Doctors and Nurse Practitioner Arrested in Prescription Drug Abuse Raid

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

A crackdown on prescription drug abuse by New York law enforcement has resulted in the arrests of 98 people. Two doctors and a nurse practitioner were among those charged.

A series of raids were carried out by Brooklyn federal prosecutors, the Drug Enforcement Administration (DEA), district attorney’s offices, and local law enforcement agencies. The raids began June 5, 2012 and resulted in the arrests.

To view the DEA’s press release concerning the raid, click here.

Both Doctors Accused of Overprescribing.

One of the doctors is accused of conspiring to distribute oxycodone to patients that were not legitimate. Allegedly, the doctor surrendered his DEA registration. This terminated his authority to prescribe controlled substances such as oxycodone. However, he allegedly attempted to use other health care practitioners to continue to prescribe drugs, which the government contends is illegal.

Another doctor involved in the crackdown is charged with illegal distribution of oxycodone. During the execution of a federal search warrant at his offices on March 1, 2012, the doctor voluntarily surrendered his DEA registration. However, he allegedly continued to issue prescriptions to those whom he knew were not legitimate patients.

We continually warn against “voluntarily relinquishing” DEA registrations or medical licenses with any investigation pending as this is treated the same as a revocation in most cases. For an article we have written on this, click here.

Florida Has Experienced Similar Prescription Drug Abuse Crackdowns.

Starting around two years ago, Florida health providers involved in narcotics precribing became routine targets for law enforcement. This was part of a concerted effort by state and federal officials to crackdown on “pill mill” operations. Regulations increased. Lawmakers enacted severe penalties for doctors and other health professionals accused of over-prescribing. Most physicians were banned from dispensing drugs in their offices. The governor created a Florida drug “strike force” with a mission to eliminate any pain clinics that were found to be breaking the law. The Florida Surgeon General and the Board of Medicine made announcements about the “crackdown” on “over-prescribing.”

Since the implementation of the new pain management and prescribing laws, the Florida strike force has made thousands of arrests and seized millions of pills of narcotics. This has resulted in serious concerns by those in the pain management profession.

Law Enforcement will Continue to Pursue Physicians, Pharmacists, Nurses and Other Health Providers.

The recent raid in New York and ongoing actions in Florida demonstrate that law enforcement will continue to pursue health professionals who prescribe large amounts of narcotics.

Contact Health Law Attorneys Experienced with Overprescribing Charges and DEA Cases.

The Health Law Firm represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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

Sources Include:

Allen, Jonathon. “Doctors Arrested in New York Prescription Drug Crackdown.” Reuters. (June 7, 2012). From http://in.reuters.com/article/2012/06/06/usa-crime-painkillers-idINL1E8H6E3J20120606

CBS News. “98 Arrested in NY Prescription Drug Sweep.” CBS News. (June 6, 2012). From http://www.cbsnews.com/8301-201_162-57448268/dozens-arrested-in-ny-prescription-drug-bust/

McKenzie-Mulvey, Erin. “U.S. Attorney Lynch, District Attorneys, DEA, Other Law Enforcement Announce Prescription Drug Initiative.” Drug Enforcement Administration. (June 7, 2012). Press Release. From: http://www.justice.gov/dea/pubs/states/newsrel/2012/nyc060712a.html

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.

Drug Enforcement Administration (DEA) Nabs New York Doctor Allegedly on Drug Charges

00011_RT8By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A raid by the Drug Enforcement Administration (DEA) on November 27, 2012, at a New York home led to the arrest of an emergency room (ER) doctor, according to a number of sources. Once inside, agents allegedly found crack cocaine, crack pipes, needles and other drug paraphernalia belonging to the doctor. It’s reported by The Buffalo News that the raid came just as the alleged drug abuser was getting ready to smoke a crack cocaine pipe.

Click here to read the entire article from The Buffalo News.

DEA Agents Allegedly Wanted to Work Quickly on This Case.

According to a press release from the DEA, the doctor had been under investigation for weeks. Agents wanted to work quickly on this case since they knew the doctor worked at a number of hospitals in Niagara County, New York.

