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Dentists, What Should You Do If You Or Your Staff Tests Positive For COVID-19 at Your Practice?

Attorney Achal A. AggarwalBy Achal A. Aggarwal, M.B.A., J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

You or a member of your staff has a confirmed case of COVID-19. What now? Your primary concern is for the individual affected. However, as a health professional operating a professional practice, you also have a duty to your employees and to your other patients. You have to be concerned about any patients with whom your infected staff might have had contact. These steps and protocols, all from prominent government agencies, are meant to help guide you if you or someone in your practice tests positive for COVID-19.

Follow these steps below to help ensure the health and safety of others and to reduce the likelihood of additional transmissions:

• The Centers for Disease Control and Prevention (CDC) recommends that employees who were exposed to the infected staff member should be quarantined for 14 days, keep track of their symptoms, and contact their own healthcare provider if the symptoms progress.

• Your entire dental office and facility, especially the waiting areas, restrooms, and treatment areas, should receive a “deep cleaning.” These should be regularly cleaned and sanitized or sterilized as the case may be. Click here for additional information on the proper ways to do so.

• According to the CDC, the Dental Healthcare Provider (DHP) should ensure that environmental cleaning and disinfection procedures are followed consistently and correctly after each patient. However, according to the CDC, the DHP does not need to attempt to sterilize a dental operatory between each patient.

• Sterilization protocols do not vary for respiratory pathogens. According to the CDC, the dental professional should perform routine cleaning, disinfection, and sterilization protocols, and follow the recommendations for “Sterilization and Disinfection of Patient-Care Items” present in the Guidelines for Infection Control in Dental Healthcare Settings.

• The Dentists should have and implement sick leave policies for any infected staff. These should be flexible, non-punitive, and consistent with public health guidance.

• As part of routine practice, dentists should also monitor themselves for fever and symptoms consistent with COVID-19 regularly.

• The dentists should screen all staff at the beginning of their shift for fever and symptoms consistent with COVID-19. One person, such as the receptionist, might be assigned to this task. Equipment that does not require actual physical contact, such as an infrared thermometer, should be used. The dentists in the practice should be required to undergo this screening, as well.

For additional information, guidance, and resource documents on this topic, please visit our Health Law Articles and Documents page.  Be sure to visit our blog page regularly to stay updated on the latest news, policies, and health law topics!

We continue to receive inquiries from healthcare practitioners requesting information regarding health law matters during this time of uncertainty. We are here for you! If you have additional questions in the COVID-19 crisis or any health law matter, please call our office at (407) 331-6620.

Additional Resources.

The following are additional resources dentists should consult on this issue:


Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in the Department of Health (DOH) investigations, Department of Regulatory Affairs (DORA) investigations, Agency for Health Care Administration (AHCA) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Office of Civil Rights (OCR) HIPAA complaints and investigations, U.S. Department of Health and Human Services (HHS) subpoenas and investigations, state board of dentistry complaints and investigations and other types of investigations of health professionals and providers.

Our firm also routinely represents physicians, dentists, orthodontists, medical groups, clinics, pharmacies, home health care agencies, nursing homes and other health care providers in Department of Health (DOH), Department of Regulatory Affairs (DORA), and Agency for Health Care Administration (AHCA) inspections, audits, and recovery actions, as well as Medicare and Medicaid investigations, audits and recovery actions.

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

 

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Headshot of The Health Law Firm's attorney George F. Indest IIIAbout 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, and Achal A. Aggarwal, M.B.A., J.D. 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.

“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 © 2020 The Health Law Firm. All rights reserved.

By |2020-08-06T12:46:15-04:00September 1st, 2020|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Question: What Should You, as a Dentist, Do If You Or One of Your Employees Tests Positive For the COVID-19 Coronavirus?

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

You or a member of your staff has a confirmed case of COVID-19. What now? Your primary concern is for the individual affected. However, as a health professional operating a professional practice, you also have a duty to your employees and to your other patients. You have to be concerned about any patients with whom your infected staff might have had contact. These steps and protocols, all from prominent government agencies, are meant to help guide you if you or someone in your practice tests positive for COVID-19.

Follow these steps below to help ensure the health and safety of others and to reduce the likelihood of additional transmissions:

• The Centers for Disease Control and Prevention (CDC) recommends that employees who were exposed to the infected staff member should be quarantined for 14 days, keep track of their symptoms, and contact their own healthcare provider if the symptoms progress.

• Your entire dental office and facility, especially the waiting areas, restrooms, and treatment areas, should receive a “deep cleaning.” These should be regularly cleaned and sanitized or sterilized as the case may be. Click here for additional information on the proper ways to do so.

• According to the CDC, the Dental Healthcare Provider (DHP) should ensure that environmental cleaning and disinfection procedures are followed consistently and correctly after each patient. However, according to the CDC, the DHP does not need to attempt to sterilize a dental operatory between each patient.

• Sterilization protocols do not vary for respiratory pathogens. According to the CDC, the dental professional should perform routine cleaning, disinfection, and sterilization protocols, and follow the recommendations for “Sterilization and Disinfection of Patient-Care Items” present in the Guidelines for Infection Control in Dental Healthcare Settings.

