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You’ve Been Accused of Impairment or Misconduct, What Happens Now?

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

In an industry that revolves around helping others, physicians and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes lead to unsafe, unprofessional behavior and impairment allegations.

We routinely work with nurses, and other health professionals who are accused by employers, hospitals, competitors, or terminated employees of impairment due to drug or alcohol abuse, or mental impairment, of being a “disruptive physician” or of sexual boundary issues. However, not all nurses and health professionals who are referred to a health program are in actual need of rehabilitation services.


What is the Impaired Practitioners Program?

The Florida Department of Health’s (DOH) Impaired Practitioners Program (IPN), Section 456.067, Florida Statutes, is administered by the Intervention Project for Nurses or “IPN” (for nurses and nurse practitioners) and by the Professionals Resource Network or “PRN” (for physicians, dentists, pharmacists, and all other health professionals). IPN is responsible for all nurses and works with and through the Florida Board of Nursing. PRN works with and through the Florida Board of Medicine, Board of Dentistry, Board of Pharmacy, and other Department of Health Professional Boards.


You Report Yourself to IPN; What Happens Now?

These types of allegations discussed above made against a nurse or other health professional are extremely serious because they are usually treated by the DOH as “Priority 1” or “Fast Track” offenses. This means that the charges against the individual will usually be automatically considered for an Emergency Suspension Order (ESO) issued by the Florida Surgeon General at the request of the Department of Health. Unless a qualified, experienced health care attorney is able to immediately produce reliable documentation and evidence showing the health professional is not impaired, the Surgeon General will usually issue an ESO. Click here to read one of my prior blogs to learn more.

Even in cases where the individual may actually have committed an offense, there are a number of administrative and procedural measures that may be used to avoid a suspended license. For the innocent health professional, an experienced attorney familiar with such matters may be able to obtain additional drug testing, polygraph (lie detector) testing, medical examinations, scientific evidence, expert witnesses, evaluations by certified addictions professionals, character references, or other evidence which may help to show innocence and lack of impairment.


Call an Attorney Immediately, Before Making Any Decisions or Calls!

If you are accused of wrongdoing, especially accusations involving drug or alcohol abuse or impairment, even if you are threatened with being reported to the DOH or the Board of Nursing, then it may be much better to defend yourself and fight such charges instead of trying to “take the easy way out.” This is especially true if you are being falsely accused. There are many problems that you can avoid by having good legal advice before you make a stupid mistake. We are often consulted and retained by clients when, after they have made the mistake of talking to the wrong people about the wrong things, they are in a situation they could have avoided.

Our firm has extensive experience in representing nurses, physicians, and other professionals accused of drug abuse, alcohol impairment, mental impairment, and sexual boundary issue, as well as in dealing with the IPN and the PRN, their advantages and disadvantages, their contracts, their policies and procedures, and their requirements.

The bottom line is: if you are accused of drug impairment, alcohol impairment, drug diversion, sexual boundary issues, sexual misconduct, or of being mentally or physically impaired, immediately contact an attorney experienced with IPN and PRN and with the Board of Nursing, Board of Medicine, Board of Dentistry, Board of Pharmacy, and other professional boards. Don’t risk losing your livelihood by just taking the apparently easy way out without checking into it. There may be other options available for you, especially if you are innocent and not impaired.

To read one of my prior blogs about the recent changes to Florida’s Impaired Practitioners Program, click here.

Contact Experienced Health Law Attorneys in Matters Involving IPN.

The Health Law Firm’s attorneys routinely represent nurses, physicians, dentists, and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

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

Sources:

Masterson, Les. “Physician wellness, quality of care go hand-in-hand, analysis finds.” Healthworks Collective. (September 10, 2018). Web.

Maria Panagioti, Keith Geraghty, Judith Johnson. “Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction.” Journal of American Medical Association (JAMA). (September 4, 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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

Impaired Practitioner Programs: What To Do if You’ve Been Accused?

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

In an industry that revolves around helping others, physicians and other health professionals sometimes find that they are the ones being pushed toward a treatment program. Long hours, heavy workloads, and stress among health care professionals can sometimes lead to unsafe, unprofessional behavior and impairment allegations.

We routinely work with physicians, nurses, and other health professionals who are accused by employers, hospitals, competitors, or terminated employees of impairment due to drug or alcohol abuse, or mental impairment, of being a “disruptive physician” or of sexual boundary issues. However, not all physicians and health professionals who are referred to a health program are in actual need of rehabilitation services.

What is the Impaired Practitioners Program?

The Florida Department of Health’s (DOH) Impaired Practitioners Program (IPN), Section 456.067, Florida Statutes, is administered by the Intervention Project for Nurses or “IPN” (for nurses and nurse practitioners) and by the Professionals Resource Network or “PRN” (for physicians, dentists, pharmacists, and all other health professionals). IPN is responsible for all nurses and works with and through the Florida Board of Nursing. PRN works with and through the Florida Board of Medicine, Board of Dentistry, Board of Pharmacy, and other Department of Health Professional Boards.