The press release states DEA agents stopped a vehicle driven by the doctor’s female companion and caught her in possession of crack cocaine. The woman told agents that she purchased the drugs for the ER doctor, and that they were going to use them that night. The DEA obtained a search warrant and raided the doctor’s house the same night.

To read the entire press release from the DEA, click here.

Charges Stemming from Possession. 

Bond for the doctor has been set at $5,000. Possessing crack cocaine carries a maximum sentence of one year in prison and a $10,000 fine.

As in all media reports, please remember that all persons are presumed to be innocent until proven guilty in a court of law.

Contact Health Law Attorneys Experienced with DEA Cases.

The Health Law Firm represents physicians, pharmacists, pharmacies, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the 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 do you think about this story? Is there an industry-wide problem with health providers abusing drugs? Please leave any thoughtful comments below.

Sources:

Herbeck, Dan. “DEA Raid Ends with ER Doctor in Trouble Over Crack Cocaine.” The Buffalo News. (November 28, 2012). From: http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20121128/CITYANDREGION/121129271/1003

Guggenmos, Emily. “ER Doctor Faces Crack Cocaine Charge.” WIVB. (November 29, 2012). From: http://www.wivb.com/dpp/news/crime/er-doctor-faces-crack-cocaine-charge

Drug Enforcement Administration. “Physician Charged with Possessing Crack Cocaine.” DEA New York City Division. (November 28, 2012). From: http://www.justice.gov/dea/divisions/nyc/2012/nyc112812a.shtml

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.

Drug Enforcement Administration Agents Raid Central Florida Pain Management Clinic

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

Drug Enforcement Administration (DEA) agents along with local police and sheriffs’ deputies raided a Longwood, Florida, pain management clinic on June 14, 2013. According to the Orlando Sentinel, agents searched for evidence at the clinic associated with multiple doctors. DEA agents stated the clinic was operating as a “pill mill” and allegedly diverting legal prescriptions for illegal purposes. No one was arrested during the raid. Longwood is a suburb of Orlando.

Investigation Spreads to South Florida.

According to WESH-TV, during the raid agents took everything from the clinic that could help them build a criminal prosecution. This included paper records, computer equipment and prescription drugs. DEA agents would not say how many people they were investigating, but they did say this raid was the result of a two-year long investigation.

In addition to the Longwood pain clinic, DEA agents said they are also searching locations in Brevard County, Florida, where associates of the Longwood clinic allegedly live.

To watch the WESH-TV report, click here.
Two Doctors Associated With the Longwood Clinic Allegedly “Blacklisted” by Pharmacy.

According to the Orlando Sentinel, two doctors associated with the Longwood clinic were allegedly “blacklisted” in 2011, by CVS Pharmacy. This means that CVS notified those physicians that the pharmacy chain would no longer fill prescriptions they wrote for certain drugs such as oxycodone, due to suspiciously high prescribing rates. To read a previous blog on the CVS blacklist, click here.

Click here to read the entire Orlando Sentinel article.

The Longwood pain clinic is currently closed. Whether this will be temporary or permanent is unknown at this time.

Different Clinic, Similar Storyline.

This raid on the Longwood clinic is just one of the many we’ve recently seen in Florida. DEA agents and local law enforcement officials are not slowing down in their fight against illegal pill mills, and illegal prescribing and dispensing practices. To read a blog on two Orlando-area pharmacists recently arrested on charges of alleged drug trafficking, click here. Even the biggest pharmacy chains are not immune to investigations. Walgreens just agreed to pay $80 million to settle a DEA investigation into the chain’s dispensing practices of prescription drugs. To read more, click here.

Contact Health Law Attorneys Experienced with DEA Cases and Licensing Actions.

The Health Law Firm represents physicians, pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the 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 do you think about all of these raids on pharmacies and pain clinics? Please leave any thoughtful comments below.

