Pharmacy Law Blog

Home/Pharmacy Law Blog

Question: Is Exposure to COVID-19 For Healthcare Workers, Causing Illness, Disability, or Death, Considered an Employment-Related Injury Under Workers’ Comp?

Attorney Amanda I. ForbesBy Amanda I. Forbes, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In answering the question posed in the title of this blog, first, it should be noted that the World Health Organization (WHO) classifies COVID-19 as an “occupational disease.”  (Reference:  World Health Organization, “Coronavirus Disease (COVID-19) Outbreak: Rights, Roles and Responsibilities Of Health Workers. . . .”)

Click here to view the classification by the WHO on our website.

Most state workers’ compensation laws cover the worker for occupational diseases if the worker acquires it during the course and scope of their employment.  For example, Section 440.151(2), Florida Statutes, states:

Whenever used in this section the term “occupational disease” shall be construed to mean only a disease which is due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation, process, or employment, and to exclude all ordinary diseases of life to which the general public is exposed, unless the incidence of the disease is substantially higher in the particular trade, occupation, process, or employment than for the general public. “Occupational disease” means only a disease for which there are epidemiological studies showing that exposure to the specific substance involved, at the levels to which the employee was exposed, may cause the precise disease sustained by the employee.

Section 440.151(2), Florida Statutes, (emphasis added).  Many other states have similar requirements to those of Florida.

Healthcare workers are at the front line of any outbreak response and as such are exposed to hazards that put them at an increased risk of infection with the COVID-19 virus.  Therefore, as COVID-19 meets the criteria as an “occupational disease.”

Moreover, Section 440.151(1)(a), Florida Statutes, states:

Where the employer and employee are subject to the provisions of the Workers’ Compensation Law, the disablement or death of an employee resulting from an occupational disease as hereinafter defined shall be treated as the happening of an injury by accident, notwithstanding any other provisions of this chapter, and the employee or, in case of death, the employee’s dependents shall be entitled to compensation as provided by this chapter, except as hereinafter otherwise provided; and the practice and procedure prescribed by this chapter shall apply to all proceedings under this section, except as hereinafter otherwise provided.  Provided, however, that in no case shall an employer be liable for compensation under the provisions of this section unless such disease has resulted from the nature of the employment in which the employee was engaged under such employer, was actually contracted while so engaged, and the nature of the employment was the major contributing cause of the disease. Major contributing cause must be shown by medical evidence only, as demonstrated by physical examination findings and diagnostic testing. “Nature of the employment” means that in the occupation in which the employee was so engaged there is attached a particular hazard of such disease that distinguishes it from the usual run of occupations, or the incidence of such disease is substantially higher in the occupation in which the employee was so engaged than in the usual run of occupations. In claims for death under s. 440.16, death must occur within 350 weeks after last exposure. Both causation and sufficient exposure to a specific harmful substance shown to be present in the workplace to support causation shall be proven by clear and convincing evidence.

Section 440.151(1)(a), Florida Statutes.

It is important to note that COVID 19 or any other communicable disease (TB, H1N1, etc.):  The employee has to test positive for the disease/contagion and it must be determined with a reasonable amount of certainty that their exposure to the virus occurred in the workplace and was not community-acquired.

In addition,  per Section 440.151(1)(c), Florida Statutes states:

Where an occupational disease is aggravated by any other disease or infirmity, not itself compensable, or where disability or death from any other cause, not itself compensable, is aggravated, prolonged, accelerated or in anywise contributed to by an occupational disease, the compensation shall be payable only if the occupational disease is the major contributing cause of the injury. Any compensation shall be reduced and limited to such proportion only of the compensation that would be payable if the occupational disease were the sole cause of the disability or death as such occupational disease, as a causative factor, bears to all the causes of such disability or death, such reduction in compensation to be effected by reducing the number of weekly or monthly payments or the amounts of such payments, as under the circumstances of the particular case may be for the best interest of the claimant or claimants. Major contributing cause must be demonstrated by medical evidence based on physical examination findings and diagnostic testing.

Section 440.151(1)(c), Florida Statutes, (emphasis added).

With regard to emergency medical technicians (EMTs) or paramedics Section 440.09(3), Florida Statutes, states:

If an emergency medical technician or paramedic is appointed or employed full time by a municipality, the state, or any political subdivision, is certified under chapter 401.23, in an emergency situation in this state, any such activities would be considered to be within the course of his or her employment and an emergency medical technician or paramedic and covered by the employer’s jurisdiction or area of responsibility, such activities are considered to be within the course of employment. The provisions of this subsection do not apply if the emergency medical technician or paramedic is performing activities for which he or she is paid by another employer of contractor.

Section 440.09(3), Florida Statutes (emphasis added).

Workers Compensation Benefits for Healthcare Professionals.

As of March 26, 2020, Florida has not issued any order or legislation explicitly stating that healthcare professionals exposed to COVID-19 will be entitled to Workers Compensation benefits.

By way of example, In the City of Phila. v. Workers’ Comp. Appeal Bd. (Sites), 889 A.2d 129 (Pa. Commw. Ct. 2005), a claimant was successful in proving that his hepatitis C was caused by his exposure to blood that occurred while working as a firefighter and emergency medical technician  (EMT).  Similar to COVID-19, hepatitis C was also classified as a compensable “occupational disease.”  Therefore, it is likely that a healthcare professional’s exposure to COVID-19 would result in viable workers’ compensation claim.

Federal workers’ compensation laws are similar to those quoted above. Therefore, federal health care providers and those working in federal facilities will also most probably be entitled to federal employment compensation (FECA) benefits under similar situations.