You Are Instructed to Report Yourself to IPN or PRN; What Now?

These types of allegations discussed above made against a physician, nurse, or other health professional are extremely serious because they are usually treated by the DOH as “Priority 1” or “Fast Track” offenses. This means that the charges against the individual will usually be automatically considered for an Emergency Suspension Order (ESO) issued by the Florida Surgeon General at the request of the Department of Health. Unless a qualified, experienced health care attorney is able to immediately produce reliable documentation and evidence showing the health professional is not impaired, the Surgeon General will usually issue an ESO. Click here to read one of my prior blogs to learn more.

Even in cases where the individual may actually have committed an offense, there are a number of administrative and procedural measures that may be used to avoid a suspended license. For the innocent health professional, an experienced attorney familiar with such matters may be able to obtain additional drug testing, polygraph (lie detector) testing, medical examinations, scientific evidence, expert witnesses, evaluations by certified addictions professionals, character references, or other evidence which may help to show innocence and lack of impairment.

Call an Attorney Immediately, at the Beginning, and Prior to Making Any Decisions or Calls!

If you are accused of wrongdoing, especially accusations involving drug or alcohol abuse or impairment, even if you are threatened with being reported to the DOH or your professional board, then it may be much better to defend yourself and fight such charges instead of trying to “take the easy way out.” This is especially true if you are being falsely accused. There are many problems that you can avoid by having good legal advice before you make a stupid mistake. We are often consulted and retained by clients when, after they have made the mistake of talking to the wrong people about the wrong things, they are in a situation they could have avoided.

Our firm has extensive experience in representing physicians and other professionals accused of drug abuse, alcohol impairment, mental impairment, and sexual boundary issue, as well as in dealing with the IPN and the PRN, their advantages and disadvantages, their contracts, their policies, and procedures, and their requirements.

The bottom line is: if you are accused of drug impairment, alcohol impairment, drug diversion, sexual boundary issues, sexual misconduct, or of being mentally or physically impaired, immediately contact an attorney experienced with IPN and PRN and with the Board of Medicine, Board of Nursing, Board of Dentistry, Board of Pharmacy, and other professional boards. Don’t risk losing your livelihood by just taking the apparently easy way out without checking into it. There may be other options available for you, especially if you are innocent and not impaired.

To read one of my prior blogs about the recent changes to Florida’s Impaired Practitioners Program, click here.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses, and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Masterson, Les. “Physician wellness, quality of care go hand-in-hand, analysis finds.” Healthworks Collective. (September 10, 2018). Web.

Maria Panagioti, Keith Geraghty, Judith Johnson. “Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction.” Journal of American Medical Association (JAMA). (September 4, 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 Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

10 Biggest Mistakes Dentists Make That Cause DOH Complaints

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

In representing dentists in complaints against their licenses, we see similar cases over and over again. The dentists could have avoided many Department of Health (DOH) complaints that may wind up before the Board of Dentistry.

These are the ten biggest mistakes we see dentists make, leading to DOH complaints being filed and investigations being opened against them.

1.  Requiring patients to pay an outstanding dental bill before releasing a copy of their dental records. This is prohibited by law. However, the patient can be charged for the copy of the record, up to $1.00 per page for the first 25 pages, ($.25 per page after that), and actual costs of reproduction for other forms of dental records (X-rays, CD’s photographs).

2.  Not having the original patient x-rays or a good digitized copy. Believe it or not, many dentists we have represented either gave their x-rays to the patient or sent them to a subsequent treating dentist. Always release copies (for which you may charge). Always keep the originals. (Not having them when needed). With the expanding use of digital x-rays stored in an electronic dental record, this is not so problematic as it was in the past.

3.  Accepting a new patient who has had more than one other primary dentist within the prior five years (when the patient hasn’t relocated to a new geographical area). Unhappy, disgruntled, unrealistic patients will change dentists often. Identify these patients early and refuse to accept them as your patients or terminate them as patients as soon as you identify them. Closely related to this is accepting or failing to terminate the “disgruntled” patient. If a patient is a chronic complainer or threatens to sue or file a complaint, this is a patient who will, most likely, never be satisfied. Terminate this patient immediately.

4.  Failing to fully inform the patient of possible less-than-desirable outcomes (documenting this in writing, preferably signed by the patient). This includes but is not limited to the fact that there may be subsequent pain or infection, that the bite may be less than perfect and may have to be adjusted, that a bridge or other fixture may not fit correctly and may need to be adjusted, etc.

