CMS Woes: Zone Program Integrity Contractors (ZPICs) Criticized for Oversight in Fraud Investigations

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

Zone Program Integrity Contractors (ZPIC) are private companies or business entities, that have contracted with the Centers for Medicare and Medicaid Services (CMS). Their purpose is to carry out certain functions related to auditing for possible fraud, that Medicare regional carriers (now called Medicare Administrative Contractors or “MACs”) performed in the past. They are specifically charged by CMS to data mine, identify, and investigate potentially fraudulent behavior in Medicare providers.

Because of this, health care providers that receive a letter from the ZPIC often see it as a potential death sentence, and certainly an eye-opening event, because it involves investigating for fraudulent activity. However, in recent years CMS has been criticized about its oversight (actually, lack of oversight) of these fraud-detection contractors.

Taking a Closer Look at the ZPIC.

ZPIC audit letters are required to comply with regulations and guidelines established by CMS when it comes to making additional documentation requests (ADRs) for pre-payment and post-payment reviews, initiation of Medicare suspension of payments and other areas for which they have authority to investigate under the direction of CMS.

Studies have found many failures of their obligations to comply with guidelines and regulations adopted by CMS and the Department of Health and Human Services (HHS). There has been so much concern over their borderline “unethical behavior” and violations of Medicare regulations that the United States Senate Committee on Finance, as well as the Office of the Inspector General (OIG) of HHS, have both issued scathing reports on them. These reports often warn against what they see as destructive and harmful behavior toward physician practices and smaller medical businesses.

In 2012 a report was issued at the request of the Senate Finance Committee and included the following quote: “CMS and its contractors often cultivate an environment of mistrust and suspicion that all providers of certain services are inherently fraudulent. The sentiment is widely shared by anyone that has worked with CMS contractors in the area of program integrity and a similar environment is probable within the CMS Program Integrity Group. This type of environment leads investigators, contractors, and CMS to pursue providers in an aggressive manner, sometimes unfairly, based on little evidence or collaboration of any wrongdoing.”

According to the OIG: “Often the ZPIC contractors have had no experience in the areas of fraud and abuse for which they should be accountable. The result is a loss to CMS of fraud and abuse funds and providers, many of which are small – medium sized businesses, are forced to spend thousands of dollars to address unfounded audits and investigations.”

To read the OIG report to Congress in full, click here.

Make sure to visit our website’s ZPIC articles and documents section to learn more.

What To Do If You Are Notified of a ZPIC Audit.

When a physician, medical group or other health care provider receives a notice of an audit and site visit from a ZPIC, things happen fast with little opportunity to prepare. A ZPIC will routinely fax a letter to the practice shortly before the end of a business day the day before a site visit/audit to that practice. Auditors will request to inspect the premises, will photograph all rooms, equipment, furniture, and diplomas on walls. They will usually request copies of several patient records to review later. They will request copies of practice policies and procedures, treatment protocols, all staff licenses and certifications, drug formularies, medications prescribed, and medications used in the office. ZPIC auditors will inspect any medication/narcotic lockers or storage cabinets and will request drug/medication invoices and inventories. You will usually be contacted for follow-up information and documentation after the audit and will eventually be provided a report and, possibly, a demand for repayment of any detected overpayments.

For a checklist on what to do after you receive initial notification of a ZPIC audit, read our two-part blog. Click here for part one and click here for part two.

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.

Additional Sources:

Waesch, Amanda; Cohen, Frank and Weiss, Sean. “The Truth about ZPICs – Why Oversight is Needed.” Brennan Manna & Diamond Law firm. (August 29, 2017). Web.

Carlson, Joe. “Review notes ZPIC oversight woes.” Modern Healthcare. (November 14, 2011). Web.

