California Dental Practice Pays $23,000 Settlement For Potential HIPAA Privacy Violations Involving Yelp Posts

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

On December 14, 2022, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) settled with New Vision Dental (NVD) over a potential HIPAA Privacy violation. The California-based dental practice paid $23,000 to OCR and agreed to implement a corrective action plan after allegedly including protected health information (PHI) in its responses to reviews on Yelp.

The Complaint and Investigation.

On November 29, 2017, the Office for Civil Rights (OCR) received a complaint alleging New Vision Dental had posted responses to several unfavorable reviews by patients on Yelp and frequently disclosed confidential protected health information (PHI) in its responses. For example, in some posts, patients were allegedly identified, and NVD revealed their full names when the patient may have only chosen to use a made-up name on the platform. Other information allegedly posted included detailed information about the patient’s visits, treatment, and health insurance, when that information had not been posted publicly by the patient.

The federal agency’s investigation found potential violations of the HIPAA Privacy Rule, including impermissible uses and disclosures of PHI and failures to provide adequate Notice of Privacy Practices and implement Privacy policies and procedures. “This latest enforcement action demonstrates the importance of following the law even when you are using social media. Providers cannot disclose protected health information of their patients when responding to negative online reviews. This is a clear ‘NO,’” said OCR Director Melanie Fontes Rainer in a statement.

To read more, click here for the press release from the HHS.

In addition to the settlement, NVD agreed to implement a corrective action plan (CAP) that will be monitored for two years by OCR. As part of its CAP, the dental practice agreed to develop, revise, and maintain written policies and procedures to comply with federal privacy and security standards. All workforce members will also receive training on those policies and procedures, and NVD is required to remove all social media postings that include PHI.

The resolution agreement and CAP can be viewed here.

Guidelines for Appropriate use of Social Media and Social Networking.

Healthcare professionals are discouraged from interacting with current or past patients on personal social networking sites and should never, under any circumstances, reveal personal information about the patient or the patient’s treatment or care. Online interaction with patients should only occur when discussing the patient’s medical treatment within the physician-patient relationship and with written, signed consent by the patient to use e-mail or other online services for such messaging. These interactions should never occur on personal social networking or social media websites.

Patient privacy must be protected at all times, especially on social media and social networking websites. Breaches in patient confidentiality could harm the patient and violate federal privacy laws such as the Health Insurance Portability and Accountability Act of 1996 and applicable state privacy laws.

Failure to Comply With HIPAA Can Result in Both Civil and Criminal Penalties.

This penalty was the 21st financial penalty to be imposed by OCR in 2022 to resolve HIPAA violations, more than in any other year since it was given the authority to enforce HIPAA compliance. With the increased popularity and availability of social media platforms also comes an increase in potential privacy violations. To read a previous blog I wrote on this, click here.

If Notified of a HIPAA Investigation or Audit, Consult an Experience Health Law Attorney Immediately.

If you receive notice that you have a HIPAA Privacy Complaint, are suspected of a HIPAA breach, or are subject to a HIPAA audit, consult with an experienced health care attorney immediately. There are many technicalities to these laws and regulations, and what may initially seem like a violation may be proven to be nothing. Many defenses can be raised, and often a complaint may be dismissed by the OCR once the correct facts are shown to it by your attorney.

Don’t Wait Until It’s Too Late, Contact a Health Law Attorney Experienced in Defending HIPAA Complaints and Violations.

The attorneys of The Health Law Firm represent physicians, nurses, and other healthcare 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 toll-free (888) 331-6620.

Sources:

Alder, Steve. “OCR Fines California Dental Practice for PHI Disclosures on Yelp.” HIPAA Journal. (December 14, 2022). Web.

McKeon, Jill. “OCR Settles Potential HIPAA Violation After Dental Practice Discloses PHI on Yelp.” Health Care It News. (December 14, 2022).

Health News Weekly. “California Dental Practice Pays $23,000 to Resolve Potential HIPAA Violations Involving Social Media Posts.” AHLA. (December 16, 2022). 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 or Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“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 © 2023 The Health Law Firm. All rights reserved.

By |2024-04-10T20:00:49-04:00April 12, 2024|Categories: Dental Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on California Dental Practice Pays $23,000 Settlement For Potential HIPAA Privacy Violations Involving Yelp Posts

Florida Primary Care Practice Settles HIPAA Investigation for $20,000

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

On December 15, 2022, the Department of Health and Human Services (HHS), Office for Civil Rights (OCR), announced that Health Specialists of Central Florida, Inc., will pay $20,000 to resolve alleged violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule’s right of access standard.

The primary care provider also agreed to a corrective action plan (CAP) with two years of monitoring.

