracts with the state of Florida alone. Click here to learn more.

The agreement with Washington State resolves allegations that it overcharged its Medicaid program for pharmacy benefit management services, Washington Attorney General Bob Ferguson announced in a press release.

Under the deal, in addition to the $19 million payment to Washington State, the federal government will receive $13.3 million related to the settlement, according to the Attorney General’s office. In addition, a whistleblower who sued the company on behalf of the state will also receive $1 million. It is the second-largest Medicaid fraud settlement in Washington’s history.

An Investigation and a Whistleblower.

According to the press release, the Washington AG’s office began investigating pharmacy benefit managers in 2019 after a whistleblower said the company failed to disclose actual pharmacy benefits and service costs. Furthermore, Centene allegedly failed to pass on discounts it received to the state Medicaid program, causing inflated fees, according to the release.

Washington sued Centene in July 2022, alleging the company and a subsidiary, Coordinated Care of Washington, violated the state’s Medicaid False Claims Act. Coordinated Care of Washington contracts with Washington’s Health Care Authority to manage its Medicaid program, Apple Health.

Shelling Out Big Bucks For Settlements.

Centene did not admit to any wrongdoing in this case, as is usual with settlement agreements. “This no-fault agreement reflects the significance we place on addressing their concerns and our ongoing commitment to making healthcare delivery local, simple and transparent,” Centene’s spokesperson said.

But, while denying any wrongdoing, it has settled claims over similar alleged conduct in ten other states for more than $260 million. Additionally, it said last year that it was still in negotiations with more states and had set aside $1.25 billion to settle such claims. Click here to learn more.

To view the settlement agreement in full, click here.

Similar Patterns of Misconduct?

We need to ask: “Is this the business model of Centene and its different owned subsidiary companies?” We note that on March 22, 2022, the Centers for Medicare and Medicaid Services (CMS) assessed civil monetary penalties (CMP) against Centene Corporation for similar alleged wrongful activities involving the states of California, South Carolina, Texas, Ohio, Michigan, and others. And in a letter dated March 11, 2022, the Florida Agency for Health Care Administration issued a $9.1 million fine over Centene/Sunshine Health’s improper failure to pay benefits to Florida’s neediest, sick children. We have not found any report that Centene challenged or appealed either government penalty.

When multiple billions of dollars in government contracts are handed out to one contractor, and it is the subject of so many allegedly wrongful acts, one must ask if it is just treating such penalties and fines as the routine costs of doing business. Considering that $9.1 million is less than three (3) hundredths of a percent (.0003) of its $31 billion in contracts with the state of Florida, this cost may not even be significant enough for it to post on its profit ad loss statements.

Contact Health Law Attorneys Experienced with Medicare and Medicaid Audits, Healthcare Audits, and Insurance Payment Disputes.

The attorneys of The Health Law Firm represent counselors, therapists, physicians, healthcare providers and healthcare facilities in defense of Medicare and Medicaid audits, audits by insurance companies and managed care, and demands for repayment of overpayments. They represent healthcare providers in audits, audit appeals and repayment disputes against Centene Corporation and Sunshine Sate Health Plan d/b/a Sunshine Health. They also represent healthcare providers in defense against allegations of false billing, overbilling, False Claims Act violations and civil monetary penalties (CMP).

Our attorneys represent physicians, mental health counselors, behavior therapists, professional counselors, occupational therapists, social workers, medical groups, home health agencies, pharmacies, pharmacists, home nursing care providers, and other healthcare providers and institutions.

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

Sources:

Redmond, Nell. “Centene to pay $33.3 million to settle Washington Medicaid fraud claims.” Reuters. (August 25, 2022). Web.

Elletson, Grace. “Centene Strikes $33M Deal To End Wash. Medicaid Fraud Suit.” Law360. (September 2, 2022). Web.

Health Law Weekly. “Centene Will Pay $19 Million to Resolve Medicaid Fraud Allegations.” AHLA. (September 2, 2022). Web.

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

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in the practice of health law. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: PAlexander@TheHealthLawFirm.com or fax to: (407) 331-3030.

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Nurse Faces Suit for Wrongful Death of Jail Inmate Says 10th Circuit Court of Appeals

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

On March 3, 2021, the U.S. 10th Circuit Court of Appeals reversed in part, a Utah court’s decision on a lawsuit for the death of a 21-year-old inmate, affirming that the jail’s doctor could claim qualified immunity, but not the nurse. After the inmate’s death, her estate sued for depriving her of her civil rights. The U.S. district court granted summary judgment in favor of the county. It ruled that qualified immunity applied to shield jail supervisors and staff. However, it denied qualified immunity to jail nurse Jana Clyde and to a private doctor who consulted with the prison, Dr. Kennon Tubbs.

The 10th Circuit appeal panel reversed the lower court’s decision, stating that one doctor can claim qualified immunity. It ruled that the jail’s nurse must face claims of civil rights violations, which are not subject to immunity. Court filings alleged that jail staff, including its nurse, ignored the inmate’s rapidly deteriorating health.

Failure to Secure Medical Treatment Despite Obvious Risks to the Inmate.

In 2016, Madison Jensen, the inmate, allegedly died from opiate withdrawal at the Duchesne County jail in Utah. After the 21-year old inmate was booked, she was allegedly placed in a cell with another woman and almost immediately began vomiting. Her vomiting allegedly continued for five days. The jail’s nurse failed to tell the physician’s assistant or doctor about Jensen’s condition, according to the complaint.

The jail’s video recording system captured the female inmate rolling off her bed and having a seizure. About 30 minutes later, both the nurse and doctor discovered she had died in her cell, the complaint said. The inmate’s cause of death was reported to be cardiac arrhythmia from dehydration due to opiate withdrawal.

