Texas Hospital’s COVID-19 Vaccine Mandate Upheld by Federal Court

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

As some states lift COVID-19 restrictions, the business community is still grappling with the dynamic between the COVID-19 vaccine and workplace operations. To address this, some U.S. employers have elected to adopt mandatory vaccination policies. These policies, in essence, require that, subject to a few exceptions, all employees must receive the COVID-19 vaccine as a condition of continued employment.

Not surprisingly, we see various legal challenges to mandatory COVID-19 vaccination policies across the country. On June 12, 2021, a federal court in Texas became the first to rule on the permissibility of such policies enforced by private employers. In a landmark ruling, the court stated that mandatory workplace vaccination policies are lawful under Texas and federal law and may be enforced as a condition of continued employment.


The Court’s Ruling on Mandatory Vaccination Policies.

The lawsuit, Bridges v. Houston Methodist Hospital, was initially filed on behalf of 117 employees after their employer, Houston Methodist Hospital, instituted a policy requiring employees to receive a COVID-19 vaccine as a condition of continued employment. Employees who were not vaccinated by the deadline were to be placed on a two-week unpaid suspension to allow them to comply with the policy. Under the policy, those who ultimately did not comply would be terminated.

In the law suit challenging the employer’s policy, the Plaintiffs asserted: (1) the employees whose employment was terminated as a result of this policy were wrongfully terminated in violation of Texas law, and (2) the vaccine mandate violated public policy of the state of Texas.

Texas Wrongful Termination Claim.

Under Texas law, the court found that firing an employee who is unwilling to comply with an employer’s mandatory COVID-19 vaccine policy does not constitute wrongful termination. Texas law only protects employees who are fired for refusing to commit an illegal act at the request of their employer. The court reasoned that receiving the vaccine is not an illegal act given the U.S. Supreme Court’s rulings upholding involuntary quarantines and mandatory vaccines.

Violation of Public Policy.

The court dismissed the plaintiffs’ public policy arguments because, according to the court, Texas law does not recognize a public policy exception to the at-will employment doctrine. Additionally, the court noted that a mandatory vaccine requirement is consistent with public policy. The Supreme Court has previously held that state-imposed quarantine and vaccination requirements do not violate due process of law.

The court held that the plaintiffs were not being coerced to get the vaccine but were being given a basic choice by its employer: get the vaccine so the hospital could safely continue its business of saving lives or seek employment elsewhere.

Lastly, the court also cited recent Equal Employment Opportunity Commission (EEOC) guidance in its decision. The guidance states that employers can require employees to be vaccinated, subject to the obligation to provide reasonable accommodations to employees with legitimate medical or religious reasons for not being vaccinated. Click here to view.

To view the court’s order in full, click here.

Important Takeaway From This Court Decision.

While there are sure to be future legal challenges to mandatory workplace vaccination policies, this decision provides strong support for their use and permissibility. However, even with this ruling, employers with policies need to be mindful of their obligations and potentially provide reasonable accommodations to employees with disabilities or sincerely held religious beliefs that prevent them from receiving the COVID-19 vaccine. Of course, we will see numerous legal challenges of all kinds to these decisions.

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. We do NOT represent plaintiffs in COVID-19 injury suits, however.

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:

Downie, Alex. “Federal Court Upholds Employer’s COVID-19 Vaccine Mandate.” The National Law Review. (June 15, 2021). Web.

Brown, Amanda, Goldstein, Mark. “In first-of-its-kind decision, federal court rules that mandatory workplace COVID-19 vaccine policies are lawful.” Employment Law Watch. (June 16, 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 Avenue, Suite 1000, Altamonte Springs, Florida 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 Firm. All rights reserved.

 

By |2024-04-21T20:00:10-04:00April 23, 2024|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Texas Hospital’s COVID-19 Vaccine Mandate Upheld by Federal Court
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University of Colorado Sued For Denying COVID-19 Vaccine Religious Exemptions

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

On September 29, 2021, a pediatrician and medical student sued the University of Colorado Anschutz Medical Campus (CU) for denying COVID vaccine religious exemptions. The U.S. District Court lawsuit argued that school administrators judge the validity of personal religious beliefs in violation of the First Amendment.

