Good News and Bad News for ECFMG & USMLE Applicants: Recent Changes for the USMLE Step Exams

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

These are some recently announced changes that could significantly impact anyone seeking to take the USMLE Step exams. This could be construed as good news by many and bad news by many others. Regardless, here it is.

Step 1 Exam Changing to Pass/Fail Grade and Score Reporting.

The USMLE announced recently that it would change the scoring and reporting for Step 1 exam scores. Step 1 score reporting will transition to pass/fail only for administrations on or after January 26, 2022. All of the worry about passing with a low score and how that might affect residency choices will be eliminated by this change.

Number of Attempts for Step 1 or Step 2 Exam Limited to Four (4) Lifetime Attempts.

Remember when you had no limit on the number of times you could take a USMLE Step exam? Remember when it was reduced to a maximum of six (6) attempts, not that long ago? Guess what? Not anymore!

Effective July 1, 2021, the number of attempts you can have to pass any USMLE Step exam will change. The change latest change reduces the total number of allowable attempts from six (6) attempts to four (4) attempts for any single Step exam, including any incomplete attempts. This is in effect for all applications submitted on or after July 1, 2021. So now, examinees who have already attempted any USMLE Step exam four (4) or more times and have not passed, will no longer be eligible to apply for the USMLE exams.

Is it possible to obtain an exemption? Depending on your circumstances, we can petition for one, but that does not mean it will be granted.

Step 2-CS Exam Completely Eliminated!!!!

Remember the Test of English as a Foreign Language (TOEFL), also known as “der Teufel” (1), that used to be required for Foreign Medical Graduates (now known as “International Medical Graduates” or “IMGs”)? No? Well, I don’t either.

Remember when the Step 2-CS was easily considered the most difficult exam for a foreign medical graduate to pass. Well, I do remember this!

The Step 2-CS (for “clinical skills”) exam was supposed to address any foreign language problems in practicing in the United States. This became, in my opinion, one of the biggest obstacles to for IMGs becoming licensed in the U.S. It was originally discontinued for approximately a year and a half because of problems caused by the COVID-19 epidemic.

Guess what? It doesn’t exist anymore. Accordingly, the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), co-sponsors of the United States Medical Licensing Examination (USMLE) by the USMLE Secretariat, announced on January 26, 2021, that it was discontinuing the Step 2-CS exam.

I guess the powers that be learned when they eliminated the Step 2-CS during the COVID-19 pandemic in 2020, that it was not so necessary after all. Now it is gone.

“Will it ever return, no it will never return; its fate is still unknown.”(1) There is no expectation that it will ever come back. What do you do now with all of those low score “fails” and lows test score “passes” you previously received on the Step 1 exam and the Step 2-CS? The answer is lost in chaos. We will just have to wait and see.

Major Chinese Medical Schools Disqualified in 2019.

See my next blog on what happened to eight (8) major Chinese medical schools so that their graduates cannot take the Step exams or become licensed in the U.S. anymore. Click here to read about the Chines medical schools.

Endnotes:

(1) German for “the Devil”

(2) Paraphrase of verse from “MTA” [standing for the Boston Metropolitan Transit Authority or subway train] written by Jacqueline Steiner and Bess Lomax Hawes, recorded and made famous by The Kingston Trio in 1959.

(3) Answer to the final question asked at the end of every episode of the Japanese Anime series “Dorohedoro” or “Doro and Doro” (2020) (available on Netflix), about a man named “Caiman” who wakes up one morning with the head of a lizard and amnesia and searches for the reason.

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.

Sources:

“USMLE policy updates following Step 2 CS discontinuation.” United States Medical Licensing Examination Announcements. (July 21, 2021). Web.

About the Author: George F. Indest III, J.D., M.P.A., L.L.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

 

“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 © 2021 The Health Law Firm. All rights reserved.

 

 

Eight Major Chinese Medical Schools No Longer Listed in World Directory Relied on by ECFMG and USMLE

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

In April 2014, the new World Directory of Medical Schools (“World Directory”) was published. It took over as the definitive list of medical schools in the world (yes, the whole world). There are 180 Chinese medical schools listed on the World Directory of Medical Schools. Medical graduates from these schools are routinely eligible to take the United States Medical Licensing Examination (USMLE) Step exams, required for licensing in the United States, after applying and obtaining permission through the Educational Commission for Foreign Medical Graduates (ECFMG).