5.  Failing to have and use appropriate consent forms including, but not limited to:

a.  Refusal of a treatment consent form

b.  Consent for less than optimal dental treatment (to use when a patient refuses to follow dentist’s recommended treatment plan). This is also called “Refusal of Recommended Treatment.”

c.  Root Canal consent form
d.  Tooth Extraction
e.  Endodontic procedures
f.  Dentures and bridges

6.  Failing to refund dental fees when complaining patients demand it. We do not routinely recommend that you refund dental fees based solely on a patient’s demand that you do so. In many cases, the patient will have benefited from the treatment, procedure, or appliance, and should pay for it. However, in many instances, this must be a business decision based on risk management principles. It is always a good idea to weigh the amount in attorney’s fees, time, and aggravation, mental anguish, or increase in insurance premiums that will result if you fail to refund demanded fees. Base your decision on a calculation of how likely it is that a complaint will result.

7.  Failing to have good, legible, comprehensive treatment records on the patient. A documented, comprehensive written treatment plan signed by the patient is mandatory in all cases except emergency cases and specialty consults. This also includes failing to prepare and maintain a periodontal chart on a patient. If you are going to treat and follow a patient for more than an emergency visit or a specialty consultation, you should perform a periodontal exam. Just as important, the Board of Dentistry will expect you to chart this on a periodontal chart.

8.  Failing to document the type of and amount of a drug administered, a sedative used, a compound used, etc. Be sure this is accurately stated in your chart. Be sure this is accurately billed with the correct billing code.

9.  Failing to give patients a copy of their dental chart within a reasonable period of time after requested. (The courts usually define “reasonable” as 14 calendar days or ten business days; however, the Board of Dentistry allows up to 30 days. If you can reasonably provide it earlier, do so, documenting the date.

10.  Producing only part of the complete dental chart to the patient, subsequent treating dentist, or DOH investigator when requested. This has become more problematic as dentists’ convert more and more into electronic dental records. Be sure to print out and produce all treatment plans, histories, physical exams, family history questionnaires, medical history questionnaires, informed consent forms, photographs, treatment plans, x-rays, periodontal charts, progress notes, daily journal entires, bills, correspondence with health insurers or other third-party payers. Also included are prior dentists’ records received, operative reports, or any other documents you have relating to the patient’s treatment.

These are not hard and fast rules. We cannot assure you that you will never receive a DOH complaint, a patient complaint, a grievance, or a lawsuit if you follow them. However, if you follow them, you will probably find your patients happier, your practice calmer and more productive, and your risks of having a complaint filed significantly reduced or eliminated.

Click here to read one of my prior blogs about DOH complaints and investigations.

Contact Health Law Attorneys Experienced with Investigations of Dentists and Health Professionals Today.

The attorneys of The Health Law Firm provide legal representation to dentists, dental hygienists, physicians, nurses, nurse practitioners, CRNAs, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (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. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or toll-free: (888) 331-6620.

KeyWords: Legal representation for Department of Health (DOH) investigations, legal representation for DOH complaints, licensure defense attorney, DOH defense attorney, representation for DOH cases, DOH complaint representation, representation for dentists, dental law defense attorney, dentist representation, health law defense attorney, legal representation for health care professionals, legal representation for disciplinary actions against your license, legal representation for license revocation, licensure defense attorney, administrative complaint attorney, legal representation for administrative complaints, legal counsel for Board representation, Board of Dentistry representation, Board of Dentistry defense lawyer, The Health Law Firm, health law defense attorney, Florida health law attorney, reviews of The Health Law Firm, The Health Law Firm attorneys review

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999. Copyright © 2021 The Health Law Firm. All rights reserved.

10 Biggest Mistakes Dentists Make That Cause DOH Complaints

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

In representing dentists in complaints against their licenses, we see similar cases over and over again. The dentists could have avoided many Department of Health (DOH) complaints that may wind up before the Board of Dentistry.

These are the ten biggest mistakes we see dentists make, leading to DOH complaints being filed and investigations being opened against them.

1.  Requiring patients to pay an outstanding dental bill before releasing a copy of their dental records. This is prohibited by law. However, the patient can be charged for the copy of the record, up to $1.00 per page for the first 25 pages, ($.25 per page after that), and actual costs of reproduction for other forms of dental records (X-rays, CD’s photographs).

2.  Not having the original patient x-rays or a good digitized copy. Believe it or not, many dentists we have represented either gave their x-rays to the patient or sent them to a subsequent treating dentist. Always release copies (for which you may charge). Always keep the originals. (Not having them when needed). With the expanding use of digital x-rays stored in an electronic dental record, this is not so problematic as it was in the past.

3.  Accepting a new patient who has had more than one other primary dentist within the prior five years (when the patient hasn’t relocated to a new geographical area). Unhappy, disgruntled, unrealistic patients will change dentists often. Identify these patients early and refuse to accept them as your patients or terminate them as patients as soon as you identify them. Closely related to this is accepting or failing to terminate the “disgruntled” patient. If a patient is a chronic complainer or threatens to sue or file a complaint, this is a patient who will, most likely, never be satisfied. Terminate this patient immediately.

4.  Failing to fully inform the patient of possible less-than-desirable outcomes (documenting this in writing, preferably signed by the patient). This includes but is not limited to the fact that there may be subsequent pain or infection, that the bite may be less than perfect and may have to be adjusted, that a bridge or other fixture may not fit correctly and may need to be adjusted, etc.

