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Question: What Should You, as a Dentist, Do If You Or One of Your Employees Tests Positive For the COVID-19 Coronavirus?

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

You or a member of your staff has a confirmed case of COVID-19. What now? Your primary concern is for the individual affected. However, as a health professional operating a professional practice, you also have a duty to your employees and to your other patients. You have to be concerned about any patients with whom your infected staff might have had contact. These steps and protocols, all from prominent government agencies, are meant to help guide you if you or someone in your practice tests positive for COVID-19.

Follow these steps below to help ensure the health and safety of others and to reduce the likelihood of additional transmissions:

• The Centers for Disease Control and Prevention (CDC) recommends that employees who were exposed to the infected staff member should be quarantined for 14 days, keep track of their symptoms, and contact their own healthcare provider if the symptoms progress.

• Your entire dental office and facility, especially the waiting areas, restrooms, and treatment areas, should receive a “deep cleaning.” These should be regularly cleaned and sanitized or sterilized as the case may be. Click here for additional information on the proper ways to do so.

• According to the CDC, the Dental Healthcare Provider (DHP) should ensure that environmental cleaning and disinfection procedures are followed consistently and correctly after each patient. However, according to the CDC, the DHP does not need to attempt to sterilize a dental operatory between each patient.

• Sterilization protocols do not vary for respiratory pathogens. According to the CDC, the dental professional should perform routine cleaning, disinfection, and sterilization protocols, and follow the recommendations for “Sterilization and Disinfection of Patient-Care Items” present in the Guidelines for Infection Control in Dental Healthcare Settings.

• The Dentists should have and implement sick leave policies for any infected staff. These should be flexible, non-punitive, and consistent with public health guidance.

• As part of routine practice, dentists should also monitor themselves for fever and symptoms consistent with COVID-19 regularly.

• The dentists should screen all staff at the beginning of their shift for fever and symptoms consistent with COVID-19. One person, such as the receptionist, might be assigned to this task. Equipment that does not require actual physical contact, such as an infrared thermometer, should be used. The dentists in the practice should be required to undergo this screening, as well.

For additional information, guidance, and resource documents on this topic, please visit our Health Law Articles and Documents page.  Be sure to visit our blog page regularly to stay updated on the latest news, policies, and health law topics!

We continue to receive inquiries from healthcare practitioners requesting information regarding health law matters during this time of uncertainty. We are here for you! If you have additional questions in the COVID-19 crisis or any health law matter, please call our office at (407) 331-6620.

Additional Resources.

The following are additional resources dentists should consult on this issue:


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, Department of Regulatory Affairs (DORA) investigations, Agency for Health Care Administration (AHCA) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Office of Civil Rights (OCR) HIPAA complaints and investigations, U.S. Department of Health and Human Services (HHS) subpoenas and investigations, state board of dentistry complaints and investigations 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 Department of Health (DOH), Department of Regulatory Affairs (DORA), and Agency for Health Care Administration (AHCA) inspections, 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 (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

 

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Headshot of The Health Law Firm's attorney George F. Indest IIIAbout the Authors: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, and Achal A. Aggarwal, M.B.A., J.D. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“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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Avoid Being Labeled as a “Disruptive Physician” at All Costs

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

Although “old news” at this point, on July 9, 2008, the Joint Commission (TJC) published the following alert to health care organizations:
Sentinel Event Alert;  Issue 40, July 9, 2008
Behaviors That Undermine a Culture of Safety

Intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and to preventable adverse outcomes, increase the cost of care, and cause qualified clinicians, administrators and managers to seek new positions in more professional environments.  Safety and quality of patient care is dependent on teamwork, communication, and a collaborative work environment. To assure quality and to promote a culture of safety, health care organizations must address the problem of behaviors that threaten the performance of the health care team.
For the entire text and greater detail on detection, analysis, and prevention, as provided to health care organizations by the JCAHO, you may refer to:  http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm

This was considered a big flag to hospitals that they should aggressively move to discipline and terminate those physicians in their facilities whose conduct could lead to a label of “disruptive physician.”  Since that time, we have seen increasing numbers of physicians having to defend themselves because they were too demanding, had too high expectations of nursing and hospital staff, had a low thresh hold for incompetence, or just were trying too hard to be sure quality care was provided to their patients.  Often we have seen this type of complaint initiated by nurses on the hospital’s staff who just did not like a physician for various reasons.
The Joint Commissions Alert was a green light to hospitals that they could use the peer review and credentialing process to punish and terminate such physicians.