It is extremely important that Florida physicians and health professionals remember that there is a federal law requirement under HIPAA that requires the timely furnishing of a health record requested by a patient. You must be sure to meet the deadline, but, more importantly, document that you have met it. Use cover letters, obtain receipts when possible, and document the date you provided the record in the record.

Click here to view the press release issued by the OCR.

Right of Access Standard.

OCR first launched an investigation into Health Specialists of Central Florida after the daughter of a deceased patient filed a complaint in November 2019. The complainant made a written access request for her father’s medical records but did not receive them for nearly five months, and only after multiple requests.

The HIPAA right of access standard requires covered entities to respond to requests for records within 30 days of receipt or 60 days if it obtains an extension of time. OCR’s guidance on the right of access is available here.

The Settlement.

In addition to the monetary settlement, Health Specialists of Central Florida will undertake a corrective action plan (CAP) that includes two years of monitoring. The CAP requires the practice to develop, maintain, and revise its written privacy procedures and policies, distribute them to the workforce, and review and update its right of access to PHI policy.

This case marks the 42nd case resolved under OCR’s HIPAA Right of Access Initiative. To view the settlement agreement and CAP, click here.

 

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

The attorneys of The Health Law Firm represent physicians, dental practices, medical groups, nursing homes, home health agencies, pharmacies, hospitals, and other healthcare providers and institutions in investigating and defending against HIPAA investigations and complaints 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 toll-free (888) 331-6620.

Sources:

Health Law Weekly. “Florida Primary Care Provider to Pay $20,000 to Resolve Right of Access Probe.” AHLA. (December 16, 2022). Web.

Giles, Bruce. “Florida primary care practice fined HHS $20K for not giving timely access to patient data.” Becker’s Hospital Review. (December 16, 2022). Web.

McKeon, Jill. “OCR Resolves HIPAA Right of Access Case With FL Primary Care Practice.” Health IT Security. (December 16, 2022). 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 or Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“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 © 2022 The Health Law Firm. All rights reserved.

 

 

By |2024-03-21T20:00:52-04:00March 23, 2024|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Florida Primary Care Practice Settles HIPAA Investigation for $20,000

Ex-Surgery Technician Slaps Georgia Urology Practice With Federal Discrimination Lawsuit

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

On November 7, 2022, a former surgical technician hit a Georgia urology practice with a federal discrimination lawsuit, claiming it denied him a raise after complaining that a co-worker threatened him because of his sexuality. The plaintiff sued Georgia Urology, P.A., alleging violations of the Americans with Disabilities Act, Title VII of the Civil Rights Act, the Fair Labor Standards Act, and various state laws. He said that in addition to harassment from co-workers, management denied him a predetermined raise after he complained about an unnecessary, unlawful disclosure of his medical history and denied him overtime pay. He is seeking back pay and future pay (front pay), lost benefits, and other damages.

Alleged Ongoing Harassment.

Georgia Urology hired the former surgical tech in July 2020, and shortly after this, he alleges that his co-workers started referring to him using slurs concerning his sexual orientation. After he reported the statements to the operations director, the interim director of the practice, and the CEO, they told him if he was that unhappy at work, he should find a new job, according to the complaint.

Additionally, as part of his onboarding procedure with the medical practice, the plaintiff was required to take a blood test. According to the complaint, the director of ambulatory surgery centers asked a nurse manager to administer the test and send the results to a lab. In early November 2020, the nurse manager contacted the lab using her company credentials and asked for the plaintiffs’ lab information. But she said she was calling concerning a patient, rather than an employee, of Georgia Urology, he alleged. As a result, the lab disclosed his diagnosis to her, which he said was not a necessary term of employment. The complaint did not indicate any diagnosis.

He reported the breach of privacy to the urology practice’s director of people operations, but she was never disciplined for her actions. Instead, according to the complaint, the nurse manager denied his automatic pay raise several days after, even though he had completed the 90-day probationary period. Furthermore, she later asked him how he was even hired given his diagnosis, he claims later in his complaint.

Alleged Retaliatory Behavior From Co-Workers.

Later in November 2020, he said the nurse manager issued a write-up for an alleged incident that had occurred several weeks before his reporting her for obtaining his medical files. The former surgical tech said the retaliatory write-up was removed from his file, but the defendant never disciplined her for issuing the write-up.

In early December 2020, he again complained to management about the ongoing harassment. In response, the practice agreed to give him his raise on the condition that he “stop whining so much,” but he claims he never received the raise, according to the complaint.

The defendant eventually fired the plaintiff on December 17, 2020, for allegedly creating a staff shortage when he was out sick, even though the practice was not short-staffed. You can read the complaint in this case in full here.

To read about a similar case involving a pharmacist, click here to read one of our prior blogs.