5.  Failing to have and use appropriate consent forms including, but not limited to:

a.  Refusal of a treatment consent form

b.  Consent for less than optimal dental treatment (to use when a patient refuses to follow dentist’s recommended treatment plan). This is also called “Refusal of Recommended Treatment.”

c.  Root Canal consent form
d.  Tooth Extraction
e.  Endodontic procedures
f.  Dentures and bridges

6.  Failing to refund dental fees when complaining patients demand it. We do not routinely recommend that you refund dental fees based solely on a patient’s demand that you do so. In many cases, the patient will have benefited from the treatment, procedure, or appliance, and should pay for it. However, in many instances, this must be a business decision based on risk management principles. It is always a good idea to weigh the amount in attorney’s fees, time, and aggravation, mental anguish, or increase in insurance premiums that will result if you fail to refund demanded fees. Base your decision on a calculation of how likely it is that a complaint will result.

7.  Failing to have good, legible, comprehensive treatment records on the patient. A documented, comprehensive written treatment plan signed by the patient is mandatory in all cases except emergency cases and specialty consults. This also includes failing to prepare and maintain a periodontal chart on a patient. If you are going to treat and follow a patient for more than an emergency visit or a specialty consultation, you should perform a periodontal exam. Just as important, the Board of Dentistry will expect you to chart this on a periodontal chart.

8.  Failing to document the type of and amount of a drug administered, a sedative used, a compound used, etc. Be sure this is accurately stated in your chart. Be sure this is accurately billed with the correct billing code.

9.  Failing to give patients a copy of their dental chart within a reasonable period of time after requested. (The courts usually define “reasonable” as 14 calendar days or ten business days; however, the Board of Dentistry allows up to 30 days. If you can reasonably provide it earlier, do so, documenting the date.

10.  Producing only part of the complete dental chart to the patient, subsequent treating dentist, or DOH investigator when requested. This has become more problematic as dentists’ convert more and more into electronic dental records. Be sure to print out and produce all treatment plans, histories, physical exams, family history questionnaires, medical history questionnaires, informed consent forms, photographs, treatment plans, x-rays, periodontal charts, progress notes, daily journal entires, bills, correspondence with health insurers or other third-party payers. Also included are prior dentists’ records received, operative reports, or any other documents you have relating to the patient’s treatment.

These are not hard and fast rules. We cannot assure you that you will never receive a DOH complaint, a patient complaint, a grievance, or a lawsuit if you follow them. However, if you follow them, you will probably find your patients happier, your practice calmer and more productive, and your risks of having a complaint filed significantly reduced or eliminated.

Click here to read one of my prior blogs about DOH complaints and investigations.

Contact Health Law Attorneys Experienced with Investigations of Dentists and Health Professionals Today.

The attorneys of The Health Law Firm provide legal representation to dentists, dental hygienists, physicians, nurses, nurse practitioners, CRNAs, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (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. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or toll-free: (888) 331-6620.

KeyWords: Legal representation for Department of Health (DOH) investigations, legal representation for DOH complaints, licensure defense attorney, DOH defense attorney, representation for DOH cases, DOH complaint representation, representation for dentists, dental law defense attorney, dentist representation, health law defense attorney, legal representation for health care professionals, legal representation for disciplinary actions against your license, legal representation for license revocation, licensure defense attorney, administrative complaint attorney, legal representation for administrative complaints, legal counsel for Board representation, Board of Dentistry representation, Board of Dentistry defense lawyer, The Health Law Firm, health law defense attorney, Florida health law attorney, reviews of The Health Law Firm, The Health Law Firm attorneys review

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999. Copyright © 2021 The Health Law Firm. All rights reserved.

 

 

 

How an American Board of Internal Medicine Policy is Robbing America of Qualified Physicians

By Achal A. Aggarwal, M.B.A., J.D.

In July 2012, the American Board of Internal Medicine (“ABIM”) implemented a policy change placing limits on how long a physician could be considered “board eligible.”  This policy nearly ended the ability of many otherwise qualified physicians to become certified in internal medicine.  In many cases, this also caused them to lose hospital clinical privileges or to not qualify for them.

Board eligibility and board certification are big deals in the medical community, as you know.  A physician who is not board eligible or board certified stands to lose a lucrative career. Insurance companies will not allow the physicians on their panels; medical groups refrain from hiring them, and hospital medical staffs refuse them privileges.  This then forces many physicians to open private practices on a cash-basis, a business model that may be impossible to sustain in today’s healthcare system.

Details of the Policy.

Prior to 2012, internal medicine physicians could practice medicine under the designation “board eligible” and still get hired by hospitals and get onto health insurance panels.  Additionally, ABIM did not have a time limit on when a physician needed to become board certified.  This allowed many safe, capable, and qualified physicians to provide health care to patients throughout the United States without having to become board certified, meeting hospital or insurance company requirements.

