Real Risks of Caregivers on Continuing Care Community Property

by admin on February 15, 2022 No comments

Providing a high-quality and safe environment and care for vulnerable seniors is a top priority for continuing care communities (CCCs).  Senior communities that provide a full continuum for seniors aging in place (including independent living, assisted living, skilled nursing, and memory care) often focus their safety concerns and resources on the licensed areas of the community, where falls and skin breakdown are the subject of lawsuits.  Sometimes overlooked are the risks that arise when independent living residents bring their own personal caregivers into the community to support their needs.

Growing Use of Personal Caregivers

More and more seniors are finding safety and security in CCCs throughout the country.  And, as they age in place, maintaining that independence often involves the use of personal caregivers who come into the CCCs and create additional risks.  Each time a personal caregiver is allowed admittance to the CCC, real risk is created- and that risk can lead to legal liability, including:

  • Injury to other residents
  • Injury to the resident that hired the caregiver
  • Injury to the caregiver caused by other residents
  • Slip, trip and fall (or other general liability claims) by the caregiver against the CCC
  • Theft/damage to property

But there are a few basic steps that a CCC can do to reduce those risks, while still allowing residents their independence.  Here are some simple considerations:

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Types of Intentional Torts

by admin on February 15, 2022 No comments

In the state of Florida, intentional tort charges can mean some pretty hefty consequences.

From jail time and fines to expensive court dates and long probationary periods, the consequences of successful prosecution of intentional torts can be devastating.

Even though intentional tort charges are serious, there are some important things to know when mounting a case, especially if the intent of the individual charged was not to inflict harm.

What Are Intentional Torts?

An intentional tort refers to an action that a person makes intentionally that results in harm to someone else.

It’s important to note that the person may not have intended to cause harm, but if they willfully made a choice to do something that ultimately hurt someone in some way, they can be charged with an intentional tort.

This means that negligence on the job or even a prank can turn into a criminal charge if it means that someone is hurt as a result of that intentional choice.

What Are the Intentional Torts Recognized by Florida?

Every state is different when it comes to defining intentional tort according to law. Most include variations of the same six to eight actions. In Florida, the intentional torts recognized by the courts include the following:

  • Battery
  • Purposeful infliction of emotional distress
  • Assault
  • False imprisonment
  • Trespass on land
  • Interference with someone’s personal property (called trespass to chattels and conversion)

What Are Intentional Tort Elements?

Just like the definition of intentional tort, the elements required by any court in order to prove an intentional tort may vary according to the type of court and the situation.

In most cases, the elements a plaintiff must prove will include:

  • That the person did indeed complete the action that caused harm.
  • The intent behind the action.
  • The motivation or cause for the choice to engage in the action or that recklessness was at play.
  • The harm caused by that action.

Help With Intentional Tort Charges

A healthcare business or healthcare professional may be the target of an intentional tort investigation, and if that is the case, Florida State Healthcare Law Firm can help.

Call now for more information about available assistance.

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Controlling Controlled Substances Risks

by admin on February 10, 2022 No comments

As a pharmacy, it is part of the job to stock and dispense controlled substances.  But with all of the headlines about misuse of opioids and DEA raids, pharmacists are concerned about the risks of having controlled substances on hand and confused about when to refuse to fill a prescription.

But there are a few simple steps pharmacies and pharmacists can take to control their risks.  Doing so should help pharmacists feel more at ease in handling CS inventory and evaluating CS prescriptions.

Effective Controls on CS Inventory

Ordering and accounting for controlled substances can be a challenge.  But many risks can be controlled by having well-written policies and procedures that are strictly followed, as well as assuring adequate security and periodic inventory/audits.

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What Is Healthcare Open Enrollment?

by admin on February 7, 2022 No comments

Enrollment periods for healthcare are exactly what they sound like — they are the only time of year when it is possible to sign up for health insurance coverage.

It is important to find out the dates of the enrollment period for health insurance at work or through the federal government in order to not miss the opportunity to get affordable healthcare.

What Is Healthcare Open Enrollment?

Healthcare open enrollment is the term describing the period of time when it is possible to sign up for health coverage.

Most of the year, enrollment is closed unless there is a major life change, such as getting married, having a baby, or starting or ending a job.

For those who get health insurance through their employer, the open enrollment period will vary. Some companies only open health insurance enrollment during the same period each year. Others make health insurance available after a certain period of employment.

Is the Healthcare Open Enrollment Period Different for Medicaid?

It is possible to apply for and get coverage under Medicaid or under the Children’s Health Insurance Program (CHIP) at any time. There is no closed period of enrollment to ensure that those who are the most vulnerable always have access to healthcare.

When Is Open Enrollment?

Open enrollment for health insurance usually occurs between November 1st and January 15th of the following year.

However, some states that have their own insurance exchanges may have different start or end dates, usually starting a bit earlier than November 1st and/or ending a bit later than January 15th the following year.

Florida does not have a state specific exchange and offers open enrollment for federal healthcare options between November 1st and January 15th.

When Does Coverage Begin After Open Enrollment?

