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Maryland & Missouri Become 20th and 21st States to Legalize Recreational Marijuana

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

Five states had proposals to legalize recreational marijuana on the ballot in the midterm elections held on November 8, 2022. Voters in Maryland and Missouri approved the legalization, while Arkansas, North Dakota, and South Dakota rejected similar proposals. As a result of the vote, Maryland and Missouri became the 20th and 21st states to legalize cannabis for adult recreational use.

Maryland.

Maryland’s voters overwhelmingly approved Question 4 as it passed, with 65% of voters casting ballots in favor. The amendment creates a right to possess and use marijuana and directs the state Legislature to enact laws governing its sale. Following its passage, adults in the state will be allowed to possess up to 1.5 ounces, or two marijuana plants, beginning July 1, 2023.

Additionally, it allows for the expungement of records for people arrested for marijuana possession and for people serving time for simple possession to have their sentences reconsidered. It would also establish a cannabis business assistance fund for small businesses and minority- and women-owned companies entering the cannabis industry.

Next up, the state’s lawmakers will decide on licensing and taxation.

Missouri.

Missouri voters passed Amendment 3, with 53% of voters in favor. The measure removes existing state prohibitions on marijuana and legalizes the purchase, possession, consumption, use, delivery, manufacture, and sale of marijuana for personal use for adults 21 and older. It also allows individuals with certain marijuana-related offenses to be released from prison, parole, or probation. More specifically, it levies a 6% state tax rate on sales and allows local governments to impose an additional tax rate of up to 3%.

Other States With Drugs On The Ballot.

Three other states with existing medical marijuana programs also saw voters head to the polls to decide whether to legalize recreational marijuana. At the same time, voters in Colorado considered a historic bill to decriminalize certain psychedelics.

Voters in Arkansas, North Dakota, and South Dakota rejected proposals to bring the states from medical marijuana use to full recreational legalization.

Lastly, in Colorado, Proposition 122, a bill to decriminalize plant and fungi-based psychedelic compounds, appeared to pass with approximately 51% of the vote narrowly. The passing of this historic measure comes ten years after Colorado made history as one of the first states to legalize retail marijuana by ballot initiative.

For updates on important marijuana laws and policies, check out our Marijuana Law Blog and YouTube page.

Contact Experienced Health Law Attorneys for Medical Marijuana Regulatory Matters and Other Health Care Licensing Matters.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists, and pharmacies, participating in the medical marijuana industry. We represent doctors, pharmacies, and pharmacists facing proceedings brought by state regulators or agencies. We represent health-related businesses and medical professionals in all types of licensing and regulatory matters, including state and federal administrative hearings. Several of our attorneys, including Mr. Indest, act as expert witnesses in attorney’s fee litigation and in health law litigation.

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.

Sources:

Reisman, Sam. “Maryland And Missouri Legalize Pot, 3 Others Just Say No.” Law360. (November 9, 2020).

Sykes, Stefan. “Here’s how five states voted on the legalization of recreational marijuana.” CNBC. (November 9, 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.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030

Good News and Bad News for ECFMG & USMLE Applicants: Recent Changes for the USMLE Step Exams

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

These are some recently announced changes that could significantly impact anyone seeking to take the USMLE Step exams. This could be construed as good news by many and bad news by many others. Regardless, here it is.

Step 1 Exam Changing to Pass/Fail Grade and Score Reporting.

The USMLE announced recently that it would change the scoring and reporting for Step 1 exam scores. Step 1 score reporting will transition to pass/fail only for administrations on or after January 26, 2022. All of the worry about passing with a low score and how that might affect residency choices will be eliminated by this change.

Number of Attempts for Step 1 or Step 2 Exam Limited to Four (4) Lifetime Attempts.

Remember when you had no limit on the number of times you could take a USMLE Step exam? Remember when it was reduced to a maximum of six (6) attempts, not that long ago? Guess what? Not anymore!

Effective July 1, 2021, the number of attempts you can have to pass any USMLE Step exam will change. The change latest change reduces the total number of allowable attempts from six (6) attempts to four (4) attempts for any single Step exam, including any incomplete attempts. This is in effect for all applications submitted on or after July 1, 2021. So now, examinees who have already attempted any USMLE Step exam four (4) or more times and have not passed, will no longer be eligible to apply for the USMLE exams.

Is it possible to obtain an exemption? Depending on your circumstances, we can petition for one, but that does not mean it will be granted.

Step 2-CS Exam Completely Eliminated!!!!

Remember the Test of English as a Foreign Language (TOEFL), also known as “der Teufel” (1), that used to be required for Foreign Medical Graduates (now known as “International Medical Graduates” or “IMGs”)? No? Well, I don’t either.

Remember when the Step 2-CS was easily considered the most difficult exam for a foreign medical graduate to pass. Well, I do remember this!

The Step 2-CS (for “clinical skills”) exam was supposed to address any foreign language problems in practicing in the United States. This became, in my opinion, one of the biggest obstacles to for IMGs becoming licensed in the U.S. It was originally discontinued for approximately a year and a half because of problems caused by the COVID-19 epidemic.

Guess what? It doesn’t exist anymore. Accordingly, the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), co-sponsors of the United States Medical Licensing Examination (USMLE) by the USMLE Secretariat, announced on January 26, 2021, that it was discontinuing the Step 2-CS exam.

I guess the powers that be learned when they eliminated the Step 2-CS during the COVID-19 pandemic in 2020, that it was not so necessary after all. Now it is gone.

“Will it ever return, no it will never return; its fate is still unknown.”(1) There is no expectation that it will ever come back. What do you do now with all of those low score “fails” and lows test score “passes” you previously received on the Step 1 exam and the Step 2-CS? The answer is lost in chaos. We will just have to wait and see.

Major Chinese Medical Schools Disqualified in 2019.

See my next blog on what happened to eight (8) major Chinese medical schools so that their graduates cannot take the Step exams or become licensed in the U.S. anymore. Click here to read about the Chines medical schools.

