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Healthcare Fraud Scheme Indictment Starts the New Year

January 14th, 2022 by

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!

Statute of Limitations for Medical Malpractice In Florida

December 20th, 2021 by

Medical malpractice is devastating for both patient and the medical professional. There are some statutes in place in Florida that limit how long it is legally an option for a patient to pursue a medical malpractice case.

Timing is important in these situations, as is proof of negligence or error on the part of the medical professional.

Here’s what you need to know.

What Is the Malpractice Statute of Limitations in Florida?

The statute of limitations for a medical malpractice suit is two years from the date that the harm caused by malpractice was discovered or could reasonably be discovered, according to Florida Statute 95.11 (4)(b).

However, there are a few exceptions to this rule. Oftentimes, an injury caused by medical malpractice may not immediately come to light.

If the case involves an adult and was immediately obvious, there is a two-year statute of limitations.

In the event that the patient is an adult, and the injury was not immediately obvious, and also involved fraud or an attempt to conceal the problem by medical staff, the statute is extended two years from the time it is identified but no more than seven years from the incident that caused the harm.

If it is an adult as the patient, the injury was not immediately discoverable, and there was no attempt to conceal the issue by medical professionals, the statute is four years from discovery.

If the patient is a minor, every case is different. There are no hard guidelines in terms of statutes of limitations in Florida.

What Defines Medical Malpractice in Florida?

Not every case in which the outcome is negative will have legal basis for a malpractice suit. If the doctor followed industry standards and made no mistakes when performing a medical service and the outcome is negative, there is no case for malpractice.

Additionally, if a mistake is made during a medical procedure but there is no clear and lasting damage to the patient’s health and well-being as a result, there is no case for malpractice.

In order to be classified as medical malpractice in the state of Florida, there must be a clear professional patient-doctor relationship between the two people, the doctor must fail to do their duty through negligence or error, and there must be demonstrable harm or injury to the patient that is serious in nature.

I Need Assistance With a Medical Malpractice Suit

Florida Healthcare Law Firm is the only boutique law firm in Florida dedicated to helping medical professionals handle any and all legal issues, including the nuances of a medical malpractice suit.

Contact us today to set up a consultation and get the help you need.

What Is the Florida Board of Nursing?

December 17th, 2021 by

The Florida Board of Nursing plays a number of roles in the state of Florida, but all of them have one goal in common: to protect patients from receiving substandard medical care.

For nurses, this can be a positive support system, but it can also mean a lot of unexpected hurdles, paperwork, and stress.

At Florida Healthcare Law Firm, we can help you navigate the system, address issues that may threaten your employment status, and allow you to spend more time focusing on doing your job rather than managing licensure updates or disciplinary requirements.

Here’s what you need to know.

What Does the Florida Board of Nursing Do?

The Florida Board of Nursing does a few things when it comes to ensuring that working nurses are fully qualified to do their jobs. They:

  • Manage the details of licensing and require all Florida nurses to update and maintain their licenses as needed.
  • Monitor nurses who are currently employed in Florida and address any issues that may arise with employers or patients.
  • Discipline nurses as needed if there are measures needed to address wrong action on the job.
  • Educate nurses on what is expected of them on the job and in terms of managing their documentation, ongoing education, and licensure.
  • Rehabilitate nurses who need help getting back to work after disciplinary action.

What Do I Do If I Need a Florida Board of Nursing Re-Examination Application?

If the board of nursing in Florida has determined that you have fallen below the minimum competency level, you may need to apply again for proper licensure, so you can legally be employed as a nurse in the state of Florida.

If you are having difficulties in maintaining licensure and you need help working with the Florida Board of Nursing, we can help.

At the Florida Healthcare Law Firm, we can assist you in determining what documentation and actions are necessary on your part as you work to gain or regain nursing licensure in the state of Florida. We can also assist you in appealing any denials you face.

Contact us today to set up your first consultation.

