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The American Nurses Association Breathes New Life Into The Nursing Code of Ethics For 2015

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

On a daily basis, the average nurse uses knowledge, training and ethical standards to make vital decisions regarding patient health. Nurses are required to quickly process simple and complex emergency situations, which leaves little room for second guessing. So, to help guide those in the profession, the American Nurses Association (ANA) created a Code of Ethics.

This Code is the structure that provides foundational standards and offers guidance to practicing nurses for various situations. It also sets the standards against which nursing performance can be judged. For the first time since 2001, the ANA has revised the Nursing Code of Ethics. The revised Code was released to the public on January 1, 2015.

 

Why Now?

The revised version of the Nursing Code of Ethics is geared to help nurses in a more modern practice environment. It addresses some of the more current issues, including confidentiality issues raised by social media, treatment for end-of-life care and the integration of social justice into health care policy as a whole. These guidelines need to be updated as conditions and society changes, and health care advances and presents new problems.

 

What Changes Were Made?

Provisions 1-3: These contain newly established guidelines on advocating for the                                    patient, family and community, along with the need to exercise                                        kindness and respect in all professional relationships.

Provisions 4-6: Contains new guidelines on delivering and maintaining competent care                            that includes self-respect and self-care, accountability, and                                              responsibility to continue learning and growing personally and                                          professionally.

Provisions 7-9: Sets forth broader health issues in the community and on a national                                and international level, along with the advancement of professional                                  values, social policy and education.

 

The Nursing Code of Ethics is a reflection of the proud ethical heritage of nursing and serves as a guide and promise to society for all nurses now and into the future.

To view the complete revised Nursing Code of Ethics, click here.

ANA

Click here to find out more information on the American Nurses Association’s 2015 Year of Ethics

 

Comments?

What are your thoughts on the updates made to the code of ethics? Do you think it will help nurses identify components of real-world problems and analyze the situation effectively? Please leave any thoughtful comments below.
Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, Department of Justice (DOJ) 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.
Sources:

Howard, Cynthia. “2015: The Year of Nursing Ethics.” Nurse Together. (February 5, 2015). From: http://www.nursetogether.com/2015-the-year-of-nursing-ethics

Northeast Ohio Media Group Marketing Staff. “Year of Ethics Offers Nurses Guidance and Support Regarding Moral Decisions.” Cleveland.com. (April 15, 2015). From: http://blog.cleveland.com/university_hospitals_health_system_inc/2015/04/year_of_ethics_offers_nurses_g.html

American Nurses Association. “Code of Ethics for Nurses With Interpretive Statements.” (May 1, 2015). From: http://www.nursingworld.org/Mobile/Code-of-Ethics

 

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 © 1999-2015 The Health Law Firm. All rights reserved.

Florida Nurse Accused of Abusing Patient

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

A Florida State Hospital licensed practical nurse (LPN) has been arrested and charged with one count of abuse of a disabled adult at the facility. The nurse was arrested on a felony warrant by the Attorney General’s Medicaid Fraud Control Unit (MFCU). The arrest was announced by the Florida Attorney General on June 29, 2012.

Nurse Accused of Abusing Patient During Medication Administration.

The nurse allegedly struck a disabled woman at the mental health facility, while trying to administer medication. The nurse attempted to administer medications to the patient by holding her nose closed in an attempt to force her mouth open, slapping her across the face, and pulling the patient’s hair, according to the charges filed.

The nurse has been charged with one count of abuse of a disabled adult, which is a third degree felony. If convicted she faces up to five years in prison and a $5,000 fine.

Medicaid Fraud Control Unit (MFCU) Conducted Investigation.

Investigators with the Medicaid Fraud Control Unit (MFCU) received information regarding the alleged abuse from the Florida Department of Children and Families’ (DCF) Adult Protective Services Program. The Calhoun County Sheriff’s Office assisted in the arrest. The case will be prosecuted by the State Attorney’s Office for the Second Judicial Circuit of Florida.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health investigations, before the Board of Nursing, in appearances before the Board of Nursing in licensing matters, and in 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 Include:

Lucas, John. “Attorney General Pam Bondi Announces Arrest of Nurse for Abusing a Disabled Adult at Florida State Hospital.” Florida Office of the Attorney General. (June 29, 2012). Press Release. From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/AF6292E44D8579B685257A2C0069ED2D

WCTV. “Nurse at Florida State Hospital Arrested for Abuse.” WCTV.com. (June 29, 2012). From: http://www.wctv.tv/home/headlines/Nurse_at_Florida_State_Hospital_Arrested_for_Abuse_160893645.html

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.

New Immigration Law in Georgia Slows Down License Renewal Process for Doctors and Nurses

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

Hundreds of Georgia health providers are without a professional license to practice, because a new immigration law is causing massive backups in paperwork, according to a number of sources. The Illegal Immigration Reform and Enforcement Act of 2011 or House Bill 87 went into effect on January 1, 2012, and requires every person to prove his or her citizenship or legal residency when the individual renews his or her license.

