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How to Find the Right Attorney for Your Irregular Behavior Case Before the USMLE or ECFMG

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

If you have received a letter from the United States Medical Licensing Examination (USMLE) Secretariat or the Educational Commission for Foreign Medical Graduates (ECFMG) accusing you of “irregular behavior,” this is very serious stuff. You need an experienced lawyer to assist you. But how do you find one? This blog will provide several tips on how to locate an experienced effective attorney who will really provide the legal assistance you need.

You Don’t Need a Philadelphia Attorney to Represent You.

First, there are only a handful of attorneys in the United States who have handled more than one of these cases. Even if you find one, this does not mean he or she is really experienced and will really advocate your position before the Committee for Individualized Review (CIR) or the ad hoc committee which is appointed to hear your case. You don’t need an attorney who is actually in Philadelphia, Pennsylvania (where the USMLE and the ECFMG have offices and where such hearings are usually held), to represent you. Most of the work is actually done before the hearing.

What you do need is someone who is experienced and knows how to properly prepare you for the nerve-wracking hearing you will have. The attorneys of our firm routinely do this.

What to Look for in an Attorney Before You Select One.

1. First, make sure that the attorney you select actually has ample experience in actually appearing before the committee and representing individuals and has done this multiple times in the past. Ask how many hearings.

2. Second, Look for an attorney who is board certified by their state bar association in the legal specialty of health law. Many states now have such certifications, including Florida, Pennsylvania, and Texas. Board certification in a legal specialty is like board certification in a medical specialty. It is the mark of attaining a higher degree of expertise and excellence. An attorney who is certified in health law will understand the medical issues involved in your case, the impact this can have on your future as a physician and other aspects a criminal law attorney or civil litigation attorney will not.

3. Third, check out the background of each attorney before you hire one. Google them and review everything you can find. Check with the state licensing board or state bar association for adverse actions.

4. Ask the attorney how the attorney exactly how the attorney will prepare you for the hearing. When we prepare an individual for a hearing, we review everything from the physical layout of the hearing room, to exactly how the actual hearing will be conducted, to whom the members of the hearing committee will be. We review how to speak and answer questions effectively and the types of questions that may be asked of you. All of this helps you to be better prepared and less nervous when appearing at the hearing.

5. Ask the attorney if the attorney uses expert witnesses in these cases. In many cases, no expert witness is required. However in some cases experts such as computer technicians, forensic document examiners or handwriting experts, polygraphers (lie detector analysts), statistics experts, or other experts should be hired to provide an expert report for the committee to consider.

6. Find out if the attorney will meet with you in person a week or two prior to the hearing to help prepare you. We always do this. If you cannot come to our office in the Orlando, Florida area (which most people do), we will meet with you via Zoom, Skype, video chat, or just telephonically if necessary.

7. We recommend that you select an attorney who is not a solo practitioner. An attorney who has several attorneys in his firm in the same area of specialty will have additional back up if it is needed. If you hire an attorney who is alone by himself, illness, accidents, family emergencies, and other unforeseen events can cause you to be without legal representation at the last minute.

8. Often the cheapest attorney is not the best one for you. Remember the old saying that “you get what you pay for.” Cheaper is not always better. However, paying the most may not ensure that you get the most effective legal counsel. You must do your homework, finding out the information above.

Contact Us for an Initial Consultation on Your Irregular Behavior Case.

Contact our firm and we will be happy to discuss your irregular behavior case with you before you decide on hiring an attorney.

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education, and those being challenged by the National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG)

The Health Law Firm and its attorneys represent interns, residents, fellows and medical school students in disputes with their medical schools, supervisors, residency programs and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs 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 any other matters. We routinely help those who have disputes with the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG), including on hearings and appeals concerning “Irregular Behavior,” “unprofessionalism,” and “Irregular Conduct.”

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

About the Author: 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 or Toll-Free: (888) 331-6620.

KeyWords: Irregular behavior defense lawyer, irregular conduct legal representation, graduate medical education (GME) defense attorney, international medical graduate attorney, graduate medical education defense lawyer, lawyer for medical students, medical resident physician attorney, residency program legal dispute, residency program litigation, medical school litigation, legal representation for medical residents, legal dispute with medical school, medical students legal counsel, disruptive physician attorney, impaired medical student legal counsel, impaired resident legal defense attorney, United States Medical Licensing Examination (USMLE) defense lawyer, USMLE defense attorney, National Board of Medical Examiners (NBME) defense counsel, Educational Commission for Foreign Medical Graduates (ECFMG) defense lawyer, ECFMG defense attorney, legal representation for USMLE investigations, legal representation for NBME investigations, legal representation for irregular behavior, irregular behavior defense attorney, irregular behavior defense counsel, health law attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Philadelphia attorney for ECFMG hearing, Philadelphia lawyer for NBME hearing, Philadelphia legal counsel for USMLE hearing

“The Health Law Firm” is a registered fictitious business name 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.

New Policy Changes to USMLE Exams and How They Impact Medical Students, Graduates

Attorney Achal A. AggarwalBy Achal A. Aggarwal, J.D. and Carole C. Schriefer, J.D.

The United States Medical Licensing Examination (“USMLE”) is a three-step examination required to obtain a medical license. It is written and administered by the USMLE Secretariat of the National Board of Medical Examiners (“NBME”) and is sponsored by the Federation of State Medical Boards (“FSMB”) and the USMLE.

Medical students desiring to practice in the U.S. are under immense pressure to not only pass the exams but to excel at them. Specifically, the USMLE Step 1 Examination, the USMLE Step 2 Clinical Knowledge (“CK”) Examination, and the USMLE Step 2 Clinical Skills (“CS”) Examination are the most significant deciding factors that residency programs use for selecting applicants to interview for residency positions. However, a lot is about to change.

Important Policy Changes.

On February 12, 2020, the FSMB and the NBME announced the following policy changes:

1. The Step 1 Exam will be changed to pass/fail grading;

2. The number of examination attempts for each exam will be reduced from six (6) to four (4); and

3. All examinees must pass the Step 1 Exam before taking the Step 2-CS Exam.

Changing the Step 1 Exam to Pass/Fail.

The USMLE has announced that it will change the Step 1 exam’s grading system from a three-digit score to a pass/fail grading system. This change will go into effect on January 1, 2022.  A statement published on the website states that changing to pass/fail could help reduce some of the current overemphasis on USMLE performance while also retaining the ability of medical licensing authorities to use the exam for its primary purpose of medical licensure eligibility. Click here to visit the USMLE website and read the statement.