Physicians Are Easily Labeled “Disruptive”.

Physicians are often unfairly labeled as “disruptive physicians” by hospitals, health care institutions, employers or economic competitors of theirs in a health care setting.  This label can be assigned to the most skilled, compassionate and innocent physician.  Unless immediate action is taken by the physician to counter this false labeling, it may result in extremely serious repercussions, loss of income and tremendous expense.

You Can Be Labeled Disruptive Even With The Best Intentions.

We have seen, first-hand, examples of physicians where attempts were made to label them as “disruptive physicians” for a number of reasons.

An individual can be labeled disruptive:

• For refusing to allow unnecessary and expensive invasive procedures to be performed on patients by another physician in a hospital setting.
• For refusing to provide a drug seeking addict (who was hospitalized after a gunfight with police) with additional narcotics.
• By an economic competitor of a physician, who had been able to obtain election as president of the medical staff in order to drive her off of the hospital staff, thereby eliminating her competition with him.
• By competing medical groups forming an alliance with administrators at a for-profit hospital to label a physician competitor as a “disruptive physician” and enlist the aid of nursing staff to document every alleged transgression of the physician.
• When hospital nursing staff are instructed to scrutinize every act of a surgeon on the staff and to write up every perceived action of this doctor that might possibly be considered to be inappropriate any respect (even “rudeness”).
• Because a surgeon cancelled an elective surgery after the scheduled surgery on their patient was delayed three hours because hospital staff did not come in on time and other surgeries started late.
• Because nursing staff desired to get rid of a foreign physician that the nurses felt did not treat nurses respectfully enough.

Often physicians reacting to protect their patients from other physicians, or who may attempt to correct incompetent nursing staff, are labeled as “disruptive” because of their comments or actions.  Physicians who are somewhat demanding or who are perfectionists (as many, naturally, are), are often unfairly labeled as “disruptive.”  We have seen the most highly skilled sub-specialists, whose only major concern is their patients care and safety, branded as a “disruptive physician” by hospital staff.  We have also seen this occur in smaller, more rural hospitals where the nursing staff may be less than totally competent.

All Physicians Need To Be Aware Of The Risks Of Being Labeled “Disruptive”.

It is extremely important that a physician be sensitive to the possibility of being labeled a “disruptive physician” and the possible consequences this can bring.  It may result in the initiation of peer review proceedings to terminate clinical privileges and medical staff membership.  It may result in a complaint to the state licensing board against the physician.  We have handled a number of cases where complaints were made (even “anonymous” complaints”) to the state impaired physician program, resulting in a long, expensive battle with psychiatric experts and psychologists, in order to refute the allegations.

Immediately Seek Legal Help To Counter Allegations.

It is necessary that any allegation made that insinuates that the physician is a “disruptive physician” be immediately, but objectively, countered.  A neutral, factual rebuttal is often all that is required.  However, sometimes an economic competitor, or an unfriendly hospital administrator, will attempt to push the matter to extremes in an attempt to get rid of the physician, to make his or her job easier.  It may be advisable to obtain the services of an experienced healthcare attorney in fashioning a responsive or even formulating a strategy for a long-term defense in such situations.

It Is Critical To Gather Evidence From Professionals Of Stability.

In some cases, it may be advisable to have our client evaluated by trained psychiatrists and other health care professionals ahead of time, in order to have expert evidence immediately available that the physician does not have a personality disorder or other impairment.  This may be used to head off any complaint to or from the state licensing board or impaired physician program.

Florida Has High Number Of Incidents.

In Florida, especially, we have seen an increase in referrals to the state impaired physician program for allegedly “disruptive physicians” where a cottage industry seems to have arisen in making such diagnoses and preparing treatment and monitoring plans for them.  We have been involved in at least one case where a prominent, successful surgeon was forced to undergo testing, evaluation, and psychoanalysis, while he was excluded by a major hospital, over a course of approximately two years, with the threat of disciplinary action by his state licensing board if he refused to “cooperate.”  Finally, after spending tens of thousands of dollars on the recommended psychiatric and psychological evaluations, and after spending tens of thousands of dollars in attorney’s fees, it was decided he had no such problems, he was not a “disruptive physician” and there was no probable cause for any disciplinary action against him.

Legal Action May Be Only Way To Fix a Damaged Reputation.