Religious Exception For COVID Vaccine.

Both plaintiffs are challenging the denial of their requests for religious exemptions from the school’s COVID vaccination mandate. The lawsuit alleges that the university arbitrarily grants religious exemptions to its vaccine requirement for all staff and students. It also claims that CU is approving requests that are based on organized religious beliefs that oppose vaccinations while subjecting requests based on personal religious beliefs to “intrusive religious inquisition to test the veracity of students’ and employees’ asserted religious beliefs.”

Details of the Denials.

Neither plaintiff is named in the lawsuit ostensibly to protect them from retaliation. Instead, the pediatrician is referred to as “Dr. Jane Doe,” and the first-year medical student as “John Doe.”

According to the complaint, Dr. Jane Doe requested a religious exemption based on her Catholic beliefs and opposition to “abortion-derived cell lines” used in the three available U.S. vaccines. However, she did not oppose other vaccines, such as the flu shot.

Because of this, CU denied her request, stating that campus policy “only recognizes religious exemptions based on a religious belief whose teachings are opposed to all immunizations,” according to the complaint. Jane Doe argues that her pending termination will harm her reputation and stain her record as a licensed medical professional.

According to the complaint, the second plaintiff, John Doe, a first-year medical student, requested a religious exemption citing his Buddhist beliefs and avoidance of “products developed through the killing or harming of animals (including human beings).”

CU officials also denied the exception request, stating that John Doe’s objections to the vaccine “are all of a personal nature and not part of a comprehensive system of religious beliefs.”

The lawsuit says John Doe’s pending termination from CU would bar him from transferring to a different medical school under guidelines issued by the Association of American Medical Colleges and that he would have to reapply to attend a different U.S. medical program.

In response to the lawsuit, a spokesperson for the university said their mandatory vaccine policy “offers the best way to protect” the more than two million patients that the university faculty serve annually.

Both plaintiffs seek approval of their requests for religious exemptions and money for court costs and personal damages. This lawsuit is just one example of the fight over a growing number of COVID vaccine mandates nationwide. As a result, businesses need to be mindful and provide reasonable accommodations to employees with disabilities or religious beliefs that prevent them from receiving the COVID vaccine.

To read about another recent case regarding a hospital’s COVID vaccine mandate, click here to read my prior blog.

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

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, 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, medical groups, institutions, and individual health professionals 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 and DORA investigations. We represent medical students and resident physicians in disputes with their medical education programs. We do NOT represent plaintiffs seeking to avoid vaccinations or in COVID-19 injury suits, however.

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:

Nieberg, Patty. “University of Colorado faces COVID religious exemption suit.” AP News. (September 29, 2021). Web.

“Pediatrician, medical student sue University of Colorado over denial of COVID vaccine religious exemption.” The Colorado Sun. (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 Avenue, Suite 1000, Altamonte Springs, Florida 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 Firm. All rights reserved.

 

By |2024-04-21T20:00:11-04:00April 23, 2024|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on University of Colorado Sued For Denying COVID-19 Vaccine Religious Exemptions
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Walgreens Accused of Providing Insufficient COBRA Notices, Class Action Lawsuit Says

Lawyer, Author HeadshotBy 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.

By |2024-04-17T20:00:37-04:00April 19, 2024|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Walgreens Accused of Providing Insufficient COBRA Notices, Class Action Lawsuit Says
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Male Surgeon Wins $15 Million Verdict in Suit Based on “Reverse Discrimination” and Anti-Male Bias;  Hospital Requests New Trial