Sources:

McDaniel, Dave. “Agents Raid Longwood Pain Clinic.” WESH-TV. (June 14, 2013). From: http://www.wesh.com/news/central-florida/seminole-county/agents-raid-longwood-pain-clinic/-/17597106/20572512/-/item/0/-/afpnwwz/-/index.html

Pavuk, Amy. “Agents Raid Longwood Pain Clinic.” Orlando Sentinel. (June 14, 2013). From: http://www.orlandosentinel.com/news/local/breakingnews/os-professional-pain-care-raid-20130614,0,3826330.story#tugs_story_display
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.

Pediatricians Who Are Targets of Medicaid Audits Should Request Hearings on the Final Audit Report Results

00011_RT8By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

We have recently been contacted by several pediatric practices that were subject to Medicaid audits. In several cases, the pediatricians received the final audit reports (FARs) stating that they owed Medicaid refunds, because of overbillings, in the tens of thousands of dollars.

With such demands for repayment of the alleged overpayments also come:

  1. Fines;
2. Penalties;
3. Requirements to sign agreements to refrain from such practices in the future;
4. Requirements to have personnel retrained; and
5. The specter of future audits.

In many cases, Medicare and Medicaid auditors may swiftly review supporting medical records and overlook key components that support the level of services (or CPT codes) that were billed, erroneously downgrading the code or disallowing the charge completely. Other times the pediatric or medical practice may have only provided partial records and have left out some key records that would support the codes billed.

Challenging the Determination.

Unfortunately, after receipt of the FAR, the only hope of challenging the determination would come by filing a written request or petition for a formal hearing in, specifically, a Medicaid case. In Medicare cases, other interim reviews or appeals are available.

If you have additional records you failed to provide, or if after a thorough review of the records you did provide show that all of the elements of a CPT code you billed (e.g., 99204 or 99205) were documented, then we recommend that you immediately retain the services of a board certified health lawyer experienced with Medicare and Medicaid audits to file a petition for you. Be sure a written request or petition for a formal hearing is filed within the time stated in the letter you receive, even if you must retain an attorney afterwards. Remember that the request must be in writing and must be received by the agency at the address specified before the date in the letter has passed.

You can always work out a settlement agreement, repayment agreement, or agreement for a different resolution of the situation. What you can’t do is to go back and get back your hearing rights after they have expired.

Steps to Take if you Receive Notice of an Audit.

What you should do immediately upon receiving notice of an audit:

 1. Retain the services of a board certified health lawyer who is experienced with such audits.

 2.  In a timely manner, provide all relevant documents pertaining to the audit, properly labeled and pages numbered (note:  in many instances, this may include more than just the minimum documents the audit requested).

 3. Watch for any interim, initial or preliminary audit reports (PARs), and be prepared to rebut it in detail if it requests a refund.

 4. If you receive a FAR demanding a repayment, be prepared to hire a board certified health lawyer who is experienced with such audits, if you have not already done so.

 5. If you disagree with the findings in the FAR, be sure the agency receives your request for a formal hearing to challenge the determination, prior to the date given in the FAR or demand letter.

For additional details, pointers and tips on this subject you may click here to read the prior blog we have published.

For information, details, pointers and tips on the subject of Medicare audits, you may click here to read the prior blog we have published on this.

Comments?

Do you know what to do if you are the target of a Medicaid audit? Did you know about requesting a hearing on the final audit report results? Please leave any thoughtful comments below.

Contact Health Law Attorneys Experienced with Medicare and Medicaid Cases.

Attorneys with The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program. We also handle Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S.

Our attorneys also represent health care professionals and health facilities in qui tam or whistleblower cases both in defending such claims and in bringing such claims. 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 whistleblower 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.

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 © 1996-2014 The Health Law Firm. All rights reserved.

 

Walgreens Reaches Settlement in False Claims Act Case

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

Walgreens has reached a $7.9 million settlement with the United States and participating states that resolves allegations that Walgreens violated the False Claims Act. The DOJ announced the settlement on April 20, 2012. To view the DOJ’s press release concerning the settlement with Walgreens, click here. To view the False Claims Act, click here.