Telemedicine Pharmacy Fraud Trial Ends in Convictions

December 7th, 2021 by

Telemedicine pharmacy arrangements continue to be of significant interest to fraud enforcement.  A 2018 case in which four individuals and seven companies were indicted ended in a month-long jury trial of one of the individuals, a Florida pharmacy owner.  The federal jury trial in the billion-dollar telehealth pharmacy fraud scheme resulted in conviction on 22 counts of mail fraud, conspiracy to commit health care fraud and introduction of misbranded drugs into interstate commerce.  Sentencing in the case is set for May of 2022.  Other co-conspirators entered plea agreements along the way, pleading guilty to various charges including felony conspiracy to commit health care fraud, felony misbranding, conspiracy to commit wire fraud, and fraudulent telemarketing of dietary supplements, skin creams and testosterone.  Many of these are still awaiting sentencing, also expected to be scheduled sometime in 2022.

THE SCHEME

The scheme involved several individuals, compounding pharmacies and telemarketers engaged in a conspiracy to commit health care fraud, mail fraud and introducing misbranded drugs into interstate commerce.  Peter Bolos, along with two other co-conspirators, owned and operated Synergy Pharmacy in Palm Harbor, Florida.  Working with HealthRight, a telemarketer, the co-conspirators generated prescriptions for drugs such as pain creams, scar creams, and vitamins.  Using the HealthRight telemarketing platform, they would call consumers and deceive them into providing their personal insurance information and accept the drugs. HealthRight then communicated the prescription requests to physicians who authorized the prescriptions without ever interacting with the patients, and paid those physicians for issuance of the prescriptions. Through this scheme, the co-conspirators were able to solicitate insurance coverage information from consumers across the county for prescription pain creams, fraudulently obtain prescriptions, mark up the prices of the drugs and bill private insurance carriers. read more

House Physician License in Florida

December 6th, 2021 by

If you’re a house physician who has recently moved to Florida from out of state, or out of the country, it’s a good idea to get the ball rolling to get your medical license in Florida.

Many doctors move to Florida, a highly sought after location, with the intention to live and practice medicine. Rather than take a chance on the paperwork taking too long and getting in trouble for practicing without a license, it’s a good idea to reach out to Florida Healthcare Law Firm for help and get started now.

How Do I Get a House Physician License in Florida?

There are a couple of different ways to get your medical license in the state of Florida, according to the Florida Board of Medicine.

You can seek licensure by endorsement, as long as you have:

  • A degree from an Allopathic US Medical School of a school recognized and approved by the US Office of Education (AMG) as well as at least one year of residency,

OR

  • A degree from an international medical school, passed both parts of the NBME or ECFMG exams, performed a year of supervised clinical training, and finished a 2+ year-long residency,

OR

  • Passed all parts of the NBME, FLEX, or USMLE and have a medical license in another jurisdiction while practicing medicine for a minimum of two of the past four years, or passed a clinical competency exam approved by the board in the last year, or finished a postgrad training program within the last two years.

You can also seek licensure by examination.

How Long Does It Take to Get a Florida House Physician License?

It can take anywhere from three to six months once you have all the documentation in place and filed. A law firm can help the process to move much more quickly.

Where Can I Get Help Filing for My House Physician License in Florida?

Florida Healthcare Law Firm is a boutique law firm designed specifically to support medical professionals with all legal issues. We can assist you with the process of getting your house physician license in Florida. Call now to set up your initial consultation and get the process started.

Can You Work in the Medical Field With a Felony?

December 4th, 2021 by

The question of whether or not a felon can work in the medical field is tricky to answer.

The truth is that it depends heavily on the nature of the felony as well as the medical education and experience the person has. It also depends on what specific medical job the person with a felony is hoping to get.

In general, if someone has a violent or drug-related felony, it’s going to be difficult to work in the medical profession handling medications or working with patients.

However, if the felony is nonviolent and non-drug-related, the right combination of education, volunteer experience, and distance from that felony could be acceptable in certain medical jobs.

Can a Felon Become a Medical Assistant?

Medical assistants are the first line of medical contact that patients cross when they come to see the doctor.

