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Don’t Voluntarily Relinquish Your Medical License or DEA Registration Number, Here’s Why
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Don’t Voluntarily Relinquish Your Medical License or DEA Registration Number, Here’s Why

DEA, Licensing issues, The Health Law Firm Blog

Don’t Voluntarily Relinquish Your Medical License or DEA Registration Number, Here’s Why

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

I am often contacted by clients who are health professionals or own businesses in the health care industry who have been approached by government agents or investigators regarding possible complaints or charges. In many cases, the individuals involved do not think to consult with an attorney until many months later. This may be too late to save the business or professional practice involved. This holds for physicians, dentists, nurses, pharmacists, pharmacies, pain management clinics, physician assistants, group homes, assisted living facilities (ALFs), and home health agencies.

“Voluntary” Relinquishment Treated the Same as a Revoked License.

We have seen a trend recently, especially here in Florida, of investigators immediately offering the person being investigated the option to voluntarily relinquish his or her professional license. This is offered as an option to being investigated, even in the event of very minor or frivolous complaints. The problem is that once an investigation has been opened, voluntary relinquishment of a license is treated as if it were revoked for disciplinary reasons. It will be very difficult, if not impossible, to ever get a new license under the circumstances.

Furthermore, if the professional has other licenses or similar licenses in other states, this will be reported to the other states, and disciplinary action will probably be initiated against those other licenses.

We have heard horror stories of investigators, accompanied by police or sheriff’s deputies, or Drug Enforcement Administration (DEA) agents, making all sorts of threats against health professionals to intimidate them into giving up a DEA registration number or professional license, including medical licenses, nursing licenses, and pharmacy licenses.

In the case of such an incident occurring in Florida, the “voluntary” relinquishment must still be presented to the applicable professional Board and voted on at a scheduled meeting since it is considered disciplinary. It may be possible to withdraw the “voluntary” relinquishment before it is voted on, so all may not be lost.

Think Long and Hard About Relinquishing DEA Registration Number.

However, in the case of the DEA, a DEA registration number is considered gone as soon as the “voluntary” relinquishment paper is signed. This is one of the reasons it is crucial to talk with a knowledgeable health law attorney before making such a decision. The ones putting pressure on you to do this will do everything they can to persuade you not to talk to an attorney. But it is your right to do so. Don’t be rushed or intimidated into making a foolish decision you regret.

We have represented clients attempting to obtain a new DEA registration number or a new professional license years after their voluntary relinquishment. In most cases, it is a highly uphill battle and is often not successful.

Additional Consequences of Voluntary Relinquishment of a Professional License or DEA Registration Number.

The following are some of the additional consequences of voluntary relinquishment of a professional license or DEA number after notice of an investigation:

1. Disciplinary action will be commenced against any other professional licenses in the state.

2. Disciplinary action will be commenced against similar licenses in other states.

3. The matter will be reported to any national certification boards of which you are a member. They will most likely commence an action against you to revoke your national certification.

4. You will be placed on the Office of the Inspector General’s (OIG) List of Excluded Entities and Individuals (LEIE) and excluded from the federal Medicare Program.

5. You will be terminated from the state’s Medicaid Program if you are a Medicaid provider.

6. You will be terminated from the panels of any health insurers or managed care plans of which you are a provider member.

There are many other possible repercussions to such actions, so it is extremely important to be prepared for such an event. To prepare, you can:

1. Purchase professional licensing defense insurance coverage through Lloyd’s of London, Healthcare Provider’s Service Organization (HPSO), Nurses Service Organization (NSO), or one of the other reputable insurance companies that provide such coverage.

2. Have the names, telephone numbers, and other information on good, reputable criminal defense and health law attorneys. Make sure your practice manager has this information as well.

3. Call as soon as an investigator walks in. Don’t wait.

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, 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.

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.

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

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

By The Health Law Firm|2024-03-14T09:59:16-04:00December 3, 2023|Categories: DEA, Licensing issues, The Health Law Firm Blog|Tags: DEA attorney, DEA lawyer, DEA registration, defense attorney, defense lawyer, disciplinary action, Drug Enforcement Administration (DEA), exclusion form Medicaid, exclusion from Medicare, health care attorney, health care investigation, health care lawyer, health care license, health law attorney, health lawyer, health license revoked, investigation of a health care provider, medical license revoked, Office of the Inspector General (OIG) health care complaint, professional license revoked, relinquishment of DEA number, relinquishment of medical license, should I relinquish my DEA number, should I relinquish my medical license, voluntary relinquishment of DEA number, voluntary relinquishment of license|Comments Off

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

By 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.