Walgreens Allegedly Offered Illegal Inducements to Medicare and Medicaid Beneficiaries.

The settlement was reached after Walgreens was accused of offering illegal inducements to beneficiaries of government health programs (Medicare, Medicaid, the Federal Employees Health Benefits Program (FEHBP), and TRICARE ). Walgreens allegedly offered gift cards to government health program beneficiaries when they transferred a prescription from another pharmacy to Walgreens. The government maintains that such inducements are a violation of state and federal laws.

Walgreens Pays Back Individual State Medicaid Programs.

Since the initial settlement was announced by the DOJ, Walgreens has begun to pay back individual state Medicaid programs that were impacted by the alleged inducements. State and federal laws prohibit such inducements to buy services and goods provided under Medicaid. Walgreens is now paying the states for prescription claims it submitted for reimbursement to Medicaid that were a result of the alleged inducements. Some of the states involved include California, Indiana, Michigan, and Missouri.

Whistleblowers Initiated Government Investigation of Walgreens’ Gift Card Inducements.

The allegations were brought to the government by two whistleblowers. Two separate whistleblower lawsuits were filed under the qui tam, or whistleblower, provisions of the False Claims Act and state False Claims Act statutes. The whistleblowers will receive $1,277,172 from the United States for their role in filing the qui tam actions.

Contact Health Law Attorneys Experienced with False Act Claims Cases.

The Health Law Firm represents physicians, medical practices, pharmacists, pharmacies, and other health provider in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving government health programs (Medicare, Medicaid, TRICARE). The Health Law Firm also represents health providers in False Claims Act cases.

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

Sources Include:

Cohen, Bryan. “Whistleblower Lawsuits Against Walgreens Settled.” LegalNewsline. (June 12, 2012). From: http://www.legalnewsline.com/news/236427-whistleblower-lawsuits-against-walgreens-settled

Department of Justice, Office of Public Affairs. “Walgreens Pharmacy Chain Pays $7.9 Million to Resolve False Prescription Billing Case.” Department of Justice. (April 20, 2012). Press Release. From: http://www.justice.gov/opa/pr/2012/April/12-civ-505.html

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.

22 New Synthetic Drugs Outlawed in Florida: Citizens Keep an Eye Out for Zombies

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

On December 11, 2012, Attorney General (AG) Pam Bondi filed an emergency rule outlawing 22 new synthetic drugs, commonly known as “bath salts,” “K2,” and “Spice.” This emergency rule modifies Section 893.03(1)(c), Florida Statutes, by expanding the list of synthetic drugs in Schedule I of controlled substances of the Florida Comprehensive Abuse Prevention and Control Act.

Click here to view a copy of the emergency rule.

I previously wrote a blog on House Bill 1175 in July 2012, which originally outlawed 90 forms of synthetic drugs. Click here to read that blog.

Authorities Having a Hard Time Staying on Top of These Drugs.

The new law puts restrictions on those who manufacture, sell or deliver synthetic substances including certain synthetic cannabinoids and synthetic stimulants. Many of the synthetic substances are also commonly known as synthetic marijuana, bath salts, K2, potpourri, and incense. According to an article in the Orlando Sentinel many of these drugs look like snacks for children. One of these drugs is even marketed as a “Scooby Snack,” another looks like cotton candy. To read the entire article from the Orlando Sentinel, click here.

Florida’s officials are continuously updating the list of outlawed synthetic substances because the chemical compounds in these substances are easy to change. The ease of converting these substances into illegal drugs helps drug makers, users and sellers avoid arrest and prosecution.

Click here to see the entire list of outlawed controlled substances.

Anyone with These Drugs Asked to Voluntarily Surrender Supply.

The emergency rule by the AG makes it a third-degree felony for an individual to sell, manufacture or deliver these synthetic drugs.

These drugs are widely available in smoke shops, truck stops, convenience stores and on the internet. In a press release the AG and local law enforcement reached out to people handling these drugs, asking them to voluntarily surrender the substances or face action from law enforcement.

To read the entire press release from the AG, click here.

AG Wants a Zombie-Free Holiday.