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. Several of our attorneys act as expert witnesses in attorney’s fee litigation and in health law litigation.

To contact The Health Law Firm, please call (407) 331-6620 or toll free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Wargo, Abbey. “Ex-Surgery Tech Accuses Urology Practice Of Anti-Gay Bias.” Law360. (November 7, 2020). Web.

Ferrier, Valerie. “Bias Ruling Spotlights Confusion Over Protected Categories.” Law360. (August 25, 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 the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“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 © 2022 The Health Law Firm. All rights reserved.

Maryland & Missouri Become 20th and 21st States to Legalize Recreational Marijuana

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

Five states had proposals to legalize recreational marijuana on the ballot in the midterm elections held on November 8, 2022. Voters in Maryland and Missouri approved the legalization, while Arkansas, North Dakota, and South Dakota rejected similar proposals. As a result of the vote, Maryland and Missouri became the 20th and 21st states to legalize cannabis for adult recreational use.

Maryland.

Maryland’s voters overwhelmingly approved Question 4 as it passed, with 65% of voters casting ballots in favor. The amendment creates a right to possess and use marijuana and directs the state Legislature to enact laws governing its sale. Following its passage, adults in the state will be allowed to possess up to 1.5 ounces, or two marijuana plants, beginning July 1, 2023.

Additionally, it allows for the expungement of records for people arrested for marijuana possession and for people serving time for simple possession to have their sentences reconsidered. It would also establish a cannabis business assistance fund for small businesses and minority- and women-owned companies entering the cannabis industry.

Next up, the state’s lawmakers will decide on licensing and taxation.

Missouri.

Missouri voters passed Amendment 3, with 53% of voters in favor. The measure removes existing state prohibitions on marijuana and legalizes the purchase, possession, consumption, use, delivery, manufacture, and sale of marijuana for personal use for adults 21 and older. It also allows individuals with certain marijuana-related offenses to be released from prison, parole, or probation. More specifically, it levies a 6% state tax rate on sales and allows local governments to impose an additional tax rate of up to 3%.

Other States With Drugs On The Ballot.

Three other states with existing medical marijuana programs also saw voters head to the polls to decide whether to legalize recreational marijuana. At the same time, voters in Colorado considered a historic bill to decriminalize certain psychedelics.

Voters in Arkansas, North Dakota, and South Dakota rejected proposals to bring the states from medical marijuana use to full recreational legalization.

Lastly, in Colorado, Proposition 122, a bill to decriminalize plant and fungi-based psychedelic compounds, appeared to pass with approximately 51% of the vote narrowly. The passing of this historic measure comes ten years after Colorado made history as one of the first states to legalize retail marijuana by ballot initiative.

For updates on important marijuana laws and policies, check out our Marijuana Law Blog and YouTube page.

Contact Experienced Health Law Attorneys for Medical Marijuana Regulatory Matters and Other Health Care Licensing Matters.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists, and pharmacies, participating in the medical marijuana industry. We represent doctors, pharmacies, and pharmacists facing proceedings brought by state regulators or agencies. We represent health-related businesses and medical professionals in all types of licensing and regulatory matters, including state and federal administrative hearings. Several of our attorneys, including Mr. Indest, act as expert witnesses in attorney’s fee litigation and in health law litigation.

To contact The Health Law Firm please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Reisman, Sam. “Maryland And Missouri Legalize Pot, 3 Others Just Say No.” Law360. (November 9, 2020).

Sykes, Stefan. “Here’s how five states voted on the legalization of recreational marijuana.” CNBC. (November 9, 2022). 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 or Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030

“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 © 2022 The Health Law Firm. All rights reserved.

 

Nurse Faces Suit for Wrongful Death of Jail Inmate Says 10th Circuit Court of Appeals

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

On March 3, 2021, the U.S. 10th Circuit Court of Appeals reversed in part, a Utah court’s decision on a lawsuit for the death of a 21-year-old inmate, affirming that the jail’s doctor could claim qualified immunity, but not the nurse. After the inmate’s death, her estate sued for depriving her of her civil rights. The U.S. district court granted summary judgment in favor of the county. It ruled that qualified immunity applied to shield jail supervisors and staff. However, it denied qualified immunity to jail nurse Jana Clyde and to a private doctor who consulted with the prison, Dr. Kennon Tubbs.

The 10th Circuit appeal panel reversed the lower court’s decision, stating that one doctor can claim qualified immunity. It ruled that the jail’s nurse must face claims of civil rights violations, which are not subject to immunity. Court filings alleged that jail staff, including its nurse, ignored the inmate’s rapidly deteriorating health.

Failure to Secure Medical Treatment Despite Obvious Risks to the Inmate.