It appears that USMLE, FSMB, NBME, and the American Medical Association (AMA) are attempting to alleviate the stress and pressure the Step 1 exam puts on medical students. However, this change may cause issues for residency programs that are trying to screen for which students they want to interview.

In the current system, the Step 1 score is a three-digit score that is graded on a bell-curve. The minimum passing score for each Step 1 exam is different and depends on the performance of the total universe of the students who take that particular examination.

The three-digit score helps residency programs assess which students were more likely to excel in their program and which students would not. By changing the exam to a pass/fail scoring system, residency programs will be forced to rely more heavily on the Step 2-CK scores, medical school performance, and overall curriculum vitae.

Greater Emphasis to Be Placed on Step 2-CK Exam.

Currently, the Step 2-CK exam is only the fourth-most deciding factor in how residency programs select applicants for interviews. Approximately 80% of residency program directors stated that it was an important factor, but not the most.

On the other hand, the Step 2-CS exam score is a less influential factor, with only 56% of residency program directors saying that it was essential to their decision. Students should anticipate that the Step 2-CK and Step 2-CS will become more important as program directors shift their attention to the scores of those exams.

For more information click here.

What remains to be seen is how these changes will impact international medical graduates (“IMG”), commonly referred to as “foreign medical graduates.” To distinguish themselves, IMGs often tried to get the highest possible USMLE score, as this was the most objective way for them to be compared to other U.S. medical school students.

Since each domestic and international medical school has its own unique clinical grading system, the USMLE Step 1 was one of the most objective ways to compare residency applicants. Now that Step 1 scoring has been eliminated, it might be harder for IMGs to make themselves attractive to competitive residency programs.

Reducing Overall Exam Attempts from Six to Four.

Additionally, the USMLE is changing the limit on the total number of times an examinee may take the same Step exam from six (6) attempts to four (4) attempts. This means that after the policy is implemented, it will be ineligible to take a Step exam if the examinee has made four (4) prior attempts on that Step exam, including incomplete attempts.

The policy is set to be implemented on July 1, 2021. Learn more about the policy here.

Examinees Must Pass Step 1 Before Taking Step 2-CS.

Although the USMLE has suspended the Step 2-CS exam administration at the present time because of the COVID-19 pandemic, it is set to implement a rule requiring all examinees to pass the Step 1 exam before qualifying to take the Step 2-CS exam.

Implementing such a rule would reduce the USMLE’s burden of administering the Step 2-CS exam multiple times since students will be required to qualify for the exam. Students can currently take the Step 1 exam, Step 2-CS exam, and Step 2-CK exam in any order they choose, depending on the requirements of their medical school. This new rule seeks to shift that burden by funneling students through the Step 1 exam.

The impact of such a change remains to be seen, however, we anticipate that this policy will reduce the testing burden on the USMLE while also maintaining the importance of the Step 1 exam despite changing its scoring to pass/fail.

It does represent a complete shake-up in how the system of testing has previously been administered.

Tips for the New Rules.

The following are suggestions we have concerning the new rules:

1. Take the Step 1 Exam as soon as you can, and begin preparing for the others.

2. Always treat every test administration extremely seriously, as though your future life and career depend on it; they do!

3. Take maximum advantage of commercial preparation courses and always try to take one of the recommended live ones before you take your examination.

4. Take off several weeks prior to the examination and find a hotel within walking distance of the test site where you will take the examination to study. Get rid of all distractions while studying for and immediately prior to taking the examination.

5. Never solicit actual test content or offer to share it with someone else.

For additional common-sense tips on preparing for and taking the USMLE Step exams, see another blog on this subject here.

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education, and those being challenged by the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG)

The Health Law Firm and its attorneys represent interns, residents, fellows, and medical school students in disputes with their medical schools, supervisors, residency programs, and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs 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 any other matters. We routinely help those who have disputes with the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG), including on hearings and appeals concerning “Irregular Behavior,” “unprofessionalism,” and “Irregular Conduct.”

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

About the Authors: Carole C. Schriefer J.D., and Achal A. Aggarwal, M.B.A., J.D. practice health law with The Health Law Firm, which has a national practice.  Its main office in the Orlando, Florida area.   1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714
Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.  Its regional office is in the Northern Colorado, area. 155 East Boardwalk Drive, Fort Collins, Colorado 80525. Phone: (970) 416-7456.  www.TheHealthLawFirm.com

KeyWords: Irregular behavior defense lawyer, irregular conduct legal representation, graduate medical education (GME) defense attorney, international medical graduate attorney, graduate medical education defense lawyer, lawyer for medical students, medical resident physician attorney, residency program legal dispute, residency program litigation, medical school litigation, legal representation for medical residents, legal dispute with medical school, medical students legal counsel, disruptive physician attorney, impaired medical student legal counsel, impaired resident legal defense attorney, United States Medical Licensing Examination (USMLE) defense lawyer, USMLE defense attorney, National Board of Medical Examiners (NBME) defense counsel, Educational Commission for Foreign Medical Graduates (ECFMG) defense lawyer, ECFMG defense attorney, legal representation for USMLE investigations, legal representation for NBME investigations, legal representation for irregular behavior, irregular behavior defense attorney, irregular behavior defense counsel, health law attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Philadelphia attorney for ECFMG hearing, Philadelphia lawyer for NBME hearing, Philadelphia legal counsel for USMLE hearing

“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.

Significant Changes to USMLE Exams and What They Mean for Medical Students and Graduates

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

The United States Medical Licensing Examination (“USMLE”) is a three-step examination required to obtain a medical license. It is written and administered by the USMLE Secretariat of the National Board of Medical Examiners (“NBME”) and is sponsored by the Federation of State Medical Boards (“FSMB”) and the USMLE.

Medical students desiring to practice in the U.S. are under immense pressure to not only pass the exams but to excel at them. Specifically, the USMLE Step 1 Examination, the USMLE Step 2 Clinical Knowledge (“CK”) Examination, and the USMLE Step 2 Clinical Skills (“CS”) Examination are the most significant deciding factors that residency programs use for selecting applicants to interview for residency positions. However, a lot is about to change.

Important Policy Changes.

On February 12, 2020, the FSMB and the NBME announced the following policy changes:

1. The Step 1 Exam will be changed to pass/fail grading;

2. The number of examination attempts for each exam will be reduced from six (6) to four (4); and

3. All examinees must pass the Step 1 Exam before taking the Step 2-CS Exam.

Changing the Step 1 Exam to Pass/Fail.

