Two Central Florida CVS Pharmacies get Controlled Substance Licenses Revoked

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
The U.S. Drug Enforcement Administration (DEA) revoked the registrations (controlled substance licenses) from two CVS pharmacies in Sanford, Florida, on September 12, 2012, according to a number of sources. The two pharmacies will no longer be able to fill prescriptions for drugs such as oxycodone, Dilaudid, Vicodin, Ritalin and Xanax. This decision is in response to a government crackdown on the distribution of painkillers. Sanford is in Seminole County, a suburb of the greater Orlando area.
To see the court records from this case, click here.
We've been following this story and previously blogged on this topic in our blogs on February 10, 2012, February 29, 2012, and March 7, 2012.
Pharmacies Allegedly Filled Prescriptions for a Large Number Painkillers.
According to an article from Reuters, the DEA believed the stores, located on Orlando Drive and West First Street, in Sanford, were allegedly filling an inappropriate number of prescriptions for oxycodone and had a suspicious number of sales of other controlled substances.
In the same article, CVS argued that the large number of oxycodone and other prescription painkillers from the two stores is due to that fact that the two locations are busy stores, with one store open 24 hours a day. The DEA apparently did not accept this justification.
Click here to read the entire article from Reuters.

Previous DEA Raided At Same CVS Pharmacies Back in February 2012.

Back in February of 2012, the DEA raided the same two Sanford CVS pharmacies. The DEA called the pharmacies an “imminent danger” to the public and filed immediate suspension orders against both stores. I previously wrote a blog about the emergency suspension order and the subsequent request from CVS for a restraining order against the DEA. Click here to read the blog.

DEA Battles War on Prescription Drugs.
In a press release, a special agent in charge of the DEA’s Miami Division said the final order reflects “the continued commitment of the DEA to identify and bring to light the diversion of controlled substance pharmaceutical drugs.”
To see the entire press release from the DEA, click here.
According to the Orlando Sentinel, the major newspaper in Orange County and Seminole County, this measure is thought to be the first of its kind against a national retail pharmacy chain.
In my personal opinion, if the large retail giants can’t survive such an attack, the small independent pharmacies stand little chance.
Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.
The Health Law Firm represents pharmacists and pharmacies in DEA investigations, regulatory matters, licensing issues, litigation, administrative hearings, inspections and audits. The firm's 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:
Reuters. “U.S. Revoking 2 CVS Stores' Controlled Substance Licenses” Thomson Reuter. (September 12, 2012). From: http://www.reuters.com/article/2012/09/12/us-usa-drugstores-cvs-idUSBRE88B0KN20120912
Pavuk, Amy. “Two Sanford CVS Pharmacies Banned from Selling Oxycodone, Other Controlled Substances.” Orlando Sentinel. (September 12, 2012). From: http://articles.orlandosentinel.com/2012-09-12/news/os-sanford-cvs-caremark-revoke-drugs-20120912_1_revokes-prescription-drug-abuse-oxycodone-and-other-prescription
Holiday CVS, L.L.C., v. Eric H. Holder, JR., et al., No. 12-5072 United States Court of Appeals for the District of Columbia Circuit. (September 11, 2012), available at http://www.thehealthlawfirm.com/uploads/CVS%20License%20Revoked.pdf.

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

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

The Aftermath of Having Your Massage Therapy License Revoke (Or Relinquishing it After a Notice of an Investigation)

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

Many massage therapists, when confronted with an investigation against their license, do not fight the charges, sometimes they decide it is cheaper and easier just to give up their license.  Either choice is likely to be a mistake.
A charge can be filed causing an investigation to be opened against a massage therapist by many different sources and often without any supporting evidence.  If challenged and defended by an attorney with knowledge and experience in such matters, these investigations may often be dismissed with no disciplinary action against the massage therapists’ license.It is Common for Massage Therapists to Go on to Obtain Licenses in Other Health Specialties.
A massage therapist often has to spend tens of thousands of dollars on school tuition and sacrifice a year or more of their lives to meet the basic criteria for licensing.  In many cases this is merely a stepping stone for a later degree and license in another healthcare specialty, such as physical therapy, nursing, acupuncture, or chiropractic medicine. Protect Your Greatest Assets: Your Professional Reputation and Your Personal Reputation.
One of the maxims that the Romans took as truth was:  "A good reputation is more valuable than money," (attributed to Publilius Syrus approximately 100 B.C.).  Socrates wrote in approximately 400 B.C.:  "Regard your good name as the richest jewel you can possibly be possessed of."
However, despite the fact that you may have worked hard, sacrificed and paid a fortune for an education and training in massage therapy, many are willing to sacrifice their personal reputation rather than paying a few thousand dollars to fight unjust charges against them.  What they do not realize is the permanent black mark that will be placed on their record and the long term devastating consequences of any such action.