In some cases, it may even be necessary for the physician to take the extreme measure of suing the hospitals or the individuals who are behind such action.  We have been required to do this on behalf of clients in a number of different cases.  Often, this is the only way to get the truth of the matter out, especially when it related to economic competitors of the physician who may be in control of the hospital’s medical staff.

Hospitals’ Role In Identifying Disruptive Physicians.

We believe that, as a result of the foregoing, we will see a much greater attempt on the part of hospitals to identify and discipline physicians on hospital staffs as “disruptive physicians” through hospital peer review procedures, and through reports to state licensing boards and the organizations that were established to monitor physicians with substance abuse problems (such as the Professionals Resource Network (PRN) in Florida).  Any correspondence, warning, letter or counseling a physician receives that mentions the word “disruptive” or makes such an insinuation, should be taken very seriously by the physician.  It should be responded to immediately, with facts, in an objective and dispassionate manner without attempting to “blame” anyone else.  When in doubt, consult with an experienced board certified health law attorney.

Being Labeled Disruptive Should Not Be Taken Lightly, Contact Health Law Attorneys Experienced In Handling All Cases of Disruptive Physician Accusations.

The Health Law Firm’s attorneys routinely represent physicians in cases of the disruptive label.  Being labeled disruptive cannot be taken lightly. This label can go on your record and affect your current and future work as a physician. Contact an experienced Health Law attorney the second allegations are made against you.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Keywords: legal representation for disruptive physician, allegations of disruptive physicians, legal representation for disruptive physician allegations, disruptive physician defense attorney, health care professional defense attorney, legal representation for health care professionals, health law defense attorney, Florida health law attorney, reviews of the Health Law Firm, The Health Law Firm attorney reviews, Health law defense attorney, medical staff peer review attorney, clinical privileges legal counsel, medical staff fair hearing defense attorney, peer review legal counsel, hospital fair hearing attorney
“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.

Avoid Being Labeled as a “Disruptive Physician” at All Costs

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

Although “old news” at this point, on July 9, 2008, the Joint Commission (TJC) published the following alert to health care organizations:
Sentinel Event Alert;  Issue 40, July 9, 2008
Behaviors That Undermine a Culture of Safety

Intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and to preventable adverse outcomes, increase the cost of care, and cause qualified clinicians, administrators and managers to seek new positions in more professional environments.  Safety and quality of patient care is dependent on teamwork, communication, and a collaborative work environment. To assure quality and to promote a culture of safety, health care organizations must address the problem of behaviors that threaten the performance of the health care team.
For the entire text and greater detail on detection, analysis, and prevention, as provided to health care organizations by the JCAHO, you may refer to:  http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm

This was considered a big flag to hospitals that they should aggressively move to discipline and terminate those physicians in their facilities whose conduct could lead to a label of “disruptive physician.”  Since that time, we have seen increasing numbers of physicians having to defend themselves because they were too demanding, had too high expectations of nursing and hospital staff, had a low thresh hold for incompetence, or just were trying too hard to be sure quality care was provided to their patients.  Often we have seen this type of complaint initiated by nurses on the hospital’s staff who just did not like a physician for various reasons.
The Joint Commissions Alert was a green light to hospitals that they could use the peer review and credentialing process to punish and terminate such physicians.

Physicians Are Easily Labeled “Disruptive”.

Physicians are often unfairly labeled as “disruptive physicians” by hospitals, health care institutions, employers or economic competitors of theirs in a health care setting.  This label can be assigned to the most skilled, compassionate and innocent physician.  Unless immediate action is taken by the physician to counter this false labeling, it may result in extremely serious repercussions, loss of income and tremendous expense.

You Can Be Labeled Disruptive Even With The Best Intentions.

We have seen, first-hand, examples of physicians where attempts were made to label them as “disruptive physicians” for a number of reasons.

An individual can be labeled disruptive:

• For refusing to allow unnecessary and expensive invasive procedures to be performed on patients by another physician in a hospital setting.
• For refusing to provide a drug seeking addict (who was hospitalized after a gunfight with police) with additional narcotics.
• By an economic competitor of a physician, who had been able to obtain election as president of the medical staff in order to drive her off of the hospital staff, thereby eliminating her competition with him.
• By competing medical groups forming an alliance with administrators at a for-profit hospital to label a physician competitor as a “disruptive physician” and enlist the aid of nursing staff to document every alleged transgression of the physician.
• When hospital nursing staff are instructed to scrutinize every act of a surgeon on the staff and to write up every perceived action of this doctor that might possibly be considered to be inappropriate any respect (even “rudeness”).
• Because a surgeon cancelled an elective surgery after the scheduled surgery on their patient was delayed three hours because hospital staff did not come in on time and other surgeries started late.
• Because nursing staff desired to get rid of a foreign physician that the nurses felt did not treat nurses respectfully enough.

