VA Physicians and Health Professionals Should Fight Allegations of Substandard Care in Peer Review Matters

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

I have represented physicians, psychologists, nurse practitioners, nurses and other health professionals working in Veterans Administration (VA) medical centers and clinics throughout the United States.  My representation has included personnel and employment issues, disciplinary actions, investigations, peer review investigations, clinical privileges actions, fair hearings, National Practitioner Data Bank (NPDB) actions and appeals.

If a complaint involving allegations of lack of clinical competence or skill is made, it is extremely important for the physician or nurse practitioner to retain the services of an experienced health lawyer to represent him or her immediately.  This is not the time to seek the cheapest attorney you can find.  You need skilled representation by an advocate who knows medical terminology, understands medical issues and procedures, knows physicians, and has experience with fair hearings.

You Have Rights.

VA Handbook 1100.19, Credentialing and Privileging, requires that the VA hospital afford you due process of law and fundamental fairness at every step of the process in any clinical privileges action.  This includes timely advance notice of the specific allegations made against you, the evidence that is to be used against you, legal representation, advance notice of witnesses and documents that may be introduced against you, the opportunity to prepare a defense to the allegations, the right to cross examine witnesses, the right to introduce evidence (documents and witnesses, including expert witnesses) in your defense, a neutral and unbiased hearing panel, and other such rights.  Attorneys who are not familiar with such hearings may be unaware of your rights or how to properly exercise and safeguard them.

How to Take Care of Your License.

Don’t seek legal advice from your colleagues, from your accountant or from an attorney who does not specialize in such matters. We don’t recommend shopping around for the cheapest attorney you can find.  Please do not hire a personal injury attorney, a civil litigation attorney, and employment law attorney or any other attorney without health law experience.  Your professional life, career and medical license are at stake.  You are in the fight of your life.  Treat it as such.

If you were diagnosed with a brain tumor, would you attempt to perform your own brain surgery?  Would you shop around to find the cheapest neurosurgeon to perform the surgery?  Or would you look for the best?  Yet, physicians routinely believe they can represent themselves in such matters.  In our experience, this simply is not the case.

Contact an Experienced Health Law Attorney Before You Do Anything.

Far too frequently we are contacted by physicians after the investigation has been completed, after the hearing has been held and after the physician’s clinical privileges have been revoked.  Except for an appeal on narrow grounds, little can be done.

If the VA revokes your clinical privileges, by regulation, this will be reported to the NPDB and to every state in which you have a license.  The NPDB report remains on your file for 50 years.  Any time in the future you apply for clinical privileges, for a medical license or for medical malpractice insurance, this report will come up and cause you serious problems.  It is extremely difficult, if not impossible, to obtain employment or to obtain clinical privileges in any hospital or institution with such a NPDB report on your file.  Additionally, any state in which you hold a license will also open an investigation against your medical license.

NPDB reports can be mitigated by filing an explanatory rebuttal (as is your right) or by filing a request for a Secretarial Review (appeal).  We can do this for you.  However, it is best to prevent a NPDB report from being filed to begin with.

Contact a Health Law Attorney Experienced in the Representation of Veterans Administration (VA) Physician Representation and Military Physician Representation.

The attorneys of The Health Law Firm have represented physicians, psychologists, nurse practitioners, nurse and other health professionals working in Veterans Administration medical centers and clinics throughout the United States.  Representation has included personnel and employment issues, disciplinary action, investigations, peer review investigations, clinical privileges actions, fair hearings, National Practitioner Data Bank (NPDB) actions and appeals.

To contact The Health Law Firm, please call (407) 331-6620 or (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.

Governor Requests the Agency for Health Care Administration to Inspect Florida’s VA Hospitals

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

In response to recent deaths at Veterans Affairs (VA) hospitals throughout Florida and the rest of the nation, on April 1, 2014, Governor Rick Scott wrote a letter to the Florida Agency for Health Care Administration (AHCA) requesting the agency begin inspecting VA hospitals in the Sunshine Health Network. This network under investigation includes Florida, south Georgia, Puerto Rico and the U.S. Virgin Islands. So far the VA has denied AHCA any permission to inspect its hospitals, and it is unclear whether the federal government will allow such inspections moving forward.