Endnotes:

(1) German for “the Devil”

(2) Paraphrase of verse from “MTA” [standing for the Boston Metropolitan Transit Authority or subway train] written by Jacqueline Steiner and Bess Lomax Hawes, recorded and made famous by The Kingston Trio in 1959.

(3) Answer to the final question asked at the end of every episode of the Japanese Anime series “Dorohedoro” or “Doro and Doro” (2020) (available on Netflix), about a man named “Caiman” who wakes up one morning with the head of a lizard and amnesia and searches for the reason.

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education, and those being challenged by the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG)

The Health Law Firm and its attorneys represent interns, residents, fellows, and medical school students in disputes with their medical schools, supervisors, residency programs, and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation, and any other matters. We routinely help those who have disputes with the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG), including on hearings and appeals concerning “Irregular Behavior,” “unprofessionalism,” and “Irregular Conduct.”

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.

Sources:

“USMLE policy updates following Step 2 CS discontinuation.” United States Medical Licensing Examination Announcements. (July 21, 2021). Web.

About the Author: George F. Indest III, J.D., M.P.A., L.L.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Avenue, 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 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.

By The Health Law Firm|2024-03-14T09:59:11-04:00February 26, 2024|Categories: Health care Law, Medical Education Law Blog|Tags: disruptive physician attorney, ECFMG defense attorney, Educational Commission for Foreign Medical Graduates (ECFMG) defense lawyer, Graduate medical education (GME) defense attorney, graduate medical education defense lawyer, health law attorney, impaired medical student legal counsel, impaired resident legal defense attorney, international medical graduate attorney, irregular behavior defense attorney, irregular behavior defense counsel, Irregular behavior defense lawyer, irregular conduct legal representation, lawyer for medical students, legal dispute with medical school, legal representation for irregular behavior, legal representation for medical residents, legal representation for NBME investigations, legal representation for USMLE investigations, medical resident physician attorney, medical school litigation, medical students legal counsel, National Board of Medical Examiners (NBME) defense counsel, Philadelphia attorney for ECFMG hearing, Philadelphia lawyer for NBME hearing, Philadelphia legal counsel for USMLE hearing, residency program legal dispute, residency program litigation, reviews of The Health Law Firm attorneys, The Health Law Firm reviews, United States Medical Licensing Examination (USMLE) defense lawyer, USMLE defense attorney|Comments Off

Eight Major Chinese Medical Schools No Longer Listed in World Directory Relied on by ECFMG and USMLE

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

In April 2014, the new World Directory of Medical Schools (“World Directory”) was published. It took over as the definitive list of medical schools in the world (yes, the whole world). There are 180 Chinese medical schools listed on the World Directory of Medical Schools. Medical graduates from these schools are routinely eligible to take the United States Medical Licensing Examination (USMLE) Step exams, required for licensing in the United States, after applying and obtaining permission through the Educational Commission for Foreign Medical Graduates (ECFMG).

However, in 2019, eight (8) previously recognized Chinese medical schools were dropped from the World Directory or “delisted.” According to the Korean Medical Association (KMA)’s Research Institute for Medical Policy, the World Federation for Medical Education (WFME) (the organization that maintains and publishes the directory) deleted the eight Chinese medical schools from the World Directory. The eight (8) Chinese medical schools were delisted from the World Directory of Medical Schools (WDMS) a year after Oriental medical schools in Korea also failed to be listed on the directory any longer.

The eight “delisted” medical schools are Beijing University of Chinese Medicine, Guiyang College of Traditional Chinese Medicine, Heilongjiang University of Chinese Medicine, Liaoning University of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanxi College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, and Yunnan University of Traditional Chinese Medicine.

According to the Korean Medical Association’s reports and other publications, the WFME’s decisions clearly show that the world’s medical community does not recognize both Korea’s Oriental medicine and traditional Chinese [Oriental] medicine as modern, scientifically-based medicine.

What Does This Mean?

This means that if you graduated from one of the delisted eight (8) Chinese medical schools, you will no longer be allowed to apply for and receive services from the Educational Commission for Foreign Medical Graduates (ECFMG). In addition, it means you will not be able to apply for and take the Step exams administered by the United States Medical Licensing Examination (USMLE) Secretariat, and you will not be able to become licensed in the United States.

Hey, Don’t Shoot Me! I’m Just the Messenger!

Inquiries and other correspondence regarding the World Directory may be sent to [email protected] or to:

World Federation for Medical Education
13A Chemin du Levant
01210 Ferney-Voltaire
France
www.wfme.org

What Might Possibly Be Done?

Some ideas that might (or might not) work include:

1. Graduates of the delisted schools might apply for recognized medical schools and seek to graduate from one of these. Whether or not you will be able to get any credit for your prior medical school is a different question.

2. Bring pressure on your delisted medical school to add courses and curricula to meet the same requirements as a “Western” medical school or “scientific medical school.”

3. Sorry, that’s about all I could think of. Petitioning for an exception or suing the ECFMG or USMLE is a “non-starter” by my way of thinking.

To read about a similar case involving a Caribbean medical school, click here.

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.

Sources:

Yuqiao, Ji. “TCM [tradional Chinese Medicine] grads struggle after removal from world medical list.” Global Times. (Nov. 18, 2019) (https://www.globaltimes.cn/content/1170466.shtml).

Gwang-seok, I. “8 Chinese medical schools delisted from world directory of medical schools.” Korea Biomedical Review. (November 7, 2019). (https://www.koreabiomed.com/news/articleView.html?idxno=6769).

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.

