license investigation | The Health Law Firm Blog

Florida Suspends 81 Massage Therapists’ Licenses

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

According to a number of sources, state authorities have announced the suspension of more than 80 massage therapists’ licenses, who appear to have fraudulently obtained their licenses with the help of a Florida College of Natural Health employee. On September 19, 2012, 81 emergency suspension orders (ESOs) were signed, suspending the licenses of massage therapists who are part of ongoing investigations.

To see the entire press release from the Florida governor’s office, click here.

Investigation Found More Than 200 Therapists Obtained Their Licenses Fraudulently.

According to the Tampa Bay Times, earlier this year the Florida Department of Health (DOH), Clearwater Human Trafficking Task Force and the South Florida Human Trafficking Task Force began an investigation into several massage therapy businesses. The investigation turned up more than 200 massage therapists who appeared to have obtained their massage therapy licenses by fraud.

Florida Massage School Employee Helped Obtain the Fraudulent Licenses.

It is believed the 200 people did not enroll in massage therapy school, but received transcripts showing they completed training at the Florida College of Natural Health in Pompano Beach, Florida. The Tampa Bay Times article states that these people allegedly paid between $10,000 and $15,000 to an individual who worked at the Florida College of Natural Health in exchange for transcripts.

The transcripts were then used to get massage licenses from the DOH.

The governor has now ordered a seven-day review of massage schools to ensure they are complying with licensure requirements and regulations. Authorities believe more suspensions will likely be issued.

Massage Therapist Suspensions Thought to Be Tied to Human Trafficking.

According to the Tampa Bay Times, in a news conference authorities said the emergency suspension orders were, in part, an effort to target Florida’s human trafficking problem. Authorities said massage parlors are a typical place for finding victims of human trafficking.

Authorities also said they do not know if these 81 fake massage therapists are victims of human trafficking. It is clear, however, they are not operating legally.

Click here to read the entire article from the Tampa Bay Times.

Reference Articles for Licensed Massage Therapists.

On our website we provide helpful information for licensed massage therapists. To read about the consequences of having your massage therapy license revoked (or relinquishing it after a notice of an investigation), click here. To see the 25 biggest mistakes made by massage therapists after being notified of a DOH complaint, click here. You can also click here to read our advice for preparing for an informal hearing before the Florida Board of Massage Therapy.

Routine Legal Advice Given to Massage Therapists.

We routinely advise massage therapists and all other licensed health professionals with whom we have a legal consultation:

1. Do NOT speak with any Department of Health (DOH) investigator until you have talked to an experienced health law attorney.
2. Do not make any written statement or respond to any letters from the DOH until you have talked to an experienced health attorney.
3. Read everything you receive and be sure to file election of rights (EOR) statements by the deadline, but only after consulting with an experienced health lawyer.
4. You should not attempt to defend yourself without an attorney.
5. Attempting to talk your way out of the situation or explain your side of it will only hurt you.
6. Many types of massage therapist insurance will actually pay for an attorney to defend you in this type of situation.

Contact Health Law Attorneys Experienced with Department of Health Investigations of Massage Therapists.

The attorneys of The Health Law Firm provide legal representation to massage therapists in Department of Health (DOH) 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.

Sources:

Department of Health. “Governor Rick Scott Joins Law Enforcement and Anti-Human Trafficking Groups to Suspend Licenses of 81 Massage Therapists.” DOH News Room. (September 19, 2012). From: http://newsroom.doh.state.fl.us/wp-content/uploads/newsroom/2011/08/91912-EOGMassage-Therapy-Licenses.pdf

Velde, Jessica. “Florida Suspends 81 Massage Therapists’ Licenses.” Tampa Bay Times. (September 19, 2012). From: http://www.tampabay.com/news/publicsafety/florida-suspends-81-massage-therapists-licenses/1252355#

Turner, Jim. “Florida Suspends 81 Massage Therapists in Human Trafficking Probe.” Sunshine State News. (September 19, 2012). From: http://www.sunshinestatenews.com/blog/florida-suspends-81-massage-therapists-human-trafficking-probe

About the Authors: Joanne Kenna, J.D., R.N., 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

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.

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

Consequences of Having Your Massage Therapy License Revoked (Or Relinquishing it after Notice of an Investigation)

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

Many massage therapists, when confronted with an investigation against their license, do not fight the charges, sometimes they decide it is cheaper and easier just to give up their license. Either choice is likely to be a mistake.

A charge can be filed causing an investigation to be opened against a massage therapist by many different sources and often without any supporting evidence. If challenged and defended by an attorney with knowledge and experience in such matters, these investigations may often be dismissed with no disciplinary action against the massage therapist’s license.

Massage Therapists Often Go on to Obtain Licenses in Other Health Specialties.

A massage therapist often has to spend tens of thousands of dollars on school tuition and sacrifice a year or more of their lives to meet the basic criteria for licensing. In many cases this is merely a stepping stone for a later degree and license in another healthcare specialty, such as physical therapy, nursing, acupuncture, or chiropractic medicine.

Your Greatest Assets are Your Professional and Personal Reputation.

One of the maxims that the Romans took as truth was: “A good reputation is more valuable than money,” (attributed to Publilius Syrus approximately 100 B.C.). Socrates wrote in approximately 400 B.C.: “Regard your good name as the richest jewel you can possibly be possessed of.”

However, despite the fact that you may have worked hard, sacrificed and paid a fortune for an education and training in massage therapy, many are willing to sacrifice their personal reputation rather than paying a few thousand dollars to fight unjust charges against them. What they do not realize is the permanent black mark that will be placed on their record and the long term, devastating consequences of any such action.

When Confronted with Charges Most Massage Therapists Do Not Defend Themselves.

It is my opinion, based on what I have seen at Florida Board of Massage Therapy meetings and reviewing Florida Board of Massage Therapy meeting minutes, very few massage therapists, when confronted with an investigation or charges, hire an attorney to defend them. This may be because they do not have the financial resources or because they underestimate the harm that will be caused to their personal or professional reputations.

Regardless, in my personal opinion and experience:

1. Few massage therapists return their election of rights (EOR) forms on time and therefore, a default is entered against them.

2. Few massage therapists return their election of rights (EOR) forms to state they are contesting the facts and desire a formal hearing to contest the charges against them.