This emergency rule is evidence of Floridians’ fear of zombies and cannibal attacks allegedly linked to the misuse of the outlawed substances. Florida has been linked to both in the national news, thus scaring away many of our tourists who usually flood the state. For an update on the zombie apocalypse in Florida, click here. Of course, there are those detractor who contend that face-chewing and other alleged zombie behavior is just natural behavior for Floridians, regardless of the chemicals imbibed.

Since Florida seems to be the only state infected with these flesh-eaters, we are taking a poll. Should Florida be renamed “the Zombie State?” Let us hear from you.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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 do you think of this new list of outlawed synthetic drugs? Do you think sellers will voluntarily surrender their products? Will this new list keep the zombies away? Tell us, do you think we should rename Florida the Zombie state? Click here to vote in a poll on our Facebook page.

Sources:

Meale, Jenn. “Attorney General Pam Bondi Outlaws Additional Synthetic Drugs.” Office of the Attorney General. (December 11, 2012). From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/C2FED4E8849E737685257AD1006EED54

Haughney, K. “Bondi Files Emergency Rule to Outlaw Additional Synthetic Drugs.” Orlando Sentinel. (December 11, 2012). From: http://blogs.orlandosentinel.com/news_politics/2012/12/bondi-files-emergency-rule-to-outlaw-additional-synthetic-drugs.html

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.

Terrible Things That Can Happen after Discipline on Your Professional License or Resignation of a License after Notice of Investigation

Patricia's Photos 013By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Do you have a medical, pharmacy or nursing license in several different states?  Do you have a license in more than one health profession?  Have you been notified that an investigation has been opened against you?  Are you thinking about resigning your professional license or voluntarily relinquishing such a license?  Then you must be aware of the following.

First, you should never voluntarily relinquish or resign your license after you know that an investigation has been opened or that disciplinary action has been taken against you.  Such a resignation is considered to be a “disciplinary relinquishment” and is treated the same as if your license had been revoked on disciplinary grounds.

Second, this will be reported out to other states, agencies, to the National Practitioner Data Bank (NPDB), to any certifying bodies for certifications you have and to other reporting agencies (such as the National Council of State Board of Nursing, the National Association of Boards of Pharmacy or the American Board of Internal Medicine).  Other states and other professional boards will most likely initiate disciplinary action based upon the first one.

Protect Your License from These Adverse Actions.

The following is a list of some of the adverse actions that you can expect to be taken against you after discipline on your license or after you resign your professional license after receiving notice of investigation:

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

2.  Must be reported to and included in the Department of Health (DOH) profile that is available to the public online (for those having one), and remains for at least ten years.

3.  Any other states or jurisdictions in which the nurse has a license will also initiate an investigation and possible disciplinary action against him or her in that jurisdiction.  (Note:  I have had two clients who had licenses in seven other states and all, even ones that were inactive or not renewed years ago, initiated action).

4.  The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (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 HHS OIG.

a.  If this happens, you are prohibited by law from working in any position in any capacity for any individual or business, including hospitals, nursing homes, home health agencies, physicians, medical groups, insurance companies, etc., that contract with or bill Medicare or Medicaid.  This means, for example, you are prohibited from working as a janitor in a nursing home that accepts Medicare or Medicaid, even as an independent contractor.

b.  If this happens, you are also automatically “debarred” or prohibited from participating in any capacity in any federal contracting, and you are placed on the U.S. General Services Administration’s (GSA) debarment list.  This means you are prohibited by law from working in any capacity for any government contractor or anyone who takes government funding.  This applies, for example, to prevent you from being a real estate agent involved in selling property financed by a government backed loan, prohibited from working for an electrical company that bids on contracts for government housing projects, working as a school teacher in a public school, etc.

c.  If this happens, your state Medicaid Program is required to terminate you “for cause” from the state Medicaid Program.  In many states, this is also grounds for revocation of your license.

5.  Any profile or reporting system maintained by a national organization or federation (e.g., NURSYS profile maintained by the National Council of State Boards of Nursing, American Medical Association physician profile, or the Federation of State Board of Physical Therapy profile) will include the adverse action in it, generally available to the public.