Attorney and Author George F. Indest III HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm
In a massive jury verdict awarding a male attending physician more than he requested, a jury found that a hospital demonstrated reverse discrimination and an anti-mail bias in how it handled a female resident physician’s complaint against him.
On January 8, 2024, Thomas Jefferson University Hospital urged a Pennsylvania Federal court to reverse a $15 million judgment against it over its handling of a sexual assault investigation in a gender bias case. In December 2023, a federal jury in the U.S. District Court for the Eastern District of Pennsylvania found that there was proof that the hospital exhibited anti-male bias and violated a male orthopedic surgeon’s civil rights when it investigated allegations that he sexually assaulted a medical resident.  Thomas Jefferson University Hospital claimed the court unfairly excluded key evidence that would have countered the surgeon’s claims that the female medical resident was actually the aggressor.
The Initial Incident. 
In 2018, Plaintiff John Abraham, a male orthopedic surgeon at Thomas Jefferson University Hospital, alleged that a female resident physician attended a pool party at his residence and engaged in sexually aggressive behavior towards him without his consent.  According to the law suit, he reported the female resident’s conduct to the hospital.
Dr. Abraham later learned that the female resident had already filed a complaint against him, resulting in an investigation into his behavior.  No charges against him aver resulted from the hospital’s investigation or a related criminal investigation.
The Alleged Gender Discrimination. 
Dr. Abraham sued Thomas Jefferson University Hospital, accusing it of practicing discrimination against men during its investigation of the sexual assault allegations.  According to him, the hospital demonstrated gender bias by disregarding his allegation that he was assaulted by the female and pressuring him to take a leave of absence.  This was compounded by its failure to take any action against the alleged female aggressor about whom he complained.  The investigation was eventually terminated with no findings after Dr. Abraham relinquished his privileges at the hospital.
In the suit Dr. Abraham sought $5 million in compensatory damages.  However, after the four-day civil trial, the federal jury awarded him $11 million in compensatory damages and $4 million in punitive damages.
The Hospital’s Request for a New Trial.
Thomas Jefferson University Hospital requested a new trial after the jury handed down the verdict. The hospital claimed that the court excluded critical evidence that it would have used on cross-examination of Dr. Abraham to help it win its case.  The excluded evidence included texts stating Dr. Abraham was not drunk at the party and that he intended to have sex with the female resident even though he knew it was unethical because she was his student.
The hospital also argued that the court gave incorrect jury instructions about the difference between anti-male discrimination and anti-respondent discrimination in a sexual assault investigation. According to the hospital’s motion, taking “risk minimization measures” against someone accused of sexual assault, like placing them on a leave of absence, is not cause for a Title IX gender discrimination lawsuit. Additionally, the hospital claims, not specifying this difference to the jury incorrectly led the jury to believe that anti-respondent bias was, in fact, anti-male bias.
The judge has not yet ruled on the hospital’s request.
To read two recent blogs I wrote about Title IX and its applications to resident physicians and fellows, click here and here.
Contact Experienced Health Law Attorneys Representing Health Care Professionals, Medical Students, Residents, and Fellows.
The Health Law Firm routinely represents students, including medical students, dental students, nursing students, pharmacy students, resident physicians, and fellows, who have legal problems with their schools or programs. We also represent students, residents, and fellows in investigations, academic probation and suspensions, disciplinary hearings, clinical competence committee (CCC) hearings, and appeals of adverse actions taken against them. The Health Law Firm’s attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.
Our firm also specializes in providing legal representation to a wide range of healthcare professionals, including pharmacists, massage therapists, mental health counselors, registered nurses, and more.
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:
Abraham v. Thomas Jefferson University No. 2:20-cv-02967-MMB (E.D. PA. January 8, 2024)
Abraham v. Thomas Jefferson University No. 2:20-cv-02967-MMB (E.D. PA. June 19, 2020)
D’Annunzio, P.J.. “Info Kept From Jury In $15M Gender Bias Case, Pa. Court Told.” Law360. (9 January 2024) https://www.law360.com/articles/1783770
Rock, Amy. “Thomas Jefferson University to Pay $15 Million to Male Surgeon for Gender-Biased Rape Investigation.” Campus Safety Magazine. (15 December 2023) https://www.campussafetymagazine.com/university/thomas-jefferson-university-to-pay-15-million-to-male-surgeon-for-gender-biased-rape-investigation/
Ruderman, Wendy. “Former Rothman orthopedic surgeon takes on Jefferson in federal court over sexual assault allegations.” The Philadelphia Inquirer. (5 December 2023) https://www.inquirer.com/health/john-abraham-rothman-jefferson-sex-discrimination-case-jury-federal-20231205.html
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 the Orlando, Florida area.
The Health Law Firm can be visited at:  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 © 2024 George F. Indest III, The Health Law Firm. All rights reserved. No part of this work may be reproduced in any way in any medium without the written permission of the copyright owner. The author of this work reserves the right to have his name associated with any use or publication of this work or any part of it.
By |2024-03-14T09:59:08-04:00April 16, 2024|Categories: Dental Law Blog, Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Male Surgeon Wins $15 Million Verdict in Suit Based on “Reverse Discrimination” and Anti-Male Bias;  Hospital Requests New Trial
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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