Often physicians reacting to protect their patients from other physicians, or who may attempt to correct incompetent nursing staff, are labeled as “disruptive” because of their comments or actions.  Physicians who are somewhat demanding or who are perfectionists (as many, naturally, are), are often unfairly labeled as “disruptive.”  We have seen the most highly skilled sub-specialists, whose only major concern is their patients care and safety, branded as a “disruptive physician” by hospital staff.  We have also seen this occur in smaller, more rural hospitals where the nursing staff may be less than totally competent.

All Physicians Need To Be Aware Of The Risks Of Being Labeled “Disruptive”.

It is extremely important that a physician be sensitive to the possibility of being labeled a “disruptive physician” and the possible consequences this can bring.  It may result in the initiation of peer review proceedings to terminate clinical privileges and medical staff membership.  It may result in a complaint to the state licensing board against the physician.  We have handled a number of cases where complaints were made (even “anonymous” complaints”) to the state impaired physician program, resulting in a long, expensive battle with psychiatric experts and psychologists, in order to refute the allegations.

Immediately Seek Legal Help To Counter Allegations.

It is necessary that any allegation made that insinuates that the physician is a “disruptive physician” be immediately, but objectively, countered.  A neutral, factual rebuttal is often all that is required.  However, sometimes an economic competitor, or an unfriendly hospital administrator, will attempt to push the matter to extremes in an attempt to get rid of the physician, to make his or her job easier.  It may be advisable to obtain the services of an experienced healthcare attorney in fashioning a responsive or even formulating a strategy for a long-term defense in such situations.

It Is Critical To Gather Evidence From Professionals Of Stability.

In some cases, it may be advisable to have our client evaluated by trained psychiatrists and other health care professionals ahead of time, in order to have expert evidence immediately available that the physician does not have a personality disorder or other impairment.  This may be used to head off any complaint to or from the state licensing board or impaired physician program.

Florida Has High Number Of Incidents.

In Florida, especially, we have seen an increase in referrals to the state impaired physician program for allegedly “disruptive physicians” where a cottage industry seems to have arisen in making such diagnoses and preparing treatment and monitoring plans for them.  We have been involved in at least one case where a prominent, successful surgeon was forced to undergo testing, evaluation, and psychoanalysis, while he was excluded by a major hospital, over a course of approximately two years, with the threat of disciplinary action by his state licensing board if he refused to “cooperate.”  Finally, after spending tens of thousands of dollars on the recommended psychiatric and psychological evaluations, and after spending tens of thousands of dollars in attorney’s fees, it was decided he had no such problems, he was not a “disruptive physician” and there was no probable cause for any disciplinary action against him.

Legal Action May Be Only Way To Fix a Damaged Reputation.

In some cases, it may even be necessary for the physician to take the extreme measure of suing the hospitals or the individuals who are behind such action.  We have been required to do this on behalf of clients in a number of different cases.  Often, this is the only way to get the truth of the matter out, especially when it related to economic competitors of the physician who may be in control of the hospital’s medical staff.

Hospitals’ Role In Identifying Disruptive Physicians.

We believe that, as a result of the foregoing, we will see a much greater attempt on the part of hospitals to identify and discipline physicians on hospital staffs as “disruptive physicians” through hospital peer review procedures, and through reports to state licensing boards and the organizations that were established to monitor physicians with substance abuse problems (such as the Professionals Resource Network (PRN) in Florida).  Any correspondence, warning, letter or counseling a physician receives that mentions the word “disruptive” or makes such an insinuation, should be taken very seriously by the physician.  It should be responded to immediately, with facts, in an objective and dispassionate manner without attempting to “blame” anyone else.  When in doubt, consult with an experienced board certified health law attorney.

Being Labeled Disruptive Should Not Be Taken Lightly, Contact Health Law Attorneys Experienced In Handling All Cases of Disruptive Physician Accusations.