To see a copy of the Governor’s letter to the AHCA, click here.

Governor Scott Wants Answers in Patient Death Cases.

According to The Tampa Bay Tribune, Governor Scott wants answers in regard to the deaths of five patients in the VA region serving Florida. It was reported in March 2014, that five cancer patients died and nine others sustained injuries because of delays in diagnosis or treatment. The Tampa Bay Tribune report states that the delays were less than a year but more than 90 days. So far, VA officials have not said at which hospitals the deaths occurred, which concerns Governor Scott. Through AHCA’s investigation he hopes to determine where the deaths took place, how the U.S. Department of Veterans Affairs is going to ensure the quality of care for veterans improves, and how the federal government can increase transparency on the quality of care in VA hospitals.

Click here to read the entire article from The Tampa Bay Tribune.

AHCA Agents Booted from One Florida VA Hospital.

Two days after Governor Scott’s letter was sent to AHCA, two agency inspectors were allegedly denied access to records at the VA Medical Center in Riviera Beach, Florida, according to the Palm Beach Post. The inspectors were told an official response would be provided from the VA’s national office in Washington, D.C. One VA spokeswoman stated that the VA will cooperate with AHCA, but could not do so on the specific day of AHCA’s inspection.

To read the entire article from the Palm Beach Post, click here.

It is not yet known how the VA will work with AHCA in regards to inspections. Check our blog regularly for updates.

Florida’s Lack of Legal Authority and Federal Supremacy.

Governor Scott apparently has forgotten that the state lacks authority over federal facilities and federal agencies. The federal government and its laws and regulations are superior to and take precedence over any state laws, regulations or authorities. This is a key principle of our constitutional government in the United States of America.

I am sensitive to such issues having personally lived through times when state governors “stood up to” the federal government while trying to keep public schools from being desegregated during the Civil Rights Era. The “states rightists” lost that battle like Governor Scott is likely to lose this battle.

As a lawyer friend of mine used to say in reference to similar conflicts between state and federal authorities, “I seem to recall that we fought a war about this issue some time in the past and the South lost.”

I doubt that Governor Scott is ignorant of the law. I also doubt that the VA or any other federal agency is likely to give up its autonomy to kowtow state officials. I believe it is most likely that Governor Scott is merely grand standing to make a show that may appeal to state right advocates and veterans as part of his campaign for reelection. But, of course, this is just my personal opinion.

Contact a Health Law Attorney Experienced in the Representation of Veterans Administration (VA) Physician Representation and Military Physician Representation.

The attorneys of The Health Law Firm have represented physicians, psychologists, nurse practitioners, nurse and other health professionals working in Veterans Administration medical centers and clinics throughout the United States. Representation has included personnel and employment issues, disciplinary action, investigations, peer review investigations, clinical privileges actions, fair hearings, National Practitioner Data Bank (NPDB) actions and appeals.

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

Comments?

What do you think of Governor Scott’s request for answers? Why do you think the AHCA agents were denied access? Please leave any thoughtful comments below.

Sources:

Scott, Rick. Letter from Governor Rick Scott to Ms. Elizabeth Dudek at the Florida Agency for Health Care Administration. (April 1, 2014). From: http://www.flgov.com/wp-content/uploads/2014/04/SKMBT_C35314040107040.pdf

Altman, Howard. “Gov. Scott Asks Answer in VA Hospital Deaths.” The Tampa Bay Tribune. (April 1, 2014). From: http://tbo.com/list/military-news/gov-scott-wants-inspection-of-federal-hospitals-20140401/

Bennett, George. “Turf War Escalates as 2 Florida Health Care Inspectors ‘Escorted Out’ of VA Hospital, Official Says.” Palm Beach Post. (April 3, 2014). From: http://www.postonpolitics.com/2014/04/turf-war-escalates-as-2-florida-health-care-inspectors-escorted-out-of-va-hospital-official-says/

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

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2014 The Health Law Firm. All rights reserved.

What Happens in the VA System Has Implications for all Health Care Professionals; FBI Investigates VA

1 Indest-2008-1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Veterans Administration healthcare system is at a crossroads. After the recent revelations about long wait times for veterans and systematic cover-ups, it is clear that reforms in the Veterans Health System are needed.