When Confronted with Charges Most Massage Therapists Do Not Defend Themselves.
It is my opinion, based on what I have seen at Florida Board of Massage Therapy meetings and reviewing Florida Board of Massage Therapy meeting minutes, very few massage therapists, when confronted with an investigation or charges, hire an attorney to defend them.  This may be because they do not have the financial resources or because they underestimate the harm that will be caused to their personal or professional reputations.
Regardless, in my personal opinion and experience:

1.  Few massage therapists return their election of rights (EOR) forms on time and therefore, a default is entered against them.
2.  Few massage therapists return their election of rights (EOR) forms to state they are contesting the facts and desire a formal hearing to contest the charges against them.
3.  Few massage therapists even bother to show up at informal hearings involving their licenses.
4.  When they do, they show up at a hearing with a spouse or friend to represent them instead of an experienced attorney familiar with such matters (Q:  If you needed brain surgery, would you have it performed by a spouse or friend instead of an experienced neurosurgeon?)
5.  If they do retain an attorney to advise and represent them, they either go with the cheapest one they can find or go with one who has no experience at all before the Board of Massage Therapy.  (Q:  If you needed brain surgery, would you pay your family practice physician to perform it?)

Your Best Line of Defense:  Purchase Insurance with Professional License Defense Coverage.
Often physicians and others concerned about liability issues ask our advice on asset protection in case they are sued.  We advise them that their best way of protecting their assets is to purchase good insurance that will pay for a legal defense that protects them against unjust law suit.  The same principle applies to massage therapists;  except that massage therapy insurance is much, much cheaper, and the major liability that a massage therapist will face is usually from a complaint against his or her license.
If you purchase massage therapy liability insurance, you must make sure that it covers defense expenses of a complaint filed against your license.  Many such policies do not.  Additionally, you should be sure that it provides at least $25,000 in coverage for such matters.  This should be sufficient to provide adequate coverage in the event a fully contested formal hearing is required to defend you.
We have seen many policies and they are as different as night and day in this coverage.  When purchasing a professional liability policy, always ask about such coverage.  Get the coverage stated in writing.  To date, the only company we have experienced which is providing such coverage for massage therapists, and at an incredibly low price, is Healthcare Providers Service Organization (HPSO).  Compare this with whatever you have now. If you know of others that provide this coverage, I would like to hear from you.
It has been my personal experience that a massage therapist will be 30 or 40 times more likely to need licensure defense coverage as ever to need defense against a civil lawsuit.


Additional Consequences of Discipline on Your Massage Therapy License.
There are many, many additional adverse consequences that you will experience if you receive discipline on (especially revocation of) your massage therapy license.  First and foremost, this is on your record forever;  it never comes off and cannot be expunged.  Additionally, it will be reported to the National Practitioner Data Bank (NPDB) and available anywhere you go in the future in any state, to any licensing board.  There are many others. I will detail these in a future blog.

Voluntary Relinquishment after Investigation Has Started Treated as Revocation, the "Death Sentence."
Many massage therapists believe that the easy and cheap way out if a complaint is filed and an investigation is opened is to resign their license.  This is treated the same as a disciplinary revocation and is reported that way.  You should never expect to work in health care again or to have a health professional license in any other health specialty or in any other state.
Remember: The State Has to Prove the Allegations Against You;  You Don't Have to Prove Anything.
If the state brings charges against your massage therapy license, the burden of proof is on the state, just as in a criminal investigation.  You do not have to prove anything, and in most cases, you should never make any statement to an investigator or attorney representing the state department of health;  these can only be used against you to prove the state's case against you.
You can remain silent, not say anything and not produce any evidence, and the state may not have enough witnesses or evidence to ever prove a case against you.
Most massage therapists, their non-lawyer representatives and their inexperienced lawyer representatives make a very big mistake.  They advise the massage therapist to be interviewed or to make a statement "explaining themselves."  There is no criminal defense attorney worth his or her salt that would ever advise a criminal defendant to do this.  Why then must they take leave of their senses and advise a health professional to do this in a "quasi-criminal" or "quasi-penal" investigation?  This is almost always very bad advice.
Then, request a formal hearing and contest the facts. Don’t admit to them!
This is The Time to Defend Your Reputation and Your License.
In conclusion, take precautions and defend your professional livelihood, your professional reputation and  your professional license.
This is Florida.  We have hurricanes.  If you have a house you own, you purchase insurance on it to protect yourself in the event of a hurricane.
Without your license, you will not have an income and you will not be able to even make house payments.  Why wouldn't you purchase professional insurance that would pay for a defense in the event of that worst case scenario, an investigation of your license.  Why wouldn't you defend yourself to the max if this happened?  This will probably feel worse to you and have worse long-term implications to you financially than any hurricane.
Stay tuned to this blog for more.