In most cases, health coverage will begin on the first day of the month following enrollment. So, if someone were to sign up on November 2nd, their coverage would begin on December 1.

If you have questions about healthcare coverage in Florida, contact us at Florida Healthcare Law Firm today.

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What Is Mobile IV Therapy?

by admin on February 3, 2022 No comments

Mobile IV therapy connects patients with highly valuable intravenous drop therapies in their homes, eliminating the often difficult — and sometimes impossible — trip to the hospital for treatment.

Traditionally, IV therapy has been supported only in hospital or clinic settings, limiting accessibility for patients who could greatly benefit from the therapy.

Thankfully, IV mobile therapy is increasingly more common as patients seek out the ability to get the care they need at home.

What Is Mobile IV Therapy?

IV mobile therapy provides the benefits of an intravenous drip infusion in the privacy and comfort of the patient’s home.

Just as a patient would receive in the hospital, the IV is set up to deliver fluids directly into the bloodstream.

Everything from hydration treatments to vitamin and nutrient delivery can be delivered via mobile IV therapy, helping patients to get lifesaving treatment as well as treatments designed to improve overall health and wellness.

What Is Advanced Mobile IV Therapy?

Advanced mobile IV therapy may go beyond the basics of hydration and vitamin/nutrient infusions, providing more intensive treatments delivered by IV to the home setting.

For example, chemotherapy or blood transfusions may be classified as advanced mobile IV therapy treatments since they will typically require a certified medical provider to deliver these specific treatments.

How Do I Start a Mobile IV Therapy Business?

Starting a mobile IV therapy business as a standalone or as an add-on to a current home care business is a very simple process once you have the right paperwork, credentials, and tools in hand to make sure the business is in compliance with local, state, and federal regulations.

Legal Help for Mobile IV Therapy Businesses

If you would like assistance setting up a mobile IV therapy business or adding this level of care to a current home care business, contact Florida Healthcare Law Firm today. We can help you streamline the process so your business is up and running in no time.

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Pharmacy Enforcement Remains Top Priority

by admin on January 31, 2022 No comments

Today’s Topic:  Did you know that pharmacies and pharmacists continue to be a top enforcement priority for the U.S. Department of Justice and the myriad health care fraud task forces around the country?

Recent Sentencing in Compounding Pharmacy Fraud Case

This past week, a Mississippi pharmacist was sentenced to 5 years in prison for defrauding TRICARE (the government healthcare payer for the U.S. military and veterans) and some private insurance companies of $180 million through various kickback schemes.  These schemes might sound familiar because they all take on common characteristics- essentially payments to someone in exchange for referral of prescriptions to boost the pharmacy’s numbers.  And, more often than not, these prescriptions are medically unnecessary and driven by the greed of the people involved instead of the best interests of the patients.

This particular case became known as the “Mississippi Pain Cream Scheme” and led to three individuals who pled guilty, were sentenced to jail time and lost virtually everything. This past week’s announcement involved the sentencing of David “Jason” Rutledge, a pharmacist and co-owner of several compounding pharmacies.  Two others pled guilty earlier, including a Louisiana veteran, Tommy Shoemaker, who in December was ordered to pay $1.7 million in restitution and forfeit proceeds from the sale of his luxury vehicles.  And the Florida connection- Mitchell “Chad” Barrett of Gulf Breeze, was the mastermind behind this scheme as well as a larger national scheme that resulted in more than $1.5 BILLION in fraud nationwide!  It’s no wonder the government is on the hunt.

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Can Florida Dental Board Execute Disciplinary Actions?

by admin on January 24, 2022 No comments

Gross negligence, incompetence, unprofessional conduct, and repeated incidences of any or all of these may give the Florida Board of Dentistry cause to levy disciplinary action against a dentist, dental hygienist, or dental provider in the state of Florida.

Fraud, licensure issues, and other problems may also be the source of a disciplinary action brought by the Florida Board of Dentistry.

What Does the Florida State Dental Board Do?

The Florida Board of Dentistry helps dentists, dental hygienists, and dental labs to secure licensing in the state of Florida as well as supply them with the information they need to remain in compliance year after year.

For dental professionals, there is an online resource available to assist with the process, making it easy to stay current with regulatory changes, renew licensing, and keep up with other dental information as needed.

Dental board of Florida license verification is an especially important duty, providing all dental professionals across the state with easy access to the tools they need to make sure they are always up-to-date.

Dental Board of Florida Complaints and Disciplinary Actions

Florida dental board disciplinary actions may be the result of an investigation into a complaint made by a patient or other entity claiming negligence, fraud, or civil rights violation.

When complaints are filed with the Dental Board of Florida, an investigation usually follows. If the board finds that the complaints are valid, a citation or other disciplinary action may ensue.

However, the filing of a complaint or an investigation by the Florida Board of Dentistry does not guarantee that disciplinary action will result.

Whether the complaint is filed against you as a dental professional or against your clinic or agency, you may have recourse to respond and rectify the situation without disciplinary action. If that is available to you, you should take it.