• The Dentists should have and implement sick leave policies for any infected staff. These should be flexible, non-punitive, and consistent with public health guidance.

• As part of routine practice, dentists should also monitor themselves for fever and symptoms consistent with COVID-19 regularly.

• The dentists should screen all staff at the beginning of their shift for fever and symptoms consistent with COVID-19. One person, such as the receptionist, might be assigned to this task. Equipment that does not require actual physical contact, such as an infrared thermometer, should be used. The dentists in the practice should be required to undergo this screening, as well.

For additional information, guidance, and resource documents on this topic, please visit our Health Law Articles and Documents page.  Be sure to visit our blog page regularly to stay updated on the latest news, policies, and health law topics!

We continue to receive inquiries from healthcare practitioners requesting information regarding health law matters during this time of uncertainty. We are here for you! If you have additional questions in the COVID-19 crisis or any health law matter, please call our office at (407) 331-6620.

Additional Resources.

The following are additional resources dentists should consult on this issue:


Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in the Department of Health (DOH) investigations, Department of Regulatory Affairs (DORA) investigations, Agency for Health Care Administration (AHCA) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Office of Civil Rights (OCR) HIPAA complaints and investigations, U.S. Department of Health and Human Services (HHS) subpoenas and investigations, state board of dentistry complaints and investigations and other types of investigations of health professionals and providers.

Our firm also routinely represents physicians, dentists, orthodontists, medical groups, clinics, pharmacies, home health care agencies, nursing homes and other health care providers in Department of Health (DOH), Department of Regulatory Affairs (DORA), and Agency for Health Care Administration (AHCA) inspections, audits, and recovery actions, as well as Medicare and Medicaid investigations, audits and recovery actions.

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

 

KeyWords: Health law defense lawyer, legal representation of health care professionals, Medicare fraud defense attorney, Medicare audit defense attorney, Medicaid fraud defense attorney, Medicaid audit defense attorney,  disruptive physician defense attorney, legal representation for disruptive physician, legal representation for Medicare fraud, legal representation for Medicaid fraud, legal representation for clinical research investigations, legal representation for clinical research fraud, Florida health law attorney, legal representation for administrative hearings, DEA hearing defense attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Department of Health defense attorney,  healthcare employment law representation, legal representation for physicians, doctor defense legal representation, legal representation for healthcare professionals, complex health care litigation attorney, complex civil litigation attorney, complex healthcare litigation lawyer, complex medical litigation lawyer, representation for complex medical litigation, representation for healthcare business litigation matters, administrative procedure act defense, representation for administrative hearing, Board of Dentistry defense lawyer, representation for Board of Dentistry investigation, representation for Board of Dentistry hearing, Board hearing defense attorney, Board of Medicine defense lawyer, dental hygienist defense lawyer, dentist defense lawyer, representation for dentists Department of Health (DOH) representation, DOH defense attorney, representation for DOH hearings, representation for DOH investigations, representation for disciplinary charges, representation for disciplinary complaint

Headshot of The Health Law Firm's attorney George F. Indest IIIAbout 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, and Achal A. Aggarwal, M.B.A., J.D. 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.

“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 © 2020 The Health Law Firm. All rights reserved.

By |2020-07-28T12:15:48-04:00July 28th, 2020|Categories: Dental Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Will a Death from COVID-19 be Considered “Accidental Death” for Life Insurance Policies or a Death from “Accidental Causes?”

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

Almost all life insurance policies, including term policies, pay a “double indemnity,” that is, double the limits of coverage if a death occurs from “accidental causes” as opposed to “natural causes.”  A question arises, given the COVID-19 pandemic, of whether a death caused by the novel corona versus would be considered a natural death or an accidental death.  Fortunately, there is some guidance on this issue.

One reason it is important to distinguish between “accidental death” and “natural death” is that:

There is no pandemic exclusion for life insurance.  General life insurance covers pandemics, assuming you were truthful about your travel plans and exposure to illness during the application process.  . . . .  An accidental death & dismemberment policy is more limited and covers deaths only when they’re accidental.  It generally doesn’t [usually] cover deaths caused by illness and disease.

Nat’l Ass’n of Ins. Comm’rs, COVID-19 & Ins. (2020), https://content.naic.org/sites/default/files/inline-files/Insurance%20Brief%20-%20Covid-19%20and%20Insurance.pdf. (Emphasis added).

Definition of “Accidental Death”

According to Black’s Law Dictionary, an “accidental death” is defined as:  “A death that results from an unusual event, one that was not voluntary, intended, expected, or foreseeable.”  Accidental Death, Black’s Law Dictionary (4th pocket ed. 2011).  Likewise, Ballentine’s Law Dictionary states than an “accidental death” is:

One that occurs unforeseen, undesigned, and unexpected. 29 Am J Rev ed Ins § 1166.  One which occurs by accident, that is, was not designed or anticipated, albeit it may occur in consequence of a voluntary act.

