Nurses, No More Excuses: Get Personal Professional Liability Insurance Policy Now-Part 2

5 Indest-2008-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Nurses, I am writing this to strongly encourage you to purchase your own professional liability insurance policy. I have noticed many nurses fail to carry any insurance to protect one of their most precious assets, their nursing licenses. Yet such insurance is cheap and easy to obtain. Professional liability insurance will protect a nurse in the event of a lawsuit, and it may also pay legal defenses in the event of a complaint against a nurse’s license to practice or for other legal problems. If you already have nursing liability insurance, make sure it also pays all legal expenses incurred in defending a complaint against your license.

I’ve heard every excuse as to why a nurse does not have professional liability insurance. In this blog series, I am exploring many of those excuses. I want every nurse to understand the importance of buying personal professional liability insurance now, before it is too late.

This is part two of the series, click here to read part one.

Excuse: Professional Liability Insurance is Expensive.

All nurses should protect themselves by obtaining professional liability insurance. A good policy will provide medical malpractice and, very importantly, licensure protection coverage. The costs on these policies vary, but it is generally quite reasonable. It is common to find professional liability insurance that provides excellent coverage and excellent benefits for less than a dollar a day. We’ve seen policies cost as low as $10 to $15 a month. That is a small price to pay to protect your livelihood.

Excuse: Licensure Defense Coverage Is Not Necessary.

When you buy professional liability insurance, again, it is very important you make sure it includes legal defense coverage for professional licensing defense and other administrative proceedings in an amount of coverage of at least $25,000. If it does not, I recommend you purchase a “rider” or additional coverage from that insurer for a small additional premium.  Also, attempt to obtain “broad form coverage.” This will pay for your legal defense costs for other types of regulatory and administrative proceedings such as: a) an internal hospital/facility peer review proceeding; b) a Medicare or Medicaid audit or investigation; c) a Medicare medical quality assurance investigation or review; d) an EEOC discrimination or harassment complaint or investigation; e) an alleged HIPAA privacy violation; f) a hospital clinical privileges action (if you have privileges); g) action to exclude you from the Medicare or Medicaid Program; or h) action to suspend or revoke your DEA registration (if you have one).  There are some insurance companies that sell professional license defense and defense costs and expenses for other types of administrative proceedings as a stand-alone insurance policy.

You should buy this coverage now, when you don’t need it. Otherwise, when you do need it, it will be too late.

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.

Comments?

Do you have personal professional liability coverage? Are you thinking about getting a personal policy now? Please leave any thoughtful comments below.

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, No More Excuses: Get a Personal Professional Liability Insurance Policy Now-Part 1

5 Indest-2008-2By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

To protect yourself from automobile accidents, you carry auto liability insurance. To protect your home from fire, storms and other accidents, you carry homeowners’ insurance. However, I have noticed many nurses fail to carry any insurance to protect one of their most precious assets, their nursing licenses. Yet such insurance is cheap and easy to obtain. I cannot stress enough how important it is for a nurse to carry a personal professional liability insurance policy that covers any investigation, complaint or administrative hearing that might be filed or opened against a nurse’s license.

In my experience, I’ve heard every excuse as to why a nurse does not have a personal professional liability insurance policy. In this blog series, I am exploring those excuses. I want every nurse to understand the importance of buying personal professional liability insurance now, before it is too late.

Keep in mind that a great deal more nursing license complaints are filed against nurses than there are liability lawsuits.

Excuse: I Am a Good Nurse, I Don’t Need Professional Liability Insurance.

You may be a good nurse, but good nurses are the subject of lawsuits and complaints. All it takes is just one violation that gets reported to the DOH or BON, and the nurse is suddenly in a position of having his or her license investigated. The nurse then has to defend his or her actions to protect the integrity of his or her license, and possibly the ability to continue practicing.

The harsh reality is that legal representation is very expensive. Without insurance, even if the nurse is found to be not negligent, the nurse is still responsible for the attorney’s fees and expenses incurred during trial. However, professional liability insurance will protect the nurse in the event of a lawsuit, and it may also pay legal defenses in the event of a complaint against the nurse’s license to practice or for other legal problems.

Excuse: I am Covered By My Employer’s Insurance.