In 2016, Madison Jensen, the inmate, allegedly died from opiate withdrawal at the Duchesne County jail in Utah. After the 21-year old inmate was booked, she was allegedly placed in a cell with another woman and almost immediately began vomiting. Her vomiting allegedly continued for five days. The jail’s nurse failed to tell the physician’s assistant or doctor about Jensen’s condition, according to the complaint.

The jail’s video recording system captured the female inmate rolling off her bed and having a seizure. About 30 minutes later, both the nurse and doctor discovered she had died in her cell, the complaint said. The inmate’s cause of death was reported to be cardiac arrhythmia from dehydration due to opiate withdrawal.

Civil Rights Violation Claims.

After the inmate’s death, her estate sued for deprivation of her civil rights. The United States District Court for the District of Utah granted summary judgment for the county and the jail supervisors and staff, based on their qualified immunity. However, it denied qualified immunity to the jail nurse and the contracted doctor. Jensen’s estate claimed the jail nurse had shown deliberate indifference to the inmate’s serious medical needs, as she failed to secure medical treatment despite obvious signs and risks. In response, the nurse argued that she took reasonable steps to provide care and that she wasn’t aware that the inmate faced serious medical needs.

The circuit court judges held that “the unique circumstances of this case” allow the doctor to raise the defense of his qualified immunity. As for the jail nurse, the court said, “a trier of fact could conclude that she did not just misdiagnose Ms. Jensen, she ‘completely refused to fulfill her duty as gatekeeper.’ The nurse showed “near-complete indifference” toward the inmate that “grossly deviated from the standard of care for treating severe dehydration, especially when the result of a failure to treat is death” according to the court’s opinion.

“We believe that these circumstances — particularly her [the inmate’s] self-report that she had been vomiting for four days and could not keep down water — present a risk of harm that would be obvious to a reasonable person,” the court said. To read more, click here for the court’s opinion in full.

This isn’t the first case of an inmate’s family suing after Improper Care. Click here to read about a similar wrongful death suit of a Florida inmate.

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, nurse practitioners, certified registered nurse anesthetists (CRNAs), dentists, psychologists, psychiatrists, mental health counselors, home health agencies, 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 school professors and clinical staff. We represent health 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, patient complaints, and in Department of Health investigations.

To contact The Health Law Firm, please call our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Gill, Lauren. “UTAH JAIL NURSE FACES NEGLIGENT HOMICIDE CHARGE IN DEATH OF 21-YEAR-OLD WOMAN.” The Appeal. (August 1, 2019). Web.

O’Brian, Rachel. “10th Circ. Says Nurse Must Face Wrongful Death Suit.” Law360. (March 13, 2021). 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 Avene, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toff-Free: (888) 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 © 2021 The Health Law Firm. All rights reserved.

Appellate Court Reverses Nursing Board’s Revocation of License For Florida Nurse; “Due Process Rights Violated” Says Court of Appeal

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

On September 22, 2022, Florida’s First District Court of Appeal reversed a final administrative order from the Board of Nursing, saying that the state agencies engaged in “a game of bait and switch” when revoking a Florida nurse’s license. As a result, the discipline imposed on the nurse, revocation of her nursing license, is reversed. The appeals court said that the Florida Board of Nursing violated the nurse’s due process rights by imposing a penalty for violating patient confidentiality when she was only charged with having her license suspended in another state.

Details About the Case.

In 2018, the Florida Department of Health (DOH) filed a complaint and an amended complaint against the nurse. According to the DOH, she violated section 464.018(1)(b) by having her license to practice nursing in another state suspended. However, the Florida state nursing board issued a final order permanently revoking her Florida license, a punishment that was not within the regulatory guidelines that the Board of Nursing had previously adopted for the offense with which she was charged.

Also, the nurse had originally requested a formal hearing. She was allegedly informed she was not entitled to a formal hearing and was not notified she should appear when the Board of Nursing held the informal hearing on her case.

The nurse claimed the actions by the Florida DOH and the Florida Board of Nursing deprived her of her right to due process of law according to the U.S. Constitution’s Fifth Amendment, as applied to the states through the Fourteenth Amendment. The appellate court agreed.

State Agencies Not Communicating?

According to the court opinion, the Board and the DOH engaged in a “bait and switch game.” The state’s DOH allegedly failed to notify her of all the alleged violations that later led to the permanent revocation of her nursing license. The opinion of the appellate court stated: “More egregious than this, there was no mention in the amended complaint of an alleged violation of section 464.018(1)(h), [of Florida Statutes,] pertaining to her allegedly unprofessional conduct. In essence, the Board punished Appellant [the nurse] for this uncharged violation.”

