mental health counselor and social worker defense attorney

Florida Telehealth Laws for Mental Health Counselors, Social Workers and Marriage and Family Therapists

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

The Florida Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling has published the following guidance regarding the provision of telehealth services.

As of October 11, 2021, it is still effective and is provided verbatim as follows:
(See more at: https://floridasmentalhealthprofessions.gov/latest-news/telehealth/)

During the 2019 legislative session, Florida passed section 456.47 Florida Statutes, which establishes standards of practice for telehealth services, including patient evaluations, and record-keeping. The law also authorizes out-of-state health care practitioners to perform telehealth services for patients in Florida. Signed by the Governor on June 25, 2019, this law became effective on July 1, 2019.

Out-of-State Health Care Practitioners.

Out-of-state health care practitioners must be registered with the Florida Department of Health to perform telehealth services for patients in Florida. The out-of-state telehealth provider registration is for health care practitioners licensed outside of Florida ONLY. Florida licensees can already provide telehealth services to patients in Florida that they can treat in person.

Pursuant to section 491.014(4)(d), Florida Statutes, you may practice under a limited basis without a license as specified below:

4) No person shall be required to be licensed, provisionally licensed, registered, or certified under this chapter who:

(d) Is not a resident of this state but offers services in this state, provided:

1. Such services are performed for no more than 15 days in any calendar year; and

2. Such nonresident is licensed or certified to practice the services provided by a state or territory of the United States or by a foreign country or province.

The Department has created a website that allows interested parties to review information about Florida telehealth, sign up for updates, and register to become an out-of-state telehealth provider. For more information, please visit www.flhealthsource.gov/telehealth. Information Regarding a Designated Registered Agent can be found here: https://floridasmentalhealthprofessions.gov/help-center/out-of-state-telehealth-provider-registration/.

For questions, contact the Telehealth Office at [email protected].

Florida Practitioners.

If you would like to provide services to a client outside of the state of Florida, you must contact the board in the jurisdiction where the patient is located. Not all states permit telehealth service even under emergency circumstances.

Florida Registered Interns.

Pursuant to Rule 64B4-2.002, Florida Administrative Code, registered interns may provide face-to-face psychotherapy by electronic methods if the registered intern has a written telehealth protocol and safety plan in place with their current qualified supervisor which includes the provision that the qualified supervisor must be readily available during the electronic therapy session. Additionally, the registered intern and their qualified supervisor must have determined, through their professional judgment, that providing face-to-face psychotherapy by electronic methods is not detrimental to the patient, is necessary to protect the health, safety, or welfare of the patient, the registered intern, or both, and does not violate any existing statutes or regulations.

Qualified supervisors may utilize face-to-face electronic methods, including telephone only communication, to conduct all supervisory sessions for internship hours if the qualified supervisor determines, through their professional judgment, that such methods are not detrimental to the registered intern’s patients and are necessary to protect the health, safety, or welfare of the qualified supervisor, the registered intern, or both.

Any clinical hours obtained via face-to-face psychotherapy by electronic means shall be considered clinical hours for the purpose of meeting internship requirements.

For further information regarding the Florida telehealth guidelines, please click here.

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

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, psychiatrists, social workers, and family therapists in Department of Health (DOH) investigations, Department of Regulatory Agencies (DORA) investigations, board hearings, FBI investigations, and other types of investigations of health professionals and providers.

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

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at 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 © 2021 The Health Law Firm. All rights reserved.

Mental Health Counselors & Social Workers: If You’re Applying for Your Professional License, Read This First!

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

The process of obtaining a mental health counselor or social worker professional license can be challenging and time-consuming. When seeking initial licensure or applying for a license in another state, you should be aware of delays in the application process due to the investigation of credentials and past practice, as well as the need to comply with licensing standards.

