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.

ADA Files Class Action Lawsuit For Antitrust Violations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On November 26, 2019, the American Dental Association (ADA) and two individual dentists filed a class-action lawsuit against the Delta Dental Plans Association, its affiliated national entities, and 39 independent Delta Dental companies. The suit alleges the provider network engaged in anticompetitive conduct and violated federal antitrust laws.

The ADA filed its lawsuit in the U.S. District Court for the Northern District of Illinois.

Details of the Suit.

The complaint alleges Delta Dental allocated territories of operation and divided the national market to restrict competition, reduce reimbursement rates, and force unfavorable coverage to dentists. “Its harm is reflected in the suppression of compensation below levels that would prevail in a competitive marketplace to dentists who are members of the Delta Dental provider network,” the suit alleges.

Hurting Both Dentists and Patients.

The complaint goes on to say that Delta’s anticompetitive acts hurt both dentists and patients by limiting the choices of dental care available. When compensation can’t cover dentists’ costs, they aren’t able to take time from commercially insured customers and serve the dental needs of other patients, like those on Medicaid, said the ADA.

Click here to view the complaint in this case in full.

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

Click here to read one of my prior blogs on a similar case dealing with dentists and an antitrust case.

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in the Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

Our firm also routinely represents physicians, dentists, orthodontists, medical groups, clinics, pharmacies, home health care agencies, nursing homes and other health care providers in AHCA investigations, audits and recovery actions, as well as Medicare and Medicaid investigations, audits and recovery actions.

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

Sources:

Cullen, Anne. “Dentists Sue Delta Dental Over Antitrust Conspiracy.” Law360. (November 27, 2019). Web.

Versaci, Mary Beth. “American Dental Association files lawsuit against Delta Dental.” ADA. (November 26, 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 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 © 2019 The Health Law Firm. All rights reserved. federal antitrust laws, health defense attorney, health defense lawyer, legal representation for dentists, health law firm, The Health Law Firm

ADA Files Class Action Lawsuit Against Delta Dental For Antitrust Violations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On November 26, 2019, the American Dental Association (ADA) and two individual dentists filed a class-action lawsuit against the Delta Dental Plans Association, its affiliated national entities, and 39 independent Delta Dental companies. The suit alleges the provider network engaged in anticompetitive conduct and violated federal antitrust laws.

The ADA filed its lawsuit in the U.S. District Court for the Northern District of Illinois.

Details of the Suit.

The complaint alleges Delta Dental allocated territories of operation and divided the national market to restrict competition, reduce reimbursement rates, and force unfavorable coverage to dentists. “Its harm is reflected in the suppression of compensation below levels that would prevail in a competitive marketplace to dentists who are members of the Delta Dental provider network,” the suit alleges.

Hurting Both Dentists and Patients.

The complaint goes on to say that Delta’s anticompetitive acts hurt both dentists and patients by limiting the choices of dental care available. When compensation can’t cover dentists’ costs, they aren’t able to take time from commercially insured customers and serve the dental needs of other patients, like those on Medicaid, said the ADA.

Click here to view the complaint in this case in full.

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

Click here to read one of my prior blogs on a similar case dealing with dentists and an antitrust case.

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in the Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

Our firm also routinely represents physicians, dentists, orthodontists, medical groups, clinics, pharmacies, home health care agencies, nursing homes and other health care providers in AHCA investigations, audits and recovery actions, as well as Medicare and Medicaid investigations, audits and recovery actions.

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

Sources:

Cullen, Anne. “Dentists Sue Delta Dental Over Antitrust Conspiracy.” Law360. (November 27, 2019). Web.