Moreover, the appellate court said that the DOH applied the wrong disciplinary guideline for the uncharged violation. The applicable guideline only authorized a fine of up to $500 and probation as the maximum penalty. See Rule 64B9-8.006(3)(f)3, Florida Administrative Code (2012).

Based on these findings, the three-judge appellate panel reversed the revocation order, remanding it for further proceedings. Read the entire Florida court opinion on our website.

Click here to read our blog to learn more about state and DOH investigations that could help save your professional license.

Contact Health Law Attorneys Experienced in Board of Nursing Cases.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health investigations, before the Board of Nursing, in appearances before the Board of Nursing in licensing matters, in formal and informal administrative hearings, and in appeals of Final Orders.

To contact The Health Law Firm please call (407) 331-6620 or toll free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Dunn, Allison. “State Agencies Engaged in ‘Game of Bait-and-Switch’ When Revoking Nursing License, Florida Appeals Court Rules.” Daily Business Review. (September 22, 2022). Web.

Pazanowski, Mary Ann. “Florida Nurse Gets New Hearing in License Revocation Dispute.” Bloomberg Law. (September 21, 2022). 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 or toll-free (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.

“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 © 2022 The Health Law Firm. All rights reserved.

 

By |2024-03-14T09:59:12-04:00February 15, 2024|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Appellate Court Reverses Nursing Board’s Revocation of License For Florida Nurse; “Due Process Rights Violated” Says Court of Appeal

Florida Nurse Wins Reversal by Appellate Court of Nursing Board’s Revocation of License; “Due Process Rights Violated” Says Court of Appeal

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

On September 22, 2022, Florida’s First District Court of Appeal reversed a final administrative order from the Board of Nursing, saying that the state agencies engaged in “a game of bait and switch” when revoking a Florida nurse’s license. As a result, the discipline imposed on the nurse, revocation of her nursing license, is reversed. The appeals court said that the Florida Board of Nursing violated the nurse’s due process rights by imposing a penalty for violating patient confidentiality when she was only charged with having her license suspended in another state.

Details About the Case.

In 2018, the Florida Department of Health (DOH) filed a complaint and an amended complaint against the nurse. According to the DOH, she violated section 464.018(1)(b) by having her license to practice nursing in another state suspended. However, the Florida state nursing board issued a final order permanently revoking her Florida license, a punishment that was not within the regulatory guidelines that the Board of Nursing had previously adopted for the offense with which she was charged.

Also, the nurse had originally requested a formal hearing. She was allegedly informed she was not entitled to a formal hearing and was not notified she should appear when the Board of Nursing held the informal hearing on her case.

The nurse claimed the actions by the Florida DOH and the Florida Board of Nursing deprived her of her right to due process of law according to the U.S. Constitution’s Fifth Amendment, as applied to the states through the Fourteenth Amendment. The appellate court agreed.

State Agencies Not Communicating?

According to the court opinion, the Board and the DOH engaged in a “bait and switch game.” The state’s DOH allegedly failed to notify her of all the alleged violations that later led to the permanent revocation of her nursing license. The opinion of the appellate court stated: “More egregious than this, there was no mention in the amended complaint of an alleged violation of section 464.018(1)(h), [of Florida Statutes,] pertaining to her allegedly unprofessional conduct. In essence, the Board punished Appellant [the nurse] for this uncharged violation.”

Moreover, the appellate court said that the DOH applied the wrong disciplinary guideline for the uncharged violation. The applicable guideline only authorized a fine of up to $500 and probation as the maximum penalty. See Rule 64B9-8.006(3)(f)3, Florida Administrative Code (2012).

Based on these findings, the three-judge appellate panel reversed the revocation order, remanding it for further proceedings. Read the entire Florida court opinion on our website.

Click here to read our blog to learn more about state and DOH investigations that could help save your professional license.

Contact Health Law Attorneys Experienced in Board of Nursing Cases.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health investigations, before the Board of Nursing, in appearances before the Board of Nursing in licensing matters, in formal and informal administrative hearings, and in appeals of Final Orders.

To contact The Health Law Firm please call (407) 331-6620 or toll free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Dunn, Allison. “State Agencies Engaged in ‘Game of Bait-and-Switch’ When Revoking Nursing License, Florida Appeals Court Rules.” Daily Business Review. (September 22, 2022). Web.

Pazanowski, Mary Ann. “Florida Nurse Gets New Hearing in License Revocation Dispute.” Bloomberg Law. (September 21, 2022). 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 or toll-free (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.

“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 © 2022 The Health Law Firm. All rights reserved.

 

By |2024-03-14T09:59:13-04:00January 11, 2024|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Florida Nurse Wins Reversal by Appellate Court of Nursing Board’s Revocation of License; “Due Process Rights Violated” Says Court of Appeal

Tele-behavioral Health: Important Legal Considerations for Mental Health Providers

By Amanda I. Forbes, J.D.