Don't Wait Until It’s Too Late;  Consult with an Experienced Health Law Attorney Early.
Do not wait until action has been taken against you to consult with an experienced attorney in these matters.  Few cases are won on appeal.  It is much easier to win your case when there is proper time to prepare and you have requested a formal hearing so that you may actually dispute the facts being alleged against you.
The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing massage therapists in investigations and at Florida Board of Massage Therapy hearings.  Call now or visit our website www.TheHealthLawFirm.com.

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

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

 

Florida Suspends the Licenses of More Than 80 Massage Therapists

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

According to a number of sources, state authorities have announced the suspension of more than 80 massage therapists’ licenses, who appear to have fraudulently obtained their licenses with the help of a Florida massage school employee. On September 19, 2012, 81 emergency suspension orders (ESOs) were signed, suspending the licenses of massage therapists who are part of ongoing investigations.

To see the entire press release from the Florida governor’s office, click here.

Investigation Found More Than 200 Therapists Obtained Their Licenses Fraudulently.
According to the Tampa Bay Times, earlier this year the Florida Department of Health (DOH), Clearwater Human Trafficking Task Force and the South Florida Human Trafficking Task Force began an investigation into several massage therapy businesses. The investigation turned up more than 200 massage therapists who appeared to have obtained their massage therapy licenses by fraud.

Florida Massage School Employee Helped Obtain the Fraudulent Licenses.
It is believed the 200 people did not enroll in massage therapy school, but received transcripts showing they completed training. The Tampa Bay Times article states that these people allegedly paid between $10,000 and $15,000 to an individual who worked at a Florida massage school in exchange for transcripts.

The transcripts were then used to get massage licenses from the DOH.

The governor has now ordered a seven-day review of massage schools to ensure they are complying with licensure requirements and regulations. Authorities believe more suspensions will likely be issued.

Massage Therapist Suspensions Thought to Be Tied to Human Trafficking.
According to the Tampa Bay Times, in a news conference authorities said the emergency suspension orders were, in part, an effort to target Florida’s human trafficking problem. Authorities said massage parlors are a typical place for finding victims of human trafficking.

Authorities also said they do not know if these 81 fake massage therapists are victims of human trafficking. It is clear, however, they are not operating legally.

Click here to read the entire article from the Tampa Bay Times.

Reference Articles for Licensed Massage Therapists.
On our website we provide helpful information for licensed massage therapists. To read about the consequences of having your massage therapy license revoked (or relinquishing it after a notice of an investigation), click here. To see the 25 biggest mistakes made by massage therapists after being notified of a DOH complaint, click here. You can also click here to read our advice for preparing for an informal hearing before the Florida Board of Massage Therapy.

Routine Legal Advice Given to Massage Therapists.
We routinely advise massage therapists and all other licensed health professionals with whom we have a legal consultation:

1.  Do NOT speak with any Department of Health (DOH) investigator until you have talked to an experienced health law attorney.
2.  Do not make any written statement or respond to any letters from the DOH until you have talked to an experienced health attorney.
3. Read everything you receive and be sure to file election of rights (EOR) statements by the deadline, but only after consulting with an experienced health lawyer.
4. You should not attempt to defend yourself without an attorney.
5. Attempting to talk your way out of the situation or explain your side of it will only hurt you.
6. Many types of massage therapist insurance will actually pay for an attorney to defend you in this type of situation.

Contact Health Law Attorneys Experienced with Department of Health Investigations of Massage Therapists.
The attorneys of The Health Law Firm provide legal representation to massage therapists in Department of Health (DOH) investigations and other types of investigations of health professionals and providers.
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:
Department of Health. “Governor Rick Scott Joins Law Enforcement and Anti-Human Trafficking Groups to Suspend Licenses of 81 Massage Therapists.” DOH News Room. (September 19, 2012). From: http://newsroom.doh.state.fl.us/wp-content/uploads/newsroom/2011/08/91912-EOGMassage-Therapy-Licenses.pdf
Velde, Jessica. “Florida Suspends 81 Massage Therapists' Licenses.” Tampa Bay Times. (September 19, 2012). From: http://www.tampabay.com/news/publicsafety/florida-suspends-81-massage-therapists-licenses/1252355#
Turner, Jim. “Florida Suspends 81 Massage Therapists in Human Trafficking Probe.” Sunshine State News. (September 19, 2012). From: http://www.sunshinestatenews.com/blog/florida-suspends-81-massage-therapists-human-trafficking-probe

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

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Pharmacists: Please, Talk to a Lawyer Before You Talk to an Investigator

By Christopher E. Brown, J.D.
You DO NOT Have to Speak to an Investigator, in Florida!