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By The Health Law Firm|2024-03-14T09:59:11-04:00February 26, 2024|Categories: Medical Education Law Blog|Tags: disruptive physician attorney, ECFMG defense attorney, Educational Commission for Foreign Medical Graduates (ECFMG) defense lawyer, Graduate medical education (GME) defense attorney, graduate medical education defense lawyer, health law attorney, impaired medical student legal counsel, impaired resident legal defense attorney, international medical graduate attorney, irregular behavior defense attorney, irregular behavior defense counsel, Irregular behavior defense lawyer, irregular conduct legal representation, lawyer for medical students, legal dispute with medical school, legal representation for irregular behavior, legal representation for medical residents, legal representation for NBME investigations, legal representation for USMLE investigations, medical resident physician attorney, medical school litigation, medical students legal counsel, National Board of Medical Examiners (NBME) defense counsel, Philadelphia attorney for ECFMG hearing, Philadelphia lawyer for NBME hearing, Philadelphia legal counsel for USMLE hearing, residency program legal dispute, residency program litigation, reviews of The Health Law Firm attorneys, The Health Law Firm reviews, United States Medical Licensing Examination (USMLE) defense lawyer, USMLE defense attorney|Comments Off

Follow These Simple Rules To Keep Your License & Avoid Complaints If You Are a Counselor or Psychotherapists

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

I represent many mental health counselors, social workers, psychologists, and professional counselors, defending them on complaints being investigated against their professional licenses. Many complaints and investigations arise because the therapist has strayed over the line and crossed the therapist-client boundary. In reviewing these cases, I have drawn up a list of a few simple “bright line” rules that can help save you many hours of stress and mental anguish as well as thousands of dollars in attorney’s fees and costs defending yourself

These “rules” may seem to be common sense, but there they are, anyway:

1. DO NOT ever meet the client at an outside social activity or attend a social event with the client. This includes “just dinner” or “just-drinks.”

2. DO NOT text the client. Texting is not secure and leads to casual and unprofessional thinking and conversation with the client. Many health care institutions prohibit their physicians and employees from texting with clients because of the HIPAA Security and Privacy Rules. You can use that as an excuse if you need one.

3. DO take a screenshot and print out the text when you violate the above rule. Place it in the client’s health record because you will probably be seeing it again, attached to a complaint.

4. DO send an e-mail or, better yet, a professional letter to the client, instead of texting the client. Print out a copy and place it in the client’s health record, because you will probably see it again.

5. DO NOT EVER make any suggestive or sexual remarks to the client in any communications, oral or written or text, or e-mail. In fact, DON’T even think about it. This includes off-color jokes and comments.

6. DO immediately terminate the relationship with the client, transferring care to a different therapist, if the client suggests anything of a sexual nature involving you.

7. DO NOT talk about other clients with the client.

8. DO NOT talk about your own personal life with the client. Especially DO NOT let the client have your personal home address or personal e-mail address.

9. DO NOT ever have sex with a client or former client. DO NOT even think of it. If you start to think of it, see Rule 6, above. Consider clients and former clients “off-limits” no matter how much you are tempted. If you are religious, just consider this as an attempt by Satan to seduce you. If it works, you are going to be in Hell, even before you die.

10. DO know what professional boundaries are and DO NOT cross them. This includes allowing a personal relationship to grow between you and the client, and includes selling anything to the client (e.g., Girl Scout cookies, tickets to a charitable event, Amway products, candy bars for your kids’ school band, etc.), agreeing to meet the client at any outside event, accepting gifts from the client, hiring the client to work for you, accepting “voluntary” services from the client (including volunteering to work in your office). If you need a friend that bad, terminate the therapist-client relationship and see Rule 6, above.

11. DO know that if you have even a suspicion that your therapist-client relationship is getting out of bounds, then it already is out of bounds. See Rule 6, above.

12. DO call a professional therapist colleague who is more senior to you and consult her or him about the “situation” if you think there may be a “situation.”

These may sound like “no-brainers” to you, but you would be surprised at how many complaints against licensed counselors and psychologists there are as a result of violating one or more of these “rules.”

(Note: These “rules” are just guidelines meant to help you keep out of trouble; these are not meant to be enforced against anyone, nor do they create or represent any “standard of care.”)

For additional information on how our firm can assist you in matters like this, click here to read one of our prior blogs.

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. 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.

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: (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 Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620

By The Health Law Firm|2024-03-14T09:59:11-04:00February 21, 2024|Categories: Health Facilities Law Blog|Tags: administrative complaint defense attorney, administrative complaint defense lawyer, administrative hearing defense counsel, defense lawyer for psychologists, Department of Regulatory Agencies (DORA) complaint investigation defense counsel, Department of Regulatory Agencies (DORA) defense attorney, Department of Regulatory Agencies (DORA) investigations administrative hearing defense lawyer, Florida Board of Medicine hearing defense attorney, Florida Department of Health (DOH) attorney, Florida health law defense attorney, Healthcare Providers Service Organization (HPSO attorney, informal administrative hearing defense attorney, legal representation for psychiatrists, licensed professional counselor (LPC) defense attorney, licensed professional counselor (LPC) legal representation, medical license defense, mental health counselor defense lawyer, mental health counselor legal representation, representation for administrative complaint hearings, representation for administrative hearings, representation for Department of Health (DOH) complaint investigations, representation for health care professionals, representation for licensed mental health counselors (LMHCs), representation for psychiatric nurse practitioners, representation for social workers, representation in complaint investigations, reviews of The Health Law Firm attorneys, social worker complaint cases, social worker defense attorney, social worker defense lawyer, The Health Law Firm reviews|Comments Off

Nurse Faces Suit for Wrongful Death of Jail Inmate Says 10th Circuit Court of Appeals

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

On March 3, 2021, the U.S. 10th Circuit Court of Appeals reversed in part, a Utah court’s decision on a lawsuit for the death of a 21-year-old inmate, affirming that the jail’s doctor could claim qualified immunity, but not the nurse. After the inmate’s death, her estate sued for depriving her of her civil rights. The U.S. district court granted summary judgment in favor of the county. It ruled that qualified immunity applied to shield jail supervisors and staff. However, it denied qualified immunity to jail nurse Jana Clyde and to a private doctor who consulted with the prison, Dr. Kennon Tubbs.