We want to emphasize that this is merely our preliminary opinion based on limited analysis and research.  It is provided for informational purposes only. It does not constitute the provision of legal advice.  Each state has different workers’ compensation laws and different case law, as does the federal government. Each individual set of circumstances may be different. Contact your local workers’ compensation plaintiff’s (claimant’s) attorney for advice and representation in your individual case.

For more information and more examples of employment compensation benefit cases for health care professionals, click here.

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

At the Health Law Firm, we provide legal services for all health care providers and professionals.  This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical student professors and clinical staff. We represent facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, in patient complaints, and in Department of Health investigations.

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

About the Authors:  Amanda I. Forbes, practices health law with The Health Law Firm in its Altamonte Springs, Florida, office.  George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law;  he is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com.  The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“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 © 2020 The Health Law Firm. All rights reserved.

By |2020-05-07T16:12:25-04:00May 25th, 2020|Categories: Pharmacy Law Blog|0 Comments

Florida Prosecutors Want Telehealth Suspect to Remain in Jail For $424 Million Fraud Scheme

Attorney George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 19, 2020, federal prosecutors in New Jersey federal court pushed to keep a suspect involved in a $424 million telemedicine scheme in jail.  Authorities called him an “unrepentant conman” who carried out one of the largest health care fraud schemes in U.S. history and is likely to flee the country if released.

Telehealth Fraud & Illegal Kickback Scheme.

The defendant, who owns telehealth companies, has been locked up for nearly 11 months since he was charged last year with running an international fraud and kickback scam. He allegedly paid doctors to order unnecessary orthotic braces for Medicare beneficiaries and solicited bribes and kickbacks from brace suppliers in exchange for patient referrals.

Prosecutors say he went to great lengths to hide his scheme, including lying to obtain legal opinion letters bolstering his claim that he ran legitimate companies that profited from patient subscription fees. In reality, he was concealing the fact that most of those payments were kickbacks from brace suppliers.

Is He a Flight Risk?

In an opposition brief, prosecutors said that there aren’t any suitable bail conditions for the suspect, given his risk of flight and the danger he poses to the community. According to the government, he has a long history of deception and scheming involving foreign businesses, residences, and assets, including a $1 million yacht. Additionally, he claimed to control several foreign bank accounts and once told a cooperating witness that if the government started investigating him, he would flee to Venezuela.

The defendant argued that he’s not a flight risk because he has no criminal history and has close ties to his South Florida community.

Florida’s Involved in a Major Fraud Case, Shocker!

Another scenario that seems to be right out of a Carl Hiaasen or Tim Dorsey novel.  Why does Florida continue to attract and protect the assets fo fraudsters, conmen, and deadbeats?  Does it go back to our history of being the wintering ground for carnies and traveling circuses?

In 2019, the defendant was charged along with 23 other individuals in a crackdown on telehealth fraud schemes in New Jersey, Pennsylvania, South Carolina Texas, Florida, and California, involving over $1.2 billion in losses.

Given his close community ties and its reputation, it comes as no surprise that getting doctors to sign off on fraudulent prescriptions was a part allegedly played by telehealth company owners in Florida. Click here to view the indictment.

For years, Florida has been the home to health care fraudsters and ranked number one in terms of fraud cases. So, it’s not shocking that three Florida telehealth executives were also charged in what appears to be the biggest case in the takedown.
Click here to learn more about this case.

Therefore, to prevent flight and protect the public, prosecutors requested that the Court deny the
defendant’s motion to revoke the detention order and keep him detained. Click here to read the opposition brief.

To read about a similar telehealth case in Florida, click here to read my prior blog.

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

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider. We represent facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions.

The services we provide include reviewing and negotiating contracts, business transactions, professional license defense, representation in investigations, credential defense, representation in peer review and clinical privileges hearings, Medicare and Medicaid audits, commercial litigation, and administrative hearings. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 or (970) 416-7456 or visit our website at www.TheHealthLawFirm.com.

Sources:

Bishop, Stweart. “Feds Push To Keep Telehealth Fraud Suspect Locked Up.” Law360. (March 19, 2020). Web.

Godoy, Jody. “Execs, MDs Charged In $1.2B Medicare Fraud Scheme.” Law360. (April 9, 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. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Registered agent for telehealth provider, telehealth provider investigation defense lawyer attorney, telemedicine representation, Florida telemedicine defense lawyer, telehealth expansion, representation for telehealth investigations, representation for telemedicine investigations, Florida Department of Health (DOH) representation, DOH defense lawyer, representation for DOH investigations, representation for Agency for Health Care Administration (AHCA) investigations, AHCA defense lawyer, AHCA investigation attorney, health care defense attorney, health care compliance defense lawyer, Florida health care attorney, representation for health care professionals, defense lawyer for health care providers, doctor lawyer, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Medicare audit defense attorney, Medicare inspection defense lawyer, Medicare subpoena defense lawyer, Medicare search warrant defense attorney, legal representation on Medicare fraud investigation, legal representation for Medicare fraud inspection, Medicare overpayment demand defense attorney, Department of Justice Health and Human Services subpoena defense attorney, legal representation for Department of Justice (DOJ) Health and Human Services subpoena, RAC audit defense attorney, ZPIC audit defense lawyer, Medicare fraud defense attorney, health care subpoena defense attorney

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

Hospital Countersues Whistleblower for Failing to Report Conduct Internally First

George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the whistleblower/relator in the lawsuit, breached his fiduciary duty to the company by failing to report the unlawful conduct internally, first. Instead, he used the information as the basis for his whistleblower claim. In the countersuit filed in the U.S. District Court for the Northern District of West Virginia, the Hospital accuses the former executive-turned-whistleblower of attempting to ‘extort a settlement’ and filing the FCA whistleblower suit as an act of revenge.