Despite mailing out hundreds of thousands of postcards and letters to pharmacists, throughout Florida, we continue to receive calls from new clients and from potential clients, after they have already spoken to and made critical harmful admissions against their own interests to investigators. In Florida, you do not have any duty to cooperate with any investigator who is investigating you. This extends to Department of Health (DOH) investigators (who are sometimes titled "Medical Quality Assurance Investigators" or "Medical Malpractice Investigators"), Drug Enforcement Administration (DEA) special agents, police officers, sheriff's deputies, or criminal investigators of any type.

Investigators are NOT on Your Side.

Let me state this as succinctly and clearly as possible. If you are being investigated, you will not be better off making a statement. You will not be better off explaining your side of the story. The investigator is not your friend. The investigator is not on your side. All you are doing is falling for a trick and helping the government to make a case against you.

Protect  Yourself, Your License and Your Reputation.

You have a right under the U.S. Constitution to not make any statement that may be used against you. This is so important that in criminal cases government investigators are required to advise you of this by reciting to you your Miranda rights.

However, in cases where you might have your pharmacy license revoked or have your DEA number revoked, the investigator is not required to advise you of your rights.

In a criminal case, there may be ways to have your statement thrown out. However, in a professional licensing case or other administrative case, it may be too late to avoid the damage. You may be the best witness the government has, and you may be the only witness the government needs to prove this case against you.

In the case where you could receive a $100 criminal fine, the investigators are required to read you your constitutional Miranda rights and to be sure that you understand them before you make a statement. However, in a case where you can lose your professional license, where you could lose your livelihood and ability to make a living, where you could lose everything you have worked so hard to obtain, they are not required to do this. You must protect yourself.

Many pharmacists, when confronted by an investigator, who will usually call at a very inconvenient time (to catch you by surprise) and will usually flash a badge (to intimidate you), will refuse to acknowledge the seriousness of the matter and will fall for the bait to "tell their side of the story." This can be fatal to your defense and fatal to your license.

Do NOT Admit to Anything; What You Say May Ruin Your Defense.

In the absence of a statement by the suspect (in this case, let's assume this is YOU), the government may have a very difficult time of proving that you have committed any offense. It may have other witnesses (who may not be around at the time of any hearing or trial). It may have a lot of physical evidence or documents. But it may be impossible for the government investigators to make any link between you and the evidence, unless you help the investigators do this. You would be surprised at how many pharmacists believe that they can just talk their way out of the situation; in reality, they are just giving evidence that is used to make the case against them.

Any evidence at all, just admitting that you were there, admitting that the documents are yours, admitting that the patient was yours, admitting that you worked at the pharmacy, admitting that filled the prescription, admitting that the property is yours, admitting that you were on duty at the time, admitting that you have taken a drug, admitting that you signed the form, can be a crucial piece of evidence that could not otherwise be proven without your own testimony.

Remember, this is the investigators' job and profession. This is what they do full time, every day. And they are very good at it. They are 1,000 times better at getting you to admit the crucial elements of a disciplinary infraction than you are in "talking your way out of it." They will not be convinced by any excuses you make. They do not have to be. They will not be the ones making the final decision against you. Theirs is the job of putting together the case against you. You will help them by talking to them, explaining why your decisions are correct, explaining why what you did is excusable, etc. It will not work. You will merely be giving them enough rope to hang you with.

How to Determin the Purpose of the Investigation.

Hint: If it is a Medicaid Fraud Control Unit (MFCU) special agent (investigator), you are probably under investigation for Medicaid fraud.

Hint: If it is an "auditor," "surveyor" or "investigator" from an agency or company with "integrity" or "program integrity" in its name, they are probably investigating you for "lack of integrity," i.e., false claims or fraud.

Hint: If it is a Drug Enforcement Administration (DEA) special agent (investigator) they are probably investigating you to prosecute you or to revoke your DEA registration for drug or prescribing violations.

Hint: If it is an Office of the Inspector General (OIG) special agent (investigator), you are probably under investigation for Medicare fraud or Medicare false claims.

You Cannot Outsmart the Investigator; Do Not Try to Talk Your Way Out.

Do not believe for a second that you are smarter than the investigator. Do not believe for a second that you will convince the investigator (or anyone else) that there is a legal or medical justification for what you did or what they allege. If it were as simple as that, then why would there be an investigation and why would you be the one being investigated?

Additionally, do not believe for a second that you can lie your way out of it, either. Remember, if the government cannot prove the basic offense that it is investigating against you, it may be able to prove that you have committed perjury or lied to an investigator. In the case of a federal official or a federal investigation, merely making a false statement (oral or written) to an investigator is a criminal act. This is what Martha Stewart and many others have served time for in federal prisons.

These investigators are lied to all the time. They are usually better at detecting lies than a polygraph expert is. Furthermore, in most cases, you will be the very last person to be interviewed. Therefore, they will already know just about everything that can be used against you. If your statement contradicts in any way what others have told them, they will know you are the one who is lying. However, knowing something or suspecting something does not mean it will be something that can be proven in court or in an administrative hearing.

