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 info@wdoms.org 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.

 

 

 

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.

Eight Tips For Academic, Disciplinary or Legal Problems with Your Residency Program

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

Here are some tips to set the record straight on various inaccurate information I have heard from physicians in medical residency programs in representing them in appeals of disciplinary actions including suspension and terminations.

1. Nothing you tell your Program Director, advisor, mentors, attendings, senior resident, or co-resident is confidential. Go ahead and pour your heart out about all of your problems and concerns, but none of it is confidential, even if you said it was “in confidence.” What is confidential: what you tell your priest or religious adviser (preacher, rabbi, imam) and what you tell your own personal physician or psychotherapist (unless you have signed a waiver) that you have hired and you are paying. Anyone else, it is not confidential. So if you tell your program director you were raped when you were younger, not confidential. If you tell your senior resident you suffer from panic attacks, not confidential. You tell your attending that you had cancer ten years ago, not confidential. This applies no matter what “magic words” you attach to it.

2. Take and use whatever time period is offered to you to retain counsel and prepare. If you are given ten (10) days to file an appeal or a request for hearing, take the full ten (10) days. Do not file it on the same day. Otherwise, you are using up valuable preparation time that you cannot get back.

3. Make sure that whatever you are required to file is actually received by the due date indicated. If a request for a hearing must be filed within fifteen (15) days, that means that it must be received within the fifteen days. Check after you send it or deliver it to make sure it has been successfully received.

4. It is never too early to hire an attorney. Hire an attorney to represent and advise you at the first sign of trouble. However, you must be sure to hire an attorney who is experienced in representing residents and fellows in disputes with graduate medical education programs. An experienced attorney can help you prepare any written submissions you make, organize your response and any documents you care to submit, and otherwise assist you in identifying what is relevant and what is not relevant.

5. Always read your program’s graduate medical education (GME) manual, residency manual, due process policy or whatever handbook or manual contains your hearing and appeal rights. Be familiar with them and follow them.

6. If you are given remedial actions you must take, documents your completion of each one. Whether the requirement you must perform is in a corrective action plan (CAP), a remediation letter, or a probation letter, document your completion of it in writing and report it to whatever authority gave you the requirement. Send a courtesy copy (“cc”) to your program director.

7. Make sure any correspondence you send to anyone is complete, correct and in the form of a professional business letter. Make sure it meets all of the requirements of a professional business letter. This is especially true for rebuttals, appeals, hearing requests, etc. What, you don’t know what this is? Then go online and Google it. Your letter should look very similar to any letter you received from your program director or institution. Be sure it has all of your return contact information on it as well as a date. Do not start your letter with “Hi,” “Hello,” or “Good day.” Do place a reference (“Re:”) line or subject line on your letter that states what the subject of your letter is.

8. Do not be afraid to appeal, file a discrimination complaint or exercise any of your legal rights. Often I hear from residents, after they are already terminated from their program, that they are afraid to get a lawyer involved. I usually ask: “What are you afraid of? What is the worst that can happen? You have already been terminated.” Remember, also, that if your program retaliates against you for exercising any of your rights, that is illegal. The ACGME would like to hear about that and in almost all cases, you will then have a legal cause of action upon which you can sue the program.

Contact a Health Care Attorney Experienced in the Representation of Medical Resident Physicians, Fellows, Medical Students, Dental Students and Residents, Pharmacy Students and Residents, Mental Health Counselor Interns, and other health professionals. The attorneys of The Health Law Firm, also represent those applicants accused of irregular behavior 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), in responses, hearings and appeals, including on charges of “unprofessional conduct” and “improper behavior.”

The Health Law Firm and its attorneys 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.

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 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 Legal Tips If You Are Having Academic, Disciplinary or Problems with Your Residency Program

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

Here are some tips to set the record straight on various inaccurate information I have heard from physicians in medical residency programs in representing them in appeals of disciplinary actions including suspension and terminations.