The USMLE has announced that it will change the Step 1 exam’s grading system from a three-digit score to a pass/fail grading system. This change will go into effect on January 1, 2022.  A statement published on the website states that changing to pass/fail could help reduce some of the current overemphasis on USMLE performance while also retaining the ability of medical licensing authorities to use the exam for its primary purpose of medical licensure eligibility. Click here to visit the USMLE website and read the statement.

It appears that USMLE, FSMB, NBME, and the American Medical Association (AMA) are attempting to alleviate the stress and pressure the Step 1 exam puts on medical students. However, this change may cause issues for residency programs that are trying to screen for which students they want to interview.

In the current system, the Step 1 score is a three-digit score that is graded on a bell-curve. The minimum passing score for each Step 1 exam is different and depends on the performance of the total universe of the students who take that particular examination.

The three-digit score helps residency programs assess which students were more likely to excel in their program and which students would not. By changing the exam to a pass/fail scoring system, residency programs will be forced to rely more heavily on the Step 2-CK scores, medical school performance, and overall curriculum vitae.

Greater Emphasis to Be Placed on Step 2-CK Exam.

Currently, the Step 2-CK exam is only the fourth-most deciding factor in how residency programs select applicants for interviews. Approximately 80% of residency program directors stated that it was an important factor, but not the most.

On the other hand, the Step 2-CS exam score is a less influential factor, with only 56% of residency program directors saying that it was essential to their decision. Students should anticipate that the Step 2-CK and Step 2-CS will become more important as program directors shift their attention to the scores of those exams.

For more information click here.

What remains to be seen is how these changes will impact international medical graduates (“IMG”), commonly referred to as “foreign medical graduates.” To distinguish themselves, IMGs often tried to get the highest possible USMLE score, as this was the most objective way for them to be compared to other U.S. medical school students.

Since each domestic and international medical school has its own unique clinical grading system, the USMLE Step 1 was one of the most objective ways to compare residency applicants. Now that Step 1 scoring has been eliminated, it might be harder for IMGs to make themselves attractive to competitive residency programs.

Reducing Overall Exam Attempts from Six to Four.

Additionally, the USMLE is changing the limit on the total number of times an examinee may take the same Step exam from six (6) attempts to four (4) attempts. This means that after the policy is implemented, it will be ineligible to take a Step exam if the examinee has made four (4) prior attempts on that Step exam, including incomplete attempts.

The policy is set to be implemented on July 1, 2021. Learn more about the policy here.

Examinees Must Pass Step 1 Before Taking Step 2-CS.

Although the USMLE has suspended the Step 2-CS exam administration at the present time because of the COVID-19 pandemic, it is set to implement a rule requiring all examinees to pass the Step 1 exam before qualifying to take the Step 2-CS exam.

Implementing such a rule would reduce the USMLE’s burden of administering the Step 2-CS exam multiple times since students will be required to qualify for the exam. Students can currently take the Step 1 exam, Step 2-CS exam, and Step 2-CK exam in any order they choose, depending on the requirements of their medical school. This new rule seeks to shift that burden by funneling students through the Step 1 exam.

The impact of such a change remains to be seen, however, we anticipate that this policy will reduce the testing burden on the USMLE while also maintaining the importance of the Step 1 exam despite changing its scoring to pass/fail.

It does represent a complete shake-up in how the system of testing has previously been administered.

Tips for the New Rules.

The following are suggestions we have concerning the new rules:

1. Take the Step 1 Exam as soon as you can, and begin preparing for the others.

2. Always treat every test administration extremely seriously, as though your future life and career depend on it; they do!

3. Take maximum advantage of commercial preparation courses and always try to take one of the recommended live ones before you take your examination.

4. Take off several weeks prior to the examination and find a hotel within walking distance of the test site where you will take the examination to study. Get rid of all distractions while studying for and immediately prior to taking the examination.

5. Never solicit actual test content or offer to share it with someone else.

For additional common-sense tips on preparing for and taking the USMLE Step exams, see another blog on this subject here.

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education, and those being challenged by the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG)

The Health Law Firm and its attorneys represent interns, residents, fellows, and medical school students in disputes with their medical schools, supervisors, residency programs, and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs 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 any other matters. We routinely help those who have disputes with the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG), including on hearings and appeals concerning “Irregular Behavior,” “unprofessionalism,” and “Irregular Conduct.”

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

About the 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, Toll-Free: (888) 331-662.

KeyWords: Irregular behavior defense lawyer, irregular conduct legal representation, graduate medical education (GME) defense attorney, international medical graduate attorney, graduate medical education defense lawyer, lawyer for medical students, medical resident physician attorney, residency program legal dispute, residency program litigation, medical school litigation, legal representation for medical residents, legal dispute with medical school, medical students legal counsel, disruptive physician attorney, impaired medical student legal counsel, impaired resident legal defense attorney, United States Medical Licensing Examination (USMLE) defense lawyer, USMLE defense attorney, National Board of Medical Examiners (NBME) defense counsel, Educational Commission for Foreign Medical Graduates (ECFMG) defense lawyer, ECFMG defense attorney, legal representation for USMLE investigations, legal representation for NBME investigations, legal representation for irregular behavior, irregular behavior defense attorney, irregular behavior defense counsel, health law attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Philadelphia attorney for ECFMG hearing, Philadelphia lawyer for NBME hearing, Philadelphia legal counsel for USMLE hearing

“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.

 

 

 

Dermatologist Pays $1.74 Million Settlement in FCA Suit For Inflated Medicare Claims in Florida

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2020, a Florida dermatologist and cosmetic surgeon agreed to pay $1.74 million to resolve allegations that he violated the False Claims Act (FCA). United States Attorney Maria Chapa Lopez announced that Dr. Thi Thien Nguyen Tran and Village Dermatology and Cosmetic Surgery, L.L.C. agreed to settle the case involving allegedly inflated Medicare claims. The settlement concludes the qui tam (whistleblowers) civil lawsuit originally filed in the United States District Court for the Middle District of Florida.

Alleged Inflated Claims to Medicare.

According to the settlement agreement, from 2011 through 2016, Dr. Tran and Village Dermatology billed for 14,000 tissue transfers, which should have been billed as lower-level wound repairs. These submissions allegedly resulted in inflated claims that Medicare paid at rates higher than it should have paid. The exaggerated claims that were submitted to Medicare were for wound repairs related to Mohs surgery, a common, in-office procedure for dermatologists.

Qui Tam, Whistleblower Provisions.

The suit was originally filed under the qui tam, or whistleblower, provisions of the False Claims Act. This law, originally enacted during the Civil War, allows a private citizen to sue on behalf of the United States for false claims the government paid; if successful in recovering money, the whistleblower shares in the recovery. The Act also allows the United States to intervene and prosecute the action. According to the DOJ, the whistleblowers in this suit will receive over $305,000 of the proceeds from the settlement it made with Dr. Tran and Village Dermatology.

This case just shows that even physicians can and should bring such claims and be rewarded for their whistleblowing activities.

To read the press release issued by the DOJ, click here.

Read about a recent case involving FCA allegations by reading one of my prior blogs here.

False Claims Act Cases Can Often be Settled Early and Greater Penalties, Including Prison, Avoided.

This case shows that getting an experienced attorney involved early in the proceedings can lead to a monetary settlement on a case for a much lower price than if it were unnecessarily and aggressively defended. False Claims Act cases carry with them the threat of a possible criminal prosecution which can result in years in prison for a physician. They could also result in civil monetary penalties in the millions of dollars. This is because the government is allowed to pursue treble dames, plus $11,500 (adjusted for inflation), plus attorneys fee and costs, for each claim. Thus, if a physician has only 100 possibly false claims that Medicare paid for $100 each, this could result in over $1,150,300.00, plus attorney fees and costs for them. 1,000 false claims, over $11 million in possible penalties.

If the physician can retain the services of an experienced health lawyer who can negotiate down the amount sought by the government millions of dollars in penalties, legal fees and lost time from medical practice may be achieved. On the other hand, in the right case, if a physician is not guilty of any false billings, these cases can be identified early and a cohesive, organized defense planned early.

Contact Health Law Attorneys Experienced with Qui Tam, Whistleblower Cases, and False Claims Act Violations.

Attorneys with The Health Law Firm represent dermatologists and other physicians, nurse practitioners and other nurses, and health professionals who need to defend a False Claims Act case, or who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups, and health facilities who have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters.

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

Sources:

Pederson, Joe. “Villages doctor agrees to pay $1.7 million to settle False Claims Act Liability after inflating Medicare claims.” Orlando Sentinel. (March 13, 2020). Web.

“Villages doctor agrees to pay $1.7 million to settle False Claims Act after inflating Medicare claims.” MSN News. (March 16, 2020). Web.

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

Keywords: qui tam lawyer, health law attorney, dermatologist defense lawyer, Mohs surgery defense lawyer, dermatologist legal representation, legal representation in Mohs surgery litigation, The Health Law Firm, health law attorney, health law defense lawyer, health care fraud attorney, whistle blower attorney, Anti-Kickback Statute (AKS) attorney, False Claims Act defense lawyer, FCA attorney, illegal kickbacks, DOJ settlement attorney, government health care fraud, health fraud and abuse allegations, health fraud attorney, complex medical litigation defense lawyer, complex health care litigation defense attorney, legal representation in complex medical business litigation, FCA legal representation, whistle blower defense attorney, Florida qui tam whistle blower attorney, Colorado qui tam whistle blower lawyer, Louisiana qui tam whistle blower attorney, Kentucky qui tam whistle blower lawyer, Virginia qui tam whistle blower attorney, District of Columbia (D.C.) qui tam whistle blower lawyer, Florida False Claims Act (FCA) and civil monetary penalties attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer, Virginia False Claims Act (FCA) and civil monetary penalties attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

By |2020-05-07T12:54:14-04:00June 18th, 2020|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Florida Dermatologist Pays $1.74 Million To Settle Medicaid FCA Suit

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2020, a Florida dermatologist and cosmetic surgeon agreed to pay $1.74 million to resolve allegations that he violated the False Claims Act (FCA). United States Attorney Maria Chapa Lopez announced that Dr. Thi Thien Nguyen Tran and Village Dermatology and Cosmetic Surgery, L.L.C. agreed to settle the case involving allegedly inflated Medicare claims. The settlement concludes the qui tam (whistleblowers) civil lawsuit originally filed in the United States District Court for the Middle District of Florida.

Inflated Claims to Medicare Alleged in Suit.

According to the settlement agreement, from 2011 through 2016, Dr. Tran and Village Dermatology billed for 14,000 tissue transfers, which should have been billed as lower-level wound repairs. These submissions allegedly resulted in inflated claims that Medicare paid at rates higher than it should have paid. The exaggerated claims that were submitted to Medicare were for wound repairs related to Mohs surgery, a common, in-office procedure for dermatologists.

Qui Tam, Whistleblower Provisions.

The suit was originally filed under the qui tam, or whistleblower, provisions of the False Claims Act. This law, originally enacted during the Civil War, allows a private citizen to sue on behalf of the United States for false claims the government paid; if successful in recovering money, the whistleblower shares in the recovery. The Act also allows the United States to intervene and prosecute the action. According to the DOJ, the whistleblowers in this suit will receive over $305,000 of the proceeds from the settlement it made with Dr. Tran and Village Dermatology.

This case just shows that even physicians can and should bring such claims and be rewarded for their whistleblowing activities.

To read the press release issued by the DOJ, click here.

Read about a recent case involving FCA allegations by reading one of my prior blogs here.

False Claims Act Cases Can Often be Settled Early and Greater Penalties, Including Prison, Avoided.

This case shows that getting an experienced attorney involved early in the proceedings can lead to a monetary settlement on a case for a much lower price than if it were unnecessarily and aggressively defended. False Claims Act cases carry with them the threat of a possible criminal prosecution which can result in years in prison for a physician. They could also result in civil monetary penalties in the millions of dollars. This is because the government is allowed to pursue treble dames, plus $11,500 (adjusted for inflation), plus attorneys fee and costs, for each claim. Thus, if a physician has only 100 possibly false claims that Medicare paid for $100 each, this could result in over $1,150,300.00, plus attorney fees and costs for them. 1,000 false claims, over $11 million in possible penalties.

If the physician can retain the services of an experienced health lawyer who can negotiate down the amount sought by the government millions of dollars in penalties, legal fees and lost time from medical practice may be achieved. On the other hand, in the right case, if a physician is not guilty of any false billings, these cases can be identified early and a cohesive, organized defense planned early.

Contact Health Law Attorneys Experienced with Qui Tam, Whistleblower Cases, and False Claims Act Violations.

