Completing an Application for a Nursing License? Here Are Some Helpful Tips!

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

The process of obtaining a nursing or health care professional license is not only challenging, but it’s also time-consuming. If you have a criminal conviction or unique circumstance which may negatively impact your ability to be granted a health care license, you must consult with an experienced attorney. Your career or future depends on your ability to positively present yourself to the board.

In instances where the applicant has a criminal history, substance abuse/alcohol problem, or discipline in another state, the board members are trying to discern from the testimony if he or she is safe to practice medicine.

Don’t Face State Licensing Boards On Your Own.

If you are applying for a nursing or health care license and have had prior adverse action taken against you in another state or during your academic training, you should contact an experienced healthcare attorney to assist you in the process.

Some tips to ease the process include:

  1. After obtaining an experienced attorney, ask how to answer application questions when unclear.
  2. Submit follow-up documents in a timely manner.
  3. Make sure your address is correct and complete.
  4. Follow-up with sources sending the Board of Nursing documents.
  5. Provide answers to the questions asked, and no more.
  6. Submit corrections when it becomes apparent you need to modify an answer.

If you are in the process of applying for a nursing license or any other license in the medical field, you will want an experienced health law attorney to be on your side to guide you through the process. Let the attorneys at The Health Law Firm be there for you. Call the Health Law Firm today, visit our website, and click on Contact Us.

Contact Health Law Attorneys With Experience Representing Nurses and Handling Licensing Issues.

If you are applying for a nursing or health care license, have had a license suspended or revoked, or are facing imminent action againstlawyer sitting with nurse in front of paperwork at desk your license, you must contact an experienced healthcare attorney to assist you in defending your career. Remember, your license is your livelihood, it is not recommended that you attempt to pursue these matters without the assistance of an attorney. The Health Law Firm routinely represents nurses, physicians, dentists, medical groups, clinics, and other healthcare providers in personal and facility licensing issues.


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. 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 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: PAlexander@TheHealthLawFirm.com 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.

Under Medical Peer Review from the Military or the Veterans Administration? Get Experienced Legal Representation Now

Author and Attorney HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Military physicians, Veterans Administration (VA) physicians, and former military and VA physicians often consult our firm concerning matters involving peer reviews of their care. In the military, whether Army, Navy, or Air Force, peer review for all physicians is governed by one general Department of Defense (DOD) Regulation.  It is called the Defense Health Agency Procedures Manual (abbreviated DHA PM) 6025.13, which became effective October 1, 2019. VA physicians have different but somewhat similar regulations that apply to them.
We are often consulted by these physicians, who no longer even serve with those agencies after action has already been taken to report them to the National Practitioner Data Bank (NPDB) for allegedly substandard care. Such reports go into the NPDB for fifty (50) years and are reported to all state licensing boards and the Federation of State Medical Boards (FSMB).
They can haunt a physician’s career for life.

What to Do When Notified of a Claim, Investigation, Peer Review Action, or Quality Assurance Investigation (QAI)?

At your first notice that you are the subject of or named by a Federal Tort Claims Act (FTCA) claim or any inquiry or investigation related to your care, you should consult a healthcare attorney with experience in such matters. We are few and far between, but you can find us if you look for us.
You will have at least two opportunities for input into such matters, but you must take advantage of your earliest opportunity to influence the outcome.
1. You do need to obtain and review a copy of the medical record.
2. You do need to have an expert in your medical field review the case for you.
          3. You can request an extension of time if needed.

What Are Questions I Should Ask of an Attorney with Whom I Consult?

These are the questions that I suggest you ask any attorney you consult with:

1. What is your experience in dealing with the military or VA medical system?

2. How many similar matters of this nature have you handled?

3. Are you familiar with National Practitioner Data Bank (NPDB) reports, challenges, and appeals?

4. How many such NPDB matters have you handled?

5. How many cases have you handled in which you assisted in making statements for input into such investigations or inquiries?

6. Are you familiar with the Memorandum of Understanding (MOU) between the DOD and the Department of Health and Human Services (DHHS) taking DOD NPDB reports out from under the regular NPDB procedures?

7. How many military or VA quality assurance investigations have you represented physicians?

8. How many VA and military peer review/clinical privileges hearings have you done?

9. How familiar are you with hospitals and health systems?

10. How familiar are you with the military medical system, the roles of the Surgeons General, and the Department of Defense Division of Health Affairs (DOD HA)?

