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DeSantis Yanks Large Number of Appointments Made by Former Governor, Several on Board of Nursing

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

On February 22, 2019, Florida’s new Governor, Rick DeSantis retracted 169 appointments that the former governor made before leaving office. Several of these were appointments that had been made to the Florida Board of Nursing. This is not the first time he has called back last-minute decisions made by his predecessor. In January 2019, he retracted 46 of Scott’s “lame duck appointments.”

The new governor has now pulled a total of 215 of Scott’s prior appointments to various boards and committees.

Here’s a List of the Appointments Made by Scott That Governor DeSantis Pulled for the Professional Boards Under the Department of Health (DOH):

Heather Baumwald, Board of Nursing

Jennifer Raymond, Board of Nursing

Mary Julie Talmadge, Board of Nursing

Steve Moreau, Board of Acupuncture

Angela Sissine, Board of Dentistry

Steven Falcone, Board of Medicine

Andre Perez, Board of Medicine

Merle Preston Stringer, Board of Medicine

Elna Rose Vizvary, Board of Occupational Therapy Practice

Katie Gilbert-Spear, Board of Optometry

John Edmund Griffin, Board of Optometry

David Rouse, Board of Optometry

Paul Weott, Board of Orthotists and Prosthetists

Mark Block, Board of Podiatric Medicine

Soorena Sadri, Board of Podiatric Medicine

In January 2019, Governor DeSantis retracted nearly 46 of Scott’s appointments. The Senate withdrew all of the names from their appointments.

The Retractions Made In January for DOH Boards Included:

Philip Diaz, Board of Chiropractic Medicine

Dr. Emique Ginzburg, Board of Medicine

Nicolas Romanello, Board of Medicine

Linville Atkins, Board of Optometry

The list of retracted appointments also included nominations to a host of major and minor positions, from college boards of trustees to trade boards and state commissions. To take a look at the full list of appointments, not just those listed on the DOH, click here.

Click here to read the press release that Governor DeSantis’s issued regarding the matter.
You can also view a copy of the letter he wrote to Senate President Galvano here.

A spokeswoman for Senate President Galvano said the Senate will fully comply with DeSantis’ request. “Senate President Bill Galvano will act in accordance with the Senate Rules and will direct the Secretary to return the documentation of the appointments and document the return in the Journal,” said Katie Betta.

To learn more about DOH matters and investigations, click here.

 

Contact Health Law Attorneys Experienced with Nursing Issues Today.

The attorneys of The Health Law Firm provide legal representation to nurses, nurse practitioners, and CRNAs in investigations, contract negotiations, licensing issues and at Board of Nursing hearings.  They also advise nurses wrongfully accused of diverting drugs and those wrongfully terminated from employment.  Its attorneys represent nurses in DOHinvestigations, Board of Nursing cases and administrative hearings.

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

Sources:

Ogles, Jacob. “Governor sacks college board trustees across the state.” Florida Politics. (February 24, 2019). Web.

Ogles, Jacob. “Ron DeSantis pulls back nearly 170 Rick Scott appointments.” Florida Politics. (February 25, 2019). Web.

Schweers, Jeffrey. “Florida ethics commission reviewing rules after Ron DeSantis yanks Rick Scott appointments.” Tallahassee Democrat. (February 26, 2019). 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: Legal representation for Department of Health (DOH) investigations, legal representation for DOH complaints, DOH compliant representation, professional license defense attorney, professional license representation, healthcare license representation, healthcare license defense representation, Board defense representation,  legal defense for nurses, legal representation for nurses, nurse defense attorney, board of nursing attorney, board of nursing defense representation, health care license defense lawyer, DOH defense attorney, DOH investigation defense lawyer, representation for DOH investigation, Florida health law attorney, health law defense attorney, legal representation for health care professionals, legal representation for disciplinary actions against your license, legal representation for license revocation, Board of Medicine defense lawyer, administrative complaint attorney, legal representation for administrative complaints, Board of Medicine representation, legal counsel for Board representation, The Health Law Firm, health law defense attorney, Florida health law attorney, reviews of The Health Law Firm, The Health Law Firm attorneys review

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

By |2019-03-25T22:52:27+00:00March 25th, 2019|Nursing Law Blog|0 Comments

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

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

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

Changes to Past Health Questions.

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

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

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

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

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

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

The attorneys of The Health Law Firm provide legal representation to physicians, physician assistants, nurses, nurse practitioners, cardiologists, CRNAs, pain management doctors, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

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

Sources:

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

“Change Seeks To Remove ‘Stigma’ For Doctors.” Health News Florida. (January 16, 2019). Web.