We hear this on a weekly basis. Many nurses mistakenly believe that their employer insures them for legal fees and costs associated with defending against licensure complaints, Emergency Suspension Orders (ESOs), Notices of Investigation, and Administrative Complaints. In the overwhelming majority of cases, this is false. Often it is the employer that files the complaint against the nurse that causes the investigation. If you are told your employer will cover you in such circumstances, ask for a letter in writing and signed by the employer stating that the employer will pay for your defense in any DOH or BON investigation or subsequent administrative proceedings that arise out of your employment. It is unlikely that you will get it.

When a nurse is “covered” under a hospital’s (you can substitute nursing home, clinic, etc., as applicable here) policy, that policy primarily protects the hospital’s interests. Therefore, this “coverage” extends only to those situations and occurrences where the hospital might have liability.

Check This Blog for More.

I will continue to explore excuses I hear from nurses as to why they do not have a personal professional liability insurance policy in later blogs.

It is my hope that after reading this you will look into purchasing your own professional liability insurance policy.

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 (BON) 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.

Comments?

Do you have personal professional liability coverage? Are you thinking about getting a personal policy now? Please leave any thoughtful comments below.

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.

Think You Have Professional Liability Insurance Through Your Employer? Think Again, Nurse!

00034_RT8By Joanne Kenna, R.N., J.D., The Health Law Firm

Not a week goes by without a call coming into the firm from a nurse whose license is under investigation for some reason or another.  The nurse is generally dumbfounded that this has happened.  “But I’m a good nurse.  I never thought this could happen to me,” is the sad refrain.

Very often the nurse is correct.  He/she is a clinically good nurse.  Often there has never been any prior problem or any question of this.  But all it takes is one instance, just one violation that gets reported to the Department of Health (DOH), and the nurse is suddenly in the position of having his/her license investigated.  The nurse then has to defend his/her actions to protect the integrity of his/her license, and possibly even his/her ability to continue practicing, against the allegations of the violation.

Employer’s Insurance Coverage Protects the Employer, Not You.

Normally when a licensure investigation is initiated, the nurse is upset and angry, and is determined to do whatever is necessary to protect his/her license.  At this point the intelligent  nurse will usually start making telephone call(s) to seek legal advice and counsel.  Then comes the harsh reality.  Obtaining good legal services is expensive.  It can be very expensive.  Inevitably the question is put to the nurse as to whether he/she has insurance.  All too often the nurse responds that his/her insurance is (or more often at this point, was) through his/her employer.

Then more reality hits.   Often the nurse has already been terminated from employment by this point.  So, no insurance.  Even if the nurse is still employed, the nurse quickly finds out that the coverage he/she believed existed, and often was led by the employer to believe existed, is not really a policy for the nurse at all.  The nurse is “covered” under the hospital’s (you can substitute nursing home, clinic, etc., as applicable here) policy really only to protect the hospital’s interests.  Therefore, this “coverage” extends only to those situations and occurrences where the hospital might have liability.  (And even in that case the nurse should be wary because it is really the hospital’s interests that are being protected by the policy.   Where the nurse’s interests happen to be aligned with the hospital’s, all is good.  But where they are not, well, the hospital has coverage and its interests will be protected; as for the nurse, he/she is on his/her own).

What you should know is that the hospital’s insurance coverage is there to protect the hospital – – period.

Protect Your Nursing License with a Personal Professional Liability Insurance Policy.

You should also recognize that no nurse is immune from a professional liability claim.  No matter how conscientious and clinically competent the nurse may be, the potential for a professional licensure action always exists.   Day after day nurses forego legal representation when they are under licensure investigation because legal representation is unaffordable for them.  While some nurses get lucky and will have a good outcome in spite of this, many others will not.  The very idea of gambling with your nursing license that took so much effort to earn and is the key to your future earning capacity, is not only risky, it is downright foolish.

The truth of the matter is that all nurses should protect themselves by obtaining a personal professional liability insurance policy.  A good policy will provide medical malpractice and, very importantly, licensure protection coverage.  The cost on these policies varies, but it is generally quite affordable, often costing little more that $10 – $15 a month.

Licensure protection coverage provides the nurse with the ability to obtain competent legal representation from an attorney or a law firm that is familiar with handling licensure investigations and the disciplinary actions that can ensue from them.  Good policies will provide $10,000 – $25,000, and even more for legal expense.  Having this money available at the time it is needed allows the nurse to focus on his/her defense and provides the nurse the opportunity to pursue this defense all the way through the administrative process.  All too often the alternative is having the limited available funds dictate the nurse’s acceptance of an undesired resolution to the matter.