1. Nothing you tell your Program Director, advisor, mentors, attendings, senior resident, or co-resident is confidential. Go ahead and pour your heart out about all of your problems and concerns, but none of it is confidential, even if you said it was “in confidence.” What is confidential: what you tell your priest or religious adviser (preacher, rabbi, imam) and what you tell your own personal physician or psychotherapist (unless you have signed a waiver) that you have hired and you are paying. Anyone else, it is not confidential. So if you tell your program director you were raped when you were younger, not confidential. If you tell your senior resident you suffer from panic attacks, not confidential. You tell your attending that you had cancer ten years ago, not confidential. This applies no matter what “magic words” you attach to it.

2. Take and use whatever time period is offered to you to retain counsel and prepare. If you are given ten (10) days to file an appeal or a request for hearing, take the full ten (10) days. Do not file it on the same day. Otherwise, you are using up valuable preparation time that you cannot get back.

3. Make sure that whatever you are required to file is actually received by the due date indicated. If a request for a hearing must be filed within fifteen (15) days, that means that it must be received within the fifteen days. Check after you send it or deliver it to make sure it has been successfully received.

4. It is never too early to hire an attorney. Hire an attorney to represent and advise you at the first sign of trouble. However, you must be sure to hire an attorney who is experienced in representing residents and fellows in disputes with graduate medical education programs. An experienced attorney can help you prepare any written submissions you make, organize your response and any documents you care to submit, and otherwise assist you in identifying what is relevant and what is not relevant.

5. Always read your program’s graduate medical education (GME) manual, residency manual, due process policy or whatever handbook or manual contains your hearing and appeal rights. Be familiar with them and follow them.

6. If you are given remedial actions you must take, documents your completion of each one. Whether the requirement you must perform is in a corrective action plan (CAP), a remediation letter, or a probation letter, document your completion of it in writing and report it to whatever authority gave you the requirement. Send a courtesy copy (“cc”) to your program director.

7. Make sure any correspondence you send to anyone is complete, correct and in the form of a professional business letter. Make sure it meets all of the requirements of a professional business letter. This is especially true for rebuttals, appeals, hearing requests, etc. What, you don’t know what this is? Then go online and Google it. Your letter should look very similar to any letter you received from your program director or institution. Be sure it has all of your return contact information on it as well as a date. Do not start your letter with “Hi,” “Hello,” or “Good day.” Do place a reference (“Re:”) line or subject line on your letter that states what the subject of your letter is.

8. Do not be afraid to appeal, file a discrimination complaint or exercise any of your legal rights. Often I hear from residents, after they are already terminated from their program, that they are afraid to get a lawyer involved. I usually ask: “What are you afraid of? What is the worst that can happen? You have already been terminated.” Remember, also, that if your program retaliates against you for exercising any of your rights, that is illegal. The ACGME would like to hear about that and in almost all cases, you will then have a legal cause of action upon which you can sue the program.

Contact a Health Care Attorney Experienced in the Representation of Medical Resident Physicians, Fellows, Medical Students, Dental Students and Residents, Pharmacy Students and Residents, Mental Health Counselor Interns, and other health professionals. The attorneys of The Health Law Firm, also represent those applicants accused of irregular behavior 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), in responses, hearings and appeals, including on charges of “unprofessional conduct” and “improper behavior.”

The Health Law Firm and its attorneys 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.

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 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.

 

 

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

Attorney Achal A. Aggarwal HeadshotBy Achal A. Aggarwal, 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 Changes That Could Affect You.

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 Author: 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

“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.

Eight Legal Tips If You Are Having Academic, Disciplinary or Legal Problems with Your Residency Program

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

Here are some tips to set the record straight on various inaccurate information I have heard from physicians in medical residency programs in representing them in appeals of disciplinary actions including suspension and terminations.

1. Nothing you tell your Program Director, advisor, mentors, attendings, senior resident, or co-resident is confidential. Go ahead and pour your heart out about all of your problems and concerns, but none of it is confidential, even if you said it was “in confidence.” What is confidential: what you tell your priest or religious adviser (preacher, rabbi, imam) and what you tell your own personal physician or psychotherapist (unless you have signed a waiver) that you have hired and you are paying. Anyone else, it is not confidential. So if you tell your program director you were raped when you were younger, not confidential. If you tell your senior resident you suffer from panic attacks, not confidential. You tell your attending that you had cancer ten years ago, not confidential. This applies no matter what “magic words” you attach to it.

2. Take and use whatever time period is offered to you to retain counsel and prepare. If you are given ten (10) days to file an appeal or a request for hearing, take the full ten (10) days. Do not file it on the same day. Otherwise, you are using up valuable preparation time that you cannot get back.

3. Make sure that whatever you are required to file is actually received by the due date indicated. If a request for a hearing must be filed within fifteen (15) days, that means that it must be received within the fifteen days. Check after you send it or deliver it to make sure it has been successfully received.

4. It is never too early to hire an attorney. Hire an attorney to represent and advise you at the first sign of trouble. However, you must be sure to hire an attorney who is experienced in representing residents and fellows in disputes with graduate medical education programs. An experienced attorney can help you prepare any written submissions you make, organize your response and any documents you care to submit, and otherwise assist you in identifying what is relevant and what is not relevant.

5. Always read your program’s graduate medical education (GME) manual, residency manual, due process policy or whatever handbook or manual contains your hearing and appeal rights. Be familiar with them and follow them.

6. If you are given remedial actions you must take, documents your completion of each one. Whether the requirement you must perform is in a corrective action plan (CAP), a remediation letter, or a probation letter, document your completion of it in writing and report it to whatever authority gave you the requirement. Send a courtesy copy (“cc”) to your program director.

7. Make sure any correspondence you send to anyone is complete, correct and in the form of a professional business letter. Make sure it meets all of the requirements of a professional business letter. This is especially true for rebuttals, appeals, hearing requests, etc. What, you don’t know what this is? Then go online and Google it. Your letter should look very similar to any letter you received from your program director or institution. Be sure it has all of your return contact information on it as well as a date. Do not start your letter with “Hi,” “Hello,” or “Good day.” Do place a reference (“Re:”) line or subject line on your letter that states what the subject of your letter is.

8. Do not be afraid to appeal, file a discrimination complaint or exercise any of your legal rights. Often I hear from residents, after they are already terminated from their program, that they are afraid to get a lawyer involved. I usually ask: “What are you afraid of? What is the worst that can happen? You have already been terminated.” Remember, also, that if your program retaliates against you for exercising any of your rights, that is illegal. The ACGME would like to hear about that and in almost all cases, you will then have a legal cause of action upon which you can sue the program.

Contact a Health Care Attorney Experienced in the Representation of Medical Resident Physicians, Fellows, Medical Students, Dental Students and Residents, Pharmacy Students and Residents, Mental Health Counselor Interns, and other health professionals. The attorneys of The Health Law Firm, also represent those applicants accused of irregular behavior 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), in responses, hearings and appeals, including on charges of “unprofessional conduct” and “improper behavior.”

The Health Law Firm and its attorneys 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.

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 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.

 

 

Legal Tips If You Are Having Academic, Disciplinary or Legal Problems with Your Residency Program

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

Here are some tips to set the record straight on various inaccurate information I have heard from physicians in medical residency programs in representing them in appeals of disciplinary actions including suspension and terminations.

1. Nothing you tell your Program Director, advisor, mentors, attendings, senior resident, or co-resident is confidential. Go ahead and pour your heart out about all of your problems and concerns, but none of it is confidential, even if you said it was “in confidence.” What is confidential: what you tell your priest or religious adviser (preacher, rabbi, imam) and what you tell your own personal physician or psychotherapist (unless you have signed a waiver) that you have hired and you are paying. Anyone else, it is not confidential. So if you tell your program director you were raped when you were younger, not confidential. If you tell your senior resident you suffer from panic attacks, not confidential. You tell your attending that you had cancer ten years ago, not confidential. This applies no matter what “magic words” you attach to it.

2. Take and use whatever time period is offered to you to retain counsel and prepare. If you are given ten (10) days to file an appeal or a request for hearing, take the full ten (10) days. Do not file it on the same day. Otherwise, you are using up valuable preparation time that you cannot get back.