Versaci, Mary Beth. “American Dental Association files lawsuit against Delta Dental.” ADA. (November 26, 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 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 © 2019 The Health Law Firm. All rights reserved. federal antitrust laws, health defense attorney, health defense lawyer, legal representation for dentists, health law firm, The Health Law Firm

Dental Clinic Owners Found Guilty of $1 Million Medicaid, Tax Scheme

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

On February 21, 2019, a federal jury found the owners of several dental clinics in Missouri guilty of a $1 million scheme to defraud the government. The owners of All About Smiles LLC, were convicted of submitting false claims to Medicaid for dentures and other services and payroll tax fraud, according to prosecutors.

Submitting False Claims.

Prosecutors alleged that the couple that owned the practice ran several schemes through the dental clinics from 2010 to 2015, including conspiring to defraud Medicaid. A main part of the scheme was to provide dentures and other services to adults who didn’t qualify for Medicaid. They would then bill the Medicaid program anyway, receiving more than $720,000, according to the DOJ.

The pair also allegedly ran a similar scheme with orthodontic equipment, racking up an estimated 241 false claims, said prosecutors. All About Smiles was paid approximately $165,700 during the the duration of the scheme.

Payroll Problems.

In addition to the fraud, the owners allegedly failed to forward payroll taxes to the Internal Revenue Service (IRS) even though the money was withheld from employee paychecks. Instead, the married pair used the almost $195,000 to cover lavish personal expenses and make payments on a variety of vehicles, said the DOJ.

Not Smiling Anymore.

Jurors found the couple guilty on all charges detailed in a 40-count indictment accusing them of fraudulently operating three All About Smiles LLC dental clinics, said the DOJ. Additionally, their legal woes continued to stack up as each was also convicted on a count of theft of public money for collecting unemployment benefits while working.

The female owner faces up to 10 years in prison on every count besides the payroll tax conspiracy charge, which comes with a maximum penalty of five years. The husband owner could get up to a decade for obtaining unemployment benefits and five years for each additional charge, prosecutors said.

Click here to read the DOJ’s press release.

To read one of my prior blogs on a similar case about a dentist defrauding medicaid, click here.

Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicaid Billing Issues Now.

The attorneys of The Health Law Firm represent dentists, oral surgeons, and other health care providers in Medicaid audits, Medicare audits, insurance billing audits, ZPIC audits, RAC audits, administrative litigation and civil litigation throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in licensure complaints and investigations, DEA investigations, Medicare and Medicaid fraud investigations, audits, recovery actions and terminations from the Medicare or Medicaid Program.

For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Sources:

“All About Smiles Owners Convicted of Fraud.” Ozark Independent. (February 21, 2019). Web.
Posses, Shayna. “Couple Found Guilty Of $1M Medicaid, Payroll Tax Scheme.” Law360. (February 21, 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: legal representation for improper billing, improper billing defense attorney, Medicaid audit defense attorney, legal representation for Medicaid fraud, Medicaid fraud defense lawyer, legal representation for false claims, false claims legal defense representation, Medicaid fraud defense lawyer, Medicaid overpayment demand defense attorney, Medicaid Fraud Control Unit (MFCU) defense attorney, Medicaid Fraud Control Unit (MFCU) subpoena defense lawyer, Medicaid Fraud Control Unit (MFCU) search warrant defense attorney, False Clams Act (FCA) attorney, FCA defense lawyer, representation for allegations of false claims, Board of dentistry defense lawyer, dentist defense attorney, board of dentistry defense legal representation, Medicaid provider defense attorney, ZPIC audit defense attorney, Medicaid audit defense lawyer, dentist defense attorney, Board of Dentistry defense attorney, representation for health care professionals, representation for dental clinics, health law defense lawyer, health defense attorney, legal representation for dentists, The Health Law Firm reviews, Dentist Advantage Insurance defense attorney, The Health Law Firm attorney reviews, The Health Law Firm, Department of Health complaint investigation attorney, Health Providers Service Organization (HPSO) Insurance defense lawyer, the Doctors Company Insurance defense lawyer, Department of Justice (DOJ) investigation attorney, representation in DOJ investigations, DOJ defense lawyer, healthcare fraud defense lawyer

“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 © 2019 The Health Law Firm. All rights reserved.