 

 

 

 

 

By |2024-03-24T20:02:08-04:00March 26, 2024|Categories: In the News, Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Humana Agrees To Pay $11.2 Million to End Nurses’ Overtime Suit
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Male Surgeon Wins $15 Million Verdict in Suit Based on “Reverse Discrimination” and Anti-Male Bias; Hospital Requests New Trial

By 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
In a massive jury verdict awarding a male attending physician more than he requested, a jury found that a hospital demonstrated reverse discrimination and an anti-mail bias in how it handled a female resident physician’s complaint against him.
On January 8, 2024, Thomas Jefferson University Hospital urged a Pennsylvania Federal court to reverse a $15 million judgment against it over its handling of a sexual assault investigation in a gender bias case. In December 2023, a federal jury in the U.S. District Court for the Eastern District of Pennsylvania found that there was proof that the hospital exhibited anti-male bias and violated a male orthopedic surgeon’s civil rights when it investigated allegations that he sexually assaulted a medical resident.  Thomas Jefferson University Hospital claimed the court unfairly excluded key evidence that would have countered the surgeon’s claims that the female medical resident was actually the aggressor.
The Initial Incident.
In 2018, Plaintiff John Abraham, a male orthopedic surgeon at Thomas Jefferson University Hospital, alleged that a female resident physician attended a pool party at his residence and engaged in sexually aggressive behavior towards him without his consent.  According to the law suit, he reported the female resident’s conduct to the hospital.
Dr. Abraham later learned that the female resident had already filed a complaint against him, resulting in an investigation into his behavior.  No charges against him aver resulted from the hospital’s investigation or a related criminal investigation.
The Alleged Gender Discrimination. 
Dr. Abraham sued Thomas Jefferson University Hospital, accusing it of practicing discrimination against men during its investigation of the sexual assault allegations.  According to him, the hospital demonstrated gender bias by disregarding his allegation that he was assaulted by the female and pressuring him to take a leave of absence.  This was compounded by its failure to take any action against the alleged female aggressor about whom he complained.  The investigation was eventually terminated with no findings after Dr. Abraham relinquished his privileges at the hospital.
In the suit Dr. Abraham sought $5 million in compensatory damages.  However, after the four-day civil trial, the federal jury awarded him $11 million in compensatory damages and $4 million in punitive damages.
The Hospital’s Request for a New Trial.
Thomas Jefferson University Hospital requested a new trial after the jury handed down the verdict. The hospital claimed that the court excluded critical evidence that it would have used on cross-examination of Dr. Abraham to help it win its case.  The excluded evidence included texts stating Dr. Abraham was not drunk at the party and that he intended to have sex with the female resident even though he knew it was unethical because she was his student.