11. How familiar are you with DOD PM 6025.13?

12. How familiar are you with:  VHA Directive 1190 (Peer Review for Quality Managment), VHA Handbook 1050.01 (VHA National Patient Safety Improvement Handbook), VHA Handbook 1100.17 (National Practitioner Data Bank (NPDB) Reports), VHA Handbook 1100.19 (Credentialing and Privileging), VHA Directive 2008-077 (Quality Management (QM) and Patient Safety Activities . . . ), VHA Directive 1026 (VHA Enterprise Framework for Quality, Safety and Management), and VA Handbook 5120/14 (Employee/Management Relations)?

Don’t Wait until after the Decision to Report You Has Been Made.
Be sure to obtain experienced legal counsel to represent you in defending yourself against allegations of substandard care before the final decision has been made. Avail yourself all opportunities to provide your concise, objective, and well-reasoned medical rationale for your care at the earliest stage you can.
Click here to read a prior blog on how our firm can assist you in your legal matter.
For additional information on our representation of military physicians and where we represent them, click here.
For additional information on our representation of Veterans Administration (VA) physicians and where we represent them, click here.

Consult a Health Law Attorney Familiar with Army, Navy, and Air Force Health Care Professionals and Their Problems.

The attorneys of The Health Law Firm have represented physicians, nurses, dentists, and other health professionals in the Army, Navy, and Air Force, active duty and retired, as well as physicians, nurses, and other health professionals working for the Veterans Administration (VA), the Indian Health Service (IHS) and the Public Health Service (PHS), nationwide in the U.S. and around the world. Representation includes assisting in making significantly involved provider (SIP) statements, Defense Health Agency (DHA) investigation representation, DHA-PM 6025.13 legal representation, hospital clinical privileges hearings, medical staff fair hearings, medical staff peer reviews, disciplinary actions, investigations, National Practitioner Data Bank (NPDB) actions, and appeals. 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, and former military attorneys.
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 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: KBrant@TheHealthLawFirm.com 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.

The Do’s and Don’ts If You Are Under Investigation For Discipline on Your Professional License, Part 2

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

You are reading Part 2 of this blog series. To read Part 1, click here.

If you are notified that you are under investigation, DO NOT take the easy way out by immediately relinquishing your license. And DO NOT hide your head in the sand by thinking the case will just go away on its own. DO NOT think that you can just talk to the investigator, explain your side, and the case will go away. Also, DO NOT request an informal hearing or agree to a settlement agreement (consent order) in which you admit the facts alleged against you are all true.  If you do this you are, in effect, “pleading guilty.” If you are innocent of the charges, request a formal hearing and contest the charges; defend yourself.

DO immediately seek the advice of an attorney who has experience in such professional licensing matters and administrative hearings.  These attorneys are out there, but you may have to search for one.  Do this before you talk to or make any statement (oral or written) to an investigator.

DO purchase professional liability insurance that includes legal defense coverage for any professional license investigation against you, whether it is related to a malpractice claim or not.  This insurance is cheap and will provide you with needed legal assistance at the time when you may be out of a job and not have money to hire an attorney.  However, beware of the insurance policy that only covers professional license defense related to a malpractice claim.

DO NOT count on your employer to provide this type of insurance for you. In fact, most of such complaints against your license may well be filed by your employer or ex-employer.

If you are a traveling nurse or other contract or temporary type of health professional, always purchase your own insurance.

Our Advice On Professional Liability Insurance.

We strongly encourage nurses, mental health counselors, and all licensed health professionals and facilities to purchase independent insurance coverage.  Make sure it covers professional license complaint defense expenses under all circumstances.

Also, make sure you have enough coverage to actually get you through a hearing. For example, $25,000 coverage for just professional licensure defense is the absolute minimum you should purchase;   $50,000 may be adequate, but $75,000 or $100,000 may be what you need in such a situation.  You can usually buy the higher limits for a few dollars more (and I do mean only a few). If necessary, such insurance is usually cheap enough that you can actually purchase two or more different policies.

Also, I will repeat, make sure it covers your legal defense in an administrative disciplinary proceeding against your license, even if there is no malpractice claim filed against you or likely to be filed against you. We also recommend that you purchase coverage through an insurance company that allows you to select your own attorney and does not make you use one that the insurance company picks for you.

Companies we have dealt with in the past which provide an inexpensive quality insurance product for professional license defense costs include CPH & Associates Insurance, Nurses Service Organization (NSO) insurance, Healthcare Providers Organization (HPSO) Insurance, and Lloyd’s of London Insurance.

To learn more, visit our Video Q&A section on our website and watch our video titled, “Should I voluntarily relinquish my professional license because I am being investigated?” and visit our YouTube page.