Examples That Would Delay Your Mental Healthcare License Application:

• Disciplinary or academic actions during postgraduate training (probation, suspension, remediation)
• Action by another state’s regulatory or licensing board
• Action by a different professional licensing board
• Misdemeanor or felony convictions
• Results of the criminal background check (remember, it shows arrests, not necessarily the results of the arrests)
• Civil judgments/malpractice
• Medical, physical, mental, or chemical dependence impairment/condition within the last five years
• Adverse action against your clinical privileges by a hospital, ambulatory surgical center, skilled nursing facility, or other health facility or professional organization.
• Adverse action (e.g., termination for cause) by a former employer
• Action by a specialty board
• Lack of recent active practice
• Action by DEA against your DEA registration number
• Disciplinary action (especially court-martial) by the military
• Applications that require a petition of waiver or variance for a job

Not being 100% truthful about your history and education is the number one reason for denial of an application for a license! Don’t try to hide potentially derogatory information from a state licensing board, if it is required by the question or the instructions that further elaborate on the question. It is much better to come forward with the information and be upfront.

This being said, you do not want to volunteer adverse information that a question does not ask. For example, if a question asks about felony convictions, DO NOT disclose misdemeanor convictions or traffic ticket convictions. If a question asks about convictions, DO NOT disclose arrests for which you were acquitted or were dismissed. If a question asks about medical malpractice lawsuits, DO NOT disclose civil lawsuits that were not related to malpractice.

Tips to Speed up the License Application Process.

There are ways to ease the process of applying for a mental health counselor or social worker license and get your application processed quicker. Before submitting your application, contact the licensing board and request a copy of its current licensing requirements and the average time it takes to process applications.

Tips to ease the process of applying for mental health counselor or social worker licensure:

1. Submit follow-up documents in a timely manner online or mail them to the correct address (as required). If you cannot obtain requested follow-up documentation, provide a separate, detailed explanation (preferably in the form of an affidavit), of why you cannot do so.

2. Keep in mind that any fees you pay have to be processed by the Department vendor. This may take a few days.

3. Identify any variation of names and nicknames.

4. Once you start the process, submit the application within 30 days so that your supplemental documents, including transcripts, will have an application file in which to be filed.

5. Have the correct address on the application for training programs you have attended and the health facilities at which you have worked.

6. Send in necessary back-up documents in a timely manner.

7. Follow up with sources that are sending the Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling your documents.

8. Watch for letters or e-mail from your reviewer. This is how you will be instructed on what additional documents or information may be needed for your application to be complete.

9. If asked for follow-up information from the Board, please read the request carefully to identify exactly what is needed to make your application complete.

10. Answer questions honestly and provide an explanation where appropriate. But do not provide information that is not being requested.

Mental health counselors, social workers, and other medical professionals seeking a license should expect at least a 60-day period from the time they initially submit a completed application and the actual date licensure is granted.

For more information and ways that The Health Law Firm can help in licensure matters, visit our Video Q&A section or visit our website’s Areas of Practice page.

Contact Health Law Attorneys With Experience Handling Licensing Issues.

If you are applying for a mental health counselor, social worker, massage therapy, dental, or health care license, have had a license suspended or revoked, or are facing imminent action against your license, it is imperative that you contact an experienced healthcare attorney to assist you in defending your career. Remember, your license is your livelihood, it is not recommended that you attempt to pursue these matters without the assistance of an attorney.

The Health Law Firm routinely represents mental health counselors, social workers, dentists, nurses, physicians, medical groups, clinics, and other healthcare providers in personal and facility licensing issues.

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:

“Obtaining a Medical License.” American Medical Association (AMA). Web.

Florida Board of Clinical Social Work, Marriage & Family Therapy and Mental Health Counseling, “Licensing FAQs,” https://floridasmentalhealthprofessions.gov/licensing/

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 © 2021 The Health Law Firm. All rights reserved.

Florida Governor Signs New Controlled Substance Telemedicine Prescribing Law

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

On April 6, 2022, Florida’s Governor signed into law legislation to remove the state’s prior restrictions on telemedicine prescribing of controlled substances. The new law in Florida allows healthcare providers to prescribe many controlled substances via telemedicine.