The 10th Circuit appeal panel reversed the lower court’s decision, stating that one doctor can claim qualified immunity. It ruled that the jail’s nurse must face claims of civil rights violations, which are not subject to immunity. Court filings alleged that jail staff, including its nurse, ignored the inmate’s rapidly deteriorating health.

Failure to Secure Medical Treatment Despite Obvious Risks to the Inmate.

In 2016, Madison Jensen, the inmate, allegedly died from opiate withdrawal at the Duchesne County jail in Utah. After the 21-year old inmate was booked, she was allegedly placed in a cell with another woman and almost immediately began vomiting. Her vomiting allegedly continued for five days. The jail’s nurse failed to tell the physician’s assistant or doctor about Jensen’s condition, according to the complaint.

The jail’s video recording system captured the female inmate rolling off her bed and having a seizure. About 30 minutes later, both the nurse and doctor discovered she had died in her cell, the complaint said. The inmate’s cause of death was reported to be cardiac arrhythmia from dehydration due to opiate withdrawal.

Civil Rights Violation Claims.

After the inmate’s death, her estate sued for deprivation of her civil rights. The United States District Court for the District of Utah granted summary judgment for the county and the jail supervisors and staff, based on their qualified immunity. However, it denied qualified immunity to the jail nurse and the contracted doctor. Jensen’s estate claimed the jail nurse had shown deliberate indifference to the inmate’s serious medical needs, as she failed to secure medical treatment despite obvious signs and risks. In response, the nurse argued that she took reasonable steps to provide care and that she wasn’t aware that the inmate faced serious medical needs.

The circuit court judges held that “the unique circumstances of this case” allow the doctor to raise the defense of his qualified immunity. As for the jail nurse, the court said, “a trier of fact could conclude that she did not just misdiagnose Ms. Jensen, she ‘completely refused to fulfill her duty as gatekeeper.’ The nurse showed “near-complete indifference” toward the inmate that “grossly deviated from the standard of care for treating severe dehydration, especially when the result of a failure to treat is death” according to the court’s opinion.

“We believe that these circumstances — particularly her [the inmate’s] self-report that she had been vomiting for four days and could not keep down water — present a risk of harm that would be obvious to a reasonable person,” the court said. To read more, click here for the court’s opinion in full.

This isn’t the first case of an inmate’s family suing after Improper Care. Click here to read about a similar wrongful death suit of a Florida inmate.

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, nurse practitioners, certified registered nurse anesthetists (CRNAs), 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 our office at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Gill, Lauren. “UTAH JAIL NURSE FACES NEGLIGENT HOMICIDE CHARGE IN DEATH OF 21-YEAR-OLD WOMAN.” The Appeal. (August 1, 2019). Web.

O’Brian, Rachel. “10th Circ. Says Nurse Must Face Wrongful Death Suit.” Law360. (March 13, 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 the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avene, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toff-Free: (888) 331-6620.

By The Health Law Firm|2024-03-14T09:59:11-04:00February 18, 2024|Categories: Nursing Law Blog|Tags: administrative complaint defense attorney, administrative hearing defense lawyer, and Florida GBoard of Nursing defense attorney, appeal of board of nursing final order, Board of Nursing informal hearing attorney, Certified Nurse Midwife (CNM) legal representation, Certified Registered Nurse Anesthetist (CRNA) attorney representation, Colorado Division of Regulatory Agencies (DORA) defense attorney, Colorado Division of Regulatory Agencies (DORA) defense lawyer, Department of Health (DOH) investigation of nurses, Georgia, Georgia and Florida Department of Health (DOH) defense lawyer, Health Law Firm reviews, legal representation of Advanced Registered Nurse Practitioners (ARNPs), Louisiana, nurse administrative complaint defense, nurse attorney Florida Colorado Louisiana Virginia, nurse emergency suspension order appeals representation, nurse legal representation, nurse license application, representation for deposition of nurses, representation for Florida Colorado Division of Regulatory Agencies (DORA) complaint investigations, representation for Louisiana and Florida Department of Health (DOH) complaint investigations, reviews of The Health Law Firm attorneys|Comments Off

Appellate Court Reverses Nursing Board’s Revocation of License For Florida Nurse; “Due Process Rights Violated” Says Court of Appeal

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

On September 22, 2022, Florida’s First District Court of Appeal reversed a final administrative order from the Board of Nursing, saying that the state agencies engaged in “a game of bait and switch” when revoking a Florida nurse’s license. As a result, the discipline imposed on the nurse, revocation of her nursing license, is reversed. The appeals court said that the Florida Board of Nursing violated the nurse’s due process rights by imposing a penalty for violating patient confidentiality when she was only charged with having her license suspended in another state.

Details About the Case.

In 2018, the Florida Department of Health (DOH) filed a complaint and an amended complaint against the nurse. According to the DOH, she violated section 464.018(1)(b) by having her license to practice nursing in another state suspended. However, the Florida state nursing board issued a final order permanently revoking her Florida license, a punishment that was not within the regulatory guidelines that the Board of Nursing had previously adopted for the offense with which she was charged.

Also, the nurse had originally requested a formal hearing. She was allegedly informed she was not entitled to a formal hearing and was not notified she should appear when the Board of Nursing held the informal hearing on her case.

The nurse claimed the actions by the Florida DOH and the Florida Board of Nursing deprived her of her right to due process of law according to the U.S. Constitution’s Fifth Amendment, as applied to the states through the Fourteenth Amendment. The appellate court agreed.

State Agencies Not Communicating?

According to the court opinion, the Board and the DOH engaged in a “bait and switch game.” The state’s DOH allegedly failed to notify her of all the alleged violations that later led to the permanent revocation of her nursing license. The opinion of the appellate court stated: “More egregious than this, there was no mention in the amended complaint of an alleged violation of section 464.018(1)(h), [of Florida Statutes,] pertaining to her allegedly unprofessional conduct. In essence, the Board punished Appellant [the nurse] for this uncharged violation.”