However, in 2019, eight (8) previously recognized Chinese medical schools were dropped from the World Directory or “delisted.” According to the Korean Medical Association (KMA)’s Research Institute for Medical Policy, the World Federation for Medical Education (WFME) (the organization that maintains and publishes the directory) deleted the eight Chinese medical schools from the World Directory. The eight (8) Chinese medical schools were delisted from the World Directory of Medical Schools (WDMS) a year after Oriental medical schools in Korea also failed to be listed on the directory any longer.

The eight “delisted” medical schools are Beijing University of Chinese Medicine, Guiyang College of Traditional Chinese Medicine, Heilongjiang University of Chinese Medicine, Liaoning University of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanxi College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, and Yunnan University of Traditional Chinese Medicine.

According to the Korean Medical Association’s reports and other publications, the WFME’s decisions clearly show that the world’s medical community does not recognize both Korea’s Oriental medicine and traditional Chinese [Oriental] medicine as modern, scientifically-based medicine.

What Does This Mean?

This means that if you graduated from one of the delisted eight (8) Chinese medical schools, you will no longer be allowed to apply for and receive services from the Educational Commission for Foreign Medical Graduates (ECFMG). In addition, it means you will not be able to apply for and take the Step exams administered by the United States Medical Licensing Examination (USMLE) Secretariat, and you will not be able to become licensed in the United States.

Hey, Don’t Shoot Me! I’m Just the Messenger!

Inquiries and other correspondence regarding the World Directory may be sent to [email protected] or to:

World Federation for Medical Education
13A Chemin du Levant
01210 Ferney-Voltaire
France
www.wfme.org

What Might Possibly Be Done?

Some ideas that might (or might not) work include:

1. Graduates of the delisted schools might apply for recognized medical schools and seek to graduate from one of these. Whether or not you will be able to get any credit for your prior medical school is a different question.

2. Bring pressure on your delisted medical school to add courses and curricula to meet the same requirements as a “Western” medical school or “scientific medical school.”

3. Sorry, that’s about all I could think of. Petitioning for an exception or suing the ECFMG or USMLE is a “non-starter” by my way of thinking.

To read about a similar case involving a Caribbean medical school, click 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.

Sources:

Yuqiao, Ji. “TCM [tradional Chinese Medicine] grads struggle after removal from world medical list.” Global Times. (Nov. 18, 2019) (https://www.globaltimes.cn/content/1170466.shtml).

Gwang-seok, I. “8 Chinese medical schools delisted from world directory of medical schools.” Korea Biomedical Review. (November 7, 2019). (https://www.koreabiomed.com/news/articleView.html?idxno=6769).

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888)-331-6620.

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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 © 2021 The Health Law Firm. All rights reserved.

 

 

 

Accused of Irregular Behavior on the USMLE? Here’s What You Will Do Wrong

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

We frequently receive calls for consultations from students who receive a letter from the National Board of Medical Examiners (NBME) accusing the medical student or medical resident of “Irregular Behavior” on the United States Medical Licensing Examination (USMLE). In many cases, these are graduates of foreign medical schools who have applied through the Examination Committee for Foreign Medical Graduates (ECFMG).

Irregular behavior can consist of many different things before, during, or after taking the USMLE. What you must know is that, in effect, you are being accused of cheating.

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 on a blog over the internet.

These are just a few. For more examples, please read this previous article.

Most Common Errors You Will Make When Accused of Irregular Behavior.

We have represented students accused of irregular behavior by consulting with them before and after USMLE hearings and appealing the results. We have represented many examinees at the hearings held before the NBME at its headquarters in Philadelphia, Pennsylvania.

From our experience in such cases, the following are the errors that most of you will make when accused by the USMLE of irregular behavior.

1. You will fail to obtain an attorney experienced with such cases immediately upon receipt of a letter from the NBME accusing you of irregular behavior. Take this as a formal charge accusing you of, in effect, cheating. THIS IS SERIOUS.

2. You will telephone, write, or e-mail the NBME and explain “your side of the story.” This will be full of admissions that will help prove the case against you and you will not even understand this. (Please note that under U.S. law any statements you make, oral or written, can be used as evidence against you in any civil, criminal or administrative proceeding. This is not the case with statements that your attorney makes on your behalf.)

