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Finding a Healthcare Providers Service Organization (HPSO) Insurance Attorney to Defend you in a Complaint Against Your Pharmacist or Pharmacy License

Carole C. SchrieferBy Carole C. Schriefer, J.D.
Many pharmacists or their pharmacies carry professional malpractice insurance through Healthcare Providers Service Organization (HPSO) or one of the other similar professional liability insurance companies. What they may not realize is that this insurance will pay for their legal defense expenses if there is a complaint filed against their pharmacist license or the pharmacy’s license. It will also pay for legal defense expenses if they receive a subpoena for records, if they are required to attend a deposition, or if they are accused of violating HIPAA or a client’s medical confidentiality.

Under this type of policy, the insurance company will pay the legal fees and other costs related to your defense or legal representation. However, you will be required to locate and retain the appropriate attorney to represent you in the matter.

What to Look For When Retaining an Attorney to Defend You.

1. The primary qualification for any attorney you hire to represent you should be his or her experience in working with health professionals in the same field. If the attorney is not familiar with your area of health practice, with the type of legal proceeding you have, or with your professional licensing board, it may be difficult for that attorney to represent you properly.

2. If consult with an attorney who states that she or he will help you make a statement to the investigator or assist you in the investigation, but will not agree to appear and represent you in hearings, then this is the wrong attorney. You need an attorney that can represent you from start to finish.

3. Seek and retain an attorney who accepts the insurance that you have, whether it is HPSO Insurance, CPH & Associates Insurance, Philadelphia Insurance, Pharmacist Mutual Insurance Company (PMIC), Trust Management Services, Philadelphia Insurance, Firemans Fund, or another national company. This will ensure that you have an attorney who will give you the lower rates the insurance company has negotiated and will have a good working relationship established with your insurance company. If an attorney with our firm cannot represent you, we will try to find you an attorney who will.

4. You also want to retain the services of an attorney who has appeared before your professional board or professional licensing authority in investigations and hearings, especially in formal administrative hearings.

5. Often you will come across an attorney who only wants you to accept a consent order, stipulation, or settlement agreement. Remember that these are all merely plea bargains and you will be pleading guilty to whatever offenses are charged. This is teh easy way out and often the easy way is not the right way. IF you plead guilty then, from that point on, you are guilty. In most cases, however, you will actually be innocent of the charges and will need a formal administrative hearing in order to prove this.

6. You don’t necessarily need an attorney who resides in your city, state, or location. Almost all the work on the case will be done by telephone and e-mail. You usually have only one meeting or hearing and, depending on what type of hearing it is, it could be located in many different locations. Our attorneys will travel to those locations for meetings and hearings.

7. Beware of attorneys who hold themselves out in Internet advertising as health attorneys or professional license defense attorneys but are really some other type of attorneys. We see this a lot from medical malpractice attorneys, criminal defense attorneys and attorneys who sue insurance companies. Be sure you get an attorney who concentrates his or her practice in defending those in the specialty of pharmacy and in board of pharmacy complaints, investigations, and hearings.

8. If you can’t find an attorney to meet your immediate needs through our firm or an Internet search, you may contact your insurance company or professional association and ask if they have a list of attorneys that can do the legal work you require.

For example, you may reach Healthcare Providers Service Organization (HPSO) at (800) 982-9491; you can reach Nurses Service Organization (NSO) at (800) 247-1500; you can reach CPH & Associates at (800) 875-1911 or (312) 987-9823; you can reach Pharmacists Mutual Insurance Company (PMIC) at (800) 247-5930.

Contact Health Law Attorneys Experienced Investigations of Pharmacists and Pharmacies.

The attorneys of The Health Law Firm provide legal representation to pharmacists, pharmacies, prescribing physicians, dispensing physicians and nurse practitioners, and other health providers in pharmacy board complaints and investigations, Department of Health (DOH) investigations, Colorado DORA investigations, Drug Enforcement Administration (DEA) investigations, Medicare and Medicaid audits, Medicaid Fraud Control Unit (MFCU) investigations, and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

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

About the Author: Carole C. Schriefer is an attorney and former registered nurse. She practices with The Health Law Firm, which has a national practice. Its regional office is in the Northern Colorado, area. www.TheHealthLawFirm.com The Health Law Firm, 155 East Boardwalk Drive, Fort Collins, Colorado 80525. Phone: (970) 416-7456. Its main office is in the Orlando, Florida area.