By The Health Law Firm|2024-03-14T10:00:00-04:00May 7, 2020|Categories: Health Facilities Law Blog|Tags: administrative complaint, Administrative Hearing, Department of Health (DOH), DOH defense attorney, Florida health law attorney, health care attorney, health care fraud, health care fraud defense attorney, health care lawyer, health law defense attorney, health law firm, representation for healthcare professionals, reviews of The Health Law Firm|1 Comment

Massage Therapists: Please DON’T Talk to the DOH Investigator Before Your Attorney!

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

Massage therapists, I beg you: please do not talk to a Department of Health (DOH) investigator until you have talked to a health lawyer who is experienced with DOH investigations and board licensing complaints. Do not answer or respond to even the most basic questions about where you work now, what your address is or if you know the patient.

Admitting to the Simplest Fact May Harm Your Career.

We are routinely consulted by massage therapists and other healthcare providers for representation for DOH investigations. Unfortunately, often times it is after they have already discussed the case and after it is too late to undo the damage they have caused to themselves. Often they do not understand the seriousness of the matter or the possible consequences until it’s too late. Admitting to even the most basic facts causes damage to any possible defense.

Administrative Licensure Investigations Such as These are Considered “Quasi-Criminal.”

The vast majority of massage therapists and even most attorneys do not realize that DOH investigations concerning complaints against a massage therapist’s license are considered to be “penal” or “quasi-criminal” proceedings. This means the same laws and constitutional rights apply to them as apply to criminal investigations. However, since they are also administrative proceedings and not strictly criminal proceedings, investigators do not need to advise you of your Miranda rights or tell you that you have the right to remain silent, the right to an attorney, etc.

In any criminal investigation, a good criminal defense attorney would always tell you “Do not talk to the investigator” and “Tell the investigator you have a lawyer.”

Investigators’ Techniques Include Trying to Persuade You to Not Consult a Lawyer.

DOH investigators, police investigators, FBI investigators, and other law enforcement officers, are well trained in investigative techniques and how to get information out of suspects. Often the approach used is to catch you by surprise before you even know there is an investigation and the investigation is of you. Another technique used is to lull you into a false sense of security that the investigation is about someone or something else and not you. Another investigative technique is to convince you that you need to “Tell your side of the story” so that the investigation is accurate. Yet another is that “Things will go much better for you if you cooperate.” None of these things are true.

However, if it is truly in your best interest to cooperate or to make a statement after you consult with your attorney, your legal counsel will surely advise you to do this. The investigator should not mind waiting until you consult your attorney. However, many will go to extremes to convince you that you don’t need an attorney and shouldn’t get an attorney.

Contact Health Law Attorneys Experienced in the Representation of 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. We have represented a number of massage therapists who have had summary actions initiated against their massage therapy licenses by the Department of Health (DOH).

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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Disclaimer: Please note that this article represents our opinions based on our many years of practice and experience in this area of health law. You may have a different opinion; you are welcome to it. This one is mine.

Note: This article is for informational purposes only; it is not legal advice.

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By The Health Law Firm|2024-03-14T10:00:14-04:00May 23, 2019|Categories: Massage Law Blog|Tags: administrative hearing representation, administrative licensure investigation attorney, board licencing defense lawyer, board licensing complaints, DOH attorney, DOH defense lawyer, DOH investigation representation, DOH lawyer, Florida health law attorney, Florida massage laws, health care attorney, investigation of massage therapist, massage therapy attorney, massage therapy defense, massage therapy lawyer, massage therapy licensing investigations, massage therapy licensure defense, Massage therapy representation, representation for administrative complaint, representation for board licencing complaints, representation for DOH investigations, representation for massage therapy, representation for massage therapy investigations, The Health Law Firm reviews|Comments Off

Phony Florida Physician Uses Silicone and Krazy Glue – Arrested Twice for Practicing Medicine Without a License

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

A South Florida man was arrested on February 6, 2013, for allegedly injecting people with silicone in a West Palm Beach motel room. He has been charged with practicing medicine without a license. According to the Sun Sentinel, this was the man’s second arrest within two months for the same crime.

Click here to read the entire article from the Sun Sentinel.

This “Krazy” Tale.

Police say this fake physician injected his customers with buttocks-enhancing silicone injections. He would then allegedly seal up the skin wounds with Krazy Glue. Victims said he would not wear gloves or protective clothing during the procedures. Each victim was charged $200 for each visit. This phony health professional was also arrested in January 2013, when two victims told investigators similar stories about his illegal injections.

In each case, the side effects in patients included severe infections, and the damage is thought to be permanent.

South Florida and Phony Health Professionals.

This is by no means the first report we’ve heard of phony health professionals in South Florida injecting people with toxic chemicals. Back in 2012, a number of people became sick and deformed after a Broward County, Florida, woman allegedly injected victims’ buttocks, hips and breasts with a combination of Fix-A-Flat tire sealant, cement, mineral oil and Super Glue. One of the victims died as a result of the procedure, according to the Daily Mail Reporter. The victims claimed the woman administering the injections presented herself as a medical professional and wore a nurse’s uniform.