Starting in 2020 and throughout the COVID-19 pandemic, tele-behavioral health services, also known as “e-counseling,” rapidly expanded. Because individuals were quarantined or fearful to venture out, remote mental health care services became very popular among patients. A study published in The Journal of the American Medical Association (JAMA), including 36 million working-age individuals, revealed that tele-health services increased by 766% in the first three months of the pandemic.

Thanks to remote services like tele-behavioral health, the doctor’s “house call” is making a comeback;  but instead of ringing the doorbell, your doctor will be ringing your smartphone.

What is Tele-behavioral Health?

The National Institute of Mental Health defines telebehavioral health as “the use of telecommunications or videoconferencing technology to provide remote mental health services.” Providers can use video conferencing, text messaging, or smartphone apps. Additionally, many different types of behavioral health services are available remotely.
The U.S. Department of Health and Human Services (HHS) says remote visits are a safe and convenient way for mental and behavioral health providers to offer services such as:

1. One-on-one and group therapy
2. Substance abuse counseling
3. Medication management and prescribing
4. Anxiety and depression monitoring
5. Mental health screening
6. Referrals

What Are the Potential Benefits?
Tele-behavioral health services enable clinicians to reach more patients, such as people living in rural areas, working irregular hours, and homebound patients. It removes patient barriers to attending in-person appointments, such as taking time off work, transportation, and arranging childcare.

The Downside to Tele-behavioral Health.

In addition to its convenience, tele-behavioral health also ushers in a new era of risks for treatment providers to be aware of.  It’s particularly true if the counseling occurs via text or a similar instant messaging application. As a licensed mental health care professional, you must know about liability exposures and ways to improve patient safety.
Click here to read about a case study demonstrating the issues that can arise when conducting tele-behavioral health.
When it comes to tele-behavioral health services and technology, there are significant legal considerations to think about.
To make sure you can provide remote counseling effectively while handling the risks that come with it, follow these risk management tips and recommendations:

1. Obtain the necessary training to provide telebehavioral health services. Take continuing education units (CEUs) in tele-behavioral health and retain any certificates of completion associated with those CEUs.

2. Determine whether tele-behavioral health treatment is in the client’s best interest. The provider should consider the following: Can the client effectively use the technology required for tele-behavioral health?  Does the client’s insurance cover telebehavioral health services?  Is the client emotionally and cognitively compatible with this treatment modality?

3. Obtain informed consent from the client.  In addition, document the purpose of the counseling, the use of technology to facilitate the tele-behavioral health services, and confidentiality and privacy. Obtain informed consent by having the client sign a consent form.  Have a document record of the consent process and consent form in the client’s file.

4. Providers must adhere to encryption standards. Some examples are using a secure platform, ensuring that the vendor signs a HIPAA Business Associate Agreement, which is required by HIPAA laws and regulations, and stating the vendor will follow federal privacy requirements.
5. Ensure client confidentiality by advising them of their responsibility to be in a private space during the telebehavioral health session. Document this discussion and include this as part of your agreement with the client.

6. Providers must check their state and third-party requirements related to tele-behavioral health services, credentialing, and licensure. Contact your respective licensing board for additional information and consult a health law attorney if unsure.

To read one of our prior blogs on telehealth services and learn more information on this growing area of practice, click here.

Contact Health Law Attorneys Experienced Investigations of Mental Health Counselors, Psychologists, Social Workers, and Family Therapists.

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, psychiatrists, social workers, and family therapists in Department of Health (DOH) investigations, Department of Regulatory Agencies (DORA) investigations, board hearings, FBI investigations, and other types of investigations of health professionals and providers. 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 toll-free: (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Counselor Liability Claim Report: 2nd Edition.”CNA AND HPSO COUNSELOR SPOTLIGHT: Telebehavioral Health”. Healthcare Providers Service Organization (HPSO). (2019). https://www.hpso.com/getmedia/f9369f13-7035-4955-bcb6-9843b9ff44c2/counselor-spotlight-telebehavioral-health.pdf 
Department of Health and Human Services (HHS). “Telehealth and behavioral health”. (July 25, 2023).https://telehealth.hhs.gov/patients/telehealth-and-behavioral-health#:~:text=Telehealth%20is%20a%20safe%20and,a%20long%2Dterm%20treatment%20plan. 
National Institute of Mental Health (NIMH). “What is Telemental Health?” (Accessed on December 12, 223). https://www.nimh.nih.gov/health/publications/what-is-telemental-health 


About the Author:
Amanda I. Forbes, practices health law with The Health Law Firm in its Altamonte Springs, Florida, office. 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 or toll-free: (888) 331-6620.