Click here to read one of our prior blogs for even more information on how to fight back against adverse NPBD reports.

Don’t forget to read part one of this blog series here!

Contact Health Law Attorneys Experienced with Investigations of Healthcare Professionals.

The attorneys of The Health Law Firm provide legal representation to medical professionals in Department of Health (DOH) investigations, licensing matters and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or 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 © 2022 The Health Law Firm. All rights reserved.

DOJ Files False Claims Suit Against Nursing Homes Over “Substandard Services and Nonexistent” Care

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

On June 15, 2022, the U.S. Department of Justice (DOJ) announced it has sued three nursing homes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.” The False Claims Act (FCA) complaint against the American Health Foundation (AHF), its affiliate AHF Management Corporation, and three nursing homes alleges the facilities fraudulently billed the Centers for Medicare & Medicaid Services (CMS) for often “nonexistent care.”

According to the complaint, all three AHF nursing homes not only provided substandard nursing home care services that failed to meet required standards of care but also did not maintain adequate staffing levels between 2016 and 2018.

Click here to view the complaint filed by the DOJ in the U.S. District Court for the Eastern District of Pennsylvania.

FCA Violations For “Substandard or Nonexistent Care.”

The government alleged AHF Management and its entities violated the FCA stemming from reimbursements for “grossly substandard” care provided at the Cheltenham, Wilmington Place, and Samaritan nursing homes.

“The defendants knowingly submitted, or caused the submission of, false claims to Medicare and Medicaid for nursing home care and services that were blatantly substandard or nonexistent,” the complaint read. “The Medicare and Medicaid programs provided reimbursement for the claims, but these payments were by mistake as CMS didn’t know the true and full extent of the defendants’ failure to provide patients with proper treatment and care.”

Alleged Patient Conditions and Mistreatment.

Examples of the appalling conditions described in the complaint included housing elderly and medically vulnerable patients in “pest-infested” buildings whose belongings were often stolen; giving residents unnecessary medications, including antibiotic, anti-psychotic, anti-anxiety, and hypnotic drugs; subjecting residents to verbal abuse; neglecting to provide residents with activities or stimulation, and failing to provide needed psychiatric care.

Additionally, the complaint outlines the suicide of a resident who was admitted with a history of self-harm and was later hospitalized after slashing his wrists but still was not provided psychiatric services. Tragically, just weeks after readmission, the resident committed suicide by hanging himself from a bedsheet in a shower room, justice officials said.

“Nursing homes are expected to provide their residents, which include some of our most vulnerable individuals, with quality care and to treat them with dignity and respect,” said Assistant Attorney General Brian M. Boynton, head of the DOJ’s Civil Division in a statement. He continued, “the department will not tolerate nursing homes, or their owners or managing entities, who abdicate these responsibilities and seek taxpayer funds to which they are not entitled.”

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

The United States’ complaint stems from an investigation that the DOJ initiated as part of its “National Nursing Home Initiative.” The department launched the initiative in March 2020 to identify and investigate nursing homes that provide grossly substandard care.

Click here to learn more about the Justice Department’s nursing home initiative.

The case is United States v. American Health Foundation Inc., case number 2:22-cv-02344, in the U.S. District Court for the Eastern District of Pennsylvania.

Contact Health Law Attorneys Experienced in Handling False Claims Act (FCA) Violations, Investigations, and other Legal Proceedings.

The attorneys of The Health Law Firm represent healthcare providers in defending audits and investigations by the Department of Health and Human Services, the Department of Justice, The Drug Enforcement Administration (DEA), the Florida Department of Health (DOH), Medicaid Fraud Control Unit (MFCU), state boards of medicine, state boards of pharmacy, and state boards of nursing. They also represent health professionals and providers in administrative litigation (state and federal) and civil litigation (state and federal). They represent physicians, nurses, medical groups, nursing homes, home health agencies, pharmacies, dentists, pharmacies, assisted living facilities, and other healthcare providers and institutions in recovery actions and termination from Medicare and Medicaid Programs.

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:

D’Annunzio, P.J. “Feds Hit Nursing Home With FCA Suit Over ‘Nonexistent’ Care.” Law360. (June 15, 2022). Web.

Marceas, Kimberly. ‘Grossly substandard’ care leads to False Claims charges for Ohio-based nursing home operator. McKnights Long Term Care News. (June 16, 2022). Web.

“Nursing Homes Face DOJ False Claims Suit Over Standards of Care.” Bloomberg Law. (June 15, 2022). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 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 © 2022 The Health Law Firm. All rights reserved.