Civil Rights Violation Claims.

After the inmate’s death, her estate sued for deprivation of her civil rights. The United States District Court for the District of Utah granted summary judgment for the county and the jail supervisors and staff, based on their qualified immunity. However, it denied qualified immunity to the jail nurse and the contracted doctor. Jensen’s estate claimed the jail nurse had shown deliberate indifference to the inmate’s serious medical needs, as she failed to secure medical treatment despite obvious signs and risks. In response, the nurse argued that she took reasonable steps to provide care and that she wasn’t aware that the inmate faced serious medical needs.

The circuit court judges held that “the unique circumstances of this case” allow the doctor to raise the defense of his qualified immunity. As for the jail nurse, the court said, “a trier of fact could conclude that she did not just misdiagnose Ms. Jensen, she ‘completely refused to fulfill her duty as gatekeeper.’ The nurse showed “near-complete indifference” toward the inmate that “grossly deviated from the standard of care for treating severe dehydration, especially when the result of a failure to treat is death” according to the court’s opinion.

“We believe that these circumstances — particularly her [the inmate’s] self-report that she had been vomiting for four days and could not keep down water — present a risk of harm that would be obvious to a reasonable person,” the court said. To read more, click here for the court’s opinion in full.

This isn’t the first case of an inmate’s family suing after Improper Care. Click here to read about a similar wrongful death suit of a Florida inmate.

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, nurse practitioners, certified registered nurse anesthetists (CRNAs), dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

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

Sources:

Gill, Lauren. “UTAH JAIL NURSE FACES NEGLIGENT HOMICIDE CHARGE IN DEATH OF 21-YEAR-OLD WOMAN.” The Appeal. (August 1, 2019). Web.

O’Brian, Rachel. “10th Circ. Says Nurse Must Face Wrongful Death Suit.” Law360. (March 13, 2021). 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 Avene, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toff-Free: (888) 331-6620.

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

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Pharmacy Technicians Allowed to Administer Immunizations After New Florida Legislation

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

On July 1, 2022, Florida passed HB 1209, allowing registered pharmacy technicians to administer immunizations to patients. The new law utilizes pharmacy technicians to seek certification to provide immunizations and become “Certified Registered Pharmacy Technicians.” These pharmacy technicians will then be allowed to administer all vaccines listed by the CDC in the Adult Immunization Schedule or recommended by the CDC for international travel. Additionally, it includes vaccines authorized by the FDA under an emergency use authorization or by the Florida Board of Pharmacy in response to a state of emergency declared by the Governor.

This is a big step in medicine, once again broadening the ability of health professionals to provide more efficient and less expensive health care. In the past, properly qualified pharmacists were allowed to administer vaccines, but even then, there was a shortage.

Certification Requirements.

To become certified by the Florida Board of Pharmacy, a registered pharmacy technician must complete six hours of approved immunization-related training. As a renewal condition, an additional two hours of approved continuing education must be completed each cycle, according to the Board of Pharmacy website. For more information, click here.

In comparison, for certification, registered pharmacists must have 20 hours of education to administer vaccines. Registered pharmacist interns (persons with five years of college) who are also under the supervision of a certified pharmacist must take the same 20-hour immunization course that the pharmacists take to become certified to administer immunizations.

While this new Florida law seems to adopt a substantial lessening in training requirements, remember the 20-hour course allows pharmacists to administer vaccines independently. The six-hour course is for pharmacy technicians to administer vaccines under the pharmacist’s supervision. The technician certification program or programs authorized will have to be approved by the Florida Board of Pharmacy in consultation with the Florida Board of Medicine and the Florida Board of Osteopathic Medicine.

Stay Informed and Prepared.

The Board of Pharmacy has the authority to adopt rules to add new vaccines as added by the Centers for Disease Control (CDC) and the Food and Drug Administration (FDA), but it often takes many months to do so. Pharmacies and the pharmacists, pharmacist interns, and pharmacy technicians who are responsible need to monitor these situations closely.

Pharmacies should print a copy of the CDC adult immunization schedule, the CDC’s recommended vaccines for international travel, and the FDA’s list of vaccines with emergency use authorizations and have this readily available for its staff to review. They should also update this list at least once a month. This will help the pharmacy staff keep on top if either of these federal agencies, the CDC or the FDA, changes its list of immunizations. As we’ve seen from the COVID-19 pandemic, keeping track of vaccine schedules and emergency use authorization changes can be very confusing.

Click here to read Florida HB 1209 – Administration of Vaccines, in full.

Consult With A Health Law Attorney Experienced in the Representation of Pharmacists and Pharmacies.

We routinely provide legal representation to pharmacists, pharmacies, and other health professionals who have received complaints against their licenses, notices of investigations, Medicare or Medicaid audits, Drug Enforcement Administration (DEA) audits, investigations, subpoenas, search warrants, and orders to show cause (OSC) or who are facing formal or informal administrative hearings.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians, physician assistants, and other health professionals in investigations and at Board of Pharmacy hearings. Call our office now at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website www.TheHealthLawFirm.com.

Sources:

Dix, Martin. “A Jump Forward For Fla. Pharmacy Technicians’ Vax Authority.” Law360. (August 19, 2022). Web.

Sexton, Christine. “Checking the pulse of Florida health care news and policy.” Florida Politics. (August 16, 2022). Web.

Dix, Martin. “Florida Legislation Authorizing Pharmacy Technicians to Administer Vaccines Contains Some Surprises.” Akerman. (July 28, 2022). Web.

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

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: PAlexander@TheHealthLawFirm.com or fax to: (407) 331-3030.

“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 © 2022 The Health Law Firm. All rights reserved.

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