ABIM Sets a Deadline.

If the physician failed to become board certified within those seven years, then the physician could only regain their board eligibility by completing one-year of retraining.  ABIM’s policy provided physicians who finished an internal medicine residency before 2012 a seven (7) year time period to become board certified in internal medicine.  Many physicians did not even realize this rule applied until 2019 when the seven (7) year period ran, and applications began being denied.

With the ABIM’s policy change, many of those physicians have lost their board eligible status, lost their clinical privileges or had insurance contracts terminated.  The term “board eligible” is no longer even recognized by the ABIM.  Physicians are prohibited from even using the term any longer.

Retraining is required to be at a U.S. training program accredited by the Accreditation Council for Graduate Medical Education (“ACGME”) or at a Canadian training program accredited by the Royal College of Physicians and Surgeons of Canada (“RCPSC”).

However, no such limited retraining program appears to exist.  Many physicians who have been practicing for ten years or longer cannot apply for board certification because they are unable to find or complete an accredited training program that will retrain them for just one year.


So What Can You Do If You Missed the Time Limit?

An alternative is that a physician can submit a request for an exception from the ABIM’s 2012 policy. A physician can request that their board eligibility be extended to take the internal medicine board certification exam.  The request for such an exception must be submitted to the ABIM’s Staff Credentials Committee.  However, these exceptions are rarely granted.

If you are in a residency of fellowship program in internal medicine, be sure you do not forget about the seven (7) years limitation on applying for certification.

If you decide to petition for an exception to the time period for applying for, we recommend contacting a qualified health law attorney who has experience in dealing with the ABIM and can assist in preparing such a request.  There is no guarantee of success, but at least you will have attorneys working for you who know what they are doing.

For even more information, read my prior blog here.


Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in investigations and hearings of all types.  This includes board certification hearings, medical board hearings, Drug Enforcement Administration (DEA) hearings, Food and Drug Administration (FDA) hearings, medical staff peer review and clinical privileges hearings, FBI Investigations, DOJ Investigations, Drug Enforcement Administration (DEA) investigations, Medicare and Medicaid overpayment demands and hearings, and other types of investigations of health professionals and providers.  We also undertake civil litigation in the same types of cases.

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

About the Author: Achal A. Aggarwal, M.B.A., J.D. practices health law with The Health Law Firm, which has a national practice.  Its main office in the Orlando, Florida area.   The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone:  (407) 331-6620 or Toll-Free: (888) 331-6620. www.TheHealthLawFirm.com

KeyWords: American Board of Internal Medicine (ABIM) defense lawyers, legal representation for ABIM investigations, legal representation for ABIM discipline, legal representation for ABIM certification, legal representation for Board representation, legal representation for Board investigations, defense attorney for Board investigations, attorney for Board representation, legal representation for medical students, legal representation for medical residents, legal representation for medical fellows, legal representation for physician employment agreement, physician employment contract attorney, legal representation for physician license revocation, licensure defense attorney, legal representation for health care professionals, health law defense attorney, The Health Law Firm, reviews of The Health Law Firm, The Health Law Firm attorney reviews board certification hearings, medical board hearings

“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.

Two Admins at a Veterans Home Criminally Charged For Mishandling Deadly COVID-19 Outbreak

George Indest Headshot

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

On September 25, 2020, two administrators at a Massachusetts veterans home were criminally charged with negligence for their role in a COVID-19 outbreak that killed 76 veterans. Attorney General (AG) Maura Healey reportedly stated that the criminal case involving Soldiers’ Home in Holyoke (SHH) is the first in the country against nursing home operators related to the pandemic.

Mishandling of the Coronavirus Outbreak.

The superintendent and the facility’s former medical director were indicted by a grand jury and charged with recklessly permitting bodily injury or abuse to the residents. The charges stem from their decision to combine two dementia units in March of 2020. They are accused of packing residents who were positive for the coronavirus into the same space as those with no symptoms. According to the AG, the decision contributed to the death of at least 76 residents at the facility.

The Investigation.

The AG’s Office began investigating in early April 2020 after learning of serious issues with COVID-19 infection control procedures at SHH. The investigation found that staffing shortages led to the decision to consolidate the two dementia units, totaling 42 residents. It resulted in confirmed COVID-19-positive residents being placed within feet of other veterans at the facility. The AG’s Office alleges that this decision was reckless from an infection control perspective and put the asymptomatic veterans at an increased risk of contracting COVID-19 from the positive ones.

Since March 1, 2020, 76 veterans who contracted the coronavirus at SHH have died, officials said. Click here to read the Attorney General’s press release on the case.

To read about a similar case against a Florida nursing home, click here.

Contact a Health Law Attorney Experienced in the Representation of Veterans Administration (VA) Physician Representation and Military Physician Representation.

