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The American Academy of Family Physicians Releases Third List for Choosing Wisely Campaign

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

On September 24, 2013, the American Academy of Family Physicians (AAFP) released its third list of commonly prescribed tests and procedures that may not be necessary. This list is part of the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely campaign.

The Choosing Wisely Campaign was initiated to give patients a catalog of procedures, tests and treatments that have been overused, misused or have been identified as ineffective. Since its launch in April 2012, more than fifty (50) medical specialty societies have created lists of procedures, tests and drug treatments that deserve to be questioned before a physician orders them or patients accept them.

The purpose is to help patients become more discriminating about what care they receive. Physicians and health care providers also need to use this information to review the latest research and use that information to help avoid any litigation.

I’ve previously written about the Choosing Wisely campaign. Click here for part one and here for part two.

AAFP’s Updated List of Commonly Prescribed Tests and Procedures That May Not be Necessary.

1. Do not prescribe antibiotics for otitis media in children aged 2-12 years with non-severe symptoms where the observation option is reasonable.

2. Do not perform voiding cystourethrogram routinely in first febrile urinary tract infection in children aged 2-24 months.

3. Do not routinely screen for prostate cancer using a prostate-specific antigen (PSA) test or digital rectal exam. Evidence suggests that PSA-based screening leads to an overdiagnosis of prostate tumors.

4. Do not screen adolescents for scoliosis. Potential harms include unnecessary follow-up visits resulting from false-positive test results.

5. Do not require a pelvic exam or other physical exam to prescribe oral contraceptive medications. Hormonal contraceptives are safe, effective, and well tolerated by most women.

Click here to read the AAFP’s previous recommendations.

Health Care Providers and Professionals’ Responsibility to Patients.

A doctor should have the knowledge, skill, training, and confidence to know when such tests and procedures are not warranted. Also, a health care professional or provider should not be swayed by increasing his/her personal bottom line. Specifically, physicians that work in a fee-for-service setting that rewards doctors for performing more procedures are at risk for ordering unnecessary tests or procedures. If a physician persists in ordering these tests solely for the means of increasing profits, he or she should be penalized. If not, the physician should be able to justify them.

Laws Protect Patients from Unnecessary Testing.

This situation may have the side effect of promoting additional litigation against doctors, healthcare clinics and hospitals that provide the unnecessary tests and procedures. Many states have laws that prohibit unnecessary tests and procedures and sanction those who provide them. For instance, Section 766.111, Florida Statutes, provides a private cause of action by a patient against a health provider who orders or furnishes such “unnecessary” diagnostic tests, but unlike other tort and medical malpractice statutes, it allows the prevailing party in such a case to recover attorney’s fees and costs. This law may by itself promote litigation in the face of the lists of tests produced by the specialty groups in the Choosing Wisely campaign.

Look for More Whistleblower/Qui Tam Cases.

As this list continues to grow, I believe that we will see more qui tam/whistleblower and false claims cases.

Qui tam cases have been brought under the federal False Claims Act for the recovery of Medicare payments from hospitals, physicians, nursing homes, diagnostic testing facilities, clinical laboratories, radiology facilities and many other types of healthcare providers. These cases allege that a false claim was submitted to the government. If the test or procedure was unnecessary, then it seems almost axiomatic that a claim for it is false. The plaintiff bringing such cases receives a percentage of the recovery, which often amounts to millions of dollars in successful cases.

Most states now have similar false claims act or qui tam laws providing similar causes of action and recoveries to individual plaintiffs in the case of state Medicaid payments as well.

Because medical necessity is a requirement for practically every Medicare and Medicaid service, as well as most services paid by private health insurers, the lists provided by the specialty may very well be exhibit one in future lawsuits.

We’ve recently written about a couple of whistleblower/qui tam cases stemming from unnecessary procedures. To read a blog on a group of Florida radiation oncology service providers accused of performing unnecessary and improperly supervised procedures, click here. To read a blog on Winter Park Urology’s settlement over allegations stemming from radiation therapy used to treat cancer patients, click here.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

As a health care professional or provider what do you think of the Choosing Wisely campaign? Please leave any thoughtful comments below.