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

Key Words: Zone Program Integrity Contractors (ZPICs), ZPIC audit defense attorney, ZPIC defense lawyer, Medicare audit defense legal counsel, Medicare audit attorney, legal representation for ZPIC letters, legal representation for ZPIC audits, Medicare and Medicaid audits, legal representation for Medicare and Medicaid audits, health care fraud defense attorney, preparing for ZPIC audit, legal representation for health care fraud, Centers for Medicare and Medicaid (CMS), legal representation for CMS investigations, Office of Inspector General (OIG), health care professional defense attorney, legal representation for health care professionals, legal representation for fraud investigations, reviews for The Health Law Firm, The Health Law Firm attorney reviews, additional documentation requests (ADRs) for pre-payment and post-payment reviews, initiation of Medicare suspension of payments lawyer

“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.

 

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The 20 Major Mistakes Physicians Make After Being Notified of a Department of Health Investigation

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

The investigation of a complaint which could lead to the revocation of a physician’s license to practice, usually starts with a simple letter from the Department of Health (DOH). This is a very serious legal matter and it should be treated as such by the physician who receives it. Yet, in many cases, attorneys are consulted by physicians after the entire investigation is over and the damage is already done. Often, the mistakes that have been made severely compromise an attorney’s ability to achieve a favorable result for the physician.

These are the ten biggest mistakes we see in the physician cases we are called upon to defend after a Department of Health investigation of them is commenced:

1. Contacting the Department of Health (DOH) investigator and providing him/her an oral statement or oral interview.

2. Making a written statement in response to the “invitation” extended by the DOH investigator to do so.

3. Providing a copy of their curriculum vitae (CV) or resume to the investigator because the investigator requested them to do so.

4. Believing that if they “just explain it” the investigation will be closed and the case dropped.

5. Failing to submit a timely objection to a DOH subpoena, when there is a subpoena, and there are valid grounds to do so (e.g., patient does not want records released, patient privacy).

6. Failing to forward a complete copy of the patient medical record when subpoenaed by the DOH investigator as part of the investigation, when no objection is going to be filed.

7. Delegating the task of providing a complete copy of the patient medical record to office staff, resulting in an incomplete or partial copy being provided.

8. Failing to keep an exact copy of any document, letter or statement provided to the investigator.

9. Believing that the investigator has knowledge or experience in the medical or health care matters being investigated.

10. Believing that the investigator is merely attempting to ascertain the truth of the matter and, if the truth is known, this will result in the matter being dismissed.

11. Failing to check to see if their medical malpractice insurance carrier will pay the legal fees to defend them in this investigation.

12. Believing that because they haven’t heard anything for six or eight months (or even years in some instances) that the matter has “gone away.”

13. Believing that the case is indefensible so there is no reason to even try to advocate for getting it dismissed.

14. Failing to submit a written request to the investigator at the beginning of the investigation for a copy of the complete investigation report and file and then following up with additional requests until it is received.

15. Failing to exercise the right of submitting documents, statements, and expert opinions to rebut the findings made in the investigation report before the case is submitted to the Probable Cause Panel of the Board of Medicine for a decision.

16. Taking legal advice from their non-lawyer colleagues regarding what they should do in defending themselves in the investigation.

17. Attempting to defend themselves without the assistance of an attorney.

18. Believing that, because they know someone on (or previously on) the Board of Medicine, with the Department of Health or a state legislator, that influence can be exerted to have the case dismissed.

19. Providing copies of medical records to the DOH Investigator and signing a “Certificate of Completeness” so that the DOH can use these against them in its future disciplinary proceedings against them.

20. Failing to immediately retain the services of a health care attorney who is experienced in such matters to represent them and to communicate with the DOH investigator for them.

The key to a successful outcome in all of these cases is to obtain the assistance of a health care lawyer who is experienced in appearing before the Board of Medicine in such cases and does so on a regular basis.

To learn more about how The Health Law Firm can assist you if you are being investigated by the DOH, click here.

Contact Health Law Attorneys Experienced with Department of Health Investigations of Physicians.