Attorneys with The Health Law Firm represent dermatologists and other physicians, nurse practitioners and other nurses, and health professionals who need to defend a False Claims Act case, or who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups, and health facilities who have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters.

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

Sources:

Pederson, Joe. “Villages doctor agrees to pay $1.7 million to settle False Claims Act Liability after inflating Medicare claims.” Orlando Sentinel. (March 13, 2020). Web.

“Villages doctor agrees to pay $1.7 million to settle False Claims Act after inflating Medicare claims.” MSN News. (March 16, 2020). Web.

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

Keywords: qui tam lawyer, health law attorney, dermatologist defense lawyer, Mohs surgery defense lawyer, dermatologist legal representation, legal representation in Mohs surgery litigation, The Health Law Firm, health law attorney, health law defense lawyer, health care fraud attorney, whistle blower attorney, Anti-Kickback Statute (AKS) attorney, False Claims Act defense lawyer, FCA attorney, illegal kickbacks, DOJ settlement attorney, government health care fraud, health fraud and abuse allegations, health fraud attorney, complex medical litigation defense lawyer, complex health care litigation defense attorney, legal representation in complex medical business litigation, FCA legal representation, whistle blower defense attorney, Florida qui tam whistle blower attorney, Colorado qui tam whistle blower lawyer, Louisiana qui tam whistle blower attorney, Kentucky qui tam whistle blower lawyer, Virginia qui tam whistle blower attorney, District of Columbia (D.C.) qui tam whistle blower lawyer, Florida False Claims Act (FCA) and civil monetary penalties attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer, Virginia False Claims Act (FCA) and civil monetary penalties attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

By |2020-05-07T12:48:38-04:00May 28th, 2020|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Dermatologist in Florida Agrees to Pay $1.74 Million To Settle Medicaid FCA Suit

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2020, a Florida dermatologist and cosmetic surgeon agreed to pay $1.74 million to resolve allegations that he violated the False Claims Act (FCA). United States Attorney Maria Chapa Lopez announced that Dr. Thi Thien Nguyen Tran and Village Dermatology and Cosmetic Surgery, L.L.C. agreed to settle the case involving allegedly inflated Medicare claims. The settlement concludes the qui tam (whistleblowers) civil lawsuit originally filed in the United States District Court for the Middle District of Florida.

Inflated Claims to Medicare Claimed in Suit.

According to the settlement agreement, from 2011 through 2016, Dr. Tran and Village Dermatology billed for 14,000 tissue transfers, which should have been billed as lower-level wound repairs. These submissions allegedly resulted in inflated claims that Medicare paid at rates higher than it should have paid. The exaggerated claims that were submitted to Medicare were for wound repairs related to Mohs surgery, a common, in-office procedure for dermatologists.

Qui Tam, Whistleblower Provisions.

The suit was originally filed under the qui tam, or whistleblower, provisions of the False Claims Act. This law, originally enacted during the Civil War, allows a private citizen to sue on behalf of the United States for false claims the government paid; if successful in recovering money, the whistleblower shares in the recovery. The Act also allows the United States to intervene and prosecute the action. According to the DOJ, the whistleblowers in this suit will receive over $305,000 of the proceeds from the settlement it made with Dr. Tran and Village Dermatology.

This case just shows that even physicians can and should bring such claims and be rewarded for their whistleblowing activities.

To read the press release issued by the DOJ, click here.

Read about a recent case involving FCA allegations by reading one of my prior blogs here.

False Claims Act Cases Can Often be Settled Early and Greater Penalties, Including Prison, Avoided.

This case shows that getting an experienced attorney involved early in the proceedings can lead to a monetary settlement on a case for a much lower price than if it were unnecessarily and aggressively defended. False Claims Act cases carry with them the threat of a possible criminal prosecution which can result in years in prison for a physician. They could also result in civil monetary penalties in the millions of dollars. This is because the government is allowed to pursue treble dames, plus $11,500 (adjusted for inflation), plus attorneys fee and costs, for each claim. Thus, if a physician has only 100 possibly false claims that Medicare paid for $100 each, this could result in over $1,150,300.00, plus attorney fees and costs for them. 1,000 false claims, over $11 million in possible penalties.

If the physician can retain the services of an experienced health lawyer who can negotiate down the amount sought by the government millions of dollars in penalties, legal fees and lost time from medical practice may be achieved. On the other hand, in the right case, if a physician is not guilty of any false billings, these cases can be identified early and a cohesive, organized defense planned early.

Contact Health Law Attorneys Experienced with Qui Tam, Whistleblower Cases, and False Claims Act Violations.

Attorneys with The Health Law Firm represent dermatologists and other physicians, nurse practitioners and other nurses, and health professionals who need to defend a False Claims Act case, or who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups, and health facilities who have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters.

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

Sources:

Pederson, Joe. “Villages doctor agrees to pay $1.7 million to settle False Claims Act Liability after inflating Medicare claims.” Orlando Sentinel. (March 13, 2020). Web.

“Villages doctor agrees to pay $1.7 million to settle False Claims Act after inflating Medicare claims.” MSN News. (March 16, 2020). Web.

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

Keywords: qui tam lawyer, health law attorney, dermatologist defense lawyer, Mohs surgery defense lawyer, dermatologist legal representation, legal representation in Mohs surgery litigation, The Health Law Firm, health law attorney, health law defense lawyer, health care fraud attorney, whistle blower attorney, Anti-Kickback Statute (AKS) attorney, False Claims Act defense lawyer, FCA attorney, illegal kickbacks, DOJ settlement attorney, government health care fraud, health fraud and abuse allegations, health fraud attorney, complex medical litigation defense lawyer, complex health care litigation defense attorney, legal representation in complex medical business litigation, FCA legal representation, whistle blower defense attorney, Florida qui tam whistle blower attorney, Colorado qui tam whistle blower lawyer, Louisiana qui tam whistle blower attorney, Kentucky qui tam whistle blower lawyer, Virginia qui tam whistle blower attorney, District of Columbia (D.C.) qui tam whistle blower lawyer, Florida False Claims Act (FCA) and civil monetary penalties attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer, Virginia False Claims Act (FCA) and civil monetary penalties attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

By |2020-05-07T12:43:17-04:00May 7th, 2020|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Hospital Countersues Whistleblower for Failing to Report Conduct Internally First

George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the whistleblower/relator in the lawsuit, breached his fiduciary duty to the company by failing to report the unlawful conduct internally, first. Instead, he used the information as the basis for his whistleblower claim. In the countersuit filed in the U.S. District Court for the Northern District of West Virginia, the Hospital accuses the former executive-turned-whistleblower of attempting to ‘extort a settlement’ and filing the FCA whistleblower suit as an act of revenge.