Moreover, the appellate court said that the DOH applied the wrong disciplinary guideline for the uncharged violation. The applicable guideline only authorized a fine of up to $500 and probation as the maximum penalty. See Rule 64B9-8.006(3)(f)3, Florida Administrative Code (2012).

Based on these findings, the three-judge appellate panel reversed the revocation order, remanding it for further proceedings. Read the entire Florida court opinion on our website.

Click here to read our blog to learn more about state and DOH investigations that could help save your professional license.

Contact Health Law Attorneys Experienced in Board of Nursing Cases.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health investigations, before the Board of Nursing, in appearances before the Board of Nursing in licensing matters, in formal and informal administrative hearings, and in appeals of Final Orders.

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:

Dunn, Allison. “State Agencies Engaged in ‘Game of Bait-and-Switch’ When Revoking Nursing License, Florida Appeals Court Rules.” Daily Business Review. (September 22, 2022). Web.

Pazanowski, Mary Ann. “Florida Nurse Gets New Hearing in License Revocation Dispute.” Bloomberg Law. (September 21, 2022). Web.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.

By The Health Law Firm|2024-03-14T09:59:12-04:00February 15, 2024|Categories: Health Facilities Law Blog|Tags: administrative complaint defense attorney, administrative hearing defense lawyer, appeal of board of nursing final order, board of nursing complaint defense attorney, Board of Nursing complaint legal representation, board of nursing defense lawyer, Board of Nursing informal hearing attorney, certified nurse midwife (CNM) defense legal representation, certified registered nurse anesthetist (CRNA) defense attorney representation, Department of Health (DOH) complaint defense lawyer, Department of Health (DOH) investigation defense attorney, DOH final order appeal attorney, Health Law Firm reviews, healthcare license defense attorney, healthcare license representation, legal representation of advance nurse practitioners (ANP) defense lawyer, Louisiana Florida District of Columbia (D.C.) Department of Health (DOH) defense lawyer, medical license defense lawyer, nurse administrative complaint defense, nurse attorney Florida, nurse emergency suspension order appeal representation, nurse legal representation, nurse license application, nurse license defense representation, representation for deposition of nurses, representation for healthcare professionals, representation for Louisiana Florida and District of Columbia (D.C.) Department of Health (DOH) complaint investigations, reviews of The Health Law Firm attorneys|Comments Off

New Jersey Appeals Court Says Plaintiffs Don’t Need Affidavit to Sue LPN in Medical Malpractice Cases

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

In a precedent-setting case, on November 9, 2022, for the first time, a New Jersey appeals court ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit before filing a claim against a licensed practical nurse (LPN). In many states, Florida included, licensed practical nurses (LPNs) and registered nurses (RNs) are included in coverage by the state’s medical malpractice pre-suit screening act. This requires a plaintiff to conduct a pre-suit screening and obtain an affidavit of expert opinion from a similar expert witness that states that the nurse has committed malpractice that harmed the patient. without such an affidavit, the suit is not permitted.

No distinction is usually made between the rights of a licensed practical nurse and a registered nurse. After all, they both are required to have licenses from the state.

In this case, the Superior Court of New Jersey, Appellate Division, said that an LPN is not included in the “licensed person” definition under the state’s affidavit of merit statute. Additionally, the court’s opinion stated that an LPN could not use the lack of such an affidavit to dodge a medical malpractice suit. In this case, the malpractice suit was brought by a widower who says his wife died due to bad advice given by the LPN about how to treat his wife’s pain.

The Details of the Lawsuit.

The plaintiff claimed that the defendant (an LPN) responded to his complaints about his wife being in pain and unable to eat following her colon surgery by blaming the issue on “post-operative gas. “After ignoring numerous messages he left regarding her condition, the LPN allegedly told the husband (plaintiff) to give his wife, Pepto Bismol. The following day, his wife died, according to the lawsuit.

In July 2020, the plaintiff filed a medical malpractice claim as his wife’s estate administrator. The lawsuit originally named as defendants the doctor, Virtua Surgical Group, and an unknown nurse. Following discovery in the case, the plaintiff dismissed the claims against the other defendants and named only the LPN as a defendant. According to the appellate opinion, he alleged that the defendant was negligent in providing medical advice and failing to consult with her doctor.

You can view the court’s opinion in full here on our website.

Is a Licensed Practical Nurse a “Licensed Person” Covered by the Statute?

In New Jersey professional negligence cases, plaintiffs must file an “affidavit of merit,” or AOM, signed by a licensed medical professional with training or credentials similar to those of the professional to be sued. This comes from a tort reform law passed by the state government in 1995. The statute was originally designed to provide a balance between reducing frivolous lawsuits and permitting injured plaintiffs recovery for meritorious claims. It is similar to requirements that exist in many states.

According to the appellate court’s opinion, a plaintiff claiming “malpractice or negligence by a licensed person” must file an “affidavit of an appropriate licensed person” who can attest that there is a “reasonable probability” that defendant’s conduct “fell outside acceptable professional or occupational standards or treatment practices.” This is required before an actual suit is allowed.

The defendant argued that since the nursing portion of the statute defines “the practice of nursing” for “a registered professional nurse,” the Legislature intended for licensed practical nurses to be included. However, the appeals court held that the tort reform package would not protect her from the lawsuit because she did not fall within the definition in the law. She was not a registered professional nurse. Instead, she was a different type of nurse.

In his written opinion for the court, New Jersey Superior Court Judge Robert J. Gilson considered whether a licensed practical nurse is a “licensed person” covered under the AOM statute. “The AOM statute expressly uses the term ‘a registered professional nurse.’ Yet, nowhere in that definition of a registered professional nurse is there a reference to a licensed practical nurse,” he added.