6.  If you are a nurse practitioner or other professional with clinical privileges at a hospital, nursing home, HMO or clinic, action will be taken to revoke or suspend the clinical privileges and staff membership if you have such. This may be in a hospital, ambulatory surgical center, skilled nursing facility, staff model HMO or clinic.  This will usually be for physicians, physician assistants (PAs), advance registered nurse practitioners (ARNPs), certified registered nurse anesthetists (CRNAs), nurse midwives or certified nurse anesthetists (CNAs), podiatrists, clinical psychologist or clinical pharmacists.

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

8.  The U.S. Drug Enforcement Administration (DEA) will act to revoke the  professional’s DEA registration if he or she has one.

9.  Many employers will not hire you or will terminate your employment if they discover your license has been disciplined in another state.

What Should You Do?

–  Don’t take the easy way out by immediately relinquishing your license if you are notified you are under investigation.

–  Don’t hide your head in the sand by thinking the case will just go away on its own.

–  Don’t take the easy way out.  If you are innocent of the charges, request a formal hearing and contest the charges; defend yourself.

–  Do not request an informal hearing or a settlement agreement in which you admit the facts alleged against you are all true.  If you do this, you are “pleading guilty.”

–  Do immediately seek the advice of an attorney who has experience in such professional licensing matters and administrative hearings.  They are out there, but you may have to search for one.  Do this as soon as you get notice of any investigation and especially before you have talked to or made any statement (including a written one) to any 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 needed legal assistance at the time when you may be out of a job and not have money to hire an attorney.  Beware of the insurance policy that only covers professional license defense if it is related to a malpractice claim.

Professional Liability Insurance.

We strongly encourage all licensed health professionals and facilities to purchase their own, independent insurance coverage.  Make sure it covers professional license defense under all circumstances.  Make sure you have enough coverage to actually get you through a hearing. $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 really need in such a situation.  For a few dollars more (and I do mean only a few) you can usually purchase the higher limits.

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 encountered in the past who provide an inexpensive top 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.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents physicians, nurses, pharmacists, pharmacies, dentists, mental health counselors, massage therapists and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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.

Sexual Misconduct by Rogue Employees Can Cost Big Money: Your Responsibility as an Employer

2 Indest-2009-1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Johns Hopkins Health System agreed to shell out $190 million to more than 7,000 women and girls, in one of the largest settlements ever in the United States involving sexual misconduct by a physician.

A gynecologist, practicing in a Baltimore-based Johns Hopkins Hospital, one of the nation’s most prestigious medical institutions, was accused of using a tiny camera to secretly take videos and pictures of his patients. The doctor worked at the hospital for 25 years, but was fired after admitting to the misconduct and surrendering his recording devices to authorities.

This is a chilling example of how employers can be held responsible for “rogue” employees clearly not working under the consent of the employer. In general, employers have a responsibility to properly supervise their employees’ actions. As in this case, failure to do so can cost millions.

Background of the Case.

According to the Wall Street Journal, a co-worker tipped off Johns Hopkins officials that the gynecologist was wearing a pen around his neck that looked like a camera. In February 2013, an investigation revealed that the gynecologist secretly used the device in question to photograph and videotape thousands of women and girls during pelvic exams. The investigation found that the doctor’s camera captured 1,200 videos and 140 images of his patients, that were then stored on his computer. The doctor was fired in February 2013, and committed suicide days later.

Click here to read the entire article from the Wall Street Journal.

“Rogue” Employee.

In this case, Johns Hopkins states that insurance will cover the entire $190 million settlement. The preliminary agreement is awaiting final approval from a judge. In a statement, Johns Hopkins’ attorney said that the hospital was unaware of the doctor’s conduct, and that he had become a “rogue” employee. The hospital sent out letters of apology to the gynecologist’s patient list, calling the incident a “breach of trust.”

Click here to read all of the statements from Johns Hopkins Medicine in regard to this incident.

