Owner of Louisiana Health Care Company To Pay Nearly $7 Million for Medicaid Fraud

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

On December 20, 2016, the owner of Louisiana-based Millennium Health Care Services (Millennium) must pay the state nearly $7 million in restitution and will spend 10 years behind bars for his role in a scheme to defraud the Medicaid system, according to Louisiana Attorney General Jeff Landry.

Millennium’s owner, Dwaine Woods, was ordered to pay $6,985,249 in restitution after his wife and the company were all found guilty of engaging in a criminal conspiracy to create multiple fake CPR cards for Millennium staff. The staff did not undergo training to be properly certified in CPR, Landry said.

The Dangerous Scheme.

Millennium operated from 2004 to 2010 and was solely funded by the government program Medicaid. According to Landry, the fake CPR card scheme was not only illegal but also extremely dangerous. “Instead of service workers learning necessary skills, they were fraudulently getting certifications without any training — greatly jeopardizing the health and safety of patients.”

Millennium was convicted of 19 counts of forgery, one count of theft by fraud, and one count of conspiracy to commit forgery. In addition to the restitution payment, the company was also ordered to pay $17,500 in fines.

Dynetta Woods was also convicted of 19 counts of forgery and one count of conspiracy to commit forgery. She was reportedly sentenced to five years of supervised probation and ordered to pay $54,730 in restitution and $5,000 in fines. Additionally, she is forever barred from doing business with the state of Louisiana, according to Landry. Dwaine Woods was convicted of theft by fraud.

To learn about a similar case of Medicaid fraud and the repercussions, click here to read one of my prior blogs.

Never Falsify Any Documents if You Are a Medicare or Medicaid Provider.

We have represented a number of owners of Medicare and Medicaid providers that were investigated, charged and convicted of fraud because they had falsified, forged, created or changed documents that were in their employees’ files. These have included items so simple as the expiration date on a CPR card, but have also included forging diplomas and other qualifying credentials. State Medicaid programs and the Medicare Program takes such matters very seriously. Often prison time will result for the owners of the company.

This can also be the basis for large recoveries under federal and state whistle blower (false claims act) laws. Submission of a false statement or false document to a federal official is a felony. Employees of Medicare and Medicaid providers who are aware that their employers have falsified documents can blow the whistle on them and collect large rewards under one of the applicable false claims acts (whistle blower laws).

Fraud Investigations Are a Very Serious Matter.

We have been consulted by many individuals similar to the subject of this story, 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 to retain the services of an experienced attorney to help 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.

Do not delude yourself. This is extremely serious. Be prepared to give up whatever you have if you can avoid a conviction.
Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations and other Legal Proceedings.

Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Health Care Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.

The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (AFLs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

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

Sources:

Kennedy, John. “La. Medicaid Fraudster Will Pay Nearly $7M In Restitution.” Law360. (December 20, 2016). Web.

Gyan, Joe. “Prairieville couple sentenced in $7 million Medicaid fraud scheme.” The Advocate. (December 20, 2016). 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: Medicaid fraud defense attorney, Medicaid investigation defense attorney, legal representation for conspiracy to commit Medicaid fraud, legal counsel for Medicaid audits, legal representation for Medicaid audits, health care fraud defense attorney, legal representation for Medicaid fraud, health care fraud investigation defense lawyer, legal representation for conspiracy for defraud the government, reviews of The Health Law Firm, The Health Law Firm attorney reviews, Florida Medicaid Fraud defense attorney, Colorado Medicaid Fraud defense attorney, Louisiana Medicaid Fraud defense attorney, Kentucky Medicaid Fraud defense attorney, Virginia Medicaid Fraud defense attorney, District of Columbia (D.C.) Medicaid Fraud defense attorney, legal representation for whistleblower suits, whistleblower defense attorney, legal counsel for whistleblower, legal represenation for qui tam cases, qui tam defense attorney, legal representation for qui tam/whistblower investigations

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

Advertisements

CMS Issues Final Rule to Revise Home Health Conditions of Participation

mlb-headshot-resizedBy Michelle Bedoya, J.D., The Health Law Firm

On January 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that revises the conditions of participation (CoPs) that home health agencies (HHAs) must meet to participate in the Medicare and Medicaid. The requirements focus on the care delivered to patients by HHAs, reflect an interdisciplinary view of patient care, allow HHAs greater flexibility in meeting quality care standards and eliminate unnecessary procedural requirements. The provisions of this rule will go into effect on July 13, 2017.
Patient Centered Process.