Accidental Death, Ballentine’s Law Dictionary (3rd ed. 1969).

Under the above two definitions, definitions that are usually considered to come from the common law, death from the COVID-19 virus would be considered to be an “accidental death.”

Look to State Insurance Laws for Definitions.

One should also immediately look at the state’s insurance statutes to see if their state’s law defines “accidental death” in terms of insurance coverage.  As an example, Florida law provides such definitions in Chapter 627 of Florida Statues which deals with insurance contracts.

Section 627.429(5)(c), Florida Statutes, is of particular note.  Regarding death from HIV, for example, it states:

Except for preexisting conditions specifically applying to sickness or medical condition of the insured, benefits under a life insurance policy shall not be denied or limited based on the fact that the insured’s death was caused, directly or indirectly, by exposure to the HIV infection or a specific sickness or medical condition derived from such infection. This paragraph does not prohibit the issuance of accidental death only or specified disease policies.

Section 627.429(5)(c), Florida Statutes (emphasis added).

This is significant because the Human Immunodeficiency Virus (HIV) is a very slow-acting disease that harms one’s immune system by destroying the white blood cells that fight infection.  Death may not occur for years, even decades from an infection.  Whereas, COVID-19 is a fast-acting respiratory virus.  If death from HIV could be considered an “accidental death,” than death from COVID-19 certainly could be classified as “accidental death,” as well.


Legal Arguments for “Accidental Death”

If you have a death in your family and there is life insurance coverage on that person, you should not accept the insurance company’s determination that the death is from “natural causes” as opposed to “accidental death.” Challenge this decision, in court, if necessary.

A death caused by the COVID-19 virus is clearly “from an unusual event.”  I doubt that anyone would even contest this issue.  It is also clearly “one that was not voluntary, intended, [or] expected.”  Again, the novel coronavirus pandemic has taken the world by surprise.  How can anyone in their right mind argue that it was truly “expected.”  “Foreseeable” would be an objective test as to whether this was something “reasonably foreseeable.”  It does not appear, from the shock and unreadiness displayed by state and national governments and health officials, that this event was truly reasonably foreseeable.

I did not foresee it, did you?  If 99.999% of the populace did not foresee it, how can it be argued that it is reasonably foreseeable?  At the very least, this is a jury question and the foregoing should be argued to the jury.  If the average reasonable man (the man who is a legal fiction) did not foresee this pandemic and the deaths that result, how can it not be an “accidental death”?  It seems that any jury would be hard-pressed to find other than an “accidental death.”

 
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. It also includes medical students, resident physicians, and fellows, as well as medical student professors and clinical staff. We represent 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, in patient complaints, and in Department of Health investigations.

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

About the Author:  George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law;  he is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com.  The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 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 © 2020 The Health Law Firm. All rights reserved.

Always Provide Complete Records in Response to Government Subpoenas

Headshot of The Health Law Firm's attorney George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
At a recent Florida Board of Dentistry meeting, a dentist was charged with violations of her practice act and standard of care violations. This happened because her prior practice had provided incomplete patient records to an investigator when it received a subpoena. The records that had been provided were missing written notes and other documentation, along with copies of the prescriptions the dentist had written. This is just one example of what can happen if patient records are not provided in an orderly and complete manner to investigators.

Important Points for Board Hearings.

The dentist attended the Board meeting, having requested an informal administrative hearing. To obtain this type of hearing means that the dentist agrees that there are no disputed issues of fact; this equates to a “guilty” plea. The dentist is waiving her right to have a formal hearing, present a defense and contest the allegations made against her. When questioned by the Board, it was clear that the dentist did not understand this. She also stated that she had an attorney, but the attorney was not present to represent her or to advise her during the Board hearing.

Even though this was a dental case, the same principles of administrative law apply in the case of a physician, nurse, mental health counselor, pharmacist or any other licensed health care professional.

Most importantly, the dentist testified that her prior practice had failed to provide a complete copy of the patient’s health record to the Department of Health (DOH) investigator. The prosecuting attorney showed the Board where the records had been subpoenaed from the prior practice twice, and they had been provided to the DOH twice, along with affidavits from the practice that these were complete copies of the entire record. (These affidavits were false.)

Fortunately for the dentist, the Board members reviewed the records that had been provided and could see for themselves that key portions were missing. Also, fortunately, the Board decided to table the case and send it back for more investigation.

If the Board had decided to go forward, the dentist would likely have received discipline on her license forever.

Important Lessons for Mental Health Care Professionals, Dentists, Physicians, and Other Licensed Health Care Professionals.

Valuable lessons that all licensed health professionals can learn from this case include:

1. Hire an experienced health law attorney as soon as you know you are under investigation. Many times your malpractice (professional) liability insurance will pay your legal defense expenses in these cases.

2. Your experienced attorney will obtain a copy of the complete investigation file (including all documents it contains) shortly after it is completed and long before any hearings. If your attorney doesn’t, then you should do so. You can review it and supplement any incomplete records, documents or information.