The Whistleblower’s Complaint.

The whistleblower, a former accountant, and senior executive at Wheeling Hospital, was discharged in August 2015. In December 2017, he filed a complaint under the qui tam provisions of the False Claims Act (FCA). He alleged the hospital violated the federal Anti-Kickback Statute (AKS) by paying kickbacks to physicians for patient referrals to the Hospital. Based on this, it is alleged, the claims for the services the hospital provided to the referred patients were false claims, subject to recoupment by the government.

The Hospital’s Countersuit.

In an unusual strategy, the Hospital filed a counter-suit against the whistleblower, alleging that he breached his fiduciary duty to the Hospital and abused the legal process. The Hospital’s case asserts that instead of carrying out his duty to the Hospital, instead, he capitalized on his alleged knowledge of the conduct to “extort a settlement” through a “false and frivolous” FCA suit as an act of revenge.

Additionally, the Hospital alleges that “at no time during his employment, or in his role as a partner at Deloitte, did he report any suspicions of fraud or violations of federal regulations to Wheeling Hospital’s compliance officer.”

You can read Wheeling Hospital’s countersuit against the whistleblower on our website in full.

The Significance of This Case: Unique Defense Strategy for Defending a Whistleblower Suit.

This case shows a unique, but legally valid, defense strategy that might be used in other future whistleblower cases. Often the information about false claims is produced by a high-ranking hospital or institutional employees whose job duties may have required them to report what they knew to the company as part of their job. The company should then have the opportunity to investigate and correct any improper billing or other misconduct that an errant employee might be carrying out on his own. By failing to do this, the employee may breach his duties to the company, may violate his employment contract, and may be subject to a suit or counter-suit over this. To the extent that the actions of the ex-employee cause the employer damages, the employer may be entitled to indemnification from the ex-employee.

However, the other side of the story is when an employee does make his or her superiors aware of suspected misconduct and false claims within the company and the company does nothing about it. This is often the case that we have when potential blowers contact us about filing a False Claims Act case. Often the whistleblower attempts to do the right thing by reporting it within the company and is stymied by his or her superiors. To us, this opens the door to legitimate whistleblower suits.

To read one of my prior blogs about South Florida Hospital reaching a settlement for similar FCA
claims, click here.

Click here to learn more about who can file a whistleblower/qui tam lawsuit and the reward programs for coming forward with a false claim.

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

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities that have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

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

Sources:

Pearlman, Steve and Freeman, Meika. “Top 10 Whistleblowing And Retaliation Events Of The Year.” Law360. (December 20, 2019). Web.

Goldberg, Pinchos. “Hospital Sues Whistleblower for Failing to Report Information And Choosing Instead to Use As Basis for Claim.” JD Supra. (May 8, 2019). Web.

Commins, John. “HOSPITAL COUNTERSUES FALSE CLAIMS WHISTLEBLOWER.” Health Leaders. (May 9, 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. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Keywords: Florida health law attorney, whistleblower attorney, whistleblower defense lawyer, Florida health law defense attorney, whistleblower defense attorney, whistleblower defense legal counsel, legal representation for whistleblower cases, qui tam lawyer, health law attorney, qui tam defense lawyer, qui tam plaintiff lawyer, whistleblower legal representation, False Claims Act lawyer, False Claims Act attorney, False Claims Act legal counsel, The Health Law Firm, DOJ defense lawyer, Office of Inspector General (OIG) defense counsel, Office of Inspector General (OIG) defense attorney, Office of Inspector General (OIG) legal representation, medcila legal defense attorney, health care fraud attorney, health care fraud lawyer, attorney legal representation for qui tam cases, Anti-Kickback Statute (AKS) attorney, Anti-Kickback Statute (AKS) lawyer, Anti-Kickback Statute (AKS) defense counsel, Medicare fraud defense lawyer attorney, Medicare fraud legal representation, Medicaid fraud defense lawyer attorney, legal representation for Medicare and Medicaid fraud, legal representation for Stark Law violations, healthcare fraud defense attorney, whistle blower lawyer attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida qui tam whistle blower lawyer attorney, Colorado qui tam whistle blower lawyer attorney, Louisiana qui tam whistle blower lawyer attorney, Kentucky qui tam whistle blower lawyer attorney, Virginia qui tam whistle blower lawyer attorney, District of Columbia (D.C.) qui tam whistle blower lawyer attorney, civil monetary penalties lawyer attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer attorney legal counsel, Virginia False Claims Act (FCA) and civil monetary penalties lawyer attorney, Virginia whistleblower lawyer attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer attorney, civil monetary penalties lawyer attorney

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

By |2019-12-30T21:22:42-05:00March 16th, 2020|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Walgreens Agrees to Pay $7.5 Million To End Lawsuit Over Unlicensed Pharmacist

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 February 4, 2020, Walgreens agreed to pay $7.5 million to settle allegations that for more than a decade it let an unlicensed pharmacist handle hundreds of thousands of prescriptions. The pharmacy giant settled with authorities after an employee was criminally charged with impersonating a pharmacist in California. Prosecutors said that from 2006 through 2017, she used the license numbers of other registered pharmacists to dispense more than 745,000 prescriptions at Walgreens stores.

A Phony Pharmacist.

According to the lawsuit, Kim Thien Le worked for Walgreens for more than 15 years, first as an intern and then a pharmacist, despite never having her license. Le allegedly used the license of another person with the same first name to dispense more than 100,000 prescriptions for dangerous controlled substances. By using the license numbers of legitimate pharmacists, she was able to illegally impersonate and dispense highly regulated controlled substances, including prescription opioids such as fentanyl, oxycodone, hydrocodone, morphine, and codeine.