3. If you submit documents or statements to the NBME in support of your case, these will not be well-organized, well-labeled and in a form simple and easy to understand. In many instances, you will not even understand the legal issues you are facing or how to refute them.

4. You will fail to request or attend in person the hearing before the NBME Committee on Irregular Behavior (“The Committee”) in Philadelphia, Pennsylvania.

5. You will fail to take an attorney experienced in such medical administrative hearings to represent you at The Committee hearing in Philadelphia.

6. You will not know how to properly present your evidence or present your own position to The Committee, if you do attend the hearing.

7. You will not know when or what kind of witnesses, including expert witnesses, you need to use to prove issues in your case before The Committee.

8. You will fail to understand and correctly respond to the questions that the many different Committee members (usually 15 or more) will ask you during the hearing.

9. You will fail to correctly follow all procedures in order to preserve your rights in the proceedings.

10. You will falsely believe that if you lose at The Committee hearing you can win on appeal or somehow sue in court and prove you are right; this is almost never correct. You will have only one chance at proving your case and this is at The Committee hearing in Philadelphia.

11. You will incorrectly believe that even if you are only suspended from taking the USMLE again for a short period of time, this will have no effect on your education or career. (Note: Your USMLE transcript will note this fact and this will probably prevent you from ever getting into a good residency program. See #1 above.)

Invest in Your Future Career.

You and your family have invested tens of thousands, if not hundreds of thousands of dollars, in your education so that you can become a physician. You have spent years of sacrifice and studying to become a physician. This is not the time to be cheap and to think that the cost of hiring an experienced legal counsel is too high. You could lose everything you and your family have invested in this. Do not be “penny wise and pound foolish.” You will need professional help if you are to get through this successfully. If you don’t care about these matters or you don’t believe this is a serious matter worthy of an investment for attorney’s fees, then go ahead and ignore this advice.

If you are not reading this until after you have lost the case and been found to have committed “irregular behavior” by the USMLE Committee on Irregular Behavior, I am sorry for you, but it is probably too late to do anything about it.

Contact Experienced Health Law Attorneys Today.

The attorneys of The Health Law Firm provide legal representation to medical students, residents, interns, and fellows in academic disputes, graduate medical education (GME) hearings, 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 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 Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or toll-free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2024 George F. Indest III, The Health Law Firm. All rights reserved. No part of this work may be reproduced in any way in any medium without the written permission of the copyright owner. The author of this work reserves the right to have his name associated with any use or publication of this work or any part of it.

 

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. For additional information, click here to read our E-book on “Tips for Answering Allegations of Irregular Behavior For USMLE Step Exams.”


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. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2024 George F. Indest III, The Health Law Firm. All rights reserved. No part of this work may be reproduced in any way in any medium without the written permission of the copyright owner. The author of this work reserves the right to have his name associated with any use or publication of this work or any part of it.

What is the Cost For Legal Defense in a Hospital Medical Staff Peer Review Fair Hearing?

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

If you are a physician, nurse practitioner, oral surgeon, dentist, or other health professional with clinical privileges in a hospital, you may face a situation where you are required to defend yourself at a “fair hearing.”  A “fair hearing” is held by the hospital’s medical staff pursuant to the Medical Staff Bylaws or Rules and Regulations of the Medical Staff.

“Fair Hearing”–A Term of Art.

The hearing is called a “fair hearing,” which is a term of art.  Usually, those defending themselves at such hearings don’t find them to be fair at all. However, according to the federal Health Care Quality Improvement Act (HCQIA), such proceedings are required to provide the affected healthcare practitioner with certain “due process,” such as the right to be advised of the specific charges made against them, the right to legal representation, the right to produce witnesses and evidence of their own and other rights.

Be Sure You Have Professional Liability Insurance That Includes Coverage for Clinical Privileges Actions.

If you face such a hearing, you will find it difficult to find an experienced lawyer to represent you and, when you do, it will be a costly endeavor.  This is one of the primary reasons to purchase good professional liability insurance, including legal defense of such peer review actions. Unfortunately, most insurance companies that provide such coverage have limits far too low to pay all legal defense expenses you will probably incur.

Standard Insurance Coverage Amounts May Not Be Sufficient to Protect You Properly.