Sources:

Hand, Larry. “AAFP Releases Third Choosing Wisely List.” Medscape. (September 25, 2013). From: http://www.medscape.com/viewarticle/811638

Carman, Diane. “Useless, Costly Medical Procedures Targeted by Choosing Wisely Campaign.” Health Policy Solutions. (October 15, 2013). From: http://www.healthpolicysolutions.org/2013/10/15/useless-costly-medical-procedures-targeted-by-choosing-wisely-campaign/

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

By The Health Law Firm|2024-03-14T10:00:52-04:00June 1, 2018|Categories: Health Care Industry, The Health Law Firm Blog, Whistleblower|Tags: American Academy of Family Physicians (AAFP), American Board of Internal Medicine (ABIM) Foundation, Choosing Wisely, defense attorney, defense lawyer, doctors, false claims cases, Florida health care attorney, Florida health law attorney, health care attorney, health care lawyer, health law attorney, health lawyer, medicaid, medicare, physicians, qui tam, the health law firm, unnecessary procedures, unnecessary tests, whistleblower|Comments Off

Doctors’ Medicare Payment Data to be Released Spring 2014

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

For years, the Centers for Medicare and Medicaid Services (CMS) has kept private its records on Medicare claims payments made to individual physicians. However, beginning March 18, 2014, the government may disclose the payment data on a case-by-case basis. According to CMS, this directive is a push by the Obama Administration to crack down on doctors who are making a habit out of repeatedly overcharging Medicare. On January 15, 2014, CMS stated that recalcitrant providers could face civil fines and exclusion from Medicare and other federal health care programs. According to CMS, a recalcitrant provider is defined as one who is abusing the program and not changing inappropriate behavior even after extensive education to address these behaviors.

Data Made Public to Fight Healthcare Fraud.

According to The New York Times, federal officials estimate that 10 percent (10%) of payments in the fee-for-service Medical program are improper. Supporters of releasing the data say it could help identify patterns of waste and fraud. The Medicare payment data, combined with data from other sources, could be enormously useful to consumers, researchers and whistleblowers analyzing patterns of health spending.

Physician groups express caution in Medicare releasing individual payment information, saying it could lead to public misunderstanding and unintended consequences, according to The New York Times.

Click here to read the entire article from The New York Times.

Data Prohibited From Being Release for Past Thirty Years.

In 1979, a federal district judge in Jacksonville, Florida, issued an injunction that prohibited Medicare officials from releasing what Medicare pays individual doctors. The ruling, in a lawsuit filed by doctors, said such disclosure would violate the Privacy Act and constitute a clearly unwarranted invasion of personal privacy. In May 2013, the judge lifted the injunction.

According to a MedPage Today article, the decision does not require the wholesale release of Medicare payment data but allows Medicare officials and courts to consider the merits of each request.

To read the entire article from MedPage Today, click here.

Healthcare Providers Should Prepare for Possible Public Scrutiny.

Although it remains to be seen how CMS will implement its new policy, health care providers should be prepared for the possibility that their coding, billing and reimbursement patterns will become the subject of public scrutiny, particularly those providers in specialized areas including internal medicine, radiation oncology and ophthalmology.

Contact Health Law Attorneys Experienced with Healthcare Fraud Cases.

Attorneys with The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program. We also handle Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S.

Our attorneys also represent health care professionals and health facilities in qui tam or whistleblower cases both in defending such claims and in bringing such claims. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

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

Comments?

What do you think about the decision to release payment data for physicians? How will this effect health care providers? Please leave any thoughtful comments below.

Sources:

Pear, Robert. “Doctors Abusing Medicare Face Fines and Expulsion.” The New York Times. (January 25, 2014). From: http://nyti.ms/1cpIaOg

Pittman, David. “Medicare to Release Doc Pay Data This Spring.” MedPage Today. (January 14, 2014). From: http://bit.ly/1ndaCHu

The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

By The Health Law Firm|2024-03-14T10:00:54-04:00June 1, 2018|Categories: Health Care Industry, Medicare, The Health Law Firm Blog|Tags: Centers for Medicare and Medicaid, CMS, defense attorney, defense lawyer, doctor attorney, doctor lawyer, doctor payment information, doctors, exclusion from Medicare, expelled from Medicare, health law firm, improper payments, internal medicine, medically necessary claims, medically unnecessary claims, medicare, Medicare abuse, Medicare doctor services, Medicare fraud, Medicare payment data, Medicare payments, Medicare physician services, ophthalmology, overcharge Medicare, physician attorney, physician lawyer, physician payment information, physicians, radiation oncology, Recalcitrant providers, the health law firm|Comments Off

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

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

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

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

Click here to read more from Modern Healthcare.

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

The Alleged Scandal that Rocked the U.S.

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

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

AMA Volunteers to Provide Help.

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

Click here to read the press release from the AMA.

What This Means for Private Sector Health Providers.

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

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

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

The VA Needs More Resources, Congress!

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

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

Comments?

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

Contact Experienced Health Law Attorneys.
The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, NPDB actions, inspections and audits involving the Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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

Sources:

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

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

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

Florida “wrongful births” leave health care providers liable

According to Institute of Medicine statistics, approximately 98,000 Americans die each year as a result of medical errors that could have been prevented. This is an example of ‘wrongful death,’ a term recognizable to many. However, the term ‘wrongful birth’ may not provide the same familiarity, but is causing just as much commotion in the legal arena.