Florida Senate Bill (SB) 312, signed into law, eliminates the prior ban that had existed prohibiting the prescription of Schedule II controlled drugs (with certain exceptions). Schedule II drugs can now be prescribed in Florida via telemedicine if the clinical situation meets one of four exceptions.

A Big Win For Patients Whose Treatment Requires Controlled Substances.

The prescribing of controlled substances is a heavily regulated medical service. Healthcare providers must usually meet specific criteria to prescribe controlled substances via telemedicine, including conducting an in-person examination of the patient before moving to telehealth examinations.

The new law will allow Florida clinicians to prescribe refills in connection with their ongoing care management more efficiently. For example, the clinician can periodically conduct patient examinations via telemedicine instead of requiring in-person exams.

SB312 was seen to be a big win for Florida patients with medical conditions requiring controlled substances as part of the treatment regimen. This includes, for example, endocrinology or substance use disorder (both of which use Schedule III medications now permitted under the new law), allowing these patients to obtain better access to more care. This is especially so for patients whose medical conditions may have limited their travel or mobility.

The allowance is limited for Schedule II drugs. It is now allowed but only for the treatment of psychiatric disorders, inpatient treatment at a licensed hospital, hospice services, and treatment for residents in a nursing home.

The Florida Law Doesn’t Supersede Federal Law.

It is important to remember that Florida law doesn’t supersede federal law. Therefore, providers should be certain that they meet the requirements of both federal and state law.

In this context, the telemedicine prescribing of controlled substances is governed by the federal Ryan Haight Act, as well. This means prescribers still need to meet one of seven conditions that would allow them to prescribe a controlled substance via telemedicine without first having an in-person exam. Florida law must be read in harmony with the federal Ryan Haight Act requirements and a prescriber must comply with both.

Learn more about the Ryan Haight Act and the federal requirements.

To view SB312 in full, click here.

Contact Health Law Attorneys Experienced in Handling Medicare Audits, Investigations and other Legal Proceedings.

The attorneys of The Health Law Firm represent healthcare providers in defending audits and investigations by the Department of Health and Human Services, the Department of Justice, The Drug Enforcement Administration (DEA), the Florida Department of Health (DOH), the Colorado Department of Regulatory Agencies, Medicaid Fraud Control Unit (MFCU), state boards of medicine, state boards of pharmacy, and state boards of nursing. They also represent health professionals and providers in administrative litigation (state and federal) and civil litigation (state and federal). They represent physicians, nurses, medical groups, nursing homes, home health agencies, pharmacies, dentists, pharmacies, assisted living facilities, and other healthcare providers and institutions in recovery actions and termination from Medicare and Medicaid Programs.

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

Sources:

Wicklund, Erik. “NEW FLORIDA LAW OKS PRESCRIBING MOST CONTROLLED SUBSTANCES BY TELEMEDICINE.” Healthleaders Media. (April 11, 2022).Web.

“New Florida Law Allows Telemedicine Prescribing of Controlled Substances.” National Law Review.” (April 7, 2022). Web.

Lacktman, Nathaniel. “New Florida Law Allows Telemedicine Prescribing of Controlled Substances.” Foley & Lardner. (April 7, 2022). 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 © 2022 The Health Law Firm. All rights reserved.