3. Do not hire an attorney who is unable to attend the hearing with you. Continuances can be routinely requested and granted if the attorney has a conflicting hearing somewhere else, is ill or is otherwise unable to attend. Don’t attend the hearing without your attorney, if you have one.

4. Know the difference between an informal hearing and a formal hearing. If you request an informal hearing, you are admitting the charges against you are true and you are guilty. (There are only one of two very limited exceptions to this rule) You are only there to argue about how much discipline you should receive.

5. If you are investigated, personally make sure a complete copy of the patient’s record is sent to the DOH investigator. This includes everything: demographics, insurance info, financial responsibility forms, treatment plans, orders, prescriptions, lab reports, periodontal charts, informed consent forms, patient instructions, office visits, telephone notes, operative reports, sedation charts on notes, history and physical, medical clearances from outside physicians, and dental or medical records from other providers. Even if you are no longer employed at that practice, you have the right to request and receive a copy of all of the records you generated when you treated the patient under Section 456.057, Florida Statutes. At least obtain these.

For more information on this topic and to find out more about how The Health Law Firm can assist you in matters like this, read my prior blog here.

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

The attorneys of The Health Law Firm provide legal representation to dentists, dental technicians, physicians, nurses, nurse practitioners, CRNAs, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

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

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

KeyWords: administrative procedure act defense, representation for administrative hearing, Board of Dentistry defense lawyer, representation for Board of Dentistry investigation, representation for Board of Dentistry hearing, Board hearing defense attorney, Board of Medicine defense lawyer, dental hygienist defense lawyer, dentist defense lawyer, representation for dentists Department of Health (DOH) representation, DOH defense attorney, representation for DOH hearings, representation for DOH investigations, representation for disciplinary charges, representation for disciplinary complaint, representation for Florida Administrative Codes, physician lawyer, representation for doctor, representation for healthcare professionals, representation for deposition coverage, last-minute deposition coverage, short notice representation of physician, short notice of representation of doctors, hearing representation for healthcare professional, Board of Medicine defense, Board of Medicine hearing defense lawyer, representation for administrative procedure act, representation for Rules of Civil Procedure, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“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 © 2020 The Health Law Firm. Altamonte Springs, Florida.

Healthcare Professionals Should Ensure Records Provided in Response to Government Subpoenas are Complete

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
At a recent Florida Board of Dentistry meeting, a dentist was charged with violations of her practice act and standard of care violations. This happened because her prior practice had provided incomplete patient records to an investigator when it received a subpoena. The records that had been provided were missing written notes and other documentation, along with copies of the prescriptions the dentist had written. This is just one example of what can happen if patient records are not provided in an orderly and complete manner to investigators.

Important Points for Board Hearings.

The dentist attended the Board meeting, having requested an informal administrative hearing. To obtain this type of hearing means that the dentist agrees that there are no disputed issues of fact; this equates to a “guilty” plea. The dentist is waiving her right to have a formal hearing, present a defense and contest the allegations made against her. When questioned by the Board, it was clear that the dentist did not understand this. She also stated that she had an attorney, but the attorney was not present to represent her or to advise her during the Board hearing.

Even though this was a dental case, the same principles of administrative law apply in the case of a physician, nurse, mental health counselor, pharmacist or any other licensed health care professional.

Most importantly, the dentist testified that her prior practice had failed to provide a complete copy of the patient’s health record to the Department of Health (DOH) investigator. The prosecuting attorney showed the Board where the records had been subpoenaed from the prior practice twice, and they had been provided to the DOH twice, along with affidavits from the practice that these were complete copies of the entire record. (These affidavits were false.)

Fortunately for the dentist, the Board members reviewed the records that had been provided and could see for themselves that key portions were missing. Also, fortunately, the Board decided to table the case and send it back for more investigation.

If the Board had decided to go forward, the dentist would likely have received discipline on her license forever.

Important Lessons for Dentists, Physicians, and Other Licensed Health Professionals.

Valuable lessons that all licensed health professionals can learn from this case include:

1. Hire an experienced health law attorney as soon as you know you are under investigation. Many times your malpractice (professional) liability insurance will pay your legal defense expenses in these cases.

2. Your experienced attorney will obtain a copy of the complete investigation file (including all documents it contains) shortly after it is completed and long before any hearings. If your attorney doesn’t, then you should do so. You can review it and supplement any incomplete records, documents or information.

3. Do not hire an attorney who is unable to attend the hearing with you. Continuances can be routinely requested and granted if the attorney has a conflicting hearing somewhere else, is ill or is otherwise unable to attend. Don’t attend the hearing without your attorney, if you have one.

4. Know the difference between an informal hearing and a formal hearing. If you request an informal hearing, you are admitting the charges against you are true and you are guilty. (There are only one of two very limited exceptions to this rule) You are only there to argue about how much discipline you should receive.