The attorneys of The Health Law Firm provide legal representation to osteopathic physicians in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations and other types of investigations of health professionals and providers.  To contact The Health Law Firm, please call (407) 331-6620 or 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 Department of Health (DOH) investigations, DOH attorney, DOH investigation attorney, DOH defense attorney, Legal representation for DOH complaints, legal representation for licensure issues, legal representation for health care professionals, DOH complaint attorney, legal representation for Board of Medicine investigations, Board of Medicine attorney, Board of Medicine investigation attorney, Board of Medicine defense attorney, legal representation for Board of Medicine complaints, legal representation for licensure issues, legal representation for physicians, Board of Medicine complaint attorney, health law attorney, health law defense attorney, legal representation for physicians, doctor attorney, legal representation for complaints against physicians, The Health Law Firm, Florida health law defense attorney, 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.

 

 

 

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.

 

 

CMS Drops Florida Nursing Home From Medicare Program After 14 Patients Died During Storm

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

On October 12, 2017, federal health officials announced they are dropping a Florida nursing home from the Medicare program after 14 patients died allegedly as a result of the Hurricane Irma emergency. On Sept. 13, 2017, eight residents died and the others were evacuated from the Rehabilitation Center at Hollywood Hills after the facility lost air conditioning. Six more have since died, which attorneys say was a result of the conditions and evacuations immediately after the storm.

CMS Sanctions.

The Centers for Medicare & Medicaid Services (CMS) said in a statement that the facility will be terminated “due to their [sic] failure to meet Medicare’s basic health and safety requirements.” CMS also imposed a penalty of $20,965 a day for the three days that Hollywood Hills lost power to its air conditioning unit.

Under the CMS sanctions, Medicare will continue to pay the Hollywood Hills center through November 12, 2017, for any care that was provided to residents before the evacuation and closure.

This incident is what allegedly prompted Florida Governor Rick Scott to impose emergency rules requiring all nursing homes and assisted-living facilities in Florida (over 3,000 facilities) to have emergency power generators and fuel installed within 60 days to keep their residents air conditioned for up to 96 hours during a power failure. To read more on the emergency rule, click here.

Despite all this, the rehabilitation center has not given up hope on reopening. A spokeswoman for Hollywood Hills said they’ll appeal the decision and look forward to showing evidence that their actions were consistent with all state and federal rules.

To learn more about CMS’s authority to suspend or terminate Medicare to providers, click here to read one of my prior blogs.

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

If you receive any notice related to any audit, overpayment or action to terminate you or your company, take immediate action. 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.

We also represent physicians, medical groups, pharmacies. health facilities and therapists in notices of termination of Medicare billing privileges, corrective action plans (CAPs), OIG exclusion hearings, Medicaid hearings and applications for removal from the List of Excluded Individuals and Entities (LEIE).

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

Sources:

Chang, Daniel. “Feds to cut Medicare for Hollywood Hills nursing home after residents died.” Miami Herald. (October 12, 2017). Web.

“Florida nursing home where 14 died cut from Medicare program.” Associated Press. (October 12, 2017). Web.

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

KeyWords: Legal representation for Medicare investigations, legal representation for Medicare exclusion, Medicare attorney, Medicare defense attorney, OIG exclusion, legal representation for nursing home compliance, legal representation for nursing home regulations, Centers for Medicare and Medicaid Services (CMS), legal representation for CMS investigations, legal representation for Medicare providers, nursing facility license defense, legal attorney for health facilities, CMS termination of Medicare provider status, legal representation for Medicare reinstatement, legal representation for health care compliance, 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

 

“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.

 

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.

Inmates Family Sues Jail After Improper Care

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

Orange Country Jail Sued.

A wrongful death suit has been filed against Orange County Jail due to what some are saying was a preventable death.  The suit was filed directly against Robert Buck, the head of the jails health services department, along with four nurses that cared for the late inmate.

Dog Bites Leads to Death In Jail.

