Tag Archives: Legal representation for health care professionals

Florida Department of Health and Law Enforcement Investigate School Providing Nurse Practitioner Courses

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

A subpoena purportedly issued by the Clerk of Court for Seminole County, Florida, recently requested academic records on advanced registered nurse practitioner (ARNP) students, including preceptorship agreements for clinical courses they had taken. A follow-up inquiry revealed that the Florida Department of Health was behind the subpoena, seeking evidence concerning possible fraudulent practices involving the supervision of those clinicals.

Apparently South University, which has its main campus and headquarters located in Savannah, Georgia, but offers courses in Florida, had agreements with one or more physicians in the Orlando area to furnish training for nurse practitioner students within their medical practices. Under the terms of the agreement, the physician was required to provide a nurse practitioner to supervise the student taking the clinicals.

However, what is being investigated is the allegation that no nurse practitioners were actually used to supervise those clinicals and the students. Instead, it is apparently being alleged that the names of various licensed advanced registered nurse practitioners (ARNPs) were used without their knowledge and put down as the supervisors for those students’ clinicals. Supposedly at least 20 names of nurse practitioners have been fraudulently used in this manner. Apparently the names of the nurse practitioners were also fraudulently signed to attestations that the students had actually completed the hours of clinical training. Usually there were four quarters or rotations of clinicals required of each student, encompassing hundreds of hours of clinical time.

It is estimated that over 100 advanced registered nurse practitioner (ARNP) students went through this program and graduated. Based on their advanced degrees, they were licensed as advanced registered nurse practitioners (ARNPs) by the Florida Department of Health.

Will those unsupervised student clinical hours be disallowed?

The question is whether action will be taken by the Florida Department of Health, or another organization, to disallow those clinical nurse practitioner hours gained by students in this manner. If so, many who are currently licensed as nurse practitioners who went through this program may lose their licenses and be required to retake required clinical hours. Both the students and the college were apparently unaware of the fraudulent activity.

This case is reminiscent of the massage therapist cases rising in 2012.

This situation seems somewhat similar to the situation that over 180 Florida licensed massage therapists (LMTs) found themselves during 2012. Click here to read one of our prior blogs on this story.

In the case of the massage therapists, each of them had taken courses and graduated from a school in another state. However, when they moved to Florida they had to have the courses re-certified by a Florida approved college and take the additional required courses for Florida licensure. They went to a well known, reputable private college offering massage therapy courses. They paid their tuition and were provided documentation showing that their out of state credits had been transferred in. They were provided other documents by the college showing that they had completed all course requirements and met the standards for licensure. They received their Florida licenses based on this.

Later it was discovered that the registrar at that college had actually been stealing the tuition money paid by these massage therapists and not enrolling them in the college. She was falsifying college documents, including course completion certificates, diplomas, transcripts and other documents using the college’s official seal on them. To see a class action law suit filed discussing this scheme in greater detail, click here.

When the Florida Department of Health found out about this situation, it reacted in a “knee-jerk” fashion and did an emergency suspension of hundreds of massage therapist’s licenses, many of them with no advance notice to the massage therapists. To see a blog I wrote on this, click here.

Hundreds of massage therapist who could not afford to pay a lawyer to mount a legal defense wound up having their licenses revoked or felt compelled to voluntary relinquish their licenses. They lost their national certification in massage therapy because of this.

However, the massage therapists who challenged the revocation and demanded a formal administrative hearing on it, many of whom we represented, were successful in keeping their licenses, mainly because they were not at fault and did not know what the crooked registrar was doing.

Actions to take if you are a nurse practitioner notified of licensure action or that you are under investigation:

Following are the recommendations we would make to any potential client contacting us who has been notified that he or she may be under investigation by the Florida Department of Health or law enforcement authorities:

1. Do not talk to or make any statement, oral or written, to any investigator without first consulting with an experienced health law attorney.

2. Immediately obtain the services of an experienced health law attorney to represent you in the case.

3. Check with your professional liability insurance carrier for any professional liability insurance you had at the time or currently have to see if they will cover the matter. Your current policy may not cover it unless you had it when the events occurred. However, it might.