Practicing Without a License Is a Crime.

Practicing medicine without a license is a crime. Additionally, so is helping someone practice medicine without a license. As a practitioner, you may be asked to supervise or join a practice. Remember that your license may be at stake with any wrongdoing by your subordinates. Before you join a practice or agree to supervise others, check first with the Department of Health (DOH) that the other providers are legitimate. You can verify a license for free on the DOH’s website.

Also, remember that a license to practice medicine in Venezuela, Cuba, or anywhere else, is just that: a license to practice in that country. It does not allow a person to practice medicine in the United States. A specific license from the State of Florida is required to practice in Florida, except for certain military and federal physicians. Always check the physician’s license.

More Stories on Fake Physicians and Other Phony and Fraudulent Professionals to Come.

In the near future on this blog we will include additional articles on fake doctors and health professionals, some old, some new.

To see a blog on a fake dentist in Miami, click here. You can also read the story of a fake plastic surgeon in New York by clicking here.

Contact Health Law Attorneys Experienced with 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.
Comments?

What do you think of all of these news stories of phony health care professionals? Please leave any thoughtful comments below.

Sources:

Komedna, Ed. “‘Motel Surgeon’ Arrested Again for Silicone Injections, Deputies Say.” Sun Sentinel. (February 6, 2013). From: http://www.sun-sentinel.com/news/palm-beach/fl-butler-surgery-arrest-20130206,0,2237567.story

United Press International Inc. “Man Arrested Again for Buttocks Injections.” United Press International Inc. (February 6, 2013). From: http://www.upi.com/Top_News/US/2013/02/07/Arrest-for-illegal-silicone-injections/UPI-97251360271074/?spt=hs&or=tn

Daily Mail Reporter. “Toxic tush transgender nurse charged with manslaughter after patient DIES following ‘injection with rubber cement and tire sealant in backroom cosmetic surgery’.” (July 26, 2012). From: www.dailymail.co.uk/news/article-2179631/Toxic-tush-nurse-Oneal-Morris-charged-manslaughter-patient-DIES.html#axzz2KKi2pPmh

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.

Watch Out for Legal Pitfalls Associated with Telemedicine

By Lance O. Leider, J.D., The Health Law Firm

With all the new technologies, mobile medical applications, expansion of access to health care under the Affordable Care Act (ACA), and the emphasis on quality care, telemedicine is at the forefront of the health care industry.

Now is the time to educate yourself on the new opportunities in practicing telemedicine. As with any new health care business model, you also have to assess the risks and be sure you are complying with the ever increasing number of regulations.

Where Telemedicine Stands Today.

The Centers for Medicare and Medicaid Services (CMS) can be credited for the telemedicine revival. In 2011, CMS issued a final rule permitting a more flexible process for credentialing and privileging practitioners who provide telemedicine services. Telemedicine escalated in 2013, when federal and state legislation and major insurers expanded the types of reimbursable telemedicine services. Now in 2014, there are more partnerships between insurers and health care delivery systems to provide patients access to specialists through telemedicine programs.
For example, WellPoint, Inc., and Aetna, Inc., among other health insurers, are letting millions of patients schedule online visits with health care professionals. These insurance companies are working together with companies that offer virtual visits with doctors who, in some states, can prescribe drugs for anything from sinus infections to back pain. According to Bloomberg, this is a major advancement for telemedicine. To read the entire article from Bloomberg, click here.

The Current Status of Telemedicine in Florida.

In March 2014, the Florida Boards of Medicine and Osteopathic Medicine adopted updated standards for practicing telemedicine. The final rule, 64B8-9.0141, Florida Administrative Code, defines telemedicine as:

the practice of medicine by a licensed Florida physician or physician assistant where patient care, treatment, or services are provided through the use of medical information exchanged from one site to another via electronic communications. Telemedicine shall not include the provision of health care services only through an audio only telephone, email messages, text messages, facsimile transmission, U.S. mail or other parcel service, or any combination thereof.

The rule states that the standard of care shall remain the same regardless of whether a physician provides services in person or by telemedicine. Also, those providing telemedicine services are responsible for the safety, security and adequacy of their equipment.

Several other parts of the new Florida telemedicine rule are worth noting:

1. Telemedicine is sufficient to establish a physician-patient relationship;
2. All regulations regarding patient confidentiality and record keeping are applicable;
3. The rule specifically exempts medical advice given by emergency responders including EMTs, paramedics and emergency dispatchers;
4. The rule also does not apply to physicians or physician assistants providing emergency care under conditions requiring immediate medical care; and
5. Florida law presently prohibits prescribing controlled substances via telemedicine.

Telemedicine and the Potential Legal Issues.