 

Study Reveals 1 in 5 Medicare Recipients Use Medical Marijuana, 66% Agree It Should Be Covered

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

A new study has revealed that one in five Medicare recipients use medical marijuana and two-thirds think Medicare should cover it. MedicarePlans.com, a group examining various Medicare issues, commissioned the online poll of 1,250 Medicare recipients in April 2022.

Two-thirds of those polled said they “strongly agree” or “agree” that medical marijuana should be covered by Medicare. Thirty-four percent said they “disagree” or “strongly disagree.”

More Details About Responses.

In the poll, 23% admitted to using medical pot in the past, and 21% said they currently use it to treat one or more medical conditions. Additionally, current use for health reasons was highest among respondents who used marijuana recreationally (39%). 28% of recreational users said they previously used medical marijuana.

The study revealed that respondents use it to treat various physical and mental health conditions, including 32% for anxiety and 31% for chronic pain. In addition, roughly one-quarter said they use it to treat depression, glaucoma, and symptoms associated with HIV/AIDS, including nausea, appetite loss, and pain.

Nearly six in ten supporters of Medicare coverage of medical marijuana said they do so because it can be effective when other treatments fail. To learn more details and facts about the study, click here to view the Medicare Plan’s website poll.

Reasons Why Medicare Should Cover Medical Marijuana.

  1. It would save the Medicare Program a fortune in payments it would otherwise make for high-priced prescription drugs peddled by “Big Pharma.”
  2. It would save the Medicare Program a fortune in payments for physician office visits for such ailments as depression, anxiety, glaucoma, insomnia, chronic pain, lack of appetite, and other such ailments it is known to treat.
  3. It would help cut down on patients who are unable to get timely appointments to see physicians.
  4. It would make an otherwise relatively harmless medication more easily available to those who need it.
  5. It would help reduce prescriptions for highly addictive drugs such as opioids and other “heavy duty” pain medications.

Reasons Why Medicare Can’t Cover Medical Marijuana.

    1. Because it is illegal under federal law, solely because it is on Schedule I of the Controlled Substances Act, defining it as a substance with “high potential for abuse, no currently accepted medical use in treatment in the United States, and a lack of accepted safety for use under medical supervision.” Yes, it is right there along with heroin and LSD. All that has to be done is for the federal government to remove it from Schedule 1.

To keep up to date on the status of medical marijuana, be sure to visit our Marijuana Law Blog regularly.

Contact Experienced Health Law Attorneys for Medical Marijuana Regulatory Matters and Other Health Care Licensing Matters.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists, and pharmacies, participating in the medical marijuana industry. We represent doctors, pharmacies, and pharmacists facing proceedings brought by state regulators or agencies. We represent health-related businesses and medical professionals in all types of licensing and regulatory matters, including state and federal administrative hearings.

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:

Scatton, Kristin. “1 IN 5 MEDICARE RECIPIENTS USE MEDICAL MARIJUANA.” Medicare Plans. (April 12, 2022). Web.

Preidt, Robert. “1 in 5 Medicare Patients Use Medical Marijuana: Survey.” HealthDay. (April 14, 2022). Web.

Health Law Daily. “One In Five Medicare Recipients Say They Use Medical Marijuana, Two-Thirds Say It Should Be Covered By Medicare, Survey Finds.” AHLA. (April 14, 2022). 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 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 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.

Fight Back in National Practitioner Data Bank Disputes and Appeal Adverse Reports

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

The National Practitioner Data Bank (NPDB), created in 1986, was part of the Health Care Quality Improvement Act (HCQIA). Its purpose is to improve the quality of health care by encouraging state licensing boards, hospitals, health care entities, and professional societies to report into a national data bank those physicians and health professionals who demonstrate substandard skills or engage in unprofessional behavior.  In part, it is used to make sure that incompetent physicians do not move from one state to another in order to avoid the consequences.

Adverse Reports Stay in the NPDB for Life.

How long does an adverse NPDB report stay in the Data Bank?  I have received two (2) different answers to this question from different authorities.  I was originally informed that adverse NPDB reports are for life, and believed that for my first 25 or so years of practice.  However, more recently I have been informed that they only stay in the Data Bank for 50 years.  However, there is little difference whether it is actually 50 years or for life.  For most physicians 50 years is a lifetime for a medical career.

A Negative NPDB Report Has the Ability to Ruin Your Career.