5. If you are investigated, personally make sure a complete copy of the patient’s record is sent to the DOH investigator. This includes everything: demographics, insurance info, financial responsibility forms, treatment plans, orders, prescriptions, lab reports, periodontal charts, informed consent forms, patient instructions, office visits, telephone notes, operative reports, sedation charts on notes, history and physical, medical clearances from outside physicians, and dental or medical records from other providers. Even if you are no longer employed at that practice, you have the right to request and receive a copy of all of the records you generated when you treated the patient under Section 456.057, Florida Statutes. At least obtain these.

For more information on this topic and to find out more about how The Health Law Firm can assist you in matters like this, read my prior blog here.

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

The attorneys of The Health Law Firm provide legal representation to dentists, dental technicians, physicians, nurses, nurse practitioners, CRNAs, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

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

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

KeyWords: administrative procedure act defense, representation for administrative hearing, Board of Dentistry defense lawyer, representation for Board of Dentistry investigation, representation for Board of Dentistry hearing, Board hearing defense attorney, Board of Medicine defense lawyer, dental hygienist defense lawyer, dentist defense lawyer, representation for dentists Department of Health (DOH) representation, DOH defense attorney, representation for DOH hearings, representation for DOH investigations, representation for disciplinary charges, representation for disciplinary complaint, representation for Florida Administrative Codes, physician lawyer, representation for doctor, representation for healthcare professionals, representation for deposition coverage, last-minute deposition coverage, short notice representation of physician, short notice of representation of doctors, hearing representation for healthcare professional, Board of Medicine defense, Board of Medicine hearing defense lawyer, representation for administrative procedure act, representation for Rules of Civil Procedure, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“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 © 2020 The Health Law Firm. Altamonte Springs, Florida.

 

One in Four Florida Healthcare Providers Skipped Required Opioid Prescribing Class

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

On February 5, 2019, state officials announced that about one in four Florida health care providers failed to take a required two-hour continuing education (CE) course on prescribing controlled substances.  The deadline for the mandated course was January 31, 2019. The Florida Department of Health (DOH) is now preparing to send non-compliance letters advising the providers that they have 15 days to take the mandated course or face disciplinary action, said DOH agency spokesman Brad Dalton.

“If the department does not receive a response within 15 days from receipt of the notice, a formal complaint will be initiated,” he said.


New Standards for Prescribing Controlled Substances.

A law in 2018 required all health care providers registered with the DEA and authorized to prescribe controlled substances to take a CE course.  The course covers the current standards for prescribing controlled substances, particularly opiates.

Click here to read our prior blog and learn more about House Bill 21, the Controlled Substances Bill.

In in the of Florida, nurses, dentists physicians, podiatrists, physician assistants and advanced practice registered nurses practitioners (APRNs) can prescribe controlled substances for pain. Prior to the passage of this law in 2018, only physician assistants and APRNs were required to take CE courses on controlled substances as part of licensure requirements.

The new mandate impacts an estimated 114,000 Florida healthcare providers including all dentists, according to the DOH.

Click here to read one of our prior blogs on the importance of health care compliance for all health care providers.

We have seen firsthand the kinds of problems that can arise when licensed health professionals do not follow up on continuing education requirements.  Click here to read one of my prior blogs and learn more.


How a Disciplinary Action May Affect Your Healthcare License.

It is important that health care providers understand how this could impact your professional license and professional reputation. Failing to obtain the required CE during the time period set forth by state and board regulation can result in disciplinary action being taken against a licensee. Disciplinary action in one state can lead to disciplinary action commenced against a license held in another state, if the licensee holds multiple licenses.

Often consulting an experienced health law attorney on such matters can save a great deal of turmoil, mental anguish, cost and damage. Click here to read one of our prior blogs and learn more.

Contact Health Law Attorneys Experienced with Department of Health Investigations of Pharmacists, Pharmacies and Other Healthcare Professionals.

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, Medicare investigations, Medicaid investigations 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:

“A Quarter Of Florida Docs, Dentists Skip Required Opioid Training.” Health New Florida. (February 5, 2019). Web.

Sexton, Christine. “Thousands of Florida doctors, dentists skip required opioid training.” Orlando Sentinel. (Web.)

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

KeyWords: Legal representation for Department of Health (DOH) investigations, legal representation for DOH complaints, licensure defense attorney, DOH defense attorney, health law defense attorney, legal representation for health care professionals, legal representation for disciplinary actions against your license, non-compliance representation, non-compliance defense attorney, healthcare compliance attorney, healthcare compliance representation, representation for non-compliance allegations, legal representation for license revocation, healthcare license defense attorney, administrative complaint attorney, legal representation for administrative complaints, Board of Medicine representation, pharmacy law attorney, legal counsel for Board representation, The Health Law Firm, health law defense attorney, Florida health law attorney, reviews of The Health Law Firm, The Health Law Firm attorneys review

“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 © 2019 The Health Law Firm. All rights reserved.

Florida Gov. Pulls Large Number of Appointments Made by Predecessor, One from Board of Acupuncture

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

On February 22, 2019, Florida’s new Governor, Rick DeSantis retracted 169 appointments that the former governor made before leaving office. One of these was to the Florida Board of Acupuncture. This is not the first time he has called back last-minute decisions made by his predecessor. In January 2019, he retracted 46 of Scott’s “lame duck appointments.”