3. Make sure that whatever you are required to file is actually received by the due date indicated. If a request for a hearing must be filed within fifteen (15) days, that means that it must be received within the fifteen days. Check after you send it or deliver it to make sure it has been successfully received.

4. It is never too early to hire an attorney. Hire an attorney to represent and advise you at the first sign of trouble. However, you must be sure to hire an attorney who is experienced in representing residents and fellows in disputes with graduate medical education programs. An experienced attorney can help you prepare any written submissions you make, organize your response and any documents you care to submit, and otherwise assist you in identifying what is relevant and what is not relevant.

5. Always read your program’s graduate medical education (GME) manual, residency manual, due process policy or whatever handbook or manual contains your hearing and appeal rights. Be familiar with them and follow them.

6. If you are given remedial actions you must take, documents your completion of each one. Whether the requirement you must perform is in a corrective action plan (CAP), a remediation letter, or a probation letter, document your completion of it in writing and report it to whatever authority gave you the requirement. Send a courtesy copy (“cc”) to your program director.

7. Make sure any correspondence you send to anyone is complete, correct and in the form of a professional business letter. Make sure it meets all of the requirements of a professional business letter. This is especially true for rebuttals, appeals, hearing requests, etc. What, you don’t know what this is? Then go online and Google it. Your letter should look very similar to any letter you received from your program director or institution. Be sure it has all of your return contact information on it as well as a date. Do not start your letter with “Hi,” “Hello,” or “Good day.” Do place a reference (“Re:”) line or subject line on your letter that states what the subject of your letter is.

8. Do not be afraid to appeal, file a discrimination complaint or exercise any of your legal rights. Often I hear from residents, after they are already terminated from their program, that they are afraid to get a lawyer involved. I usually ask: “What are you afraid of? What is the worst that can happen? You have already been terminated.” Remember, also, that if your program retaliates against you for exercising any of your rights, that is illegal. The ACGME would like to hear about that and in almost all cases, you will then have a legal cause of action upon which you can sue the program.

Contact a Health Care Attorney Experienced in the Representation of Medical Resident Physicians, Fellows, Medical Students, Dental Students and Residents, Pharmacy Students and Residents, Mental Health Counselor Interns, and other health professionals. The attorneys of The Health Law Firm, also represent those applicants accused of irregular behavior 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), in responses, hearings and appeals, including on charges of “unprofessional conduct” and “improper behavior.”

The Health Law Firm and its attorneys 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.

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 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.

Cheating, Irregular Behavior and Other Challenges Facing Medical Students and Graduates

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

The road to becoming a physician is paved with many unique challenges. The long, exhausting journey begins and students are faced with the first battle: rigorous undergraduate course work, followed by the MCAT and medical school applications. During medical school, and for some, after graduation, the USMLE (United States Medical Licensing Examination) and its STEP 1, STEP 2, and STEP 3 exams provide another hurdle in the uphill battle. At any of these stages, medical students can face a gauntlet of accusations including cheating, misrepresentation, falsification of information, unfair advantages, and the many faces under the general label of “irregular behavior.”

Challenges Prior to Entering Medical School.

Prior to medical school, pre-med students must be ambitious, inquisitive, and extra cautious about any disciplinary action. A minor blemish on a pre-med student’s academic record (from academic dishonesty or other accusations), will become a major red flag once that student begins applying. Not only will any kind of discipline record hinder a student’s chances of acceptance, but an infraction can also ruin that student’s reputation as they apply for residency and beyond.

Because the process of becoming a physician is difficult without having a discipline record, any charge against a pre-med student must be taken with the utmost seriousness. Don’t raise a white flag early on in the uphill battle!

Challenges After Medical School.

The battle continues for medical students; medical school courses and clinical rotations will be rigorous and challenging, calling on every neuron you possess to fire efficiently. You will be tested, in more ways than one. You will forget the term “MCAT” and substitute for it a new acronym–“USMLE” which stands for United States Medical Licensing Examination.

The USMLE is a four-stage examination required for medical licensure in the United States. Because the USMLE is the barrier between you and your medical license, it is an extremely important component of your medical education.

