The Do’s and Don’ts If You Are Under Investigation For Discipline on Your Professional License, Part 2

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

You are reading Part 2 of this blog series. To read Part 1, click here.

If you are notified that you are under investigation, DO NOT take the easy way out by immediately relinquishing your license. And DO NOT hide your head in the sand by thinking the case will just go away on its own. DO NOT think that you can just talk to the investigator, explain your side, and the case will go away. Also, DO NOT request an informal hearing or agree to a settlement agreement (consent order) in which you admit the facts alleged against you are all true.  If you do this you are, in effect, “pleading guilty.” If you are innocent of the charges, request a formal hearing and contest the charges; defend yourself.

DO immediately seek the advice of an attorney who has experience in such professional licensing matters and administrative hearings.  These attorneys are out there, but you may have to search for one.  Do this before you talk to or make any statement (oral or written) to an investigator.

DO purchase professional liability insurance that includes legal defense coverage for any professional license investigation against you, whether it is related to a malpractice claim or not.  This insurance is cheap and will provide you with needed legal assistance at the time when you may be out of a job and not have money to hire an attorney.  However, beware of the insurance policy that only covers professional license defense related to a malpractice claim.

DO NOT count on your employer to provide this type of insurance for you. In fact, most of such complaints against your license may well be filed by your employer or ex-employer.

If you are a traveling nurse or other contract or temporary type of health professional, always purchase your own insurance.

Our Advice On Professional Liability Insurance.

We strongly encourage nurses, mental health counselors, and all licensed health professionals and facilities to purchase independent insurance coverage.  Make sure it covers professional license complaint defense expenses under all circumstances.

Also, make sure you have enough coverage to actually get you through a hearing. For example, $25,000 coverage for just professional licensure defense is the absolute minimum you should purchase;   $50,000 may be adequate, but $75,000 or $100,000 may be what you need in such a situation.  You can usually buy the higher limits for a few dollars more (and I do mean only a few). If necessary, such insurance is usually cheap enough that you can actually purchase two or more different policies.

Also, I will repeat, make sure it covers your legal defense in an administrative disciplinary proceeding against your license, even if there is no malpractice claim filed against you or likely to be filed against you. We also recommend that you purchase coverage through an insurance company that allows you to select your own attorney and does not make you use one that the insurance company picks for you.

Companies we have dealt with in the past which provide an inexpensive quality insurance product for professional license defense costs include CPH & Associates Insurance, Nurses Service Organization (NSO) insurance, Healthcare Providers Organization (HPSO) Insurance, and Lloyd’s of London Insurance.

To learn more, visit our Video Q&A section on our website and watch our video titled, “Should I voluntarily relinquish my professional license because I am being investigated?” and visit our YouTube page.

Click here to read one of our prior blogs for even more information on how to fight back against adverse NPBD reports.

Don’t forget to read part one of this blog series here!

Contact Health Law Attorneys Experienced with Investigations of Healthcare Professionals.

The attorneys of The Health Law Firm provide legal representation to medical professionals 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 Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in 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.

Legally Speaking: Professional Liability Insurance for Psychologists, Mental Health Counselors, Social Workers and Therapists

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

Those supervised by the Board of Psychology and the Board of Clinical Social Work, including Marriage and Family Therapy and Mental Health Counseling, psychologists, Licensed Mental Health Counselors, Clinical Social Workers and Licensed Marriage and Family Therapists are responsible for one of the most important component of patient care: mental health.

Professional Liability Insurance.

Insuring the mental health of a patient does not come without inerrant risks. For this reason, every mental health professional should carry professional liability insurance that includes professional license defense coverage (sometimes called disciplinary defense, license defense, administrative hearing coverage or broad coverage). This type of insurance coverage is included in most professional liability policies. However, if it is not, it can often be added as a rider to the insurance policy for an additional charge. Mental health professionals should be sure that coverage for professional license defense is at least $25,000 and a $50,000 increase is recommended.

“Broad form coverage” should also be requested and obtained that includes coverage of legal fees for defense of all administrative or governmental proceedings, including Medicare audits, Medicaid audits, EEOC complaints, and other types of governmental actions that could be initiated.