By The Health Law Firm|2024-03-14T09:59:25-04:00July 20, 2023|Categories: Nursing Law Blog|Tags: defense in opioid overprescribing, Department of Health (DOH) complaint defense lawyer, Department of Regulatory Agencies (DORA) defense attorney, Drug Enforcement Administration (DEA) defense lawyer, Drug Enforcement Administration (DEA) hearing attorney, Drug Enforcement Administration (DEA) Order to Show Cause (OTSC) attorney, Florida health law attorney, Florida telemedicine defense lawyer, health care compliance defense lawyer, health care defense attorney, health law defense attorney, informal administrative hearing attorney, legal defense in medical board complaint, legal defense representation in OIG investigations, legal representation for Board of Medicine investigation, legal representation for board of nursing complaint investigation, legal representation for board of pharmacy complaint investigation, legal representation for defense of health care fraud, legal representation for defense of Medicare and Medicaid fraud charges, Medicaid and Medicare fraud defense lawyer attorney, medical board attorney, medical license defense counsel, medical licensure attorney, Medicare and Medicaid fraud defense attorney, Medicare Medicaid audit defense lawyer, mental health counselor and social worker defense attorney, nurse attorney, nursing complaint defense attorney, OIG investigation defense attorney, pharmacist defense lawyer, pharmacy defense lawyer, professional licensure defense attorney, protecting your professional license, representation for applying for a medical license, representation for Board of Clinical Social Work, representation for pharmacist, representation for pharmacy, Representation for telehealth, representation for telehealth investigations, representation for telemedicine, representation for telemedicine investigations, representation of health care professionals, reviews of The Health Law Firm, reviews of The Health Law Firm attorneys, telehealth defense lawyer, telehealth lawyer, telehealth provider investigation defense lawyer attorney, telemedicine attorney, telemedicine defense attorney, telemedicine representation, the health law firm, The Health Law Firm attorney reviews|Comments Off

Attorneys Involved In Multi-Million Dollar UnitedHealth Case Want $3.35 Million Fee Award

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

In October 2021, attorneys who had acted as the class counsel in litigation suing UnitedHealth Group over mental health reimbursement policies asked a New York federal court to approve a $3.35 million fee award. If approved, it would be an award of attorney’s fees in addition to the $10 million the insurer agreed to pay to settle their case.

According to the memorandum of law filed with the court, the mental health advocacy law firm argued that the results which they had achieved on behalf of the class of victims (who were all health insurance plan clients) easily justified the seemingly large requested fees and expenses.

We would agree with their argument. Too often disabled individuals, especially those suffering from mental disabilities, who need the help most, are victimized by large for-profit corporations. The attorneys and law firms who stand up for these individuals, especially those who are able to actually see the case through to completion, should be rewarded for their efforts.

Background.

The settlement reached in August 2021 resolved several consolidated lawsuits over UnitedHealth’s use of a “tiered” system to reimburse patients for out-of-pocket mental health treatment at lower rates than medical and surgical care were reimbursed. In addition to the $10 million private settlement agreement, UnitedHealth agreed to pay out $5.6 million to end claims from the New York State Attorney General and the U.S. Department of Labor. Read more about that here.

Payment of Full Legal Fees and Expenses.

The attorneys who are designated as “class counsel” in a class-action lawsuit are entitled to reasonable reimbursement of litigation expenses incurred in prosecuting a class action. In this case, after settling the case in chief, the class counsel negotiated a separate payment by United of up to $3.35 million for legal fees and expenses subject to court approval, according to the memorandum.

Additionally, the attorneys requested the court grant payment of $20,000 each for service (or incentive) awards for the three different class representatives. Incentive awards are designed to compensate the named plaintiffs for bearing the risks of bringing the suit, as well as for any time spent participating in the actual litigation of the case as an individual would have to do.

To be clear, the attorney’s fees will not be deducted from the $10 million settlement paid to the class members; they will be paid separately By UnitedHealth.

Is the Requested Amount Reasonable?

According to the memorandum filed with the court, the plaintiffs’ lawyers spent thousands of hours combing through data for over 110,000 class members and leading negotiations that included the federal and state agencies and the parties to the litigation. “Given the substantial risks plaintiffs faced in every phase of this case, the results achieved by class counsel are exceptional by any measure,” the memorandum argued.

To view the memorandum in full, click here to view it on our webpage.