One such issue is being accused of “irregular behavior.” This broad label includes anything from cheating to disruptions during testing or soliciting information on actual examination content. In the event that your test score is held up or invalidated due to irregular behavior you will want to correct the situation immediately, or you may be prohibited from taking future exams (meaning you won’t be able to obtain your license or a residency in the U.S.). If you are accused of irregular behavior or if you feel that you were faced with inadequate testing conditions, resolving the issue may be as simple as requesting a rescoring of the examination or a retest. Sometimes, because of problems at a test site or because of technical problems, retesting is an option.

The National Board of Medical Examiners and the USMLE take all such matters concerning the administration and the security of the test contents extremely seriously. In certain cases, they have sued those they believe may have compromised actual test contents. Click here to read more about the case.

After years of schooling, don’t allow an allegation of irregular behavior to mark your test transcripts and prevent you from attaining your goals and reaping the benefits of your hard work.

To learn more about USMLE, irregular behavior, and how we can help you, click here to read one of my prior blogs.  Check our Medical Education Law Blog Regularly to stay on top of news and tips!

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

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.

To contact The Health Law Firm please call (407) 331-6620 or Toll-Free (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

“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.

Women Who Posed as Nurse Sentenced to Prison For Health Care Fraud, Identity Theft, and Wire Fraud

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

On September 23, 2020, a Tennessee woman who posed as a nurse working at several medical facilities was sentenced to more than four years in prison. In December 2019, she pled guilty to wire fraud, healthcare fraud, identity theft, and practicing nursing without a license.

How a Phony Nurse Gained Employment.

According to a news release from the U.S. Attorney’s Office, the woman posed as a registered nurse, despite not having a nursing degree or a nursing license, and having no nursing experience. To accomplish the fraud, she obtained the license numbers of real nurses with similar first names. She admitted to providing fraudulent information on job applications to gain employment. She was employed by at least eight different health care providers between September 2012 and November 2018. She also falsely claimed that she held nursing degrees from two educational institutions, Walters State College and Carson Newman University.

This is a long time, six years, to get away with health fraud. Usually, we only see things like this in Florida. However, in the past few years, Florida seems to be seeing fewer and fewer fake doctors, nurses, and health professionals. Perhaps the crackdown by the Florida Department of Health on the unlicensed practice of health professions has had some impact on this.

Continuing Lies & Fraudulent Behavior.

While posing as a nurse, the fake R.N. worked in various medical settings, including nursing homes, rehabilitation and assisted living facilities, a doctor’s office, and home health agencies. She rendered nursing care to numerous patients, dispensed prescription medications, and gained access to patients’ sensitive and private medical information, the U.S. Attorney’s Office said. Furthermore, the woman made false entries in patients’ medical records and submitted or caused the submission of at least $500,000 in false claims to public and private health care benefit programs.

The phony nurse performed procedures that she was, of course, unqualified to perform. She failed to act or to notify others of the necessary procedures for patients and failed to chart and document patient care. According to the written plea agreement, at least one patient required re-admittance to the hospital and an additional three-day hospital stay due to her inept care.

The Tennessee Bureau of Investigation Director David Rausch is quoted in the media as having stated: “Our Medicaid Fraud Control Division remains committed to working with our federal partners to ensure healthcare fraud and identity theft cases like this one are addressed and investigated thoroughly.”

Judge Clifton L. Corker of the U.S. District Court for the Eastern District of Tennessee sentenced her to 51 months in prison, followed by three years of supervised release. She was also ordered to repay $700,000 in restitution to her employers.

To read the DOJ’s press release about this case in full, click here.

To read about a similar case in Florida, click here to view one of my prior blogs.

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 (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Morristown woman posed as nurse for 6 years at 8 health care providers.” ABC 6 Local News. (December 12, 2019). Web.

Starks, Ariel. “Fake nurse sentenced to 51 months in prison, ordered to repay employers $700,000.” WVLT 8 Local News. (September 23, 2020). Web.

Bonvissuto, Kimberly. “Nurse imposter who worked in assisted living sentenced for wire fraud, healthcare fraud, identity theft.” McKnight’s Senior Living. (September 25, 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 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 © 2020 The Health Law Firm. All rights reserved.

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