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

By |2020-02-04T16:56:51-05:00February 4th, 2020|Categories: Colorado Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Finding a Healthcare Providers Service Organization (HPSO) Insurance Attorney to Defend you in a Complaint Against Your Pharmacist or Pharmacy License

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Many pharmacists or their pharmacies carry professional malpractice insurance through Healthcare Providers Service Organization (HPSO) or one of the other similar professional liability insurance companies. What they may not realize is that this insurance will pay for their legal defense expenses if there is a complaint filed against their pharmacist license or the pharmacy’s license. It will also pay for legal defense expenses if they receive a subpoena for records, if they are required to attend a deposition, or if they are accused of violating HIPAA or a client’s medical confidentiality.

Under this type of policy, the insurance company will pay the legal fees and other costs related to your defense or legal representation. However, you will be required to locate and retain the appropriate attorney to represent you in the matter.

What to Look For When Retaining an Attorney to Defend You.

1. The primary qualification for any attorney you hire to represent you should be his or her experience in working with health professionals in the same field. If the attorney is not familiar with your area of health practice, with the type of legal proceeding you have, or with your professional licensing board, it may be difficult for that attorney to represent you properly.

2. If consult with an attorney who states that she or he will help you make a statement to the investigator or assist you in the investigation, but will not agree to appear and represent you in hearings, then this is the wrong attorney. You need an attorney that can represent you from start to finish.

3. Seek and retain an attorney who accepts the insurance that you have, whether it is HPSO Insurance, CPH & Associates Insurance, Philadelphia Insurance, Pharmacist Mutual Insurance Company (PMIC), Trust Management Services, Philadelphia Insurance, Firemans Fund, or another national company. This will ensure that you have an attorney who will give you the lower rates the insurance company has negotiated and will have a good working relationship established with your insurance company. If an attorney with our firm cannot represent you, we will try to find you an attorney who will.

4. You also want to retain the services of an attorney who has appeared before your professional board or professional licensing authority in investigations and hearings, especially in formal administrative hearings.

5. Often you will come across an attorney who only wants you to accept a consent order, stipulation, or settlement agreement. Remember that these are all merely plea bargains and you will be pleading guilty to whatever offenses are charged. This is teh easy way out and often the easy way is not the right way. IF you plead guilty then, from that point on, you are guilty. In most cases, however, you will actually be innocent of the charges and will need a formal administrative hearing in order to prove this.

6. You don’t necessarily need an attorney who resides in your city, state, or location. Almost all the work on the case will be done by telephone and e-mail. You usually have only one meeting or hearing and, depending on what type of hearing it is, it could be located in many different locations. Our attorneys will travel to those locations for meetings and hearings.

7. Beware of attorneys who hold themselves out in Internet advertising as health attorneys or professional license defense attorneys but are really some other type of attorneys. We see this a lot from medical malpractice attorneys, criminal defense attorneys and attorneys who sue insurance companies. Be sure you get an attorney who concentrates his or her practice in defending those in the specialty of pharmacy and in board of pharmacy complaints, investigations, and hearings.

8. If you can’t find an attorney to meet your immediate needs through our firm or an Internet search, you may contact your insurance company or professional association and ask if they have a list of attorneys that can do the legal work you require.

For example, you may reach Healthcare Providers Service Organization (HPSO) at (800) 982-9491; you can reach Nurses Service Organization (NSO) at (800) 247-1500; you can reach CPH & Associates at (800) 875-1911 or (312) 987-9823; you can reach Pharmacists Mutual Insurance Company (PMIC) at (800) 247-5930.

Contact Health Law Attorneys Experienced Investigations of Pharmacists and Pharmacies.