Gilson stated in the opinion that the New Jersey Legislature was aware that it had separately defined the two different types of nurses. Therefore, the statute did not apply to or protect the LPN, and the plaintiff was allowed to pursue claims without an AOM. Nevertheless, the court said, the plaintiff must still prove the defendant’s negligence to succeed.

Click here to view the opinion in full.

Click here to read one of our related blogs about legal issues LPNs often face.

The New Jersey Case is Probably Not a Precedent for Most States.

Usually, the test for whether or not malpractice or professional negligence has been committed for legal purposes is whether or not the individual is a member of a learned profession. This is usually indicated by the requirement of a professional license to practice that profession. Using this definition, both a licensed practical nurse and a licensed registered nurse are considered professionals, and their “professional negligence” is considered malpractice covered by medical (nursing) malpractice laws.

Moreover, the laws in some states, such as Florida, define which professionals are covered by their medical malpractice presuit screening act by listing the licensing laws to which the medical malpractice presuit screening act applies. Thus, in Florida, Section 766.202(4), Florida Statutes refer to those licensed by Chapter 464 (Part I), Florida Statutes. Both licensed practical nurses and registered nurses are licensed in accordance with that Chapter of Florida Statutes. Thus both are covered by the Florida Medical Malpractice Presuit Screening Act.

Contact Health Law Attorneys With Experience Representing Nurses and Handling Licensing Issues.

If you are applying for a nursing or healthcare license, have had a license suspended or revoked, or are facing imminent action against your license, you must 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 nurses, physicians, dentists, medical groups, clinics, and other healthcare providers in personal and facility licensing issues. If you have received a notice that a complaint has been filed against you or that you are under investigation by the department of health or your licensing board, we routinely provide legal representation in such matters; often, there may be insurance coverage that may pay for your legal defense.

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

Sources:

Karpan, Andrew. “No Affidavit Needed To Sue ‘Practical’ Nurses, NJ Court Says.” Law360. (November 9, 2022). Web.

Murphy, Colleen. “NJ Appeals Court: No Affidavit of Merit Needed for Negligence Claim Against Licensed Practical Nurse.” Law.com. (November 10, 2022). Web.

Employment with The Health Law Firm. The Health Law Firm is always seeking qualified attorneys, paralegals and legal staff interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified legal professional or secretary, who is interested, please forward your cover letter and resume to: [email protected] or fax them to (407) 331-3030.

By The Health Law Firm|2024-03-14T09:59:12-04:00February 8, 2024|Categories: Nursing Law Blog|Tags: administrative complaint defense attorney, appeal of board of nursing final order, board of nursing complaint defense attorney, Board of Nursing complaint legal representation, board of nursing defense lawyer, Board of Nursing informal hearing attorney, certified registered nurse anesthetist (CRNA) defense attorney representation, Department of Health (DOH) complaint defense lawyer, Department of Health (DOH) investigation defense attorney, formal administrative hearing defense lawyer, Health Law Firm reviews, healthcare license defense attorney, legal representation nurses, legal representation of advance nurse practitioners (ANP) defense lawyer, medical license defense lawyer, military and Veterans Administration (VA) defense lawyer, nurse administrative complaint defense, nurse attorney, nurse attorney Florida, nurse defense attorney, nurse defense lawyer, nurse deposition defense attorney, nurse emergency restriction order (ERO) appeal representation, nurse emergency suspension order (ESO) appeal representation, nursing negligence defense lawyer, patient complaint defense attorney, representation for deposition of nurses, representation for healthcare professionals, representation for nursing license complaint defense, reviews, reviews of The Health Law Firm attorneys, the health law firm|Comments Off

Accused of Irregular Behavior on the USMLE? Here’s What You Will Do Wrong

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

We frequently receive calls for consultations from students who receive a letter from the National Board of Medical Examiners (NBME) accusing the medical student or medical resident of “Irregular Behavior” on the United States Medical Licensing Examination (USMLE). In many cases, these are graduates of foreign medical schools who have applied through the Examination Committee for Foreign Medical Graduates (ECFMG).

Irregular behavior can consist of many different things before, during, or after taking the USMLE. What you must know is that, in effect, you are being accused of cheating.

Types of Irregular Behavior.

Examples of the types of conduct which we have seen before include:

– Attending a commercial USMLE preparation course that provides some of the actual examination questions.

– Soliciting information on the contents or questions on the examination.

– Using a cell phone during the examination.

– Talking with another person during the examination.

– Sharing information on the types of questions or cases that were on your examination with another person or on a blog over the internet.

These are just a few. For more examples, please read this previous article.

Most Common Errors You Will Make When Accused of Irregular Behavior.

We have represented students accused of irregular behavior by consulting with them before and after USMLE hearings and appealing the results. We have represented many examinees at the hearings held before the NBME at its headquarters in Philadelphia, Pennsylvania.

From our experience in such cases, the following are the errors that most of you will make when accused by the USMLE of irregular behavior.

1. You will fail to obtain an attorney experienced with such cases immediately upon receipt of a letter from the NBME accusing you of irregular behavior. Take this as a formal charge accusing you of, in effect, cheating. THIS IS SERIOUS.

2. You will telephone, write, or e-mail the NBME and explain “your side of the story.” This will be full of admissions that will help prove the case against you and you will not even understand this. (Please note that under U.S. law any statements you make, oral or written, can be used as evidence against you in any civil, criminal or administrative proceeding. This is not the case with statements that your attorney makes on your behalf.)

3. If you submit documents or statements to the NBME in support of your case, these will not be well-organized, well-labeled and in a form simple and easy to understand. In many instances, you will not even understand the legal issues you are facing or how to refute them.

4. You will fail to request or attend in person the hearing before the NBME Committee on Irregular Behavior (“The Committee”) in Philadelphia, Pennsylvania.

5. You will fail to take an attorney experienced in such medical administrative hearings to represent you at The Committee hearing in Philadelphia.

6. You will not know how to properly present your evidence or present your own position to The Committee, if you do attend the hearing.