The Health Law Firm’s attorneys routinely represent physicians in cases of the disruptive label.  Being labeled disruptive cannot be taken lightly. This label can go on your record and affect your current and future work as a physician. Contact an experienced Health Law attorney the second allegations are made against you.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Keywords: legal representation for disruptive physician, allegations of disruptive physicians, legal representation for disruptive physician allegations, disruptive physician defense attorney, health care professional defense attorney, legal representation for health care professionals, health law defense attorney, Florida health law attorney, reviews of the Health Law Firm, The Health Law Firm attorney reviews, Health law defense attorney, medical staff peer review attorney, clinical privileges legal counsel, medical staff fair hearing defense attorney, peer review legal counsel, hospital fair hearing attorney
“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.

If You Are a Dentist Facing Legal Challenges, Choose an Attorney Who is Board Certified by The Florida Bar in Health Law

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

Dentists, nurses, pharmacists, health professionals, and health facilities often face legal challenges from many different sources. These challenges can come from federal and state regulators, medical malpractice trial lawyers, hospitals, clinics and colleagues. If you find yourself faced with a legal problem, the first person you should contact is an attorney who is Board Certified by The Florida Bar in Health Law.

A Board Certified Health Law Attorney is Your Legal Specialist.

To find a lawyer who has expertise in the area of law relating to your legal needs, the Supreme Court of Florida directed The Florida Bar to offer a “Board Certification” program for Florida Bar members. The program is designed to help the public make an informed decision when seeking and selecting a lawyer. Not all states use board certification to designate attorneys, and those that do may not have board certification in the area of Health Law. However, both Florida and Texas are states that do offer a board certification program for their health lawyers.

While all lawyers are allowed to advertise, only certified attorneys are allowed to identify themselves as “Florida Bar Board Certified” or as a “specialist.” Being certified is the highest level of recognition by The Florida Bar of the competency and experience of attorneys in health law.

A lawyer who is a member in good standing of The Florida Bar and who meets the standards set by the state’s Supreme Court, may become a “Board Certified Health Law Attorney.”

Not all qualified lawyers are certified, but those who are board certified have taken the extra step to have their competence and experience recognized. You can read more about what distinguishes “Board Certified” attorneys from others by visiting The Florida Bar website here.

Requirements for Becoming Board Certified by The Florida Bar in Health Law.

To qualify to take the health law certification examination, attorneys must:

1. be members of The Florida Bar for at least five years,
2. be engaged in the full-time practice of law,
3. be substantially involved, at least forty percent (40%), in health law for the prior three years of their practice,
4. complete at least 60 hours of advanced continuing legal education of approved health law credits and,
5. Pass a stringent peer review process.

To become certified in health law, an attorney is also required to pass a rigorous written board certification examination designed to test the attorney’s knowledge, skills and proficiency in the field of health law. All currently certified attorneys must apply for recertification every five years.

Read more on The Health Law Firm’s Board Certified Health Law attorneys here.

To view a press release on the recertification of George F. Indest III and Michael L. Smith, click here.

You Seek Specialized Medical Care from a Medical Specialist; Seek Specialized Legal Services from a Health Law Specialist.

If you have a medical issue you seek treatment from a physician who is board certified in a medical specialty, such as obstetrics and gynecology, orthopedic surgery, neurology or others. This is because they have superior education, training, knowledge and experience in that area of medicine.

Likewise, when you have a legal problem in the area of health practice, health licensing, health care regulation or other legal situations unique to the health care industry, you should seek legal advice and representation from a legal specialist in health law.
Contact The Health Law Firm to Speak with an Attorney who is Board Certified by The Florida Bar in Health Law.

The Health Law Firm currently has two Board Certified Health Law attorneys:

George F. Indest III, J.D., M.P.A., LL.M, is Board Certified by The Florida Bar in Health Law.
Michael L. Smith, J.D., R.R.T., is Board Certified by The Florida Bar in Health Law.

To learn more about all the attorneys at The Health Law Firm, click here.

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: Board Certified by The Florida Bar in Health Law, Board Certified in Health Law, health law attorneys, health law attorneys Florida, health law expert, legal specialist in health law, Health law defense lawyer, legal representation of health care professionals, Medicare fraud defense attorney, Medicare audit defense attorney, Medicaid fraud defense attorney, Medicaid audit defense attorney, Baker Act defense attorney, disruptive physician defense attorney, legal representation for disruptive physician, legal representation for Baker Act cases, legal representation for Medicare fraud, legal representation for Medicaid fraud, legal representation for clinical research investigations, legal representation for clinical research fraud, Florida health law attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys
“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.

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