In 2015, Max Gracia was arrested. During his arrest, he sustained many bites from one of the police dogs. He was treated in the hospital until he was stable. Once he was moved to the jail cell he was found unconscious and later died in the hospital. The autopsy reported that he died from an E Coli infection that stemmed from the dog bites. His mother, Willine Gracia, has filed the wrongful death suit claiming that her son received subpar care and as a result died.

Claimants Allege “A Culture of Neglect.”

Reportedly the medical staff of the jail stated that Garcia was exaggerating or faking the illness. The lawsuit claims the jail has a “culture of neglect”and this was really what was at work here.  Willine Gracia states that she hopes that this lawsuit will bring attention to the wrongful health care services so many inmates receive.

Providing Representation For All Health Care Professionals.

Our firm has represented a number of nurses, physicians and other health care professionals who provide care in jails and prisons, as well as in other government facilities and institutions.  We routinely represent physicians, nurses and advance practice nurses who work for the VA, the Department of Health, the county, the military, the Indian Health Service and other government agencies.  Although government employees may have personal immunity from civil suits, they are not protected against termination and other employment actions, complaints against their professional license, National Practitioner Data Bank reports, and other types of administrative actions;  our firm represents them in all of these.  The government is not going to represent you in these.  Call us at the first sign of a legal problem.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at http://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.

Sources:

Hayes, Christal. “Family Sues Orange County Jail, Nursing Staff after Inmate’s Death from Police-Dog Bite.” OrlandoSentinel.com, 1 Aug. 2017. (Print).

Walden, Tiffany. “Inmate Son Suffered Seizure before Death, Mom.” Orlando Sentinel. (16 Aug. 2016). Web.

Key Words: Legal representation for government physicians, legal representation for government nurses, legal defense of professional licensure cases, legal representation for Board of Nursing cases, legal representation for Board of Medicine cases, Board of Nursing investigation defense attorney, legal representation for peer review, legal representation for administrative actions, legal representation for VA physicians, legal representation for VA nurses,  health care lawyer, The Health Law Firm 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.

 

First Medical Marijuana Dispensary in Hawaii Gets Green Light From DOH

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

On August 8, 2017, after waiting 17 years, Hawaii will begin dispensary sales of medical marijuana to patients. Maui Grown Therapies got the green light from the Hawaii Department of Health (DOH) to begin selling medical cannabis. I know (from reliable sources, that is) that Hawaiian grown marijuana has always been a favorite with the connoisseur.

Maui Grown Therapies.

The Maui dispensary has been pre-registering patients and will begin selling medical cannabis to patients by appointment only, said Freitas Gorman, director of community relations and patient affairs. Walk-in sales will start in about a week.

In 2000, Hawaii was among the first states to legalize medical marijuana. But the state didn’t legalize dispensaries until 2015, so the state’s 18,000 patients had to grow or obtain the drug on their own.

“This is an important day for qualified patients and caregivers on Maui who now have assurance the medical cannabis they purchase at Maui Grown Therapies has been thoroughly tested and is safe for them to use,” said Virginia Pressler, director of the state Department of Health, in a statement. “Implementing a new health program is always challenging, and the dispensary program was no exception.”

To read the press release from the DOH, click here.

To read more on the status of medical marijuana in Florida, click here to read my prior blog.

To learn more about how the attorneys of The Health Law Firm can assist you in legal matters involving medical marijuana, click here.

To stay on top of medical marijuana issues, be sure to check out our Medical Marijuana Law Blog regularly.

Contact Experienced Health Law Attorneys for Medical Marijuana Concerns.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting and/or licensing, while complying with Florida law. We can also represent doctors, pharmacies and pharmacists facing proceedings brought by state regulators or agencies.

Sources:

Bussewitz, Cathy. “FIRST MEDICAL MARIJUANA DISPENSARY OPENING IN HAWAII.” The Associated Press. (August 8, 2017). Web.

Department of Health. “First dispensary receives approval from Department of Health to
begin sales of medical cannabis for Hawai‘i patients.” State of Hawaii, DOH. (August 8, 2017). Web.

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

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.