4. Do not respond to any subpoena for records for testimony until you have consulted with an experienced health law attorney. Even a current professional liability insurance policy should cover you in responding to a subpoena or if a deposition is sought.

5. Do not, under any circumstances, voluntarily relinquish your license, without retaining any experienced health law attorney familiar with this matter to represent you. Such a relinquishment may be the equivalent of a revocation and reported to national reporting bodies as such.

6. If charges arise and you are offered the right to a hearing, always elect a formal administration hearing at which you dispute the issues. Do not elect an informal hearing. In an informal hearing, you have to agree that the charges against you are true, in effect, admitting you are guilty. Do not make that common mistake.

If you desire to see information on emergency suspension orders and emergency restriction orders, click here.

 

Contact Health Law Attorneys Experienced with Department of Health (DOH) Investigations of Nurse Practitioners.

The attorneys of The Health Law Firm provide legal representation to nurses, nursing students and ARNPs in Department of Health (DOH) investigations, licensure defense representation, investigation representation, Department of Health investigations, Board of Nursing investigations , administrative hearings, emergency suspension orders, emergency restriction orders 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.

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.

KeyWords: Legal representation for nurses, legal representation for nursing students, legal representation for ARNPs, legal representation for ARNP students, Licensure Defense Representation, Investigation Representation, Department of Health Investigations, Board of Nursing Investigations , Administrative Hearings, Emergency Suspension Orders, Emergency Restriction Orders, nurse attorney, legal representation for health care professionals, health law defense attorney, nursing student defense attorney, ARNP defense attorney, legal representation for licensure issues, legal representation for medical students, legal representation for investigations of health care professionals, DOH investigation defense attorney, The Health Law Firm, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“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 © 2017 The Health Law Firm. All rights reserved.

 

 

Advertisements

Recommendations For Physicians Who Receive Notice of Investigation From the ABIM

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In 2010, the American Board of Internal Medicine (ABIM) sanctioned 139 physicians for seeking out and sharing board examination questions with a testing preparation company. For the physicians involved in that cheating scandal, disciplinary action taken by the ABIM included revocation of board certification or suspension of certification for one to five years, depending on the severity of the offense. The ABIM also reported these actions to state medical boards.  The ABIM routinely takes such actions against physicians, investigating any similar type of “misconduct” or “irregular behavior” which it comes across.

Recommendations to the individual physician (“Physician”)who finds himself or herself in receipt of a letter notifying of investigation or possible disciplinary action from the ABIM:

1. Retain the services of an experienced healthcare attorney who is familiar with such matters, immediately.  The American Health Lawyers Association or your state bar association are good sources.  Ask for a referral of a health lawyer who represents physicians.

2. Avoid e-mailing or discussing your situation on any listservs or blogs.  You do not know how many places such communications may wind up and your complete identity will be easily determinable.

3. Be completely candid with your attorney and reveal all facts, documents and prior communications that have occurred.  Your attorney cannot effectively represent you otherwise.

4. Do not let any deadlines go by without requesting, in writing, via a verifiable method (not e-mail) that you have requested a review, hearing, appeal or other due process rights.  “Verifiable” means sent by a method that can be tracked and receipt of which is documented (e.g., U.S. express mail with a return receipt requested, Federal Express, etc.).  It does not hurt to send by two or three different methods.

5. If there is documented proof that you have actually been involved in a compromise of the examination, sometimes it will be advisable to admit this to the committee, produce any mitigating factors, apologize and propose a less harsh sanction (note:  this will be contrary to what most defense attorneys would ordinarily recommend.)  In the face of convincing evidence that you breached the rules, this may be the most reasonable and least damaging course to pursue.  Discuss this with an experienced health care attorney first, though.

6. Review any employment contracts, independent contractor agreements, provider agreements with third-party payers and medical staff bylaws (for hospitals at which you have privilege) with your attorney to determine if you are required to report this event.