As telemedicine grows, so will the oversight and scrutiny by state medical boards and federal and state regulatory agencies. Here are some areas to be mindful of:

– Reimbursement: This is continuously an issue with telemedicine. Medicare reimbursement for telemedicine services is limited and generally requires face-to-face contact between patients and providers. Medicaid reimbursement varies from state-to-state, and only about 20 states have enacted statutes that require reimbursement for certain telemedicine services. This means health care providers need to review Medicare and Medicaid reimbursement policies, state health insurance regulations, and provider payer contract requirements so that they are aware of the reimbursement requirements that may affect their billing. Educate yourself on what will and what won’t be reimbursed, and only submit compliant claims to avoid audits.

– Fraud and Abuse: As a telemedicine provider, you will most likely initiate business arrangements between distinct health care entities that may include the lease of equipment or the use of a product owned, in part, by physicians. Arrangements like this need to be written with federal fraud and abuse laws in mind, including the Anti-Kickback Statute and the Stark Law. For more advice on telemedicine-related fraud issues, review advisory opinions issued by the Office of the Inspector General (OIG).

– Medical Staff Bylaws: Health care organizations that depend on information from a distant-site hospital or telemedicine entity to credential and privilege telemedicine practitioners must revise their medical staff bylaws and policies to include criteria for granting privileges to distant practitioners, and a procedure for applying the criteria. Additions should also include what category of the medical staff distant-site telemedicine practitioners will join, the level of involvement they may have in medical staff committees, and what procedural rights they should be given.

– Credentialing and Privileging: Under CMS’ final rule, health care organizations may rely on the credentialing and privileging decisions of distant-site hospitals or the information provided by other telemedicine entities when determining privileges for distant-site practitioners who provide telemedicine services, as long as certain conditions are met, including a compliant written agreement.

– Patient Privacy: Providers are responsible for ensuring they have secure communication channels, implementing business associate and other confidentiality and privacy agreements, educating staff regarding the appropriate use of telemedicine, and understanding how and what patient information is being collected and stored.

– Compliance with State Requirements: Most states require physicians engaging in telemedicine to be licensed in the state where the patient is located. It would be wise for health care organizations to seek the legal guidance of an experienced health law attorney to navigate individual state requirements.

– Interactions with Pain Management Laws: Our practice has seen many physicians become the subject of some kind of government investigation or action resulting from the remote practice of medicine in a pain management setting. These telemedicine rules do not alter the status quo in pain management. Physicians are still required to see patients in a face-to-face encounter in order to prescribe controlled substances for the treatment of pain. There are discussions among the members of the Florida Boards of Medicine and Osteopathic Medicine to permit limited prescribing of controlled substances through telemedicine. However, the boundaries of a future rule are unclear. Considering the hard-line stance the Boards have taken toward pain management in general, it is unlikely that any final rule would authorize the remote practice of pain management.

Health care providers need to stay mindful of the listed legal issues, and any others that may come up. It is important when practicing telemedicine to ensure your services are compliant, and you appropriately protect patient safety and privacy.

Comments?

Does your practice use telemedicine? In your opinion what are the benefits and what are the difficulties of telemedicine? Please leave any thoughtful comments below.

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 health care provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

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, 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.

Sources:

French, Marie. “The Doctor Will Click on You Now.” Bloomberg. (July 13, 2014). From: http://www.bloomberg.com/news/2014-07-14/the-doctor-will-click-on-you-now.html

Kadzielski, Mark and Kim, Jee-Young. “Telemedicine: Many Opportunities, Many Legal Issues, Many Risks.” JD Supra. (July 30, 2014). From: http://www.jdsupra.com/legalnews/telemedicine-many-opportunities-many-l-18993/

About the Author: 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.

By The Health Law Firm|2024-03-14T10:00:57-04:00June 1, 2018|Categories: HHS, The Health Law Firm Blog|Tags: administrative law, Centers for Medicare and Medicaid (CMS), defense attorney, defense lawyer, doctor shortage, e-visit, electronic medical questionnaire, Florida standards for telemedicine, Florida telemedicine, health care attorney, health care lawyer, health care reform, health law, online house call, physician shortage, Telemedicine|Comments Off

Lehigh University Student Sues Grad School for $1.3 Million for Bad Grade

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

While in school, we all received grades that we believed to be unfair or unwarranted. One graduate of Lehigh University in Pennsylvania, has taken her bad grade to court. She is suing the university over a “C+” grade. In the lawsuit, the student claims that if not for a zero she was given in participation for a fieldwork class in 2009, she would have gotten a “B.” That grade would have allegedly allowed the student to move on toward finishing her master’s in counseling and human services. The student claims the one bad grade prevented her from attaining her dream to become a licensed professional counselor. Now she is suing the university for $1.3 million, according to an article in The Morning Call.

Click here to read the entire article from The Morning Call.

Was the Grade Given for Unprofessional Behavior or in Retaliation of Student’s Activism?

