complex healthcare litigation lawyer | The Health Law Firm Blog

Walgreens Accused of Providing Insufficient COBRA Notices, Class Action Lawsuit Says

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

On November 30, 2022, a group of former Walgreens workers filed a proposed class action in Florida federal court that accuses the pharmacy chain of sending confusing, incomplete COBRA notices. The former employees sued, saying the company purposely sent former employees “haphazard and piecemeal” information about their rights to continued insurance coverage under the federal COBRA law to save itself money.

As a result, the lawsuit claims, they lost access to their medical coverage when they were terminated and, therefore, had to pay out-of-pocket to cover medical expenses.

Details of the Class Action.

The plaintiffs filed the class action complaint against Walgreens Co. in the United States District Court Middle District of Florida, Tampa Division, alleging violations of the Employee Retirement Income Security Act (ERISA) and the Consolidated Omnibus Budget Reconciliation Act (COBRA). This federal law provides details on what employer-sponsored health plans must do.

The plaintiffs claim they were all terminated from Walgreens between 2018 and 2020 for reasons not related to gross misconduct, they said in their complaint. After their termination, they received COBRA notices that are required to be written in a manner that an average plan participant could understand. However, rather than receiving one document clearly outlining that information on their post-employment COBRA benefits, they received multiple separately mailed documents that lacked critical information, according to the complaint.

The lawsuit claims the first notice failed to include an address indicating where COBRA payments should be mailed. “It also fails to explain how to enroll in COBRA, nor does it bother including a physical election form,” the lawsuit alleges.

The lawsuit states that a second notice contained some but not all of the required information.

The insufficient COBRA notices confused and misled the plaintiffs and caused them economic injuries in the form of lost health insurance and informational injuries, they claim.

Similar Suits Against Walgreens.

Because similar lawsuits alleging deficient COBRA notices have been filed against Walgreens before, the pharmacy chain was aware that its notices were inconsistent with the Department of Labor’s model, alleged the workers. Therefore, they claim its choice to use a non-compliant notice was in “deliberate or reckless disregard” of the workers’ rights.

The plaintiffs seek to represent a class of all Walgreens health care plan participants and beneficiaries who were sent similar COBRA notices during the applicable statute of limitations period and did not elect to continue coverage.

The plaintiffs seek reinstatement of their right to coverage, damages, fees, and costs. Click here to read the complaint.

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

At the Health Law Firm, we provide legal services for pharmacists and pharmacies, as well as all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and other healthcare providers. 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 (407) 331-6620 or Toll-Free (888) 331-6620 and visit our website at www.ThehealthLawFirm.com

Sources:

Edwards, Jesse. “Walgreens class action claims company fails to provide legal COBRA notices.” Top Class Actions. (December 5, 2022). Web.

Freedman, Emily. “Walgreens Provides Deficient COBRA Notices, Suit Says.” Law360. (December 1, 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.

New Jersey Appeals Court Says Plaintiffs Don’t Need Presuit Affidavits to Sue LPNs in Medical Malpractice Cases

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

In a possibly precedent-setting case, on November 9, 2022, for the first time, an appeals court in New Jersey ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit to file claims against a licensed practical nurse (LPNs). The Superior Court of New Jersey, Appellate Division, said that an LPN is not included in the “licensed person” definition under the state’s affidavit of merit statute.

Additionally, the court’s ruling stated that an LPN could not use the absence of such an affidavit to avoid a medical malpractice suit. In this case, the malpractice suit was brought by a widower who says his wife died as a result of bad medical advice given by her LPN.

Allegations Made in the Lawsuit.

The plaintiff claimed that the defendant (an LPN) responded to his complaints about his wife being in pain and unable to eat following her colon surgery by blaming the issue on “post-operative gas.” After allegedly ignoring numerous messages he left regarding her condition, the LPN allegedly told the husband to give his wife, Pepto Bismol. The following day, his wife died, according to the lawsuit.

In July 2020, the plaintiff filed a medical malpractice claim on behalf of himself as the administrator of his wife’s estate. The lawsuit originally named the doctor, Virtua Surgical Group, and an unknown nurse. Following discovery, the plaintiff dismissed the claims against the doctor and Virtua Surgical Group, and proceeded against only the LPN. According to the opinion, the plaintiff alleged that the LPN was negligent in providing medical advice and in failing to consult with her doctor.

You can view the court’s opinion in full here on our website.

Is a Licensed Practical Nurse a “Licensed Person” Covered by the AOM Statute?

In New Jersey professional negligence cases, plaintiffs must file an “affidavit of merit,” or AOM, signed by a licensed medical professional, before they are allowed to sue those [professionals for malpractice. This results from a tort reform package passed by the state government in 1995.

Why there hasn’t been a case similar to this one, or lobbying by LPNs to sew up the legal “loophole” before now, is unclear.

Like many similar state statutes passed around the same time, the New Jersey statute was designed to balance between reducing frivolous lawsuits and permitting injured plaintiffs recovery for meritorious claims. According to the court’s decision, a plaintiff claiming “malpractice or negligence by a licensed person” must file an “affidavit of an appropriate licensed person” who can attest that there is a “reasonable probability” that defendant’s conduct “fell outside acceptable professional or occupational standards or treatment practices.”

The defendant in this case argued that since the nursing portion of the statute defines “the practice of nursing” for “a registered professional nurse,” the Legislature intended for licensed practical nurses to be included. However, the New Jersey appeals court held that the tort reform package would not protect the LPN from the lawsuit because she was a different kind of nurse from a registered nurse.

In his written opinion for the court, New Jersey Superior Court Judge Robert J. Gilson considered whether a licensed practical nurse is a “licensed person” covered under the AOM statute. “The AOM statute expressly uses the term ‘a registered professional nurse.’ Yet, nowhere in that definition of a registered professional nurse is there a reference to a licensed practical nurse,” he added.

Gilson stated in the court’s opinion that the Legislature was aware that it had separately defined the two types of nurses. In other words, if it had wanted to protect LPNs at the same time as it was protecting RNs, it could have done so. Therefore, the plaintiff was allowed to pursue claims without an AOM. However, the plaintiff would still be required to prove the defendant’s negligence to succeed.

Click here to view the opinion in full.

Click here to read one of our related blogs about legal issues LPNs often face.

Who Is a “Professional” and What Is “Malpractice”?

“Malpractice” is usually defined as the negligence of or the breach of a professional duty by a professional. In other words, professional negligence.

How do we determine who is a “professional” then? The simple rule of thumb is that anyone who is required to have a license in order to perform his or her occupation is a professional. Thus, under this definition, we have attorneys, dentists, accountants, architects, engineers, funeral directors, teachers, all are required to have licenses, depending upon what state they are in. Thus there can be accounting malpractice, engineering malpractice, architectural malpractice and, yes, even legal malpractice. Under this definition, a licensed practical nurse would be considered a professional who could commit nursing malpractice.

However, if the wording of law limits coverage to only certain listed professions, and other professions are left out, then only the ones specifically listed will be covered by its application.

Is the Decision Limited or Possibly Widespread?

The decision appears to be a correct one based on the wording of the New Jersey statute. If “licensed practical nurses” was not a category of licensed professionals included by the Legislature in the New Jersey statute, then the courts should not “read them into” coverage by the statute. Unfortunately, this was probably merely an oversight on the part of whatever bill drafter and committee proposed the legislation in the first place. Licensed practical nurses and their professional associations should immediately lobby the Legislature of New Jersey to have the “loophole” filled.

Whether similar results are possible in other states will depend on the wording of the similar laws in those states. For example, Florida has a somewhat similar statute, but it does not actually name the specific category of medical provider covered by the act (e.g., “medical doctor,” “chiropractor”). Instead, the Florida Law, Section 766.202, Florida Statutes, refers to those covered by the medical malpractice statute as “any person licensed under part I of chapter 464, Florida Statutes. . . .[etc.]” Registered nurses, licensed practical nurses and advanced nurse practitioners are all licensed under that part and chapter of the Florida law. So a problem similar to the one in New Jersey never arises.

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

If you are applying for a nursing or healthcare license, have had a license suspended or revoked, or are facing imminent action against 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 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, call (407) 331-6620 or toll-free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Karpan, Andrew. “No Affidavit Needed To Sue ‘Practical’ Nurses, NJ Court Says.” Law360. (November 9, 2022). Web.

Murphy, Colleen. “NJ Appeals Court: No Affidavit of Merit Needed for Negligence Claim Against Licensed Practical Nurse.” Law.com. (November 10, 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.

Humana Agrees To Pay $11.2 Million to End Nurses’ Overtime Suit

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

On September 27, 2021, Humana agreed to pay $11.2 million to end claims that the health insurance company denied a group of nurses overtime pay by misclassifying them as exempt employees. A Wisconsin federal judge approved the deal with Humana, and a group of more than 200 nurses reached, securing a $36,000 average payment for each nurse involved in the suit.

A Violation of the Fair Labor Standards Act (FLSA).

This dispute stems from a class-action lawsuit filed in 2017 alleging that Humana misclassified its clinical nurse advisers as exempt employees and denied them overtime compensation, violating the Fair Labor Standards Act. Many professionals and supervisors or managerial employees are considered to be exempt from overtime laws.

In the suit, the company faced allegations from nurses who claimed they were never paid for overtime even though they were required to work more than 40 hours per week to meet Humana’s production goals and expectations.

The Settlement.

The settlement agreement will allocate almost $3 million to cover attorney fees and costs. Additionally, the 221 nurses that are part of the settling class will get nearly $8 million based on the number of full-time weeks the nurses worked. According to the motion, the average payment per nurse for unpaid overtime and liquidated damages will be over $36,000.

The case is O’Leary v. Humana Insurance Co., et al., case number 17-cv-1774, in the U.S. District Court for the Eastern District of Wisconsin. Click here to view the court’s brief in full.

To read about another case dealing with alleged pay discrimination in the healthcare field, click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in Representing Nurses and Other Healthcare Professionals.

The Health Law Firm’s attorneys routinely provide legal representation to nurses, pharmacists, pharmacy technicians, dentists, dental assistants, physicians, physician assistants, mental health counselors, and other health providers. We also provide legal representation for employers in EEOC complaints, workplace discrimination complaints, and suits involving harassment or discrimination complaints. We also provide legal representation in Department of Health, Board of Medicine, Board of Nursing investigations and complaints, DORA investigations and complaints. We provide litigation services in state and federal courts and state and federal administrative hearings. We provide legal representation across the U.S., not just in Colorado, Florida, Louisiana, Virginia, and Washington, D.C.

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:

Spezzemonte, Irene. “Humana To Pay $11.2M To End Nurses’ Misclassification Suit.” Law360. (September 27, 2021). Web.

Webster, Katherine. “Court OKs $11.2M Overtime Settlement Between Humana, Nurses.” Top Class Actions. (September 30, 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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-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

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

By 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.

By The Health Law Firm|2024-03-14T09:59:10-04:00March 2, 2024|Categories: Medical Education Law Blog|Tags: administrative complaint defense attorney, administrative hearing defense lawyer, attorney for resident physicians, attorney's fee expert witness, complex civil litigation attorney, complex health care litigation attorney, complex healthcare litigation lawyer, complex litigation representation, complex medical litigation lawyer, discrimination attorney, Equal Employment Opportunity Commission (EEOC) investigation defense, graduate medical education hearing lawyer, health law expert witness, hospital medical staff peer review defense legal counsel, legal fees expert witness, legal representation for investigations against health care professionals, legal representation for physicians, medical staff clinical privileges defense attorney lawyer, medical staff clinical privileges defense legal representation, medical staff peer review defense attorney lawyer, nurse legal representation, residency program dispute legal representation, resident physician defense legal representation, reviews of The Health Law Firm attorneys, the health law firm, The Health Law Firm attorney|Comments Off

Rapper 50 Cent Sues Florida Plastic Surgeon Over “Penile Enhancement” Ads & Social Media Photos

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

On September 16, 2022, 50 Cent, the rapper and entrepreneur, sued a plastic surgeon and her Sunny Isle Beach, Florida, medical practice in federal court. The suit alleges that the doctor used photographs she took with 50 Cent to promote her business on social media. without his consent. The suit also alleges that the ads and social media falsely implied that 50 Cent had received penile enhancement treatment from the doctor’s practice when he had not.

A 32-page complaint (lawsuit) was filed in federal court in the Southern District of Florida by 50 Cent, whose real name is Curtis J. Jackson III. It was filed against Angela Kogan, M.D., and Perfection Plastic Surgery and Medspa.

And whoever said the practice of health law wasn’t fun and interesting?

Allegations Made in the Complaint.

According to the complaint, the plaintiff is a “world-famous celebrity and entrepreneur.” In February 2020, according to the complaint, 50 Cent agreed to take a photograph with Dr. Kogan. He thought she was a fan. Once she had taken the picture, the complaint states, she allegedly used it as promotional content for Perfection Plastic Surgery, touting 50 Cent as a client and insinuating his endorsement.

50 Cent claims that since the defendant took the photo, it’s also been featured in a news article opposite an image of a faceless male allegedly undergoing a penile enhancement procedure. He argues that this made the implication of the article clear, stating that “not only were [plaintiff’s] image and name linked to a sexual enhancement treatment he never had, but Kogan also falsely implied that [plaintiff] was her client for plastic surgery.”

Between February 2020, when the photos were taken, and August of 2022, the complaint alleges, Dr. Kogan and her business posted the images on her business accounts seven times, along with multiple hashtags for users to find them. However, the posts did not include disclaimers that 50 Cent was not a client/patient, the suit says.

Causes of Action Include Invasion of Privacy, Lanham Act Violations and More.

The complaint states that 50 Cent never received plastic surgery from the defendants. The complaint concludes by asserting that the defendants “opportunistically misappropriated Jackson’s (50 Cent’s) name and image for their own promotional and commercial advantage,” in violation of the Lanham Act and the plaintiff’s right to publicity.

The six-count complaint cites right of publicity, common law invasion of privacy, two violations of the Lanham Act, conversion, and unjust enrichment. 50 Cent is seeking punitive, treble, and exemplary damages, a permanent injunction preventing the defendants from further misconduct, litigation fees, interest, disgorgement of profits, and any other relief deemed proper by the court.
Read the complaint in full here.

Stay tuned for more on this interesting Florida law suit, as it unfolds.

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

At the Health Law Firm, we provide legal services, including defense in complex medical litigation, for physicians, medical groups, and other healthcare providers. This includes plastic surgeons, cosmetic dermatologists, nurse practitioners, oral and maxillofacial surgeons, psychologists, psychiatrists, mental health counselors, and many others. This includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We also represent health facilities, individuals, groups, and institutions in contracts, sales, and mergers, and acquisitions. The lawyers of The Health Law Firm are also experienced in litigation at 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:

Atkins, Dorothy. “50 Cent Sues Fla. Surgeon Over ‘Penile Enhancement’ Ads.” Law360. (September 20, 2022). Web.

Heebink, Kendall. “Rapper 50 Cent Sues Florida Plastic Surgeon Over False Claims.” Law Street Media. (September 19, 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 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.

KeyWords: healthcare legal representation, legal representation for physicians, doctor defense legal representation, insurance audit defense attorney, complex health care litigation attorney, complex civil litigation attorney, complex healthcare litigation lawyer, complex medical litigation lawyer, Florida Louisiana District of Columbia (D.C.) professional license defense attorney, representation for complex medical litigation, representation for healthcare business litigation matters, legal representation for telemedicine issues, The Health Law Firm, reviews of The Health Law Firm Attorneys, The Health Law Firm attorney reviews, legal representation for health care professionals, nurse defense lawyer, representation for healthcare business litigation matters, legal representation for administrative hearing, legal representation for Department of Health investigation defense lawyer, doctor defense lawyer, legal representation for healthcare facility, legal representation in defense of complex medical and healthcare litigation, legal representation of plastic surgeons, legal representation of cosmetic dermatologists,
legal representation for oral and maxillofacial surgeons, legal representation for nurse practitioners, nurse practitioner defense lawyer, nurse practitioner defense, legal representation for business and contracting matters, legal representation for preparation and review of medical practice forms, legal representation for business litigation matters, legal representation for healthcare contracting litigation, legal representation for medical practice administrative litigation

“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.

New Study Reveals Complex Coding Structures in U.S. For Rise in Medical Billing Costs

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

A study publicized in August 2022 revealed that the complex coding structures used in the United States drive up medical billing costs. This helps to make the U.S. one of the most expensive countries for health providers to get paid. According to the study, researchers used a micro-level accounting of billing and insurance-related (often abbreviated “BIR”) expenses in different national settings at six provider locations in five nations: Australia, Canada, Germany, the Netherlands, and Singapore. This most recent study supplements a prior study measuring such costs in the U.S.

The findings, published in Health Affairs Journal, revealed “BIR (billing and insurance-related) costs in the U.S. are generally much higher than the costs in other countries.” This means that all the extra costs of coding and billing, including the related expenses, are a significant factor in driving up health care cases in the U.S. Say what you want about doctors’ hating paperwork, but this study seems to validate that feeling.

The Findings of the Study.

The study confirmed what research has established that billing and insurance-related (BIR) costs in the U.S. are much higher than in other countries. For example, prices range from $6 in Canada to $215 in the U.S. for an inpatient surgical bill. In the U.S., that represented about 3.1 percent of the total professional revenue for the procedure. Providers also spent about 100 minutes processing the claim.

To compare, only Australia had similar billing and insurance-related costs to the U.S. Australia has a mix of publicly and privately funded payers and universal coverage. Billing and insurance-related costs were significantly less in Canada than in the other nations. The study said Germany, Singapore, and the Netherlands had equal billing and insurance-related costs.

A Common Trend: Complex Coding.

The U.S. has a coding process in which each payer has its forms and documentation requirements, creating a significant burden on providers to translate clinical documentation into billable codes for reimbursement.

Because of standardization in other countries, providers spend less time coding or do not need coders to translate documentation into billable codes. Additionally, “little physician time is spent entering billing-related information into the EHR [electronic health record] system, as charge codes are either generated automatically or entered manually by a lower-wage or nonclinical teammate,” the study stated. “As a consequence, these countries’ billing systems either require fewer labor resources or much less costly labor and physician time than the one in the U.S.”

Researchers also found that financial counseling could reduce overall billing and insurance-related costs in the U.S.

You can read the study in full and learn more by visiting Health Affairs, a leading peer-reviewed journal of health policy thought and research.

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, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and other healthcare providers. 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:

LaPointe, Jacqueline. “Coding Drives Up Medical Billing Costs in the US.” Rev Cycle Intelligence. (August 3, 2022) Web.

Norris, Amanda. “REV CYCLE PROCESSES PUSH U.S. TO TOP OF LIST FOR HIGHEST MEDICAL BILLING COSTS.” Health Leaders Media. (August 10, 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 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.

“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.

New Study Faults Coding Structures For Increased Medical Billing Costs in U.S.

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

A study publicized in August 2022 revealed that the complex coding structures used in the United States drive up medical billing costs. This helps to make the U.S. one of the most expensive countries for health providers to get paid. According to the study, researchers used a micro-level accounting of billing and insurance-related (often abbreviated “BIR”) expenses in different national settings at six provider locations in five nations: Australia, Canada, Germany, the Netherlands, and Singapore. This most recent study supplements a prior study measuring such costs in the U.S.

The findings, published in Health Affairs Journal, revealed “BIR (billing and insurance-related) costs in the U.S. are generally much higher than the costs in other countries.” This means that all the extra costs of coding and billing, including the related expenses, are a significant factor in driving up health care cases in the U.S. Say what you want about doctors’ hating paperwork, but this study seems to validate that feeling.

The Findings of the Study.

The study confirmed what research has established that billing and insurance-related (BIR) costs in the U.S. are much higher than in other countries. For example, prices range from $6 in Canada to $215 in the U.S. for an inpatient surgical bill. In the U.S., that represented about 3.1 percent of the total professional revenue for the procedure. Providers also spent about 100 minutes processing the claim.

To compare, only Australia had similar billing and insurance-related costs to the U.S. Australia has a mix of publicly and privately funded payers and universal coverage. Billing and insurance-related costs were significantly less in Canada than in the other nations. The study said Germany, Singapore, and the Netherlands had equal billing and insurance-related costs.

A Common Trend: Complex Coding.

The U.S. has a coding process in which each payer has its forms and documentation requirements, creating a significant burden on providers to translate clinical documentation into billable codes for reimbursement.

Because of standardization in other countries, providers spend less time coding or do not need coders to translate documentation into billable codes. Additionally, “little physician time is spent entering billing-related information into the EHR [electronic health record] system, as charge codes are either generated automatically or entered manually by a lower-wage or nonclinical teammate,” the study stated. “As a consequence, these countries’ billing systems either require fewer labor resources or much less costly labor and physician time than the one in the U.S.”

Researchers also found that financial counseling could reduce overall billing and insurance-related costs in the U.S.

You can read the study in full and learn more by visiting Health Affairs, a leading peer-reviewed journal of health policy thought and research.

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, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and other healthcare providers. 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:

LaPointe, Jacqueline. “Coding Drives Up Medical Billing Costs in the US.” Rev Cycle Intelligence. (August 3, 2022) Web.

Norris, Amanda. “REV CYCLE PROCESSES PUSH U.S. TO TOP OF LIST FOR HIGHEST MEDICAL BILLING COSTS.” Health Leaders Media. (August 10, 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 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.

“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 The Health Law Firm|2024-03-14T09:59:16-04:00November 30, 2023|Categories: Health Facilities Law Blog|Tags: billing and coding legal defense, complex civil litigation attorney, complex health care litigation attorney, complex healthcare litigation lawyer, complex medical business litigation attorney, complex medical litigation lawyer, doctor defense legal representation, Florida Louisiana District of Columbia (D.C.) administrative hearing defense lawyer, Florida Louisiana District of Columbia (D.C.) health law defense lawyer, Florida Louisiana District of Columbia (D.C.) professional license defense attorney, legal representation for Department of Health investigation defense, legal representation for health care professionals, legal representation for healthcare professionals, legal representation for healthcare providers, legal representation for physicians and health care professionals, legal representation for telemedicine issues, Medicaid HMO Defense attorney, Medicaid managed care plan audit defense, Medicaid managed care plan defense attorney, Medicare Medicaid audit legal defense, nurse defense lawyer, physician complaint defense attorneys, representation for complex medical litigation, representation for healthcare business litigation matters, reviews of The Health Law Firm attorneys, telemedicine defense lawyer, the health law firm, The Health Law Firm attorney reviews|Comments Off

U.S. Government Renews COVID-19 Public Health Emergency, Extending Health Benefits for Millions of Americans

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

On July 15, 2022, the United States again renewed the COVID-19 public health emergency, allowing millions of Americans special access to free tests, vaccines, and treatments. The public health emergency was initially declared in January 2020, when the coronavirus pandemic began. Since then, the Department of Health and Human Services has renewed it each quarter. HHS Secretary Xavier Becerra officially renewed the declaration extending it through October 13, 2022. View it in full here.

Ensuring Continued Access to Special Services During the Public-Health Emergency.

The declaration allows the U.S. to grant emergency authorizations of drugs, vaccines, and other medical countermeasures. As a result, it can administer those products to millions of people at no out-of-pocket cost. It’s also enabled millions of Americans to get health coverage through Medicaid, among other benefits.

It may also have additional benefits, such as allowing certain health care professionals to practice across state lines without getting a license in the state where the patient is and encouraging the continuation of video visits (telemedicine). But check your state and national regulations to be sure.

When the public health emergency expires, insured patients will be subject to co-pays or other costs, while the uninsured will lose easy access to free testing. In addition, millions could risk losing Medicaid coverage as states reinstate stricter enrollment rules that they had loosened to qualify for enhanced federal funding.

The Biden administration has ensured states it will give 60 days’ notice before ending the emergency to allow sufficient time to prepare for changes to specific programs and regulatory authorities. To learn more about Public Health Emergency Declarations, visit the Office for the Assistant Secretary of Preparedness and Response.

To read one of my prior blogs on the status of the COVID-19 pandemic in the healthcare industry, click here.

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

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and other healthcare providers. It also includes medical students, resident physicians, fellows, 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 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:

Aboulenein, Ahmed. “U.S. Renews COVID-19 Public Health Emergency.” Reuters. (April 13, 2022). Web.

Griffin, Riley. “Biden Administration to Again Extend the Covid Public-Health Emergency.” Bloomberg Law. (July 11, 2022). Web.

AHLA. “US Government To Extend COVID-19 Public Health Emergency Again.” Health Law Daily. (July 13, 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 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.

“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 The Health Law Firm|2024-03-14T09:59:18-04:00October 12, 2023|Categories: Mental Health Law Blog|Tags: complex civil litigation attorney, complex health care litigation attorney, complex healthcare litigation lawyer, complex medical business litigation attorney, complex medical litigation lawyer, doctor defense legal representation, Florida Louisiana District of Columbia (D.C.) health law defense lawyer, Florida Louisiana District of Columbia (D.C.) professional license defense attorney, healthcare legal representation, legal representation for Department of Health investigation defense lawyer, legal representation for health care professionals, legal representation for healthcare professionals, legal representation for physicians, legal representation for physicians and health care professionals, legal representation for telemedicine issues, nurse defense lawyer, physician complaint defense attorneys, representation for administrative hearing, representation for complex medical litigation, representation for healthcare business litigation matters, reviews of The Health Law Firm attorneys, telemedicine defense lawyer, the health law firm, The Health Law Firm attorney reviews|Comments Off

Rapper 50 Cent Reaches Settlement with Floridians in Lawsuit Over Fake Penis Enlargement Ad

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

On February 21, 2023, Houston rapper 50 Cent settled a lawsuit with a publication over alleged false penis enlargement claims. The rapper, whose real name is Curtis J. Jackson III, sued The Shade Room LLC using three alternative theories of defamation, per se, per quod, and by implication.

The lawsuit revolved around a website article and social media posts, including a photo of him standing next to Angela Kogan of Perfection Plastic Surgery & Medspa in Florida. Both Kogan and Perfection are also named in the rapper’s complaint, which you can read here.

The Complaint.

The rapper initially sued Kogan in September 2022. He maintains that she stole a photo of him to promote her business under the false pretense he’d used the company’s services. In addition, he accused The Shade Room of further enlarging the story by re-posting it and opening him up to further “ridicule.” 50 Cent and his legal team claimed: “By publishing the article and falsely stating or implying that Jackson had received plastic surgery procedures from Kogan or MedSpa, or the penile enhancement or other procedures described in the article, TSR committed a clear act of defamation.

The Settlement.

According to the settlement notice, 50 Cent and the publication “are in the process of executing their respective obligations pursuant to the agreement.” Additionally, it stated that a notice of voluntary dismissal would be forthcoming. The terms of the settlement were not disclosed. You can read the notice of settlement in the case here.

For more information on this case, read my prior blog.

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

At the Health Law Firm, we provide legal services, including defense in complex medical litigation, for physicians, medical groups, plastic surgeons, cosmetic dermatologists, and other healthcare providers. This includes plastic surgeons, cosmetic dermatologists, nurse practitioners, oral and maxillofacial surgeons, psychologists, psychiatrists, mental health counselors, and many others. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We also represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are also experienced in litigation at 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:

Keller, Aaron. “50 Cent Settles Penile Enhancement Ad Suit With Publication.” Law360. (February 21, 2023). Web.

AllHipHop. “EXCLUSIVE: 50 Cent’s Penis Enlargement Lawsuit Grows: He’s Now Suing The Shade Room.” MSN. (January 21, 2023). Web.

Brown, Preezy. “50 Cent Settles Lawsuit With The Shade Room Over Alleged Penis Enhancement Photo.” Vibe. (February 21, 2023). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 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 © 2023 The Health Law Firm. All rights reserved.

First COVID-19 Breathalyzer Test Authorized By FDA

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

On April 14, 2022, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization for the first Covid-19 diagnostic test that uses breath samples. The test, made by Texas-based company, InspectIR Systems, is authorized for those patients 18 and older.

InspectIR expects to produce approximately 100 testing instruments per week, which can each be used to evaluate approximately 160 samples per day. At this level of production, testing capacity using the InspectIR COVID-19 Breathalyzer is expected to increase by about 64,000 samples per month, according to the FDA’s statement.

The Testing Requirements.

The test can only be performed in environments where the patient’s specimen is collected and analyzed, such as doctor’s offices, hospitals, and mobile testing sites.

Additionally, the test must be performed by a qualified, trained operator under the supervision of a licensed health care provider or authorized by state law to prescribe tests. The test detects chemicals associated with the virus that causes the disease in a breath sample in less than three minutes. If it’s positive, it should be followed up by a molecular test, the agency said in a statement.

“Today’s authorization is yet another example of the rapid innovation occurring with diagnostic tests for Covid-19,” Dr. Jeff Shuren, director of the FDA’s Center for Devices and Radiological Health, said.

Read the FDA’s press release and get even more information.

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, 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:

Helsel, Phil. “FDA authorizes first Covid-19 breath test.” NBC News. (April 14, 2022). Web.

Muller, Madison. “Breathalyzer Test for Covid-19 Wins Approval From FDA.” Bloomberg. (April 14, 2022). Web.

Mckinney, Jim. “Coronavirus (COVID-19) Update: FDA Authorizes First COVID-19 Diagnostic Test Using Breath Samples.” U.S. Food and Drug Administration. (April 14, 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 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.

“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 The Health Law Firm|2024-03-14T09:59:25-04:00July 20, 2023|Categories: Pharmacy Law Blog|Tags: Civil Monetary Penalty defense lawyer, complex civil litigation attorney, complex health care litigation attorney, complex healthcare litigation lawyer, complex medical business litigation against health insurers, complex medical litigation lawyer, defense lawyer for pharmacies and pharmacists, defense lawyer for physicians, defense lawyer representation for complex medical litigation, doctor defense legal representation, federal administrative hearing defense lawyer, Food and Drug Administration (FDA) defense lawyer, Health law defense lawyer, healthcare regulation attorney, legal representation for healthcare business litigation matters, legal representation for healthcare professionals, legal representation for informal administrative hearing, legal representation for pharmacies and pharmacists, legal representation for physicians, legal representation in Food and Drug Administration (FDA) administrative hearings, medical regulation attorney, nurse defense lawyer, physician complaint defense attorneys, representation for healthcare business litigation matters, reviews of The Health Law Firm attorneys, the health law firm, The Health Law Firm attorney reviews|Comments Off