Consult an Attorney First, Before You Do or Say ANYTHING.

It is much better to make no statement at all. Blame it on your attorney. Tell the investigator that your attorney will kill you if you were to talk to the investigator without your attorney being there ahead of time. "Speak to my attorney." "My attorney can help you, I can't."

All you have to do is state "I must talk to my lawyer before I say anything." "I will have my lawyer contact you." "I cannot say anything until I talk to my lawyer." "I want a lawyer."

If you are not the one being investigated, then there is no good reason why the investigator would want you to make a statement before you consulted with your attorney. What is the rush?

Then you must also avoid the old trick of the investigator telling you "If you don't have anything to hide, why would you need a lawyer?" Please don't fall for this trick, either. This is America. Smart people and rich people spend a lot of money on attorneys and other professionals to represent them and advise them. There is a good reason why they do this.

Far too often the pharmacist only calls us after he has given a statement. This is usually too late to avoid much of the damage that will have been be caused.

Everything above applies to oral statements or written statements. Do not make either. Contact a lawyer as soon as possible, preferably before making any statement, no matter how simple, defensive, self-serving or innocuous you may think it to be.

Think of this as an intelligence test. Are you smart enough to follow this guidance and avoid this type of mistake?

Contact Health Law Attorneys Experienced with Investigations of Pharmacists.

The attorneys of The Health Law Firm provide legal representation to pharmacists 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 (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: Christopher E. Brown, J.D. 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Tag Words: Department of Health, DOH, investigation, quality assurance, Medicare investigation, Medicaid investigation, DEA, DEA investigation, FBI, criminal charges, physician, DEA number, license revoked, D.O., pharmacist, pharmacy investigation, pharmacist investigation

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Registered Nurse Arrested for Neglecting Elderly Patient

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

An investigation led by the Attorney General’s Medicaid Fraud Control Unit (MFCU) ended with an arrest of a north Florida registered nurse (RN), in Suwannee County. The arrest was based on allegations of failing to assess and monitor a 94-year-old patient’s condition. The patient fell and broke her hip and shoulder, and later died.
Click here to see the full press release from the Attorney General’s (AG) Office.

RN Faces Jail Time and Fine for Neglect and Falsifying Hospital Records.
According to the investigation, the RN allegedly failed to care for and monitor the condition of a 94-year-old woman. The RN is accused of falsifying hospital medical records to conceal her failure to provide proper nursing care to the victim.

The RN turned herself in to the Suwannee County Sheriff’s Office. The nurse faces up to five years and two months in prison and a $5,500 fine, according to the AG’s Office.
The AG’s press release states that this case will be prosecuted by the State Attorney’s Office for the Third Judicial Circuit of Florida.

Tips for Responding to a MFCU Investigation.
The MFCU is in charge of investigating and prosecuting health care providers suspected of defrauding the state's Medicaid program. When the unit opens a case against a provider, the first step is usually the issuance of an investigative subpoena, requesting specific patient records.
I previously wrote a blog with tips on how to properly respond to such a subpoena and how to be prepared to defend oneself. Click here to read that blog.

Contact Health Law Attorneys Experienced in Representing Nurses and Registered Nurses (RNs).
The Health Law Firm's attorneys routinely represent nurses and registered nurses (RNs) in MFCU investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:
Gainesville.com. “Nurse Arrested, Charged with Neglecting Elderly Patient Who Died.” The Gainesville Sun. (June 13, 2012). From: http://www.gainesville.com/article/20120613/articles/120619840
Meale, Jenn. “Attorney General Bondi Announces Arrest of Registered Nurse for Neglecting an Elderly, Disabled Adult.” Florida Office of the Attorney General. (June 13, 2012). From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/358A1FC528F9A06D85257A1C00729C63

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

 

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Palm Beach Speech Pathologist Arrested for Alleged Medicaid Fraud

By Dr. Thu Pham, O.D., Law Clerk, The Health Law Firm

A Palm Beach, Florida, speech pathologist has allegedly been charged with Medicaid fraud and grand theft by the Attorney General’s (AG) Office of Statewide Prosecution. According to the press release posted on June 29, 2012, from the AG’s office, the speech pathologists is accused of attempting to defraud Medicaid out of more than $459,000.


To read the entire press release from the Florida Attorney General, click here.

Speech Therapy was Performed by Unsupervised Assistants.
The speech pathologist allegedly allowed her assistants to perform unsupervised speech therapy to Medicaid recipients, many of whom were children.  She then proceeded to bill Medicaid for their services, which was against Medicaid rules. 

Charges for Speech Pathologist Inlcude a Fine and Jail Time.
If convicted, the speech pathologist could face up to $1.5 million dollars in fines and up to 60 years in prison.
This case was investigated by the Attorney General’s Medicaid Fraud Control Unit (MFCU).  Please remember, all persons are considered innocent until proven guilty in a court of law.