7. You will not know when or what kind of witnesses, including expert witnesses, you need to use to prove issues in your case before The Committee.

8. You will fail to understand and correctly respond to the questions that the many different Committee members (usually 15 or more) will ask you during the hearing.

9. You will fail to correctly follow all procedures in order to preserve your rights in the proceedings.

10. You will falsely believe that if you lose at The Committee hearing you can win on appeal or somehow sue in court and prove you are right; this is almost never correct. You will have only one chance at proving your case and this is at The Committee hearing in Philadelphia.

11. You will incorrectly believe that even if you are only suspended from taking the USMLE again for a short period of time, this will have no effect on your education or career. (Note: Your USMLE transcript will note this fact and this will probably prevent you from ever getting into a good residency program. See #1 above.)

Invest in Your Future Career.

You and your family have invested tens of thousands, if not hundreds of thousands of dollars, in your education so that you can become a physician. You have spent years of sacrifice and studying to become a physician. This is not the time to be cheap and to think that the cost of hiring an experienced legal counsel is too high. You could lose everything you and your family have invested in this. Do not be “penny wise and pound foolish.” You will need professional help if you are to get through this successfully. If you don’t care about these matters or you don’t believe this is a serious matter worthy of an investment for attorney’s fees, then go ahead and ignore this advice.

If you are not reading this until after you have lost the case and been found to have committed “irregular behavior” by the USMLE Committee on Irregular Behavior, I am sorry for you, but it is probably too late to do anything about it.

Contact Experienced Health Law Attorneys Today.

The attorneys of The Health Law Firm provide legal representation to medical students, residents, interns, and fellows in academic disputes, graduate medical education (GME) hearings, contract negotiations, license applications, board certification applications and hearings, credential hearings, and civil and administrative litigations.

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 Avenue, 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 © 2024 George F. Indest III, The Health Law Firm. All rights reserved. No part of this work may be reproduced in any way in any medium without the written permission of the copyright owner. The author of this work reserves the right to have his name associated with any use or publication of this work or any part of it.

By The Health Law Firm|2024-03-14T09:59:12-04:00February 7, 2024|Categories: Medical Education Law Blog|Tags: disruptive physician attorney, ECFMG defense attorney, Educational Commission for Foreign Medical Graduates (ECFMG) defense lawyer, Graduate medical education (GME) defense attorney, graduate medical education defense lawyer, health law attorney, impaired medical student legal counsel, impaired resident legal defense attorney, international medical graduate attorney, irregular behavior defense attorney, irregular behavior defense counsel, Irregular behavior defense lawyer, irregular conduct legal representation, lawyer for medical students, legal dispute with medical school, legal representation for irregular behavior, legal representation for medical residents, legal representation for NBME investigations, legal representation for USMLE investigations, medical resident physician attorney, medical school litigation, medical students legal counsel, National Board of Medical Examiners (NBME) defense counsel, Philadelphia attorney for ECFMG hearing, Philadelphia lawyer for NBME hearing, Philadelphia legal counsel for USMLE hearing, residency program legal dispute, residency program litigation, reviews of The Health Law Firm attorneys, The Health Law Firm reviews, United States Medical Licensing Examination (USMLE) defense lawyer, USMLE defense attorney|Comments Off

Find the Right Attorney For Your Irregular Behavior Case Before the USMLE or ECFMG

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

If you have received a letter from the United States Medical Licensing Examination (USMLE) Secretariat or the Educational Commission for Foreign Medical Graduates (ECFMG) accusing you of “irregular behavior,” this is very serious stuff. You need an experienced lawyer to assist you. But how do you find one? This blog will provide several tips on how to locate an experienced effective attorney who will really provide the legal assistance you need.

You Don’t Need a Philadelphia Attorney to Represent You.

First, there are only a handful of attorneys in the United States who have handled more than one of these cases. Even if you find one, this does not mean he or she is really experienced and will really advocate your position before the Committee for Individualized Review (CIR) or the ad hoc committee which is appointed to hear your case. You don’t need an attorney who is actually in Philadelphia, Pennsylvania (where the USMLE and the ECFMG have offices and where such hearings are usually held), to represent you. Most of the work is actually done before the hearing.

What you do need is someone who is experienced and knows how to properly prepare you for the nerve-wracking hearing you will have. The attorneys of our firm routinely do this.

What to Look for in an Attorney Before You Select One.

1. First, make sure that the attorney you select actually has ample experience in actually appearing before the committee and representing individuals and has done this multiple times in the past. Ask how many hearings.

2. Second, Look for an attorney who is board certified by their state bar association in the legal specialty of health law. Many states now have such certifications, including Florida, Pennsylvania, and Texas. Board certification in a legal specialty is like board certification in a medical specialty. It is the mark of attaining a higher degree of expertise and excellence. An attorney who is certified in health law will understand the medical issues involved in your case, the impact this can have on your future as a physician and other aspects a criminal law attorney or civil litigation attorney will not.

3. Third, check out the background of each attorney before you hire one. Google them and review everything you can find. Check with the state licensing board or state bar association for adverse actions.

4. Ask the attorney how the attorney exactly how the attorney will prepare you for the hearing. When we prepare an individual for a hearing, we review everything from the physical layout of the hearing room, to exactly how the actual hearing will be conducted, to whom the members of the hearing committee will be. We review how to speak and answer questions effectively and the types of questions that may be asked of you. All of this helps you to be better prepared and less nervous when appearing at the hearing.

5. Ask the attorney if the attorney uses expert witnesses in these cases. In many cases, no expert witness is required. However in some cases experts such as computer technicians, forensic document examiners or handwriting experts, polygraphers (lie detector analysts), statistics experts, or other experts should be hired to provide an expert report for the committee to consider.

6. Find out if the attorney will meet with you in person a week or two prior to the hearing to help prepare you. We always do this. If you cannot come to our office in the Orlando, Florida area (which most people do), we will meet with you via Zoom, Skype, video chat, or just telephonically if necessary.