The attorneys of The Health Law Firm have represented nursing home administrators, health care executives, nurses, nurse practitioners, assisted living facilities, skilled nursing facilities, and health professionals working for the Veterans Administration (VA) throughout the United States. Representation has included personnel and employment issues, disciplinary action, investigations, peer review investigations, clinical privileges actions, fair hearings, National Practitioner Data Bank (NPDB) actions, and appeals.

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

Sources:

Durkin, Alanna. “2 Charged Over Handling of Virus Outbreak at Veterans Home.” Associated Press. (September 25, 2020). Web.

Dowling, Bryan. “Mass. Vet Home Leaders Charged Over Deadly Virus Outbreak.” Law360. (September 25, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620

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

 

Going For an Evaluation With Your State Providers Health Program, Peer Assistance Program, Intervention Project for Nurses, or Professionals Resource Network? Tips on What NOT To Do!

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

So you are a physician, nurse or other health professional who has been accused of drug diversion, alcohol use at work, being impaired because of use of drugs or alcohol, or being positive on a drug test. You have been reported to the state board or to your employer who has now reported you to the Professionals Resource Network (PRN), the Intervention Project for Nurses (IPN), the state peer assistance program, or the providers health program. It has contacted you and you have agreed to go to an evaluation by one of the program’s trained evaluators.

Here are a few tips that may help you. These are based on the mistakes that our clients have made before contacting us or retaining us to advise and assist in such matters.

1. Stop drinking alcoholic beverages immediately upon learning that you are facing scrutiny. Do not begin drinking again until the entire case is completely resolved. (Hint: If you cannot stop drinking or do not want to stop drinking, then you are probably an alcoholic and should be in a recovery monitoring program.)

2. In most cases, you will be required to provide a urine sample, a blood sample, a nail sample and/or a hair sample. This may disclose your use of drugs and alcohol even many weeks or months after-the-fact. Be aware that this may occur.

3. Be on time to your evaluation. Being late for an important, career-affecting event may be the sign of a real problem or lack of adequate judgment. Plan ahead. Leave early. Prepare for the unexpected.

4. Do not take tranquilizers, mood stabilizers or other medications immediately prior to your appointment with

5. Dress and groom appropriately. If your clothes and your person are dirty and unkempt, this may be considered to be a sign of an underlying problem.

6. Answer any questions the evaluator asks briefly and concisely. Do not volunteer information not requested. This is not a confessional, you are not there to confess your sins. You should know that there are a number of “red flags” that psychologists and psychiatrists use against you to find that you have a significant problem that requires treatment and long-term monitoring. For example, if your parents divorced, this is a red flag and counts against you (yes, I have argued with a psychologist that over half the marriages in the U.S. wind up in a divorce). Having a relative with an addiction an alcohol problem or a mental disorder will also do this. Be careful about whom you say was an alcoholic if you haven’t seen the doctors’s diagnosis of it.

7. There are some things that the only way the evaluator will know of these is if you tell her. For example, if no one knows you were sexually abused by a relative when you were young, this is not the time or place to tell. You are not there for treatment. This is not your doctor or therapist.

8. There is no confidentiality in such an evaluation. Nothing you tell the evaluator is confidential;. And it can be used against you later.

Before going for such an evaluation, consult with an experienced health care attorney, one who is familiar with such matters and is familiar with the licensing issues for your profession. To learn more, read one of our prior blogs on this topic here.

Contact Experienced Health Law Attorneys in Matters Involving PRN or IPN.

The Health Law Firm’s attorneys routinely represent physicians, dentists, nurses and other health professionals in matters involving PRN or IPN. Our attorneys also represent health providers in Department of Health investigations, before professional boards, in licensing matters, and in administrative hearings.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

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

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2021 The Health Law Firm. All rights reserved.

Two Administrators Charged With Negligence For Deadly COVID-19 Outbreak at Veterans Home

George Indest Headshot

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

On September 25, 2020, two administrators at a Massachusetts veterans home were criminally charged with negligence for their role in a COVID-19 outbreak that killed 76 veterans. Attorney General (AG) Maura Healey reportedly stated that the criminal case involving Soldiers’ Home in Holyoke (SHH) is the first in the country against nursing home operators related to the pandemic.

Mishandling of the Coronavirus Outbreak.

The superintendent and the facility’s former medical director were indicted by a grand jury and charged with recklessly permitting bodily injury or abuse to the residents. The charges stem from their decision to combine two dementia units in March of 2020. They are accused of packing residents who were positive for the coronavirus into the same space as those with no symptoms. According to the AG, the decision contributed to the death of at least 76 residents at the facility.

The Investigation.

The AG’s Office began investigating in early April 2020 after learning of serious issues with COVID-19 infection control procedures at SHH. The investigation found that staffing shortages led to the decision to consolidate the two dementia units, totaling 42 residents. It resulted in confirmed COVID-19-positive residents being placed within feet of other veterans at the facility. The AG’s Office alleges that this decision was reckless from an infection control perspective and put the asymptomatic veterans at an increased risk of contracting COVID-19 from the positive ones.

Since March 1, 2020, 76 veterans who contracted the coronavirus at SHH have died, officials said. Click here to read the Attorney General’s press release on the case.

To read about a similar case against a Florida nursing home, click here.

Contact a Health Law Attorney Experienced in the Representation of Veterans Administration (VA) Physician Representation and Military Physician Representation.

The attorneys of The Health Law Firm have represented nursing home administrators, health care executives, nurses, nurse practitioners, assisted living facilities, skilled nursing facilities, and health professionals working for the Veterans Administration (VA) throughout the United States. Representation has included personnel and employment issues, disciplinary action, investigations, peer review investigations, clinical privileges actions, fair hearings, National Practitioner Data Bank (NPDB) actions, and appeals.

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

Sources:

Durkin, Alanna. “2 Charged Over Handling of Virus Outbreak at Veterans Home.” Associated Press. (September 25, 2020). Web.

Dowling, Bryan. “Mass. Vet Home Leaders Charged Over Deadly Virus Outbreak.” Law360. (September 25, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620

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

 

Two Criminally Charged For Mishandling Deadly COVID-19 Outbreak at Veterans Home

By Carole C. Schriefer, J.D.

On September 25, 2020, two administrators at a Massachusetts veterans home were criminally charged with negligence for their role in a COVID-19 outbreak that killed 76 veterans. Attorney General (AG) Maura Healey reportedly stated that the criminal case involving Soldiers’ Home in Holyoke (SHH) is the first in the country against nursing home operators related to the pandemic.


Did They Mishandle the Deadly Coronavirus Outbreak?

The superintendent and the facility’s former medical director were indicted by a grand jury and charged with recklessly permitting bodily injury or abuse to the residents. The charges stem from their decision to combine two dementia units in March of 2020. They are accused of packing residents who were positive for the coronavirus into the same space as those with no symptoms. According to the AG, the decision contributed to the death of at least 76 residents at the facility.

AG’s Investigation.

The AG’s Office began investigating early April 2020 after learning of serious issues with COVID-19 infection control procedures at SHH. The investigation found that staffing shortages led to the decision to consolidate the two dementia units, totaling 42 residents. It resulted in confirmed COVID-19-positive residents being placed within feet of other veterans at the facility. The AG’s Office alleges that this decision was reckless from an infection control perspective and put the asymptomatic veterans at an increased risk of contracting COVID-19 from the positive ones.

Since March 1, 2020, 76 veterans who contracted the coronavirus at SHH have died, officials said. Click here to read the Attorney General’s press release on the case.

To read about a similar case against a Florida nursing home, click here.

Contact a Health Law Attorney Experienced in the Representation of Veterans Administration (VA) Physician Representation and Military Physician Representation.

The Health Law Firm attorneys have represented nursing home administrators, health care executives, nurses, nurse practitioners, assisted living facilities, skilled nursing facilities, and health professionals working for the Veterans Administration (VA) throughout the United States. Representation has included personnel and employment issues, disciplinary action, investigations, peer review investigations, clinical privileges actions, fair hearings, National Practitioner Data Bank (NPDB) actions, and appeals.

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

Sources:

Durkin, Alanna. “2 Charged Over Handling of Virus Outbreak at Veterans Home.” Associated Press. (September 25, 2020). Web.

Dowling, Bryan. “Mass. Vet Home Leaders Charged Over Deadly Virus Outbreak.” Law360. (September 25, 2020). Web.

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.  The Health Law Firm, 155 East Boardwalk Drive, Fort Collins, Colorado 80525. Phone: (970) 416-7456 or Toll-Free: (888) 331-6620. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com

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

 

 

Question: Is Exposure to COVID-19 For Nurses and Other Healthcare Workers, Causing Illness, Disability, or Death, Considered an Employment-Related Injury Under Workers’ Comp Coverage?

Attorney Amanda I. ForbesBy Amanda I. Forbes, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In answering the question posed in the title of this blog, first, it should be noted that the World Health Organization (WHO) classifies COVID-19 as an “occupational disease.”  (Reference:  World Health Organization, “Coronavirus Disease (COVID-19) Outbreak: Rights, Roles and Responsibilities Of Health Workers. . . .”)

Click here to view the classification by the WHO on our website.

Most state workers’ compensation laws cover the worker for occupational diseases if the worker acquires it during the course and scope of their employment.  For example, Section 440.151(2), Florida Statutes, states:

Whenever used in this section the term “occupational disease” shall be construed to mean only a disease which is due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation, process, or employment, and to exclude all ordinary diseases of life to which the general public is exposed, unless the incidence of the disease is substantially higher in the particular trade, occupation, process, or employment than for the general public. “Occupational disease” means only a disease for which there are epidemiological studies showing that exposure to the specific substance involved, at the levels to which the employee was exposed, may cause the precise disease sustained by the employee.

Section 440.151(2), Florida Statutes, (emphasis added).  Many other states have similar requirements to those of Florida.