All reports in the NPDB on an individual can and are queried by state licensing boards, hospitals, and other health care facilities to assist in investigating adverse incidents and disciplinary actions that may have been taken against a physician applying for a license or clinical privileges. Therefore, adverse NPDB reports can have long-lasting, devastating effects on the career of a health care provider.

Additionally, the real-world consequences of being the subject of an NPDB report include possible exclusion from the panels of health plans and independent physician organizations, termination for cause from state Medicaid programs, loss of medical staff privileges at hospitals and health facilities, increases in professional liability insurance premiums, exclusion from the Medicare Program, and additional licensing investigations and potential discipline by other organizations and states.

If you are the subject of an adverse NPDB report, there are several actions you should take to correct any errors, provide your side of the facts, and possibly have the adverse report removed or corrected.

What Happens If You Disagree With Your Report?

Reports to the NPDB are, for all practical purposes for life, as explained above.  But healthcare professionals may appeal adverse reports through a dispute resolution process involving the Secretary of the Department of Health and Human Services (HHS). You can dispute reports if you disagree with factual accuracy of the report or if the event reported are not proper under NPDB guidelines.  For example, getting fired from a job or having a contract terminated for cause are not proper events to cause an adverse NPDB report. We have had to represent physicians in the past having these types of reports removed from the NPDB.

It’s important to note that entering the report into dispute status does not automatically trigger a review. When in dispute status, you have to notify the reporting organization.  The reporting organization can correct, void, or choose to leave the report unchanged. If after 60 days you have received no response from the reporting organization, or you are unsatisfied with the response you received, you can elevate the report to dispute resolution (appeal).

Visit the NPDB website here for more details on this process.

For more reference, you can see what a successful voided NPDB report looks like here. This example results from The Health Law Firm’s recent successful appeal of an adverse NPDB report for a client.

Your Career May Depend On Having Legal Counsel Who Understands the NPDB.

If you have received a negative National Practitioner Data Bank report and wish to appeal it, contact The Health Law Firm. Our attorneys routinely represent physicians, dentists, and other healthcare professionals in disputing and appealing NPDB reports. To learn more, click here to read one of my prior blogs.

Don’t Wait Until It’s Too Late, Contact Experienced Health Law Attorneys.

The Health Law Firm attorneys routinely represent physicians, physician assistants (PAs), nurses, nurse practitioners (NPs), dentists, and other health professionals in dealing with reports being made to the NPDB, disputing NPDB reports and appealing NPDB reports, hospital clinical privileges hearings, medical staff fair hearings, medical staff peer reviews. 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.

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 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 © 2022 The Health Law Firm. All rights reserved.

Court Allows New York Doctor To Subpoena Yelp for User Information in Defamation Suit

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

On October 7, 2021, the United States District Court for the Southern District of New York ruled that Yelp is subject to a subpoena to reveal the names of anonymous users who left negative reviews for a doctor and his medical practice. The federal court judge found that the statements in the reviews made on Yelp contained factual claims that the doctor did have a legal right to contest in court. This is a factor that is usually missing in such cases. Accordingly, a motion for expedited discovery filed by the plaintiff physician was granted by the federal judge.

A Litigious History of Lawsuits.

The embattled physician has reportedly filed other lawsuits against reviewers for defamation. The doctor himself says he’s won or reached settlements with three of the negative reviewers, forcing them to take down their “false” reviews and paying an undisclosed amount of money.

Most recently, the physician filed suit in November 2020 against nine anonymous Yelp account-holders. According to the complaint, from November 2019 to August 2020, the users posted several reviews that contained statements that harmed his practice by making untrue and libelous comments.

In the present case we are discussing filed against the Yelp reviewer, the judge found that statements such as the physician “diluted” injectables and deceived patients about pricing to be factual statements. (The physician is apparently one who performs cosmetic procedures on patients like using botox and fillers.) Therefore, if they were false statements, as the physician alleged, this establishes a prima facie claim for defamation that courts have the authority to hear. According to the court’s order: “Because Plaintiff has alleged a prima facie case . . . and they cannot identify John Doe[s] without a court-ordered subpoena, the Court agrees that there is good cause to allow for early discovery.”  Click here to view the court’s opinion on our website.

I see this as a positive occurrence. Too often reviewers on Yelp, Google, Glass Door, and other such websites post egregious comments amounting to character assassination and libel, because they believe they can remain anonymous. And the owners of the websites fight tooth and toenail to avoid any liability and to avoid any co-operation when justice is sought by those harmed by their actions. We have had a number of cases we have handled where a “reviewer” uses a phony name and creates a phony user account just for the purpose of making a libelous, damaging review. Then, if caught, they just create a new phony account and re-post the same thing again. If the major carriers and websites like Yelp, Google, Bing, AOL, and Glass Door, want to remain free of liability, then they should co-operate when a person has to hire a lawyer and pursue legal action in order to obtain justice.