In 2007, the Tampa Tribune provided details of such a case involving a University of South Florida doctor. This doctor told Daniel and Amara Estrada to go ahead with a second pregnancy, despite the fact that their first child had significant birth defects. However, the doctor did not provide all of the facts needed by the Estrada’s to make a decision about having a second child.

If this doctor properly diagnosed the first child with Smith-Lemli-Opitz syndrome (a syndrome with which the doctor was familiar), the Estrada’s would have known that a 25% chance existed that their second child would have this same genetic disorder, and a test could have been done during the pregnancy to find out for sure. Had they known that their second child had Smith-Lemli-Optiz syndrome, the Estrada’s would have terminated the pregnancy.

According to the Tampa Tribune, the “jury determined the Estradas deserve $23.5 million for lifetime care of their second child, born with the same genetic disorder as their first. The award includes payment for the pain and suffering caused by the doctor’s misdiagnosis.”

A similar case just resolved in September in Palm Beach County. In this incident, a boy was born without arms and with only one leg, but his parents had no prior knowledge that this would occur, despite regular prenatal care and sonograms.

According to Miami Injury Lawyer Blawg, the jury found that the doctor and ultrasound technician involved with this pregnancy fell below the standard of care by negligently administering a sonogram. Had they not been negligent, they would have discovered the abnormalities. If the parents were made aware of these abnormalities, they would have terminated the pregnancy. The parents were awarded $4.5 million to help them buy prostheses, wheelchairs and other medical services needed to aid in their child’s care.

Both of these lawsuits deal with a controversial matter: the right of a parent to sue on behalf of children with disabilities, claiming that they wouldn’t have had the child had they known the extent of the child’s disability. Florida is one of approximately 25 states that allow for these ‘wrongful birth’ suits, which present sensitive issues for jurors.

Health care providers in Florida need to be aware of the protections provided for parents in similar cases and strive to go above and beyond the standard of care. To learn more about how to protect yourself in these matters, visit http://www.thehealthlawfirm.com/.

By The Health Law Firm|2024-03-14T10:00:25-04:00June 1, 2018|Categories: In the News, The Health Law Firm Blog|Tags: attorneys, doctors, health law attorneys, negligence, physicians, standard of care, wrongful birth, wrongful death|Comments Off

July Issue of Medical Economics Features Article by George F. Indest III

By Cori Pope, The Health Law Firm

The July 25, 2012, issue of Medical Economics features an article written by George F. Indest III, President and Managing Partner of The Health Law Firm. The article, “Beware Legal Ramifications of Unnecessary Tests,” discusses lists that were recently released by nine medical specialty societies on medical tests and procedures patients and physicians should question or avoid.

What Patients and Doctors Need to Know about These Lists.

In the article Mr. Indest provides his insights into what these lists of questionable procedures may mean for patients and doctors.

Patients now have access to some of the same information as their doctors and can ask whether a test or procedure is warranted. This ability allows shared decision-making between patients and physicians and can result in less uncertainty by patients about the medical care they are receiving.

For doctors, health care clinics and hospitals, these lists could mean additional litigation for ordering “unnecessary” tests and procedures for their patients.

To read the entire article, click here.

About the Author.

Mr. Indest is a well-known attorney specializing in the representation of health professionals and healthcare providers throughout Florida. He is Board Certified by The Florida Bar in the legal specialty of Health Law. His practice encompasses all aspects of health law, including malpractice defense, qui-tam or “whistle-blower” and false claims, defense of professional licensing cases, representation in investigations, defense in credentialing matters, Medicare and Medicaid audits, formation of corporations and limited liability companies (LLCs), Board of Medicine hearings, peer review actions, clinical privileges hearings, representation of medical students, and other matters of healthcare law and legal representation of healthcare professionals.

In 1999, Mr. Indest started The Health Law Firm, which has three Florida offices located in Altamonte Springs, Orlando, and Pensacola. A former Navy JAG Corps attorney, he has practiced law for more than 30 years.

For more information about The Health Law Firm, visit http://www.thehealthlawfirm.com.

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

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

The services we provide include reviewing and negotiating contracts, business transactions, professional license defense, representation in investigations, credential defense, representation in peer review and clinical privileges hearings, opinion letters, Medicare and Medicaid audits, commercial litigation, and administrative hearings.

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

By The Health Law Firm|2024-03-14T10:00:34-04:00June 1, 2018|Categories: Health Care Industry, In the Know, In the News, The Health Law Firm Blog|Tags: Board Certified, clinical privileges hearings, defense attorney, defense in credentialing matters, defense of professional licensing cases, doctors, florida bar, health law, Health Law expert, malpractice defense, Medical Economics, opinion letters, peer review actions, physicians, representation in investigations, representation of health professionals and healthcare providers|Comments Off

Human Body Parts Discovered in Self-Storage Facility that Belonged to a Former Medical Examiner

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

A former medical examiner, who is accused of keeping the body parts of more than 100 people in his Pensacola storage facility, was arrested September 7, 2012. He now faces a felony charge of improper storage of hazardous waste, a misdemeanor charge of “nuisance injurious to public health” and driving with a suspended license, according to a number of sources.