Recourse Against Florida Board of Dentistry Disciplinary Action

Depending on the nature of the complaint, there will almost always be a path to respond within a certain timeframe. Your response could clarify the situation enough that the investigation is closed right there. In some cases, however, more clarification may be requested or the investigation may be elevated.

Knowing how and when to respond to disciplinary action and complaints can be the key to simplifying the process, saving you time and money.

Get Help With the Florida Board of Dentistry

If you believe that you have been the victim of a fraudulent complaint or if you are unsure how to protect yourself or your dental business going forward, contact Florida Healthcare Law Firm today to set up a consultation.

We can assist you with navigating the legal paperwork, manage meditation and court appearances, and help you to upgrade your processes in the workplace so you can get back to doing what you do best.

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What Is AHCA in Florida?

by admin on January 20, 2022 No comments

The Agency for Health Care Administration (AHCA) in Florida was created by Chapter 20 of the Florida Statutes and serves as the primary health policy and planning institution for all of Florida.

Florida’s Medicaid program is worth $25.2 billion. The more than 4 million Floridians served by that program and the licensure of the almost 50,000 health care facilities in Florida all fall under the jurisdiction of the AHCA in Florida.

What Does the AHCA Do in Florida?

Essentially, the AHCA regulates and coordinates the Medicaid system and the healthcare providers that offer medical services through that program to Floridians, so there is sharing of healthcare data and resources across the state through the Florida Center for Health Information and Policy Analysis.

As much as the AHCA is a regulatory agency in Florida, they have ongoing goals to get more Floridians the health insurance they need, identify and eliminate fraudulent providers that are raising costs for everyone, and cut back on regulations that aren’t valuable or productive.

What Are Florida AHCA Regulations?

It may be easier to list what Florida AHCA does NOT regulate rather than all it does, but here are just a few of the primary things that ACHA regulates:

  • Fraud and abuse of billing and services
  • Licensure of healthcare professionals, healthcare clinics and other facilities, including hospitals and long-term care programs
  • Quality of care and civil rights complaints in all healthcare facilities
  • Compilations of healthcare data
  • Background screenings for those who work as administrators or employees in nursing homes
  • Health plan enrollment, rates, contracts, and related information

What Do I Need to Be in Compliance With ACHA in Florida?

Every healthcare provider and facility will have a different list of regulations, licensure, and other compliance tools to address with the ACHA. Contact us at the Florida Healthcare Law Firm to set up an appointment. We can help you discover what you and your business need to remain compliant.

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Healthcare Fraud Scheme Indictment Starts the New Year

by admin on January 14, 2022 No comments

The U.S. Attorney arrested 13 people in a $100 Million healthcare fraud scheme in NY and NJ involving automobile insurance claims.  Some of the facts alleged include—

  • Bribed 911 operators and hospital employees for confidential information of insured drivers
  • Unnecessary and painful medical procedures
  • A non-physician owning medical clinics
  • Paying hundreds of thousand of dollars to “runners” who used the money to bribe people

Healthcare businesses that largely serve people injured in motor vehicle accidents remain a top tier focus for law enforcement and special investigative units (SIUs) of insurers.  But so do many other providers in the healthcare sector, such as pharmacies, durable medical equipment (DME) providers, addiction treatment providers and labs.  Payer and governmental presumption is often that financial motives are driving clinical behavior, NOT documented medical necessity.  Hence the need for active compliance plans and policies and procedures that don’t sit on a shelf, but rather are woven into daily business and clinical operations.  Nothing less than the right contracts, the right compliance plan and the right business culture will establish and maintain a sustainable healthcare business!

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What Is the Anti-Kickback Statute?

by admin on January 10, 2022 No comments

Gifts from another healthcare business or professional may seem harmless enough. They may actually be nothing more than a gesture that says, “Thank you for your time,” or “Thank you for recommending me.”

But the federal government may not agree that these gifts are harmless if you are in the healthcare industry and the gift is a thank you for a referral for a patient who paid for care or services with Medicare or Medicaid.

Anti-fraud laws come with stiff penalties. Getting to know them can help you to protect yourself and your business from inadvertently triggering investigations, fines, and/or prison time.

What Is the Anti-Kickback Statute?

The Anti-Kickback Statute, or AKS, is a criminal statute designed to stop medical professionals from encouraging Medicaid or Medicare patients to enroll in medical treatment or take drugs that may not be medically necessary in return for a “kickback” or remuneration of any kind, be it in cash, supplies, or services.

In some industries, receiving an affiliate fee or otherwise getting paid for referrals is standard practice and perfectly above board, but when it comes to the federal health care program, any payment for referrals is a criminal act.

Is the Anti-Kickback Statute Impacting Your Business?

If you, your business, or a colleague within your clinic is being investigated for potentially violating the Anti-Kickback Statute, contact Florida Healthcare Law Firm.

We can assist you in navigating the investigation process and help with any legal issues that arise as a result, including meetings with mediators and court dates. We can also help you adjust your best practices for handling referrals for your Medicare and Medicaid patients, so there is no future risk to your business or your career due to the Anti-Kickback Statute.

Call Florida Healthcare Law Firm now to set up your consultation.

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