Employer’s Responsibility.

The lawsuit against Johns Hopkins alleged that the hospital failed to properly supervise the doctor and should have known of his alleged misconduct.

This situation brings up an interesting point, even though the employee was acting on his own accord, the health system would still likely have been held liable if the case was not settled.

Employers are generally “vacariously liable” for their employees’ actions. The basic idea of vicarious liability or the doctrine of respondeat superior is that an employer is held responsible for the negligent acts of its employee that cause injuries to a third party, provided that such acts were committed during the course of and within the scope of the employment.

To establish that the employee’s conduct was within the scope of employment:

1. The conduct must have occurred substantially within the time and space limits authorized by the employment;
2. The employee must have been motivated, at least partially, by a purpose to serve the employer; and
3. The act must have been of a kind that the employee was hired to perform.

In certain circumstances, including the example of the gynecologist, an employer’s vicarious liability can extend to intentional or even criminal acts committed by the employee.

Vicarious liability is a powerful concept and, as evident by the Johns Hopkins case, can result in an employer being responsible for significant sums of money. Employers should institute policies which curb activities that could be injurious to others. The employer has a responsibility to monitor employees and immediately investigate any suspicious activity.

Despite the fact that Johns Hopkins acted quickly, the hospital system will still most likely be left holding a settlement sum of $190 million for actions of an employee.

Comments?

As an employer, how do you make sure your employees aren’t acting on their own or violating company policies and procedures? Please leave any thoughtful comments below.

Contact Health Attorneys Experienced in Health Law and Employment Law.

The Health Law Firm represents both employers and employees in the health care industry in defending allegations of sexual misconduct and other complaints from employees and patients. We represent employers in unemployment compensation hearings, in defending against EEOC (discrimination) complaints, and in defending litigation involving wage and hour disputes, as well as other types of contract or employment litigation. We also can investigate such allegations and attempt to negotiate settlements where warranted. Our attorneys represent individuals and institutions in litigation, civil or administrative, state or federal.

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

Sources:

Linderman, Juliet. “Hopkins Pays $190M in Pelvis Exam Pix Settlement.” Associated Press. (July 22, 2014). From: http://apne.ws/UquXOI

Levitz, Jennifer. “Johns Hopkins Agrees to $190 Million Exam-Photos Settlement.” Wall Street Journal. (July 21, 2014). From: http://online.wsj.com/articles/johns-hopkins-hospital-agrees-to-190-million-exam-photos-settlement-1405961572

Johns Hopkins Hospital. “Statement from Johns Hopkins Medicine on the recent news surrounding Nikita Levy, M.D.” Hopkins Medicine. (July 21, 2014). From: http://www.hopkinsmedicine.org/news/Nikita_Levy.html

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 © 1996-2014 The Health Law Firm. All rights reserved.

Medical Marijuana Legalized in Connecticut: Will More Problems Develop for Doctors, Pharmacists?

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

The use of marijuana for medical reasons has been legalized in Connecticut. The state’s governor signed into law HB 5389 on May 31, 2012, which allows licensed physicians to certify a patient’s use of marijuana for medical purposes. Connecticut is the 17th state to legalize marijuana for medical use.

To view Connecticut HB 5389, click here.

Medical Marijuana Legislation in Connecticut Imposes Restrictions on Patients.

The new law outlines restrictions to prevent abuse of the substance. Patients and caregivers in Connecticut must register with the Connecticut Department of Consumer Protection. In addition, a doctor must certify there is a medical need for marijuana to be dispensed. HB 5389’s qualifying medical conditions are cancer, glaucoma, HIV, Parkinson’s, multiple sclerosis, spinal cord injuries causing spasticity, epilepsy, Crohn’s disease, and PTSD. The Connecticut Department of Consumer Protection is authorized to add additional medical conditions.

Special License Needed for Pharmacists to Dispense Marijuana for Medical Use.

According to HB 5389, only a pharmacist with a special license can dispense medical marijuana. Pharmacists can obtain marijuana from licensed producers, who will pay an application fee of at least $25,000.