According to an article in The Morning Call, the student claims she received the low grade because the teacher and the then-director of the degree program conspired to hold her back. The student allegedly claims they were unhappy she had complained after being forced to find a supplemental internship partway through the semester. The student also claims the teacher was biased against her (the student’s) activism for gay and lesbian rights.

Attorneys for the university argue the grade was given to the student in an effort to help her address the skills she needed to be a licensed professional counselor. It’s stated in the complaint that the student expressed unprofessional behavior during class, including outbursts of cursing and crying.

The student ended up graduating from Lehigh University with a master’s degree in human development. She now works as a drug and alcohol counselor, according to The Morning Call. The $1.3 million she is seeking represents the alleged difference in her earnings over her career if she was instead a state-certified counselor.

Can a Judge Change a Grade?

The judge in this case questions whether he has the legal authority to actually change a grade received by a student. He has looked at cases nationally and has been unable to find one in which a judge had done so. The student’s attorney believes the judge has a wide enough latitude to impose “equitable remedies,” according to The Morning Call.

From our experience with such matters, the courts are extremely reluctant to become involved in such academic matters. Absent convincing evidence of discrimination, it is doubtful the courts will decide in the student’s favor.

Legal Ramifications of this Case.

According to an article on Huffington Post, there have been a number of students who have sued their alma maters in grading conflicts. For example, two former Texas Southern University law students filed a lawsuit in 2012 against the university’s Thurgood Marshall School of Law because they received “Ds.” The bad grades led to their dismissal for not maintaining 2.0 GPAs and put a stop to their pursuit of becoming attorneys.

Click here to read more stories of students suing their schools.

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 learn more about our experience in the representation of medical students, click here.

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 this case? Do you think the judiciary should be injecting itself into the academic process? How do you think this lawsuit will end? Please leave any thoughtful comments below.

Sources:

Yates, Riley. “Judge decides quickly after request to dismiss Lehigh lawsuit over C+ grade.” The Morning Call. (February 13, 2013). From: http://articles.mcall.com/2013-02-13/news/mc-lehigh-university-student-sues-over-grade-0213-20130213_1_carr-and-nicholas-ladany-zero-in-classroom-participation-daughter-of-lehigh-finance

Kingkade, Tyler. “Megan Thode, Lehigh University Grad, Files $1.3 Million Lawsuit Over C+ Grade.” HuffingtonPost. (February 13, 2013). From: http://www.huffingtonpost.com/2013/02/13/megan-thode-lehigh-university-lawsuit_n_2671739.html?view=print&comm_ref=false

By The Health Law Firm|2024-03-14T10:00:45-04:00June 1, 2018|Categories: In the Know, In the News, Medical Students, The Health Law Firm Blog|Tags: counselor defense, defense attorney, defense lawyer, fellow representation, Florida health care attorney, Florida health care lawyer, health care attorney, health lawyer, intern representation, medical student representation, professional counselor|Comments Off

Physician Argues Definition of “Peer” at Formal Administrative Hearing

FACTS: The Agency for Health Care Administration (“AHCA”) is responsible for administering Florida’s Medicaid program and conducting investigations and audits of paid claims to ascertain if Medicaid providers have been overpaid. With regard to investigations of physicians, section 409.9131, Florida Statutes, provides that AHCA must have a “peer” evaluate Medicaid claims before the initiation of formal proceedings by AHCA to recover overpayments. Section 409.9131(2)(c) defines a “peer” as “a Florida licensed physician who is, to the maximum extent possible, of the same specialty or subspecialty, licensed under the same chapter, and in active practice.” Section “109.9131(2)(a) deems a physician to be in “active practice” if he or she has “regularly provided medical care and treatment to patients within the past two years.”

Alfred Murciano, M.D., treats patients who are hospitalized in Level III neonatal intensive care units and pediatric intensive care units in Miami-Dade, Broward, and Palm Beach County hospitals. His practice is limited to pediatric infectious disease. He has been certified by the American Board of Pediatrics in two areas: General Pediatrics and Pediatric Infectious Diseases. AHCA initiated a review of Medicaid claims submitted by Dr. Murciano between September 1, 2008, and August 31, 2010, and referred those claims to Richard Keith O’Hern, M.D., for peer review. Dr. O’Hern practiced medicine for 37 years, and was engaged in a private general pediatric practice until he retired in December of 2012. During the course of his career, he was certified by the American Board of Pediatrics in General Pediatrics, completed a one-year infectious disease fellowship at the The University of Florida, and treated approximately 16,000 babies with infectious disease issues. However, he was never board certified in pediatric infectious diseases, and at the time he reviewed Dr. Murciano’s Medicaid claims, Dr. O’Hern would have been ineligible for board certification in pediatric infectious diseases. In addition, Dr. O’Hern would have been unable to treat Dr. Murciano’s hospitalized patients in Level III NICUs and PICUs.