3. Few massage therapists even bother to show up at informal hearings involving their licenses.

4. When they do, they show up at a hearing with a spouse or friend to represent them instead of an experienced attorney familiar with such matters (Q: If you needed brain surgery, would you have it performed by a spouse or friend instead of an experienced neurosurgeon?)

5. If they do retain an attorney to advise and represent them, they either go with the cheapest one they can find or go with one who has no experience at all before the Board of Massage Therapy. (Q: If you needed brain surgery, would you pay your family practice physician to perform it?)

Best Advice: Purchase Insurance with Professional License Defense Coverage.

Often physicians and others concerned about liability issues ask our advice on asset protection in case they are sued. We advise them that their best way of protecting their assets is to purchase good insurance that will pay for a legal defense that protects them against unjust law suit. The same principle applies to massage therapists; except that massage therapy insurance is much, much cheaper, and the major liability that a massage therapist will face is usually from a complaint against his or her license.

If you purchase massage therapy liability insurance, you must make sure that it covers defense expenses of a complaint filed against your license. Many such policies do not. Additionally, you should be sure that it provides at least $25,000 in coverage for such matters. This should be sufficient to provide adequate coverage in the event a fully contested formal hearing is required to defend you.

We have seen many policies and they are as different as night and day in this coverage. When purchasing a professional liability policy, always ask about such coverage. Get the coverage stated in writing. To date, the only company we have experienced which is providing such coverage for massage therapists, and at an incredibly low price, is Healthcare Providers Service Organization (HPSO). Compare this with whatever you have now. If you know of others that provide this coverage, I would like to hear from you.

It has been my personal experience that a massage therapist will be 30 or 40 times more likely to need licensure defense coverage as ever to need defense against a civil lawsuit.

Additional Consequences of Discipline on Your Massage Therapy License.

There are many, many additional adverse consequences that you will experience if you receive discipline on (especially revocation of) your massage therapy license. First and foremost, this is on your record forever; it never comes off and cannot be expunged. Additionally, it will be reported to the National Practitioner Data Bank (NPDB) and available anywhere you go in the future in any state, to any licensing board. There are many others. I will detail these in a future blog.

Voluntary Relinquishment after Investigation Has Started Treated as Revocation, the “Death Sentence.”

Many massage therapists believe that the easy and cheap way out if a complaint is filed and an investigation is opened is to resign their license. This is treated the same as a disciplinary revocation and is reported that way. You should never expect to work in health care again or to have a health professional license in any other health specialty or in any other state.

Burden of Proof Is on the State to Prove the Allegations Against You; You Don’t Have to Prove Anything.

If the state brings charges against your massage therapy license, the burden of proof is on the state, just as in a criminal investigation. You do not have to prove anything, and in most cases, you should never make any statement to an investigator or attorney representing the state department of health; these can only be used against you to prove the state’s case against you.

You can remain silent, not say anything and not produce any evidence, and the state may not have enough witnesses or evidence to ever prove a case against you.

Most massage therapists, their non-lawyer representatives and their inexperienced lawyer representatives make a very big mistake. They advise the massage therapist to be interviewed or to make a statement “explaining themselves.” There is no criminal defense attorney worth his or her salt that would ever advise a criminal defendant to do this. Why then must they take leave of their senses and advise a health professional to do this in a “quasi-criminal” or “quasi-penal” investigation? This is almost always very bad advice.

Then, request a formal hearing and contest the facts. Don’t admit to them!

Conclusion: Defend Your Reputation and Massage Therapy License.

In conclusion, take precautions and defend your professional livelihood, your professional reputation and your professional license.

This is Florida. We have hurricanes. If you have a house you own, you purchase insurance on it to protect yourself in the event of a hurricane.

Without your license, you will not have an income and you will not be able to even make house payments. Why wouldn’t you purchase professional insurance that would pay for a defense in the event of that worst case scenario, an investigation of your license. Why wouldn’t you defend yourself to the max if this happened? This will probably feel worse to you and have worse long-term implications to you financially than any hurricane.

Stay tuned to this blog for more.

Don’t Wait Until It’s Too Late; Consult with an Experienced Health Law Attorney Early.

Do not wait until action has been taken against you to consult with an experienced attorney in these matters. Few cases are won on appeal. It is much easier to win your case when there is proper time to prepare and you have requested a formal hearing so that you may actually dispute the facts being alleged against you.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing massage therapists in investigations and at Florida Board of Massage Therapy hearings. Call now or visit our website 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.

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

Department of Health (DOH) Asking Suspended Florida Massage Therapists to Voluntarily Relinquish Their Licenses

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

On September 19, 2012, Florida state authorities announced the suspension of more than 80 massage therapists’ licenses. They are accused of fraudulently obtaining their licenses based on fake documentation obtained from a staff member at the Florida College of Natural Health, in Pompano Beach, Florida. On September 20, 2012, one massage therapist, whose license was suspended, spoke to the Sun Sentinel saying she had legitimately completed all of the requirements to obtain a license and is now being asked by the Department of Health (DOH) to voluntarily relinquish her license.

Click here to read the original blog post on the suspension of 81 massage therapists’ licenses.

Alleged “Rogue” Employee at the Florida College of Natural Health Immediately Terminated.

According to the Sun Sentinel, every massage therapist that had his or her license suspended allegedly received fraudulent documents from a “rogue” employee at the Florida College of Natural Health. The documents allegedly made it appear the person had completed the necessary course requirements to obtain a massage therapy license. Officials with the Florida College of Natural Health said the former staff member was immediately terminated when the scam came to light.

Alleged Fake Documents Spotted by a DOH Official.

A DOH official noticed the difference between one applicant’s fraudulent credentials and the actual course load at the Florida College of Natural Health, according to the Sun Sentinel. The credentials allegedly stated the applicant had completed a 500-hour massage course, but according to the school, the basic massage program the college offers is 768 hours.

One Suspended Massage Therapist Speaks Out.

One South Florida massage therapist spoke to the Sun Sentinel about her license suspension. She claims the investigation against her license has no merit, and said she studied at three different schools, including the Florida College of Natural Health. A check on the DOH website, showed that she has been licensed in Florida since 2008.

To read the Sun Sentinel article, click here.

DOH Requesting Suspended Massage Therapists to Voluntarily Relinquish Licenses.

According to the now suspended massage therapist, she received a notice of investigation letter from the DOH. Included in the letter was a Voluntary Relinquishment of License form.

There is a blog on our website about the consequences of having a massage therapy license revoked or relinquishing a license upon notice of an investigation. Click here to read this prior blog.

From experience, we know a charge can be filed causing an investigation to be opened against a massage therapist by many different sources and often without any supporting evidence. If challenged and defended by an attorney with knowledge and experience in such matters, these investigations may often be dismissed with no disciplinary action against the massage therapist’s license.

Other Consequences of a Voluntary Relinquishment.

A voluntary relinquishment in such circumstances is treated the same as a disciplinary revocation. The negative consequences of this are many and long lasting. They include:

1. Mandatory report to the National Practitioner Data Base (NPDB) (Note: Healthcare Integrity and Protection Data Bank or HIPDB recently folded into NPDB) which remains there for 50 years.

2. Any other states or jurisdictions in which the client has a license will also initiate action against him or her in that jurisdiction. (Note: I have had two clients who had licenses in seven other states).

3. The Office of Inspector General (OIG) of Health and Human Services (HHS) will take action to exclude the provider from the Medicare Program. If this occurs (and most of these offense require mandatory exclusion) the provider will be placed on the List of Excluded Individuals and Entities (LEIE) maintained by the HHS OIG.

4. If the above occurs, the provider is also automatically “debarred” or prohibited from participating in any capacity in any federal contracting and is placed on the U.S. General Services Administration’s (GSA’s) debarment list.

5. The massage therapist’s national board or certifying organization will act to revoke his or her certification. After this, you won’t be able to be licensed anywhere in the U.S.

For more reasons why a health care provider should not relinquish a professional license, click here.

Contact Health Law Attorneys Experienced with Department of Health (DOH) Investigations of Massage Therapists.

The attorneys of The Health Law Firm provide legal representation to massage therapists in Department of Health (DOH) investigations, licensing matters and other types of investigations of health professionals and providers.

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

Sources:

Clarkson, Brett. “Over 80 Massage Therapists in Trafficking Probe Used Fake Credentials from Same College, Say Regulators.” Sun Sentinel. (September 20, 2012). From: http://articles.sun-sentinel.com/2012-09-20/news/fl-massage-trafficking-20120920_1_massage-therapists-massage-licenses-fake-credentials

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.

Christopher E. Brown, J.D., 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

The Collateral Effects of Voluntary Relinquishment with Investigation Pending or other Discipline on Your Massage Therapy License

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

Many massage therapists are unaware of the drastic long-term effects that discipline on their massage therapist license could have. This includes submitting a voluntary relinquishment of the massage therapist’s license while there is an investigation pending or while there are charges pending. Although this particular article is being prepared specifically for massage therapists, similar principles apply to physicians, nurses, pharmacists, psychologists, dentists, mental health counselors and other licensed health professionals.

A voluntary relinquishment of the license after notice of the opening of an investigation or while a charge is pending is treated the same as a disciplinary revocation of the license. It is reported out the same and is treated the same. In some cases it may even be worse, if the agreement to voluntarily relinquish also includes an agreement to never apply for another license again.

Even discipline on the massage therapy license such as a suspension, probation, restrictions, etc., can have far-lasting adverse repercussions. Most people do not understand what else can happen as a result of a discipline, revocation or even voluntary relinquishment (under these circumstances).

Reports to National Organizations on the Discipline.

First and foremost, the discipline (including voluntary relinquishment) will be a public record. It will also be reported out to national reporting agencies, including the National Practitioner Data Bank (NPDB) and the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB).

As a result of the report to the NPDB, the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) will probably start action to exclude the disciplined therapist from the Medicare Program and place him or her on the OIG’s List of Excluded Individual’s and Entities (LEIE). This will bar you from the Medicare Program or working for or contracting with anyone else who does (including insurer’s medical clinics and most health care providers). This by itself will also have many negative consequences. For example, if you are excluded from the Medicare Program you are automatically placed on the U.S. General Services Administration (GSA) “debarred” list. You are automatically excluded from working for or contracting with, in any capacity, any organization, individual or agency that has any government contracts or accepts any federal funding. This act can bar you from working for a public school, working as a real estate agent, or many other jobs.

The NCBTMB will also take action to revoke your national certification given by the NCBTMB. This will exclude you from being licensed in any other state.

Summary of Adverse Consequences of Revocation or Other Discipline.

To summarize, the most important adverse problems that may be caused as a result of discipline on your license, may include the following:

1. May cause discipline to be commenced against any other health professional license you have, such as a nurse, acupuncture physician, chiropractic assistant, nurse’s aide, home health assistant, etc.

2. Will prevent you from obtaining any health professional license in the future.

3. May cause discipline to be commenced against any massage therapy establishment license for a massage therapy establishment you own in whole or in part.

4. Any other states or jurisdictions in which you have a license will also initiate action against him or her in that jurisdiction.

5. The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) will also take action to revoke your national certification given by the NCBTMB. This will exclude you from being licensed in any other state and will cause any other state in which you are licensed to take action against you.

6. Mandatory report to the National Practitioner Data Base (NPDB)), which remains there for 50 years. (Note: Healthcare Integrity and Protection Data Bank or HIPDB recently folded into NPDB.)

7. The OIG of HHS will take action to exclude the provider from the Medicare Program. If this occurs, (and most of these offenses require mandatory exclusion) the provider will be placed on the List of Excluded Individuals and Entities (LEIE) maintained by the OIG HHS.

8. If the above occurs, the provider is also automatically “debarred” or prohibited from participating in any capacity in any federal contracting and is placed on the U.S. General Services Administration’s (GSA’s) debarment list.

9. Third party payors (health insurance companies, HMOs, etc.) will terminate the professional’s contract or panel membership with that organization.

10. Regardless of any of the above, any facility licensed by AHCA (hospitals, skilled nursing facilities (SNFs), public health clinics, group homes for the developmentally disabled, etc.) that are required to perform background screenings on their employees will result in AHCA notifying the facility and the professional that he or she is disqualified from employment.

What Can be Done?

If you have submitted a voluntary relinquishment without understanding the consequences, and the Board of Massage Therapy (“Board”) has not acted to accept it, you may withdraw it. What we do is submit a letter to the Executive Director of the Board stating it was submitted by mistake without fully understanding the consequences, and the massage therapist desires to withdraw the voluntary relinquishment. We submit this immediately (keeping a copy, of course) and by certified mail, return receipt requested, so we have proof of sending and proof of receipt.

However, you must also ask for a formal hearing to dispute the facts in your case, as well. We usually do this at the same time and by the same method. If you fail to request a formal hearing, then you are waiving your rights to challenge your guilt or innocence.

If you have requested an informal hearing, you have made a big mistake. For an informal hearing, you admit that everything stated in the complaint against you is true. You have admitted that all of the charges against you are correct, so you are pleading guilty to the charges. You are then giving up the right to have a hearing to determine whether you are really guilty or innocent. All you are going to be arguing about is the punishment you will receive. You will not be allowed to testify on or introduce any evidence on your guilt or innocence.

If you have submitted a request for an informal hearing, not realizing this, then what we usually do is to submit an immediate request to have the hearing changed over to a formal administrative hearing where you are allowed to dispute the facts against you and prove your innocence. In such a case, it is necessary to submit a Petition for a Formal Administrative Hearing and to specify which facts are contested or disputed and why.

The case is then sent to a neutral administrative law judge (ALJ) to hold a hearing on the case. The state Department of Health (DOH) (the parent agency over the Board of Massage Therapy) is then required to prove the facts against you by clear and convincing evidence. In fact, you do not even have to introduce any evidence or testimony, the burden of proof is on the DOH to prove the case against you.

Emergency Suspension Orders (ESOs), Appeals and Election of Rights (EOR) Forms.

In Florida, if you have an Emergency Suspension Order (ESO), you can appeal it to a court of appeal. The problem with this is that it is very technical to do so and is very costly. Call an attorney who specializes in appeals or appellate law and ask. Additionally, the court of appeal only rules on the law and not the facts. The appeal court will be required to accept everything that is stated in the ESO as true. There is no fact hearing, there are only legal arguments. Your basic case will be delayed while this takes place, and you will probably lose on appeal. This may not be the correct choice for you.

However, if there is an ESO, you also have the right to an expedited fact hearing on it. This may be the best course of action if you have documents and facts to show you are not guilty of the charges.

Furthermore, there will also be an additional document served on you, an administrative complaint (AC). When you receive the AC, it will probably say just about the same thing as the ESO. You will be given your hearing rights when this occurs (called an “Election of Rights” form or “EOR”). As we indicated above, you will almost always want to select a formal administrative hearing in which you dispute (challenge or contest) the allegations (charges) made against you. This is the only way you will have the right to have a full and fair hearing on your innocence of the charges. Make sure it is submitted in plenty of time to be received within the 21 days given. Seek legal advice in completing it. Do not admit to anything; you don’t have to as the state DOH has the burden of proof.

The Need for an Experienced Health Law Attorney.

It is very difficult to take the actions necessary yourself if you do not have any legal training. Nonlawyers make many stupid mistakes in these proceedings, including submitting written statements that can be used against them when they do not have to do so, talking to the DOH investigator or Board personnel, talking to the DOH prosecuting attorney, making admissions which can be used against them, and waiving their rights when they do not have to do so.

Most attorneys are not familiar with these types of procedures if they do not practice health law. They do not realize that the same rights which apply in criminal cases also apply to professional licensure cases. You need to find and hire an attorney experienced in this type of case. That would be a health law attorney, and preferably one who is Board Certified by the Florida Bar in Health Law.

What You Should Do.

So the bottom line is that if you are innocent and want to dispute any charges against you, you should:

1. If you have professional insurance coverage, such as HPSO Insurance, see if your insurance will cover your legal defense expenses in this type of case. Many will. We know HPSO will.

2. Act right away to request all of your rights in any matter. Make sure that anything you submit is actually received (not mailed, received) before the deadline given.

3. Do not call, write or speak to the DOH investigator, Board personnel, DOH personnel or the DOH attorney.

4. Do not make a statement, written or oral, to the DOH investigator, Board personnel, DOH personnel or the DOH attorney.

5. Contest (dispute or fight) every action that might be stated against you, including one by the NCBTMB or OIG.

6. Do not admit to anything you don’t have to as the state DOH has the burden of proof.

7. Keep copies of all forms or letters submitted, along with proof of mailing and proof of receipt (send via certified mail, return receipt requested).

8. Retain the services of a health lawyer who has experience in Board of Massage Therapy/Department of Health (DOH) cases (ask him or her how many he or she has actually done). DO THIS FIRST, NOT LAST!

Contact Health Law Attorneys Experienced with Department of Health (DOH) Investigations of Massage Therapists.
The attorneys of The Health Law Firm provide legal representation to massage therapists in Department of Health (DOH) investigations, licensing matters and other types of investigations of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or (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.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

The Health Law Firm2012-10-01T15:48:54-04:00June 1st, 2018|Categories: Department of Health, Health Care Industry, In the Know, In the News, Informal Hearings, Licensing issues, Massage Therapy, Massage Therapy License, The Health Law Firm Blog|Tags: administrative charges, administrative complaint, advanced therapy, back pain investigation, defense attorney, dentists, Department of Health (DOH), DOH investigation, election of rights (EOR), emergency suspension order (ESO), fake massage therapist, Florida Board of Massage Therapy, Florida College of Natural Health, formal hearing, human trafficking, Informal hearing, license investigation, licensed health professionals, licensed massage therapist, licensure defense coverage, massage therapist, Massage therapy, massage therapy defense, mental health counselors, neck pain investigation, neuromuscular therapy, nurses, pharmacists, physical therapy, physicians, psychologists, rehabilitation investigation, shoulder surgery investigation, sports medicine therapy, trigger point therapy|1 Comment

Florida Woman Arrested for Allegedly Posing as a Nurse, Giving Botox Injections-For Second Time

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

A Boca Raton, Florida, woman was arrested on June 21, 2013, after authorities say she posed as a nurse and offered Botox injections. The fake nurse has been charged with unlicensed practice of a health care professional. If found guilty, the phony nurse could be sentenced to up to five years in jail. This was a joint investigation between the Florida Department of Health (DOH) Investigative Services Unit, the City of Boca Raton Police Department and the Florida Department of Corrections.

To read the press release from the DOH, click here.

Undercover Agents Visited Fake Nurse at her Place of Business.

According to The Palm Beach Post, officials began their investigation of the fake nurse on June 6, 2013, after receiving an anonymous tip. Local police officials and the DOH set up an undercover sting. Days later an undercover agent scheduled a Botox appointment with the phony nurse and then visited the office. Hours later, investigators allegedly arrested the fake nurse.

Click here to read the entire article from The Palm Beach Post.

According to the DOH, this is not the first time she has claimed to be a nurse and got caught. The same phony nurse was allegedly previous arrested for unlicensed activity in Palm Beach, Florida, according to DOH authorities.

Verifying the License of a Health Care Professional.

This particular woman allegedly claimed to be an operating room nurse and on the website Groupon.com she allegedly claimed to be a surgical nurse.

The DOH has several resources to fight unlicensed activity. Patients are encouraged to check the DOH’s website to verify the license information of their health care providers. Complaints can also be filed calling the DOH. Click here to view the DOH’s website.

Practicing Without a License Is a Crime.

Practicing medicine without a license is a crime. Additionally, so is helping someone practice medicine without a license. As a practitioner, you may be asked to supervise or join a practice. Remember, your license may be at stake with any wrongdoing by your subordinates. Before you join a practice or agree to supervise others, check first with the DOH that the other providers are legitimate. You can verify a license for free on the DOH’s website.

Remember, a license to practice medicine in Venezuela, Cuba, or anywhere else, is just that: a license to practice in that country. It does not allow a person to practice medicine in the United States.

More Stories on Fake Physicians and Other Health Professionals to Come.

In the future on this blog, we will continue to include additional articles on fake doctors and health professionals.

To see a blog on a fake South Florida dentist and the damage he inflicted on a teenage girl, click here. To read a blog on an infamous Florida teen impersonating a physician assistant (PA), click here. You can also read the story of a fake plastic surgeon in New York by clicking here.

Contact a Health Law Attorney Experienced in Representing Health Care Providers in DOH Cases.

If you find yourself working for or supervising someone that does not have a valid Florida license, your own license may be at risk. If and when the Department of Health (DOH) becomes involved, do not sign anything, do not speak to the investigators and do not make any statements. Contact an experienced health law attorney immediately to review your case.

The Health Law Firm represents physicians, nurses, dentists, pharmacists, pharmacies and other health care providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the Drug Enforcement Agency (DEA), Department of Health (DOH), and other law enforcement agencies. If you are aware of an investigation of you or your practice, or if you have been contacted by the DEA or DOH, contact an experienced health law attorney immediately.

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

Comments?

What are your thoughts on this story? Please leave any thoughtful comments below.

Sources:

Florida Department of Health. “Joint Investigation Leads to Arrest in Palm Beach County.” Florida Department of Health. (June 21, 2013). From: http://newsroom.doh.state.fl.us/wp-content/uploads/newsroom/2013/05/062113Goldman.pdf

Alcantara, Chris. “Woman Arrested a Second Time for Allegedly Posing as Nurse, Offering Botox Injections in Boca Raton.” The Palm Beach Post. (June 22, 2013). From: http://www.palmbeachpost.com/news/news/crime-law/woman-arrested-a-second-time-for-allegedly-posing-/nYSDh/

Entin, Brian. “Sheri Goldman: Boca Woman Arrested After Police Say She Offered Botox, Told People She was a Nurse.” WPTV. (June 21, 2013). From: http://www.wptv.com/dpp/news/region_s_palm_beach_county/boca_raton/boca-woman-arrested-after-police-say-she-offered-botox-and-told-people-she-was-a-nurse

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.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Deadline Looming: New Fingerprint Requirement for Florida Massage Therapists

By Lance O. Leider, J.D., The Health Law Firm

You can run, but you can’t hide.

During the 2014 Legislative Session CS/HB 1065 was passed. This law requires all new applicants and existing massage therapists and establishment owners to submit digital fingerprints. The law has been in effect since July 1, 2014 for new licenses. However, the deadline to submit fingerprints for existing licenses is January 31, 2015.

Click here to read CS/HB 1065.

Law Details.

According to the law, the following individuals must undergo a criminal background screening prior to January 31, 2015:

– All massage therapists licensed in Florida prior to July 1, 2014.

– Any person with an ownership interest in a massage establishment licensed in
Florida prior to July 1, 2014.

– If the massage establishment is owned by a corporation that has more than
$250,000 of business assets in Florida, the owner, officer or individual directly
involved in the management of the establishment will be required to submit to
background screenings.

What’s a Digital Fingerprint?

If you haven’t already, massage therapists must locate a Florida Department of Law Enforcement (FDLE)-approved LiveScan Provider. LiveScan is a digital fingerprint used throughout the country by law enforcement, state agencies, and employers. The LiveScan provider will electronically send your fingerprint to the FDLE.

The cost for submitting a digital fingerprint varies by location, as does the information an applicant needs to bring with them.

It’s important to remember, if you include a photo with a LiveScan fingerprint, it will stay in the Florida Department of Health’s (DOH) database. However, if there is no photo included, then you will need to resend your finger print every two years.

Exemptions with New Requirement.

Licensed physicians, osteopathic physicians or chiropractors, who employ a licensed massage therapist to perform massages on the physician’s patients at the physician’s practice, are exempt from the background screening requirements.

Purpose of the New Law.

This law is new to massage therapists, not to the field of healthcare. Many other healthcare providers in Florida, including doctors, dentists, chiropractors, and nurses, have been required to submit digital fingerprints for years.

If a qualifying felony offense does show up on the background screening, the DOH will issue an emergency suspension order (ESO), suspending the license of that massage therapist or massage establishment. The DOH will also deny the application or renewal of any massage therapist or massage establishment with certain prior felony conviction. The purpose of the fingerprint-based background checks are to eliminate people with past felony convictions from obtaining or keeping their massage therapy licenses. Be mindful that any and all prior convictions will show up on this background check. This means, that even if you have a very old criminal history, it can potentially result in an investigation by the Board and possible disqualification from licensure. If you have questions regarding your massage therapy license, contact an experienced healthcare attorney.

Comments?

Did you know about this new law? Have you sent in your digital fingerprint yet? Please leave any thoughtful comments below.

Contact Health Law Attorneys Experienced in the Representation of Massage Therapists.

The attorneys of The Health Law Firm provide legal representation to massage therapists in Department of Health (DOH) investigations, licensing matters and other types of investigations of health professionals and providers. We have represented a number of massage therapists who have had summary actions initiated against their massage therapy licenses by the Department of Health (DOH).

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: Lance O. Leider 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.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2014 The Health Law Firm. All rights reserved.

Think You Have Professional Liability Insurance Through Your Employer? Think Again, Nurse!

By Joanne Kenna, R.N., J.D., The Health Law Firm

Not a week goes by without a call coming into the firm from a nurse whose license is under investigation for some reason or another. The nurse is generally dumbfounded that this has happened. “But I’m a good nurse. I never thought this could happen to me,” is the sad refrain.

Very often the nurse is correct. He/she is a clinically good nurse. Often there has never been any prior problem or any question of this. But all it takes is one instance, just one violation that gets reported to the Department of Health (DOH), and the nurse is suddenly in the position of having his/her license investigated. The nurse then has to defend his/her actions to protect the integrity of his/her license, and possibly even his/her ability to continue practicing, against the allegations of the violation.

Employer’s Insurance Coverage Protects the Employer, Not You.

Normally when a licensure investigation is initiated, the nurse is upset and angry, and is determined to do whatever is necessary to protect his/her license. At this point the intelligent nurse will usually start making telephone call(s) to seek legal advice and counsel. Then comes the harsh reality. Obtaining good legal services is expensive. It can be very expensive. Inevitably the question is put to the nurse as to whether he/she has insurance. All too often the nurse responds that his/her insurance is (or more often at this point, was) through his/her employer.

Then more reality hits. Often the nurse has already been terminated from employment by this point. So, no insurance. Even if the nurse is still employed, the nurse quickly finds out that the coverage he/she believed existed, and often was led by the employer to believe existed, is not really a policy for the nurse at all. The nurse is “covered” under the hospital’s (you can substitute nursing home, clinic, etc., as applicable here) policy really only to protect the hospital’s interests. Therefore, this “coverage” extends only to those situations and occurrences where the hospital might have liability. (And even in that case the nurse should be wary because it is really the hospital’s interests that are being protected by the policy. Where the nurse’s interests happen to be aligned with the hospital’s, all is good. But where they are not, well, the hospital has coverage and its interests will be protected; as for the nurse, he/she is on his/her own).

What you should know is that the hospital’s insurance coverage is there to protect the hospital – – period.

Protect Your Nursing License with a Personal Professional Liability Insurance Policy.

You should also recognize that no nurse is immune from a professional liability claim. No matter how conscientious and clinically competent the nurse may be, the potential for a professional licensure action always exists. Day after day nurses forego legal representation when they are under licensure investigation because legal representation is unaffordable for them. While some nurses get lucky and will have a good outcome in spite of this, many others will not. The very idea of gambling with your nursing license that took so much effort to earn and is the key to your future earning capacity, is not only risky, it is downright foolish.

The truth of the matter is that all nurses should protect themselves by obtaining a personal professional liability insurance policy. A good policy will provide medical malpractice and, very importantly, licensure protection coverage. The cost on these policies varies, but it is generally quite affordable, often costing little more that $10 – $15 a month.

Licensure protection coverage provides the nurse with the ability to obtain competent legal representation from an attorney or a law firm that is familiar with handling licensure investigations and the disciplinary actions that can ensue from them. Good policies will provide $10,000 – $25,000, and even more for legal expense. Having this money available at the time it is needed allows the nurse to focus on his/her defense and provides the nurse the opportunity to pursue this defense all the way through the administrative process. All too often the alternative is having the limited available funds dictate the nurse’s acceptance of an undesired resolution to the matter.

Be Smart, Get Professional Insurance Before it is Too Late.

So, if your independently wealthy, you can continue practicing without much concern about how you will be able to afford legal services for licensure defense if and when that becomes necessary. If though you are not, and your answer to the question of whether you have insurance would be that you do through your employer, now is the time to start thinking about changing that. Tomorrow just might be too late.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

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

Comments?

Do you have personal professional liability coverage? Are you thinking about getting it now? Please leave any thoughtful comments below.

About the Author: Joanne Kenna is a nurse-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.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

The Health Law Firm2013-07-15T09:00:52-04:00May 15th, 2018|Categories: Nursing Law Blog|Tags: am I covered by my employer’s insurance, counsel for nurses, CPH and Associates, Department of Health (DOH), employer insurance coverage, good nurse, Healthcare Providers Service Organization (HPSO), hospital’s insurance, legal advice for nurses, license investigation, licensure defense, licensure investigation, licensure protection coverage, Lloyd’s of London, medical malpractice insurance, nurse, nurse attorney, nurse insurance, nurse insurance coverage, nurse investigation, Nurse lawyer, nurse license investigation, nurse professional liability insurance, Nurse Service Organization (NSO), nurses, nursing license, practicing nurse, professional liability claim, professional liability insurance, terminated nurse, the health law firm|1 Comment

Nurses, No More Excuses: Get a Personal Professional Liability Insurance Policy Now-Part 1

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

To protect yourself from automobile accidents, you carry auto liability insurance. To protect your home from fire, storms and other accidents, you carry homeowners’ insurance. However, I have noticed many nurses fail to carry any insurance to protect one of their most precious assets, their nursing licenses. Yet such insurance is cheap and easy to obtain. I cannot stress enough how important it is for a nurse to carry a personal professional liability insurance policy that covers any investigation, complaint or administrative hearing that might be filed or opened against a nurse’s license.

In my experience, I’ve heard every excuse as to why a nurse does not have a personal professional liability insurance policy. In this blog series, I am exploring those excuses. I want every nurse to understand the importance of buying personal professional liability insurance now, before it is too late.

Keep in mind that a great deal more nursing license complaints are filed against nurses than there are liability lawsuits.

Excuse: I Am a Good Nurse, I Don’t Need Professional Liability Insurance.

You may be a good nurse, but good nurses are the subject of lawsuits and complaints. All it takes is just one violation that gets reported to the DOH or BON, and the nurse is suddenly in a position of having his or her license investigated. The nurse then has to defend his or her actions to protect the integrity of his or her license, and possibly the ability to continue practicing.

The harsh reality is that legal representation is very expensive. Without insurance, even if the nurse is found to be not negligent, the nurse is still responsible for the attorney’s fees and expenses incurred during trial. However, professional liability insurance will protect the nurse in the event of a lawsuit, and it may also pay legal defenses in the event of a complaint against the nurse’s license to practice or for other legal problems.

Excuse: I am Covered By My Employer’s Insurance.

We hear this on a weekly basis. Many nurses mistakenly believe that their employer insures them for legal fees and costs associated with defending against licensure complaints, Emergency Suspension Orders (ESOs), Notices of Investigation, and Administrative Complaints. In the overwhelming majority of cases, this is false. Often it is the employer that files the complaint against the nurse that causes the investigation. If you are told your employer will cover you in such circumstances, ask for a letter in writing and signed by the employer stating that the employer will pay for your defense in any DOH or BON investigation or subsequent administrative proceedings that arise out of your employment. It is unlikely that you will get it.

When a nurse is “covered” under a hospital’s (you can substitute nursing home, clinic, etc., as applicable here) policy, that policy primarily protects the hospital’s interests. Therefore, this “coverage” extends only to those situations and occurrences where the hospital might have liability.

Check This Blog for More.

I will continue to explore excuses I hear from nurses as to why they do not have a personal professional liability insurance policy in later blogs.

It is my hope that after reading this you will look into purchasing your own professional liability insurance policy.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, in appearances before the Board of Nursing (BON) in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

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

Comments?

Do you have personal professional liability coverage? Are you thinking about getting a personal policy now? Please leave any thoughtful comments below.

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.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

The Health Law Firm2018-07-09T20:09:41-04:00May 15th, 2018|Categories: Board of Nursing, Defense, Department of Health, Insurance, Nurses Service Organization|Tags: am I covered by my employer’s insurance, counsel for nurses, CPH and Associates, defense attorney, defense lawyer, Department of Health (DOH), employer insurance coverage, good nurse, Healthcare Providers Service Organization (HPSO), hospital’s insurance, legal advice for nurses, license investigation, licensure defense, licensure investigation, licensure protection coverage, Lloyd’s of London, medical malpractice insurance, nurse, nurse attorney, nurse insurance, nurse insurance coverage, nurse investigation, Nurse lawyer, nurse license investigation, nurse professional liability insurance, Nurse Service Organization (NSO), nurses, nursing license, practicing nurse, professional liability claim, professional liability insurance, terminated nurse, the health law firm|1 Comment

Nurses, No More Excuses: Get Personal Professional Liability Insurance Policy Now-Part 2

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

Nurses, I am writing this to strongly encourage you to purchase your own professional liability insurance policy. I have noticed many nurses fail to carry any insurance to protect one of their most precious assets, their nursing licenses. Yet such insurance is cheap and easy to obtain. Professional liability insurance will protect a nurse in the event of a lawsuit, and it may also pay legal defenses in the event of a complaint against a nurse’s license to practice or for other legal problems. If you already have nursing liability insurance, make sure it also pays all legal expenses incurred in defending a complaint against your license.

I’ve heard every excuse as to why a nurse does not have professional liability insurance. In this blog series, I am exploring many of those excuses. I want every nurse to understand the importance of buying personal professional liability insurance now, before it is too late.

This is part two of the series, click here to read part one.

Excuse: Professional Liability Insurance is Expensive.

All nurses should protect themselves by obtaining professional liability insurance. A good policy will provide medical malpractice and, very importantly, licensure protection coverage. The costs on these policies vary, but it is generally quite reasonable. It is common to find professional liability insurance that provides excellent coverage and excellent benefits for less than a dollar a day. We’ve seen policies cost as low as $10 to $15 a month. That is a small price to pay to protect your livelihood.

Excuse: Licensure Defense Coverage Is Not Necessary.

When you buy professional liability insurance, again, it is very important you make sure it includes legal defense coverage for professional licensing defense and other administrative proceedings in an amount of coverage of at least $25,000. If it does not, I recommend you purchase a “rider” or additional coverage from that insurer for a small additional premium. Also, attempt to obtain “broad form coverage.” This will pay for your legal defense costs for other types of regulatory and administrative proceedings such as: a) an internal hospital/facility peer review proceeding; b) a Medicare or Medicaid audit or investigation; c) a Medicare medical quality assurance investigation or review; d) an EEOC discrimination or harassment complaint or investigation; e) an alleged HIPAA privacy violation; f) a hospital clinical privileges action (if you have privileges); g) action to exclude you from the Medicare or Medicaid Program; or h) action to suspend or revoke your DEA registration (if you have one). There are some insurance companies that sell professional license defense and defense costs and expenses for other types of administrative proceedings as a stand-alone insurance policy.

You should buy this coverage now, when you don’t need it. Otherwise, when you do need it, it will be too late.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

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

Comments?

Do you have personal professional liability coverage? Are you thinking about getting a personal policy now? Please leave any thoughtful comments below.

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.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

The Health Law Firm2013-10-30T09:00:28-04:00May 15th, 2018|Categories: Defense, Insurance, Malpractice, Nurse License|Tags: am I covered by my employer’s insurance, counsel for nurses, CPH and Associates, defense attorney, defense lawyer, Department of Health (DOH), employer insurance coverage, good nurse, Healthcare Providers Service Organization (HPSO), hospital’s insurance, legal advice for nurses, license investigation, licensure defense, licensure investigation, licensure protection coverage, Lloyd’s of London, medical malpractice insurance, nurse, nurse attorney, nurse insurance, nurse insurance coverage, nurse investigation, Nurse lawyer, nurse license investigation, nurse professional liability insurance, Nurse Service Organization (NSO), nurses, nursing license, practicing nurse, professional liability claim, professional liability insurance, terminated nurse, the health law firm|0 Comments

Purpose of Florida E-FORCSE Prescription Database Not for Disciplinary or Criminal Prosecution Purposes Against Physicians, Pharmacists or Other Health Professionals

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

As you are no doubt aware now, Florida has an active prescription drug monitoring program (PDMP). It is called the “Electronic-Florida Online Reporting of Controlled Substances Evaluation” or “E-FORCSE.” More often it is referred to simply as the “prescription drug database” by Florida physicians.

The Florida Legislature adopted the E-FORCSE system in Florida by Section 893.055, Florida Statutes.

Section 893.055(7)(b), Florida Statutes, States Access to Program’s Database is Limited to Program Manager.

A pharmacy, prescriber, or dispenser shall have access to information in the prescription drug monitoring program’s database which relates to a patient of that pharmacy, prescriber, or dispenser in a manner established by the department as needed for the purpose of reviewing the patient’s controlled substance prescription history. Other access to the program’s database shall be limited to the program’s manager and to the designated program and support staff, who may act only at the direction of the program manager or, in the absence of the program manager, as authorized. Access by the program manager or such designated staff is for prescription drug program management only or for management of the program’s database and its system in support of the requirements of this section and in furtherance of the prescription drug monitoring program. Confidential and exempt information in the database shall be released only as provided in paragraph (c) and s. 893.0551. . . .