7. Advise your employer (or prospective employer) of the situation and offer to do whatever is required to help alleviate any problems this causes to your employer.

8. See if your employer (or prospective employer) would be amenable to negotiating an amendment to the terms of your employment, including different duties, more supervisory, administrative or managerial duties, lower salary, etc., if necessary.  Also consider requesting a postponement of starting date, leave of absence, sabbatical or other alternatives to full-time employment.

9. Explore charitable work and community service opportunities, such as service in community health clinics, volunteering in free/charity clinics and hospices, volunteering for overseas medical organizations such as Physicians without Borders, service in medically under served areas, and similar opportunities.  This might also serve as a basis to convince ABIM to reduce the period for retaking the exam or becoming certified.

10. Every individual, every case and every situation is unique.  You should consult with your attorney on every issue and follow his or her advice.

Recommendations to the employer or prospective employer of a Physician who has received notice from ABIM that he or she will not be certified:

1. Consult your health care attorney regarding the matter immediately.

2. If your contract with the Physician requires him or her to be board certified (as almost any well-written contract will require) and it does not appear he or she will be able to meet this requirement, this will most likely be grounds to terminate or void the contract.

3. Attempt to obtain complete information from the Physician on what his or her exact circumstances are and whether or not he or she is likely to become certified in the near future.

4. The easiest and least expensive resolution may be to terminate the Physician’s contract, if the contract provides for this.  A voluntary agreement from both parties or voluntary resignation by the employee may be the least harmful way out.  The more complex and more expensive resolution may be to negotiate an amendment to the Physician’s contract and to try to find alternative duties for the Physician.

5. If it looks like you will be terminating or voiding the contract, start looking for a replacement physician right away.  (The law requires you to mitigate your damages.)

6. If you have a medical group, use group numbers to bill third-party payers, and the physician is a member of your group or is a participating physician on the panel of the payer, review your provider contracts to determine if you must report this or take action to avoid having the payers patients treated by the physician.

To read further on the cheating scandal in 2010, click here to read my prior blog.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in investigations and hearings of all types.  This includes board certification hearings, medical board hearings, Drug Enforcement Administration (DEA) hearings, Food and Drug Administration (FDA) hearings, medical staff peer review and clinical privileges hearings, FBI Investigations, DOJ Investigations, Drug Enforcement Administration (DEA) investigations, Medicare and Medicaid overpayment demands and hearings, and other types of investigations of health professionals and providers.  We also undertake civil litigation in the same types of cases.

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.

KeyWords: American Board of Internal Medicine (ABIM), legal representation for ABIM investigations, legal representation for ABIM discipline, legal representation for ABIM certification, legal representation for Board representation, legal representation for Board investigations, defense attorney for Board investigations, attorney for Board representation, legal representation for medical students, legal representation for medical residents, legal representation for medical fellows, legal representation for physician employment agreement, physician employment contract attorney, legal representation for physician license revocation, licensure defense attorney, legal representation for health care professionals, health law defense attorney, The Health Law Firm, reviews of The Health Law Firm, The Health Law Firm attorney reviews board certification hearings, medical board hearings, Drug Enforcement Administration (DEA) hearings, Food and Drug Administration (FDA) hearings, medical staff peer review and clinical privileges hearings, FBI Investigations, DOJ Investigations, Drug Enforcement Administration (DEA) investigations, Medicare and Medicaid overpayment demands and hearings, and other types of investigations of health professionals

“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 © 2017 The Health Law Firm. All rights reserved.

Texas Appeals Court Affirms$1.37 Million in Sanctions Against Doctor who Sued Hospital Former Employers

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On November 16, 2016, an appeals court in Texas affirmed a $1.37 million sanction against a doctor. The physician was ordered to pay the fine after the dismissal of a defamation lawsuit he filed against his former employers. The decision affirmed that the actions of his former employers, Baylor College of Medicine (Baylor) and Texas Children’s Hospital, did not cause the litigation fees which the court assessed to the doctor as sanctions.