Majority of HB 5389 Provisions are Effective October 1, 2012.

The majority of the bill will go into effect on October 1, 2012, including a provision to allow patients to obtain a temporary registration to possess marijuana while the department implements the remainder of the act.

New Legislation Could Mean More Issues for Physicians, Pharmacists.

The passing of HB 5389 could mean more issues for physicians and pharmacists in Connecticut. Because the bill places many restrictions on the medical use of marijuana, the state may closely monitor the actions of physicians and pharmacists who prescribe and dispense medical marijuana.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

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

Sources Include:

Clark, Mary Ellen. “Connecticut is the 17th State to Legalize Marijuana for Medical Use.” Reuters. (June 1, 2012). From http://www.reuters.com/article/2012/06/01/us-usa-marijuana-connecticut-idUSBRE85018X20120601

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.

How Safe Is Your Hospital?

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

It’s been a long time since most of us have seen a report card, but hospitals all over the nation received their safety grades on November 28, 2012. Leapfrog, a national group that advocates for safer health care, determined the grades. According to the Orlando Sentinel, Florida hospitals ranked well. Overall, 39 percent (39%) of the 156 hospitals graded received A’s, earning the Sunshine State a tenth place ranking in the nation.

Click here to read the entire article from the Orlando Sentinel.

How Florida Hospitals Did.

Here is a list of the grades received by Florida hospitals:

A’s: 61 (This includes Orlando Regional Medical Center, Dr. P. Phillips Hospital,

Orlando Regional South Seminole Hospital and Health Central.)

B’s: 38 (This includes Florida Hospital campuses in Orlando, Altamonte, Apopka, Celebration, east Orlando, Kissimmee and Winter Park.)

C’s: 49

D’s: 8

F’s: 0

To see the number of hospitals receiving each grade for patient safety by state, click here.

Grades Were Calculated by Safety Measures in Hospitals.

According to the Kaiser Health News article, Leapfrog calculated the grades based on 26 different measures of safety. The company used publicly-available data, including the number of blood line infections, falls in the hospital, bedsores and the consistency that hospitals follow recommended methods of care.

Physicians Believe Rating System is Pointless.

This grading system has physicians reportedly complaining. In the Kaiser Health News article doctors interviewed said that the grades are redundant and offer no benefit to hospitals since Medicare calculates and publishes most hospital-related issues.

Click here to read the Kaiser Health News article.

Leapfrog defends the ratings, saying the report cards provide a more transparent health care system for patients.

How to Fight Poor Online Reviews.

The Leapfrog grading system is just one of the many ways the performance of physicians, hospitals, nurses, dentists and all health providers is put on the chopping block. Other internet review websites like Vitals.com and Yelp.com allow patients to post virtually anything they want – good or bad. If you’ve personally received an unfavorable review that was possibly planted by a disgruntled patient, competitor or former employee you need to fight it. When the comment is posted, search engines like Google, Yahoo, Bing, AOL, or MSN may bring up the false statement every time someone searches for that health provider’s name. To learn legal strategies for health providers to fight bad online reviews, click here.

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

At the Health Law Firm we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

The services we provide include reviewing and negotiating contracts, business transactions, professional license defense, representation in investigations, credential defense, representation in peer review and clinical privileges hearings, Medicare and Medicaid audits, commercial litigation, and administrative hearings.

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

Comments?

As a health professional, do you think this grading system is redundant? Do you believe there is any merit to the grades hospitals received? Do you think patients benefit from the published grades? Please leave any thoughtful comments below.

Sources:

Jameson, Marni. “Did Your Hospital Make the Grade? Group Rates Quality of Care, More.” Orlando Sentinel. (November 28, 2012). From: http://www.orlandosentinel.com/news/local/breakingnews/os-leapfrog-hospital-grades-20121127,0,5928170.story

Rau, Jordan. “Hospitals Get New Grades on Safety.” Kaiser Health News. (November 28, 2012). From: http://capsules.kaiserhealthnews.org/index.php/2012/11/hospitals-get-new-grades-on-safety/

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.

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