After Dr. O’Hern’s review, AHCA issued a Final Agency Audit Report alleging Dr Murciano had been overpaid by $l,051.992.99, and that he was required to reimburse AHCA for the overpayment. In addition, AHCA stated it was seeking to impose a fine of $210,398.60.

OUTCOME: Dr. Murciano argued at the formal administrative hearing that Dr O’Hern was not a “peer” as that term is defined in section 409.9131(20)(c). The ALJ agreed and issued a Recommended Order on May 22, 2014, recommending that AHCA’s case be dismissed because it failed to satisfy a condition precedent to initiating formal proceedings. While recognizing that AHCA is not required to retain a reviewing physician with the exact credentials as the physician under review, the ALJ concluded Dr. O’Hern was not of the same specialty as Dr. Murciano.

On July 31, 2014, AHCA rendered a Partial Final Order rejecting the ALJ’s conclusion that Dr. O’Hern was not a “peer.” In the course of ruling that it has substantive jurisdiction over such conclusions and that its interpretation of section 409.9131(2)(c), Florida Statutes, is entitled to deference, AHCA stated that it interprets the statute “to mean that the peer must practice in the same area as Respondent, hold the same professional license as Respondent, and be in active practice like Respondent.” AHCA concluded that “Dr. O’Hern is indeed a ‘peer’ of Respondent under the Agency’s interpretation of Section 409.9131(2)(c), Florida Statutes, because he too has a Florida medical license, is a pediatrician and had an active practice at the time he reviewed Respondent’s records. That Dr. O’Hern did not hold the same certification as Respondent, or have a professional practice identical to Respondent in no way means he is not a ‘peer’ of Respondent.” AHCA’s rejection of the ALJ’s conclusion of law regarding Dr. O’Hern’s “peer” status caused AHCA to remand the case back to the ALJ to make the factual findings on the claimed overpayments that were not made in the Recommended Order because of the ALJ’s conclusion that Dr. O’Hern did not qualify as a “peer.”

On August 18, 2014, the ALJ issued an Order respectfully declining AHCA’s remand. AHCA then filed a Petition for writ of Mandamus in the First District Court of Appeal, asking the court to direct the ALA to accept the remand and to enter findings of fact and conclusions of law with regard to each overpayment claim. The court assigned case number 1D14-3836 to AHCA’s Petition, and the case is pending.
Source:

AHCA v. Alfred Murciano, M.D., DOAH Case No. 13-0795MPI (Recommended Order May 22, 2014), AHCA Rendition No. 14-687-FOF-MDO (Partial Final Order July 31, 2014)
About the Author: The forgoing case summary was prepared by and appeared in the DOAH case notes of the Administrative Law Section newsletter, Vol. 36, No. 2 (Dec. 2014), a publication of the Administrative Law Section of The Florida Bar.

By The Health Law Firm|2024-03-14T10:00:58-04:00June 1, 2018|Categories: Administrative law, Agency for Health Care Administration, Appeal, Health Care Industry, Medicaid, Medicaid audit, Medicaid Fraud, The Health Law Firm Blog|Tags: Administrative Hearing, administrative law, administrative law judge, Agency for Health Care Administration (AHCA), AHCA appeal, AHCA petition, credentials, defense attorney, defense lawyer, final agency audit report, formal administrative hearing, formal hearing, health care attorney, health law, health law attorney, health law defense attorney, Medicaid Audits, Medicaid claims, Medicaid fraud, Medicaid overpayment, partial final order, pediatrician, pediatrics, peer, peer review|Comments Off

Multiple States Move to Enact New Laws Related to Controlled Substances

By Lance O. Leider, J.D., The Health Law Firm

In reports from both coasts, three states have recently made moves to tighten monitoring and prescribing of controlled substances. Legislators in California, Pennsylvania and Kentucky are contemplating new actions. Health professionals should take note, these prescription drug monitoring programs can, and will be, used as a prosecution tool.

Prescription Drug Monitoring Programs by State.

According to the Los Angeles Times, California is looking to utilize its prescription drug monitoring program CURES to find physicians who are a little too loose with the prescription pad. Lawmakers are contemplating mining the data compiled by CURES to find physicians who are overprescribing and take action against them. Click here to read the entire Los Angeles Times article.

The Pennsylvania house recently forwarded a bill from committee to the floor for a final vote. The bill would establish a monitoring program like those in California, Florida and Kentucky. This monitoring program would be used to combat abuse and doctor shopping by identifying patients that have already received an adequate supply of medications.

Kentucky, already the home of some tough prescription drug laws, is looking to fine tune its regulatory scheme. According to The Courier-Journal, the new bill would clarify existing regulations by providing medical exemptions for patients that would otherwise be wrapped up in the enforcement provisions. To learn more on the proposed changes to Kentucky’s prescription drug laws, click here.

You Can Run, But You Can’t Hide from Prescription Drug Monitoring.