However, the basic amount provided for such coverage in most insurance policies is not sufficient to cover the actual expenses of the proceeding.  Standard coverage amounts are usually in amounts of $25,000, $35,000, or $50,000;  again, these are not sufficient to pay for even the most basic fair hearing.  Some insurers have much higher limits;  it is important to find out precisely what you have to increase the coverage or buy additional coverage.

There are often additional “riders” to insurance policies that you can purchase, “additional coverages,” or even a completely separate policy that will provide such legal defense coverage for you.  It is usually not that expensive and is worth inquiring about.  This type of coverage often goes hand-in-hand with professional license defense coverage as one can cause the other to occur. For example, a hospital peer review action can result in a report to your state licensing board. A licensing complaint or action may cause hospital peer review action to be initiated against you.

You should think of a “fair hearing” as similar to a medical malpractice trial and plan accordingly.


Costs and Expenses of a “Fair Hearing”

One of the most significant expenses you will incur in preparing for a “fair hearing” is expert witness fees. In almost every case we have ever had, obtaining one or more expert witnesses to testify at the hearing has been necessary.  Obtaining experts in medical sub-specialties will cost more, of course, than those in specialties such as family medicine and internal medicine.  It is often difficult to find an expert witness who will not only support your position in the case but will also show up at the hospital to testify at the “fair hearing.”

Additionally, the mere preparation for the hearing (including document reviews and working with the expert witnesses) and representation at the hearing is a time-intensive endeavor.  It has been our experience that even the most routine “fair hearing” costs approximately $100,000. For example, in one case we had involving several different areas of spinal surgery, requiring five (5) expert witnesses, cost in excess of $250,000 (note:  all charges against the doctor were dismissed at the hearing).

Conclusion.

Peer review “fair hearings” in hospitals are costly to defend and require an experienced attorney and the financial resolve to see the case through to its conclusion.  Often insurance does not provide sufficient coverage for such hearings. Therefore, physicians, nurse practitioners, oral surgeons, psychologists, and others having hospital clinical privileges should purchase additional coverage for such events and hire experienced legal counsel to represent them at the earliest stage of the proceedings.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers in Peer Review and “Fair Hearing” Matters.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

About the Author: George F. Indest III, J.D., M.P.A., L.L.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“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 © 2021 The Health Law Firm. All rights reserved.

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

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

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.

Are You the Target of a Medicaid Audit? Tips Health Professionals Should Be Following

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

The Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), and Bureau of Medicaid Program Integrity is the Florida agency responsible for routine Medicaid audits The agency ensures that the Medicaid program was billed correctly for services by health care professionals. Those receiving the greatest amounts of Medicaid payments are also the ones most likely to be audited.

These include pediatricians, Ob/Gyns, family practice physicians, and dentists. The Medicaid audit usually requests information in a questionnaire form. It also includes a request for copies of medical records (including X-rays and other diagnostic studies) for the patients selected for the audit.

If AHCA determines that Medicaid overpaid for services, it will use a complex mathematical extrapolation formula to determine the repayment amount. Additionally, fines and penalties can be added by the Medicaid program. However, you can eliminate or reduce the amount of any such repayment by actions taken both before and during the Medicaid audit.

Practical Tips for Your Practice.

There are ways to run the everyday practice that will help you if you are selected for a Medicaid audit.
1. Every patient record entry should be clearly dated and signed or initialed by the provider. Make sure this is always done.

2. When documenting the patient’s record, make sure that you document exactly what services were needed and completed to support what was billed to Medicaid.

3. Communicate with the person responsible for your billing so that the actual services provided are billed for. Do not bill in advance for anticipated services needed as indicated in the appointment calendar or on a treatment plan.

4. Keep the patient records organized and ready for copying, if necessary. Using only one-sided documents and securely fastening small forms (prescriptions, telephone memos, small sticky notes) onto 8-1/2″ by 11″ paper will help those still using paper charts. Scan all such documents into the patient record using an electronic health record (EHR).

5. Services provided by a physician not enrolled in the Medicaid program to a Medicaid patient may not be billed to or paid by the Medicaid program. Therefore, never allow any other physician associated with your practice who is not enrolled as a Medicaid provider to provide services to Medicaid patients. Do not allow a new physician coming into your practice to treat Medicaid patients until he or she actually has received his or her Medicaid provider number. The group may not bill for the services, nor may another physician bill for the services.