They generally gather vital statistics (like weight, height, temperature, and blood pressure), and ask about the nature of the visit so the doctor has some information to work with.

If a person has a violent or drug-related felony in their past, it may be difficult to secure this position. The concern that most clinics would have is liability should the individual become violent with a patient or steal medications they have access to.

Can a Felon Become a Nurse or a Doctor?

Both nurses and doctors spend even more time with patients and have more access to medication than a medical assistant. Thus, people with drug-related felonies will likely struggle to enter the field at this level unless they have a history of working as a nurse or a doctor and agree to follow strict regulations regarding substance use and exposure.

For example, drug tests and total abstinence may be required.

Those with violent felonies in their pasts, even with extensive experience and education as a nurse or a doctor, will likely find it difficult to gain employment.

Florida Healthcare Law Firm

If you are attempting to regain employment in the medical profession after a felony, you may have legal recourse depending on the nature of the job you seek and the felony on record. Contact us at Florida Healthcare Law Firm today to find out more.

Which Health Care Law Can Lead to Criminal Liability?

November 20th, 2021 by

Health care laws are designed to protect patients, and health care businesses are tasked with keeping up with new laws and their nuances in order to remain compliant.

Ignorance is never a defense, but it is not easy to keep up with liability law in Florida, especially in the healthcare industry.

For this reason, many healthcare-related businesses reach out to Florida Healthcare Law Firm for support.

Healthcare Law and Criminal Liability for Patient Care

There are a number of reasons why a healthcare business might be in danger of criminal liability, and medical malpractice is one of the big ones. This can include charges for:

  • Negligent medical care that caused harm or death to a patient.
  • Giving medical services or medication to a patient without gaining their consent first.
  • Practicing medicine without a license or otherwise providing services beyond the certification scope.
  • Breaking HIPAA laws by violating patient confidentiality.
  • Having a romantic or sexual relationship with a patient.
  • Prescribing too much of an addictive medication or prescribing abusable medication without medical necessity.
  • Providing medical services that are illegal at the state or federal level.
  • Assisting any patient in ending their life.

Criminal Liability Is Possible for Health Care Fraud

Medicare fraud is one of the most common types of fraud and a primary reason for criminal liability complaints across the healthcare industry. In fact, any kind of billing fraud is grounds for a criminal offense.

Billing fraud can mean:

  • Accepting payment or favors for using certain medical products or prescriptions.
  • Billing for medical care that was not provided.
  • Double billing for medical care claims.
  • Billing for services that were not medically necessary.
  • Billing using a medical code that is more expensive than the actual amount of services provided.

Health Care Law Can Lead to Liability

The law is set up to protect patients, as it should. But, without knowledge of what current law requires, many healthcare businesses are at risk of criminal liability.

One of the best ways to protect against surprise lawsuits is to hire a healthcare law firm to assist your business in:

  • Assessing current software, forms, and records to ensure that there are no concerns in day-to-day practices.
  • Updating protocol if there are any issues that require attention.
  • Keeping up with changes to existing law and recommending adjustments to procedures as needed.
  • Staying current on new laws as they are introduced, voted on, passed, and put into effect, and creating plans to stay in compliance.

If you have a healthcare business in Florida, whether or not you work directly with patients, it is imperative to ensure that you remain in compliance with Florida law. Contact us at Florida Healthcare Law Firm today to find out how we can assist you in this process.

Florida Law Healthcare for Children

November 15th, 2021 by

Passed in the summer of 2021, the law called HB 241: Parents’ Bill of Rights seeks to put power over a child’s healthcare and education into the hands of parents.

This child healthcare law can prove critical for parents who want to ensure that they are allowed to make their own choices regarding their child’s medical care and education without being penalized by schools or government organizations.

This law is a win for parents, but it should also be a primary concern for healthcare businesses that work with children. In order to avoid fines and fees, healthcare businesses need to ensure that they are not only protecting parental rights to advocate for their children but also setting up structures and processes within their business that encourage parental involvement.