Is This Abusing the Legal System in An Effort to Stifle Free Speech?

Yelp reportedly warns users of the physician’s previous attempts to sue over negative reviews in a “Consumer Alert” pop-up notice on the doctor’s review page. Additionally, it reminds users, “reviewers who share their experiences have a First Amendment right to express their opinions on Yelp.”

Unlike a newspaper or television outlet, Yelp, Google, Glass Door, and other Internet carriers and websites enjoy immunity from liability for what they allow to be posted because of a federal law that protects them. Why are they given such a big advantage over more traditional media outlets? Why should they be?

In a separate lawsuit, a judge denied the effort by the same doctor to reveal the anonymous reviewer who wrote: “Cheap product and he’s absolutely not experienced nor does he care!!!!!” Yelp argued that the review is not defamatory as there is no statement of fact that can be proven true or false. The court agreed and found that the review used a “loose, figurative tone,” suggesting that the author expressed opinions rather than facts based on a negative experience.

Therefore, according to the court, the plaintiff was not able to make “a sufficient showing of prima facie defamation.” Click here to read the judge’s order in full in that case.

I disagree with the court’s ruling, however. Whether or not the physician has any experience is certainly a fact. It can easily be proven or disproven. It seems that if a doctor hung up a sign that said “Absolutely no Experience,” this would be perceived by most reasonable people to be a negative thing. I doubt that many people would be attracted to that doctor or his practice.

Key Takeaway From the Case.

The key takeaway from this case is that contrary to what Yelp’s pop-up notice implies, Yelp’s users have “implicitly agreed” to the release of their personal data if ordered by a court.

To learn more about fighting negative reviews on websites like Yelp as a healthcare professional, click here to read my prior blog.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm, we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. We represent facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians in investigations and at Board of Medicine and Board of Osteopathic Medicine hearings. We represent physicians accused of wrongdoing, in patient complaints and in Department of Health investigations.

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

Sources:

Capriel, Jonathan. “Doc Can Subpoena Yelp User Info In Botox Defamation Suit.” Law360. (October 7, 2021). Web.

Marza, Mike. “Manhattan doctor sues over Yelp reviews he says are false.” ABC 7NY. (November 19, 2019). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 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 © 2021 The Health Law Firm. All rights reserved.

From the archives: Mississippi Becomes 37th State to Legalize Medical Marijuana

Previously published on March 24, 2022
Attorney and Author HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On February 2, 2022, the Gov. of Mississippi signed the “Mississippi Medical Cannabis Act” legalizing medical marijuana in the state. The law permits the use of medical cannabis to treat certain debilitating medical conditions, including cancer, Parkinson’s disease, Huntington’s disease, muscular dystrophy, HIV/AIDS, hepatitis, ALS, Crohn’s disease, ulcerative colitis, sickle-cell anemia, Alzheimer’s disease, dementia, post-traumatic stress disorder, autism, cachexia or wasting syndrome, chronic pain, severe or intractable nausea, seizures, intense muscle spasms, among others.

Although the law became effective immediately upon signing by the Governor, medical cannabis will not become available for months.

Specifics of Mississippi SB 2095.

Under the new Mississippi law, medical pot products will include cannabis flower, cannabis extracts, edible cannabis products, beverages, topical products, ointments, oils, tinctures, and suppositories. In addition, it allows approved patients up to 3 ounces of marijuana a month.

Favorable Provisions For Employers Included in Mississippi S.B. 2095:

There are a number of provisions in the new law to protect employers; employees should be aware of these, also. They include:

1. Employers are not required to permit or accommodate the medical use of medical cannabis or to modify any job or working conditions or any employee who engages in the medical use of cannabis or seeks to engage in the medical use of cannabis.

2. Employers are not prohibited from refusing to hire, discharging, disciplining, or otherwise taking adverse employment action against an individual concerning hiring, discharging, tenure, terms, conditions, or privileges of employment as a result, in whole or in part, of that individual’s medical use of medical cannabis, regardless of the individual’s impairment or lack of impairment resulting from the medical use of medical cannabis.

3. Employers are not prohibited from establishing or enforcing a drug testing policy.

4. Employers may discipline employees who use medical cannabis in the workplace or work while under the influence of medical cannabis.