6. Ensure that all health care professionals’ licenses and permits are updated. Ensure that all X-rays, clinical lab, and diagnostic equipment are permitted and kept up to date. Ensure that any CLIA license or exemption certificate is correct and kept up to date. Services billed by unlicensed personnel or services provided by improperly-licensed facilities may not be paid by the Medicaid program.

7. Use only standard abbreviations in your medical records documentation, orders, and reports. While an abbreviation may seem familiar to you or your practice, the auditors may not recognize it if it is not a universally accepted abbreviation.

8. Make sure all records are timely made, accurate and legible. Safeguard them, and never let the original leave your office. Illegible records are treated as a non-record, and payment is wholly disallowed for an illegible note or order. A missing record, X-ray, or chart entry will result in a complete repayment being directed for those services.


The Medicaid Audit.

If you are on the receiving end of an audit, AHCA will send you a letter notifying you. AHCA will also supply you with a list of patients to be sampled. A standard sample will include a list of anywhere from 30 to 150 patient names, as a general rule, depending on the size of the practice. Regular audits routinely request 30 to 50 patients’ records. The audit letter will also include a questionnaire to be completed (Medicaid Provider Questionnaire) and a “Certification of Completeness of Records” form to complete and return with the copies of the patient records. (Please note: This will be used against you in the future if you attempt to add or supplement the copies of the records you provided.)

For more information, read a past blog that will let you know if you are the subject of an audit.

You must retain the services of an expert consultant or experienced health care attorney to correctly and accurately complete the questionnaire. The letter will also request that you provide copies of the patient records for the list of patients included with the letter. You will only be given a short time to provide these documents.

If you have been accused of Medicaid fraud and need to prepare for an audit, watch our informational video blog.

Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations and other Legal Proceedings.

Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Healthcare Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health law attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.

The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (AFLs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

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

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

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2018 The Health Law Firm. All rights reserved.

Iowa Appellate Court Reverses $6 Million Nursing Home Negligence Decision Because of Hearsay Testimony

Author HeadshotBy George F. Indest III, J.D., M.P.A, LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm
On June 21, 2023, the Iowa Court of Appeals overturned the verdict in a nursing home negligence case that awarded $6 million in compensation and damages to the plaintiff. The case was reversed and remanded for a new trial because the trial court judge admitted inadmissible hearsay testimony into evidence. The testimony being appealed was that of staff members who claimed to have heard “reports” and “rumors” of alleged abuse by a nurse on staff toward not only the resident in question but other residents.
Hearsay in Iowa law is defined as “a statement, other than one made by the declarant while testifying at the trial or hearing, offered to prove the truth of the matter asserted.” Click here to read the Iowa Rules of Evidence concerning hearsay. This is the same definition used by the federal and most other courts.
Essentially, hearsay is when someone repeats something they heard from another person and presents it as if they know it to be true. Hearsay is often equated to rumor. Hearsay is not admissible due to the nature of speculation required in making such a statement, the fact that such statements are inherently unreliable and that the actual witness is not in court to answer questions about it. Thus there is no way for a party or the judge to test the credibility of the actual witness or determine facts that may have influenced the observation and statement.
Hearsay is considered unreliable because the person who knows what happened (who saw what happened or heard what happened) is not to be questioned about it. Therefore, there is no way to know what really happened for sure.
Details of the Case. 
In this case, the estate of the former nursing home resident, who succumbed to her injuries after a fall in the nursing home, claimed adult abuse and that negligence caused a wrongful death. In its defense, the nursing home focused on the alleged abuse by a nurse on the staff. The statements challenged in the appeal included testimony made by six nursing home staff members that residents, other unnamed employees, and an Iowa Department of Inspections and Appeals surveyor told them that the nurse in question had been physically rough with and swore at residents.
The employees testifying did not actually witness any such incidents. They were only testifying about someone else’s words (“hearsay”). 
The trial court admitted these statements, allegedly not for their truth, but in an attempt to show that abuse had been reported and there had not been any follow-up investigation. The appellate court stated that this was not a valid reason to admit inadmissible hearsay into evidence because the estate must prove that the conduct existed to prevent the jury from engaging in rampant speculation based on unreliable hearsay evidence.
People in today’s society, yes, even judges, often forget this basic principle of law. With all of the fabricated lies being put out as “news” on some news channels, Internet rumors running rampant, and politicians making egregiously false statements, it’s often hard to remember how to distinguish a fact from an unreliable rumor or hearsay.
This is one of the problems with hearsay. It is often just gossip and rumor, which change from person to person. Especially egregious conduct, criminal activity, and salacious acts become increasingly exaggerated with each retelling. The founding fathers in English and American law realized the inherently unreliable nature of such “evidence.”
Under the hearsay rule, the Court of Appeals agreed with the nursing home that the statements being challenged were inadmissible hearsay evidence that influenced the jury’s verdict. Due to this, the court reversed the verdict and remanded the case for a new trial. To read the court’s opinion in full, click here.
Contact Experienced Health Law Attorneys.
The Health Law Firm routinely represents health professionals and health facilities in civil and administrative litigation. We also represent physicians, nurses, and other health providers in investigations, regulatory matters, licensing issues, board hearings, inspections, and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies. Its attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.  We represent medical students, interns, resident physicians, and fellows in disputes with their graduate medical education (GME) programs.  We represent clinical professors and instructors in contract disputes, employment disputes, clinical privileges matters, and other disputes with their employers.  We often act as the physician’s personal counsel in medical malpractice litigation.
To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.
Source: 
About the Authors: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Hartley Brooks is a law clerk with the health law firm. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.
Attorney Positions with The Health Law Firm. The Health Law Firm always seeks qualified attorneys interested in health law practice. 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 © 2023 The Health Law Firm. All rights reserved.