To see the case against the former medical examiner, click here.

It is reported that he had previously been fired as a medical examiner in Jackson County, Missouri. His medical license was allegedly revoked in Missouri. A check of the Florida Department of Health (DOH) licensing website lists his license as null and void. To see his license verification, click here. He could also have some serious points added to his driving license, making his auto insurance premiums go up (if convicted of the traffic offense).

Livers, Brains and Hearts Allegedly Found in Storage Facility.

According to an article in the Pensacola News Journal, the former medical examiner rented the self-storage unit for about three years. On August 22, 2012, he defaulted on his payments, and the unit was auctioned off.

When the storage facility was auctioned off, the new purchaser allegedly discovered 10 cardboard boxes containing human remains stored in a liquid. Garbage bags containing human remains packaged in soda cups and plastic food containers were also found.

This is one auction I doubt you are going to see on “Auction Hunters” or “Storage Wars” on television.

According to a related Associated Press article, the District 1 Medical Examiner’s Office in Pensacola said that the remains appear to have come from private autopsies that were performed between 1997 and 2007 at funeral homes in the Florida Panhandle and in Tallahassee. Allegedly 111 containers filled with body parts, including hearts, brains, a liver, and a lung were found.

Although there were lots of brains found, there were no “Abbie Normal” brains reportedly found.

For a related story regarding zombie outbreaks in Florida and the Florida Legislature’s effort to control them by banning bath salts, click here.

Former Medical Examiner Fired from Medical Examiner’s Office in Pensacola.

The former medical examiner reportedly worked at the District 1 Medical Examiner’s Office in Pensacola from 1997 to 2003. He was fired for allegedly having a large backlog of cases and failing to complete autopsy reports in a timely manner.

Investigation Continues.

Right now, the former medical examiner faces a felony charge of improper storage of hazardous waste, a misdemeanor charge of “nuisance injurious to public health” and driving with a suspended license. These charges alone could land him in prison for more than five years.

The District 1 Medical Examiner’s Office in Pensacola is contacting all the family members of the decedents whose body parts were found. If the family did not give permission to the former doctor, more charges could be coming. Exactly how these body parts are being identified has not been made clear.

Click here to read the entire Pensacola News Journal article.

Your Thoughts?

Tell us below what you think of this story. We would love to hear from you.

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

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, license complaints, administrative hearings, business and commercial litigation, and other types of investigations of health professionals and providers.

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

Sources:

Heisig, Eric. “Charges Filed Against Doctor in Body Parts Cases.” Pensacola News Journal. (September 9, 2012). From: http://www.pnj.com/apps/pbcs.dll/article?AID=2012309080010

Associated Press. “Ex-Medical Examiner Charged After Human Organs Found in Storage Unit.” Associated Press (September 8, 2012). From: http://articles.orlandosentinel.com/2012-09-08/news/os-human-organs-storage-unit-florida-20120908_1_human-organs-storage-unit-medical-examiner

“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.

By The Health Law Firm|2024-03-14T10:00:36-04:00June 1, 2018|Categories: In the News, The Health Law Firm Blog|Tags: administrative action, defense attorney, doctor felony, doctors, licensing and regulatory, licensing issues, licensure cases, medical license, physician felony, physicians|1 Comment

Students Graduating Medical School in Three Years

By Danielle M. Murray, J.D.

To combat the nationwide shortage of primary care physicians and the increase in student debt, several medical schools around the country are offering the chance for students to finish school in three years, instead of four. According to a number of news articles, these programs are geared specifically toward medical students looking to practice primary care. The hope is that these programs will be cost less for students and add more primary care physicians to under-served areas.

Schools Across the U.S. Offer Three-Year Degrees.

According to an article in The New York Times, a small number of students are currently participating in the three-year degree program. There are about 16 incoming students in the program at New York University (N.Y.U.), nine students at Texas Tech Health Science Center School of Medicine and an even smaller number are at the Mercer University School of Medicine campus in Georgia. In an interview in The New York Times, the dean at Texas Tech said if this approach works, the schools will open up the program to a larger number of students.

To read the entire New York Times article, click here.

Condensed Medical School Not for Everyone.

According to an article in American Medical News, the condensed medical school eliminates breaks and electives and allows students to begin clerkship training in their second year. This is a full year earlier than the traditional four-year curriculums. In the same article, medical experts warn these accelerated programs are not for everyone, saying it takes a mature person to go through rotations earlier and at a quicker pace.

Students are given a chance to opt out if they decide to pursue a different career path. The American Medical News article explains that at Mercer, students who decide that family medicine is not for them are integrated into the traditional four-year program.

