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Are You Worried About Health Care Compliance Consequences? Have They Gone Too Far?

By Lance O. Leider, J.D., LL.M., The Health Law Firm

From large hospital systems to solo practitioners, there is no escaping health care compliance in the industry. The concept of compliance can spark different thoughts in different people. For example, some believe it is an unnecessary government intrusion and others believe it’s a way to improve the quality and costs of health care.

No matter your thoughts on health care compliance and government oversight, regulation of the health care industry will never be eliminated. In fact, we expect it to increase as more quality-based requirements are implemented.

We believe compliance and regulations are necessary, but we have to wonder if sometimes these laws go too far.

Those Cute Baby Photos Can Cost You.

As an example of laws going too far, photos of cooing newborn babies used to cover the bulletin boards of doctors’ offices. However, under the Health Insurance Portability and Accountability Act (HIPAA), these baby photos are considered protected health information, along the same lines as a medical chart or social security number. A report by The New York Times indicates many offices have removed these types of photos or moved them to private portions of the office. According to the Office for Civil Rights (OCR) Department of Health and Human Services (HHS), doctors’ offices are not allowed to post these photos without a specific written authorization from the parent.

To read more on this topic, click here.

Health Care Compliance Overview.

Health care compliance is the ongoing process of meeting or exceeding the legal, ethical and professional standards applicable to a particular health care organization or provider. Health care compliance requires health care organizations and providers to develop effective processes, policies, and procedures to define appropriate conduct, train the organization’s staff, and then monitor the adherence to the processes, polices and procedures.

Health care compliance covers numerous areas including patient care, billing, reimbursement, managed care contracting, OSHA, and HIPAA privacy and security to new a few.

To read a basic overview of health care compliance for organizations and providers, click here.

How to Deal with Compliance Overkill.

The primary purpose of health care compliance is to improve patient care. It is nearly impossible to overstate the complexity of health care compliance. Health care organizations and providers are not only required to comply with Medicare rules and regulations, but they are also required to comply with numerous other federal and state health care laws, rules and regulations.

When dealing with compliance issues, our recommendation is to use your common sense and best judgment. Fear usually leads to absurd situations. With all the fear and propaganda out there it is important to stick to your instincts and put patient care first.

Health care compliance is cumbersome, many may agree too cumbersome. However, it is here to stay.

Do you think health care compliance has gone too far? How do you try to keep up with health care compliance laws and regulations? Are you worried about compliance consequences?

Contact a Health Law Attorney Experienced in Defending HIPAA Complaints and Violations.

The attorneys of The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other health care providers and institutions in investigating and defending alleged HIPAA complaints and violations and in preparing Corrective Action Plans (CAPs).

For more information about HIPAA violations, electronic health records or corrective action plans (CAPs) please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Sources:

Hartocollis, Anemona. “Baby Pictures at the Doctor’s? Cute, Sure, but Illegal.” The New York Times. (August 9, 2014). From: http://www.nytimes.com/2014/08/10/nyregion/baby-pictures-at-doctors-cute-sure-but-illegal.html?_r=0

Kirsch, M.D., Michael. “The Consequences of Zero Tolerance: Why HIPAA is Overkill.” Kevin M.D. (January 1, 2014). From: http://www.kevinmd.com/blog/2014/01/consequences-tolerance-hipaa-overkill.html

About the Author: Lance O. Leider 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 Insurance Portability and Accountability Act (HIPAA), HIPAA Omnibus Rule, HIPAA compliance, HIPAA lawyer, HIPAA compliance attorney, data security lawyer, protected health information (PHI), Patient privacy, U.S. Department of Health and Human Services (HHS), Office of Civil Rights (OCR), patient rights, HIPAA compliance audit, privacy defense attorney, health care compliance lawyer, compliance defense attorney, healthcare compliance defense lawyer, health care defense lawyer, HIPAA attorney, HIPAA lawyer, compliance plans, health law firm, The Health Law Firm, health law defense attorney, health care professional defense attorney, legal representation for healthcare professionals, 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 © 2018 The Health Law Firm. All rights reserved.

By |2018-10-27T07:48:12+00:00October 27th, 2018|The Health Law Firm Blog|0 Comments

Health Care Professionals: Fight Back Against Bad Online Reviews

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

Defamatory attacks against health care professionals have become increasingly prevalent as more and more review sites join the world wide web. This allows patients to post virtually anything they want – good or bad – about a physician or any professional. With more physicians becoming employees of hospital systems or large healthcare institutions, adverse surveys, reports or reviews can affect advancement, bonuses and basic income.

Online Review Websites.

Internet ratings on review sites like Vitals.com and Yelp.com can range from snide comments about the patient’s waiting time in the physician’s office to vicious attacks that can have a serious implications for a physician. In many cases, the review, comment, or rating may be a purposely untrue statement by a disgruntled patient, competitor or former employee. When the comment is posted, search engines like Google, Yahoo, Bing, AOL, or MSN may bring up the false statement every time someone searches for that doctor’s name. This can cost doctors both their reputation and their business, especially if they start losing patients because of bad reviews.

Many health professionals are now seeking legal strategies to combat alleged online libel and defamation in order to save their reputation and their practice. However, not all negative online comments or ratings meet the actual definition of “defamation.” Defamation generally is a factual statement that can be proven true or false. For example, if a patient writes that she had a procedure performed by a doctor, this is a statement of fact that can be confirmed or disproved. However, if someone writes about a doctor’s poor attitude during a visit, this statement is usually considered to be an opinion which cannot necessarily be proven true or false.