Attorney Positions with The Health Law Firm.
The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.
“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 © 2024 The Health Law Firm. All rights reserved. No part of this work may be reproduced in any fashion in any medium for any purpose without the written permission of the copyright owner.  The copyright owner asserts the right to have its name associated with the use of any part of this work.
By |2024-03-14T09:59:14-04:00January 2, 2024|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Tele-behavioral Health: Important Legal Considerations for Mental Health Providers

Completing an Application for a Nursing License? Here Are Some Helpful Tips!

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

The process of obtaining a nursing or health care professional license is not only challenging, but it’s also time-consuming. If you have a criminal conviction or unique circumstance which may negatively impact your ability to be granted a health care license, you must consult with an experienced attorney. Your career or future depends on your ability to positively present yourself to the board.

In instances where the applicant has a criminal history, substance abuse/alcohol problem, or discipline in another state, the board members are trying to discern from the testimony if he or she is safe to practice medicine.

Don’t Face State Licensing Boards On Your Own.

If you are applying for a nursing or health care license and have had prior adverse action taken against you in another state or during your academic training, you should contact an experienced healthcare attorney to assist you in the process.

Some tips to ease the process include:

  1. After obtaining an experienced attorney, ask how to answer application questions when unclear.
  2. Submit follow-up documents in a timely manner.
  3. Make sure your address is correct and complete.
  4. Follow-up with sources sending the Board of Nursing documents.
  5. Provide answers to the questions asked, and no more.
  6. Submit corrections when it becomes apparent you need to modify an answer.

If you are in the process of applying for a nursing license or any other license in the medical field, you will want an experienced health law attorney to be on your side to guide you through the process. Let the attorneys at The Health Law Firm be there for you. Call the Health Law Firm today, visit our website, and click on Contact Us.

Contact Health Law Attorneys With Experience Representing Nurses and Handling Licensing Issues.

If you are applying for a nursing or health care license, have had a license suspended or revoked, or are facing imminent action againstlawyer sitting with nurse in front of paperwork at desk your license, you must contact an experienced healthcare attorney to assist you in defending your career. Remember, your license is your livelihood, it is not recommended that you attempt to pursue these matters without the assistance of an attorney. The Health Law Firm routinely represents nurses, physicians, dentists, medical groups, clinics, and other healthcare providers in personal and facility licensing issues.


To contact The Health Law Firm please call (407) 331-6620 or toll-free (888) 331-6620 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. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in the practice of health law. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.

“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 © 2022 The Health Law Firm. All rights reserved.

Doctor’s Defamation Suit Against University over Use of Resident Physicians Moves Forward

Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On July 11, 2023, the United States District Court for the Eastern District of Kentucky allowed a doctor to move forward with one of his defamation claims against the university’s provost for allegations made to support his termination.

A medical doctor and oral surgeon at the University of Kentucky (UK) sued the university and university officials on multiple grounds, including making a defamation claim against the university’s provost. The defamation claim stems from the Statement of Charges made by the provost in the physician’s termination proceedings.

The Statement of Charges claims that the doctor stole from the UK, took credit for patient care services that a resident performed, caused the College of Dentistry to submit false claims to the federal government, and encouraged a colleague to falsify medical records.

The court granted summary judgment on three counts but denied summary judgment on the claim that the doctor stole from the university.

University of Kentucky Policy.

The UK employed the doctor from 2001 to 2019. Before 2017, UK policy approved by its Dental Care Board required its staff to designate the faculty member as the treatment provider on billing documents when a resident helped the faculty member with treatment and documented the care. During 2017, billing practices changed, and employees began designating residents as the treatment providers whenever the residents documented a patient’s care.

When the faculty member was designated as the treatment provider, the faculty member would be entitled to 40 percent of the fees paid.

University of Kentucky’s Investigation.

From April 2017 to July 2018, UK documents designated a resident as the treatment provider for 89 patients the plaintiffs doctor alleges he treated. The doctor, believing he was entitled to income for this care, reviewed the files and removed any reference to a resident from the patient notes, or so it is alleged in the pleadings.

The altered documents triggered an internal investigation. The university interviewed seven residents whose notes had been changed by the doctor. The residents confirmed that patient clinical care occurred in two ways: 1) they would treat the patient and present their findings to the doctor, and he would then reevaluate the patient, or 2) the resident and doctor would treat the patient simultaneously.

Since none of the 89 patients left without seeing the doctor, he alleges that he was entitled to the income for their care.

The investigation confirmed that there were no patient care issues. The issues were purely with the documentation of the patient care. The medical records do not reflect the services performed because the documents do not mention a resident providing care. The report alleges that the doctor removed all references to residents in the documentation solely to obtain compensation for these visits.