Click here to read the article from American Medical News.

Program Developed to Help with Student Debt and Doctor Shortage.

This three-year program is expected to save a quarter of the cost of medical school, which is more than $49,000 a year in tuition and fees at N.Y.U., according to The New York Times. The money saved helps primary care physicians lessen their debt as they go to work in a lower paying field. This program is expected to attract more students to practice in fields such as pediatrics and internal medicine.

According to the Association of American Medical Colleges, the physician shortage is expected to reach 91,500 physicians by 2020. This program, as it grows, can help alleviate the shortage and bring more doctors to areas in need.

Contact a Health Care Attorney that is Experienced in the Representation of Medical Students, Interns, Residents and Applicants.

The Health Law Firm and its attorneys represent medical school students in disputes with their medical schools, internship supervisors, and in dismissal hearings. We have represented residents, interns and fellows in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation and on other matters.

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

Comments?

What do you think of a three-year medical school degree for doctors? Do you think the fourth year of medical school is necessary for primary care physicians? Please leave any thoughtful comments below.

Sources:

Hartcocollis, Anemona. “N.Y.U. and Other Medical Schools Offer Shorter Course in Training, for Less Tuition.” The New York Times. (December 23, 2012). From: http://www.nytimes.com/2012/12/24/education/nyu-and-others-offer-shorter-courses-through-medical-school.html?pagewanted=all&_r=0

Krupa, Carolyne. “Med School on the Fast Track: A 3-Year Degree.” American Medical Association. (May 7, 2012). From: http://www.ama-assn.org/amednews/2012/05/07/prl20507.htm

About the Author: Danielle M. Murray is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

By The Health Law Firm|2024-03-14T10:00:43-04:00June 1, 2018|Categories: Medical Student, Medical Students, The Health Law Firm Blog|Tags: defense attorney, defense lawyer, doctor shortage, doctors, fellow representation, health law attorney, health lawyer, intern representation, medical resident representation, medical school, medical student representation, medical students, medical training, physician shortage, physicians|Comments Off

Locating a Healthcare Providers Service Organization (HPSO) Insurance Defense Attorney in Florida

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

We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the Florida Department of Health (DOH) they had difficulty finding an experienced attorney in Florida who would accept their professional liability insurance. In this case, I am speaking specifically about Healthcare Providers Service Organization (HPSO) Insurance.

Benefits of HPSO Insurance.

The professionals who are covered by HPSO Insurance have excellent insurance coverage. HPSO Insurance provides professional liability coverage that protects in the event of a lawsuit or negligence claim. But much more often the professional receives a notice of an investigation, a subpoena for a deposition in someone else’s case, a demand because of an allegation of sexual harassment or sexual impropriety, a complaint because of a breach of medical records confidentiality or Health Insurance Portability and Accountability Act (HIPAA) Privacy complaint, or some other administrative type of action.

HPSO provides great coverage for these. For example, HPSO currently reimburses up to $10,000 in legal fees and expenses just for representation of you at depositions. HPSO currently reimburses up to $25,000 in legal fees and expenses for your defense in a DOH or Agency for Health Care Administration (AHCA) notice of investigation or complaint. HPSO currently reimburses up to $25,000 in legal fees and expenses for your legal representation in defense of a complaint or investigation regarding breach of medical confidentiality.

If you are a pharmacist, own a pharmacy, are a massage therapist, own an assisted living facility (ALF), are a mental health counselor or a social worker, or you are one of the many other types of health care professionals who HPSO insures, it should be fairly easy to find experienced health lawyers to represent you, especially in Florida.

Our firm and our attorneys, including George F. Indest III, Michael L. Smith, Joanne Kenna, Carole C. Schriefer, Lance O. Leider, Christopher E. Brown and Danielle M. Murray, routinely represent licensed health care professionals, interns and students in all types of administrative investigations and hearings and in defending lawsuits and other actions that have been filed. We also represent health facilities in license defense, survey complaints and administrative hearings. We represent them throughout Florida, from Pensacola, to Jacksonville, to Key West. We also occasionally represent them in other states, as well. We accept HPSO Insurance assignments.

Free Legal Advice: Get Insurance Immediately.

It is very important for every health professional to carry insurance that covers any investigation, complaint or administrative hearing that might be filed or opened against your license. You may think that you are covered for this by your employer, but you are not. If your employer contradicts this, ask for a statement in writing that your employer will pay for your legal defense for any such matter arising during your employment.

What typically happens, especially in the case of a hospital employee, nursing home employee, pharmacy employee or corporate employee, is that the employer is the one who terminates the employee and then files a complaint with the DOH. The DOH then opens an investigation against the health professional. The employer is not going to pay your legal defense costs if the employer has reported you.