The Whistleblower’s Complaint.

The whistleblower, a former accountant, and senior executive at Wheeling Hospital, was discharged in August 2015. In December 2017, he filed a complaint under the qui tam provisions of the False Claims Act (FCA). He alleged the hospital violated the federal Anti-Kickback Statute (AKS) by paying kickbacks to physicians for patient referrals to the Hospital. Based on this, it is alleged, the claims for the services the hospital provided to the referred patients were false claims, subject to recoupment by the government.

The Hospital’s Countersuit.

In an unusual strategy, the Hospital filed a counter-suit against the whistleblower, alleging that he breached his fiduciary duty to the Hospital and abused the legal process. The Hospital’s case asserts that instead of carrying out his duty to the Hospital, instead, he capitalized on his alleged knowledge of the conduct to “extort a settlement” through a “false and frivolous” FCA suit as an act of revenge.

Additionally, the Hospital alleges that “at no time during his employment, or in his role as a partner at Deloitte, did he report any suspicions of fraud or violations of federal regulations to Wheeling Hospital’s compliance officer.”

You can read Wheeling Hospital’s countersuit against the whistleblower on our website in full.

The Significance of This Case: Unique Defense Strategy for Defending a Whistleblower Suit.

This case shows a unique, but legally valid, defense strategy that might be used in other future whistleblower cases. Often the information about false claims is produced by a high-ranking hospital or institutional employees whose job duties may have required them to report what they knew to the company as part of their job. The company should then have the opportunity to investigate and correct any improper billing or other misconduct that an errant employee might be carrying out on his own. By failing to do this, the employee may breach his duties to the company, may violate his employment contract, and may be subject to a suit or counter-suit over this. To the extent that the actions of the ex-employee cause the employer damages, the employer may be entitled to indemnification from the ex-employee.

However, the other side of the story is when an employee does make his or her superiors aware of suspected misconduct and false claims within the company and the company does nothing about it. This is often the case that we have when potential blowers contact us about filing a False Claims Act case. Often the whistleblower attempts to do the right thing by reporting it within the company and is stymied by his or her superiors. To us, this opens the door to legitimate whistleblower suits.

To read one of my prior blogs about South Florida Hospital reaching a settlement for similar FCA
claims, click here.

Click here to learn more about who can file a whistleblower/qui tam lawsuit and the reward programs for coming forward with a false claim.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities that have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

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

Sources:

Pearlman, Steve and Freeman, Meika. “Top 10 Whistleblowing And Retaliation Events Of The Year.” Law360. (December 20, 2019). Web.

Goldberg, Pinchos. “Hospital Sues Whistleblower for Failing to Report Information And Choosing Instead to Use As Basis for Claim.” JD Supra. (May 8, 2019). Web.

Commins, John. “HOSPITAL COUNTERSUES FALSE CLAIMS WHISTLEBLOWER.” Health Leaders. (May 9, 2019). Web.

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

Keywords: Florida health law attorney, whistleblower attorney, whistleblower defense lawyer, Florida health law defense attorney, whistleblower defense attorney, whistleblower defense legal counsel, legal representation for whistleblower cases, qui tam lawyer, health law attorney, qui tam defense lawyer, qui tam plaintiff lawyer, whistleblower legal representation, False Claims Act lawyer, False Claims Act attorney, False Claims Act legal counsel, The Health Law Firm, DOJ defense lawyer, Office of Inspector General (OIG) defense counsel, Office of Inspector General (OIG) defense attorney, Office of Inspector General (OIG) legal representation, medcila legal defense attorney, health care fraud attorney, health care fraud lawyer, attorney legal representation for qui tam cases, Anti-Kickback Statute (AKS) attorney, Anti-Kickback Statute (AKS) lawyer, Anti-Kickback Statute (AKS) defense counsel, Medicare fraud defense lawyer attorney, Medicare fraud legal representation, Medicaid fraud defense lawyer attorney, legal representation for Medicare and Medicaid fraud, legal representation for Stark Law violations, healthcare fraud defense attorney, whistle blower lawyer attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida qui tam whistle blower lawyer attorney, Colorado qui tam whistle blower lawyer attorney, Louisiana qui tam whistle blower lawyer attorney, Kentucky qui tam whistle blower lawyer attorney, Virginia qui tam whistle blower lawyer attorney, District of Columbia (D.C.) qui tam whistle blower lawyer attorney, civil monetary penalties lawyer attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer attorney legal counsel, Virginia False Claims Act (FCA) and civil monetary penalties lawyer attorney, Virginia whistleblower lawyer attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer attorney, civil monetary penalties lawyer attorney

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

By |2019-12-30T21:22:42-05:00March 16th, 2020|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Hospital Countersues Former Employee for Failing to Report Information Internally in FCA Suit

George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the whistleblower/relator in the lawsuit, breached his fiduciary duty to the company by failing to report the unlawful conduct internally, first. Instead, he used the information as the basis for his whistleblower claim. In the countersuit filed in the U.S. District Court for the Northern District of West Virginia, the Hospital accuses the former executive-turned-whistleblower of attempting to ‘extort a settlement’ and filing the FCA whistleblower suit as an act of revenge.

The Whistleblower’s Complaint.

The whistleblower, a former accountant, and senior executive at Wheeling Hospital, was discharged in August 2015. In December 2017, he filed a complaint under the qui tam provisions of the False Claims Act (FCA). He alleged the hospital violated the federal Anti-Kickback Statute (AKS) by paying kickbacks to physicians for patient referrals to the Hospital. Based on this, it is alleged, the claims for the services the hospital provided to the referred patients were false claims, subject to recoupment by the government.

The Hospital’s Countersuit.

In an unusual strategy, the Hospital filed a counter-suit against the whistleblower, alleging that he breached his fiduciary duty to the Hospital and abused the legal process. The Hospital’s case asserts that instead of carrying out his duty to the Hospital, instead, he capitalized on his alleged knowledge of the conduct to “extort a settlement” through a “false and frivolous” FCA suit as an act of revenge.

Additionally, the Hospital alleges that “at no time during his employment, or in his role as a partner at Deloitte, did he report any suspicions of fraud or violations of federal regulations to Wheeling Hospital’s compliance officer.”