State Pharmacy Audit.

California state authorities discovered that she did not have a license during a pharmacy board audit in 2017. In California, as in most states, working as a pharmacist or pharmacist intern without a license from the state Board of Pharmacy is a crime. Le was criminally charged by the state with three felonies: false personation, identity theft, and obtaining money, labor or property by false pretenses. To read California Attorney General’s press release on this case, click here.

In a public statement, the Santa Clara County District Attorney’s Office announced the lawsuit against Walgreens alleging the company failed to properly safeguard against an unlicensed employee working for it as a pharmacist. Click here to view the press release in full.

The settlement also requires Walgreens to ensure licensure compliance by implementing a verification program, posting proof of licensure, conducting annual audits, and submitting an annual compliance report.

To read about a similar case involving overprescribing in Florida, click here to read one of my prior blogs.

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

We routinely provide deposition coverage to pharmacists, pharmacies and other health professionals being deposed in criminal cases, negligence cases, civil cases or disciplinary cases involving other health professionals.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians, physician assistants and other health professionals in investigations and at Board of Pharmacy hearings. Call now or visit our website www.TheHealthLawFirm.com.

Sources:

“Walgreens to pay $7.5M in settlement over phony pharmacist.” AP News. (February 3, 2020). Web.

Zaveri, Mihir. “A Fake Pharmacist, 745,000 Prescriptions and a $7.5 Million Settlement.” The New York Times. (February 4, 2020). Web.

Clough, Craig. “Walgreens To Pay $7.5M To End Suit Over Fake Pharmacist.” Law360. (February 4, 2020). Web.

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

KeyWords: Florida Board of Pharmacy defense representation, legal defense for pharmacists, pharmacist defense lawyer, Board of Pharmacy defense lawyer, Board of Pharmacy hearing legal representation, pharmacy license disciplinary charges defense attorney, legal representation for pharmacist, legal representation for pharmacy, pharmacy defense lawyer, pharmacy audit defense representation, pharmacy audit defense attorney, board representation for pharmacists, board representation for pharmacies, board representation for physicians, Board of Pharmacy investigation representation, legal representation for board investigations, The Health Law Firm, administrative hearing defense attorney, DEA order to show cause (OSC) defense lawyer, legal representation for administrative hearings, DEA hearing defense attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, DEA order to show cause (OSC) defense attorney, Drug Enforcement Administration (DEA) defense attorney, Drug Enforcement Administration (DEA) investigation defense attorney, Drug Enforcement Administration (DEA) subpoena defense lawyer, Drug Enforcement Administration (DEA) inspection defense attorney, Drug Enforcement Administration (DEA) hearing defense attorney, Drug Enforcement Administration (DEA) order to show cause (OTSC) defense lawyer

“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 © 2020 The Health Law Firm. All rights reserved.

Finding a Healthcare Providers Service Organization (HPSO) Insurance Attorney to Defend you in a Complaint Against Your Pharmacist or Pharmacy License

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Many pharmacists or their pharmacies carry professional malpractice insurance through Healthcare Providers Service Organization (HPSO) or one of the other similar professional liability insurance companies. What they may not realize is that this insurance will pay for their legal defense expenses if there is a complaint filed against their pharmacist license or the pharmacy’s license. It will also pay for legal defense expenses if they receive a subpoena for records, if they are required to attend a deposition, or if they are accused of violating HIPAA or a client’s medical confidentiality.

Under this type of policy, the insurance company will pay the legal fees and other costs related to your defense or legal representation. However, you will be required to locate and retain the appropriate attorney to represent you in the matter.

What to Look For When Retaining an Attorney to Defend You.

1. The primary qualification for any attorney you hire to represent you should be his or her experience in working with health professionals in the same field. If the attorney is not familiar with your area of health practice, with the type of legal proceeding you have, or with your professional licensing board, it may be difficult for that attorney to represent you properly.

2. If consult with an attorney who states that she or he will help you make a statement to the investigator or assist you in the investigation, but will not agree to appear and represent you in hearings, then this is the wrong attorney. You need an attorney that can represent you from start to finish.

3. Seek and retain an attorney who accepts the insurance that you have, whether it is HPSO Insurance, CPH & Associates Insurance, Philadelphia Insurance, Pharmacist Mutual Insurance Company (PMIC), Trust Management Services, Philadelphia Insurance, Firemans Fund, or another national company. This will ensure that you have an attorney who will give you the lower rates the insurance company has negotiated and will have a good working relationship established with your insurance company. If an attorney with our firm cannot represent you, we will try to find you an attorney who will.

4. You also want to retain the services of an attorney who has appeared before your professional board or professional licensing authority in investigations and hearings, especially in formal administrative hearings.

5. Often you will come across an attorney who only wants you to accept a consent order, stipulation, or settlement agreement. Remember that these are all merely plea bargains and you will be pleading guilty to whatever offenses are charged. This is teh easy way out and often the easy way is not the right way. IF you plead guilty then, from that point on, you are guilty. In most cases, however, you will actually be innocent of the charges and will need a formal administrative hearing in order to prove this.

6. You don’t necessarily need an attorney who resides in your city, state, or location. Almost all the work on the case will be done by telephone and e-mail. You usually have only one meeting or hearing and, depending on what type of hearing it is, it could be located in many different locations. Our attorneys will travel to those locations for meetings and hearings.

7. Beware of attorneys who hold themselves out in Internet advertising as health attorneys or professional license defense attorneys but are really some other type of attorneys. We see this a lot from medical malpractice attorneys, criminal defense attorneys and attorneys who sue insurance companies. Be sure you get an attorney who concentrates his or her practice in defending those in the specialty of pharmacy and in board of pharmacy complaints, investigations, and hearings.