CMS’ focus on a patient-centered process is notably reflected by a restructuring of Part 484 into two parts: (1) home health patient care, and (2) HHA organization and administration. The restructured new Part 484 offers expanded patients’ rights to participate in and to set goals toward care and treatment, through new and revised rules, covering admission to discharge or transfer.

The new Patient Rights Notice (PRN) under Part 484, includes patients’ right to actively participate in their initial and follow-up assessments, to develop and update their plan of care (POC) and discharge and transfer plans. Patients may also participate in deciding care preferences as well as expected outcome and measurable goals.

Under the provisions, in order to expand patient access to the PRN, an HHA must provide the PRN to patients and their representatives. It must be laid out in a writing, in a language and manner that is clearly understood. For patients and their legal representatives, the writing must further be understandable to persons who have limited English proficiency and accessible to individuals with disabilities. For patients, this means accessible websites and auxiliary aids and language services at no cost to them. Further, an HHA must provide verbal explanation of the PRN to the patient, in the patient’s primary or preferred language and in a manner the patient understands, free of charge, using an interpreter if necessary.

According to CMS, a more comprehensive understanding of patients’ status will increase the likelihood of achieving their desired outcomes. Therefore, the POC requirements have been expanded to more accurately explain the patient’s status.

Data-Driven Solutions.

To focus on data-driven solutions, CMS implemented evidence-based health care solutions by the use of the Quality Assessment and Performance Improvement (QAPI) program. The QAPI program must further measure, analyze, and track quality indicators to assess the HHA’s care processes, services, and operations. The program may use OASIS data, measurement and tools, or other relevant sources.

Outcome-Oriented Results.

According to CMS, the restructuring will better implement home health care coordination and achieve outcome-oriented results. These changes to Part 484 are part of the CMS’s overall effort to achieve broad-based, measurable improvements in the quality of care furnished through the Medicare and Medicaid programs, while at the same time eliminating unnecessary procedural burdens on providers.

To read the final rule issued by CMS, click here.

To learn more about HHAs and compliance, click here to read one of our prior blogs.

Contact Health Law Attorneys Experienced in Handling Medicaid and Medicare Audits.

The Health Law Firm’s attorneys routinely represent physicians, medical groups, clinics, pharmacies, durable medical equipment (DME) suppliers, home health agencies, nursing homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

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

Sources:

Baxter, Amy. “CMS Issues Final Rule to Modernize Home Health Conditions of Participation.” Home Health Care News. (February 24, 2017).

Lipschitz, Benjamin. “Revised Conditions of Participation for Home Health Agencies.” AHLA. (February 24, 2017). Web.


About the Author:
Michelle L. Bedoya 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: Centers for Medicare & Medicaid Services (CMS) final rule, Home Health Care Agency (HHAs) compliance, defense attorney for HHA compliance, legal representation for HHAs, legal representation for Medicare and Medicaid investigations, legal representation for Medicare and Medicaid audits, conditions of participation (CoP) for HHAs, legal representation for health care professionals, defense attorney for health professionals, Florida health law defense attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“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.

Wisconsin Supermarket Violated FCA With Illegal Kickbacks, Pharmacist Claims

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 December 20, 2016, a pharmacist and whistle blower told an Illinois federal court that Wisconsin and Chicago-area chain of grocery stores, Roundy’s Supermarket, Inc. (Roundy’s), knew gift cards it was providing Medicare and Medicaid beneficiaries were actually illegal kickbacks. In defense of his False Claims Act (FCA) Suit, the whistle blower claims the chain proceeded to hand them out anyway despite knowing they were illegal.