2019-04-18T18:44:05-04:00April 18th, 2019|Categories: Centers for Medicare and Medicaid Services, Dental Law Blog, Dentist Defense attorney, Health Care Fraud, Health care Law, Medicaid Fraud, Medicaid fraud|Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Dentists Smiling as $80 Million Settlement Reached in Dental Supply Price-Fixing Class Action Suit

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

On August 30, 2018, after two years of litigation, a group of dentists tentatively reached an $80 million settlement in a proposed class action accusing the country’s biggest dental supply companies of colluding to fix prices. The three dominant distributors, Henry Schein Inc., Patterson Cos. Inc. and Benco Dental Supply Co. Inc., allegedly artificially inflated prices on crowns, numbing agents, X-ray accessories and other products.

Artificially Inflating Prices.

In 2016, the three distributors were accused of artificially inflating prices on various dental supplies and equipment. Products at issue included supplies such as adhesives, implants, tooth brushes, pins and posts all the way to equipment such as imaging devices and dental chairs. Although there are hundreds of distributors and manufacturers of dental supplies and equipment, the defendants controlled approximately 80% of the market share. Click here to read my prior blog on this case and learn more.

The $80 million settlement comes roughly 30 months after the dentists first launched their lawsuits against the manufacturers. To learn more, click here to view the consolidated class action complaint  and the order in full.

Collusion?

In response to the suit, the three distributors accused the group of dentists of inaccurately portraying isolated actions as a nationwide conspiracy. However, a New York federal judge found reason to believe the distributors colluded to strong-arm lower cost rivals and boycott trade groups that worked with a newer distributor called SourceOne Dental Inc.

Despite reaching the settlement, the distributors deny any wrongdoing even though the Federal Trade Commission (FTC) also filed an administrative complaint against them in February 2018. In the complaint, the FTC accused the nation’s three largest dental supply companies of conspiring to refuse to provide discounts to buying groups representing small dental practitioners in violation of antitrust laws. To view the FTC’s press release, click here. Click here to view the FTC’s complaint.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals.

The Health Law Firm has attorneys who practice in the area of antitrust law and trade regulation. We have defended a hospital in federal court against allegations of violations of the antitrust laws, we routinely provide advice and opinion letters on antitrust and trade regulation matters, we have represented plaintiffs in law suits alleging anticompetitive behavior and violations of state and federal antitrust laws, we have given opinions on and been involved in litigation concerning the Lanham Act and the Robinson-Patman Amendments, and we routinely undertake litigation concerning restrictive covenants.

The attorneys of The Health Law Firm provide advice and representation concerning antitrust law, trade regulation, restraint of trade issues, and regarding deceptive and unfair trade practices. We routinely provide advice and analysis of proposed business ventures that include the foregoing. We have represented both plaintiffs and defendants in state court litigation and in federal court litigation in such matters.

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

Sources:

Overley, Jeff. “Dentists Get $80M From Supply Cos. To End Collusion Case.” Law360. (August 30, 2018). Web.

“Dentists Get $80M From Supply Cos. To End Collusion Case.” InfoTech Consulting. (September 5, 2018). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: dental class action suit, complex healthcare litigation attorneys, legal representation for antitrust violations, representation for antitrust investigations, complex medical litigation lawyer, representation for complex litigation, representation for healthcare business litigation matters, employment contract representation, representation for physician dentist employment contract, healthcare contract review attorney, restraint of trade legal representation, representation for Board of Dentistry matters, Board of Dentistry representation, dentist lawyer,  attorney for dentists, Board of Dental Examiners legal counsel, representation for Federal Trade Commission (FTC) investigations, dental law defense lawyer, representation for dental law, representation for health care professionals, representation for dental clinics, health law defense lawyer, health defense attorney, legal representation for dentists, The Health Law Firm, reviews of The Health Law Firm Attorneys, The Health Law Firm attorney reviews, board of dentistry defense attorney, dental board defense legal counsel, representation for dentists, dentist defense lawyer

“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 © 2018 The Health Law Firm. All rights reserved.