The new governor has now pulled a total of 215 of Scott’s prior appointments to various boards and committees.

Here’s a List of the Appointments Made by Scott That Governor DeSantis Pulled for the Professional Boards Under the Department of Health (DOH):

Steve Moreau, Board of Acupuncture

Angela Sissine, Board of Dentistry

Steven Falcone, Board of Medicine

Andre Perez, Board of Medicine

Merle Preston Stringer, Board of Medicine

Heather Baumwald, Board of Nursing

Jennifer Raymond, Board of Nursing

Mary Julie Talmadge, Board of Nursing

Elna Rose Vizvary, Board of Occupational Therapy Practice

Katie Gilbert-Spear, Board of Optometry

John Edmund Griffin, Board of Optometry

David Rouse, Board of Optometry

Paul Weott, Board of Orthotists and Prosthetists

Mark Block, Board of Podiatric Medicine

Soorena Sadri, Board of Podiatric Medicine

In January 2019, Governor DeSantis retracted nearly 46 of Scott’s appointments. The Senate withdrew all of the names from their appointments.

The Retractions Made In January for DOH Boards Included:

Philip Diaz, Board of Chiropractic Medicine

Dr. Emique Ginzburg, Board of Medicine

Nicolas Romanello, Board of Medicine

Linville Atkins, Board of Optometry

The list of retracted appointments also included nominations to a host of major and minor positions, from college boards of trustees to trade boards and state commissions. To take a look at the full list of appointments, not just those listed on the DOH, click here.

Click here to read the press release that Governor DeSantis’s issued regarding the matter.
You can also view a copy of the letter he wrote to Senate President Galvano here.

A spokeswoman for Senate President Galvano said the Senate will fully comply with DeSantis’ request. “Senate President Bill Galvano will act in accordance with the Senate Rules and will direct the Secretary to return the documentation of the appointments and document the return in the Journal,” said Katie Betta.

To learn more about DOH matters and investigations, click here.

 

Contact Health Law Attorneys Experienced in Representing Massage Therapists.

The attorneys of The Health Law Firm provide legal representation to massage therapists in Department of Health (DOH) investigations, licensing matters 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 http://www.TheHealthLawFirm.com.

Sources:

Ogles, Jacob. “Governor sacks college board trustees across the state.” Florida Politics. (February 24, 2019). Web.

Ogles, Jacob. “Ron DeSantis pulls back nearly 170 Rick Scott appointments.” Florida Politics. (February 25, 2019). Web.

Schweers, Jeffrey. “Florida ethics commission reviewing rules after Ron DeSantis yanks Rick Scott appointments.” Tallahassee Democrat. (February 26, 2019). Web.

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

KeyWords: Legal representation for Department of Health (DOH) investigations, legal representation for DOH complaints, DOH compliant representation, professional license defense attorney, professional license representation, healthcare license representation, healthcare license defense representation, Board defense representation, health care license defense lawyer, DOH defense attorney, DOH investigation defense lawyer, representation for DOH investigation, Florida health law attorney, health law defense attorney, legal representation for health care professionals, Legal representation for massage therapists, Board of Massage Therapy investigation defense attorney, Massage Therapist defense attorney, legal counsel for Board of Massage Therapy investigations and hearings,  legal representation for disciplinary actions against your license, legal representation for license revocation, Board of Medicine defense lawyer, administrative complaint attorney, legal representation for administrative complaints, Board of Medicine representation, legal counsel for Board representation, The Health Law Firm, health law defense attorney, Florida health law attorney, reviews of The Health Law Firm, The Health Law Firm attorneys review

“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 © 2019 The Health Law Firm. All rights reserved.

DeSantis Rescinds Large Number of Appointments Made by Former Governor, One from Board of Dentistry

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

On February 22, 2019, Florida’s new Governor, Rick DeSantis retracted 169 appointments that the former governor made before leaving office. One of these was to the Florida Board of Dentistry. This is not the first time he has called back last-minute decisions made by his predecessor. In January 2019, he retracted 46 of Scott’s “lame duck appointments.”

The new governor has now pulled a total of 215 of Scott’s prior appointments to various boards and committees.

Here’s a List of the Appointments Made by Scott That Governor DeSantis Pulled for the Professional Boards Under the Department of Health (DOH):

Angela Sissine, Board of Dentistry

Steve Moreau, Board of Acupuncture

Steven Falcone, Board of Medicine

Andre Perez, Board of Medicine

Merle Preston Stringer, Board of Medicine

Heather Baumwald, Board of Nursing

Jennifer Raymond, Board of Nursing

Mary Julie Talmadge, Board of Nursing

Elna Rose Vizvary, Board of Occupational Therapy Practice

Katie Gilbert-Spear, Board of Optometry

John Edmund Griffin, Board of Optometry

David Rouse, Board of Optometry

Paul Weott, Board of Orthotists and Prosthetists

Mark Block, Board of Podiatric Medicine

Soorena Sadri, Board of Podiatric Medicine

In January 2019, Governor DeSantis retracted nearly 46 of Scott’s appointments. The Senate withdrew all of the names from their appointments.