You may very well be out of work, out of money and face an investigation and complaint that could terminate your professional license and career. You should not take this chance. Insurance such as HPSO Insurance is inexpensive and reliable. Buy it while you can afford it. After the actions have occurred, it is too late.

Find an Experience Health Law Attorney in the Event of an Investigation.

Also, you should immediately contact an experienced health law attorney if you are telephoned or visited by any investigator, or if you receive a letter advising you that an investigation has been opened regarding your care. Call immediately for advice before you speak with an investigator or provide any documents or statements of any kind.

You cannot and should not seek “legal advice” on what to do from the investigator, from a DOH employee, from your professional board or from any attorney representing any of them. They are not your friends. They are on the side against you. You should definitely not take any advice from them.

Do Not Skimp on Insurance Coverage.

If you have good insurance, it will pay for your legal expenses from the very beginning, so use it. However, beware of cheap insurance policies from professional associations that do not provide any coverage for disciplinary complaints and licensure investigations. Always check to be sure this is covered. Get it in writing. With some companies you have to pay an extra premium to obtain this coverage. With some insurers, they do not offer it, and you have to purchase a completely separate policy covering just this. It is worth it! Do it!

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

Our firm regularly represents pharmacists, massage therapists, mental health counselors, registered nurses, assisted living facilities, home health agencies, nurse practitioners, lab technicians, occupational therapists, physical therapists, social workers, physician assistants, psychologists and other health professionals in many different legal matters.

Services we provide include representation before your professional board, in DOH investigations, in administrative hearings, in civil litigation, in defense of malpractice claims, in professional licensing matters, in defense of allegations concerning HIPAA privacy violations and medical record breaches, in Drug Enforcement Administration (DEA) actions, and in many other matters.

We routinely represent physicians, dentists, nurse practitioners, and others in defending against malpractice claims, civil lawsuits, administrative complaints, peer review actions, DOH investigations, Medicare audits, Medicaid audits, and other matters. In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

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

Comments?

Do you have professional liability insurance? Why or why not. Please leave any thoughtful comments below.

“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.

By The Health Law Firm|2024-03-14T10:00:44-04:00June 1, 2018|Categories: Administrative law, Insurance, The Health Law Firm Blog|Tags: administrative attorney, administrative complaint, administrative hearings, administrative lawyer, advanced registered nurse practitioners (ARNPs), Agency for Health Care Administration (AHCA) investigation, AHCA complaint, assisted living facility (ALF), defense attorney, defense lawyer, doctors, DOH investigation, experienced health attorney Florida, experienced health lawyer Florida, Florida defense attorney, Florida defense lawyer, Florida Department of Health (DOH), Florida license defense, health facilities, health professionals, Healthcare Providers Service Organization (HPSO) Insurance, licensed mental health counselors (LMHCs), massage therapists, nurses, physical therapists, professional liability insurance, psychologists, social worker|Comments Off

New Professional Liability Insurance Benefits for Health Professionals

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

I have been pleasantly surprised recently to discover that several professional liability insurance companies have raised their coverage amounts and added coverage in areas sorely needed by health professionals. I’m referring to coverage for incidents not necessarily related to malpractice or professional liability.

I do note that Healthcare Providers Service Organization (HPSO) Insurance has increased its basic policy limits from a cap of $3,000,000 in the aggregate per year to $5,000,000 aggregate per year for counselors on professional liability coverage.

However, we have always maintained that the most important coverage for any licensed health professional is professional licensure legal defense coverage. This is probably the most used type of coverage and the most beneficial for a health professional.

HPSO Insurance and Nurses Service Organization (NSO) Insurance, as well as several other insurers now provide up to $25,000 coverage. If an employer whether it’s a hospital, nursing home, assisted living facility (ALF), home health agency (HHA), medical group or public health clinic or a patient complains about you to the state Department of Health (DOH) or state licensing authority, you could face investigation and hearings that would cost you tens of thousands of dollars to have properly defended by an experienced attorney. If you don’t have the funds to pay for this, you could be forced to accept discipline on your license which could result in a number of unexpected additional adverse actions against you.

Although I would prefer to see this coverage increased to $50,000, and there are several companies that provide this much in coverage, $25,000 will go a long way toward defending you against meritless or unprovable complaints.

New HPSO Insurance and NSO Coverages.

Representation During a Deposition – A patient is injured at the facility where you work. You are not named in the lawsuit, but you receive a subpoena for testimony. Your coverage through HPSO Insurance will pay up to $10,000 per deposition with a $10,000 annual aggregate for you to be represented at the deposition by an attorney.

Information Privacy Coverage (added upon request) – People today are very conscious about their privacy. Most are aware of the protection they receive under the new Health Insurance Portability and Accountability Act (HIPAA) laws. This optional endorsement extends your coverage to pay for HIPAA fines and penalties arising from a HIPAA proceeding, subject to a $25,000 aggregate limit.