Iowa Appellate Court Reverses $6 Million Nursing Home Negligence Decision Because of Hearsay Testimony

Author HeadshotBy George F. Indest III, J.D., M.P.A, LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm
On June 21, 2023, the Iowa Court of Appeals overturned the verdict in a nursing home negligence case that awarded $6 million in compensation and damages to the plaintiff. The case was reversed and remanded for a new trial because the trial court judge admitted inadmissible hearsay testimony into evidence. The testimony being appealed was that of staff members who claimed to have heard “reports” and “rumors” of alleged abuse by a nurse on staff toward not only the resident in question but other residents.
Hearsay in Iowa law is defined as “a statement, other than one made by the declarant while testifying at the trial or hearing, offered to prove the truth of the matter asserted.” Click here to read the Iowa Rules of Evidence concerning hearsay. This is the same definition used by the federal and most other courts.
Essentially, hearsay is when someone repeats something they heard from another person and presents it as if they know it to be true. Hearsay is often equated to rumor. Hearsay is not admissible due to the nature of speculation required in making such a statement, the fact that such statements are inherently unreliable and that the actual witness is not in court to answer questions about it. Thus there is no way for a party or the judge to test the credibility of the actual witness or determine facts that may have influenced the observation and statement.
Hearsay is considered unreliable because the person who knows what happened (who saw what happened or heard what happened) is not to be questioned about it. Therefore, there is no way to know what really happened for sure.
Details of the Case. 
In this case, the estate of the former nursing home resident, who succumbed to her injuries after a fall in the nursing home, claimed adult abuse and that negligence caused a wrongful death. In its defense, the nursing home focused on the alleged abuse by a nurse on the staff. The statements challenged in the appeal included testimony made by six nursing home staff members that residents, other unnamed employees, and an Iowa Department of Inspections and Appeals surveyor told them that the nurse in question had been physically rough with and swore at residents.
The employees testifying did not actually witness any such incidents. They were only testifying about someone else’s words (“hearsay”). 
The trial court admitted these statements, allegedly not for their truth, but in an attempt to show that abuse had been reported and there had not been any follow-up investigation. The appellate court stated that this was not a valid reason to admit inadmissible hearsay into evidence because the estate must prove that the conduct existed to prevent the jury from engaging in rampant speculation based on unreliable hearsay evidence.
People in today’s society, yes, even judges, often forget this basic principle of law. With all of the fabricated lies being put out as “news” on some news channels, Internet rumors running rampant, and politicians making egregiously false statements, it’s often hard to remember how to distinguish a fact from an unreliable rumor or hearsay.
This is one of the problems with hearsay. It is often just gossip and rumor, which change from person to person. Especially egregious conduct, criminal activity, and salacious acts become increasingly exaggerated with each retelling. The founding fathers in English and American law realized the inherently unreliable nature of such “evidence.”
Under the hearsay rule, the Court of Appeals agreed with the nursing home that the statements being challenged were inadmissible hearsay evidence that influenced the jury’s verdict. Due to this, the court reversed the verdict and remanded the case for a new trial. To read the court’s opinion in full, click here.
Contact Experienced Health Law Attorneys.
The Health Law Firm routinely represents health professionals and health facilities in civil and administrative litigation. We also represent physicians, nurses, and other health providers in investigations, regulatory matters, licensing issues, board hearings, inspections, and audits involving the DEA, Department of Health (DOH), and other law enforcement agencies. Its attorneys include those who are board-certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.  We represent medical students, interns, resident physicians, and fellows in disputes with their graduate medical education (GME) programs.  We represent clinical professors and instructors in contract disputes, employment disputes, clinical privileges matters, and other disputes with their employers.  We often act as the physician’s personal counsel in medical malpractice litigation.
To contact The Health Law Firm, please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.
Source: 
About the Authors: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, which has a national practice. Hartley Brooks is a law clerk with the health law firm. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.
Attorney Positions with The Health Law Firm. The Health Law Firm always seeks qualified attorneys interested in health law practice. 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 © 2023 The Health Law Firm. All rights reserved.