Be Smart, Get Professional Insurance Before it is Too Late.

So, if your independently wealthy, you can continue practicing without much concern about how you will be able to afford legal services for licensure defense if and when that becomes necessary.  If though you are not, and your answer to the question of whether you have insurance would be that you do through your employer, now is the time to start thinking about changing that.  Tomorrow just might be too late.

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.

Comments?

Do you have personal professional liability coverage? Are you thinking about getting it now? Please leave any thoughtful comments below.

About the Author: Joanne Kenna is a nurse-attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone:  (407) 331-6620.

“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.

Terrible Things That Can Happen after Discipline on Your Nursing License or Resignation of a Nursing License after Notice of Investigation

indest1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Do you have nursing licenses in several different states? Do you have a license in more than one health profession? Have you been notified that an investigation has been opened against you? Are you thinking about resigning your nursing license or voluntarily relinquishing such a license? Then you must be aware of the following.

First, you should never voluntarily relinquish or resign your license after you know that an investigation has been opened or that disciplinary action has been taken against you. Such a resignation is considered to be a “disciplinary relinquishment” and is treated the same as if your license had been revoked on disciplinary grounds.

Second, this will be reported out to other states, agencies, to the National Practitioner Data Bank (NPDB), to any certifying bodies for certifications you have and to other reporting agencies (such as the National Council of State Boards of Nursing for its NURSYS data bank). Other states and other professional boards will most likely initiate disciplinary action based upon the first one.

Protect Your Nursing License from These Adverse Actions.

The following is a list of some of the adverse actions that you can expect to be taken against you after discipline on your license or after you resign your nursing license after receiving notice of investigation:

1. A mandatory report to the National Practitioner Data Base (NPDB) which remains there for 50 years. Note: The Healthcare Integrity and Protection Data Bank or HIPDB recently merged into the NPDB.

2. Must be reported to and included in the Department of Health (DOH) profile that is available to the public online (for those having one), and remains for at least ten years.

3. Any other states or jurisdictions in which the nurse has a license will also initiate investigation and possible disciplinary action against him or her in that jurisdiction. (Note: I have had two clients who had licenses in seven other states and all, even ones that were inactive or not renewed years ago, initiated action).

4. The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) will take action to exclude the provider from the Medicare Program. If this occurs (and most of these offenses require mandatory exclusion) the provider will be placed on the List of Excluded Individuals and Entities (LEIE) maintained by the HHS OIG.

a. If this happens, you are prohibited by law from working in any position in any capacity for any individual or business, including hospitals, nursing homes, home health agencies, physicians, medical groups, insurance companies, etc., that contract with or bill Medicare or Medicaid. This means, for example, you are prohibited from working as a janitor in a nursing home that accepts Medicare or Medicaid, even as an independent contractor.

b. If this happens, you are also automatically “debarred” or prohibited from participating in any capacity in any federal contracting, and you are placed on the U.S. General Services Administration’s (GSA) debarment list. This means you are prohibited by law from working in any capacity for any government contractor or anyone who takes government funding. This applies, for example, to prevent you from being a real estate agent involved in selling property financed by a government backed loan, prohibited from working for an electrical company that bids on contracts for government housing projects, working as a school teacher in a public school, etc.

c. If this happens, your state Medicaid Program is required to terminate you “for cause” from the state Medicaid Program. In many states, this is also grounds for revocation of your nursing license.

5. Any profile or reporting system maintained by a national organization or federation (e.g., NURSYS profile maintained by the National Council of State Boards of Nursing) will include the adverse action in it, generally available to the public.

6. If you are a nurse practitioner or other professional with clinical privileges at a hospital, nursing home, HMO or clinic, action will be taken to revoke or suspend the clinical privileges and staff membership if you have such. This may be in a hospital, ambulatory surgical center, skilled nursing facility, staff model HMO or clinic. This will usually be for advance registered nurse practitioners (ARNPs), certified registered nurse anesthetists (CRNAs), nurse midwives or certified nurse anesthetists (CNAs).