5. The law does not interfere with, impair or impede any federal requirements or regulations such as the U.S. Department of Transportation’s drug and alcohol testing regulations.

6. The law does not permit, authorize or establish an individual’s right to commence or undertake any legal action against an employer for refusing to hire, discharging, disciplining, or otherwise taking adverse employment action against an individual concerning hiring, discharging, tenure, terms, conditions or privileges of employment due to the individual’s medical use of medical cannabis.

7. Employers and their workers’ compensation carriers are not required to pay for or to reimburse an individual for the costs associated with the medical use of cannabis.

8. The law does not affect, alter or otherwise impact the workers’ compensation premium discount available to employers who establish a drug-free workplace program.

9. The law does not affect, alter or otherwise impact an employer’s right to deny or establish legal defenses to the payment of workers’ compensation benefits to an employee based on a positive drug test or refusal to submit to or cooperate with a drug test.

10. The law does not authorize an individual to act with negligence, gross negligence, recklessness, in breach of any applicable professional or occupational standard of care, or to effect an intentional wrong, as a result, in whole or in part, of that individual’s medical use of medical cannabis.

11. The law prohibits smoking and vaping medical cannabis in a public place or a motor vehicle.

12. The law prohibits operating, navigating, or being in actual physical control of any motor vehicle, aircraft, train, motorboat, or other conveyance in a manner that would violate state or federal law as a result, in whole or in part, of that individual’s medical use of medical cannabis.

13. The law does not create an employee’s private right of action against an employer.

Despite these provisions, employers should always review the law to determine whether any revisions to drug and alcohol testing policies or other workplace policies will be necessary.

Key Takeaway For Employees.

The absence of any employment protection language in the new bill suggests that some Mississippi employers may take adverse actions against employees who hold medical marijuana cards. However, even if taking actions against employees is lawful under the act, legal cardholders may pursue disability discrimination and accommodation claims related to their medical use of marijuana.

Individuals must have a qualifying medical condition to receive a medical marijuana card. Any of the twenty medical conditions that would make an individual eligible for a card in Mississippi likely would be considered a disability under laws such as the Americans with Disabilities Act (ADA). In past legal cases, courts and administrative agencies around the country have regularly determined that medical marijuana cardholders may assert disability discrimination and accommodation claims under state law and, in some instances, the ADA.

Click here to read my blog regarding an employee’s discrimination lawsuit in Arizona for her medical marijuana use.


List of Policies, Procedures, and Other Regulations for Patients.

1. Who can qualify for medical marijuana? Patients who have debilitating medical conditions can be prescribed medical marijuana to help treat their illness. The act lists twenty medical conditions and categories of conditions for which an individual would be eligible for a medical marijuana card in Mississippi, including cancer, Crohn’s disease, post-traumatic stress disorder, any “chronic, terminal, or debilitating” condition producing chronic pain, and “any other condition” that may be added by the Mississippi Department of Health in the future.

2. What do patients need to do to get medical marijuana? Patients seeking medical cannabis need written certification from a qualifying practitioner. The certification is good for a year unless the practitioner indicates a shorter period of time. Patients between ages 18-23 generally must have written certifications from two different practitioners from separate medical practices to qualify. (There is an exception for those who registered before they were 18 and the homebound.) Once the patient has the certification, they must then obtain a registry identification card from the Mississippi Department of Health. The state health department has the ultimate oversight authority over the medical cannabis program.

3. Possession and Purchase Limits. The legal limit for possession and purchase is calculated based on “Medical Cannabis Equivalency Units” (MCEUs) of 3.5 grams of flower, up to 100 mg of THC in infused products, and up to one gram of concentrate. Patients may not purchase more than six MCEUs in a week (21 grams, which is less than 3/4 ounce). Patients may not purchase more than 24 MCEUs in a month (84 grams, which is less than 3 ounces). Patients may not possess more than 28 MCEUs at one time (98 grams, which is less than 3.5 ounces). Flower cannot exceed 30% THC. Tinctures, oils, and concentrates may not exceed 60%.

4.  Legal protections.  Patients can designate a caregiver to assist them with the medical use of cannabis, such as by picking up their cannabis from a dispensary. Caregivers can assist no more than five patients, with exceptions when the caregiver works at a health facility or similar institution that provides care to patients. Delivery and curbside pickup is prohibited. (However, MDOH rules include, “Protocol development for the safe delivery of medical cannabis from dispensaries to cardholders.” Additionally, registered patients are protected from discrimination in child custody disputes and in reference to gun rights.