To read House Bill 87 in its entirety, click here.

With all of the extra paperwork required and too few staff members at the reviewing state agencies, many licenses are expiring before they can be renewed. Shortages of staff are being reported at the Georgia Secretary of State’s office and Georgia’s Medical Board. Licenses being affected include licenses for doctors, nurses, pharmacists and other health providers are falling through the cracks and expiring. According to a Kaiser Health News story released November 12, 2012, there’s not much that can be done to speed up the process.

So Far Georgia House Bill 87 Is Creating Confusion and Issues for Citizens.

Georgia House Bill 87 was aimed at blocking illegal immigrants from getting benefits but instead has created lots of confusion, according to an article in the Atlanta Journal-Constitution. For example, when people are confused about the requirements and fail to not submit copies of acceptable identification, then their professional licenses expire and they are not legally allowed to practice.

It is reported that some individuals, instead of forwarding copies of photo identification, are sending photos of animals or pornography into the state’s online system. Officials believe this is either a form of protest or a joke, either way it slows down the review process.

To read the article from the Atlanta Journal-Constitution, click here.

Providers Be Aware of Medicare Conditions of Participation.

Providers need to be forewarned that if their licenses are expired Medicare conditions of participation (COPs) prohibit billing for services provided. If a service was provided while the license was expired, be prepared to refund the overpayments.

Around 1,300 Doctors and Nurses Cannot Practice Due to Incorrect
Paperwork.

Last year, the secretary of state’s office received more than 49,000 new applications for licenses and since 2008 the state licensing division has lost almost 40 staff members.

According to the Atlanta Journal-Constitution, the average time it takes for the state to process new license applications has jumped from 60 days to 70 days. The same goes for renewal applications. It used to take two days to renew a license, but now it takes 10 days.

According to Kaiser Health News, it’s estimated that 1,300 doctors, nurses and other health professionals have lost their ability to work either because they did not send in the correct paperwork, or they are stuck in the backlog of work.

The same article stated so far the new document requirements have yet to find any illegal immigrants.

Click here to read the entire article from Kaiser Health News.

Georgia Nursing and Pharmacy Associations Warning Members of Delays.

The Georgia Nursing Association and the Georgia Pharmacy Association are monitoring this situation closely. The pharmacy association has been informing members about the new identification requirements and urging them to not put off applying for their licences.

Click here to see a warning about the process from the Georgia Pharmacy Association.

Contact Health Law Attorneys With Experience Handling Licensing Issues.
If you have had a license suspended or revoked, or are facing imminent action against your license, it is imperative that you contact an experienced healthcare attorney to assist you in defending your career.  Remember, your license is your livelihood, it is not recommended that you attempt to pursue these matters without the assistance of an attorney.

The Health Law Firm routinely represents physicians, dentists, nurses, pharmacists, medical groups, clinics, and other healthcare providers in personal and facility licensing issues all over the country.

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

Comments?

As a health professional what   do you think about this new law in Georgia? Do you think it is ridiculous or a necessary process? Please leave any thoughtful comments below.

Sources:

Burress, Jim. “Doctors’ And Nurses’ Licenses Snagged By New Immigration Law In Georgia.” Kaiser Health News, WABE, Atlanta and NPR. (November 12, 2012). From: http://www.kaiserhealthnews.org/Stories/2012/November/12/Georgia-immigration.aspx

Redmon, Jeremy. “New ID Law Gums Up Licensing Process.” The Atlanta Journal-Constitution. (October 15, 2012). From: http://www.ajc.com/news/news/new-id-law-gums-up-licensing-process/nSc6g/

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 |2012-11-14T15:49:01+00:00May 15th, 2018|Nurse License, Patient Care|0 Comments

Don’t Take Away From Your Professional Reputation. Make Sure Your Correspondence Is Professional: 30 Tips (Part 1 of 3)

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

I review numerous letters, e-mails, memoranda, and other kinds of correspondence prepared by my physician and nurse clients over the span of my legal representation of them.  Frequently this is the result of a dispute with a hospital, a dispute with their peers or the medical staff, a dispute with an insurance company, a law suit filed by a patient, a complaint being investigated by the licensing agency, or another serious legal matter.

In several cases, way too many cases, such correspondence is unprofessional and defeats the purpose of the reason you are sending the correspondence.  At times it is so bad, it will be disregarded by the reader to whom it was directed. I have seen this from doctors, nurses, dentists, psychologists, owners of health care businesses, and many, many other highly educated professionals who really should know better.

When these documents are dictated and transcribed by a professional medical transcriptionist, they are usually formatted correctly and many of the errors I see are avoided.  However, when the health professional types his or her own document, that is when I see the most errors.

To avoid these errors that make your correspondence and professional communications look unprofessional, follow these tips.