7. Third party payors (health insurance companies, HMOs, etc.) will terminate the professional’s contract or panel membership with that organization.

8. The U.S. Drug Enforcement Administration (DEA) will act to revoke the professional’s DEA registration if he or she has one.

9. Many employers will not hire you or will terminate your employment if they discover your license has been disciplined in another state.

What Should You Do?

- Don’t take the easy way out by immediately relinquishing your license if you are notified you are under investigation.

- Don’t hide your head in the sand by thinking the case will just go away on its own.

- Don’t take the easy way out. If you are innocent of the charges, request a formal hearing and contest the charges; defend yourself.

- Do not request an informal hearing or a settlement agreement in which you admit the facts alleged against you are all true. If you do this, you are “pleading guilty.”

- Do immediately seek the advice of an attorney who has experience in such professional licensing matters and administrative hearings. They are out there, but you may have to search for one. Do this as soon as you get notice of any investigation and especially before you have talked to or made any statement (including a written one) to any investigator.

- Do purchase professional liability insurance that includes legal defense coverage for any professional license investigation against you, whether it is related to a malpractice claim or not. This insurance is cheap and will provide needed legal assistance at the time when you may be out of a job and not have money to hire an attorney. Beware of the insurance policy that only covers professional license defense if it is related to a malpractice claim.

A Health Lawyer’s Opinion on Professional Liability Insurance.

We strongly encourage all licensed health professionals and facilities to purchase their own, independent insurance coverage. Make sure it covers professional license defense under all circumstances. Make sure you have enough coverage to actually get you through a hearing. $25,000 coverage for just professional licensure defense is the absolute minimum you should purchase; $50,000 may be adequate but $75,000 or $100,000 may be what you really need in such a situation. For a few dollars more (and I do mean only a few) you can usually purchase the higher limits.

Also, I will repeat, make sure it covers your legal defense in an administrative disciplinary proceeding against your license, even if there is no malpractice claim filed against you or likely to be filed against you.

We also recommend that you purchase coverage through an insurance company that allows you to select your own attorney and does not make you use one that the insurance company picks for you.

Companies we have encountered in the past who provide an inexpensive top quality insurance product for professional license defense costs include: CPH & Associates Insurance, Nurses Service Organization (NSO) Insurance, Healthcare Providers Organization (HPSO) Insurance and Lloyd’s of London Insurance.

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: 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.

Kudos to Wyoming State Board of Nursing for its Accurate Information on its Website for Nurses

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

As a nurse, when you are the subject of a complaint that alleges improper conduct or action that could result in discipline against your license, finding correct information regarding the disciplinary process is vital. I’ve recently found that the Wyoming State Board of Nursing (BON) is one of the few nursing board websites that provide accurate information on discipline. On this website, there is information about  nurses’ legal rights, and explanations of the investigation or hearing process, for Advanced Practice Registered Nurses (APRNs), Registered Nurses (RNs), Licensed Practical Nurses (LPNs) and Certified Nursing Assistants (CNAs).

Click here to go to the Wyoming State BON website.

Wyoming State BON Website Provides Information Regarding the Board’s Duty of Reporting to National Practitioner Data Bank.

Information about nursing discipline actions was previously reported to the Healthcare Integrity and Protection Data Bank (HIPDB) by the Board taking action. The HIPDB collected reports made by federal and state licensing agencies, federal and state prosecutors, and federal and state government agencies that had excluded a practitioner, provider or supplier from their health plan.

On May 6, 2013, the HIPDB officially merged with the National Practitioner Data Bank (NPDB). The two data banks are now known as the NPDB. To read a blog on how this merger affects you, click here. For more information about NPDB, visit the website: http://www.npdb-hipdb.hrsa.gov/.

Wyoming Website Provides Information Regarding Actions by Office of Inspector General and the Exclusion List.

The Office of the Inspector General (OIG) has the authority to exclude individuals and entities from federally funded health care programs (Medicare, Tricare, Medicaid) and maintain a list of all currently excluded individuals and entities. This is called the List of Excluded Individuals and Entities (LEIE). Anyone who hires an individual or entity that is listed on the LEIE may be subject to civil monetary penalties (CMP).