The hospital also argued that the court gave incorrect jury instructions about the difference between anti-male discrimination and anti-respondent discrimination in a sexual assault investigation. According to the hospital’s motion, taking “risk minimization measures” against someone accused of sexual assault, like placing them on a leave of absence, is not cause for a Title IX gender discrimination lawsuit. Additionally, the hospital claims, not specifying this difference to the jury incorrectly led the jury to believe that anti-respondent bias was, in fact, anti-male bias.
The judge has not yet ruled on the hospital’s request.
To read two recent blogs I wrote about Title IX and its applications to resident physicians and fellows, click here and here.
Contact Experienced Health Law Attorneys Representing Health Care Professionals, Medical Students, Residents, and Fellows.
The Health Law Firm routinely represents students, including medical students, dental students, nursing students, pharmacy students, resident physicians, and fellows, who have legal problems with their schools or programs. We also represent students, residents, and fellows in investigations, academic probation and suspensions, disciplinary hearings, clinical competence committee (CCC) hearings, and appeals of adverse actions taken against them. The Health Law Firm’s attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.
Our firm also specializes in providing legal representation to a wide range of healthcare professionals, including pharmacists, massage therapists, mental health counselors, registered nurses, and more.
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:
Abraham v. Thomas Jefferson University No. 2:20-cv-02967-MMB (E.D. PA. January 8, 2024)
Abraham v. Thomas Jefferson University No. 2:20-cv-02967-MMB (E.D. PA. June 19, 2020)
D’Annunzio, P.J.. “Info Kept From Jury In $15M Gender Bias Case, Pa. Court Told.” Law360. (9 January 2024) https://www.law360.com/articles/1783770
Rock, Amy. “Thomas Jefferson University to Pay $15 Million to Male Surgeon for Gender-Biased Rape Investigation.” Campus Safety Magazine. (15 December 2023) https://www.campussafetymagazine.com/university/thomas-jefferson-university-to-pay-15-million-to-male-surgeon-for-gender-biased-rape-investigation/
Ruderman, Wendy. “Former Rothman orthopedic surgeon takes on Jefferson in federal court over sexual assault allegations.” The Philadelphia Inquirer. (5 December 2023) https://www.inquirer.com/health/john-abraham-rothman-jefferson-sex-discrimination-case-jury-federal-20231205.html
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 the Orlando, Florida area.
The Health Law Firm can be visited at:  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 © 2024 George F. Indest III, The Health Law Firm. All rights reserved. No part of this work may be reproduced in any way in any medium without the written permission of the copyright owner. The author of this work reserves the right to have his name associated with any use or publication of this work or any part of it.
By |2024-03-14T09:59:09-04:00March 26, 2024|Categories: Health Facilities Law Blog, Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Male Surgeon Wins $15 Million Verdict in Suit Based on “Reverse Discrimination” and Anti-Male Bias; Hospital Requests New Trial
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Male Surgeon Wins $15 Million Verdict in Suit Based on “Reverse Discrimination” and Anti-Male Bias; Hospital Requests New Trial