Additionally, online review sites usually have a set of clear guidelines when posting public reviews. For example, Google has a list of prohibited and restricted content in their terms of use. The most common prohibited and restricted content includes: spam or fake content, impersonation, illegal or sexually explicit content, dangerous and derogatory content and conflict of interest. Click here to view these examples in Google’s terms of use.

If you find any statements about you or your practice that may be considered defamatory or prohibited content, the following are some legal measures you may take to try to stop the inflammatory comments:

1. Identify person making comments.

Attempt to identify the person making the negative remarks. You may find it is a disgruntled former employee or a friend or relative of the patient who does not have any first-hand knowledge. See other tips below on how you might do this. Contact that person directly.

2. Check your office records.

Your own records should be checked. Your notes about office visits or procedures, your appointment schedule or your own billing records may help you identify the patient who wrote the review or comment. If you think you may know who wrote a comment, try to contact the patient directly to discuss his or her concerns and request that the comment be removed. Sometimes you will find that you never treated this person or that the patient has the wrong physician.

3. Consult with an attorney.

Before making any decisions about the contents of a comment, consult with an experienced attorney for guidance. An experienced attorney will be able to determine whether the internet posting is considered an opinion, spam or defamation.

4. Send a letter to the website, website host, owner and internet service provider.

Once the individual responsible for the post has been identified, doctors can contact the patient directly to ask that the post be removed. If the patient refuses, a doctor should request that his or her attorney send a letter warning the poster of potential legal action if the post is not removed from the website. If that doesn’t work, the physician should have his or her attorney send a letter demanding the comments be removed to the website, website host, owner and internet service provider.

5. Contact the website.

If you are unable to determine who may have written something online, or if the person refuses to take the comment down, try contacting the website that the review or comment is posted on. Many websites have policies against spam and defamatory statements. Contact the website to ask about its policy and get the comment removed. However, be very careful about signing up as a participant on the website and, especially, of agreeing to its terms of service (TOS) or terms of use (TOU). See below.

6. Avoid agreeing to the website’s terms.

Avoid the urge to join the website, subscribe to the website or otherwise agree to the website’s policies and procedures. You may be agreeing to a legally enforceable contract that waives your rights to sue for defamation or other course of action. Every website has Terms of Service (TOS) or Terms of Use (TOU), usually with a simple block to check to acknowledge you agree to all of its terms. Do not do this. You may be waiving all of your rights to legally challenge defamatory comments that are published.

7. File a lawsuit.

Filing a lawsuit should be a physician’s last resort in handling defamatory online comments. Legal proceedings can often take years to complete and can draw more negative attention to the physician. However, in many cases the only way for a physician to defend his or her reputation is in court.

Before you can file a lawsuit you must check state laws regarding statute of limitations in which to file defamation suits. If the negative comment falls outside this statute of limitations, you will not be able to sue. You will also need to review state defamation and false light laws to see what are considered appropriate claims. Remember it is difficult to sue someone for an opinion, and many online reviews can be considered and can’t be proven true or false. It is also usually best to sue the individual poster, not the website, as The Communications Decency Act of 1996 protects Internet service providers from liability for third-party comments.

8. Seek a subpoena.

If the website provides no assistance in removing the comment, you and your attorney can seek a subpoena ordering the Internet service provider to give identification data. Generally courts will grant a subpoena during a defamation investigation. Identification information could be an email address, name or location information of the poster.

9. Request a court order.

If all requests for a post to be removed are unsuccessful, doctors can request a court order or an injunction. A doctor must be able to show that the comments are probably false and are causing irreparable harm to their reputation or practice in order for a judge to demand the comments be removed. Usually you will be required to file a petition or complaint (lawsuit) first.

There are also alternative methods for protecting your reputation online. Be proactive and make sure you are putting out positive information about yourself and your practice through your website, social media sites, and blogs. This will help bury negative comments that appear on search-engine results, making it less likely that potential patients will see bad reviews.

Physicians should also distribute surveys to their patients, which provide an instant forum for patients to express their feelings about visits. Such tools as having your own internal office complaint/grievance procedure for patient complaints may help. If patients feel that they are able to provide immediate feedback to a physician, they may be less inclined to share their feelings online.

Remember to be persistent when you are trying to fight negative online reviews! Large corporations such as Google offer the ability to flag certain negative reviews but don’t always remove it. It pays to speak to a person on the phone so that you can explain the reasoning that the review needs to be removed. Don’t give up!

The following court documents pertain to cases involving defamation against physicians:
A copy of the Preliminary Injunction filed in Barry Eppley, MD, v. Lucille Iacovelli, in the United States District Court for the Southern District of Indiana, Indianapolis Division.
A copy of the Notice of Removal filed in Doctor John Doe, Doctor John Doe Incorporated and Jane Doe v. Google Inc., in the United States District Court for the Northern District of Illinois, Eastern Division.

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. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians in investigations and at Board of Medicine and Board of Osteopathic Medicine hearings. We 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.

KeyWords: representation of health care professionals, health law defense attorney, doctor attorney, nurse attorney, Department of Health defense attorneyDOH investigation representation, quality assurance representation, Medicare investigation lawyer, representation for Medicaidinvestigation, representation for health care professionals, license defense lawyer, licensure representation, representation for license defense, licensure defense attorney, protecting your professional license, The Health Law Firm, Florida health law attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2018 The Health Law Firm. All rights reserved.

 

By |2018-09-07T22:55:23+00:00October 18th, 2018|The Health Law Firm Blog, Uncategorized|0 Comments

OIG Exclusion: What You Need to Know if You’re on the List

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

Have you ever had disciplinary action against your license as a health care professional? Have you ever been arrested or convicted of a criminal offense? Have you ever been convicted of fraud or patient neglect? If so, then you may have also been terminated or excluded from the federal Medicare Program or your state Medicaid Program.

Many health professionals don’t understand the significant repercussions that an exclusion action by the Office of the Inspector General (OIG) can have on their career and employment. Whether you are a physician, nurse, dentist, psychologist or other health professional, if you allow yourself to be excluded from the Medicare Program, devastating economic results may follow.

Check the List.

To check if you are on the federal government’s List of Excluded Individuals and Entities (LEIE), click here.

To see if you are on Florida’s list of individuals and entities who have been terminated from Florida’s Medicaid Program, click here.

Collateral Consequences to OIG Exclusion or Termination.

Termination or exclusion can have many collateral consequences about which most health care providers are not aware. These Include:

– Termination for cause from all state Medicaid Programs.

– Loss of state professional licenses in other states and jurisdictions.

– Loss of hospital, ambulatory surgical center (ASC), and nursing home clinical privileges.

– Removal from the provider panels of health insurers.

– Loss of ability to contract or work for any individual or entity that contracts with the Medicare Program in any capacity (officer agent, shareholder, director, employee or independent contractor, even for non-Medicare products and services such as office supplies, building and construction services, software and systems support, etc.), including physicians, medical groups, hospitals, healthcare systems, ambulatory surgical centers, skilled nursing facilities, health insurance companies, etc.

– Placement on the General Services Administration (GSA) Exclusions List (or “Debarred” List) from government contracting.

– Loss of ability to contract or work for any individual or entity that contracts with the federal government in any capacity (officer agent, shareholder, director, employee or independent contractor, even for such services as construction projects, janitorial contracts, computer equipment and software services, real estate brokers on federally underwritten housing loans, sales of motor vehicles, products and services to the government, etc.

To learn more on the consequences of being excluded, click here.

You’re on the List, Now What?

If you find yourself on a state’s excluded or terminated list or if you find yourself on the federal LEIE, all is not lost. There are ways to become reinstated.

The OIG exclusion list is a complicated regulatory program which requires experience and perseverance to navigate. It is highly recommended that you do not attempt to handle removal without qualified assistance. If your application is denied, even for hyper-technical reasons, you may be barred from reapplying for one full calendar year. Therefore, it is crucial that your application is complete and correct, and you are fully eligible for removal. To read a past blog about reinstatement after OIG removal, click here.

Contact Attorney Experienced in Defending Against Action to Exclude an Individual or Business from the Medicare Program and Assisting in Reinstatement Applications.

The attorneys of The Health Law Firm have experience in dealing with the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS), and defending against action to exclude an individual or business entity from the Medicare Program, in administrative hearings on this type of action, in submitting applications requesting reinstatement to the Medicare Program after exclusion, and removal from the List of Excluded Individuals and Entities (LEIE).

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: Exclusion list, Office of Inspector General, OIG, OIG exclusion list, OIG reinstatement representation, representation for physicians, representation for physician reimbursement, licensure defense attorney, professional license representation, licensure defense representation, representation for health care professionals, investigations analyst, applying for reinstatement, Application for Reinstatement, Medicare Exclusion attorney, OIG Hearing, Request for Reinstatement, Removal from List of Excluded Individuals and Entities (LEIE), Application to OIG, Medicare Reinstatement representation, Medicaid Reinstatement representation, healthcare fraud lawyes, Medicare defense attorney, Medicaid defense lawyer, Florida defense attorney, Florida defense lawyer, The Health Law Firm 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 © 2018 The Health Law Firm. All rights reserved.

By |2018-10-10T17:20:48+00:00October 10th, 2018|In the Know, The Health Law Firm Blog|0 Comments

Hey, Health Care Professionals…Why Can’t We Be Friends?!

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

Every year, our firm sponsors and attends various medical industry events. Needless to say, our law firm table is not the most popular hangout spot. If we had a penny for every time we have heard “Yikes, an attorney! I hope I never need you.” we could close our doors and all retire.

The feeling is akin to being the last kid picked for teams in gym class. So we ask ourselves: why are we attorneys shunned by health care professionals? Why won’t anyone make eye contact with us at meetings and events? Why is there a negative stigma attached to the phrase “law firm?”

We found the answer.

It’s Not Us. It’s You.

Before you take great offense to such a bold statement, hear me out. Society as a whole seems to have a misconceived notion that a law firm’s services are solely for reactive purposes. Meaning, you need defensive legal assistance. In these reactive situations, lawyers defend their clients to make the most out of an unfortunate situation. I frequently hear, “well nothing has gone wrong yet, so why do I need an attorney?” Here’s the secret: We can do much more than help you when something has gone wrong.

To reap the maximum potential from your profession, you should be utilizing “legal checkups” instead of burying your head in the sand. First, it’s more cost effective to hire a lawyer proactively BEFORE something goes wrong. When you are proactive about your legal needs, you have time to be selective in choosing the right lawyer for your needs. You can build a foundation before you invest in your legal needs. Typically, if you are in need of a lawyer to reactively defend you, you’re already knee-deep and you won’t be afforded the opportunity to find the best attorney.

Taking The Initiative Legal Business Advice.

The benefits of proactively obtaining an attorney are often overlooked. Having an attorney available at any time for legal protection and business advice may not always cross a health care professional’s mind. I find this to be ironic. Health care professionals recommend patients to eat healthy, exercise often, take daily vitamins, and schedule regular checkups. All these suggestions are proactive measures to ensure a stable life, full of longevity. Doesn’t it grind your gears when patients overlook your expert advice until something goes terribly wrong? We can both agree that preemptive measures are necessary in health and health care business.

I am not a medical expert, therefore, I would not attempt to perform a surgical procedure or offer a diagnosis. Legal services are the same. Most health care professionals cannot draft a contract themselves or set up a partnership office flawlessly without experienced legal expertise.

Proactive Legal Help We Often See Overlooked.

Whether it be our firm or not, health care professionals and businesses need a trusted health law attorney readily available to ask for help when additional legal knowledge, experience, or judgment is needed. The following list outlines health care business legal services that are proactive in nature.

– Obtain a contract review, of any agreement, before you sign the dotted line. It is crucial to
have a lawyer experienced in health law review convoluted documents that may bind you to
terms and conditions that you should not be liable for.

– Hire an attorney to negotiate your employment contracts to ensure that you are fairly
compensated for your work.

– A health law attorney adept in assisting with a business restructuring is invaluable. Whether
you are opening or closing a medical office, taking part in a merger, or launching or dissolving
a partnership, these transactions are complex. It is not in your best interest to attempt any
business maneuver without the input of a trusted health law attorney who is familiar with your
professional business goals.

– A compliance assessment is an important proactive measure for health providers and
businesses. With the increase of federal and state oversight, it is wise to have a thorough
review and analysis of your business protocols and procedures on a regular basis. An
experienced health law attorney can help you avoid critical administrative pitfalls. These
assessments verify compliance in areas such as: Medicare/Medicaid billing claims, patient
record keeping, HIPAA and HITECH procedures, etc.

You know what they say, it’s better to be safe than sorry. Hiring an attorney is NOT solely for the purpose of negative occurrences or damaging mistakes. As a health care professional, it is crucial to work with a trusted health lawyer to advise you in your business decisions. Don’t rely on the notion that you don’t need a lawyer until you are in trouble. Heeding our warning, you could save yourself a lot of time and money.

Contact a Health Care Attorney Experienced in Negotiating and Evaluating Physician and Health Professional’s Business Transactions.

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 (DME), medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider or facility.

The services we provide include reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, advice on setting aside or voiding contracts, litigation of contracts (in state or federal court), business transactions, professional license defense, opinion letters, representation in investigations, fair hearing defense, representation in peer review and clinical privileges hearings, litigation of restrictive covenant, Medicare and Medicaid audits, commercial litigation, and administrative hearings.

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

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: Proactive legal services, health law legal advice, health care professional legal help, corporate law, corporate health law, contract review, employment contract reviews, office reconstruction, medical office reconstruction, compliance assessment, partnership dissolutions, mergers, legal business advice, corporate law attorney, corporate lawyer, employment law, employment law attorney, contract negotiation, contract negotiation attorney, contract negotiation lawyer, health law, business law, legal business advice, legal advice, health care professional, attorney for health care professionals, representation for health care professionals, representation for health care facilities, health law defense lawyer, employment law representation, The Health Law Firm, 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 © 2018 The Health Law Firm. All rights reserved.

By |2018-09-11T20:05:56+00:00September 11th, 2018|The Health Law Firm Blog|0 Comments

Ready or Not, It’s Irregular Behavior Season Once Again…

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

Every year, our firm receives calls from panicked medical students and residents about a recent letter they have received, alleging irregular behavior on standardized medical examinations.

This letter may come from the National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE), or the Educational Commission for Foreign Medical Graduates (ECFMG). No matter the organization, if you receive a letter alleging irregular behavior, it will typically say the following:

A bulletin or policy related to the exam stating that Irregular Behavior is not permitted.

The facts alleging irregular behavior in this case.

You have an opportunity to respond to the allegations, in person, with counsel.

Often there is a very short window of time to respond to such allegations. While this is important because it is urgent that you get your results test results, it also gives a limited time to prepare to defend yourself.

What is Irregular Behavior?

Although irregular behavior is not the same thing as cheating, it is often thought of as the same by medical school officials and residency program directors. A notice of irregular behavior may hold up and delay your entry into a residency program, your graduation from medical school, and your job opportunities. Your examination scores will be held up while the matter is reviewed by a USMLE Committee on irregular behavior or until a hearing can be held.

What Should You Do?

Once you receive an irregular behavior letter, begin to compile documents to defend yourself. Write out your version of events in order to recall what happened. Collect character reference letters from professors and administrators that attest to your integrity.

Place the personal appearance date listed in your letter on your calendar. It is of upmost importance that you attend in person, preferably with representation. Hearings are usually held in Philadelphia, Pennsylvania, so plan accordingly.

Why Hiring an Attorney Matters.

An attorney can provide the following services to someone accused of irregular behavior:
Review documents, videos, photographs, and all other information that pertains to your case.

Recommend other documents that you should obtain in your defense.

Prepare you for a personal appearance before the respective board or committee making the allegations, and will also make a personal appearance with you at hearing.

Prepare you to answer questions under pressure and on the day of your hearing.

The takeaway message is that retaining an attorney to represent you against irregular behavior allegations could be the difference between a clear record and a mark that will follow you for the rest of your career. Don’t risk jeopardizing your future as a healthcare practitioner. Consult with an attorney as soon as you receive notice of allegations against you regarding irregular behavior.

Consequences of an Irregular Behavior Finding.

If a finding of irregular behavior is made against you, then this usually means that your best score is voided, and you must retake it. The USMLE Committee may require you to wait a year or more to retake the examination. This can prevent you from obtaining or entering a residency program or it may delay you from graduating. Furthermore, the notation that you were found to have committed irregular behavior will be placed on your Step exam transcript. This will be reported out when your test scores are reported.

As indicated above, many medical decision makers view this as similar to cheating. It may disqualify you for many jobs or residency programs that you would otherwise be considered for. If you are accused of irregular behavior, immediately consult with an attorney who has actual experience in dealing with this matter. You can find more information about irregular behavior by clicking here to watch our informational video blog. Click here to read one of my prior blogs on USMLE.

Contact Experienced Health Law Attorneys For Irregular Behavior or USMLE Issues Today.

The attorneys of The Health Law Firm provide legal representation to medical students, residents, interns and fellows in academic disputes, graduate medical education (GME) hearings, contract negotiations, license applications, board certification applications and hearings, credential hearings, and civil and administrative litigations.
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.

Keywords: National Board of Medical Examiners (NBME), medical students, medical resident, irregular behavior, United States Medical Licensing Examination (USMLE), Examination Committee for Foreign Medical Graduates (ECFMG), cheating, USMLE preparation course , USMLE hearings, USMLE appeals, defense attorney, defense lawyer, legal representation, medical student lawyer, medical student attorney, medical resident lawyer, medical resident attorney, medical intern lawyer, medical intern attorney, accused of irregular behavior, The Health Law Firm reviews

“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 © 2018 The Health Law Firm. All rights reserved.

Helpful Tips to Speed Up the Medicare Prepayment Review Process

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

For Medicare providers, being notified of an impending audit is not welcome news. Being notified of a prepayment review is even worse. In a prepayment review, the health care provider must submit documentation to the Centers for Medicare & Medicaid Services (CMS) contractor before ever receiving payment. The health care provider will only receive payment (typically months later) if the contractor is satisfied with the provider’s documentation. This can be financially disastrous for the health care provider, who still must pay day-to-day expenses while waiting for a decision.

CMS Contractors.

If you have received notice of prepayment review, you first need to determine the contractor that has initiated the review. CMS contracts with four types of contractors:

– Medicare Administrative Contractors (MACs);
– Comprehensive Error Rate Testing (CERT) contractors;
– Recovery Audit Contractors (RACs); and
– Zone Program Integrity Contractors (ZPICs).

Both the Medicare Administrative Contractors (MACs) and Zone Program Integrity Contractors (ZPICs) can initiate prepayment reviews.

MAC Prepayment Reviews.

MACs will initiate prepayment reviews of health care providers suspected of improper billing for services. If the MAC detects anything resembling fraud during the process, the prepayment review can extend for up to a year or more. However, MACs will generally terminate the prepayment review when the health care provider demonstrates a pattern of correct billing. Health care providers who are notified of a MAC prepayment review should consult with an experienced health care attorney from the beginning of the process. An experienced health attorney will be able to assist the health care provider to ensure everything is in place for a speedy prepayment review.

ZPIC Prepayment Reviews.

A MAC may refer a health care provider to a ZPIC for a benefit integrity prepayment review if they suspect fraud. A ZPIC can also initiate a benefit integrity prepayment review based on data analysis.  Unlike MACs, ZPICs generally are less willing to communicate with health care providers about the prepayment review.

Additionally, there are different time limitations for a benefit integrity prepayment review. The MAC prepayment review is governed by Medicare Manual provisions that stipulate a maximum length of time on a prepayment review. However, a benefit integrity prepayment review can last indefinitely, if the basis for the review is not timely and properly addressed by the health care provider.

Further, ZPICs make fraud referrals to the Department of Health and Human Services (HHS) Office of the Inspector General (OIG). Thus, health care providers should view ZPIC correspondence as the start of a potentially larger investigation. An experienced health care attorney should be contacted immediately after a health care provider receives any contact from ZPIC.

How to Accomplish a Speedy Review.

In many cases, the health care provider will be on Medicare prepayment review until its billing accuracy reaches a certain percentage. However there are other steps to help speed up the Medicare prepayment audit process.

1.  Read all Correspondence from the Contractor Carefully.

Pay close attention to all correspondence sent by the contractor. Make a note of the due date given and make sure your response is sent well within the time limits. Denials will usually occur if a response is not received by the given deadline. Also be sure that you send your response to the correct office.

2.  Be Familiar with Local Coverage Determinations (LCDs).

You should read and be familiar with any and all applicable local coverage determinations (LCDs) and national coverage determinations (NCDs) for any codes, services, supplies or equipment you are billing.

3.  Contact an Experienced Health Care Attorney Immediately.

A health care attorney who is experienced in prepayment reviews will be able to help you file a proper response in a timely fashion. An attorney will also be able to help find out additional information on why you have been placed on prepayment review and exactly what documentation the auditor is looking for. Alternatively, a health care consultant who has actual experience in working on Medicare cases and who has been an expert witness in Medicare hearings may be able to assist, as well.

4.  Contact the Contractor Responsible for the Review.

After you have consulted with an attorney, schedule a call with the contractor responsible for your prepayment review. During the call learn as many details about the audit as you can and find out what the reviewer wants in the documentation.

However, do not:
a. Argue with the auditor.
b. Berate or demean the auditor.
c. Challenge the auditor’s knowledge, competence or credentials.
d. Ask the auditor to prove anything to you.
e. Demand to speak to the auditor’s supervisor.

5.  Do Not File Duplicate Claims.

Keep track of all requests for additional documentation and when they were received. Do not think that you need to file another claim for the same items just because you have not received a response as quickly as other claims where additional documentation was not requested. If you provide duplicate claims, the contractor’s decision can be delayed.

6.  Organize all Submissions and Results.

You must keep track of the date you receive the document request for a claim, the date you submitted the documentation for review, the result of the audit and the date the result was received. This will help you realize how quickly claims are reviewed. If a one claim’s review has taken longer than the others you’ve submitted, you can contact the reviewer to make sure they have received the claim and everything is in order.

7.  Follow-up with the Contractor for Feedback.

Keep in contact with the contractor throughout the review. This will help to maintain the relationship you initiated after first receiving notice of the prepayment review. This will also help you keep track of any issues and resolve them. Be sure to discuss how you can improve your claim submissions to meet the standards of your particular reviewer.

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

The attorneys of The Health Law Firm represent health care providers in prepayment reviews. 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:

Baird, Jeff. “Q&A with Jeff Baird: How to Prepare for and Survive Prepayment Reviews.” Home Care. (Sept. 13, 2010). From http://homecaremag.com/news/prepayment-review-faq-20100913/

Greene, Stephanie Morgan. “5 Steps to Get Off Pre-Payment Audit – Quickly!” Harrington Managment Group. (Mar. 18, 2011). From
http://homecaremag.com/news/prepayment-review-faq-20100913/

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.

Tag Words: prepayment audit, prepayment review, Medicare audits, Medicare, Centers for Medicare & Medicaid Services, CMS, RAC, Recovery Audit Contractor, ZPIC, Zone Program Integrity Contractor, MAC, Medicare Administrative Contractor, CERT contractor, Comprehensive Error Rate Testing contractor, overpayment, prepayment reviews, First Coast Service Options, Medicare contractor, Medicare fraud, Medicare investigation, Medicare overbilling, OIG

“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 © 2018 The Health Law Firm. All rights reserved.

By |2018-08-29T18:50:11+00:00August 29th, 2018|The Health Law Firm Blog|0 Comments

Health Care Professionals Need to be Compliant with Anti-Fraud Laws

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

The federal government has several tools available to help combat Medicare fraud. Among those are the Stark Act, Anti-Kickback laws and Civil Monetary Penalty Laws. Each of these typically focuses on a particular type of behavior that is prone to abuse by health care providers.

The Stark laws exist to combat the problems that can arise from physician self-referrals. Self-referrals are cases in which a physician orders a test or service and refers the patient to a provider in which the referring physician has a financial interest. This second provider will then bill Medicare for the service, essentially allowing the referring physician to cash in twice.

The concern is that if physicians are permitted to benefit from referring to an entity, they will be prone to order tests and services that are not medically necessary. I previously wrote an article on the legal ramifications of unnecessary tests, which was published in Medical Economics. Click here to read that article.

Obligations for Compliance.

Stark compliance is a two-way street. Not only is the physician prohibited from referring to an entity in which he has a non-exempt financial interest, the provider receiving the referral is prohibited from accepting it.

Medicare conditions payment of a claim upon the certification by the claimant that it is in compliance with the Stark law. What this means is that there is an obligation on the recipient of a referral to make sure that it is proper.

In the complicated world of healthcare business entities, it is incumbent upon the management of a supplier of Designated Health Services (DHS) to know who all of its owners, investors, and stakeholders are so that it can remain in compliance and avoid any charges of impropriety.

Exceptions to Stark Law.

Like many other regulatory frameworks, the Stark law have exceptions. The law provides a number of exceptions to the rules which allow otherwise impermissible referral arrangements to pass muster.

Because the exceptions are numerous and often subject to change, it is highly recommended that any new business arrangement, or substantial change to an existing one, is reviewed by a health law attorney experienced in the area of Stark law.

Contact Health Law Attorneys Experienced in Handling Stark Compliance.

If you are involved in referring or providing DHS it is crucial that your arrangements are reviewed for compliance with Stark and other anti-fraud laws.

Violations of these laws can carry severe financial and criminal penalties. One of the best ways to avoid these sanctions is to have your current or potential arrangement reviewed by an attorney who is experienced in these matters.

The Health Law Firm routinely advises healthcare providers on Stark compliance issues for practitioners and providers of all types of DHS. We can advise you on the legality of a particular arrangement and can assist with remedying any perceived compliance issues.

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: Medicare representation, Medicare fraud representation, Medicare fraud defense lawyer, Medicare audit representation, Medicare fraud prevention, Stark Law attorney, Stark Law representation, Anti-Kickback representation, AKS defense lawyer, representation for healthcare fraud, health care fraud compliance, representation for health care professionals, health law defense attorney, health care fraud lawyer, Florida defense attorney, Florida defense lawyer, heath law attorney, health law lawyer, representation for health care professionals, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Florida health law defense attorney, protecting your professional license

“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 © 2018 The Health Law Firm. All rights reserved.

FDA Releases Draft Guidance to Revamp Drug Indication and Usage Labels

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

On July 6, 2018, the U.S. Food and Drug Administration (FDA) released draft guidance outlining its recommendations for how drug companies should word the indications and usage sections on a drug’s label. The new guidance aims to increase readability and reduce redundant information on indications and usage.

Drug Indication Label.

Prescribers can expect to see revamped drug labels with clearer descriptions of the conditions and patient populations for which an FDA-approved drug is indicated. Also, described in the guidance are circumstances when it might be appropriate for an indication to be either broader or narrower than the parameters of the clinical studies that backed its approval.

In addition to suggesting what information labels should include, the draft guidance also indicates what should be omitted to avoid unnecessary clutter the label.

The FDA hopes this guidance will give health care providers more precise information on which conditions a drug is approved to treat and, therefore, help identify the correct treatment options for patients. To read the FDA’s draft guidance in full, click here.

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

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

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

Sources:

Gever, John. “Drug Labels to Get FDA Revamp.” MedPage Today. (July 6, 2018). Web.

Field, Emily. “FDA Releases Draft Guidance On Drug Indication Labeling.” Law360. (July 6, 2018). Web.

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

KeyWords: Food and Drug Administration (FDA) defense attorney, representation for FDA matters, legal representation for health care professionals, representation for prescribers, pharmacy representation, legal representation for pharmacies, pharmacy defense lawyer, pharmacist representation, legal representation for pharmacists, pharmacist defense attorney, health care compliance lawyer, health law defense attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“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 © 2018 The Health Law Firm. All rights reserved.

By |2018-07-12T19:27:45+00:00July 12th, 2018|The Health Law Firm Blog|0 Comments

Texas Doctor Charged With Faking Diagnoses in $240 Million Health Care Fraud Scheme

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

On May 14, 2018, a Texas doctor was arrested on charges he led a $240 million health care fraud and money laundering scheme. He allegedly falsely diagnosed at least 16 patients with degenerative diseases and gave them unneeded chemotherapy and other treatments.

Fake Diagnoses and Treatments.

The doctor allegedly bilked Medicare, Medicaid, TRICARE, Blue Cross Blue Shield and others through a scheme in which he would falsely diagnose patients with diseases like rheumatoid arthritis. According to the indictment, he would then give them treatments based on those false diagnoses, and conduct repetitive and excessive unnecessary medical procedures.

Additionally, the office staff alleges that they were instructed to increase the number of medical procedures performed on patients. If patients questioned him about the diagnoses and procedures, he subsequently dismissed them from his practices, according to the indictment.

In an attempt to hide the scheme from government investigators, he created fake patient records and hid other medical records.

Money Laundering.

The doctor and his alleged co-conspirators submitted about $240 million in false claims to the health care benefit programs and he allegedly used this money to fund a very lavish lifestyle. He allegedly laundered proceeds from the scheme through a money exchange house in Texas, to various accounts maintained by financial institutions in Mexico.

According to prosecutors, the indictment lists 16 patients who were allegedly victims of the scheme, which dates back to 2000. Federal Prosecutors say they will seek the harshest punishment possible in this case.

Click here to read the indictment.

To read about a similar case involving a doctor giving false diagnoses and treatments, click here.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

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

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

Sources:

Krochtengel, Jess. “Texas Doc Charged With Faking Diagnoses In $240M Scheme.” Law360. (May 14, 2018). Web.

“Valley Doctor Charged in Alleged $240M Health Care Fraud Case.” KRGB News. (May 14, 2018). Web.

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

KeyWords: Medicaid fraud attorney, Medicaid fraud representation, Medicare fraud attorney, Medicare fraud representation, submitting false claims to the government, False Claims Act defense counsel, FCA attorney, health care litigation lawyer, legal representation for health care fraud defense, health care litigation attorney, representation for unnecessary medical procedures, intentionally misdiagnosing patients, fraudulent billings defense attorney, defrauding health care benefit programs, Medicare audit defense attorney, Medicare billing attorney, physician billing attorney, TRICARE attorney, TRICARE fraud representation, health care fraud representation, Medicaid audit attorney, Medicaid audit representation, Medicare audit representation, fraudulent billing representation, 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 © 2018 The Health Law Firm. All rights reserved.

By |2018-07-05T18:48:05+00:00July 5th, 2018|The Health Law Firm Blog|0 Comments

Terrible Things That Can Happen after Discipline on Your Professional License or Resignation of a License after Notice of Investigation

Patricia's Photos 013By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Do you have a medical, pharmacy or nursing license in several different states?  Do you have a license in more than one health profession?  Have you been notified that an investigation has been opened against you?  Are you thinking about resigning your professional license or voluntarily relinquishing such a license?  Then you must be aware of the following.

First, you should never voluntarily relinquish or resign your license after you know that an investigation has been opened or that disciplinary action has been taken against you.  Such a resignation is considered to be a “disciplinary relinquishment” and is treated the same as if your license had been revoked on disciplinary grounds.

Second, this will be reported out to other states, agencies, to the National Practitioner Data Bank (NPDB), to any certifying bodies for certifications you have and to other reporting agencies (such as the National Council of State Board of Nursing, the National Association of Boards of Pharmacy or the American Board of Internal Medicine).  Other states and other professional boards will most likely initiate disciplinary action based upon the first one.

Protect Your License from These Adverse Actions.

The following is a list of some of the adverse actions that you can expect to be taken against you after discipline on your license or after you resign your professional license after receiving notice of investigation:

1.  A mandatory report to the National Practitioner Data Base (NPDB) which remains there for 50 years. Note: The Healthcare Integrity and Protection Data Bank or HIPDB recently merged into the NPDB.

2.  Must be reported to and included in the Department of Health (DOH) profile that is available to the public online (for those having one), and remains for at least ten years.

3.  Any other states or jurisdictions in which the nurse has a license will also initiate an investigation and possible disciplinary action against him or her in that jurisdiction.  (Note:  I have had two clients who had licenses in seven other states and all, even ones that were inactive or not renewed years ago, initiated action).

4.  The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) will take action to exclude the provider from the Medicare Program.  If this occurs (and most of these offenses require mandatory exclusion) the provider will be placed on the List of Excluded Individuals and Entities (LEIE) maintained by the HHS OIG.

a.  If this happens, you are prohibited by law from working in any position in any capacity for any individual or business, including hospitals, nursing homes, home health agencies, physicians, medical groups, insurance companies, etc., that contract with or bill Medicare or Medicaid.  This means, for example, you are prohibited from working as a janitor in a nursing home that accepts Medicare or Medicaid, even as an independent contractor.

b.  If this happens, you are also automatically “debarred” or prohibited from participating in any capacity in any federal contracting, and you are placed on the U.S. General Services Administration’s (GSA) debarment list.  This means you are prohibited by law from working in any capacity for any government contractor or anyone who takes government funding.  This applies, for example, to prevent you from being a real estate agent involved in selling property financed by a government backed loan, prohibited from working for an electrical company that bids on contracts for government housing projects, working as a school teacher in a public school, etc.

c.  If this happens, your state Medicaid Program is required to terminate you “for cause” from the state Medicaid Program.  In many states, this is also grounds for revocation of your license.

5.  Any profile or reporting system maintained by a national organization or federation (e.g., NURSYS profile maintained by the National Council of State Boards of Nursing, American Medical Association physician profile, or the Federation of State Board of Physical Therapy profile) will include the adverse action in it, generally available to the public.

6.  If you are a nurse practitioner or other professional with clinical privileges at a hospital, nursing home, HMO or clinic, action will be taken to revoke or suspend the clinical privileges and staff membership if you have such. This may be in a hospital, ambulatory surgical center, skilled nursing facility, staff model HMO or clinic.  This will usually be for physicians, physician assistants (PAs), advance registered nurse practitioners (ARNPs), certified registered nurse anesthetists (CRNAs), nurse midwives or certified nurse anesthetists (CNAs), podiatrists, clinical psychologist or clinical pharmacists.

7.  Third party payors (health insurance companies, HMOs, etc.) will terminate the professional’s contract or panel membership with that organization.

8.  The U.S. Drug Enforcement Administration (DEA) will act to revoke the  professional’s DEA registration if he or she has one.

9.  Many employers will not hire you or will terminate your employment if they discover your license has been disciplined in another state.

What Should You Do?

–  Don’t take the easy way out by immediately relinquishing your license if you are notified you are under investigation.

–  Don’t hide your head in the sand by thinking the case will just go away on its own.

–  Don’t take the easy way out.  If you are innocent of the charges, request a formal hearing and contest the charges; defend yourself.

–  Do not request an informal hearing or a settlement agreement in which you admit the facts alleged against you are all true.  If you do this, you are “pleading guilty.”

–  Do immediately seek the advice of an attorney who has experience in such professional licensing matters and administrative hearings.  They are out there, but you may have to search for one.  Do this as soon as you get notice of any investigation and especially before you have talked to or made any statement (including a written one) to any investigator.

–  Do purchase professional liability insurance that includes legal defense coverage for any professional license investigation against you, whether it is related to a malpractice claim or not.  This insurance is cheap and will provide needed legal assistance at the time when you may be out of a job and not have money to hire an attorney.  Beware of the insurance policy that only covers professional license defense if it is related to a malpractice claim.

Professional Liability Insurance.

We strongly encourage all licensed health professionals and facilities to purchase their own, independent insurance coverage.  Make sure it covers professional license defense under all circumstances.  Make sure you have enough coverage to actually get you through a hearing. $25,000 coverage for just professional licensure defense is the absolute minimum you should purchase;  $50,000 may be adequate but $75,000 or $100,000 may be what you really need in such a situation.  For a few dollars more (and I do mean only a few) you can usually purchase the higher limits.

Also, I will repeat, make sure it covers your legal defense in an administrative disciplinary proceeding against your license, even if there is no malpractice claim filed against you or likely to be filed against you.

We also recommend that you purchase coverage through an insurance company that allows you to select your own attorney and does not make you use one that the insurance company picks for you.

Companies we have encountered in the past who provide an inexpensive top quality insurance product for professional license defense costs include:  CPH & Associates Insurance, Nurses Service Organization (NSO) Insurance, Healthcare Providers Organization (HPSO) Insurance and Lloyd’s of London Insurance.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents physicians, nurses, pharmacists, pharmacies, dentists, mental health counselors, massage therapists and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), 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., 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.

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