The university’s provost decided that the university needed to discipline the doctor for altering the medical records, most probably a prudent decision.

Disciplinary Actions.

The provost informed the doctor in January 2019 that university termination proceedings would begin. However, it is alleged that he did not follow the correct termination procedures. The provost decided to investigate further while suspending the doctor from clinical care pending the investigation’s outcome.

After this, the provost filed a Statement of Charges against the doctor, which began the administrative process to terminate tenured faculty. In the Statement of Charges, the provost claimed the doctor stole from the University of Kentucky, falsified medical records by claiming he provided services that a resident provided, caused the university to submit false claims to Medicare and Medicaid, and encouraged a colleague to behave similarly.

The doctor resigned and sued the university and university officials on multiple grounds, including the defamation claim against the provost for his four statements in the Statement of Charges.

Legal Proceedings.

The provost filed a motion for summary judgment for qualified privilege. Qualified privilege protects a speaker where the communication is one in which the party has an interest and it is made to another interested party.

In employment, qualified privilege applies to internal discussions and communications necessary to a company’s proper function and law enforcement. This protection will apply despite a statement’s falsity if the public interest in detecting wrongdoing outweighs the private interest for defamation if the suspicions are made in good faith.

Privilege can be overcome by showing actual malice and falsity in a statement. It is the burden of the plaintiff to defeat the assertion of qualified privilege. So, in this case, the doctor has to show that the provost’s four statements are false and were made maliciously.

In the present proceeding, the judge is not deciding if the statements are defamatory. The judge is only deciding if a jury could find the statements defamatory and whether to grant summary judgment in favor of UK.

The judge granted summary judgment in favor of the UK provost on three of the allegedly defamatory statements: 1) That the doctor falsified medical records, 2) That the doctor caused the university to submit false claims to the federal government, and 3) that the doctor influenced another faculty member to do the same.

Federal courts grant summary judgment if the moving party does not dispute a material fact. The moving party is entitled to judgment if there is no dispute between the parties. The judge found no disagreement with the statement that the doctor falsified medical records.

For the statement that the doctor caused the college to submit false claims to the government, the doctor could not overcome the qualified privilege that the provost had as a matter of law. The doctor failed to show that the provost knew or should have known that the allegation was false or that the provost spoke maliciously. Therefore, the qualified privilege stood, and that claim was dismissed.

The doctor also failed to show that the provost’s statement that the doctor influenced a colleague was false. Therefore, the doctor was also unable to defeat the qualified privilege for that statement.

The judge decided that the plaintiffs introduced sufficient evidence for a jury to decide whether he could defeat qualified privilege for the claim that he stole from the University of Kentucky. This evidence included the testimony of four other UK dentists stating that the doctor should have been designated as the treatment provider, not the residents. This means that it could be argued that the funds were earned by the plaintiff doctor and not stolen by him.

Evidence was also introduced to show that the provost recklessly disregarded the possibility that the statement was false. There was no evidence that the doctor failed to participate in caring for the patients at issue. All evidence showed that he did treat the patients with a resident. Because of this, the jury could conclude that he was entitled to the compensation and, therefore, did not steal it.

The judge denied summary judgment for the UK provost regarding the statement that the doctor stole from the University of Kentucky. However, summary judgment was granted in favor of the UK provost on the other three defamation claims dismissing them.

Click here to read the Memorandum Opinion and Order on our website.

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

At the Health Law Firm we represent dentists and oral surgeons, resident physicians and fellows, and other health professionals. We represent them in legal disputes and disciplinary cases against their universities and residency programs, in investigations and complaints against their licenses, in clinical privileges matters and peer review hearings, in administrative hearings and in complex litigation. We litigate cases in state and federal courts and in administrative forums. We have a great deal of experience in representing physicians against universities, medical schools, and graduate medical education programs. The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians in investigations complaints before the board of dentistry and board of medicine.

To contact The Health Law Firm, please call (407) 331-6620 or toll free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Cunningham v. Blackwell, CIVIL 3:20-cv-00008-GFVT-EBA (E.D. Ky. Jul. 11, 2023)
“U.S. Court in Kentucky Allows Physicians Defamation Claim to go Forward in Termination Dispute.” American Health Law Association Health Law Weekly. (21 July 2023). https://www.americanhealthlaw.org/content-library/health-law-weekly/article/7db3086c-db3c-4f85-bad7-88802f937f14/U-S-Court-in-Kentucky-Allows-Physician-s-Defamation

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.

Hartley Brooks is a law clerk with the health law firm. 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 or Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“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 © 2023 The Health Law Firm. All rights reserved.

 

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