The Retractions Made In January for DOH Boards Included:

Philip Diaz, Board of Chiropractic Medicine

Dr. Emique Ginzburg, Board of Medicine

Nicolas Romanello, Board of Medicine

Linville Atkins, Board of Optometry

The list of retracted appointments also included nominations to a host of major and minor positions, from college boards of trustees to trade boards and state commissions. To take a look at the full list of appointments, not just those listed on the DOH, click here.

Click here to read the press release that Governor DeSantis’s issued regarding the matter.
You can also view a copy of the letter he wrote to Senate President Galvano here.

A spokeswoman for Senate President Galvano said the Senate will fully comply with DeSantis’ request. “Senate President Bill Galvano will act in accordance with the Senate Rules and will direct the Secretary to return the documentation of the appointments and document the return in the Journal,” said Katie Betta.

To learn more about DOH matters and investigations, click here.

 

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

Our firm also routinely represents physicians, dentists, orthodontists, medical groups, clinics, pharmacies, home health care agencies, nursing homes and other health care providers in Medicare and Medicaid investigations, audits and recovery actions.

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

Sources:

Ogles, Jacob. “Governor sacks college board trustees across the state.” Florida Politics. (February 24, 2019). Web.

Ogles, Jacob. “Ron DeSantis pulls back nearly 170 Rick Scott appointments.” Florida Politics. (February 25, 2019). Web.

Schweers, Jeffrey. “Florida ethics commission reviewing rules after Ron DeSantis yanks Rick Scott appointments.” Tallahassee Democrat. (February 26, 2019). Web.

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

KeyWords: Legal representation for Department of Health (DOH) investigations, legal representation for DOH complaints, DOH compliant representation, professional license defense attorney, professional license representation, healthcare license representation, healthcare license defense representation, Board defense representation, health care license defense lawyer, DOH defense attorney, DOH investigation defense lawyer, representation for DOH investigation, Florida health law attorney, health law defense attorney, legal representation for health care professionals, legal representation for disciplinary actions against your license, legal representation for license revocation, Board of Medicine defense lawyer, administrative complaint attorney, dentist defense counsel, legal representation for dentist, dental board defense attorney, dental license defense attorney, legal representation for dentist, Board of Dentistry representation, Board of Dentistry defense lawyer, representation for Board of Dentistry investigation, legal representation for administrative complaints, Board of Medicine representation, legal counsel for Board representation, The Health Law Firm, health law defense attorney, Florida health law attorney, reviews of The Health Law Firm, The Health Law Firm attorneys review

“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 © 2019 The Health Law Firm. All rights reserved.

DeSantis Yanks Large Number of Appointments Made by Former Governor, Several on Board of Nursing

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

On February 22, 2019, Florida’s new Governor, Rick DeSantis retracted 169 appointments that the former governor made before leaving office. Several of these were appointments that had been made to the Florida Board of Nursing. This is not the first time he has called back last-minute decisions made by his predecessor. In January 2019, he retracted 46 of Scott’s “lame duck appointments.”

The new governor has now pulled a total of 215 of Scott’s prior appointments to various boards and committees.

Here’s a List of the Appointments Made by Scott That Governor DeSantis Pulled for the Professional Boards Under the Department of Health (DOH):

Heather Baumwald, Board of Nursing

Jennifer Raymond, Board of Nursing

Mary Julie Talmadge, Board of Nursing

Steve Moreau, Board of Acupuncture

Angela Sissine, Board of Dentistry

Steven Falcone, Board of Medicine

Andre Perez, Board of Medicine

Merle Preston Stringer, Board of Medicine

Elna Rose Vizvary, Board of Occupational Therapy Practice

Katie Gilbert-Spear, Board of Optometry

John Edmund Griffin, Board of Optometry

David Rouse, Board of Optometry

Paul Weott, Board of Orthotists and Prosthetists

Mark Block, Board of Podiatric Medicine

Soorena Sadri, Board of Podiatric Medicine

In January 2019, Governor DeSantis retracted nearly 46 of Scott’s appointments. The Senate withdrew all of the names from their appointments.

The Retractions Made In January for DOH Boards Included:

Philip Diaz, Board of Chiropractic Medicine

Dr. Emique Ginzburg, Board of Medicine

Nicolas Romanello, Board of Medicine

Linville Atkins, Board of Optometry

The list of retracted appointments also included nominations to a host of major and minor positions, from college boards of trustees to trade boards and state commissions. To take a look at the full list of appointments, not just those listed on the DOH, click here.

Click here to read the press release that Governor DeSantis’s issued regarding the matter.
You can also view a copy of the letter he wrote to Senate President Galvano here.

A spokeswoman for Senate President Galvano said the Senate will fully comply with DeSantis’ request. “Senate President Bill Galvano will act in accordance with the Senate Rules and will direct the Secretary to return the documentation of the appointments and document the return in the Journal,” said Katie Betta.

To learn more about DOH matters and investigations, click here.