Sexual Misconduct – In the past, while your coverage through HPSO Insurance would pay to defend you against allegations of sexual misconduct related to your professional services, there was no coverage for a settlement. This new endorsement provides you with a $25,000 aggregate sublimit for covered sexual misconduct claims.

Reimbursement for Rendering First Aid – This benefit provides reimbursement up to $10,000 for expenses you incur while rendering first aid to a person other than yourself. For example, this could include supplies from your personal first aid kit that you used to help a victim of an automobile accident.

Accidental Injury to Others – If someone was hurt by something like a slip and fall at your residence or your workplace and required medical attention, they can receive reimbursement for their expenses up to $10,000 per incident with a $100,000 annual aggregate. It must be an accidental injury, not a medical incident.

Service to Animals (added for pharmacists, physical therapists (PTs), massage therapists and counselors) – In the course of providing professional services to an animal, if they are injured and the owner files suit, the new service to animals endorsement provides $25,000 aggregate coverage. (Added upon request for all others.)

Accidental Damage to Others’ Property – While you are providing care at a patient’s home what if you accidentally break something? No worries. Your policy pays for unintentional damage you cause to someone else’s property while at your personal residence or workplace. This coverage provides up to $10,000 per incident with a $10,000 aggregate.

Other Coverages Added to Professional Liability Insurance Policies.

In addition to the coverages I have discussed above, there have been some other coverages added to many professional liability insurance policies that could pay off for damages or injuries the individual health professional incurs, as well.

Workplace Violence Counseling – While your assault coverage pays for the medical expenses resulting from an attack, this new endorsement broadens your coverage to include $25,000 aggregate limits for the payment of any emotional counseling needed as a result of a covered incident.

Coverage If You are Assaulted – Violence in the workplace is a sad reality. Should you be the victim of a violent action at work or on your way to or from work, this coverage will pay up to $25,000 per incident with a $25,000 aggregate for medical expenses you incur or for damage to your personal belongings.

Reimbursement for Defendant Expenses – Regardless of its outcome, a malpractice suit will likely cost you money and could mean thousands of dollars out of your pocket. Your policy through HPSO Insurance will reimburse you up to $1,000 per day, up to $25,000 aggregate for lost wages, travel and other covered expenses.

Business Owner Coverage Extension (added upon request) – The ‘named insured’ on a policy for a healthcare firm is typically the business name. If the business owner volunteers or moonlights there is always the chance they could be named in a malpractice suit under their individual name. This new extension provides protection for the owner if sued under their personal name.

HPSO Insurance Also Provides Coverage For:

   Students (Health Professional Students)
   Counselors
   Interns (Health Professional Interns)
   Physician Extenders
   Physicians
   Fitness Professionals
   Integrated Health Practitioners
   Massage Therapists
   Nurse Practitioners
   Occupational Therapists
   Pharmacists
   Physical Therapists (PTs)
   Physician Assistants (PAs)
   Radiologist Assistants
   Radiology Practitioner Assistants
   Social Workers
Healthcare Businesses:

   Assisted Living Facilities (ALFs)
   Nurse Registries
   Home Health Agencies (HHAs)
   Pharmacies
   Physical Therapy Practices
Occupational Therapy Practices
Outpatient Therapy Clinics

There is no time like the present, when you have the funds and can afford it, to purchase professional liability insurance. It is surprisingly inexpensive. Every professional should carry it. If you don’t buy it before you need it, when you do really need it, it will be too late.

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

Our firm regularly represents physicians, dentists, nurse practitioners, pharmacists, massage therapists, mental health counselors, registered nurses (RNs), assisted living facilities (ALFs), home health agencies (HHAs), nurse practitioners, lab technicians, occupational therapists, physical therapists (PTs), social workers, physician assistants, psychologists and other health professionals in many different legal matters.

Services we provide include representation before your professional board in DOH investigations, in administrative hearings, in civil litigation, in defense of malpractice claims, in professional licensing matters, in defense of allegations concerning HIPAA privacy violations and medical record breaches, in Drug Enforcement Administration (DEA) actions, and in many other matters.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

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

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

By The Health Law Firm|2024-03-14T10:00:44-04:00June 1, 2018|Categories: Health Care Industry, In the Know, Insurance, The Health Law Firm Blog|Tags: administrative attorney, administrative complaint, administrative hearings, administrative lawyer, advanced registered nurse practitioners (ARNPs), Agency for Health Care Administration (AHCA) investigation, AHCA complaint, assisted living facility (ALF), defense attorney, defense lawyer, doctors, DOH investigation, experienced health attorney Florida, experienced health lawyer Florida, Florida defense attorney, Florida defense lawyer, Florida Department of Health (DOH), Florida license defense, health facilities, health professionals, Healthcare Providers Service Organization (HPSO) Insurance, licensed mental health counselors (LMHCs), massage therapists, nurses, Nurses Service Organization (NSO), physical therapists (PTs), professional liability insurance, psychologists, social worker|Comments Off

Hydrocodone Combination Drugs Could Be Reclassified to Schedule II Category of Controlled Substances

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

A Food and Drug Administration (FDA) advisory committee voted 19 to 10 in favor of moving hydrocodone combination drugs from schedule III into the more restrictive schedule II category of controlled substances. According to a number of different sources, on January 25, 2013, the committee presented this recommendation to the FDA. If approved, hydrocodone combination drugs, such as Vicodin, will be harder for physicians to prescribe.