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, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

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:

Stone, Rachel. “Attys Who Struck $10M UnitedHealth Deal Seek $3M Payday.” Law360. (October 28, 2021). Web.

Stone, Rachel. “UnitedHealth Strikes Deal To End Mental Health Policy Suits.” Law360. (August 12, 2021). 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. 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 © 2022 The Health Law Firm. All rights reserved.

Attorneys Who Negotiated Multi-Million Dollar UnitedHealth Settlement Ask Court For $3.35 Million Fee Award

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

In October 2021, attorneys who had acted as the class counsel in litigation suing UnitedHealth Group over mental health reimbursement policies asked a New York federal court to approve a $3.35 million fee award. If approved, it would be an award of attorney’s fees in addition to the $10 million the insurer agreed to pay to settle their case.

According to the memorandum of law filed with the court, the mental health advocacy law firm argued that the results which they had achieved on behalf of the class of victims (who were all health insurance plan clients) easily justified the seemingly large requested fees and expenses.

We would agree with their argument. Too often disabled individuals, especially those suffering from mental disabilities, who need the help most, are victimized by large for-profit corporations. The attorneys and law firms who stand up for these individuals, especially those who are able to actually see the case through to completion, should be rewarded for their efforts.

Background.

The settlement reached in August 2021 resolved several consolidated lawsuits over UnitedHealth’s use of a “tiered” system to reimburse patients for out-of-pocket mental health treatment at lower rates than medical and surgical care were reimbursed. In addition to the $10 million private settlement agreement, UnitedHealth agreed to pay out $5.6 million to end claims from the New York State Attorney General and the U.S. Department of Labor. Read more about that here.

Payment of Full Legal Fees and Expenses.

The attorneys who are designated as “class counsel” in a class-action lawsuit are entitled to reasonable reimbursement of litigation expenses incurred in prosecuting a class action. In this case, after settling the case in chief, the class counsel negotiated a separate payment by United of up to $3.35 million for legal fees and expenses subject to court approval, according to the memorandum.

Additionally, the attorneys requested the court grant payment of $20,000 each for service (or incentive) awards for the three different class representatives. Incentive awards are designed to compensate the named plaintiffs for bearing the risks of bringing the suit, as well as for any time spent participating in the actual litigation of the case as an individual would have to do.

To be clear, the attorney’s fees will not be deducted from the $10 million settlement paid to the class members; they will be paid separately By UnitedHealth.

Is the Requested Amount Reasonable?

According to the memorandum filed with the court, the plaintiffs’ lawyers spent thousands of hours combing through data for over 110,000 class members and leading negotiations that included the federal and state agencies and the parties to the litigation. “Given the substantial risks plaintiffs faced in every phase of this case, the results achieved by class counsel are exceptional by any measure,” the memorandum argued.

To view the memorandum in full, click here to view it on our webpage.

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, home health agencies, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. It also includes medical students, resident physicians, and fellows, as well as medical school professors and clinical staff. We represent health facilities, individuals, groups, and institutions in contracts, sales, mergers, and acquisitions. The lawyers of The Health Law Firm are experienced in complex litigation and both formal and informal administrative hearings. We also represent physicians accused of wrongdoing, patient complaints, and in Department of Health investigations.

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:

Stone, Rachel. “Attys Who Struck $10M UnitedHealth Deal Seek $3M Payday.” Law360. (October 28, 2021). Web.

Stone, Rachel. “UnitedHealth Strikes Deal To End Mental Health Policy Suits.” Law360. (August 12, 2021). 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. 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 © 2022 The Health Law Firm. All rights reserved.

Massachusetts Mental Health Centers Submitted False Claims According to Suit

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

On January 5, 2018, the state of Massachusetts lodged a False Claims Act (FCA) suit in federal court against the operators of a number of mental health centers. In the suit, it is alleged that they improperly billed the state Medicaid program for services provided by unlicensed, unqualified and unsupervised employees.