Healthcare workers are at the front line of any outbreak response and as such are exposed to hazards that put them at an increased risk of infection with the COVID-19 virus.  Therefore, as COVID-19 meets the criteria as an “occupational disease.”

Moreover, Section 440.151(1)(a), Florida Statutes, states:

Where the employer and employee are subject to the provisions of the Workers’ Compensation Law, the disablement or death of an employee resulting from an occupational disease as hereinafter defined shall be treated as the happening of an injury by accident, notwithstanding any other provisions of this chapter, and the employee or, in case of death, the employee’s dependents shall be entitled to compensation as provided by this chapter, except as hereinafter otherwise provided; and the practice and procedure prescribed by this chapter shall apply to all proceedings under this section, except as hereinafter otherwise provided.  Provided, however, that in no case shall an employer be liable for compensation under the provisions of this section unless such disease has resulted from the nature of the employment in which the employee was engaged under such employer, was actually contracted while so engaged, and the nature of the employment was the major contributing cause of the disease. Major contributing cause must be shown by medical evidence only, as demonstrated by physical examination findings and diagnostic testing. “Nature of the employment” means that in the occupation in which the employee was so engaged there is attached a particular hazard of such disease that distinguishes it from the usual run of occupations, or the incidence of such disease is substantially higher in the occupation in which the employee was so engaged than in the usual run of occupations. In claims for death under s. 440.16, death must occur within 350 weeks after last exposure. Both causation and sufficient exposure to a specific harmful substance shown to be present in the workplace to support causation shall be proven by clear and convincing evidence.

Section 440.151(1)(a), Florida Statutes.

It is important to note that COVID 19 or any other communicable disease (TB, H1N1, etc.):  The employee has to test positive for the disease/contagion and it must be determined with a reasonable amount of certainty that their exposure to the virus occurred in the workplace and was not community-acquired.

In addition,  per Section 440.151(1)(c), Florida Statutes states:

Where an occupational disease is aggravated by any other disease or infirmity, not itself compensable, or where disability or death from any other cause, not itself compensable, is aggravated, prolonged, accelerated or in anywise contributed to by an occupational disease, the compensation shall be payable only if the occupational disease is the major contributing cause of the injury. Any compensation shall be reduced and limited to such proportion only of the compensation that would be payable if the occupational disease were the sole cause of the disability or death as such occupational disease, as a causative factor, bears to all the causes of such disability or death, such reduction in compensation to be effected by reducing the number of weekly or monthly payments or the amounts of such payments, as under the circumstances of the particular case may be for the best interest of the claimant or claimants. Major contributing cause must be demonstrated by medical evidence based on physical examination findings and diagnostic testing.

Section 440.151(1)(c), Florida Statutes, (emphasis added).

With regard to emergency medical technicians (EMTs) or paramedics Section 440.09(3), Florida Statutes, states:

If an emergency medical technician or paramedic is appointed or employed full time by a municipality, the state, or any political subdivision, is certified under chapter 401.23, in an emergency situation in this state, any such activities would be considered to be within the course of his or her employment and an emergency medical technician or paramedic and covered by the employer’s jurisdiction or area of responsibility, such activities are considered to be within the course of employment. The provisions of this subsection do not apply if the emergency medical technician or paramedic is performing activities for which he or she is paid by another employer of contractor.

Section 440.09(3), Florida Statutes (emphasis added).

Workers Compensation Benefits for Healthcare Professionals.

As of March 26, 2020, Florida has not issued any order or legislation explicitly stating that healthcare professionals exposed to COVID-19 will be entitled to Workers Compensation benefits.

By way of example, In the City of Phila. v. Workers’ Comp. Appeal Bd. (Sites), 889 A.2d 129 (Pa. Commw. Ct. 2005), a claimant was successful in proving that his hepatitis C was caused by his exposure to blood that occurred while working as a firefighter and emergency medical technician  (EMT).  Similar to COVID-19, hepatitis C was also classified as a compensable “occupational disease.”  Therefore, it is likely that a healthcare professional’s exposure to COVID-19 would result in viable workers’ compensation claim.

Federal workers’ compensation laws are similar to those quoted above. Therefore, federal health care providers and those working in federal facilities will also most probably be entitled to federal employment compensation (FECA) benefits under similar situations.

We want to emphasize that this is merely our preliminary opinion based on limited analysis and research.  It is provided for informational purposes only. It does not constitute the provision of legal advice.  Each state has different workers’ compensation laws and different case law, as does the federal government. Each individual set of circumstances may be different. Contact your local workers’ compensation plaintiff’s (claimant’s) attorney for advice and representation in your individual case.

For more information and more examples of employment compensation benefit cases for health care professionals, click here.

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

At the Health Law Firm, we provide legal services for all health care providers and professionals.  This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical student professors and clinical staff. We represent 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, in patient complaints, and in Department of Health investigations.

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

About the Authors:  Amanda I. Forbes, practices health law with The Health Law Firm in its Altamonte Springs, Florida, office.  George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law;  he is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com.  The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“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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