The advisory committee met because the Drug Enforcement Administration (DEA) is requesting the FDA to approve the reclassification of hydrocodone combination products. The DEA wants to help curb the growing number of people across the country addicted to painkillers.

Click here to read an FDA briefing document given to the advisory committee.

It is now up to the FDA to decide whether or not to implement the advisory committee’s decision as to whether hydrocodone combination drugs will stay labeled as schedule III controlled substances or move to schedule II controlled substances. If medications containing hydrocodone are moved to schedule II, they will be in the same category as the widely abused oxycodone.

Hydrocodone Abuse is Serious.

Currently, hydrocodone products are the most widely prescribed drugs in the U.S., according to an article on MedPage Today. Records show that painkiller abuse kills more people in America than heroin and cocaine combined. The DEA argues that since these drugs are so frequently abused, they should be more tightly controlled.

To read the MedPage Today article, click here.

What You Need to Know as a Health Care Provider.

This change would have wide-spread consequences for health care professionals, especially doctors and pharmacists. Under the schedule II category of controlled substances, physician assistants (PAs) and nurse practitioners would no longer be legally allowed to prescribe hydrocodone combination drugs.

If the recommendation is accepted, it would be more difficult for patients to obtain refills on hydrocodone combination drugs. Refills without a new prescription, faxed prescriptions and prescriptions called in by telephone would all be banned. Only written prescriptions from a doctor would be allowed.

If the recommendation is adopted, much stricter scrutiny on the purchasing, prescribing, retailing and use of these medications can also be expected. Prosecutions and administrative actions can also be expected to follow.

The FDA is also debating the DEA’s request to limit prescriptions of hydrocodone combination pills to a 90-day supply instead of the current regulations which permit five refills within six months.

Arguments Heard Against the Reclassification.

According to an article in The New York Times, many opponents spoke against the recommendation. Advocates for nursing home patients argued that weak and elderly residents with chronic pain would have to make a difficult trip to see a doctor just to get a prescription refilled. Click here to read The New York Times article.

Some committee members questioned if there was another option to consider versus changing the scheduling. They questioned whether greater use of e-prescribing and Prescription Drug Monitoring Programs, as well as better education efforts for clinicians and patients would be better solutions for the drug abuse epidemic.

Now it remains to be seen how the FDA will interpret the advisory committee’s recommendation.

Florida’s Prescription Drug Abuse Epidemic.

Florida law enforcement including the DEA, the Federal Bureau of Investigation (FBI), and Department of Health (DOH) all seem to be having a hard time keeping up with prescription drug abuse in Florida.

We have written a number of blogs on the abuse of narcotics in Florida. See our blog on a fake prescription ring busted in Osceola County, and a Central Florida nurse accused of illegally obtaining prescriptions for painkillers, for example. Check our website for similar blogs.

Pharmacists, pharmacies, legal distributors and physicians are often too caught up in the frenzy to stem prescription drug abuse and to eliminate “pill mills.”

Call Experienced Health Law Attorneys for Your Legal Needs.

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

As a health care professional, do you think hydrocodone products should be labeled as a schedule II controlled substance? What are the positive and negative effects of this decision? Please leave any thoughtful comment below.
Sources:

Fiore, Kristina. “FDA Panel Votes for Tighter Controls on Vicodin.” MedPage Today. (January 25, 2013). From: http://bit.ly/X8qlsu

Tavernise, Sabrina. “F.D.A. Likely to Add Limits on Painkillers.” The New York Times. (January 25, 2013). From: http://www.nytimes.com/2013/01/26/health/fda-vote-on-restricting-hydrocodone-products-vicodin.html?_r=0
About the Authors: Lance O. Leider is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

By The Health Law Firm|2024-03-14T10:00:45-04:00June 1, 2018|Categories: Administrative law, Department of Health, In the Know, Pain Management, The Health Law Firm Blog|Tags: administrative hearings, defense attorney, defense lawyer, Department of Health (DOH), doctors, Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), Food and Drug Administration (FDA), hydrocodone, license defense counsel, nurse practitioner, pharmacists, physician assistants (PAs), physicians, schedule II controlled substances, schedule III controlled substances|Comments Off