8. If you can’t find an attorney to meet your immediate needs through our firm or an Internet search, you may contact your insurance company or professional association and ask if they have a list of attorneys that can do the legal work you require.

For example, you may reach Healthcare Providers Service Organization (HPSO) at (800) 982-9491; you can reach Nurses Service Organization (NSO) at (800) 247-1500; you can reach CPH & Associates at (800) 875-1911 or (312) 987-9823; you can reach Pharmacists Mutual Insurance Company (PMIC) at (800) 247-5930.

Contact Health Law Attorneys Experienced Investigations of Pharmacists and Pharmacies.

The attorneys of The Health Law Firm provide legal representation to pharmacists, pharmacies, prescribing physicians, dispensing physicians and nurse practitioners, and other health providers in pharmacy board complaints and investigations, Department of Health (DOH) investigations, Colorado DORA investigations, Drug Enforcement Administration (DEA) investigations, Medicare and Medicaid audits, Medicaid Fraud Control Unit (MFCU) 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.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

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: Healthcare Providers Service Organization (HPSO) Insurance defense attorney, HPSO defense lawyer, Florida HPSO defense attorney lawyer, Colorado HPSO defense attorney lawyer, legal representation for HPSO matters in Colorado, legal representation for HPSO matters in Florida, representation for professional liability insurance cases, Louisiana HPSO defense attorney lawyer, legal representation for HPSO matters in Louisiana, HPSO deposition defense coverage, representation for licensed mental health counselors (LMHCs), pharmacist defense lawyer, pharmacy defense attorney lawyer, medical prescriber legal representation, pharmacist complaint cases, pharmacy complaint cases, Florida Colorado Louisiana pharmacy complaint cases, defense lawyer for pharmacists, Florida health law defense attorney, medical license defense, Florida Department of Health (DOH) attorney, representation for Louisiana and Florida Department of Health (DOH) complaint investigations, Louisiana and Florida Department of Health (DOH) defense lawyer, Colorado Division of Regulatory Agencies (DORA) defense attorney, representation for Florida Colorado Division of Regulatory Agencies (DORA) complaint investigations, Colorado Division of Regulatory Agencies (DORA) defense lawyer, Lousiana LPC Board defense attorney lawyer, Board of Pharmacy defense, Board of Pharmacy complaints, representation for Board of Pharmacy investigations, Florida Board of Pharmacy defense lawyer, Colorado Board of Pharmacy defense lawyer, Health Law Firm reviews, reviews of The Health Law Firm attorneys, administrative complaint defense lawyer, administrative complaint defense attorney, administrative hearing defense lawyer, administrative hearing defense attorney, administrative hearing defense legal counsel, Drug Enforcement Administration (DEA) investigation defense attorney lawyer, Medicare and Medicaid audit defense attorney lawyer, Medicaid Fraud Control Unit (MFCU) investigation defnse attorney lawyer

“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 © 2020 The Health Law Firm. All rights reserved.

By |2020-02-04T16:39:04-05:00February 4th, 2020|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

2019’s Largest Healthcare Fraud Case Ever Prosecuted: No Surprise, Florida Wins!

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
For years, Florida has topped the lists with the highest rates of Medicare and Medicaid fraud and abuse. But even by the standards of Florida’s rampant healthcare fraud, this 2019 case stands out for its sheer size, making Florida, once again, the leader in fakes and frauds. Often joked and written about by Florida novelists such as Carl Hiassin and Tim Dorsey, this case serves to highlight why the “Debtor’s Haven” state often excels in cases of healthcare fraud.

In April 2019, after decades of alleged schemes, illegal kickbacks and money laundering in connection with fraudulent claims to Medicare and Medicaid, Phillip Esformes was sentenced to 20 years in prison. He was also ordered to pay $44.2 million in money forfeitures and restitution, and forfeiture of his ownership interests in several skilled nursing homes.

A federal district judge sentenced the South Florida health care facility owner after he was found guilty in the largest health care fraud scheme ever charged by the U.S. Justice Department (DOJ).

A Case of “Epic” Fraud.

The nursing home mogul was accused of paying bribes and receiving kickbacks in a massive $1 billion Medicare fraud case touted by federal prosecutors as the largest in the nation. During an eight-week jury trial, prosecutors argued that Esformes himself made $38 million from Medicare and Medicaid payments between 2010 and 2016. Additionally, his South Florida network received more than $450 million through bribes and though services that weren’t medically necessary or which were never provided, according to the prosecution’s case.

To learn more about this case, click here to read one of my prior blogs.

Convicted, But Not of Healthcare Fraud.

The shocker, in this case, is that the federal jury convicted Esformes on 20 counts of conspiracy to defraud the taxpayer-funded Medicare program. The lack of a conviction for healthcare fraud itself was puzzling. Many of his alleged co-conspirators had already pled guilty to health care fraud and some had even testified against him at trial. To learn more, click here to read one of my prior blogs on another individual involved in the case.

Despite being billed as the largest healthcare fraud case prosecuted in U.S. history, it is also a stark reminder to prosecutors of how tricky it can be to secure a conviction on any particular charge.

To read the DOJ’s press release about this case in full, click here.

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 and Medicaid audits, and in ZPIC and RAC audits throughout Florida and across the U.S. We also represent health providers in civil and administrative litigation by government agencies and insurance companies attempting to recoup claims that have been paid. Our attorneys also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, recovery actions and administrative actions seeking termination from Medicare and Medicaid Programs.

The Health Law Firm’s attorneys routinely represent physicians, dentists, pharmacists, psychotherapists, medical groups, clinics, pharmacies, assisted living facilities (ALFs), home health 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.