Remember Why You Are Writing.

Remember, the basic purpose of your correspondence is to communicate ideas effectively.  In many cases, it will be to invoke your legal rights in certain situations (such as an appeal or a hearing request).  Sometimes it will be to attempt to persuade your hospital, your peers, or your employer to take certain action or to refrain from certain action.  Remember that your correspondence is often the first impression that the other side will have of you.  Do you want it to be an impression that you are sloppy, lazy, unprofessional, not knowledgeable, uneducated, or confused?

Whether you are communicating in a letter or via e-mail, these rules hold true.  In many (if not all) situations involving legal proceedings or legal issues, it is probably best to communicate via a letter sent by U.S. mail or some other reliable service (e.g., Federal Express, Airborne Express, DHL, etc.).  Even if you are transmitting your information via an e-mail, it is my suggestion to prepare it in the form of a paper letter (if your e-mail is not set up to insert your letterhead) and then scan it in and send it electronically.

I discourage legal communications via e-mail in serious matters because they are often difficult to obtain, isolate, and authenticate when you need them for hearings.  Additionally, they are rarely secure, often available to many others who shouldn’t see them and easily susceptible to being accidentally sent to others who should not see them at all.

Horror Stories of Unprofessional Correspondence.

Why do I feel this blog is necessary?  Because of all the horrible correspondence I have seen written by allegedly highly educated professionals, mostly physicians and nurses.  That’s why.

Here are just a few:

Physician never wrote a separate response to any charges or allegations made against him on any peer review documents.  He would just hand write (scribble, actually) his remarks on the bottoms and in the margins of whatever document he was sent to him and then send it back.

Nurse practitioner was required to respond to serious charges of negligence resulting in an adverse outcome to a patient.  She hand wrote, on unlined paper, a response letter that was not addressed to anyone, not dated, not signed and did snot state who was sending it.

The physician was required to provide his analysis of a patient’s case for peer review purposes.  His typed letter of three pages, single spaced, contained one long paragraph.  I used to work for a Medical Corps Admiral when I was a Navy JAG Corps officer.  He would just glance at such correspondence and state:  “I can tell this doctor doesn’t have any idea what he is talking about.”  Failing to follow good correspondence procedures will show others your thoughts lack organization and cohesion.

A health professional was required to complete an application for clinical privileges.  He wrote all of the answers by hand, not even staying within the lines on the form, writing over the questions and around in the margins of the application.  This is what he signed and turned in.  Believe me, this did not look very professional.

Physician was requested to respond to a medical staff inquiry from the hospital.  Her response came back typed in 22 characters per inch (cpi) size type font, almost too small to read.  Perhaps she was just trying to save a sheet of paper.  But many of us would have had to pull out a magnifying glass to be able to read it.  If you are actually trying to communicate your ideas, make your correspondence easier to read, not harder to read.

A dentist was notified of a pending complaint investigation being opened against her dental license.  She wrote her response to the charges back to the investigator, without using any business address or title, and began her response statement “Dear Sharon,”.  Do not treat others informally, especially in professional or formal situations.  You will be deemed to be unprofessional when you do so.

Tips for Good Professional Correspondence.

Here are some pointers on professional communications that should be followed in all of your professional written communications about business, professional or legal matters, even in e-mails. Please note, the terms below in quotation marks have certain defined meanings.  If you don’t know what these terms mean, look them up.

1.    Always remember that the reason you are sending the correspondence is to attempt to effectively and accurately communicate your position and ideas.  If you are trying to make your message indecipherable or difficult to understand, ignore these tips.  If you are trying to come across as someone who doesn’t give a damn about how he or she is perceived, ignore these tips.  If you want to come across as unprofessional, ignore these tips.

2.    Make sure you include your complete and correct “return address” and contact information.  This includes your physical or mailing address, telephone number, telefax number and e-mail address, so that the other party knows exactly how to reach you.  In cases where you already have this on your letterhead, be sure to use your letterhead.  Also, it appears more professional to create a letter head with the information in it and to use your new letterhead instead of having a professional business letter with a typed “return address.”  However, a typed “return address” is better than none.

3.    Don’t use someone else’s letterhead.  Don’t use your hospital, medical group or institutional letterhead for your own personal communications, unless you are the owner.  Use your personal letterhead (see above), instead.  If you are being accused of poor utilization review, unprofessional conduct, or personal use of hospital (or company) property, then using someone else’s letterhead just helps prove the charge against you.

4.    Date your correspondence.  Date your correspondence.  Date your correspondence.  Nothing shows a lack of professionalism and lack of attention to detail as sharply as undated correspondence.  It will certainly be difficult to prove when your letter or document was sent if you do not have a date on it.  A year or two later, it may be completely impossible to do so.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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

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: The Health Law Firm, legal representation for health care physicians, reviews of The Health Law Firm, tips for professional correspondence, The Health Law Firm attorney reviews, legal representation for nurses, professional correspondence for a legal dispute, owners of health care businesses defense attorney, physicians defense lawyer, 30 tips for professional correspondence, The Health Law Firm reviews
Don’t Detract From Your Professional Reputations. Always Ensure Your Correspondence Looks Professional: 30 Tips

 

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

Copyright © 2016 The Health Law Firm. All rights reserved.
By |2016-12-02T07:00:57+00:00May 15th, 2018|Nursing Law Blog|0 Comments

Jury Finds Four New Orleans Doctors and Others Guilty for Participation in $13.6 Million Medicare Fraud Scheme

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

On May 9, 2017, a federal jury found four New Orleans doctors and two others guilty for their participation in a Medicare fraud scheme. According to prosecutors the defendants netted more than $13.6 million in fraudulent Medicare reimbursements.

Details of the Scheme.

The six defendants worked for or with Abide Home Care Services (Abide) in New Orleans. Federal prosecutors said Abide routinely falsified diagnoses so Medicare reimbursements were inflated. Abide also falsified medical records that supported medically unnecessary home health services, prosecutors said. Abide was owned by Lisa Crinel, who pleaded guilty to her role in the scheme in 2015.

In exchange for their role in the scheme, Abide made monthly payments to the doctors that were falsely characterized as medical consultant or director fees. Abide also hired Dr. Michael Jones’ wife Paula Jones and inflated her salary payments to pay for fraudulently certifying documents. Additionally, Jonathan Nora scheduled doctor visits with Abide “well knowing” that the referral did not come from the beneficiary’s own health care professional.

The Trial.

After a month long trial, a federal jury returned guilty verdicts against the six individuals charged with committing Medicare fraud. Found guilty were Dr. Henry Evans, Dr. Michael Jones and his wife Paula Jones, Dr. Shelton Barnes, Dr. Gregory Molden and Jonathon Nora. Click here to read the press release issued by Acting U.S. Attorney Duane Evans’s Office in Eastern District of Louisiana.

The Consequences.

Dr. Evans was found guilty of five counts of health care fraud. Dr. Michael Jones, Paula Jones, Dr. Barnes, Dr. Molden and Jonathan Nora each were found guilty of conspiracies to commit health care fraud, defrauding the United States, receiving and paying kickbacks and health care fraud, according to the U.S. Attorneys Office. The four doctors and Nora were convicted of additional individual counts of health care fraud. Dr. Shelton Barnes was additionally convicted of obstruction of a federal audit.

Dr. Barnes faces a maximum penalty of up to 170 years in federal prison; Dr. Molden faces up to 115 years; Dr. Michael Jones faces up to 95 years; Dr. Evans faces up to 50 years in federal prison; Paula Jones faces up to 15 years; and Nora faces up to 25 years. Each also faces a maximum fine of up to $250,000 for each count.

Doctors Beware.

In our practice we have represented a number of doctors who have been exploited by nonphysicians intent on committing fraud. They will often target older and semi-retired physicians. The goal is merely to get their name and identification number to use in falsifying medical records and claims. If the deal you are being offered seems like too good of a deal, involves little or no work on your part to receive a large check each month or involves working for nonphysicians or individuals you do not know, you should beware. Always know who you are working for, the location of their actual place of business and residence, and with whom (physician-wise) they have done business before. You do not want to spend the later years of your life in prison, after pursuing an honorable career for decades.
Health Care Fraud Should Not Be Taken Lightly.

We have been consulted by many individuals, both before and after criminal convictions for fraud or related offenses. In many cases, those subject to Medicare fraud audits and investigations refuse to acknowledge the seriousness of the matter. Some may even decide not to spend the money required for a highly experienced health attorney to defend them.

The government is serious about combating health care fraud. It created a Medicare Fraud Strike Force in March of 2007, in an effort to further prevent and eliminate fraud and abuse of government health care programs. False claims are a growing problem in the program, costing the government billions of dollars each year. Accordingly, punishments for defrauding the system can be quite severe.

If you are accused of Medicare fraud, realize that you are in a fight for your life. Your liberty, property/possessions and profession are all at stake. Often it is possible to settle allegations of Medicare fraud by agreeing to pay civil monetary penalties and fines. If given such an opportunity, the Medicare provider should consider whether it is worth the risk of facing decades in prison. Be prepared to give up whatever you need to in order to avoid a conviction and preserve your liberty.

To read further about the seriousness of Medicare fraud, click here to read one of my prior blogs.

Additionally, you can watch our informational video blog on Medicare fraud, here.

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

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. 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 the Medicare or Medicaid Program.

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

Lane, Emily. “4 New Orleans doctors, 2 others convicted in $13.6 million Medicare fraud scheme.” The Times-Picayune. (May 10, 2017). Web.

“4 New Orleans doctors, 2 others convicted in $13.6 million Medicare fraud scheme.” Health Leaders Media. (May 11. 2017). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
Keywords: Legal representation for Medicare fraud, 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 allegations 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 illegal kickbacks, Medicare false claims defense attorney, legal representation for false billing, legal representation for allegations of unnecessary procedures, legal representation for Medicare audits, 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 © 2017 The Health Law Firm. All rights reserved.

By |2017-05-31T07:17:35+00:00May 15th, 2018|Nursing Law Blog|0 Comments

Nurse Practitioner Arrested in New York Crackdown on Prescription Drug Abuse

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

A New York law enforcement crackdown on prescription drug abuse has resulted in the arrests of 98 people. Among those charged are a nurse practitioner and two doctors.

Brooklyn federal prosecutors joined with the Drug Enforcement Administration (DEA), district attorney’s offices, and local law enforcement agencies, to carry out a series of raids that began June 5, 2012 and resulted in the arrests.

To view the DEA’s press release concerning the raid, click here.

Doctors Accused of Overprescribing.

One of the doctors is accused of conspiring to distribute oxycodone to patients that were not legitimate. Allegedly, the doctor surrendered his DEA registration. This terminated his authority to prescribe controlled substances such as oxycodone. However, he allegedly attempted to use other health care practitioners to continue to prescribe drugs, which the government contends is illegal.

Another doctor involved in the crackdown is charged with illegal distribution of oxycodone. During the execution of a federal search warrant at his offices on March 1, 2012, the doctor voluntarily surrendered his DEA registration. However, he allegedly continued to issue prescriptions to those whom he knew were not legitimate patients.

We continually warn against “voluntarily relinquishing” DEA registrations or medical licenses with any investigation pending as this is treated the same as a revocation in most cases. For an article we have written on this, click here.

Florida Has Experienced Similar Prescription Drug Abuse Crackdowns.

Beginning about two years ago, Florida health providers involved in narcotics precribing became routine targets for law enforcement. This was part of a concerted effort by state and federal officials to crackdown on “pill mill” operations. Regulations increased. Lawmakers enacted severe penalties for doctors and other health professionals accused of over-prescribing. Most physicians were banned from dispensing drugs in their offices. The governor created a Florida drug “strike force” with a mission to eliminate any pain clinics that were found to be breaking the law. The Florida Surgeon General and the Board of Medicine made announcements about the “crackdown” on “over-prescribing.”

Since the implementation of the new pain management and prescribing laws, the Florida strike force has made thousands of arrests and seized millions of pills of narcotics. This has resulted in serious concerns by those in the pain management profession.

Law Enforcement will Continue to Pursue Physicians, Pharmacists, Nurses and Other Health Providers.

The recent raid in New York and ongoing actions in Florida demonstrate that law enforcement will continue to pursue health professionals who prescribe large amounts of narcotics.

Contact Health Law Attorneys Experienced with Overprescribing Charges and DEA Cases.

The Health Law Firm represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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

Sources Include:

Allen, Jonathon. “Doctors Arrested in New York Prescription Drug Crackdown.” Reuters. (June 7, 2012). From
http://in.reuters.com/article/2012/06/06/usa-crime-painkillers-idINL1E8H6E3J20120606

CBS News. “98 Arrested in NY Prescription Drug Sweep.” CBS News. (June 6, 2012). From
http://www.cbsnews.com/8301-201_162-57448268/dozens-arrested-in-ny-prescription-drug-bust/

McKenzie-Mulvey, Erin. “U.S. Attorney Lynch, District Attorneys, DEA, Other Law Enforcement Announce Prescription Drug Initiative.” Drug Enforcement Administration. (June 7, 2012). Press Release. From:
http://www.justice.gov/dea/pubs/states/newsrel/2012/nyc060712a.html

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 |2012-06-13T12:55:23+00:00May 15th, 2018|Nursing Law Blog|0 Comments

Do You Know What A Compromised Physician or Health Care Provider Is?

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

What is a “compromised physician” or “compromised health provider”?  It may not be what you think it is.

This term is used from time to time to refer to health professionals, physicians and health facilities whose identities and billing numbers have been stolen and crooks are utilizing them to falsely bill Medicaid, Medicare, Tricare and health care insurance programs for services that were never performed.

Stolen Medical Identities

Every now and then, these “compromised healthcare providers” have their identifying information ordered into lists which are sold or exchanged from one criminal to the next. This may wind up causing thousands of false claims to be submitted using their identification.  This could cause millions of dollars in taxpayer money or in health insurance proceeds to be paid out to thieves.

The Centers for Medicare and Medicaid Services (CMS) maintains a list of compromised providers that is used to screen for any claim submitted under that providers identification, including prescriptions, orders for durable medical equipment, orders for home health services, orders for diagnostic tests and other services paid by a third party payer.  CMS estimates that there are approximately 5,000 providers whose medical identities have been stolen and used to submit false claims.  A physician may be on this list and not even know it until his or her claims start being denied.

