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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.

Florida Court Denies Motion to End Patient Wrongful Death Suit Despite Settlement

7 Indest-2008-4By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On November 15, 2016, The Florida Supreme Court refused to dismiss a lawsuit over the death of an escaped psychiatric hospital patient for the second time. The suit questions the thin line between medical and ordinary negligence, even though the parties settled their dispute several months ago.

The justices offered no explanation when they denied a motion from defendant-appellee Shands Teaching Hospital and Clinics Inc. (Shands) asking them to reconsider that ruling. Additionally, the court also maintained the same 4-3 split across both orders.

The Background.

The ongoing case stems from the January 23, 2013, death of Ashley Lawson. She escaped from Shands Psychiatric Hospital in Gainesville, and was struck and killed by a tractor trailer on Interstate 75.

According to the facts from the case that was filed, Lawson was admitted to the hospital on November 1, 2012, with a history of psychiatric illness, drug abuse, impulsive behavior and multiple suicide attempts. She was later transferred to the locked inpatient unit for her own safety, according to her estate’s initial jurisdictional brief.

As a result of a Shands employee allegedly leaving her key and badge unattended, Lawson was able to escape. Her estate, bringing the suit on her behalf, argued that the case was one of ordinary negligence and not a medical malpractice case. A medical malpractice case carries various strict presuit requirements under the Florida Medical Malpractice Act, including a presuit notice and the affidavit of a physician expert, which the estate did not provide.

Denied Motion to Dismiss.

The suit made its way to the state’s highest court as the estate sought reversal of a decision by the First District Court of Appeal to quash a lower court’s order that had denied Shands’ motion to dismiss. According to the estate’s brief, the Court of Appeal reviewed the case on its own, reaching its 8 to 6 decision, after a three-judge panel could not reach a definitive result.

Ashley Lawson’s estate argued the First District Court of Appeal’s decision stood in conflict with the Fifth District Court of Appeal’s decision on what constitutes ordinary negligence versus medical malpractice. This conflict would give the Florida Supreme Court the authority to decide what the law actually states.

In the hospital’s defense, Shands argued that the case is not a high-profile matter of great public interest, and has no effect on the “due process rights of life or liberty for a sizable group of Floridians.”

Negligence is one of the most common claims used against doctors. It is important to familiarize yourself with the repercussions and ways to avoid it from happening to you in the first place. Click here to read one of my prior blogs to learn more.

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

The attorneys of The Health Law Firm provide legal representation to psychiatrists, mental health counselors, psychologists, social workers and family therapists in Department of Health (DOH) investigations, medical malpractice investigations, business transactions, contracts, structuring business ventures, clinical privileges actions, professional licensure matters, Board hearings, business litigation, Medicare and Medicaid audits, and other types of investigations of health professionals and providers.

Often the early advice and representation of an experienced health law attorney can help avoid discipline which will be on your record for a lifetime.

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

Sources:

Hale, Nathan. “Fla. High Court Says Deal Doesn’t Stop Patient Death Case.” Law360. (November 28, 2016). Web.

Frellick, Marcia. “Florida Court Rules Physician May Be Liable in Suicide.” Medscape. (August 25, 2016). Web.

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. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“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 © 2016 The Health Law Firm. All rights reserved.

Major Health Care Reform Bill On FDA Approvals, Mental Health Policy Clears House

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On November 30, 2016, the House of Representatives passed the 21st Century Cures Act. The new bill overwhelmingly passed wide-ranging legislation meant to overhaul the drug approval process, boost biomedical research, and many other significant health-related policies.

The Bill.

The bill would change research prioritization and medication review rules at the U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH). Additionally, it would push medication development rules for a variety of items including new antibiotics to medical devices. The mental health reforms, originally developed in Helping Families in Mental Health Crisis Reform Act of 2016, would create a greater emphasis on evidence-based mental health treatments. It aims to increase cooperation between federal agencies on mental health policy.

The bill passed with a 392-26 vote, largely supported by Republican National Committee (GOP) leaders like whip Steve Scalise, R-La. Scalise called the legislation an advance that would save millions of lives and move medical innovation back to U.S. shores.

Providing Additional Funding.

In addition to the push for medical development, the bill also encompasses a host of other big initiatives. This includes more than $5 billion in funding for the NIH and money to help the FDA; $1 billion for tackling the opioid epidemic; and provisions that are meant to help pair Americans who suffer from serious mental illnesses with available psychiatric beds.

The bill is expected to pass the Senate by the beginning of December 2016.

To learn more about the importance of raising awareness about mental health issues, click here to read one of my prior blogs on this topic.

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

The attorneys of The Health Law Firm provide legal representation to psychiatrists, mental health counselors, psychologists, social workers and family therapists in Department of Health (DOH) investigations, medical malpractice investigations, business transactions, contracts, structuring business ventures, clinical privileges actions, professional licensure matters, Board hearings, business litigation, Medicare and Medicaid audits, and other types of investigations of health professionals and providers.

Often the early advice and representation of an experienced health law attorney can help avoid discipline which will be on your record for a lifetime.

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

Sources:

Mukherjee, Sy. “House Just Passed the Biggest Health Reform Bill Since Obamacare.” Fortune. (November 30, 2016). Web.

Macagnone, Michael. “Bill On FDA Approvals, Mental Health Policy Clears House.” Law360. (November 30, 2016). Web.

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. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“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.