To learn more about Medicaid audit defense visit our website by clicking here.

Contact Health Law Attorneys Experienced in Handling Medicaid Audits.
Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Healthcare 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, medical groups, clinics, pharmacies, 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:
My Florida Legal. “Attorney General Pam Bondi Announces Arrest of a Palm Beach Speech Language Pathologist for Medicaid Fraud.” AG. From:
http://www.myfloridalegal.com/newsrel.nsf/newsreleases/E6129E7B45E2590385257A2C006A280C
Turner, Jim. “Attorney General: Speech Language Pathologist Arrested for Medicaid Fraud.” Sunshine State News. (July 2, 2012). From: http://www.sunshinestatenews.com/blog/attorney-general-speech-language-pathologist-arrested-medicaid-fraud

About the Author: Dr. Thu Pham, OD, is a law clerk 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

 

 

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

MedVance Institute Agrees to Retrain Students and Donate Scholarships to Florida

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

MedVance Institute, which is a healthcare training school with four Florida campuses, reached an agreement with the Florida Office of the Attorney General (AG) on June 13, 2012. MedVance was alleged to have made misleading marketing claims to students. Under the agreement, the for-profit college is required to offer retraining to eligible students who attended specific programs between January 1, 2008, and March 31, 2012, at no cost. MedVance also agreed to direct $600,000 to Florida scholarships.

MedVance Institute has campuses in Fort Lauderdale, Miami, Port St. Lucie, and West Palm Beach.

Click here to see the full press release from the AG.

Marketing Campaign Complaints Initiated Investigation.

The AG initiated the investigation due to complaints about alleged misrepresentation in the school’s marketing to potential students relating to the admission process, deadlines for enrollment, and cost of programs.

MedVance Has Agreed to the Following.
According to the agreement between the AG’s office and MedVance, the school has agreed to:

- clearly and conspicuously disclose specific information relating to the school’s accreditation, state licensing requirements, and financial aid;
- not make certain representations;
- modify its arbitration provisions so that students can receive quick resolutions to pending grievances;
- offer retraining to students who attended specific MedVance programs between January 1, 2008, and March 31, 2012, and were unable to find employment despite diligent efforts.

To view the full agreement, click here.

MedVance Offers These Courses.

According to its online materials, MedVance has programs in the following healthcare professions:

 - Cardiovascular Technology
 - Dental Assisting
 - Medical Office Basic X-Ray Technician
 - Medical Billing and Coding Specialist
 - Medical Office Administration
 - Information Technology & Biomedical Technician
 - Medical Assistant/Medical Assisting
 - Medical Laboratory Technology
 - Pharmacy Technician
 - Radiologic Technology
 - Surgical Technology
 - Practical Nursing

Contact a Health Care Attorney that is Experienced in the Representation of Medical Students, Interns, Residents and Applicants.
The Health Law Firm and its attorneys represent medical school students in disputes with their medical schools, internship supervisors, and in dismissal hearings. We have represented residents, interns and fellows in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation and on other matters.
To learn more about our experience in the representation of medical students, click here.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:
Kamph, Stefan and Parker, Chris. “For-Profit Colleges Cheat Students and Get Away With It.” Miami News Times. (August 2, 2012). From: http://www.miaminewtimes.com/2012-08-02/news/for-profit-colleges-cheat-students-and-get-away-with-it/2/
Turner, Jim. “Pam Bondi: MedVance to Offer Retraining, Direct Scholarships to Florida.” Sunshine State News. (June 13, 2012). From: http://www.sunshinestatenews.com/print/4987463
Meale, Jenn. “Attorney General Bondi’s Office Reaches Agreement with MedVance Institute to Retrain Students and Donate $600,000 to Florida Scholarships.” Florida Office of the Attorney General. (June 13, 2012). From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/F3599CFFCC64359A85257A1C006A3B0C

About the Authors: 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.

 

Joanne Kenna, J.D., R.N., 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

 

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Whistleblower lawsuit against Adventist Health System

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

A whistleblower lawsuit based on information from a former Florida Hospital Orlando billing employee and a former staff physician alleges that seven of Adventist’s Florida hospitals overbilled the federal government between 1995 and 2009, resulting in tens of millions of dollars in false or padded medical claims, according to an article in the Orlando Sentinel and other sources.

To read the entire False Claims Act complaint filed, click here.

Alleged Details in the Case Against Adventist Health System.
The suit claims that seven Adventist Florida hospitals allegedly used improper coding to overbill Medicare, Medicaid and Tricare. In addition, the lawsuit alleges the hospitals also overbilled for a drug used in MRI scans and billed for computer analyses that were never performed.

The article states that the plaintiffs are a bill-coding and compliance officer, and a radiologist that were either employed or affiliated with Florida Hospital Orlando between 1995 and 2009. They allege the discrepancies occurred during those years. The lawsuit was filed in July 2010, according to the Orlando Sentinel.

Hospitals that allegedly partook in the overbilling include: Florida Hospital Orlando, Florida Hospital Altamonte, Florida Hospital East Orlando, Florida Hospital Apopka, Florida Hospital Celebration Health, Florida Hospital Kissimmee and Winter Park Memorial Hospital.

The U. S. district court judge has set the trial in this case for December 2013.

Click here to read the Orlando Sentinel article.

Total Exposure Could Exceed $100 Million.
If the health system is found liable for the false claims it would be responsible for repaying the excess money received, for paying civil penalties of $5,500 to $11,000 per false claim, and damages.

Under the False Claims Act, Whistleblowers Can Come Out on Top.
Whistleblowers stand to gain substantial amounts, sometimes as much as thirty percent (30%), of the award under the False Claims Act (31 U.S.C. Sect. 3730). Such awards, often reaching into millions of dollars, encourage employees to come forward and report fraud.

You can learn more on the False Claims Act on the Department of Justice (DOJ) website.

Contact Health Law Attorneys Experienced with Medicaid and Medicare Qui Tam or Whistleblower Cases.

In addition to our other experience in Medicare, Medicaid and Tricare cases, attorneys with The Health Law Firm also represent health care professionals and health facilities in qui tam or whistleblowers 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.

To learn more on our experience with Medicaid and Medicare quit tam or whistleblower cases, visit our website.
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:
Jameson, Marni. “Whistleblower Lawsuit Alleges Florida Hospital Filled Millions in False Claims.” Orlando Sentinel. (August 8, 2012). From: http://articles.orlandosentinel.com/2012-08-08/health/os-whistleblower-lawsuit-florida-hospital-20120808_1_adventist-health-suit-claims-celebration-health/2

Gamble, Molly. “Whistleblower Suit Alleges Florida Adventist Hospitals Overbilled Tens of Millions.” Becker’s Hospitals Review. (August 9, 2012). From: http://www.beckershospitalreview.com/legal-regulatory-issues/whistleblower-suit-alleges-florida-adventist-hospitals-overbilled-tens-of-millions.html

Flagler Live and Kaiser Health News. “Florida Hospital Flagler Spared Sister Hospitals’ Fraud Lawsuit and Medicare Penalties.” Flagler Live. (August 13, 2012). From: http://flaglerlive.com/42723/adventist-lawsuit-medicare/
Amanda Dittman and Charlotte Elenberger, M.D. v. Adventist Health Systems/Sunbelt, Inc. No. 6:10-cv-01062-JA-GJK (July 15, 2010), available at: http://flaglerlive.com/wp-content/uploads/whistleblower-lawsuit-adventist.pdf

Justice.Gov. “The False Claims Act.” Department of Justice. From: http://www.justice.gov/civil/docs_forms/C-FRAUDS_FCA_Primer.pdf

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

 

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Nurses, Do You Know About the Disciplinary Action Database?

By Christopher E. Brown, J.D.
Nurses, did you know the National Council of State Boards of Nursing (NCSBN) maintains a database of all state disciplinary actions?  This database, called Licensure QuickConfirm, lists all disciplinary actions from the Florida Board of Nursing and forty-six (46) other state boards. It is frequently used by hospitals and medical groups to screen potential employees.
To search the Licensure QuickConfirm list, click here.

Information Listed Comes From Boards of Nursing.

According to the website, all information listed on the database comes directly from the boards of nursing. A report will contain:

- the nurse’s name,
- licensed jurisdiction,
- license type
- license number,
- compact status (single state or multistate),
- license original issue date,
- license expiration date,
- discipline against license, and
- discipline against privilege to practice.

Check Database for Accuracy.
If you have recently received discipline from the Florida Board of Nursing, or any other state board of nursing, it would be prudent to immediately check this website to verify that any information listed under your profile is accurate.  The website clearly states that it is the nurse's responsibility to contact the board of nursing to update his or her information.

Our law firm recently encountered errors on this database that our client contended caused him lost employment opportunities.

Contact Health Law Attorneys Experienced in Representing Nurses.
The Health Law Firm's attorneys routinely represent nurses in Department of Health (DOH) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.
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: Christopher E. Brown, J.D., 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

 

 

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

California and Colorado Certified Registered Nurse Anesthetists (CRNAs) are Allowed to Administer Anesthesia Without the Supervision of a Doctor

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Recently, courts in both California and Colorado ruled that Certified Registered Nurse Anesthetists (CRNAs) are now allowed to independently administer anesthesia to patients without the supervision of a physician. In California, the decision came from the First District Court of Appeals on March 15, 2012. In Colorado, an appeals court allowed the same practice on July 19, 2012.
A recent article in American Medical News (AMN) summarizes these cases. To see the entire article, click here.