In 2011, Cybil G. Roehrenbeck of the American Medical Association wrote a good article explaining the entire problem in detail.  I highly recommend that you review it and you can do so by clicking here.

Helpful Resources

CMS has published a “Fraud, Waste and Abuse Toolkit” to help physicians and other health care providers prevent the false use of their billing information.  It is titled:  “Health Care Fraud and Program Integrity: An Overview for Providers.”  It also has several other informational publications on how physicians and other health professionals can avoid identity theft.  You can access these publications by clicking here:


Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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

Sources:
Roehrenbeck, Cybil. “Physician Identity Theft.” ABA Health eSource. (October 2011). Web.

“Fraud, Waste, and Abuse Toolkit.” Centers For Medicare and Medicaid Services.(July 2016). Web.

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

KeyWords: health care fraud defense attorney, compromised physician list, compromised health provider attorney, The Health Law Firm reviews, The Florida Bar in Health Law, Medicare fraud defense attorney, The Health Law Firm, Medicaid fraud defense attorney, consumer reports of Medicare fraud, Centers for Medicare and Medicaid Services (CMS) audit attorney, Medicaid investigation defense lawyer, Medicare investigation defense lawyer, reviews of The Health Law Firm, legal representation for health care fraud charges, false claims act case legal representation, whistle blower claims attorney

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

Copyright © 2016 The Health Law Firm. All rights reserved.

 

By |2017-01-05T07:00:31+00:00May 15th, 2018|Nursing Law Blog|0 Comments

Appealing Final Orders and Emergency Suspension Orders (ESOs)

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

George F. Indest III, Board Certified by The Florida Bar in Health Law

The professional boards for licensed health professionals in Florida, such as the Board of Nursing, are all under the Florida Department of Health (DOH).  Each board is responsible for disciplinary actions and other matters regulating the professions under its authority.  The investigators and attorneys assigned for Board of Nursing matters all work for or are assigned to the DOH.  The Florida DOH is headed up by the Florida Surgeon General.  I think of the DOH as the umbrella agency over the professional boards or as a parent corporation which owns many subsidiary corporations.

Administrative Procedures Governing Investigations and Disciplinary Actions

All agency actions, especially disciplinary actions and investigations, are governed by the Florida Administrative Procedure Act (APA), Chapter 120, Florida Statutes.  The Florida APA is modeled after the Federal Administrative Procedure Act.  However, in addition to the Florida APA, DOH investigations and hearings may also be governed by several different provisions of Chapter 456, Florida Statutes, a set of laws which govern all licensed health professionals.

For example, Section 456.073, Florida Statutes, gives certain procedural steps that must be followed in investigations and probable cause hearings involving complaints against nurses and other health professionals.  Section 456.073(13), Florida Statutes, is a new section added several years ago that provides a six (6) year “statute of limitations” for many disciplinary matters;  but there are many exceptions to this.

Section 456.074, Florida Statutes, gives the Surgeon General the authority to issue emergency suspension orders (or “ESOs”) in certain cases.  Section 456.076, Florida Statutes, authorizes the establishment of treatment programs for impaired health professionals and offers some alternatives to disciplinary action.  To date, the only recognized programs are the Intervention Project for Nurses (IPN) (which covers all nursing professionals) and the Professionals Resource Network (PRN) (which covers almost all other health professionals).  Section 456.077, Florida Statutes, authorizes nondisciplinary citations for certain offenses.  Section 456.078, Florida Statutes, authorizes mediation for certain offenses.

Mistaken Advice Regarding Appeals

We are often consulted by nurses after they have an emergency suspension orders (or ESOs) entered against them or after they have a Final Order for disciplinary action entered against them.  We often hear that they consulted an attorney who advised them at an earlier stage of the proceedings to not worry about putting together and presenting a defense or disputing the charges at a formal administrative hearing.  We are told that they have been mistakenly advised that they should just wait and file an appeal because they are more likely to win on appeal.

This is, of course, incorrect advice.  If you compare these proceedings to criminal investigations, would any competent attorney advise you to not worry about preparing for a trial or contesting the charges at a trial?  Would any competent attorney advise you to just wait until you are convicted, because you could then file an appeal?  No, of course not.  This is because appeals are based on legal defects in the proceedings and do not involve any presentation of new facts that are not already in the record.  Additionally, very few cases are reversed on appeal, whether criminal, civil or administrative in nature.  So why give up your best shots at winning a case:  presenting a good case of factual information and documents at the investigation level or disputing the charges at a formal hearing?

Don’t Try to Be Your Own Attorney on an Appellate Matter

There are, of course, many valid legal grounds for appeals of emergency suspension orders (ESOs) and Final Orders.  However, you have to understand the law and the procedural rules that govern such matters in order to be able to identify them and argue them on appeal.  In addition, appellate law is a legal specialty of its own.  If you are not familiar with researching case law and writing legal briefs, you should not be attempting to appeal your own case.  Would you attempt to perform brain surgery on yourself?  If so, you should get your head examined.  The courts of appeal are far more exacting in their requirements than trial courts are. See The Florida Rules of Appellate Procedure.  However, most Florida courts of appeal also have their own local rules which may apply to appeals.