The Whistle Blower and the Alleged Scheme.

The whistle blower in the suit, pharmacist Jefferey Kotwica, alleged the company was involved in illegal kickbacks, thus allegedly defrauding government health care programs, by offering gift cards to pharmacy customers that exceeded legal limits. Roundy’s enacted a Script Saver Program that gave all customers “pharmacy club coupons” for pharmacy purchases. When they reached five of those coupons, they could be redeemed for a $10 gift card, the complaint states. At some stores, the number of coupons necessary for a gift card was lowered to three, Kotwica said.

Roundy’s has mounted a defense to these allegations. Despite that defense, the whistle blower maintains the gift cards were more than the legal nominal value allowed. The whistle blower claimed additionally that the “retailer reward exception” failed because the gift cards were tied to the services the government health care programs reimbursed and were meant to induce customers to transfer prescriptions to the store.

The pharmacist and whistle blower in the case, claimed that he heard corporate executives discussing having Medicare and Medicaid recipients excluded from the program because they were concerned their inclusion was illegal, but never acted on that concern. Therefore, Kotwica said that this shows that Roundy’s had the intent to violate the FCA. The whistle blower also claimed that the company retaliated against him for speaking out to the point where he resigned his position as a pharmacist with it.

The case was originally filed in June 2015. Like all federal False Claims Act (FCA) cases, it remained sealed until ordered unsealed by the court. It was unsealed in July 2016 after the U.S., and the states of Illinois, Minnesota and Wisconsin declined to intervene in the case. Click here to read the response in this case.

Fighting Government Fraud and Abuse.

This case was brought under the federal False Claims Act (FCA) or federal “whistle blower law.” This law contains standards for both civil and criminal penalties against those filing false claims for services paid for by the government. False Claims Act cases, such as this recent one, are typically filed in a qui tam (or whistle blower) proceeding. This type of action involves a private party filing a lawsuit on behalf of the government against a defendant who allegedly defrauded the government. The “whistle blower” receives a percentage of the money recovered by the government (if any), through any judgment or settlement of the case. Often the amounts awarded to the whistle blower are in the millions of dollars. Whistle blowers are often protected from receiving any potential civil liability or prosecution for their involvement in the matter.

Our firm has been on both sides of both federal and state whistle blower or qui tam cases. We have represented nurses, physicians, pharmacists and other health professionals in bringing such cases. We have also defended physicians, health care providers, medical groups and health facilities in such cases.

We have also represented relators or plaintiffs bringing such actions to recover money on behalf of the government. A qui tam relator can receive up to 30% of the amount recovered on behalf of the government. This means, for example, that of a defendant settles with the government paying back $5 million, the relator or whistle blower can receive up to $1.5 million, plus his attorney’s fees and costs. Usually, the biggest obstacle to bringing any such case is being able to show an actual false claim that was filed.

If you have information concerning health care fraud by overbilling federal health care programs such as Medicare or Medicaid, do not hesitate to take action. The government urges health care providers to step forward and report illegal and fraudulent activities as soon as they are uncovered. The False Claims Act provides a system of rewards that encourages whistle blowers to bring these issues to the government’s attention.

Contact Health Law Attorneys Experienced with Health Care Fraud and Qui Tam or Whistleblower Cases.

The Health Law Firm’s attorneys routinely represent physicians, nurses, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (AFLs), home health care agencies, nursing homes, group homes and other healthcare providers in bringing or defending against False Claims Act, whistle blower or qui tam cases. We also defend health care providers in Medicare and Medicaid investigations, audits and recovery actions. We represent plaintiffs and defendants in complex health care litigation in state or federal courts.

Attorneys with The Health Law Firm also represent health care professionals and others who may desire to file a qui tam, False Claims Act or whistle blower suit. We work with physicians, nurses and other professionals to investigate, document and file such cases. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding and other services that assist us in such matters. We have represented number of doctors and other licensed health professionals as relators in bringing qui tam or whistle blower cases. Our attorneys are also available to defend physicians, medical groups and health care providers in qui tam or whistle blower cases.

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

Sources:

Kass, Dani. “Wis. Supermarket Should Face FCA Suit, Pharmacist Says.” Law360. (December 20, 2016). Web.

“Wis. Supermarket Should Face FCA Suit, Pharmacist Says.” Make Me Feed. (December 21, 2016). 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: False Claims Act (FCA) defense attorney, whistle blower defense attorney, qui tam defense attorney, legal representation for FCA claims, legal representation for qui tam cases, legal representation for whistle blower defense cases, Medicare and Medicaid fraud defense attorney, legal representation for Medicare and Medicaid fraud, legal representation for illegal kickback schemes, health care fraud defense lawyer, health care fraud scheme, legal representation for Medicare and Medicaid fraud investigation, Florida FCA defense attorney, Colorado FCA defense attorney, Kentucky FCA defense attorney, Louisiana FCA defense attorney, District of Columbia FCA defense attorney, Virginia FCA defense attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, complex health care litigation attorney, legal defense of complex health care business disputes, complex litigation defense counsel

“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 © 2016 The Health Law Firm. All rights reserved.

Orlando City Council Vote to Extend Temporary Ban on Medical Marijuana Dispensaries

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

On November 14, 2016, Orlando’s City Council voted to extend its temporary ban on new marijuana dispensaries, less than a week after Florida voters backed a constitutional amendment to expand medical use of the drug. Back in July 2016, city commissioners voted to approve the temporary pause on marijuana dispensaries. The current ban is set to expire December 2016, but the city is pursuing an extension that would stretch the ban until July 1, 2017.

The Temporary Ban.

According to the city, the temporary ban will be beneficial because it will allow staffers to study the potential impacts of marijuana distributors, including whether they should be kept at arm’s length from neighborhoods, churches and schools. After the Legislature in 2014 legalized the low-THC oil known as Charlotte’s Web, the city of Orlando determined its current rules would categorize dispensaries as drug stores, like Walgreens and CVS. The city of Orlando pursued the July 2016 moratorium after three potential sellers of either medicinal marijuana or Charlotte’s Web had expressed interest in Orlando storefronts where proper zoning would allow them. So far, several South Florida cities have also adopted similar temporary bans on new potential dispensaries. The Orlando City Council will take its final vote on the extension in December 2016.

To learn more on the status of marijuana in Florida, click here to read one of my prior blogs.

Problematic Approach.

To me this is very problematic. The citizens of Florida have spoken in making medical marijuana legal. However, it seems likely that we will be burdened with government officials acting to try to prohibit retail sellers and dispensaries in an attempt to prevent it nevertheless. For example, what would happen if every county now voted to prohibit dispensaries within their boundaries. This would cut the legs out from under the constitutional amendment passed by the voters.

We may have to go back to the polls again and vote in a constitutional amendment that blocks cities, counties and state agencies from preventing sales within their limits. Either that or elect John Morgan governor!

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.

To contact the Health Law Firm, please call (407) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Weiner, Jeff. “Orlando extends temporary ban on marijuana dispensaries.” Orlando Sentinel. (November 14, 2016). Web.

Weiner, Jeff. “City votes for pause on pot dispensaries.” Orlando Sentinel. (July 11, 2016). 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: Medical and recreational marijuana use, legal counsel for medical marijuana, marijuana defense attorney, legal representation for medical marijuana growers and distributors, expanding marijuana industry, medical marijuana defense attorney, The Health Law Firm Reviews, lawyer for medical marijuana growers and distributors, health lawyers for marijuana distributors, medical marijuana lawyer, legal counsel for marijuana industry, approval of Florida’s Amendment 2, 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 The Health Law Firm, P.A., a Florida professional service corporation, since 1999, and is also a registered service mark.
Copyright © 2016 The Health Law Firm. All rights reserved

Extensive Bribery Scheme At Dallas’ Forest Park Medical Center, 21 Charged

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

Founders and investors of a physician-owned health care facility in Dallas, Texas, known as the Forest Park Medical Center, were charged in a bribery and kickback scheme on December 1, 2016. The range of felony offenses stem from their payment or receipt of roughly $40 million in bribes and kickbacks for referring patients to Forest Park Medical Center (FPMC), according to a federal indictment in Texas federal court.

21 Took Part In Conspiracy Scheme.

The indictment was returned by a federal grand jury in November 2016, identifying 21 defendants including executives, physicians, surgeons and other individuals associated with FPMC who allegedly took part in a bribery scheme that cheated federally funded health care programs and other insurance plans for their personal financial gain.

The defendants named included, Forest Park co-founder of FPCM, CEO Alan Andrew Beauchamp, anesthesiologist and president of its board of directors Richard Ferdinand Toussaint, Jr., surgeon and board of directors member Wade Neal Baker, and Forest Park managing partner and investor Wilton McPherson Burt. However, there were many others involved in addition to these few.  It must be remembered that those named have been charged but have not been convicted in a court of law.  Often in this type of case, a defendant is acquitted or dismissed.

FPMC was an out-of-network hospital.  According to the indictment, the patients that were referred there were primarily ones with high reimbursing out-of-network private insurance benefits or benefits under certain federally-funded programs.  FPMC’s owners, managers, and employees also tried  to sell patients with lower reimbursing insurance coverage, namely Medicare and Medicaid beneficiaries, to other facilities in exchange for cash.

According to a press release from the U.S. Department of Justice, because FPMC is an out-of network hospital, it is free to set its own prices, resulting in a higher reimbursement rate than in-network providers.

Park Over Billed Patient’s Insurance Companies.

The indictment alleges that Forest Park billed patients’ insurance plans more than half a billion dollars and collected around $200 million in paid claims from 2009 to 2013 as a result of the bribes and kickbacks.

According to the DOJ, several co-defendants operated shell entities where the defendants funneled bribes and kickbacks payments though to surgeons in exchange for referrals.

“Medical providers who enrich themselves through bribes and kickbacks are not only perverting our critical health care systems, but they are committing a serious crime. Massive, multifaceted schemes such as this one, built on illegal financial relationships, drive up the cost of health care for everyone and must be stopped,” said U.S. Attorney John Parker of Texas’ Northern District in a statement.

FPCM Investors Referred Patients In Return For Kickbacks.

According to the indictment, primary care physicians who were investors in the facility and referred patients to FPCM for surgery and other specialized treatments received kickbacks ranging anywhere from $100,000 to $7 million. Those enriched funds where used to market their own personal medical practices or for personal goods and expenses.

There were several government health care programs that were affected by the alleged bribery scheme such as Tricare, The U.S Department of Labor’s FECA health care program, who was  billed $25 million; the U.S. Department of Defense’s health care program, who was billed over $10 million; and federal and retirees FEHBP health care program, who was billed over $60 million.

Each of the defendants have been charges with one count of conspiracy to pay and receive health care bribes and kickbacks. This gives the defendants a chance to be sentenced to five years in prison and a $250,00 fine.

Others involved in the scheme have been charged with violating the federal Travel Act and aiding and abetting a conspiracy to commit money laundering.

Contact Experienced Health Law Attorneys.

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

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

Sources:
Lee, Suevon. “21 At Texas Med. Center Charged In Massive Bribery Scheme.” Law360. (December 1, 2016). Web.

Krause, Kevin. “Doctor-owners, Execs of Bankrupt Forest Park Hospital Chain Indicted In Massive Kick-back Scheme.” Dallas News. (December 2, 2016). Web.