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

KeyWords: Legal representation Board of Medicine cases, Board of Medicine Representation, legal representation for physicians, legal representation for licensure issues, licensure defense lawyer, legal representation for licensure defense, legal representation for medical students, residents and fellows, legal representation for Board of Medicine hearings, legal representation for complaints against license, Medical Board Cases representation, legal representation for nurses, nurse representation, Board of Nursing Representation, Medical Board defense lawyer, Medical Board representation, Florida health law defense attorney, legal representation for U.S. Department of Health (DOH) investigations, employment law defense attorney, legal representation for employment issues, legal representation for health care professionals, reviews of The Health Law Firm, The Health Law Firm attorney reviews, health law defense attorney, mental health facility defense counsel, mental health professional defense attorney, psychologist defense counsel and legal representation, social worker legal counsel and mental health counselor defense attorney, legal representation for Credentials Committee of Board of Medicine

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

By |2019-01-30T23:37:08+00:00March 14th, 2019|Nursing Law Blog, Uncategorized|0 Comments

Miami Man to Remain Jailed for Trial in Nation’s Largest Medicare Fraud Case

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

On December 3, 2018, a Florida judge ruled that a Miami businessman who has been jailed for more than two years on $1 billion health care fraud charges, must remain in custody through his trial next year. U.S. District Judge Robert N. Scola Jr. found no violation of his due process rights and denied Philip Esformes’ motion to dismiss several money laundering charges.

Trial Date is Set.

A February 11, 2019, trial date has been set for one of the nation’s biggest Medicare fraud cases that Esformes allegedly orchestrated through nursing homes and assisted living facilities he owned. According to the government, the scheme resulted in $1 billion in false billing and at least $464 million in improper reimbursement payments from Medicare and Medicaid.

Esformes, has been in federal custody since his arrest in July 2016, and prosecutors voiced concerns early on about him being a risk for flight, possible witness tampering and his substantial resources enabling him to live comfortably overseas.

Judge Scola found that the bid for release deserved reconsideration, but ultimately found delays in the case were more attributable to giving the defense time to review the overwhelming quantity of evidence than time spent addressing the government’s conduct. He also agreed with the government that the duration of Esformes’ detention is not grounds for release under binding precedent.

Additionally, the judge rejected Esformes’ motion to dismiss nine counts of alleging money laundering concealment. Esformes had argued that the government improperly based transactions cited in other counts as alleged payments or receipts of kickbacks. You can read more about that here.

Despite problems with the conduct of prosecutors and agents, the judge is keeping the fraud case on track. The Miami businessman is charged with conspiracy, obstruction, money laundering and health care fraud. Click here to read the U.S. Department of Justice’s press release on this case.

Click here to read one of my prior blogs about a billion dollar fraud scheme in Florida.

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

The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S., as well as in civil and administrative litigation attempting to recoup claims that have been paid. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from Medicare and Medicaid Program.

The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (ALFs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

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

Hale, Nathan. “Miami Man To Remain Jailed For Trial In $1B Medicare Fraud.” Law360. (December 3, 2018). Web.

Weaver, Jay. “Miami federal judge keeps massive Medicare fraud case on track for trial in January.” Miami Herald. (November 14, 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: Medicare fraud defense representation attorney, legal representation for defense of Medicare fraud charges, Medicare fraud defense attorney, legal representation for allegations of Medicare fraud, legal representation for health care fraud, legal representation for fraudulent billing, legal representation for allegation of defrauding the government, legal representation for submitting false claims, Medicare audit defense attorney, Medicare billing defense attorney, health care clinic fraud audit, legal representation for false billing, legal representation for allegations of unnecessary procedures, legal representation for Medicare audits, Medicaid fraud defense attorney, legal representation for Medicaid fraud, audit defense lawyer, healthcare fraud representation, healthcare fraud lawyer, legal representation for Medicaid audit, Medicaid audit defense attorney, Medicare and Medicaid investigation defense attorney, legal representation for Medicare and Medicaid investigations, OIG investigation defense attorney, legal representation for OIG investigations, Department of Justice (DOJ) investigations, DOJ representation, representation for DOJ investigations, licensure defense lawyer, reviews of the Health Law Firm, The Health Law Firm attorney reviews, Health law defense attorney

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

By |2018-12-27T03:42:14+00:00February 7th, 2019|Nursing Law Blog|0 Comments

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
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