Grounds for appeal of an Emergency Suspension Order (ESO) include that less restrictive means of protecting the public were available or that the conduct alleged does not meet the legal requirement for imposing such a suspension.  Grounds for appeal of a Final Order include that the punishment it gives exceeds the disciplinary guidelines that each board has and that proper procedures were not followed which deprived the respondent of his or her right to a fair hearing.  There are many other grounds which one who practices regularly before the Board will be able to identify and raise in an appeal.

Where to Appeal May Be an Issue

The notice of appeal must be filed with the clerk of the DOH.  However, a copy must also be filed with the appropriate appellate court having jurisdiction.  The First District Court of Appeal in Tallahassee will have jurisdiction in almost all DOH and Agency for Health Care Administration (AHCA) appeals.  However, the District Court of Appeal which has jurisdiction over the county in which the respondent health professional resides will also have jurisdiction.  If the appellate case law of one of these is more favorable than the other, from a strategic viewpoint, it may be better to file in the one with the more favorable case law.

Alternative Actions to an Appeal May be Appropriate

Furthermore, there may be more effective and less expensive methods of obtaining relief from an emergency suspension orders (ESOs) or Final Order than an appeal.  If you are subject to an emergency suspension orders (ESOs), you have the right to an expedited hearing.  Sometimes this will result in quicker relief than appealing it.  If you are subject to a Final Order that has been issued in error or there was some mistake in the proceedings that led up to it, the Board may be inclined to reconsider the matter and amend it.

Always Carry Professional Liability Insurance that Includes Licensure Defense Coverage

We continue to recommend that all nursing personnel, especially those who work in hospitals, nursing homes or for agencies, carry your own professional liability insurance.  If you do purchase insurance, make sure it has professional license defense coverage that will pay for your legal defense in the event a complaint is filed against your nursing license.  Usually coverage of up to $25,000 comes with most good nursing liability policies.  There are many companies that sell such insurance for as little as $150 per year.  However, if you can get additional coverage, $50,000 is more likely to cover any foreseeable investigations, hearings and appeals.

Seek Legal Advice and Prepare Your Defenses Early

Always seek legal advice as soon as you suspect there may be a complaint of any kind or an investigation of any kind.  Don’t hide your head in the sand and think that the investigation could not possibly be about you.  Talk to an attorney before you talk to anyone else.  A good attorney will help to save you from making mistakes that could compromise a good legal defense.

Call now or visit our website www.TheHealthLawFirm.com. to set up a consultation on any of the above issues.

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.

Disclaimer:  This article is for general information and education purposes only and must not be regarded as legal advice.

Copyright © George F. Indest III, Altamonte Springs, Florida, all rights reserved.  No part of this article may be reproduced or used without the permission of the author and owner.

Detroit Medical Center Agrees to Pay $42M to End Long-Running Antitrust Suit

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

A month before trial was set to begin, Detroit Medical Center (DMC) agreed to pay $42 million to end a nine-year antitrust class action lawsuit. The suit was brought by nurses accusing eight Detroit area hospitals of conspiring to keep their wages low, violating antitrust laws from 2002-2006. The DMC was the last remaining defendant in a 2006 class-action lawsuit before Chief U.S. District Judge Gerald Rosen. To read a blog I wrote on another health care antitrust case, click here.

A copy of the class action complaint that was filed in the U.S. District Court for the Eastern District of Michigan can be found here.


Last Man Standing.

The nurses have alleged the DMC and seven other Detroit area hospitals “participated in an unlawful conspiracy to depress wages for Registered Nurses and/or to unlawfully exchange wage information in violation of Section 1 of the Sherman Antitrust Act.” For more information on antitrust laws, visit the “Areas of Practice” page on our website. The seven other hospitals involved in the suit settled with the nurses for a combined $48 million. DMC is expected to pay $42 million into a combined settlement fund, bringing total compensation in the case to $90 million. To view the class settlement agreement in this case, click here.

“It’s Not What It Looks Like.”

DMC had planned to take the case to trial in a month, but instead veered off course and decided to settle instead. “The settlement is not an admission of liability but rather a business decision to bring the matter to a resolution. We remain committed to our nurses and value the hard work and dedication of all our hospital staff,” DMC counsel released in a statement defending their decision. For more information, visit their website by clicking here.

Comments?

Do you think the settlement amount of $42 million was fair? Have you ever experienced a situation where antitrust laws were broken? Please leave any thoughtful comments below.

Contact Health Law Attorneys Experienced With Antitrust Laws and Trade Regulation.