The case had previously made its way up to the Texas Supreme Court, which makes the November 16, 2016, opinion the second time the Texas Fourteenth Court of Appeals has weighed in on the case. Additionally, it is the second time it has held the sanctions were merited for Dr. Rahul K. Nath.

The Back Story of the Case.

According to the opinion, Dr. Nath was employed by Baylor as a plastic surgeon and was affiliated with Texas Children’s Hospital. He was fired in 2004 and in February 2006 filed a lawsuit against his former supervisor at Baylor and Texas Children’s. According to court documents, Dr. Nath had accused his former supervisor of making defamatory statements about him after he stopped working. The alleged defamatory statements included that Dr. Nath had been fired, was unqualified and lacked professional ethics and integrity. (Note: We are just stating what was alleged in the lawsuit.)

To read the opinion in full, click here.

Were the Former Employers Responsible for the Accumulated Attorney and Litigation Fees?

The court was considering whether the behavior of Baylor or Texas Children’s was ultimately responsible for the fees accumulated litigation fees and expenses in the case. Previously, the trial court found that both Texas Children’s and Baylor’s actions had not caused the expenses for which Dr. Nath was sanctioned. The trial court wrote that the amount was appropriate as it was “far less” than the actual fees incurred by either party in defending Dr. Nath’s claims.

On appeal, Dr. Nath argued that the trial court hadn’t held a proper evidentiary inquiry, that it had based its sanctions award on “conclusory and self-serving” affidavits. Dr. Nath claimed that he was wrongly denied discovery in the case. To learn more about Dr. Nath’s challenge, click here.

Despite Dr. Nath’s arguments, the Fourteenth Court disagreed, holding that the trial court followed the exact instructions from the Supreme Court before deciding to impose the sanctions. Additionally, the court found that there was evidence in the record to support the conclusion that neither Texas Children’s nor Baylor’s conduct caused the expenses that were passed on to Dr. Nath as sanctions.

Adequate Supporting Evidence.

The first time the case came before the Fourteenth Court of Appeals, it affirmed the sanctions against Dr. Nath. The high court held that there was evidence to support the trial court’s finding of bad faith and improper purpose on Dr. Nath’s part with regard to certain filings in the case.

Dr. Nath appealed, and the Texas Supreme Court held that the trial court didn’t abuse its discretion in finding the doctor had exercised bad faith and improper purpose in certain filings. The high court remanded it back to the trial court to consider to what extent, if any, Texas Children’s and Baylor’s actions may have “caused the expenses for which recovery is sought.”

After a hearing, the trial court determined that neither employer’s behavior caused the expenses, and again imposed the sanctions against Nath. In appealing that ruling to the Fourteenth Court of Appeals, Dr. Nath argued that the trial court had made procedural errors in hearings and evidence submission in reaffirming the sanctions.

The trial court granted Texas Children’s and Baylor’s motions in June 2010, and also sanctioned Dr. Nath $726,000 for a portion of Texas Children’s fees in defending the suit and $644,500 for a portion of Baylor’s. The Fourteenth Court of Appeals affirmed that ruling, and Dr. Nath appealed to the state Supreme Court.
To learn more about defamatory statements and how to handle such claims, click here to read one of my prior blogs.

Contact Experienced Health Law Attorneys.

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

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

Sources:

Knaub, Kelly. “Texas Appeals Court Affirms Doc’s $1.3M Sanction.” Law360. (November 16, 2016). Web.

Knaub, Kelly. “Doc To Challenge $1.3M Sanction Before Texas High Court.” Law360. (January 15, 2014). Web.

“Texas Appeals Court Affirms Doc’s $1.3M Sanction.” LexisNexis. (November 16, 2016). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for health care professionals, health law defense attorney, legal representation for defamatory statements against health care professionals, legal representation for defamation lawsuit against a healthcare professional, healthcare litigation defense attorney, legal counsel for health care professionals, Legal representation for clients involved in the health care industry, reviews of The Health Law Firm, The Health Law Firm attorney reviews, The Health Law Firm
“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 © 2017 The Health Law Firm. All rights reserved.