“Executives, Surgeons, Physicians and Others Affiliated with Forest Park Medical Center (FPMC) in Dallas Indicted in Massive Conspiracy.” United Stated Department of Justices. (December 2, 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. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: The Health Law Firm reviews, health care fraud audit. Medicare audit defense attorney, reviews of The Health Law Firm, health care fraud scheme, Medicare fraud defense lawyer, health law criminal defense attorney, Medicaid audit defense attorney, health law, health law criminal representation, Forest Park Medical Center (FPMC), Medicaid fraud defense attorney, Tricare, U.S. Department of Defense, health care programs, U.S. Department of Labor, The Health Law firm, conspritator in health care fraud scheme, Florida physician defense attorney, Colorado physician defense lawyer, Kentucky doctor defense legal counsel, Louisiana physician defense attorney, District of Columbia (D.C.) doctor defense 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 © 2016 The Health Law Firm. All rights reserved.

Hospital Negligence Suit Dismissed by Florida High Court

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

On November 30, 2016, The Florida Supreme Court announced the decision to drop a negligence suit filed against a hospital over the death of patient Ashley Lawson.  Lawson was able to escaped from Shands Teaching Hospital and Clinic, Inc.  The Shands psychiatric hospital is located in Gainesville, Florida and is now known as the UF Health Shands Psychiatric Hospital.

The major legal issue in this case was whether the conduct of the hospital was ordinary negligence or was medical negligence (medical malpractice).  In Florida, if the facts alleged constitute a claim for simple negligence, then there are no pre-suit proceedings required, no medical expert witnesses required, and it is usually much easier and much less expensive to try the case.  However, if the facts stated in the suit are medical negligence allegations, then there are a number of procedural hurdles that a plaintiff must overcome.  Additionally, the case is usually much more expensive and time consuming to try.

Patient Was Mentally Ill.

Ashley Lawson was admitted to the hospital on November 1, 2012, because of a psychiatric illness, impulsive behavior, drug abuse and several suicide attempts, according to reports.  According to her estate’s initial jurisdictional brief, Lawson was transferred to the locked impatient unit at Shands for her own safety.

Lawson Allegedly Freed Herself.

According to reports, an employee’s badge and keys were left unattended, which gave Lawson the opportunity to free herself and escape on January 23, 2013.  Lawson died soon after she had escaped.  She was struck and killed by a tractor trailer on Interstate 75.

A Request To Reconsider The Ruling.

On November 15, 2016, the Florida Supreme Court abandoned its denial of a motion from defendant-appellee Shands Teaching Hospital and Clinics, Inc. asking it to reconsider its ruling from September 13, 2016.  The earlier ruling denied a motion for voluntary dismissal filed by the plaintiff, the Estate of Ashley Lawson.  The court’s earlier denials had decided not to dismiss the case by a 4 to 3 split decision, with Chief of Justice Jorge Labarga and Justices Barbara J. Pariente, James F.C. Perry and R. Fred Lewis in the majority and Justices Ricky Polston, Charles Canady and Peggy Quince dissenting.

Since the ruling on November 15, 2016, Lawson’s estate had relinquished its right to file a brief on the merits, noting that the parties are “contractually prohibited from further litigation in this matter.”  This language seems to indicate that a settlement had been reached between the parties.  Shands Hospital filed a motion on November 27, 2016, looking for instructions on its due process rights and its counsel’s duty to proceed.  Shands stated:  “Respondent believes it should be entitled to submit a merits brief to this court and present oral argument since, as this court has made apparent through its orders, it views this case as involving an important issue of statewide impact.”

Where Do You Draw The Line?

This case in particular has raised questions on where the line should be drawn between medical negligence and ordinary negligence.  However, in the motion for reconsideration, Shands Hospital stated that there was no certification of a question of great public importance or a certified district conflict made in the lower court’s decision in the case.

Shands Hospital’s motion to dismiss the case had been denied by the trial court.  Shands then appealed the Florida First District Court of Appeal. The three-judge panel on the Court of Appeal was unable to come up with a definitive result, so the entire Court of Appeal decided to review the case and final reached a 8-6 decision to trump the lower court’s denial.