With this law, Mississippi became the 37th state to adopt a medical marijuana program. View the “Mississippi Medical Cannabis Act” SB 2095 in full here.

Read one of my prior blogs on medical marijuana here.

Visit our Marijuana Law Blog page to stay up to date on key legislation and topics that may affect you!

Contact Experienced Health Law Attorneys for Medical Marijuana Regulatory Matters and Other Health Care Licensing Matters.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists, and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting, and/or licensing while complying with Florida law. We can also represent doctors, pharmacies, and pharmacists facing proceedings brought by state regulators or agencies. We represent health-related businesses and medical professionals in all types of licensing and regulatory matters, including state and federal administrative hearings.

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:

Russo, Kathryn. “Mississippi Enacts Medical Marijuana Law.” The National Law Review. (February 4, 2022). Web.

Gordon, Gracyn. “Medical marijuana bill now becomes law in Mississippi.” WAPT16 ABC. (February 3, 2022). 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 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 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.

NPDB Disputes and Appeals: Fight Back Against Adverse Reports

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

The National Practitioner Data Bank (NPDB), created in 1986, was part of the Health Care Quality Improvement Act (HCQIA). Its purpose is to improve the quality of health care by encouraging state licensing boards, hospitals, health care entities, and professional societies to report into a national data bank those physicians and health professionals who demonstrate substandard skills or engage in unprofessional behavior. In part, it is used to make sure that incompetent physicians do not move from one state to another in order to avoid the consequences.

Adverse Reports Stay in the NPDB for Life.

How long does an adverse NPDB report stay in the Data Bank? I have received two (2) different answers to this question from different authorities. I was originally informed that adverse NPDB reports are for life, and believed that for my first 25 or so years of practice. However, more recently I have been informed that they only stay in the Data Bank for 50 years. However, there is little difference whether it is actually 50 years or for life. For most physicians, 50 years is a lifetime for a medical career.

 

A Negative NPDB Report Has the Ability to Ruin Your Career.

All reports in the NPDB on an individual can and are queried by state licensing boards, hospitals, and other health care facilities to assist in investigating adverse incidents and disciplinary actions that may have been taken against a physician applying for a license or clinical privileges. Therefore, adverse NPDB reports can have long-lasting, devastating effects on the career of a health care provider.

Additionally, the real-world consequences of being the subject of an NPDB report include possible exclusion from the panels of health plans and independent physician organizations, termination for cause from state Medicaid programs, loss of medical staff privileges at hospitals and health facilities, increases in professional liability insurance premiums, exclusion from the Medicare Program, and additional licensing investigations and potential discipline by other organizations and states.

If you are the subject of an adverse NPDB report, there are several actions you should take to correct any errors, provide your side of the facts, and possibly have the adverse report removed or corrected.

What Happens If You Disagree With Your Report?

Reports to the NPDB are, for all practical purposes for life, as explained above. But healthcare professionals may appeal adverse reports through a dispute resolution process involving the Secretary of the Department of Health and Human Services (HHS). You can dispute reports if you disagree with factual accuracy of the report or if the event reported are not proper under NPDB guidelines. For example, getting fired from a job or having a contract terminated for cause are not proper events to cause an adverse NPDB report. We have had to represent physicians in the past having these types of reports removed from the NPDB.

It’s important to note that entering the report into dispute status does not automatically trigger a review. When in dispute status, you have to notify the reporting organization. The reporting organization can correct, void, or choose to leave the report unchanged. If after 60 days you have received no response from the reporting organization, or you are unsatisfied with the response you received, you can elevate the report to dispute resolution (appeal).

Visit the NPDB website here for more details on this process.

For more reference, you can see what a successful voided NPDB report looks like here.  This example results from The Health Law Firm’s recent successful appeal of an adverse NPDB report for a client.

Your Career May Depend On Having Legal Counsel Who Understands the NPDB.

If you have received a negative National Practitioner Data Bank report and wish to appeal it, contact The Health Law Firm. Our attorneys routinely represent physicians, dentists, and other healthcare professionals in disputing and appealing NPDB reports. To learn more, click here to read one of my prior blogs.

Don’t Wait Until It’s Too Late, Contact Experienced Health Law Attorneys.

The Health Law Firm attorneys routinely represent physicians, physician assistants (PAs), nurses, nurse practitioners (NPs), dentists and other health professionals in dealing with reports being made to the NPDB, disputing NPDB reports and appealing NPDB reports, hospital clinical privileges hearings, medical staff fair hearings, medical staff peer reviews. 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.

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

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

“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.

 

Go to Top