Sources:

Weaver, Jay. “Miami healthcare exec Esformes sentenced to 20 years in biggest Medicare fraud case.” Miami Herald. (September 12, 2019). Web.

Hale, Nathan. “The Biggest Stories In Florida Legal News Of 2019.” Law360. (December 20, 2019). Web.

Jackson, David. “Nursing home mogul Philip Esformes sentenced to 20 years for $1.3 billion Medicaid fraud.” Chicago Tribune. (September 13, 2019). Web.

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

Keywords: Medicare and Medicaid fraud defense attorney, legal representation for Medicare and Medicaid fraud defense, Medicare and Medicaid fraud defense legal counsel, Medicare and Medicaid fraud defense lawyer, defense of Medicare and Medicaid fraud charges, CMS, ZPIC and RAC audit defense attorney, CMS, ZPIC and RAC audit defense lawyer, CMS, ZPIC and RAC audit legal representation, Medicaid Fraud Control Unit (MFCU) defense attorney, health care clinic fraud audit, Medicaid Fraud Control Unit (MFCU) defense lawyer, Medicaid Fraud Control Unit (MFCU) defense legal counsel, Medicaid Fraud Control Unit (MFCU) subpoena defense attorney, Medicaid Fraud Control Unit (MFCU) subpoena legal representation, Medicaid Fraud Control Unit (MFCU) subpoena defense lawyer, OIG, HHS, DOJ and U.S. Attorney subpoena defense lawyer, OIG, HHS, DOJ and U.S. Attorney subpoena defense attorney, OIG, HHS, DOJ and U.S. Attorney subpoena legal representation, legal representation for allegations of Medicare fraud, legal representation for health care fraud, healthcare fraud defense attorney, healthcare fraud defense lawyer, reviews of the Health Law Firm, The Health Law Firm attorney reviews, Health law defense attorney, healthcare fraud defense legal representation, legal representation for submitting false claims, false claims defense lawyer, false claims legal defense representation, false claims 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) investigation defnse, DOJ defense representation, False Claims Act (FCA) legal defense attorney lawyer, False Claims Act (FCA) defense legal representation counsel, Anti-Kickback Statute (AKS) defense attorney, AKS legal defense representation, AKS defense lawyer

“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 © 2019/2020 The Health Law Firm. All rights reserved.

By |2020-01-23T17:31:06-05:00January 27th, 2020|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Florida Doctor Charged in Largest Medicare Fraud Scheme Ever Reported

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

On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. According to prosecutors, the doctor allegedly authorized genetic testing for patients he never met, in a state where he’s not licensed to practice.

The vast fraud scheme totaled $2.1 billion worth of false Medicare and Medicaid claims between July 2018 and January 2019. The physician is being charged in the United States District Court of New Jersey with conspiracy to commit health care fraud.

Fraudulent Orders for Genetic Testing.

Thirty-five separate defendants are now facing felony charges for their alleged participation in one of the largest health care fraud schemes ever investigated and charged. All defendants involved were somehow associated with telemedicine companies and cancer genetic testing laboratories, according to a Department of Justice (DOJ) news release. Click here to read the DOJ press release in full and learn more about the case and all the defendants being charged.

According to the release, one of the defendants, the Florida doctor, submitted fraudulent orders for genetic tests to numerous clinical laboratories. He allegedly authorized his signature on patient documents to order tests for patients he had never met, seen, treated or evaluated. Additionally, according to an indictment filed by the District Court of New Jersey, this physician received about $5,000 a month for his role as Privy Health Lab’s medical director in Illinois. During this period, according to prosecutors, he falsely reported himself as the patients’ ordering physician so that he could sign orders for the genetic testing. In 2018 alone, Medicare paid clinical laboratories at least $4.6 million for genetic tests that he allegedly ordered in this manner.

The Gainesville doctor faces charges of conspiracy to commit healthcare fraud following an investigation by the DOJ, U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG), and the Federal Bureau of Investigation (FBI).

To learn about a similar case of healthcare fraud dealing with genetic testing, click here to read part one and here to read part two of my blog series on a prior scam.

Innocent until Proven Guilty in a Court of Law.

We are writing this blog from information from several different media sources including those referenced below and a DOJ press release. It must be remembered that just as is consistently stated in the “Bad Boys” television series, “the defendants are presumed innocent until proven guilty in a court of law.”

Contact Health Law Attorneys Experienced with Health Care Fraud and Qui Tam or Whistleblower Cases.

The Health Law Firm’s attorneys routinely represent physicians, medical practices, clinical labs, 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.

Attorneys with The Health Law Firm also represent health care professionals and others who may desire to file a qui tam, False Claims Act or whistleblower suit. We work with physicians, nurses and other professionals to investigate, document and file such cases. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding and other services that assist us in such matters. We have represented several doctors and other licensed health professionals as relators in bringing qui tam or whistleblower cases. Our attorneys are also available to defend physicians, medical groups and health care providers in qui tam or whistleblower cases.

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

Sources:

Mavrakis, Emily. “Gainesville doctor charged for fraud over genetic testing.” The Gainesville Sun. (October 1, 2019). Web.

Villegas, Brianda. “Gainesville doctor charged in federal health care fraud case.” WCJB TV20. (October 1, 2019). Web.