The attorneys of The Health Law Firm provide legal representation to pharmacists, pharmacies, prescribing physicians, dispensing physicians and nurse practitioners, and other health providers in pharmacy board complaints and investigations, Department of Health (DOH) investigations, Colorado DORA investigations, Drug Enforcement Administration (DEA) investigations, Medicare and Medicaid audits, Medicaid Fraud Control Unit (MFCU) investigations, and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

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

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

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

By |2020-02-04T16:39:04-05:00February 4th, 2020|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Finding a Healthcare Provider Service Organization (HPSO) Insurance Attorney to Defend you in a Complaint Against Your Mental Health Counselor or Social Workers License

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
Many licensed mental health counselors (LMHCs), licensed clinical social workers (LCSWs), licensed marriage and family therapists (LMFT), and other mental health professionals carry professional malpractice insurance through the Healthcare Providers Service Organization (HPSO) or one of the many other professional liability insurance companies. What they may not realize is that their insurance will pay for their legal defense expenses if there is a complaint filed against their license, if they receive a subpoena, if they are noticed for a deposition, or if they are accused of violating HIPAA or a client’s medical confidentiality rights.

Under such policies, the insurance company will pay the legal fees and other costs related to your defense. However, you will be required to locate and retain the appropriate attorney to represent you in the matter. So how do you go about doing this?

What to Look For When Retaining an Attorney to Defend You.

1. The primary qualification for any attorney you hire to represent you should be her experience in working with health professionals in the same field. If the attorney is not familiar with your area of health practice, it may be difficult for that attorney to get up to speed to represent you properly.

2. If you come across an attorney who states that he or she will help you make a statement or assist you in the investigation, but does not appear in hearings, then this is the wrong attorney. You need an attorney that can represent you from start to finish.

3. Seek and retain an attorney who accepts the insurance that you have, whether it is HPSO Insurance, CPH & Associates Insurance, Philadelphia Insurance, Trust Management Services, or another national company. This will ensure that you have an attorney who will give you the lower rates the insurance company had negotiated and will have a good working relationship established with your insurance company. If an attorney with our firm cannot represent you, we will try to find an attorney who will.

4. You also want to retain the services of an attorney who has appeared before your professional board or professional licensing authority in investigations and hearings, especially formal administrative hearings.

5. Often you will come across an attorney who only wants you to accept a consent order, stipulation, or settlement agreement. Remember that these are all merely plea bargains and you will be pleading guilty to whatever offenses are charged. In most cases, you will be innocent and need a formal administrative hearing in order to prove this.

6. You don’t necessarily need an attorney in your city, state, or location. Almost all the work on the case will be done by telephone and e-mail. You usually have only one meeting or hearing and, depending on what type of hearing it is, it could be located in many different locations. Our attorneys will travel to those locations for meetings and hearings.

7. Beware of attorneys who hold themselves out in Internet advertising as health attorneys or professional license defense attorneys but are really some other type of attorneys. We see this a lot from medical malpractice attorneys and criminal defense attorneys. Be sure you get an attorney that concentrates her practice in defending those in your specialty in board complaints, investigations and hearings.

8. If you can’t find an attorney to meet your immediate needs through an Internet search, you may contact your insurance company or professional association and ask if they have a list of attorneys that can do the legal work you require.

For example, you may reach Healthcare Providers Service Organization at (800) 982-9491; you can reach Nurses Service Organization (NSO) at (800) 247-1500; you can reach CPH & Associates at (800) 875-1911 or (312) 987-9823. You can also access a list of professional license defense attorneys online at https://taana.org/referral/.

To learn more about finding an HPSO attorney to defend you in such matters, click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced Investigations of Mental Health Counselors, Psychologists, Social Workers, and Family Therapists.

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, social workers, and family therapists in Department of Health (DOH) investigations, FBI investigations and other types of investigations of health professionals and providers. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

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

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

KeyWords: Healthcare Providers Service Organization (HPSO) Insurance defense attorney, HPSO lawyer, Florida HPSO defense attorney lawyer, Colorado HPSO defense attorney lawyer, legal representation for HPSO matters in Colorado, legal representation for HPSO matters in Florida, representation for professional liability insurance cases, Louisiana HPSO defense attorney lawyer, legal representation for HPSO matters in Louisiana, HPSO deposition defense coverage, representation for licensed mental health counselors (LMHCs), mental health counselor defense lawyer, licensed professional counselor (LPC) defense attorney lawyer, mental health counselor legal representation, licensed professional counselor (LPC) legal representation, social worker defense lawyer, representation for social workers, social worker defense attorney, social worker complaint cases, Florida Colorado Louisiana mental health counselor complaint cases, defense lawyer for psychologists, Florida health law defense attorney, medical license defense, Florida Department of Health (DOH) attorney, representation for Louisiana and Florida Department of Health (DOH) complaint investigations, Louisiana and Florida Department of Health (DOH) defense lawyer, Colorado Division of Regulatory Agencies (DORA) defense attorney, representation for Florida Colorado Division of Regulatory Agencies (DORA) complaint investigations, Colorado Division of Regulatory Agencies (DORA) defense lawyer, Lousiana LPC Board defense attorney lawyer, Health Law Firm reviews, reviews of The Health Law Firm attorneys, administrative complaint defense lawyer, administrative complaint defense attorney, administrative hearing defense lawyer, administrative hearing defense attorney, administrative hearing defense legal counsel, representation for health care professionals

“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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By |2020-01-23T17:59:44-05:00January 23rd, 2020|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Nursing Home Chain Reaches Record High False Claims Act Settlement With DOJ

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

On October 24, 2016, the U.S. Department of Justice (DOJ) announced that Life Care Centers of America will be paying $145 million to end False Claims Act (FCA) litigation that alleged the company submitted false claims to Medicare for rehabilitation therapy services that were not necessary.  This settlement is a FCA record for the nursing industry and DOJ claims it is the largest in the Department’s history.

Who Blew The Whistle?

Tammie Taylor and Glenda Martin, the two whistle blowers and former employees of Life Care, will be splitting the $29 million cut of the payout that they receive as the persons who blew the whistle and filed the initial law suit.  The deal marks the end of two whistle blower cases and a wrongful enrichment suit brought by the DOJ against Forrest L. Preston. Preston is the owner of the Tennessee-based Life Care Center that has over 200 skilled nursing facilities.

$29 million may not be very much money to you, but it is to me.  The False Claims Act and the monetary rewards it authorizes to those who come forward and report fraudulent activities, has now become the primary tool the government has to help stamp out fraud in government programs, in my opinion.

Unnecessary Treatment Alleged.

The government joined the FCA case filed by the whistle blowers in 2012, suspecting that the company was performing excessive treatment of senior patients in order to maximize their Medicare reimbursement.  The company was accused of excessive and unreasonable treatment between January 1, 2006, and February 28, 2013, so that they would qualify for the “Ultra High” reimbursement level Medicare pays.  U.S. Attorney Nancy Stallard Harr stated on Monday that the company’s actions “exploits our most vulnerable citizens.”

According to reports, Preston announced made a statement in connection with the settlement that denied that Life Care engaged in any illegal or improper conduct but was pleased to put the matter behind it.

Big Rewards for Whistle Blowers.

This cause helps show the big monetary rewards that employees and former employees of health care businesses can obtain by coming forward and reporting it when their employer is engaged in submitting false claims to the government.  If managers and supervisors condone or turn a blind eye toward its employees submitting false claims, then this is the same as knowingly committing such violations.  The business is profiting from the false claims.

What is usually missing when an employee or former employee tries to file a whistle blowers law suit is documentation of the companies submission of claims taht are actually false.  Therefore, before an employee or former employee files such a suit, he or she must have copies of the claims that were actually submitted (such as CMS forms 1500, superbills, explanation of benefits (EOBs), etc.) and other documentation.  Without such documentation that shows that false claims were actually submitted for payment, many FCA whistle blower suits are dismissed.

Also, any claims that are paid by state or federally funded healthcare programs can be the subject of such an action.  Most states have a state false claims act that is based on the federal law.  Usually this applies to the state Medicaid program,, but it can also apply to state provided employer health clinics that some cities, counties and agencies provide or to other state funded activities.  Federally funded health care programs that can result in FCA suits include not just Medicare, but also TRICARE, Veterans Administration (VA) funding, Public Health Service (PHS) funding, Indian Health Service (IHS) funding and other government health care programs.  When in doubt, call your friendly whistle blower attorney.

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

Attorneys with The Health Law Firm also represent health care professionals and health facilities in qui tam or whistleblower cases both in defending such claims and in bringing such claims. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistleblower cases, as well.

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

Sources:
Overly, Jeff. “Nursing Home Chain Inks Record $145M FCA Deal With DOJ.” Law360.(October 24, 2016).Web.

“Life Care Centers of America Inc. Agrees to Pay $145 Million to Resolve False Claims Act Allegations Relating to the Provision of Medically Unnecessary Rehabilitation Therapy Services.” Department of Justice. (October 24, 2016). 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 the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.