You can read Wheeling Hospital’s countersuit against the whistleblower on our website in full.

The Significance of This Case: Unique Defense Strategy for Defending a Whistleblower Suit.

This case shows a unique, but legally valid, defense strategy that might be used in other future whistleblower cases. Often the information about false claims is produced by a high-ranking hospital or institutional employees whose job duties may have required them to report what they knew to the company as part of their job. The company should then have the opportunity to investigate and correct any improper billing or other misconduct that an errant employee might be carrying out on his own. By failing to do this, the employee may breach his duties to the company, may violate his employment contract, and may be subject to a suit or counter-suit over this. To the extent that the actions of the ex-employee cause the employer damages, the employer may be entitled to indemnification from the ex-employee.

However, the other side of the story is when an employee does make his or her superiors aware of suspected misconduct and false claims within the company and the company does nothing about it. This is often the case that we have when potential blowers contact us about filing a False Claims Act case. Often the whistleblower attempts to do the right thing by reporting it within the company and is stymied by his or her superiors. To us, this opens the door to legitimate whistleblower suits.

To read one of my prior blogs about South Florida Hospital reaching a settlement for similar FCA
claims, click here.

Click here to learn more about who can file a whistleblower/qui tam lawsuit and the reward programs for coming forward with a false claim.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities that have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

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

Sources:

Pearlman, Steve and Freeman, Meika. “Top 10 Whistleblowing And Retaliation Events Of The Year.” Law360. (December 20, 2019). Web.

Goldberg, Pinchos. “Hospital Sues Whistleblower for Failing to Report Information And Choosing Instead to Use As Basis for Claim.” JD Supra. (May 8, 2019). Web.

Commins, John. “HOSPITAL COUNTERSUES FALSE CLAIMS WHISTLEBLOWER.” Health Leaders. (May 9, 2019). Web.

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

Keywords: Florida health law attorney, whistleblower attorney, whistleblower defense lawyer, Florida health law defense attorney, whistleblower defense attorney, whistleblower defense legal counsel, legal representation for whistleblower cases, qui tam lawyer, health law attorney, qui tam defense lawyer, qui tam plaintiff lawyer, whistleblower legal representation, False Claims Act lawyer, False Claims Act attorney, False Claims Act legal counsel, The Health Law Firm, DOJ defense lawyer, Office of Inspector General (OIG) defense counsel, Office of Inspector General (OIG) defense attorney, Office of Inspector General (OIG) legal representation, medcila legal defense attorney, health care fraud attorney, health care fraud lawyer, attorney legal representation for qui tam cases, Anti-Kickback Statute (AKS) attorney, Anti-Kickback Statute (AKS) lawyer, Anti-Kickback Statute (AKS) defense counsel, Medicare fraud defense lawyer attorney, Medicare fraud legal representation, Medicaid fraud defense lawyer attorney, legal representation for Medicare and Medicaid fraud, legal representation for Stark Law violations, healthcare fraud defense attorney, whistle blower lawyer attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida qui tam whistle blower lawyer attorney, Colorado qui tam whistle blower lawyer attorney, Louisiana qui tam whistle blower lawyer attorney, Kentucky qui tam whistle blower lawyer attorney, Virginia qui tam whistle blower lawyer attorney, District of Columbia (D.C.) qui tam whistle blower lawyer attorney, civil monetary penalties lawyer attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer attorney legal counsel, Virginia False Claims Act (FCA) and civil monetary penalties lawyer attorney, Virginia whistleblower lawyer attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer attorney, civil monetary penalties lawyer attorney

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

By |2019-12-30T21:18:07-05:00February 24th, 2020|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Hospital Countersues Whistleblower for Failing to Report Information Internally in FCA Suit

George F. Indest IIIBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On March 13, 2019, a West Virginia hospital facing a whistleblower lawsuit countersued a former employee who filed the False Claims Act (FCA) lawsuit against the health system. Wheeling Hospital alleges that the former executive, who is the whistleblower/relator in the lawsuit, breached his fiduciary duty to the company by failing to report the unlawful conduct internally, first. Instead, he used the information as the basis for his whistleblower claim. In the countersuit filed in the U.S. District Court for the Northern District of West Virginia, the Hospital accuses the former executive-turned-whistleblower of attempting to ‘extort a settlement’ and filing the FCA whistleblower suit as an act of revenge.

The Whistleblower’s Complaint.

The whistleblower, a former accountant, and senior executive at Wheeling Hospital, was discharged in August 2015. In December 2017, he filed a complaint under the qui tam provisions of the False Claims Act (FCA). He alleged the hospital violated the federal Anti-Kickback Statute (AKS) by paying kickbacks to physicians for patient referrals to the Hospital. Based on this, it is alleged, the claims for the services the hospital provided to the referred patients were false claims, subject to recoupment by the government.

The Hospital’s Countersuit.

In an unusual strategy, the Hospital filed a counter-suit against the whistleblower, alleging that he breached his fiduciary duty to the Hospital and abused the legal process. The Hospital’s case asserts that instead of carrying out his duty to the Hospital, instead, he capitalized on his alleged knowledge of the conduct to “extort a settlement” through a “false and frivolous” FCA suit as an act of revenge.

Additionally, the Hospital alleges that “at no time during his employment, or in his role as a partner at Deloitte, did he report any suspicions of fraud or violations of federal regulations to Wheeling Hospital’s compliance officer.”

You can read Wheeling Hospital’s countersuit against the whistleblower on our website in full.

The Significance of This Case: Unique Defense Strategy for Defending a Whistleblower Suit.

This case shows a unique, but legally valid, defense strategy that might be used in other future whistleblower cases. Often the information about false claims is produced by a high-ranking hospital or institutional employees whose job duties may have required them to report what they knew to the company as part of their job. The company should then have the opportunity to investigate and correct any improper billing or other misconduct that an errant employee might be carrying out on his own. By failing to do this, the employee may breach his duties to the company, may violate his employment contract, and may be subject to a suit or counter-suit over this. To the extent that the actions of the ex-employee cause the employer damages, the employer may be entitled to indemnification from the ex-employee.

However, the other side of the story is when an employee does make his or her superiors aware of suspected misconduct and false claims within the company and the company does nothing about it. This is often the case that we have when potential blowers contact us about filing a False Claims Act case. Often the whistleblower attempts to do the right thing by reporting it within the company and is stymied by his or her superiors. To us, this opens the door to legitimate whistleblower suits.