U.S. Department of Justice, Press Release dated September 26, 2019, (https://www.justice.gov/usao-nj/pr/federal-health-care-fraud-takedown-northeastern-us-results-54-defendants-charged-and)

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: Healthcare fraud representation, healthcare fraud lawyer, healthcare fraud defense attorney, Whistle blower plaintiff-relator attorney, Qui tam suit plaintiff-relator attorney, False Claims Act suit plaintiff-relator attorney, Medicare audit defense attorney, Medicare audit defense legal representation, Medicare audit defense lawyer, Tricare audit defense attorney, Tricare audit defense legal representation, Tricare audit defense lawyer, Medicaid audit defense attorney, Medicaid audit defense legal representation, Medicaid audit defense lawyer, Medicaid Fraud Control Unit (MFCU) defense attorney, Medicaid Fraud Control Unit (MFCU) defense legal representation, Medicaid Fraud Control Unit (MFCU) defense lawyer, Medicare overpayment demand defense attorney, Medicare overpayment demand defense legal representation, Medicare overpayment demand defense lawyer, Office of Inspector General (OIG) investigation defense attorney, Office of Inspector General (OIG) investigation defense legal representation, Office of Inspector General (OIG) investigation defense lawyer, Civil Monetary Penalty defense attorney, Civil Monetary Penalty defense legal representation, Civil Monetary Penalty defense lawyer, Whistle blower suit defense attorney, Whistle blower suit defense legal representation, Whistle blower suit defense lawyer, Qui tam suit defense attorney, Qui Tam suit defense legal representation, Qui tam suit defense lawyer, False Claims Act suit defense attorney, False Claims Act suit defense legal representation, False Claims Act suit defense lawyer, representation for allegations of overbilling, representation for FCA investigations, Office of Inspector General (OIG) interview defense attorney, Office of Inspector General (OIG) interview defense legal representation, Office of Inspector General (OIG) interview defense lawyer, reviews of The Health Law Firm, The Health Law Firm attorney reviews

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

By |2019-11-07T03:42:21-05:00November 22nd, 2019|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Physician Sentenced to 40 Years in Prison For Illegally Prescribing Opioid Pills

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

On October 2, 2019, a Virginia doctor received a 40-year prison sentence for illegally prescribing more than half a million opioid pills over 19 months. The U.S. District Court for the Western District of Virginia handed down the sentence to Joel Smithers, who was reported to have operated a “pill mill” out of Virginia, according to authorities. In addition to prison time, he was given an $86,000 fine and will serve three years of supervised release upon the completion of his prison time, according to court documents.

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

Alleged Interstate Pill Mill.

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

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

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

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

The Problems I See.

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

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

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

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

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

Contact Health Law Attorneys Experienced with DEA Cases.

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

Sources:

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

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

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

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

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

“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 |2019-11-06T20:33:34-05:00November 6th, 2019|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Need Last Minute Deposition or Hearing Representation? Call The Health Law Firm

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

Our office often takes phone calls from pharmacies and pharmacists needing short-notice representation at a Board of Pharmacy hearing or at a deposition related to a health care matter.

In our experience, many other law firms refuse to represent clients at hearings unless the firm is given plenty of advance notice. We always prefer to have sufficient time to obtain documents, review files, interview witnesses, conduct research and prepare, in order to provide the best possible representation to our client. However, we realize that in certain cases, the alternative is that the client either gets legal representation on little or no advance notice or has to suffer the consequences of having no legal representation.

Administrative Proceedings Can be Complex.

In some cases, individuals may be fooled into believing that they can effectively represent themselves. They later find out that they have gotten in over their heads. Laypersons (meaning, in this case, nonlawyers) who are not aware of such complex matters as the Administrative Procedure Act, the Rules of Civil Procedure, the Rules of Evidence, the Florida Administrative Code (F.A.C.) Rules which the Board of Pharmacy and the Department of Health (DOH) have enacted, may quickly be confused.

The inexperienced individual, or even the inexperienced attorney, in these matters, can fall into a number of procedural traps that damage an effective defense. This can be advising the individual to talk to the DOH investigator, filing an unnecessary answer to an Administrative Complaint, forgetting or not knowing that the client’s right to be free of self-incrimination applies in this type of case and many, many others.

Procedural Mistakes Can Be Damaging To Your Legal Defense.

Often you will find that merely having an experienced attorney to represent you at a hearing or Board meeting will assist you in avoiding mistakes that damage your case and assist you in preserving your rights for an appeal. In other cases, it may even be possible to obtain a change in the forum to obtain a better result. For example, many laypersons do not know that if you elect an informal hearing before the Board of Pharmacy, you have waived your right to prove you are innocent by contesting the facts alleged against you.

What few know or think of in the heat of the moment is that you can ask at the informal hearing before the Board of Pharmacy to contest the facts, to prove you are not guilty of the charges, and to have the hearing converted to a formal hearing. A formal hearing will be in front of a neutral Administrative Law Judge (ALJ), and you have a great many more procedural rights than you have at an informal hearing. However, we still recommend that you have an experienced health lawyer represent you at a formal hearing.

Professional Liability Insurance May Pay Legal Fees for Deposition Coverage.

If you are a pharmacist or pharmacy that has professional liability insurance, these often provide legal coverage for depositions. This is primarily because the outcome of the deposition may include having you named as a defendant in a professional liability or negligence lawsuit or having disciplinary charges filed against you.

One of the first things you should do if you receive a subpoena or a notice of a deposition is to contact your professional liability insurance carrier and see if it will pay for an attorney to represent you. For example, Healthcare Providers Service Organization (HPSO), CPH & Associates, Nurses Service Organization (NSO), Dentists Advantage and many other malpractice insurance companies provide excellent deposition coverage.

The second thing you should do is to call an experienced attorney and schedule a consultation. Even if you cannot afford to retain the services of the attorney for the actual deposition, a consultation may assist you in properly preparing. Click here to read our blog on this matter and learn more.