Dentists Smiling as $80 Million Settlement Reached in Dental Supply Price-Fixing Class Action Suit

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

On August 30, 2018, after two years of litigation, a group of dentists tentatively reached an $80 million settlement in a proposed class action accusing the country’s biggest dental supply companies of colluding to fix prices. The three dominant distributors, Henry Schein Inc., Patterson Cos. Inc. and Benco Dental Supply Co. Inc., allegedly artificially inflated prices on crowns, numbing agents, X-ray accessories and other products.

Artificially Inflating Prices.

In 2016, the three distributors were accused of artificially inflating prices on various dental supplies and equipment. Products at issue included supplies such as adhesives, implants, tooth brushes, pins and posts all the way to equipment such as imaging devices and dental chairs. Although there are hundreds of distributors and manufacturers of dental supplies and equipment, the defendants controlled approximately 80% of the market share. Click here to read my prior blog on this case and learn more.

The $80 million settlement comes roughly 30 months after the dentists first launched their lawsuits against the manufacturers. To learn more, click here to view the consolidated class action complaint  and the order in full.

Collusion?

In response to the suit, the three distributors accused the group of dentists of inaccurately portraying isolated actions as a nationwide conspiracy. However, a New York federal judge found reason to believe the distributors colluded to strong-arm lower cost rivals and boycott trade groups that worked with a newer distributor called SourceOne Dental Inc.

Despite reaching the settlement, the distributors deny any wrongdoing even though the Federal Trade Commission (FTC) also filed an administrative complaint against them in February 2018. In the complaint, the FTC accused the nation’s three largest dental supply companies of conspiring to refuse to provide discounts to buying groups representing small dental practitioners in violation of antitrust laws. To view the FTC’s press release, click here. Click here to view the FTC’s complaint.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals.

The Health Law Firm has attorneys who practice in the area of antitrust law and trade regulation. We have defended a hospital in federal court against allegations of violations of the antitrust laws, we routinely provide advice and opinion letters on antitrust and trade regulation matters, we have represented plaintiffs in law suits alleging anticompetitive behavior and violations of state and federal antitrust laws, we have given opinions on and been involved in litigation concerning the Lanham Act and the Robinson-Patman Amendments, and we routinely undertake litigation concerning restrictive covenants.

The attorneys of The Health Law Firm provide advice and representation concerning antitrust law, trade regulation, restraint of trade issues, and regarding deceptive and unfair trade practices. We routinely provide advice and analysis of proposed business ventures that include the foregoing. We have represented both plaintiffs and defendants in state court litigation and in federal court litigation in such matters.

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

Sources:

Overley, Jeff. “Dentists Get $80M From Supply Cos. To End Collusion Case.” Law360. (August 30, 2018). Web.

“Dentists Get $80M From Supply Cos. To End Collusion Case.” InfoTech Consulting. (September 5, 2018). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: dental class action suit, complex healthcare litigation attorneys, legal representation for antitrust violations, representation for antitrust investigations, complex medical litigation lawyer, representation for complex litigation, representation for healthcare business litigation matters, employment contract representation, representation for physician dentist employment contract, healthcare contract review attorney, restraint of trade legal representation, representation for Board of Dentistry matters, Board of Dentistry representation, dentist lawyer,  attorney for dentists, Board of Dental Examiners legal counsel, representation for Federal Trade Commission (FTC) investigations, dental law defense lawyer, representation for dental law, representation for health care professionals, representation for dental clinics, health law defense lawyer, health defense attorney, legal representation for dentists, The Health Law Firm, reviews of The Health Law Firm Attorneys, The Health Law Firm attorney reviews, board of dentistry defense attorney, dental board defense legal counsel, representation for dentists, dentist defense lawyer

“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 © 2018 The Health Law Firm. All rights reserved.