Florida Attorney Says AHCA Must Put Medicaid Final Orders Online

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

Florida’s Agency for Health Care Administration (AHCA) has come under fire for failing to make Medicaid final orders accessible to the public. On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against AHCA, trying to force AHCA into compliance with state public records laws.

Attorney Nancy Wright says the AHCA orders fall under a state law that requires all proceedings determined by a state agency to be placed into a centralized electronic database accessible to the public. This would allow citizens and healthcare providers more accessible access to those decisions and transparency when understanding Medicaid policies and decisions made by AHCA.

Access to Medicaid Final Orders.

The plaintiff’s attorney argued before a three-judge panel of the court of appeal that she should not be required to pay hundreds of dollars to gain access to Medicaid final orders to prepare for clients’ Medicaid hearings when the law requires the agency to publish these. The attorney further argued that this fee was an unfair and unjustified barrier to justice and that she should be given free access to these orders to ensure that she could provide the best possible representation for her clients.

More Details of the Case.

The Florida Health Justice Project and the National Health Law Program filed the lawsuit against AHCA on behalf of Wright in December 2020 in the First District Court of Appeal of Florida.
“[Medicaid law’s] notorious complexity and rapid regulatory changes put even lawyers on edge,” she said in a statement at the time she filed her suit. “AHCA’s unwillingness to make their [sic] final orders accessible means that I am not able to fully advise my clients on how and why decisions on services are being made. For the many enrollees who are unrepresented, this lack of transparency makes a complicated system almost impossible to navigate.”

Click here to view the press release from The Florida Health Justice Project.

However, the trial court sided with AHCA and granted summary judgment to the agency.

The Appeal.

The Elder Law Section of the Florida Bar expressed their support for Wright and submitted an amicus brief on appeal. They highlighted that the Florida Department of Children and Families regulates Medicaid eligibility proceedings with the same law that provides authority to AHCA. Furthermore, the Department publishes its final orders in an electronic database, making them readily available to the public.

However, accessing these same orders on Medicaid coverage requires a public records request which can be costly and time-consuming. The Elder Law Section argued in its brief that this disparity is unfair as it burdens those attempting to gain access to said records. The brief further suggested that upholding the trial court’s summary judgment would only perpetuate this inequality of access to public records.

To learn more, read the complaint in full here.

Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations, and other Legal Proceedings

Physicians, therapists, counselors and other health professionals who accept Medicaid are routinely audited by the Medicaid Program to detect any overpayments or fraudulent claims. Medicaid fraud is a serious crime and is vigorously investigated by the state Medicaid Fraud Control Unit (MFCU), the Agency for Healthcare Administration (AHCA), Program Integrity Contractors (PICs), the FBI, and the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies may also participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health law attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.

The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, mental health counselors, therapists, home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in health law practice. 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 © 2023 The Health Law Firm. All rights reserved.

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