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

We routinely provide deposition coverage to pharmacists, pharmacies and other health professionals being deposed in criminal cases, negligence cases, civil cases or disciplinary cases involving other health professionals.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians, physician assistants and other health professionals in investigations and at Board of Pharmacy hearings. Call 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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Florida Board of Pharmacy, Legal Defense for Pharmacists, Pharmacist, Pharmacy and tagged Administrative Law Judge, administrative procedure act, administrative proceeding, ALJ, Board of Pharmacy, Board of Pharmacy hearing, defense attorney, defense lawyer, Department of Health, deposition coverage, disciplinary charges, disciplinary complaint, FAC, final hearing, Florida Administrative Code, formal hearing, health law firm, health professional, hearing representation, Informal hearing, last-minute deposition coverage, legal representation, legal representation for pharmacist, legal representation for pharmacy, local deposition coverage, negligence lawsuit, noticed of a deposition, pharmacist, pharmacy, professional liability insurance, rights for an appeal, Rules of Civil Procedure, Rules of Evidence, short notice of representation of pharmacy, short notice representation of pharmacist, subpoena, The Health Law Firm

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

Common Errors We See in Pharmacy Inspections and How to Avoid Them

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm

Pharmacies and pharmacists are subject to many types of inspections. These inspections are necessary to determine whether the business and its employees are complying with state and federal laws and regulations. Administrative agencies, such as the Drug Enforcement Administration (DEA), Food and Drug Administration (FDA) and the Department of Health (DOH), have the authority to inspect pharmacies.

Inspections may be routine and simply to confirm compliance with the law. Annual inspections by the Florida DOH are examples of these. However, inspections can also be triggered by a fear of imminent danger to the public health, safety, and welfare; a formal complaint; or the belief that a specific violation of law by the pharmacy or pharmacist has occurred or may occur.

Common Errors Found During Inspections.

With our experience working with pharmacists and pharmacies we’ve seen a number of different inspection deficiencies. These errors may result in a complaint being filed and the beginning of the administrative law process regarding investigations and hearings.

Here are some common deficiencies often found during pharmacy inspections:

1.  Pharmacy technicians not properly identified with name tags and identified as
pharmacy technicians (as opposed to pharmacists);

2.  Pharmacy technicians not supervised by pharmacist;

3.  Medication on shelves not properly labeled (including exact number of pills remaining in bottle);

4.  Controlled substances not accurately recorded on appropriate forms;

5.  Not keeping schedule II inventory and dispensing records separate from schedule III-V records;

6.  Failure to maintain a biennial inventory;

7.  Controlled substance records (including invoices, inventories and logs) not properly maintained for required number of years;

8.  Not having an accurate count for all controlled substances on hand;

9.  Required DEA forms not maintained, accurate or complete;

10.  Inadequate security measures (cameras, alarms, etc.);

11.  Failure to control access to secured areas;

12.  Proper pre-hire screenings not in place (background checks, references, etc.);

13.  Proper computer security measures not in place;

14.  Not properly identifying suspect controlled substance prescriptions;

15.  No corrective measures in place to ensure legitimacy of a controlled substance
prescription;

16.  Not knowing the requirements for filling a legitimate controlled substance
prescription;

17.  Refrigerator not being maintained at the appropriate temperature; and

18.  Food or other non medications (e.g., lab samples) being kept in refrigerator with medications.

Be Aware: All Pharmacies Are Subject to Inspections.

We are constantly writing blogs on pharmacies that, after inspections, get served with immediate suspension orders (ISO), emergency suspension orders (ESO), or have their controlled substance registrations revoked. This is not happening to just the smaller independent stores, but to the big chain pharmacies as well.

In a prior case, the DEA revoked the controlled substance licenses from two CVS pharmacies in Sanford, Florida. (Click here to read that blog.) This is why it is imperative for all pharmacies and pharmacists to know the state and federal laws and regulations.

Your Best Defense.

In our opinion, your best defenses are the following:

1.  Know the laws and rules and be sure they are fully implemented and followed, always, by everyone in the store.
2.  Maintain good professional liability insurance that includes coverage for legal defense of administrative complaints and complaints against your pharmacy license and your pharmacist license.  Cover should be at least $25,000 for legal defense expenses at the very minimum. Contact Lloyd’s of London or Healthcare Providers Service Organization (HPSO) if your agent can’t locate this insurance for you.

3.  Contract with a good pharmacy consultant and have him/her make frequent visits and “mock investigations.”

Talk to an Experienced Attorney Before You Talk to an Investigator.

In Florida, you do not have any duty to cooperate with any investigator who is investigating you. This extends to DOH investigators, DEA special agents, police officers, sheriffs’ deputies or criminal investigators of any type. Our advice is to always contact an experienced health law attorney before making a statement to an investigator. Click here to read a previous blog on the best practice tips for dealing with investigators.

Never voluntary relinquish your DEA registration or your pharmacy license without speaking to an experienced health law attorney first. Click here to read a blog on why this is so important.

Contact Health Law Attorneys Experienced with Investigations of Pharmacies and Pharmacists.

The attorneys of The Health Law Firm provide legal representation to pharmacies, pharmacists 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.

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

Carole C. Schriefer 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: Pharmacy defense lawyer, representation for pharmacies, pharmacy law defense attorney, representation for pharmacy inspections, representation for Drug Enforcement Administration (DEA), DEA investigation lawyer, DEA pharmacy investigation attorney, Food and Drug Administration (FDA) representation, FDA investigation lawyer, FDA pharmacy investigation representation, Florida Board of Pharmacy lawyer, representation for Board of Pharmacy inspections, Department of Health (DOH) representation DOH defense lawyer, DOH inspections, DOH investigators, common deficiencies in pharmacy inspection, health law defense attorney, administrative law representation,  legal defense for administrative complaints,  Florida defense attorney, Florida defense lawyer, The Health Law reviews, reviews of The Health Law Firm

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

Load More Posts