Though mental health may not seem like a high-risk field, if dissatisfied, patients can file complaints that can lead to serious consequences. These complaints can be initiated against a mental health professional based solely on anonymous calls to the Department of Health Hotline, newspaper reports, prior arrest reports, disgruntled patients, disgruntled insurance companies, competitors, or other sources. Once an investigation is initiated, psychologists, therapists, counselors and other mental health professionals should obtain legal representation immediately to ensure that each action on the part of the psychologist or other mental health professional will result in a more favorable outcome.

Retain a Board Certified Health Lawyer.

A board certified health lawyer experienced in representing mental health professionals will be the most qualified to handle a DOH case. A mental health professional may never face a DOH investigation or Board of Psychology or Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling administrative hearing, but it is important that every psychologist and counselor has knowledge of current legislation impacting the psychology field. The Florida Statutes have recently been updated to prohibit anyone from using the title of “social worker” unless certain requirements are met.

Additionally, there have been changes made to guidelines for treatment programs for impaired professional and psychologist reporting requirements.

Contact Health Law Attorneys Experienced in the Representation of Mental Health Counselors, Psychologists, Social Workers, and Marital and Family Therapists.

We have had mental health professionals who became victims of completely unreasonable demands from their clients/patients (house sitting, pet sitting, etc.), stalking by their clients/patients, identity theft and computer hacking by their clients/patients. Don’t become a victim yourself.

The attorneys of The Health Law Firm can assist and advise you in dealing with difficult clients/patients. We can stop stalking, cyber-stalking and harassment. We can respond to client/patient letters. We can defend you if a client/patient files a complaint against you.

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

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

Massachusetts Insurance Company Sued in Mental Health Discrimination Suit

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

On July 20, 2018, a Massachusetts federal judge allowed a woman to move forward with a proposed class action against Harvard Pilgrim Health Care Insurance Company (Harvard Pilgrim). The woman is claiming that Harvard Pilgrim, which covers medical expenses at nursing homes, must also cover mental health care at her son’s behavior-correcting summer camp.

Mental Health Parity Act.

U.S. District Judge Denise J. Casper denied a motion to dismiss from the insurer, saying that the plaintiff adequately equated the two types of health settings in a lawsuit. In the suit, the insurer is accused of violating the Mental Health Parity Act when it denied coverage for behavioral services at wilderness programs. Its blanket exclusion for services rendered at wilderness treatment programs is a separate treatment limitation applicable only to mental health benefits and thus violative of the Parity Act.

The statute generally requires insurers to cover mental health treatments on the same terms that they cover medical and surgical care. As a result of this violation, the plaintiff was forced to pay more than $16,000 out of pocket for her teenage son, the lawsuit alleges.
Click here to view the complaint in full.

The Defendant’s Arguments.

In response, Harvard Pilgrim argued that it excludes wilderness-like medical benefits such as diabetes camps, so excluding wilderness mental health care is not differential. In addition, in court documents it insisted that the correct comparison was whether both types of treatment, physical and cognitive, would be excluded if offered through a wilderness program.

Despite the arguments, Judge Casper stated that the First Circuit has held that a plan administrator, in terminating or denying benefits, may not rely on a theory for its termination or denial that it did not communicate to the insured prior to litigation. To read Judge Casper’s order in full, click here.

Contact Health Law Attorneys Experienced in the Representation of Mental Health Counselors, Psychologists, Social Workers, and Marital and Family Therapists.

We have had mental health professionals who became victims of completely unreasonable demands from their clients/patients (house sitting, pet sitting, etc.), stalking by their clients/patients, identity theft and computer hacking by their clients/patients. Don’t become a victim yourself.

The attorneys of The Health Law Firm can assist and advise you in dealing with difficult clients/patients. We can stop stalking, cyber-stalking and harassment. We can respond to client/patient letters. We can defend you if a client/patient files a complaint against you.

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

Sources:

Wille, Jacklyn. “Harvard Pilgrim Sued Over Wilderness Therapy Coverage.” Bloomberg Law. (July 24, 2018). Web.

Noon, Alison. “Harvard Pilgrim Must Face Mental Health Discrimination Suit.” Law360. (July 24, 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 George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999. Copyright © 2018 The Health Law Firm. All rights reserved.

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