The complaint seeks to recover MassHealth’s payments to South Bay Mental Health Center Inc. and its subsequent owners for claims they knew were false. Allegedly, they billed for services provided by unlicensed social workers who weren’t properly supervised even though it violated statutory and regulatory requirements.

The Complaint.

The complaint alleges that from at least August 2009 to the present, defendant South Bay failed to comply with applicable statutes and regulations regarding licensure and supervision requirements for staff. Additionally, the centers allegedly employ a number of staff therapists and clinic directors who aren’t licensed as social workers or mental health counselors. Unlicensed social workers can provide mental health services to MassHealth members as long as they are supervised by an independently licensed clinical social worker. This was not the case for the vast majority of South Bay’s unlicensed therapists, the complaint alleges.

The filing continues, “As a result of the noncompliance, from at least August 2009 to the present, defendant South Bay, either with actual knowledge or deliberate ignorance of or reckless disregard for the truth, submitted or caused to be submitted false claims for services to the MassHealth program in violation of [the Massachusetts False Claims Act].”

According to the suit, South Bay could have ensured that the staff at each center was properly credentialed during the hiring process and made sure that workers who needed supervision had it, but the company declined to do so.

The suit was originally brought forth in 2015 by relator Christine Martino-Fleming, who served as coordinator of staff development and training at South Bay. South Bay fired her in September 2014 after she raised concerns about the company’s regulatory violations, according to court documents.

Here is the complaint in full for Christine Martino-Fleming v South Bay Mental Health Centers, et al.

There have been an increasing number of Medicare and Medicaid audits being initiated against psychologists and other mental health professionals.
To gain more insight on these types of audits click the link above to read one of my prior blogs.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistle blower or qui tam) case. This case just shows that even physicians can and should bring such claims and be rewarded for their whistle blowing activities. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities who have been sued in False Claims Act (whistle blower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistle blower cases, as well.

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

Sources:

Posses, Shayna. “Mental Health Centers Submitted False Claims, Mass. Says.” Law360. (January 5, 2017). Web.

Foley, Elizabeth. “Supreme Court to Decide What Qualifies as “False” under the False Claims Act.” Barrett and Singal Law Firm. (January 8, 2018). Web.

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

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The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2018 The Health Law Firm. All rights reserved

Massachusetts Mental Health Centers Submitted False Claims According to Suit

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

On January 5, 2018, the state of Massachusetts lodged a False Claims Act (FCA) suit in federal court against the operators of a number of mental health centers. In the suit, it is alleged that they improperly billed the state Medicaid program for services provided by unlicensed, unqualified and unsupervised employees.

The complaint seeks to recover MassHealth’s payments to South Bay Mental Health Center Inc. and its subsequent owners for claims they knew were false. Allegedly, they billed for services provided by unlicensed social workers who weren’t properly supervised even though it violated statutory and regulatory requirements.

The Complaint.

The complaint alleges that from at least August 2009 to the present, defendant South Bay failed to comply with applicable statutes and regulations regarding licensure and supervision requirements for staff. Additionally, the centers allegedly employ a number of staff therapists and clinic directors who aren’t licensed as social workers or mental health counselors. Unlicensed social workers can provide mental health services to MassHealth members as long as they are supervised by an independently licensed clinical social worker. This was not the case for the vast majority of South Bay’s unlicensed therapists, the complaint alleges.

The filing continues, “As a result of the noncompliance, from at least August 2009 to the present, defendant South Bay, either with actual knowledge or deliberate ignorance of or reckless disregard for the truth, submitted or caused to be submitted false claims for services to the MassHealth program in violation of [the Massachusetts False Claims Act].”

According to the suit, South Bay could have ensured that the staff at each center was properly credentialed during the hiring process and made sure that workers who needed supervision had it, but the company declined to do so.

The suit was originally brought forth in 2015 by relator Christine Martino-Fleming, who served as coordinator of staff development and training at South Bay. South Bay fired her in September 2014 after she raised concerns about the company’s regulatory violations, according to court documents.