The Health Law Firm has attorneys who practice in the area of antitrust law and trade regulation. We have defended a hospital in federal court against allegations of violations of the antitrust laws, we routinely provide advice and opinion letters on antitrust and trade regulation matters, we have represented plaintiffs in law suits alleging anticompetitive behavior and violations of state and federal antitrust laws.

The attorneys of The Health Law Firm provide advice and representation concerning antitrust law, trade regulation, restraint of trade issues, and regarding deceptive and unfair trade practices. We have represented both plaintiffs and defendants in state court litigation and in federal court litigation in such matters.

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

Sources:

Kang, Peter. “Detroit Hospital to Pay $42M to End Nurse Wage-Fixing Suit.” Law360. (September 11, 2015). From: http://www.law360.com/health/articles/702135?nl_pk=68a34a8e-1544-489d-9b84-bbd4587b4d64&utm_source=newsletter&utm_medium=email&utm_campaign=health

Cwiek, Sarah. “Detroit Medical center agrees to settle with nurses, end long-running antitrust lawsuit.” Michigan Radio. (September 14, 2015). From: http://michiganradio.org/post/detroit-medical-center-agrees-settle-nurses-end-long-running-antitrust-lawsuit#stream/0

Halcom, Chad. “DMC expects to settle nurse wage class-action lawsuit for $42 million.” Crain’s Detroit Business. (September 14, 2015). From:
http://www.crainsdetroit.com/article/20150914/NEWS/150919922/dmc-expects-to-settle-nurse-wage-class-action-lawsuit-for-42-million

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: Antitrust laws, violating antitrust laws, anticompetitive conduct, Sherman Act, price fixing, wage fixing, trade regulation law, Federal Trade Commission, FTC, Detroit Medical Center, DMC, Michigan Antitrust Reform Act, unfair competition laws, deceptive and unfair trade practices, restraints on trade or business, defense attorney, defense lawyer, health care law, health law attorney, wage dispute, wage settlement, settlement agreement, health care law, health law attorney

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By |2015-09-18T14:01:55+00:00May 15th, 2018|antitrust, Health Law|0 Comments

Please, Please, Please Do NOT Talk to the Department of Health (DOH) Investigator

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

Whether you are a nurse, physician, pharmacist or dentist, I beseech you: please do not talk to a Department of Health (DOH) investigator until you have talked to a health lawyer who is experienced with DOH investigations and board licensing complaints.  Do not answer or respond to even the most basic questions about where you work now, what your address is or if you know patient x, until consulting with counsel.

Admitting to the Simplest Facts May Harm You.

We are routinely consulted by nursing professionals and other healthcare providers for representation after they have discussed the case and after it is too late to undo the damage they have caused to themselves.  Often they do not understand the seriousness of the matter or the possible consequences, until it is too late. Admitting to even the most basic facts causes damage to any possible defense.

Administrative Licensure Investigations are “Quasi-Criminal.”

The vast majority of nurses and even most attorneys do not realize that DOH investigations concerning complaints against a nurse’s licences are considered to be “penal” or “quasi-criminal” proceedings.  This means the same laws and constitutional rights apply to them as apply to criminal investigations.  However, since they are also administrative proceedings and not strictly criminal proceedings, investigators do not need to advise you of your Miranda rights or tell you you have the right to remain silent, the right to an attorney, etc.

In any criminal investigation a good criminal defense attorney would always tell you “Do not talk to the investigator” and “Tell the investigator you have a lawyer.”

Investigators’ Techniques Try to Get You to not Consult a Lawyer.

DOH investigators, like police investigators, FBI investigators and other law enforcement officers, are well-trained in investigative techniques and how to get information out of suspects.  Often the approach used is to catch you by surprise before you even know there is an investigation and the investigation is of you.  Another technique used is to lull you into a false sense of security that the investigation is about someone or something else and not you.  Another investigative technique is to convince you that you need to “Tell your side of the story” so that the investigation is accurate.  Yet another is that “Things will go much better for you if you cooperate.”  None of these things are true.

However, if it is truly in your best interest to cooperate or to make a statement, after you consult with your attorney, your legal counsel will surely advise you to do this.  The investigator should not mind waiting until you consult your attorney.  However, many will go to extremes to convince you that you don’t need an attorney and shouldn’t get an attorneys.

Consult an Experienced Health Law Attorney.

The attorneys of The Health Law Firm are experienced in dealing with DOH investigators, AHCA surveyors, Drug Enforcement Administration (DEA) agents, FBI agents, police and sheriff’s office investigators, OIG special agents (S/As) and Medicaid Fraud Control Unit (MFCU) investigators.  Call or contact The Health Law Firm for legal advice before you talk to any investigator about any matter.

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.

Disclaimer: Please note that this article represents our opinions based on our many years of practice and experience in this area of health law. You may have a different opinion; you are welcome to it. This one is mine.

Note: This article is for informational purposes only; it is not legal advice.

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