Florida Dental Receptionist Charged With Stealing Thousands of Dollars From Patients

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 October 20, 2017, a receptionist at a Deltona dental clinic was arrested on charges she stole thousands of dollars in cash payments from the business’ customers since the beginning of 2016. Lucina Rodriguez was charged with two counts of grand theft in the case, which involved 30 missing bank deposits totaling more than $18,000 in cash. Rodriguez allegedly collected the cash payments from customers at Dental Care of Deltona, according to the Volusia County Sheriff’s Office.

The Alleged Theft. 

According to Volusia County sheriffs’ detectives, Rodriguez pocketed the cash deposits that were supposed to be taken to the bank. She also collected pre-payments but didn’t give receipts and failed to make a record of any payment in the patient’s file. The missing money would go undetected until months later, when the patient returned for the procedure, and the loss was written off as a “paperwork error.” In one case, a patient came to the clinic to cancel a procedure and request a refund of her $400 pre-payment. The clinic staff searched through her file and found no record of any pre-payment.

As detectives conducted interviews and inspected records, it became clear that she was the common link in the missing deposits.

From January 2016 to September 2017, she made close to $15,000 in cash deposits to her personal bank accounts. After she was fired on September 19, 2017, money stopped disappearing from the dental clinic.

The Consequences.

Rodriguez was charged with one count of grand theft ($10,000-$20,000) for the stolen cash deposits and an additional count of grand theft ($300-$5,000) for stealing the $400 pre-payment one victim wanted refunded. To read the press release in full from the Volusia County Sheriff’s Office, click here.

Unfortunately, this isn’t the first time a health professional has stolen from an employer. To learn more on how to stop employee embezzlement, click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals in Criminal Matters and Professional Licensing Matters.

If you have been arrested, it is strongly recommended that you retain an experienced attorney who can advise you on the criminal proceeding, your rights and how it may affect you. Most important to a physician, dentist, nurse, pharmacist or other health professional are what consequences may follow this. Consequences may include loss or suspension of hospital privileges, loss or suspension of your professional license, exclusion from the Medicare Program, termination from the state Medicaid Program, termination from health care insurance panels and other severe consequences.

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

“Deltona dental clinic worker charged with stealing $18,000.” The Daytona Beach News Journal. (October 20, 2017). Web.

Padró Ocasio, Bianca. “Dental clinic employee stole thousands of dollars from patients, authorities say.” Orlando Sentinel. (October 20, 2017). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for health care professionals, criminal defense attorney for health care professionals, legal representation for criminal matters against health professionals, licensure defense attorney, legal representation for employee embezzlement, legal representation for employee theft, dental defense attorney, legal representation for dentists, legal representation for dental receptionists, legal representation for dental clinics and facilities, defense attorney for dentists, health law defense attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, The Health Law Firm

“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 © 2017 The Health Law Firm. All rights reserved.

 

Arizona Appeals Court Affirms Dentist’s Suspension Over Questionable Prescriptions

1 Indest-2008-1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On December 13, 2016, an Arizona appeals court affirmed the suspension of a dentist who allegedly had a history of opioid addiction and who also allegedly wrote dozens of questionable prescriptions. The Arizona appeals court held that the state dental board didn’t violate his due process rights and had substantial evidence backing its decision that it wasn’t safe for him to practice.

The Arizona Court of Appeals, Division One, concluded that the Arizona State Board of Dental Examiners had acted within its authority by suspending Dr. Michael Wassef’s license to practice dentistry in the state. This was following Dr. Wassef’s refusal to submit to the dental board’s requests after it discovered evidence suggesting he had relapsed. The appeals court decision upheld a lower court’s decision affirming the dental board’s order.

History of Opioid Abuse?

Dr. Wassef’s possible relapse into opioid addiction reportedly first came to the attention of authorities in March 2014. This allegedly occurred when a pharmacist contacted the dental board to raise concerns about Dr. Wassef’s prescription-writing practices, according to the court’s decision. The board discovered that he had received prescriptions for controlled substances in increasing amounts over a six-year time period. Additionally, Dr. Wassef allegedly wrote 44 prescriptions in two years for the muscle relaxant Soma for his wife, his assistant and his assistant’s daughter, the opinion said.

After he tested positive for Soma and another medication, Dr. Wassef refused to submit to an assessment. As a result, the dental board issued an interim order that he obtain an inpatient substance-abuse evaluation, according to the opinion. He refused, and the dental board suspended his license in April 2014.

Arizona State Court Sides With Board.

Dr. Wassef contended that the board denied him due process by suspending his license without allowing him the opportunity to defend himself. Despite Wassef’s claims, the appeals court wasn’t swayed, explaining that the board didn’t have to give him a hearing before entering the interim order and can summarily suspend a licensee when it concludes.

The state board had more than enough evidence to conclude that Dr. Wassef was unsafe to practice dentistry, the appeals court panel held. “Under these circumstances, the board was not required to accept Dr. Wassef’s explanations and Dr. Wassef did not disprove the board’s suspicions,” the panel held. “Thus, the dental board had reasonable grounds to take emergency action to prevent harm to the public.”

To read the decision on this matter, click here.

To read more on the repercussions of choices such as this, click here to read one of my prior blogs.

Serious Allegations Need Serious Legal Representation.

When a dentist, physician, nurse, psychologist, pharmacist, or other licensed health professional is accused of drug abuse or alcohol abuse, this is a very serious matter. As happened in this case, your license can be suspended putting you out of work and terminating your ability to pay for a legal defense.

Several things are a must. You must have good professional liability insurance that pays for the legal defense of complaints filed against your license, preferable with $50,000 or more of coverage for this type of event. Second, you must immediately retain experience health care legal counsel who deals with these types of cases routinely. Often there are options to such a harsh remedy as a suspension. Additionally, all the time spent from initial notification of the complaint, should be used in obtaining evidence to show that the dentist is not currently impaired. This can be routine random urinalysis testing, treatment with psychiatrist and certified addictions professionals, evaluation by special physicians health programs and other actions.

Usually, suspension is only appropriate when the physicians condition makes him an immediate threat to patient safety. Being able to prove that the physician is not a threat is te key to preventing a suspension. Also, using the time and money in appealing such a decision may, in may cases, be better used in requesting an emergency hearing and getting the evidence needed for that hearing.

Consult With An Attorney Experienced in the Representation of Dentists and Other Health Professionals.

The Health Law Firm routinely represents dentists, dental technicians, pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing dentists and dental hygienists and other health professionals in investigations and at Board of dentistry hearings and other legal matters. Call now or visit our website www.TheHealthLawFirm.com.

Sources:

Posses, Shayna. “Ariz. Court Backs Dentist’s Suspension Over Dubious Scripts.” Law360. (December 13, 2016). Web.

“Arizona Court Backs Dentist’s Suspension.” Lexis Nexis. (December 13, 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.

KeyWords: Legal representation for dentists, defense attorney for dentists, legal counsel for dentists and dental assistants, defense attorney for health care professionals, DEA investigation defense attorney, legal representation for DEA investigations, legal representation for board investigations, defense attorney for board of dentistry matters, reviews of The Health Law Firm, The Health Law Firm attorney reviews, dental board defense work, dental board investigations, impaired dentists, impaired professionals, physician health programs, administrative hearings, complaint investigation defense attorney for dentists, appeals (and variations on appeal ) of adverse license action, license revocation, emergency suspension orders, appeals of emergency suspension orders, Professionals Resources Network (PRN) attorney, Florida dentist defense attorney, Virginia dentist defense lawyer, Louisiana dentist defense legal counsel, Colorado dentist defense lawyer, Kentucky legal dentist defense counsel, District of Columbia dentist legal representation

“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 © 2016 The Health Law Firm. All rights reserved.

Michigan Dentist Accused of Million Dollar Medicaid Fraud Scheme Captured in Caribbean

5 Indest-2008-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Michigan dentist accused of Medicaid fraud was recently captured in the Dominican Republic after evading charges for months, state authorities announced. Dr. David Johnson operated the alleged scheme through Livernois Dental in Detroit, which he owned at the time but has since sold.

27 Charges.

Dr. Johnson was charged by Michigan Attorney General Bill Schuette in May 2017, after allegedly using another dentist’s information to improperly bill Medicaid $1.7 million over a three year period of time. The charges include one count of racketeering, punishable by up to 20 years in prison; 20 counts of false Medicaid claims, punishable by up to 10 years in prison; and six counts of false health care claims, punishable by up to four years in prison.

According to the Attorney General’s press release, since the charges were issued, the dentist was living outside of the United States in an attempt to evade arrest. To read the AG’s press release in full, click here.

Unfortunately, this is not the only case of a health care professional trying to evade arrest. To read about another case, click here to read one of my prior blogs.

Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.

The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.

For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Sources:

Rahal, Sarah. “Macomb dentist accused of fraud faces 27 felonies.” The Detroit News. (October 3, 2017). Web.

“Chesterfield Township dentist accused of Medicaid fraud captured in Caribbean.” Baltimore Voice Newspaper. (October 3, 2017). 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., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for Medicaid fraud, Medicaid defense attorney, Medicaid fraud defense attorney, legal representation for health care fraud, Medicaid Fraud Control Unit (MFCU) defense attorney, dentist defense counsel, legal representation for dentist, dental board defense attorney, dental license defense attorney, legal representation for dentist, legal representation for allegations of health care fraud, legal representation for improper billing, legal representation for defrauding the government, legal representation for defrauding Medicaid, legal representation for dentists, dentist attorney, defense attorney for dentists, The Health Law Firm, reviews of The Health Law Firm, The Health Law Firm attorney reviews, board of dentistry defense counsel, Medicaid Fraud Control Unit (MFCU) legal representation, Medicaid Fraud Control Unit (MFCU) defense counsel

“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 © 2017 The Health Law Firm. All rights reserved.

 

Florida Board of Dentistry Makes Changes to Anesthesia Rules

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

On November 13, 2017, The Florida Board of Dentistry updated rules and terminology for the use of anesthesia. The Board changed terminology from “conscious sedation” or “pediatric conscious sedation” to “moderate sedation” or “pediatric moderate sedation.”

The updates were done to ensure that the terminology adequately describes the type of anesthesia that is being performed.

Existing Permit Holders.

If you are a dentist that currently holds a “conscious sedation” or “pediatric conscious sedation” permit, you will receive a new permit with the updated terminology. The Board made no substantive changes to the definition or level of permit.

For more information on the requirements, rules and the process of getting a “moderate sedation” or “pediatric moderate sedation” permit, click here.

View the complete updated anesthesia rules including rules for all permit holders.

If you are a medical professional in the dentistry field, be sure to check our Dental Law Blog regularly to stay on top of news and changes that may affect your dental license.

Click here to find out how The Health Law Firm can assist you if you are facing legal trouble or need representation.

Contact Health Law Attorneys Experienced with Department of Health Investigations of Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations and other types of investigations of health professionals and providers. Additionally, we represent dentists in purchases and sales of dental practices, Medicaid and insurance audits, legal disputes over contracts and business matters, and Board of Dentistry hearings. To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Today’s FDA. “Information About The Florida Board of Dentistry.” www.floridadental.org. (February 27, 2018). Web.

“Important Update Regarding Conscious Sedation and Pediatric Conscious Sedation Permit Holders.” The Florida Board of Dentistry. (February 27, 2018). 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., 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 © 2018 The Health Law Firm. All rights reserved.

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