Here is the complaint in full for Christine Martino-Fleming v South Bay Mental Health Centers, et al.

There have been an increasing number of Medicare and Medicaid audits being initiated against psychologists and other mental health professionals.
To gain more insight on these types of audits click the link above to read one of my prior blogs.

Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm represent physicians, nurses and other health professionals who desire to file a False Claims Act (whistle blower or qui tam) case. This case just shows that even physicians can and should bring such claims and be rewarded for their whistle blowing activities. However, the attorneys of The Health Law Firm also defend physicians, medical groups and health facilities who have been sued in False Claims Act (whistle blower or qui tam) cases or have had administrative or civil complaints filed against them to recover civil monetary penalties. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistle blower cases, as well.

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

Sources:

Posses, Shayna. “Mental Health Centers Submitted False Claims, Mass. Says.” Law360. (January 5, 2017). Web.

Foley, Elizabeth. “Supreme Court to Decide What Qualifies as “False” under the False Claims Act.” Barrett and Singal Law Firm. (January 8, 2018). Web.

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

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The Health Law Firm” is a registered fictitious business name of The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2018 The Health Law Firm. All rights reserved

Finding an Attorney/Lawyer Who Takes Healthcare Providers Service Organization (HPSO) Insurance for Mental Health Counselors and Social Workers

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

We often hear from callers and clients in professional licensing complaints, Department of Health investigations and Board of Mental Health, that they had good insurance coverage with Healthcare Providers Service Organization (HPSO) Insurance, but could not find an attorney that would accept it. Often these professionals retain us after action has been taken to appeal or attempt to reverse an adverse disciplinary action taken against their license.

This should not be a difficult task. Our firm and its attorneys have accepted HPSO Insurance for over 25 years.

Our firm has attorneys that are licensed in and can defend mental health counselors and social workers in Florida, Colorado, Louisiana, Virginia and the District of Columbia. Additionally, there are many states, such as Tennessee, Georgia, Oregon, Pennsylvania, New York, Delaware, and others, which allow us to appear before their boards and represent clients in these state under their “multi-jurisdictional practice” rules, because this is an area in which we routinely practice.

Legal areas in which we can represent an HPSO insured that HPSO will pay for include: administrative hearings, complaints against a professional license, an investigation of a complaint made against your professional license, a deposition you may be subpoenaed for, a complaint made for violation of HIPAA or patient privacy, and many others.

Regardless of the state, contact us at:

The Health Law Firm, Main Office
1101 Douglas Ave.
ALtamonte Springs, FL 32714
Phone: (407) 331-6620
Fax: (407) 331-3030
Website: www.TheHealthLawFirm.com
Internet Contact: www.TheHealthLawFirm.com/contact-us/

One last word, regardless of whether you are covered by HPSO Insurance or not, if an investigator contacts you to obtain a statement from you, whether orally or in writing, always, always, always, consult with an experienced attorney in this area BEFORE giving any statement or talking to the investigator about anything.

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

The attorneys of The Health Law Firm provide legal representation to mental health counselors, psychologists, social workers and family therapists in Department of Health (DOH) investigations, FBI investigations and other types of investigations of health professionals and providers.

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

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for mental health professionals, legal representation for social workers, Board of Mental Health investigation defense attorney, mental health counselor and social worker defense attorney, legal counsel for Board of Mental Health investigations and hearings, health care professional defense attorney, legal representation for medical professionals, Florida HPSO health law attorneys, legal representation for cases dealing with HPSO insurance, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida health law attorney, legal representation for administrative hearings, legal representation for complaints against a professional license, licensure defense attorney, legal representation for a complaint made for violation of HIPAA or patient privacy, legal representation for mental health professionals in Florida, legal representation for mental health professionals in Colorado, legal representation for mental health professionals in Louisiana, legal representation for mental health professionals in Virginia and legal representation for mental health professionals in the District of Columbia

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved