South Dakota Optometrist Settles Health Care Fraud Claims

1 Indest-2008-1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A South Dakota optometrist reached a settlement with the South Dakota Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU), and the U.S. Department of Health and Human Services (HHS), Office of the Inspector General (OIG). The optometrist will be shelling out $283,499 to resolve allegations he submitted false claims to Medicare, Medicaid and TRICARE, according to the South Dakota AG. This settlement was announced on October 1, 2013.

Click here to read the press release from the AG.

Optometrist Will Pay Fine and Sign Integrity Agreement as Part of the Settlement.

According to the AG, the optometrist allegedly submitted false claims to the health care programs for bifocal lenses, trifocal lenses and new patient visits. He is also accused of billing Medicare, Medicaid and TRICARE for medically unnecessary visual field examinations from June 2006 until December 2012.

On top of the fine, the optometrist will also sign an Integrity Agreement with the HHS, OIG. In the agreement, the optometrist will provide free eye care to underserved patients for one year, according to an article in Rapid City Journal.

Click here to read the Rapid City Journal article.

Responding to a MFCU Investigative Subpoena.

This case against the optometrist was handled, in part, by the MFCU. The MFCU is in charge of investigating and prosecuting health care providers suspected of defrauding the state’s Medicaid program.  When the unit opens a case against a provider, the first step is usually the issuance of an investigative subpoena, requesting specific records. It is important to remember that the MFCU would not be involved unless criminal fraud was suspected. Click here to read practice tips on how to properly respond to a subpoena.

Fraud Charges Need to be Taken Seriously.

We have been consulted by many individuals, both before and after criminal convictions for fraud or related offenses. In many instances, we are convinced that the person is actually not guilty of fraud. However, in many cases those subject to Medicaid or Medicare fraud audits and investigations refuse to acknowledge the seriousness of the matter or they decide not to spend the money required for a top quality attorney to defend them.

If you are accused of Medicare or Medicaid fraud, realize that you are in the fight of your life. Your liberty, life and profession are at stake. You need to sell everything you own, borrow everything you can and hire the absolute best criminal defense attorney available who has experience in defending such cases to represent you.

If you win and are acquitted, at least you still have a professional license and can start over. However, if you lose, you will most probably be in prison for years. You will lose your license. You will be excluded from Medicare. You will be a convicted felon. You will have nothing and will have no way of starting over successfully. Be prepared to give up whatever you have if you can avoid a conviction.

Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.

The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also 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.

For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.

Comments?

Have you heard of the MFCU? How would you respond to a subpoena from the MFCU? Please leave any thoughtful comments below.

Sources:

South Dakota Attorney General. “Optometrist Settles Healthcare Case with South Dakota and United States.” South Dakota Attorney General. (October 1, 2013). From: http://atg.sd.gov/News/NewsReleases/NewsReleasesView/tabid/441/itemID/3251/moduleID/719/view/597/Default.aspx

Rapid City Journal Staff. “Optometrist Settles Case Involving Fraud Allegations.” Rapid City Journal. (October 1, 2013). From: http://rapidcityjournal.com/news/local/article_62eafa10-0c68-5240-aee5-97defb6627a5.html#.UkyGbJiR9mA.twitter

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.

Helpful Legal Tips to Ophthalmologists and Optometrists from a Health Law Attorney

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

The attorneys of The Health Law Firm represent Ophthalmologists and Optometrists in a number of different legal matters. We appear before the Board of Optometry. We represent ophthalmologists and optometrists in disciplinary matters, in credentialing matters, in licensing matters and in defending against malpractice claims and suits.

If you receive a letter from the Department of Health (DOH) notifying you that you are being investigated, this is a very serious matter. Get an attorney who is experienced in such matters.

Tips For Optometrists and Ophthalmologists After Being Notified of an Investigation:

1.  You are not required to make any statement to the investigator, oral or written, and     you should not do so.

2.  You do not have to send the investigator a copy of your resume, and you should not     do so.

3.  You have a Fifth Amendment right to refuse to say or do anything that might incriminate yourself. This applies to administrative investigations.

4.  If you have malpractice insurance (professional liability insurance) it may pay for     your legal defense in an investigation. Use it!

5.  You have the right to obtain a copy of the investigation after it is completed and to file a rebuttal to it.

Other Things to Keep in Mind When Being Investigated:

1.  You should never agree to voluntarily relinquish your license if any investigation is pending. This will be treated the same as a disciplinary revocation and the consequences will be severe. (see below.)

2.  You should never request an informal hearing. An informal hearing means you are admitting all of the allegations against you are true (pleading guilty), and you are not disputing them.

3.  If disciplinary action is taken against you (including a “voluntary” relinquishment) this will be reported to your national certification board and it will most likely revoke your national certification.

4.  If you have licenses in other states or in other health professions, this will be reported and they will commence investigations and disciplinary actions.

5. It will be reported to the National Practitioner Data Bank (NPDB) and the Office of         the Inspector General (OIG). The OIG will then commence action to exclude you from the Medicare Program. If excluded, it is likely that you will not be able to work in health care or for any government contractor in any capacity.

Our attorneys have been very successful in representing ophthalmologists and optometrists. We may be able to have your case dismissed by the Probable Cause Panel of the Board. If not, we may be able to obtain a favorable result for you in a formal administrative hearing (like a trial) where the government has to prove the case against you, and you are able to defend yourself.

You spent a great deal of time and money to get your professional education and your profession licenses. Don’t give it all up without getting advice from experienced attorneys.

If You Don’t Have Insurance Coverage, Get It Now!

Our recommendation is that every ophthalmologist and optometrist carry professional liability insurance that includes professional license defense coverage (sometimes called disciplinary defense, license defense, administrative hearing coverage or broad coverage). Often this type of insurance coverage is included in most professional liability policies; however, if it is not, it can often be added as a rider to the insurance policy for a slight additional charge. You should be sure that your coverage for professional license defense is at least $25,000, and we recommend that you increase it to $50,000. You should also request and obtain “broad form coverage” that includes coverage of your legal fees for defense of all administrative or governmental proceedings, including Medicare audits, Medicaid audits, EEOC complaints and other types of governmental actions that could be initiated against you.

If you are required to defend yourself at a formal administrative hearing, this is similar to a medical malpractice trial in civil court. Attorney’s fees, court reporter costs, expert witness fees and other costs and fees can rapidly mount up to the point where most ophthalmologists and optometrists could not afford to defend themselves. If you are then required to appeal an adverse outcome, the appeal alone could cost $10,000.

Don’t wait to purchase this type of insurance until there is a complaint filed against you, because then it is too late to purchase it. Complaints can be initiated against you based solely on anonymous calls to the Department of Health Hotline, newspaper reports, prior arrest reports, disgruntled patients, disgruntled insurance companies, competitors or other sources. Once and investigation is initiated, you should obtain legal representation right away. Without insurance, you probably will not be able to afford to hire a competent, experienced health lawyer to defend you. Always go to a board certified health lawyer experienced in representing ophthalmologists and optometrists.

For a chart depicting the Florida Department of Health investigation process, click here.

Contact  Health Law Attorneys Experienced in Representing Optometrists and Ophthalmologists.

The Health Law Firm routinely represents optometrists, ophthalmologists 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?

How much of this did your already know? As an optometrist or ophthalmologist, what are your biggest concerns? Please leave any thoughtful comments below.

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.

NAS Insurance Lawyers, Attorneys and Defense Council in Florida and Throughout the U.S.

5 Indest-2008-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Often we learn after the fact that a health professional such as physicians, dentists and other health professionals has received NAS Insurance, has had a legal problem, and has not been able to locate an attorney or law firm that accepts this type of insurance. We have offices in Florida and Colorado, but we have attorneys licensed in Florida, Colorado, Louisiana, the District of Columbia, Virginia and other states.

Additionally, we can provide legal advice and representation in license investigations and administrative proceedings in many other states.

If you have NAS Insurance, do not go without an attorney or with a lawyer that has little or no experience where you need it.

The Health Law Firm Can Work With Your Insurance Company.

Call us first. We can assist you in determining if your legal problem is covered by your insurance, and we can help you file a claim to have your legal defense expenses and costs covered. In most cases, we will accept the assignment of your insurance so that you do not have to worry about legal bills while your case is going on.

Contact  Health Law Attorneys Experienced in Representing Optometrists and Ophthalmologist.

The Health Law Firm routinely represents physicians, nurses, optometrist, ophthalmologists 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.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. We will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company, if your insurance company will allow this. Many of these insurers will pay our firm to represent you in the legal defense of an investigation or complaint against your professional (nursing, medical, dental, psychology, mental health counselor) license or for an administrative hearing involving professional discipline.

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.

Optometrists and Ophthalmologists Come to an Agreement-Optometrists Can to Prescribe Some Medications

1 Indest-2008-1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On April 4, 2013, the Florida Senate passed Florida Governor Rick Scott a hard-fought bill that would expand the drug-prescribing practices of optometrists, according to the Associated Press. House Bill 239 has pitted optometrists against ophthalmologists for years in what was called the “eyeball wars.” (Click here to read House Bill 239.) The Senate sent a measure to the governor that would allow optometrists to prescribe some medications, while adding new patient protections.

To read the article from the Associated Press, click here.

I previously blogged about this topic when the bill was still being voted on in the House. Click here to read what supporters and opponents of House Bill 239 had to say about it.

Optometrists Have to Ability to Prescribe Some Medications.

According to an article in the Orlando Sentinel, the final bill was an agreement between the Florida Society of Ophthalmologists and the Florida Optometric Association. Optometrists wanted to ability to prescribe medications other than ointments and creams. Ophthalmologists argued optometrists are not doctors and did not receive the proper training to prescribe medicine.

The compromise under the final bill says optometrists would be allowed to prescribe 14 oral drugs, including antibiotics. However, optometrists will not be allowed to prescribe controlled substances. The measure clarifies that optometrists cannot perform surgeries and requires them to report any bad medical outcomes to the state, as ophthalmologists are required to do.

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

House Bill 239 May Reduce Costs for Patients.

State Senators voted 40-0 to pass the bill. Optometrists believed that House Bill 239 will help Floridians get the most appropriate eye treatment. This bill will also allegedly help cut down on duplicate services, and in return, reduce costs for patients.

If Governor Scott signs the bill, it will officially put an end this turf war over eyes.

Contact The Health Law  Firm Attorneys Experienced with Representing of Optometrists and Ophthalmologists.

The attorneys of The Health Law Firm provide legal representation to optometrists, ophthalmologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

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

What Do You Think?

What do you think of the new bill? Do you think optometrists prescribing medication is a good idea or a bad idea? Please leave any thoughtful comments below.

Sources:

Associated Press. “Bill Expands Prescribing Powers for Optometrists.” The Tampa Bay Tribune. (April 4, 2013). From: http://hosted.ap.org/dynamic/stories/F/FL_XGR_OPTOMETRISTS_FLOL-?SITE=FLTAM&SECTION=STATE&TEMPLATE= Haughney, Kathleen. “Eyeball Wars Comes to an End.” Orlando Sentinel. (April 4, 2013). From: http://blogs.orlandosentinel.com/news_politics/?p=42985

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. http://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.

Florida Legislature Has Optometrists and Ophthalmologists Seeing Red Over Proposed Law Allowing Prescribing

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

This year Florida House Bill 239 and Florida Senate Bill 278 has been reignited in the Florida Legislature. This legislation is pitting optometrists and ophthalmologists against each other in what is being called the “eyeball wars,” according to the Fort Myers News-Press. These bills would expand the authority of optometrists to prescribe certain medications and treat some eye conditions. Optometrists and ophthalmologists are both trying to gain support for their respective viewpoints.

Click here to read the article from Fort Myers News-Press.

Elements of Florida House Bill 239 and Florida Senate Bill 278.

Most notably, the bills would expand the scope of practice for optometrists. Optometrists would have prescribing authority of oral medications. However, they would not have the ability to prescribe Schedule I and II narcotics. Optometrists would also be allowed to perform clinical laboratory studies. Click here to read Florida House Bill 239, and click here to read Florida Senate Bill 278.

Supporters Believe This Legislation Will Help Reduce Health Care Costs.

The backers of expanding prescribing authority to optometrists say it will help reduce health care costs and make treatment more available to communities short on ophthalmologists. According to a statement by the Florida Optometric Association, expanding the ability for optometrists to prescribe oral medications saves money, increases access to eye care, and saves people from losing vision due to treatment delays. According to the Fort Myers News-Press, this authority has been granted to optometrists in 48 states.

Opponents Believe Patients’ Safety is at Stake.

According to the Florida Society of Ophthalmology, allowing an expansion of prescribing authority is a dangerous move for patients. A letter from the American Academy of Ophthalmology states that the language in the legislature is vague, broad and misleading. It also states that the training ophthalmologists receive provides them with not only technical skills, but instills the judgment one needs to determine when (and when not) to prescribe specific medications. To read the entire letter, click here.

Other associations opposed to the bill include Florida Society of Interventional Pain Physicians, Florida Society of Rheumatology, Florida Society of Anesthesiologists, Hillsborough County Medical Association. Letters written by each of these societies can be read by clicking here.

Where are The Bills Now?

Florida House Bill 239 was passed by the House Health and Human Services Committee on March 7, 2013, and is now ready for the House Floor. On March 6, 2013, a Florida Senate panel voted 10-3 to approve Senate Bill 278. The bill has now been handed over to the Appropriation Committee.

Contact Health Law Attorneys Experienced with Investigations of Optometrists and Ophthalmologists.

The attorneys of The Health Law Firm provide legal representation to optometrists, ophthalmologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

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

Comments?

What do you think of optometrists being able to prescribe oral medication? Are you for or against this legislature? Please leave any thoughtful comments below.

Sources:

Gluck, Frank. “Not Seeing Eye to Eye: Optometrists, Ophthalmologists Differ on Bills.” Fort Myers News-Press. (March 7, 2013). From: http://www.news-press.com/apps/pbcs.dll/article?AID=2013303070027&nclick_check=1

Corcoran, Richard. Letter Opposing HB 239 and SB 278. American Academy of Ophthalmology. (February 4, 2013). From: http://www.mdeye.org/pdfs/AAOHB239OppositionLetter.pdf
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.

Optometrists Must Maintain Their Continuing Education Requirements

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Those who are licensed by the Department of Health (DOH) must be sure they are maintaining their continuing education requirements by taking the required courses in a timely manner. We have attended at least one professional board meeting recently where there was concern expressed about licensees failing to meet their continuing education requirements. One estimate was that approximately sixty percent (60%) were deficient in one profession.

Failing to obtain the required courses during the time period set forth by statute and by board regulation can result in disciplinary action being taken against a licensee. Disciplinary action in one state can lead to disciplinary action commenced against a license held in another state, if the licensee holds multiple licenses.

Problems We Consistently See Among Licensed Health Professionals Arising Out of Continuing Education Include the Following:

1. Failure to take courses from a continuing education provider properly approved by the state board. When in doubt, ask, in writing.

2. Failure to take and complete all required courses and hours within the period of time established by the board.

3. Failure to take the exact subject matter courses required by law (such as HIV awareness, domestic violence, prevention of medical errors, etc.).

4. Failing to maintain documents proving that the provider took the courses (such as registration, payment receipt, course attendance certificate, etc.).

5. Failing to apply for or request an exemption from continuing education requirements at the time the grounds for them first arise (e.g. hardship, medical problems, not practicing).

6. Failing to respond to an audit of continuing education completion requirements (you will then be assumed to have not completed them and a DOH investigation will be opened).

7. Failing to respond in a succinct, organized manner, by letter, with proper documentation, sent to the correct address that auditor states, via certified mail, return receipt requested.

8. Assuming that the office manager, practice manager or administrative secretary is going to take care of such matters so you do not have to be concerned with them.

9. Arguing with or being demeaning to the auditor who requests information or who advises you that you are short of hours or courses.

10. Failing to immediately make up any missing hours or courses from prior periods, in addition to fully meeting all current continuing education requirements.

11. Failing to respond to citations, complaints or letters sent to you by the DOH regarding this matter.

Often consulting an experienced health law attorney on such matters can save a great deal of turmoil, mental anguish, cost and damage to your professional license and professional reputation.

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, optometrists, 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?

Are you guilty of failing to meet your continuing education requirements? Do you think the continuing education classes are worth the time invested in them? Please leave any thoughtful comments below.

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. http://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.

Locating a Healthcare Providers Service Organization (HPSO) Insurance Defense Attorney in Florida

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

We are sometimes told by the health professionals we represent, especially optometrists, that after they received a complaint regarding their license from the Florida Department of Health (DOH) they had difficulty finding an experienced attorney in Florida who would accept their professional liability insurance.  In this case, I am speaking specifically about Healthcare Providers Service Organization (HPSO) Insurance.

Legal Fees are Expensive, Insurance Helps.