 

Contact Health Law Attorneys Experienced with Nursing Issues Today.

The attorneys of The Health Law Firm provide legal representation to nurses, nurse practitioners, and CRNAs in investigations, contract negotiations, licensing issues and at Board of Nursing hearings.  They also advise nurses wrongfully accused of diverting drugs and those wrongfully terminated from employment.  Its attorneys represent nurses in DOHinvestigations, Board of Nursing cases 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.

Sources:

Ogles, Jacob. “Governor sacks college board trustees across the state.” Florida Politics. (February 24, 2019). Web.

Ogles, Jacob. “Ron DeSantis pulls back nearly 170 Rick Scott appointments.” Florida Politics. (February 25, 2019). Web.

Schweers, Jeffrey. “Florida ethics commission reviewing rules after Ron DeSantis yanks Rick Scott appointments.” Tallahassee Democrat. (February 26, 2019). Web.

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

KeyWords: Legal representation for Department of Health (DOH) investigations, legal representation for DOH complaints, DOH compliant representation, professional license defense attorney, professional license representation, healthcare license representation, healthcare license defense representation, Board defense representation,  legal defense for nurses, legal representation for nurses, nurse defense attorney, board of nursing attorney, board of nursing defense representation, health care license defense lawyer, DOH defense attorney, DOH investigation defense lawyer, representation for DOH investigation, Florida health law attorney, health law defense attorney, legal representation for health care professionals, legal representation for disciplinary actions against your license, legal representation for license revocation, Board of Medicine defense lawyer, administrative complaint attorney, legal representation for administrative complaints, Board of Medicine representation, legal counsel for Board representation, The Health Law Firm, health law defense attorney, Florida health law attorney, reviews of The Health Law Firm, The Health Law Firm attorneys review

“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 © 2019 The Health Law Firm. All rights reserved.

Appeals Court Affirms Discipline for Doctor Who Sold Prescriptions at Bar

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 15, 2017, a physician who sold painkiller prescriptions to patients at a bar and restaurant, had his two-year probation for unprofessional conduct upheld by a Maryland appeals court. The court upheld the decision after it found that the evidence supported the state board’s disciplinary decision.

Unprofessional Conduct Alleged.

The Court of Special Appeals affirmed the ruling by the Maryland State Board of Physicians (Board) to reprimand Dr. Walter Kozachuk and place him on probation for a minimum of two years for unprofessional conduct in the practice of medicine. The Board claimed he would routinely meet with patients at a restaurant and bar and give them prescriptions for painkillers and anti-anxiety drugs in exchange for $100 per prescription. Additionally, on at least one occasion, he allegedly gave a patient a prescription in a parking lot.

The appeals court determined that there was substantial evidence supporting the board’s determination that the doctor’s sale of prescriptions in a non-office setting constituted unprofessional conduct. To read the court’s opinion in full, click here.

How You Can Avoid Legal Issues.

As a physician, you should be proactive in avoiding drug seeking patients and illicit clinic owners or coworkers. With the power of prescribing comes a great responsibility. Don’t find yourself behind bars when it can all be prevented. Here are some tips to learn from the recent pain management clinic raids.

1.    Avoid working for practices or clinics that have reputations as pill mills.

2.    Most physicians subject of investigations, such as the one written about here, are typically the sole physician in the clinic. Join a team setting in a group practice with other full-time physicians.

3.    Document everything. Make sure all medical records meet the requirements of state and federal laws. Verify all patients’ identities and be sensitive to possible false identifications.

4.    Make sure you know about everything going on in your office. Maintain a loyal and trustworthy staff who will report irregular behavior to you as physician. Have a zero tolerance for staff violations.

5.    Do NOT ever allow a lay person or non-physician to control your office. Do not give anyone like this sole access to medical records, billings, bank accounts or scheduling. Make sure that you are the one in control of these, that you have the passwords and access numbers, and that your constantly review these. You will be held accountable for this so you should remain in control.

To read more physician tips on protecting yourself and your license, click here.

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, pain management doctors, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.  We represent physicians in complaints against their medical licenses.  We also handle appeals of board of medicine cases.
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Source:

Kang, Peter. “Md. Court Affirms Discipline For Doc Who Sold Scrips At Bar.” Law360. (December 15, 2017). 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., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

KeyWords: legal representation for health care professionals, health law defense attorney, legal representation for unprofessional conduct, legal representation for employment issues, legal representation for pill mill allegations, doctor defense attorney, Board of Medicine defense counsel, medical board defense attorney, professional license defense lawyer, legal representation for prescription drug trafficking, pill mill laws, legal representation for prescribing controlled substances, pain management doctor, legal representation for pain management physicians, legal defense for pain management professionals, legal defense for doctors, legal representation for prescription drug crackdown, legal representation for prescription drug abuse, legal representation for Drug Enforcement Administration (DEA)investigations, legal representation for Federal Bureau of Investigation (FBI) investigations, legal representation for Department of Health (DOH) investigations, DOH defense attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“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 © 2017 The Health Law Firm. All rights reserved.

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