The Two Cases are Stemmed from Decisions Made by Governors to Opt Out of Requiring CRNAs to be Supervised by Physicians.
According to the AMN article, the California and Colorado cases both stem from a decision made by the sates’ governors to opt out of requiring CRNAs to be supervised by a physician. Ordinarily, in order for hospitals, ambulatory surgical centers, and critical access hospitals to receive Medicare reimbursement under Medicare when a CRNA administers anesthesia, federal regulations require that the CRNA must be supervised by a physician. However, states can opt out if governors consult with the appropriate medical boards and decide that an exemption is in the best interest of the citizens of the state.

The Colorado Medical Society and the Colorado Society of Anesthesiologists Sue.
The Colorado court case states that in 2010, the then-Colorado governor decided to opt out critical access hospitals and 14 rural hospitals in the state. The Colorado Medical Society and the Colorado Society of Anesthesiologists sued contending that the opt out was inconsistent with the state law. The plaintiffs requested the Colorado governor’s decision be blocked by the court.
In 2011, a Colorado district court upheld the exemption. The plaintiffs then appealed.
On July 19, 2012, the Colorado Court of Appeals agreed with the district court’s decision and ruled in favor of independent CRNAs.
Click here to read the entire Colorado Court of Appeals case.

The California Medical Association and the California Society of Anesthesiologists Sue to Block the Opt Out.
In California, in 2009, the state chose to opt out of requiring physician supervision of CRNAs in Medicare-participating hospitals. The California Medical Association and the California Society of Anesthesiologists sued to block the opt out. The trial court concluded that the opt out was consistent with the law and ruled in favor of independent CRNAs.
On March 15, 2012, the First District Court of Appeals agreed with a lower court’s decision to allow the exemption.
To read the full California Court of Appeals case, click here.

No Common Ground Between Doctors and CRNAs on Ruling.
According to the American Medical News article, the regional director of the Colorado Society of Anesthesiologists calls the ruling a safety issue for patients. He believes that by removing a physician’s oversight from the delivery process it diminishes patient care.
Click here to read an opinion article written by a Board Certified Anesthesiologist in Colorado agreeing that unsupervised CRNAs can put patients’ health at risk.
On the other hand, the president of the Colorado Association of Nurse Anesthetist praises the ruling stating, in the article, that research shows no differences in patient morbidity or mortality rates whether or not CRNAs are under a doctor’s supervision.
Click here to read the press release from the American Association of Nurse Anesthetists (AANA).


Major Risks Associated with Being a CRNA.
The administration of anesthesia by a CRNA requires special training and certification. Oversight and availability of an anesthesiologist is required by most organizations. The major risks for CRNAs include the improper placement and maintenance of an airway, failure to recognize significant changes in a patient's condition and the improper use of anesthetics.

To learn more on the liability risks associated with advanced nurses, read our Nursing Law Manual, by clicking here.

Contact Health Law Attorneys Experienced in Representing CRNAs.

The attorneys of The Health Law Firm represent Certified Registered Nurse Anesthetists (CRNA) in most legal matters, whether concerning licensure, investigations, allegations of impairment or substance abuse, clinical privileges, contracts or employment disputes.

Whether your legal problem involves negotiating a contract or litigating payment issues, we have the experience. We routinely represent nurse practitioners and other health providers in defending allegations of impairment, drug abuse and diversion, as well as in peer review, clinical privileges or certification by a professional association. Medicare payment issues, Medicaid payment issues and insurance payment issues are among those we routinely encounter.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:
Gallegos, Alicia. “Court Rules Nurse Anesthetists Don’t Need Physician Supervision.” American Medical News. (August 6, 2012). From: http://www.ama-assn.org/amednews/2012/08/06/prsa0806.htm

Moss, DO, William. “Anesthesia best Left to Experts” Colorado Society of Anesthesiologists. (August 1, 2012). From:
http://csa-online.org/pdfs/Anesthesia_best_left_to_experts.pdf

Shaffer, Scott. “Colorado Appellate Court Uphold Opt Out from Federal Anesthesia Rule.” American Association of Nurse Anesthetists. (July 19, 2012). From: http://www.aana.com/newsandjournal/News/Pages/071912-Colorado-Appellate-Court-Upholds-Opt-Out-from-Federal-Anesthesia-Rule.aspx

Colorado Medical Society v. John Hickenlooper and Colorado Association of Nurse Anesthetist, Colorado Nurse Association and Colorado Hospital Association, No. 11CA1005 COA (July 19, 2012),  available at http://www.courts.state.co.us/Courts/Court_Of_Appeals/Opinion/2012/11CA1005-PD.pdf.

California Society of Anesthesiologists v. California Association of Nurse Anesthetists, No. CPF-10-510191 San Francisco City & County Superior. Ct. (March 15, 2012), available at http://www.courts.ca.gov/opinions/archive/A131049.PDF.

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

 

 

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.