The professionals who are covered by HPSO Insurance have excellent insurance coverage.  HPSO Insurance provides professional liability coverage that protects in the event of a lawsuit or negligence claim.  But much more often the professional receives a notice of an investigation, a subpoena for a deposition in someone else’s case, a demand because of an allegation of sexual harassment or sexual impropriety, a complaint because of a breach of medical records confidentiality or Health Insurance Portability and Accountability Act (HIPAA) Privacy complaint, or some other administrative type of action.

HPSO provides great coverage for these.  For example, HPSO currently reimburses up to $10,000 in legal fees and expenses just for representation of you at depositions.  HPSO currently reimburses up to $25,000 in legal fees and expenses for your defense in a DOH or Agency for Health Care Administration (AHCA) notice of investigation or complaint.  HPSO currently reimburses up to $25,000 in legal fees and expenses for your legal representation in defense of a complaint or investigation regarding breach of medical confidentiality.

If you are a pharmacist, own a pharmacy, are a massage therapist, own an assisted living facility (ALF), are a mental health counselor or a social worker, or you are one of the many other types of health care professionals who HPSO insures, it should be fairly easy to find experienced health lawyers to represent you, especially in Florida.

Our firm and our attorneys, including George F. Indest III, Michael L. Smith, Joanne Kenna, Carole C. Schriefer, Lance O. Leider, Christopher E. Brown and Danielle M. Murray, routinely represent licensed health care professionals, interns and students in all types of administrative investigations and hearings and in defending lawsuits and other actions that have been filed.  We also represent health facilities in license defense, survey complaints and administrative hearings.  We represent them throughout Florida, from Pensacola to Jacksonville, to Key West.  We also occasionally represent them in other states, as well.  We accept HPSO Insurance assignments.

Free Legal Advice: Get Insurance Now.

It is very important for every health professional to carry insurance that covers any investigation, complaint or administrative hearing that might be filed or opened against your license.  You may think that you are covered for this by your employer, but you are not.  If your employer contradicts this, ask for a statement in writing that your employer will pay for your legal defense for any such matter arising during your employment.

What typically happens, especially in the case of a hospital employee, nursing home employee, pharmacy employee or corporate employee, is that the employer is the one who terminates the employee and then files a complaint with the DOH.  The DOH then opens an investigation against the health professional.  The employer is not going to pay your legal defense costs if the employer has reported you.

You may very well be out of work, out of money and face an investigation and complaint that could terminate your professional license and career.  You should not take this chance.  Insurance such as HPSO Insurance is inexpensive and reliable.  Buy it while you can afford it. After the actions have occurred, it is too late.

Talk to an Experienced Health Law Attorney if an Investigator Contacts You.

Also, you should immediately contact an experienced health law attorney if you are telephoned or visited by any investigator, or if you receive a letter advising you that an investigation has been opened regarding your care.  Call immediately for advice before you speak with an investigator or provide any documents or statements of any kind.

You cannot and should not seek “legal advice” on what to do from the investigator, from a DOH employee, from your professional board or from any attorney representing any of them.  They are not your friends.  They are on the side against you. You should definitely not take any advice from them.

Read and Understand Your Insurance Policy.

If you have good insurance, it will pay for your legal expenses from the very beginning, so use it.  However, beware of cheap insurance policies from professional associations that do not provide any coverage for disciplinary complaints and licensure investigations.  Always check to be sure this is covered.  Get it in writing.  With some companies you have to pay an extra premium to obtain this coverage.  With some insurers, they do not offer it, and you have to purchase a completely separate policy covering just this.  It is worth it!  Do it!

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

Our firm regularly represents physicians, dentists, nurse practitioners, pharmacists, massage therapists, mental health counselors, registered nurses (RNs), assisted living facilities (ALFs), home health agencies, nurse practitioners, lab technicians, occupational therapists, physical therapists, social workers, physician assistants, psychologists and other health professionals in many different legal matters.

Services we provide include representation before your professional board in DOH investigations, in administrative hearings, in civil litigation, in defense of malpractice claims, in professional licensing matters, in defense of allegations concerning HIPAA privacy violations and medical record breaches, in Drug Enforcement Administration (DEA) actions, and in many other matters.

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company.  If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

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 (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Do you have professional liability insurance? Why or why not. Please leave any thoughtful comments below.

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.