On June 11, 2014, the Federal Bureau of Investigation (FBI) announced it has opened a criminal investigation of the Department of Veterans Affairs (VA). The investigation stems from allegations that officials with the VA have been manipulating medical waiting lists and delaying care for thousands of veterans. On the same day, the U.S. Senate approved a bill that would allow veterans who experience long delays for appointments or live far away from a VA facility to get care at nearby private hospitals and medical facilities. In addition the bill would provide money for the VA to hire more doctors and nurses. According to Modern Healthcare, it is believed a compromise version of the bill will soon make its way to President Barack Obama’s desk for signature.

Click here to read more from Modern Healthcare.

What few people understand is that any false statement of any kind made to a federal official is a crime under the United States code.

The Alleged Scandal that Rocked the U.S.

Last month, it was revealed that a VA clinic in Phoenix was delaying treatment for veterans waiting to see a doctor. The clinic is accused of making official lists that showed patients were getting timely care, while covering up secret waiting lists showing it took much longer. As many as 40 military veterans may have died waiting for treatment. Due to these allegations the head of the VA stepped down. The investigation is being led by the FBI’s field office in Phoenix, the location of the primary focus of the allegations.

To read more on the FBI’s investigation, click here.

AMA Volunteers to Provide Help.

While waiting for a solution, the American Medical Association (AMA) states that it will seek the help of private sector physicians to provide health care for veterans still waiting for care. The AMA is proposing that state and local medical societies formulate registries of physicians who are ready and willing to provide care for veterans, according to an AMA press release.

Click here to read the press release from the AMA.

What This Means for Private Sector Health Providers.

Few would disagree that the VA needs help. Specifically, the VA needs to improve access to care for the growing numbers of new veterans joining the system. However, there is a bigger issue regarding whether the VA has even been given proper resources to do its job.

Until a permanent resolution is agreed upon, private sector healthcare providers that take military insurance such as TRICARE can expect to see an influx of VA patients. Note, there may be a delay in receiving reimbursement payments. There are also concerns as to how long it would take a private healthcare provider to obtain the medical records of a patient from the VA for follow up treatment. The shortage of VA administrative staff affects this, as well.

When seeing VA patients, keep in mind, the logistics of care are different in the private sector. VA patients will not be used to having labs, x-ray centers, pharmacies, etc., in different places and transportation may be more difficult. Providers should be aware of these challenges and have policies and procedures in place to ensure their veteran patients receive complete care. Having an open line of communications with these patients about their care will be essential.

The VA Needs More Resources, Congress!

The most important issue is that the VA needs more resources. It needs more physicians. It needs more ancillary health care professionals. It needs more administrative staff. It’s all good and fine for Congressional members to weep and gnash their teeth about VA shortcomings and failures. But Congress needs to put up the money the VA actually needs to provide the amount of care our existing veterans need.

Until Congress gets off the dime and funds the VA properly this type of situation, or worse, is bound to happen over and over. Republican governors can make idle threats against the VA, posturing for re-election. Congressmen and Senators can kowtow to Tea Party dogma. But if they aren’t going to fund the VA properly, it’s Congress’s fault and no one else’s.

Comments?

What do you think about the VA scandal? As a private sector healthcare provider, do you think you will see more VA patients in your office? Please leave thoughtful comments below.

Contact Experienced Health Law Attorneys.
The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, NPDB actions, 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.

Sources:

Kahn, Randi. “AMA Encourages the Federal Government to Utilize Private Sector Physicians to Help Solve VA Crisis.” American Medical Association. (June 10, 2014). From: http://www.ama-assn.org/ama/pub/news/news/2014/2014-06-10-private-sector-physicians-va-crisis.page

Kizer, Kenneth and Jha, Ashish. “Restorying Trust in VA Health Care.” New England Journal of Medicine. (June 11, 2014). From: http://www.nejm.org/doi/full/10.1056/NEJMp1406852

The New York Times. “F.B.I. Begins Criminal Inquiry in V.A. Scandal.” The New York Times. (June 11, 2014). From: http://nyti.ms/UwTXow

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.

Go to Top