Lawmakers in all three states cited laws and regulations from other states as inspiration for the moves to consider new laws to monitor prescriptions of controlled substances. What this means is that whatever state you may be in, you should be aware that lawmakers are looking around the country at what works and are implementing similar programs and laws in their governments.

Are Databases Just a Tool for Prosecution?

Enforcement of drug laws and prescribing regulations has been ever increasing in recent years. The implementation of these databases and corresponding regulations are going to provide more tools for law enforcement and state medical boards to crack down on physicians. In order to avoid trouble it is crucial that you take time to review your state’s prescribing and record keeping laws with an experienced health care attorney.

From experience, we have seen the database in Florida used mostly as a tool for prosecution of pain management physicians and pharmacists. Even in cases where the pharmacist has been the one to notify the authorities of suspected forged prescriptions and where the pharmacist has cooperated in prosecuting the criminals, I have seen this database cited as evidence against him or her. I do not believe this is what the legislation intended. Physicians and pharmacists should consider using whatever database is implemented in their respective states, or otherwise remaining vigilant to avoid being labeled an overprescriber.

To read legal tips to manage pain patients, 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.

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

Comments?

Does the state where you are located have a prescription drug monitoring program? Is it similar to any of programs we mentioned in this blog? What do you think of these programs? Are they necessary? Please leave any thoughtful comments below.

Sources:

Girion, Lisa and Glover, Scott. “Atty. Gen. Kamala Harris Urges Funding for Prescription Tracking.” Los Angeles Times. (March 3, 2013). From: http://latimesblogs.latimes.com/lanow/2013/03/attorney-general-kamala-harris-funding-prescription-database-.html

Wynn, Mike. “Kentucky Legislature Overhauls Prescription Drug Law.” The Courier-Journal. (March 4, 2013). From: http://www.courier-journal.com/apps/pbcs.dll/article?AID=2013303040093&nclick_check=1

Associated Press. “Lawmakers Mull Prescription Drug Monitoring.” Associated Press. (March 4, 2013). From: http://meadvilletribune.com/local/x986702017/Lawmakers-mull-prescription-drug-monitoring

About the Author: 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.

Chinese Nationals Indicted in Alleged U.S. Test-Taking Scheme

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

Fifteen Chinese citizens living in the United States reportedly conspired to take college entrance exams for others so they could obtain student visas, according to the Associated Press. The frauds allegedly took standardized exams including the Scholastic Aptitude Test (SAT), the Graduate Record Examination (GRE), and the Test of English as a Foreign Language (TOEFL).

The Test-Taking Conspiracy.

According to BBC News, the scheme reportedly took place between 2011 and 2015, mainly in western Pennsylvania. Six individuals named in the indictment were identified as students who supposedly paid up to $6,000 to have other individuals, also charged, take the tests. The test-takers purportedly “impersonated others, and those others were able to use the fraudulent test scores to obtain F1 visas,” U.S. Attorney for the Western District of Pennsylvania David Hickton told the Associated Press. The individuals allegedly used fake passports that contained the students’ personal information, but a picture of the test-taker substituted for the student.

Testing Services Cooperate with the Investigation.

Princeton, New Jersey-based Educational Testing Service and the New York-based College Board are cooperating with the investigation, according to Hickton. “Their actions are consistent with the College Board’s commitment to identify and stop illegal activity that undermines the integrity of our exams and the hard work of students around the world,” College Board vice president Stacy Caldwell told the Associated Press. Educational Testing Service administers the SAT, GRE, and TOEFL exams, while the College Board oversees SAT registration.

Offenders Expected to Receive More Than Just a Slap on the Wrist.

The charges against the suspects include conspiracy, counterfeiting passports, mail and wire fraud, BBC News reported. The defendants, both male and female ranging in age from 19 to 26, could face up to 20 years in prison if convicted. According to BBC’s report, Special Agent in Charge of Homeland Security Investigations of Philadelphia John Kelleghan believes “these students were not only cheating their way into the university, they were also cheating their way through our nation’s immigration system.”

Due to the ongoing investigation, a final number has not yet been released documenting an exact number of suspects believed to be involved in the ruse.

Is There Similar Activity Going On in Medical Testing for NBME, USMLE or ECFMG Administered Tests?

There have been somewhat similar alleged test-taking fraudulent activities involving medical testing. From time to time we are consulted by individuals who have been caught using fraudulent documents to attempt to take the USMLE Step exams. We are also aware of allegations that there have been compromises of actual examinations involving foreign nationals. For example, see the blog I wrote on the Optima scandal.

On the whole, the NBME, USMLE, and ECFMG and their testing centers do an excellent job in screening out fraudulent test takers. It would be foolish for anyone who ever hoped to be a practicing physician to try to perpetrate a fraud in taking these tests.

Comments?

What are your thoughts on these allegations? Do you feel standardized testing should be monitored more heavily to prevent test-taking fraud from occurring? Please leave any thoughtful comments below.