Attorney and Author George F. Indest III HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm
In a massive jury verdict awarding a male attending physician more than he requested, a jury found that a hospital demonstrated reverse discrimination and an anti-mail bias in how it handled a female resident physician’s complaint against him.
On January 8, 2024, Thomas Jefferson University Hospital urged a Pennsylvania Federal court to reverse a $15 million judgment against it over its handling of a sexual assault investigation in a gender bias case. In December 2023, a federal jury in the U.S. District Court for the Eastern District of Pennsylvania found that there was proof that the hospital exhibited anti-male bias and violated a male orthopedic surgeon’s civil rights when it investigated allegations that he sexually assaulted a medical resident.  Thomas Jefferson University Hospital claimed the court unfairly excluded key evidence that would have countered the surgeon’s claims that the female medical resident was actually the aggressor.
The Initial Incident. 
In 2018, Plaintiff John Abraham, a male orthopedic surgeon at Thomas Jefferson University Hospital, alleged that a female resident physician attended a pool party at his residence and engaged in sexually aggressive behavior towards him without his consent.  According to the law suit, he reported the female resident’s conduct to the hospital.
Dr. Abraham later learned that the female resident had already filed a complaint against him, resulting in an investigation into his behavior.  No charges against him aver resulted from the hospital’s investigation or a related criminal investigation.
The Alleged Gender Discrimination. 
Dr. Abraham sued Thomas Jefferson University Hospital, accusing it of practicing discrimination against men during its investigation of the sexual assault allegations.  According to him, the hospital demonstrated gender bias by disregarding his allegation that he was assaulted by the female and pressuring him to take a leave of absence.  This was compounded by its failure to take any action against the alleged female aggressor about whom he complained.  The investigation was eventually terminated with no findings after Dr. Abraham relinquished his privileges at the hospital.
In the suit Dr. Abraham sought $5 million in compensatory damages.  However, after the four-day civil trial, the federal jury awarded him $11 million in compensatory damages and $4 million in punitive damages.
The Hospital’s Request for a New Trial.
Thomas Jefferson University Hospital requested a new trial after the jury handed down the verdict. The hospital claimed that the court excluded critical evidence that it would have used on cross-examination of Dr. Abraham to help it win its case.  The excluded evidence included texts stating Dr. Abraham was not drunk at the party and that he intended to have sex with the female resident even though he knew it was unethical because she was his student.
The hospital also argued that the court gave incorrect jury instructions about the difference between anti-male discrimination and anti-respondent discrimination in a sexual assault investigation. According to the hospital’s motion, taking “risk minimization measures” against someone accused of sexual assault, like placing them on a leave of absence, is not cause for a Title IX gender discrimination lawsuit. Additionally, the hospital claims, not specifying this difference to the jury incorrectly led the jury to believe that anti-respondent bias was, in fact, anti-male bias.
The judge has not yet ruled on the hospital’s request.
To read two recent blogs I wrote about Title IX and its applications to resident physicians and fellows, click here and here
Contact Experienced Health Law Attorneys Representing Health Care Professionals, Medical Students, Residents, and Fellows.
The Health Law Firm routinely represents students, including medical students, dental students, nursing students, pharmacy students, resident physicians, and fellows, who have legal problems with their schools or programs. We also represent students, residents, and fellows in investigations, academic probation and suspensions, disciplinary hearings, clinical competence committee (CCC) hearings, and appeals of adverse actions taken against them. The Health Law Firm’s attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.
Our firm also specializes in providing legal representation to a wide range of healthcare professionals, including pharmacists, massage therapists, mental health counselors, registered nurses, and more.
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:
Abraham v. Thomas Jefferson University No. 2:20-cv-02967-MMB (E.D. PA. January 8, 2024)
Abraham v. Thomas Jefferson University No. 2:20-cv-02967-MMB (E.D. PA. June 19, 2020)
D’Annunzio, P.J.. “Info Kept From Jury In $15M Gender Bias Case, Pa. Court Told.” Law360. (9 January 2024) https://www.law360.com/articles/1783770
Rock, Amy. “Thomas Jefferson University to Pay $15 Million to Male Surgeon for Gender-Biased Rape Investigation.” Campus Safety Magazine. (15 December 2023) https://www.campussafetymagazine.com/university/thomas-jefferson-university-to-pay-15-million-to-male-surgeon-for-gender-biased-rape-investigation/
Ruderman, Wendy. “Former Rothman orthopedic surgeon takes on Jefferson in federal court over sexual assault allegations.” The Philadelphia Inquirer. (5 December 2023) https://www.inquirer.com/health/john-abraham-rothman-jefferson-sex-discrimination-case-jury-federal-20231205.html
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 the Orlando, Florida area.
The Health Law Firm can be visited at:  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 © 2024 George F. Indest III, The Health Law Firm. All rights reserved. No part of this work may be reproduced in any way in any medium without the written permission of the copyright owner. The author of this work reserves the right to have his name associated with any use or publication of this work or any part of it.
By |2024-03-14T09:59:10-04:00March 6, 2024|Categories: Medical Education Law Blog, The Health Law Firm Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Male Surgeon Wins $15 Million Verdict in Suit Based on “Reverse Discrimination” and Anti-Male Bias; Hospital Requests New Trial
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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.