To read one of my prior blogs about South Florida Hospital reaching a settlement for similar FCA
claims, click here.

Click here to learn more about who can file a whistleblower/qui tam lawsuit and the reward programs for coming forward with a false claim.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistleblower or qui tam) case. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities that have been sued in False Claims Act (whistleblower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

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

Sources:

Pearlman, Steve and Freeman, Meika. “Top 10 Whistleblowing And Retaliation Events Of The Year.” Law360. (December 20, 2019). Web.

Goldberg, Pinchos. “Hospital Sues Whistleblower for Failing to Report Information And Choosing Instead to Use As Basis for Claim.” JD Supra. (May 8, 2019). Web.

Commins, John. “HOSPITAL COUNTERSUES FALSE CLAIMS WHISTLEBLOWER.” Health Leaders. (May 9, 2019). Web.

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

Keywords: Florida health law attorney, whistleblower attorney, whistleblower defense lawyer, Florida health law defense attorney, whistleblower defense attorney, whistleblower defense legal counsel, legal representation for whistleblower cases, qui tam lawyer, health law attorney, qui tam defense lawyer, qui tam plaintiff lawyer, whistleblower legal representation, False Claims Act lawyer, False Claims Act attorney, False Claims Act legal counsel, The Health Law Firm, DOJ defense lawyer, Office of Inspector General (OIG) defense counsel, Office of Inspector General (OIG) defense attorney, Office of Inspector General (OIG) legal representation, medcila legal defense attorney, health care fraud attorney, health care fraud lawyer, attorney legal representation for qui tam cases, Anti-Kickback Statute (AKS) attorney, Anti-Kickback Statute (AKS) lawyer, Anti-Kickback Statute (AKS) defense counsel, Medicare fraud defense lawyer attorney, Medicare fraud legal representation, Medicaid fraud defense lawyer attorney, legal representation for Medicare and Medicaid fraud, legal representation for Stark Law violations, healthcare fraud defense attorney, whistle blower lawyer attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida qui tam whistle blower lawyer attorney, Colorado qui tam whistle blower lawyer attorney, Louisiana qui tam whistle blower lawyer attorney, Kentucky qui tam whistle blower lawyer attorney, Virginia qui tam whistle blower lawyer attorney, District of Columbia (D.C.) qui tam whistle blower lawyer attorney, civil monetary penalties lawyer attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer attorney legal counsel, Virginia False Claims Act (FCA) and civil monetary penalties lawyer attorney, Virginia whistleblower lawyer attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer attorney, civil monetary penalties lawyer attorney

The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2020 The Health Law Firm. All rights reserved

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Got a Letter From the USMLE Secretariat Accusing You of Irregular Behavior on the November 2019 Step 2 CS Exam? You Need Legal Help!

George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Have you recently received a letter from the United States Medical Licensing Examination (USMLE) Secretariat or the Educational Commission for Foreign Medical Graduates (ECFMG) accusing you of irregular behavior? We have recently been made aware of letters being sent out in January to a number of those who took the Step 2 CS Exam in Houston.

Allegations are being made that some of the test takers (and we understand that there were hundreds taking Step 2 CS prep courses and studying before the examination) may have had actual information from the exam that they were sharing.

The USMLE has often made allegations of this nature regarding notes, outlines, and other materials that individual students and study groups have assembled on their own, using their deductive reasoning and experience. They often accuse the students of having obtained the information directly from the tests, which is, of course, a violation of USMLE and ECFMG policies.

You must challenge such allegations of irregular behavior, explain and refute them and request a hearing on them. Otherwise, you are likely to be found guilty of having committed “irregular behavior” which most medical and residency program administrators and directors consider the same as cheating. Furthermore, if that happens, then all of your future transcripts of your USMLE test scores are then stamped with “IRREGULAR BEHAVIOR” and a letter with the charges against you is attached to it. It then goes with the transcripts whenever they are sent out in the future. This could ruin your chances of getting a license, chances of getting a good residency program and could ruin your whole career as a physician.

Other Types of “Irregular Behavior.”

Examples of the types of conduct which we have seen before include:

– Attending a commercial USMLE preparation course that provides some of the actual examination questions.

– Soliciting information on the contents or questions on the examination.

– Using a cell phone during the examination.

– Talking with another person during the examination.

– Sharing information on the types of questions or cases that were on your examination with another person or a blog over the internet.

These are just a few. For more examples, please see another blog I wrote on this by clicking here.

What Should You Do?

What should you do if you find yourself in this situation?

1. First of all, don’t panic. Read the letter carefully and figure out exactly what is being charged against you.

2. Do not delete or destroy any e-mails, test prep materials or study materials you have on your computer. Your attorney may be able to use these to help defend you.

3. Retain the services of a good, experienced health law attorney who is familiar with the USMLE, ECFMG, and the hearings and proceedings these organizations have. By experience, I mean someone who has represented individuals accused of irregular behavior at the hearings held in Philadelphia on this. Retain one right away.

4. Check the background of whatever attorney you consider hiring to make sure he has the experience and has no unfavorable actions against him in his background.

5. Obtain copies of any receipts you may have had for prep courses and prep materials you ordered or took.

6. Your attorney will request a copy of any files or investigation the USMLE or ECFMG has on you so that you can see what you may need to refute.

7. Do not let the time period go by for requesting a hearing and submitting information and documents.

8. Start obtaining character reference letters and copies of any awards, achievements or accomplishments you have.

9. Submit a good, well-organized package of documents to the organization for the hearing.

10. Request an in-person hearing and be prepared to get to Philadelphia a day ahead of time to work with your attorney to prepare for the hearing.

The foregoing are just a few of the many steps that I try to follow in every case.

Our attorneys have represented many individuals in many different hearings, appeals and test challenges over the years. We can help you.

Again, it is crucial to act decisively and act promptly to prove your innocence and preserve your valuable career in medicine. Click here to learn more about how the firm can help you with USMLE and irregular behavior matters.

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education, and those being challenged by the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat , and the Educational Commission for Foreign Medical Graduates (ECFMG)

The Health Law Firm and its attorneys represent interns, residents, fellows and medical school students in disputes with their medical schools, supervisors, residency programs and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs 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 any other matters. We routinely help those who have disputes with the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat , and the Educational Commission for Foreign Medical Graduates (ECFMG), including on hearings and appeals concerning “Irregular Behavior,” “unprofessionalism,” and “Irregular Conduct.”

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

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

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