Data from E-FORCSE Not Intended to be Used to Bring Disciplinary Action Against Health Care Practitioners.

Most notably, it was not the intent of the Legislature for any state or federal agency to use the data from the E-FORCSE system primarily as evidence for the purpose of taking licensure or disciplinary action against physicians, dentists, pharmacists or other licensed health professionals.

Unfortunately, we have seen cases where, contrary to the Legislature’s intent, data from E-FORCSE has been recited in a case against a licensed health professional as an example of “substandard performance,” “falling below the standard of care,” or professional “negligence.” Additionally, we have been informed of the alleged use of the E-FORCSE system by state and federal law enforcement authorities in criminal investigations and prosecutions of licensed health professionals. However, the exact wording of Sections 893.055 and 893.0551, Florida Statutes, should be carefully analyzed in determining under what conditions access and use of the information are authorized.

Defending Against E-FORCSE Data’s Being Used Against a Health Care Practitioner.

If you are a physician, dentist or pharmacist, and data from E-FORCSE is used in or discussed in any complaint investigation, license investigation, Drug Enforcement Administration (DEA) investigation, criminal investigation, administrative complaint, charge sheet or indictment, you should ask your attorney to research the advisability of filing a motion to strike it. In addition, your attorney should also consider filing a motion in limine, before any major hearing or trial, to exclude all use or mention of the data and E-FORCSE system.

In addition, the attorney for the licensed health professional may explore the possibility of moving to exclude any and all information and evidence derived from the unauthorized use of the E-FORCSE databank under the “fruit of the poisonous tree” doctrine. To date, we have not seen any cases where this has been done.

Again the exact language of Sections 893.055 and 893.0551, Florida Statutes, should be consulted to determine whether access and use have been properly authorized.

Information on Florida’s Prescription Drug Monitoring Program from the Florida Department of Health.

The information below is taken from an informational pamphlet distributed by the Florida Department of Health (DOH) called “E-FORCSE; Florida’s Prescription Drug Monitoring Program.” It is available online, at www.e-forcse.com.

Florida’s Prescription Drug Monitoring Program Facts.

E-FORCSE will take in controlled substance dispensing data from pharmacies and health care practitioners, and will make the information available to all health care practitioners who can then use the database to guide their decisions when prescribing and dispensing certain highly-abused prescription drugs. With this information, health care practitioners may be able to identify patients who are “doctor shopping”—obtaining multiple prescriptions for the same controlled substance from multiple health care practitioners. Doctor shopping is a felony in Florida.

Who is Required to Report Controlled Substance Dispensing Information to E-FORCSE?

Any health care practitioner who has dispensed a controlled substance in schedule II, III and IV, as defined in section 893.03, Florida Statutes-like OxyContin, Percocet, Vicodine, etc., will be required to report to the database. This includes pharmacies licensed under chapter 465, Florida Statutes, (including mail order and Internet pharmacies that dispense controlled substances into Florida) and health care practitioners licensed under chapters 458, 459, 461, 462, 465, or 466, Florida Statutes.

Who is Not Required to Report Controlled Substance Dispensing Information to E-FORCSE?

A health care practitioner who:

– Administers a controlled substance directly to a patient if the amount is adequate to treat the patient during that particular treatment session;
– Administers a controlled substance to a patient or resident receiving care as a patient, at a hospital, nursing home, ambulatory surgical center, hospice or intermediate care facility for the developmentally disabled;
– Administers or dispenses a controlled substance in the health care system of the Florida Department of Corrections;
– Administers a controlled substance in the emergency room of a licensed hospital;
– Administers or dispenses a controlled substance to a patient under the age of 16; and
– Dispenses a one-time, 72-hour re-supply of a controlled substance.

How Can E-FORCSE Help Improve a Patient’s Standard of Care?

– It allows the health care practitioners to choose and prescribe controlled substances that will not negatively interact with medicines prescribed by other health care practitioners.
– Pharmacists can determine for their patients if their health care practitioners have prescribed controlled substances that might negatively interact when used together.
– Health care practitioners can determine if their patient has had multiple prescriptions for the same drugs from multiple health care practitioners. This identifies those patients potentially engaged in the crime of doctor shopping. When health care practitioners intervene, they can help their patients find treatment.

How Can E-FORCSE Help Improve the Public Health of Florida?

Health care practitioners can identify a potentially illegal diversion pattern for drugs when they request and receive a Patient Activity Report (PAR). A PAR can alert health care practitioners to doctor shopping. In addition, this information can assist law enforcement, medical regulatory boards and the Attorney General’s Medicaid Fraud Control Unit (MFCU) with active investigations into criminal activity regarding controlled prescription drugs.

Who Has Access to the Information Stored in E-FORCSE?

A health care practitioner who is subject to licensure or regulation by the DOH under chapter 458, chapter 459, chapter 461, chapter 462, chapter 464, chapter 465, or chapter 466, Florida Statutes, will have direct access to their specific patient’s information. Other direct access to information will be limited to the E-FORCSE program manager and designated staff for the purpose of program management.

Indirect access may be requested by the following organizations upon being verified and authenticated by E-FORCSE staff.

– DOH or appropriate health care regulatory boards who are involved in a specific investigation involving a designated individual for one or more prescribed controlled substances;
– The Attorney General (AG) for Medicaid fraud cases involving prescribed controlled substances; and
– A law enforcement agency during active investigations regarding potential criminal activity, fraud or theft of prescribed controlled substances.

Are Health Care Practitioners Required to Access E-FORCSE Before Prescribing a Controlled Substance?

Health care practitioners will not be required to access E-FORCSE before prescribing a controlled substance. It will be voluntary; however, physicians are encouraged to use it as a tool to improve patient care.

Is E-FORCSE Compliant with the Federal Health Insurance Portability and Accountability Act (HIPAA)?

Yes, in addition to meeting the federal HIPAA requirements, E-FORCSE will meet all required DOH security requirements.

What is the Penalty for Disclosure of Confidential Information in the E-FORCSE Database?

A health care practitioner or other individual who has access to the information in the E-FORCSE database who discloses confidential information will be committing a third-degree felony.

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, pain management doctors, dentists, 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 and visit our website at www.TheHealthLawFirm.com.

Comments?

As a health care practitioner, do you use E-FORCSE? Why or why not? Please leave any thoughtful comments below.

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 George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
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