Contact Experienced Health Law Attorneys.

The attorneys of The Health Law Firm provide legal representation to medical, dental, chiropractic, other professional students, residents, interns and fellows in academic disputes, contract negotiations, license applications, board certification applications and hearings, credential hearings, and civil and administrative litigations.

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

Sources:

“Chinese Nationals Accused of Taking SATs for Others.” BBC News. (May 28 2015). From:

http://www.bbc.com/news/world-us-canada-32921737

Mandak, Joe. “Feds Indict 15 Chinese in Alleged College Test-Taking Scheme.” The Associated Press. (May 28, 2015). From:

http://abcnews.go.com/US/wireStory/feds-indict-15-chinese-alleged-college-test-taking-31366456

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: medical students, standardized tests, irregular behavior, fraud, defense attorney, legal representation, criminal proceeding, administrative law, health law, health care attorney, health care lawyer, defense lawyer, GME, graduate medical education, Step exams, medical interns, medical residents, ECFMG lawyer, USMLE attorney, foreign medical graduate attorney, legal counsel, legal advocate

“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 © 1996-2015 The Health Law Firm. All rights reserved.

By The Health Law Firm|2024-03-14T10:00:59-04:00June 1, 2018|Categories: Health care Law, Health Law, In the News, The Health Law Firm Blog|Tags: administrative law, criminal proceeding, defense attorney, defense lawyer, ECFMG lawyer, foreign medical graduate attorney, fraud defense, GME, graduate medical education, health care attorney, health care lawyer, health law, irregular behavior, legal advocate, legal counsel, legal representation, medical interns, medical residents, medical students, standardized tests, Step exams, USMLE attorney|Comments Off

Zone 4 Program Integrity Contractor (ZPIC) for Medicare and Medicaid Programs is Health Integrity, LCC

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

Health Integrity, LCC, was named the Zone 4 Program Integrity Contractor (ZPIC) for the Medicare and Medicaid programs. As the ZPIC for Zone 4, Health Integrity has been performing benefit integrity activities aimed to reduce fraud, waste and abuse in Medicare and Medicaid data matching programs.

A ZPIC is a business entity that contracts with Medicare and Medicaid and works with state Medicaid agencies, the Centers for Medicare and Medicaid Services (CMS), and law enforcement officials to identify improper billing and utilization patterns throughout Zone 4.

ZPIC Zone 4 includes Texas, Colorado, New Mexico, and Oklahoma.

What is a ZPIC?

ZPICs are private companies contracted by the CMS, used to conduct audits for Medicare and Medicaid overpayments. ZPICS also detect, investigate and gather evidence of suspected fraud and abuse to be turned over to the Office of Inspector General (OIG) for criminal or civil prosecution.. When you hear “ZPIC,” think “fraud.”

ZPIC audits are initiated by:

1. Whistleblower or qui tam lawsuits,
2. Probe audits,
3. Other audit agency findings,
4. Beneficiary/patient complaints,
5. Hotline complaints, or
6. Complaints and notices from other government programs.

How to Handle a ZPIC Audit.

When a physician, medical group or other health care provider receives a notice of an audit and site visit from a ZPIC, things happen fast with little opportunity to prepare. A ZPIC will routinely fax a letter to the practice shortly before the end of a business day the day before a site visit/audit to that practice. Auditors will request to inspect the premises, will photograph all rooms, equipment, furniture, and diplomas on walls. They will usually request copies of several patient records to review later. They will request copies of practice policies and procedures, treatment protocols, all staff licenses and certifications, drug formularies, medications prescribed, and medications used in the office. ZPIC auditors will inspect any medication/narcotic lockers or storage cabinets and will request drug/medication invoices and inventories. You will usually be contacted for follow-up information and documentation after the audit and will eventually be provided a report and, possibly, a demand for repayment of any detected overpayments.

For a checklist on what to do after you receive initial notification of a ZPIC audit, read our two-part blog. Click here for part one and click here for part two.

The Health Law Firm’s Success in a North Carolina Medicaid Action.

In October 2012, The Health Law Firm assisted a North Carolina Medicaid provider in reducing an overpayment demand made by the North Carolina Medicaid program by more than ninety-eight percent (98%). We were brought on to assist the provider in challenging an initial audit. We assembled and submitted documents to the auditor and assisted the client in presenting evidence at the hearing. The final result of the hearing reduced the Medicaid overpayment amount from $1.4 million to just $24,083. To read more on this successful Medicaid action, click here.

State Included in Zone 4.

ZPIC Zones are broken up by state. Health Integrity serves as the Zone 4 ZPIC. As indicated above Zone 4 includes Texas, Colorado, New Mexico, and Oklahoma.

Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.

The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also 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.

For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Comments?

Have you ever received notification of a ZPIC visit or audit? Please leave any thoughtful comments below.