After that, Lawson’s estate brought the case to the Florida Supreme Court, seeking reversal based on its argument that the First District Court of Appeal’s decision allegedly conflicted with two Fifth District Court of Appeal decisions on what constitutes ordinary negligence verus medical malpractice (medical negligence).  The estate asked for an extension to file its initial merits brief, stating that the parties were discussing a settlement. On July 28, 2016, the estate filed a notice for voluntary dismissal because a deal was in place.

The Supreme Court took the position that the settlement notwithstanding, the Supreme Court should move forward with the case.  Court’s will often do this when they expect that the legal question will come up again and again in the future, unless they go ahead and decide it.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.  We represent medical students, interns, residents, and fellows in disputes with their graduate medical education (GME) programs.  We represent clinical professors and instructors in contract disputes, employment disputes, clinical privileges matters and other disputes with their employers.  We often act as the physician’s personal counsel in medical malpractice litigation.

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

Sources:
“Shands Teaching Hospital and Clinic Inc. v. Estate of Ashley Lawson.” FindLaw. (August 28, 2015). Web.

Hale, Nathan. “In Shift, Fla. High Court Drops Hospital Negligence Suit.” Law360. (November 30, 2016). Web.

“Justice Won’t Drop Case In Shands Vista Patients Death.” The Gainesville Sun. (September 16, 2016). Web.

“Court Sides With Hospital In Death of Escaped Patient.” Health News Florida. (August 31, 2015). 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. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords:  Reviews of The Health Law Firm, health care lawyer, legal representation for mental health professionals, The Health Law Firm reviews, health law attorney, legal representation for health care professionals, medical malpractice defense lawyer, health care provider defense attorney, The Health Law Firm, mental health counselor defense attorney, psychologist defense attorney, physician defense lawyer, mental health professional defense attorney, board of mental health counselors defense lawyer, board of psychology defense attorney, health law, complex mental health litigation attorney, psychiatrist defense counsel, Florida physician defense attorney,
Colorado physician defense lawyer, Virginia doctor’s defense attorney, Louisiana physician defense legal counsel, Kentucky doctor’s defense lawyer, District of Columbia (D.C.) physician defense attorney

“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 © 2016 The Health Law Firm. All rights reserved.

Appeals Court Affirms $1.37 Million in Sanctions Against Doctor for Dismissed Defamation Suit Against Former Employers

7 Indest-2008-4By 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 assessed against a doctor. The doctor was ordered to pay the sanction after the dismissal of a defamation lawsuit he filed against his former employers. The doctor’s former employers were Baylor College of Medicine (Baylor) and Texas Children’s Hospital.

The case had previously been appealed to the Texas Supreme Court. This makes the November 16, 2016, opinion the second time the Texas Fourteenth Court of Appeals has had to rule on the case. Additionally, it is the second time that it has held that the sanctions against Dr. Rahul K. Nath were justified.

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 allegedly terminated in 2004. In February 2006 he 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 there. The alleged defamatory statements included that Dr. Nath had been fired, was unqualified and lacked professional ethics and integrity.

To read the court opinion, click here.

Was the Former Employer Responsible for Accumulated Fees?

The Texas high court was considering whether the behavior of Baylor or Texas Children’s was ultimately responsible for the attorney’s fees that had been accrued in the case. Previously, the trial court found that both Texas Children’s and Baylor’s actions had not caused the litigation expenses which Dr. Nath was assessed. 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 and 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 legal challenge, click here.

Despite Dr. Nath’s arguments, the court of appeals disagreed, holding that the trial court followed the Supreme Court’s instructions in 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 legal 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.

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 physicians, pharmacists, dentists, nurses, medical groups, health facilities, nurses and other health providers in complex litigation, 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 physicians, complex health care litigation attorney, business litigation lawyer, health care professionals legal representation, physician lawyer, 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, legal fees expert witness, attorney’s fees and sanctions expert witness, health care litigation expert witness, health law expert witness
“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 © 2016 The Health Law Firm. All rights reserved.