7. We recommend that you select an attorney who is not a solo practitioner. An attorney who has several attorneys in his firm in the same area of specialty will have additional back up if it is needed. If you hire an attorney who is alone by himself, illness, accidents, family emergencies, and other unforeseen events can cause you to be without legal representation at the last minute.

8. Often the cheapest attorney is not the best one for you. Remember the old saying that “you get what you pay for.” Cheaper is not always better. However, paying the most may not ensure that you get the most effective legal counsel. You must do your homework, finding out the information above.

Contact Us for an Initial Consultation on Your Irregular Behavior Case.

Contact our firm and we will be happy to discuss your irregular behavior case with you before you decide on hiring an attorney. For additional information, click here to read our E-book on “Tips for Answering Allegations of Irregular Behavior For USMLE Step Exams.”

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education, and those being challenged by the National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG)

The Health Law Firm and its attorneys represent interns, residents, fellows and medical school students in disputes with their medical schools, supervisors, residency programs and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation and any other matters. We routinely help those who have disputes with the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG), including on hearings and appeals concerning “Irregular Behavior,” “unprofessionalism,” and “Irregular Conduct.”

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.

By The Health Law Firm|2024-03-14T09:59:12-04:00February 6, 2024|Categories: Medical Education Law Blog|Tags: disruptive physician attorney, ECFMG defense attorney, Educational Commission for Foreign Medical Graduates (ECFMG) defense lawyer, Graduate medical education (GME) defense attorney, graduate medical education defense lawyer, health law attorney, impaired medical student legal counsel, impaired resident legal defense attorney, international medical graduate attorney, irregular behavior defense attorney, irregular behavior defense counsel, Irregular behavior defense lawyer, irregular conduct legal representation, lawyer for medical students, legal dispute with medical school, legal representation for irregular behavior, legal representation for medical residents, legal representation for NBME investigations, legal representation for USMLE investigations, medical resident physician attorney, medical school litigation, medical students legal counsel, National Board of Medical Examiners (NBME) defense counsel, Philadelphia attorney for ECFMG hearing, Philadelphia lawyer for NBME hearing, Philadelphia legal counsel for USMLE hearing, residency program legal dispute, residency program litigation, reviews of The Health Law Firm attorneys, The Health Law Firm reviews, United States Medical Licensing Examination (USMLE) defense lawyer, USMLE defense attorney|Comments Off

What is the Cost For Legal Defense in a Hospital Medical Staff Peer Review Fair Hearing?

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

If you are a physician, nurse practitioner, oral surgeon, dentist, or other health professional with clinical privileges in a hospital, you may face a situation where you are required to defend yourself at a “fair hearing.” A “fair hearing” is held by the hospital’s medical staff pursuant to the Medical Staff Bylaws or Rules and Regulations of the Medical Staff.

“Fair Hearing”–A Term of Art.

The hearing is called a “fair hearing,” which is a term of art. Usually, those defending themselves at such hearings don’t find them to be fair at all. However, according to the federal Health Care Quality Improvement Act (HCQIA), such proceedings are required to provide the affected healthcare practitioner with certain “due process,” such as the right to be advised of the specific charges made against them, the right to legal representation, the right to produce witnesses and evidence of their own and other rights.

Be Sure You Have Professional Liability Insurance That Includes Coverage for Clinical Privileges Actions.

If you face such a hearing, you will find it difficult to find an experienced lawyer to represent you and, when you do, it will be a costly endeavor. This is one of the primary reasons to purchase good professional liability insurance, including legal defense of such peer review actions. Unfortunately, most insurance companies that provide such coverage have limits far too low to pay all legal defense expenses you will probably incur.

Standard Insurance Coverage Amounts May Not Be Sufficient to Protect You Properly.

However, the basic amount provided for such coverage in most insurance policies is not sufficient to cover the actual expenses of the proceeding. Standard coverage amounts are usually in amounts of $25,000, $35,000, or $50,000; again, these are not sufficient to pay for even the most basic fair hearing. Some insurers have much higher limits; it is important to find out precisely what you have to increase the coverage or buy additional coverage.

There are often additional “riders” to insurance policies that you can purchase, “additional coverages,” or even a completely separate policy that will provide such legal defense coverage for you. It is usually not that expensive and is worth inquiring about. This type of coverage often goes hand-in-hand with professional license defense coverage as one can cause the other to occur. For example, a hospital peer review action can result in a report to your state licensing board. A licensing complaint or action may cause hospital peer review action to be initiated against you.

You should think of a “fair hearing” as similar to a medical malpractice trial and plan accordingly.

Costs and Expenses of a “Fair Hearing”

One of the most significant expenses you will incur in preparing for a “fair hearing” is expert witness fees. In almost every case we have ever had, obtaining one or more expert witnesses to testify at the hearing has been necessary. Obtaining experts in medical sub-specialties will cost more, of course, than those in specialties such as family medicine and internal medicine. It is often difficult to find an expert witness who will not only support your position in the case but will also show up at the hospital to testify at the “fair hearing.”

Additionally, the mere preparation for the hearing (including document reviews and working with the expert witnesses) and representation at the hearing is a time-intensive endeavor. It has been our experience that even the most routine “fair hearing” costs approximately $100,000. For example, in one case we had involving several different areas of spinal surgery, requiring five (5) expert witnesses, cost in excess of $250,000 (note: all charges against the doctor were dismissed at the hearing).

Conclusion.

Peer review “fair hearings” in hospitals are costly to defend and require an experienced attorney and the financial resolve to see the case through to its conclusion. Often insurance does not provide sufficient coverage for such hearings. Therefore, physicians, nurse practitioners, oral surgeons, psychologists, and others having hospital clinical privileges should purchase additional coverage for such events and hire experienced legal counsel to represent them at the earliest stage of the proceedings.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers in Peer Review and “Fair Hearing” Matters.

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.

About the Author: George F. Indest III, J.D., M.P.A., L.L.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

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