By |2024-03-14T09:59:10-04:00March 2, 2024|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Ex-Surgery Technician Slaps Georgia Urology Practice With Federal Discrimination Lawsuit
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Rapper 50 Cent Sues Florida Plastic Surgeon Over “Penile Enhancement” Ads & Social Media Photos

Author HeadshotBy 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.

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“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 28, 2024|Categories: Medical Education Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |Comments Off on Rapper 50 Cent Sues Florida Plastic Surgeon Over “Penile Enhancement” Ads & Social Media Photos
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HHS OIG Release of New “General Compliance Program Guidance” Provides Valuable Insight on Prevention of Health Care Fraud, Waste, and Abuse

By Michelle E. Missigman, J.D.
On November 6, 2023, the U.S. Department of Health and Human Services (HHS), Office of the Inspector General (OIG), released 91 pages of “General Compliance Program Guidance” (GCPG) on its website.  This is the first compliance program guidance the OIG has released since 2008.  The GCPG provides general compliance guidance, tools, and references for use by federal health care program providers.
This new guidance brings together many resources and links, making it a valuable and easy-to-read tool to keep on hand for any professional working within the healthcare industry.
The GCPG covers the following topics:
I.  Introduction
The GCPG  provides a thorough introduction to the OIG’s history and commitment to preventing health care fraud an abuse.  It provides a roadmap for how the OIG intends to modernize and improve its publicly available resources.  The OIG’s goal is to continue producing these resources, deliver information to the public in a user-friendly approach using modern technology, and produce informative and useful resources to help advance the health care industry’s compliance efforts in preventing fraud, waste, and abuse.
II.  Health Care Fraud Enforcement
The GCPG provides a broad overview of federal healthcare fraud enforcement standards and laws,  such as: the anti-kickback statute, physician self-referral law, false claims act, civil monetary penalties, exclusions from federal programs, criminal health care fraud statute, HIPAA privacy and security rules.
III.  Seven Elements of a Successful Compliance Program
The largest section of the GCPG reinforces and provides a thorough explanation of the seven elements of an effective compliance program:
1.  Written Policies and Procedures
2.  Compliance Leadership and Oversight
3.  Training and Education
4.  Effective Lines of Communication with the Compliance Officer and Disclosure Programs
5.  Enforcing Standards: Consequences and Incentives
6.  Risk Assessment, Auditing, and Monitoring
7.Responding to Detected Offenses and Developing Corrective Action Initiatives
Much of the guidance in this section reflects the OIG’s prior guidance in monitoring Corporate Integrity Agreements (CIAs).  Check out this article on CIAs.
IV.  Compliance Program Adaptations for Small and Large Entities
Maintaining an effective compliance program can be burdensome for smaller entities that have limited resources.  The OIG acknowledges this and provides guidance on how smaller entities can still implement a compliance program that meets the above seven elements of a compliance program.
For larger entities with more resources, the GCPG goes into detail about the compliance officer’s role within the organization.  The compliance officer should have the authority to oversee and direct the organization’s compliance function and lead the compliance department. The organization’s board of directors and compliance office should meet periodically to evaluate the compliance department and determine whether it meets the needs of the organization.
V.  Other Compliance Considerations
The GCPG considers other areas to assist entities in developing policies and procedures to reduce or eliminate potential fraud and abuse risks.  Some other areas they have considered are: quality and patient safety, new entrants in the health care industry (e.g. technology companies, new investors, and non-traditional services in health care such as social services, food delivery, and care coordination services), financial incentives, and financial arrangements.
VI.  Additional OIG Resources and Tools

Lastly, the CPCG lists links all of the resources available on the OIG website, including previous compliance program guidance, advisory opinions, special fraud alerts, safe harbor regulations, compliance toolkits, OIG reports and publications, corporate integrity agreements, self-disclosure information and access to OIG’s hotline. The OIG has even implemented a FAQ process to provide informal feedback to the health care community.
Contact Health Law Attorneys Experienced in Defending Against Action to Exclude an Individual or Business from the Medicare Program and Assisting in Reinstatement Applications.
The attorneys of The Health Law Firm have experience in dealing with the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS), and defending against action to exclude an individual or business entity from the Medicare Program, in administrative hearings on this type of action, in submitting applications requesting reinstatement to the Medicare Program after exclusion, and removal from the List of Excluded Individuals and Entities (LEIE).
To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.
About the Author: Michelle E. Missigman, is a health attorney practicing with The Health Law Firm.  The firm 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.
Sources:
“Criteria for Implementing Section 1128(b)(7) Exclusion Authority.” U.S. Department of Health and Human Services Office of Inspector General. (2016). Web.
Dani Kass. “HHS Watchdog Lays Out New Grounds For Exclusion List.” Law360. (2016). Web.
“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.
By |2024-03-14T09:59:14-04:00January 4, 2024|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , |Comments Off on HHS OIG Release of New “General Compliance Program Guidance” Provides Valuable Insight on Prevention of Health Care Fraud, Waste, and Abuse
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“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A.
The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.
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