What Does the Parents Bill of Rights Require From Businesses?

The bill requires businesses that provide education and/or healthcare to children to open up pathways for parental involvement. It also requires parental consent before big decisions are made regarding medical care or education.

If it is determined that a business in any way impinged on parental rights, the business can incur legal and financial consequences.

What Does the Florida Law on Healthcare for Children Mean for Parents of Stepchildren?

In most custodial cases, stepparents do not have legal right to make medical or educational decisions for a stepchild. In the event that there is a power of attorney, guardianship, or other paperwork in place that places those rights with the stepparent, businesses will be equally required to gain their consent and increase pathways for their involvement with their stepchildren.

Does the Healthcare Law Covering Children Include Adult Children?

No. The law is specifically designed to protect a parent’s right to advocate for minor children. Once over the age of 18, children are considered adults and expected to advocate for themselves.

If you would like legal support in understanding how the Florida law for children’s healthcare impacts your business, contact us at Florida Healthcare Law Firm today.

What Is Required in the Florida Employee Health Care Access Act?

November 10th, 2021 by

Health insurance is expensive, but the cost of medical treatment without health insurance is even more expensive.

For this reason, there is Florida legislation in place to help ensure that everyone who is employed has access to health insurance coverage, no matter what their pre-existing conditions, past health insurance claims, or current health issues might be.

Specifically, the Florida Health Care Access Act is the current law governing this process. It comes with a number of essential requirements that must be followed by the business and by the employee.

What Is Required in the Florida Health Care Access Act?

Small businesses are allowed to provide group health insurance to employees. While this right to health insurance is protected under Florida law, it comes with a laundry list of requirements that may not be simple to follow.

For example, the Florida Health Care Access Act requires that any employee signing up for insurance provide a full and accurate disclosure statement. If this statement is found to be lacking in any information that the insuring party requires to make decisions regarding the details of the health insurance policy, the insured may not be able to get the coverage they want for the medical care they need.

Do I Need Help Fulfilling Requirements for the Florida Health Care Access Act?

Small businesses ready to begin offering group health insurance may benefit from getting assistance on how to install the new program.

Effective personnel training will help to ensure that employees who sign up will have access to all benefits and won’t be denied coverage when they need it most.

To get assistance with any aspect of the Florida Health Care Access Act and to make sure that you are in compliance with state law, contact Florida Healthcare Law Firm now to set up a consultation and get started.

What Is a Healthcare Surrogate in Florida?

November 5th, 2021 by

It is impossible to know what the future holds. While we can hope that we’ll be able to make decisions about our healthcare for the rest of our lives, it doesn’t always unfold this way.

One way to protect yourself is to create an advanced medical directive. This legal process identifies a person you trust to ensure that your wishes for medical care are carried out if you are incapacitated and unable to speak for yourself.

If done incorrectly, however, it can backfire. At the moment of truth, your designated healthcare surrogate may be unable to speak on your behalf.

What Is a Health Care Surrogate in Florida?

Laws regarding health care surrogates are not the same in every state. Some states require no legal documents, while others do. Some states require that the health care surrogate agree to the position; others don’t.

In Florida:

  • A legal document is required to assign a healthcare surrogate.
  • That document must be signed in front of witnesses, and one of those witnesses must not be a surrogate.
  • An alternate healthcare surrogate may also be designated.
  • If both the primary and alternative healthcare surrogate are unable to perform the duties for any reason, the medical facility may designate a proxy.
  • It is assumed that an appointed healthcare surrogate can make healthcare decisions regarding both the physical and mental health of the individual unless it is otherwise stated in the documentation.

How Do I Designate a Health Surrogate in Florida?

Healthcare surrogate law in Florida can be tricky to navigate alone. There are legal requirements that must be met. If they are not met, your designated healthcare surrogate may be unable to navigate for your needs at the needed time.

Contact Florida Healthcare Law Firm today to learn more about how to identify a healthcare surrogate legally, so you are protected now and in the future.