The OIG has discretion to exclude individuals such as nurses or nursing assistants on a number of grounds, including misdemeanor convictions related to health care fraud (other than Medicare or a state health program); misdemeanor convictions relating to the unlawful manufacture, distribution, prescription, or dispensing of controlled substances; and purposes of disciplinary action by the Board including suspension, revocation or surrender of a license for reasons baring on professional competence or professional performance.

This means that if your license or certificate is suspended, revoked or voluntarily surrendered, your ability to be employed by a health care provider or facility that also receives federal funding, such as Medicare, may be precluded despite the statue of your licensure. In other words, once you are on the exclusion list and have not been taken off even after a reinstatement, you will not be able to be hired as a nurse or nursing assistant by medical facilities receiving federal funds.

To read more on the devastating and far-reaching effects of being excluded, click here.

The Wyoming BON website is the only one I have come across that accurately advises nurses of the collateral consequences of disciplinary action.

Legal Advice for Nurses in These Situations.

I want to commend the Wyoming State BON for including this information on its website. The information provides a great start for nurses with complaints against their licenses.

I’d like to offer up some additional advice. I encourage all nurses to buy insurance to cover license investigation legal defense expenses. Most nursing malpractice insurance policies are very inexpensive and provide excellent coverage. Most contain insurance coverage that will pay for an attorney and other legal defense expenses if you are being investigated or charged with a licensure offense. You should have at least $25,000 in coverage for such investigations and administrative proceedings.

Obtain an Experienced Health Law Attorney Immediately After Receiving Any Notification of an Investigation.

If the BON is investigating a complaint against your license, immediately obtain an experienced health law attorney to represent you throughout the investigation and disciplinary proceedings.

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.

Comments?

What do you think of the information listed on the Wyoming State Board of Nursing website? Please leave any thoughtful comments below.

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 Service Organization (NSO) Attorneys, Lawyers and Defense Council in Florida

indest1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Often we learn after the fact that a health professional such as nurses, advance registered nurse practitioners (ARNPs), certified registered nurse practitioners (CRNPs) and nurse midwives (NMs) has received Nurses Service Organization (NSO) insurance, has had a legal problem, and has not been able to locate an attorney or law firm that accepts this type of insurance. We have offices in Florida and Colorado, but we have attorneys licensed in Florida, Colorado, Louisiana, the District of Columbia, Virginia and other states.

Additionally, we can provide legal advice and representation in license investigations and administrative proceedings in many other states.

If you have NSO Insurance, do not go without an attorney or with a lawyer that has little or no experience where you need it.

The Health Law Firm Will Work with Your Insurance Company.

Call us first. We can assist you in determining if your legal problem is covered by your insurance, and we can help you file a claim to have your legal defense expenses and costs covered. In most cases, we will accept the assignment of your insurance so that you do not have to worry about legal bills while your case is going on.

Contact Health Law Attorneys Experienced in the Representation of Nurses.

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

In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company. We will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company, if your insurance company will allow this. Many of these insurers will pay our firm to represent you in the legal defense of an investigation or complaint against your professional (nursing, medical, dental, psychology, mental health counselor) license or for an administrative hearing involving professional discipline.

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

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

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: Locate a Healthcare Providers Service Organization (HPSO) Insurance Defense Attorney in Florida Company Cases

Patricia's Photos 013By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the Florida Department of Health (DOH) they had difficulty finding an experienced attorney in Florida who would accept their professional liability insurance.  In this case, I am speaking specifically about Healthcare Providers Service Organization (HPSO) Insurance.

Benefits of HPSO Insurance.

The professionals who are covered by HPSO Insurance have excellent insurance coverage.  HPSO Insurance provides professional liability coverage that protects in the event of a lawsuit or negligence claim.  But much more often the professional receives a notice of an investigation, a subpoena for a deposition in someone else’s case, a demand because of an allegation of sexual harassment or sexual impropriety, a complaint because of a breach of medical records confidentiality or Health Insurance Portability and Accountability Act (HIPAA) Privacy complaint, or some other administrative type of action.

HPSO provides great coverage for these.  For example, HPSO currently reimburses up to $10,000 in legal fees and expenses just for representation of you at depositions.  HPSO currently reimburses up to $25,000 in legal fees and expenses for your defense in a DOH or Agency for Health Care Administration (AHCA) notice of investigation or complaint.  HPSO currently reimburses up to $25,000 in legal fees and expenses for your legal representation in defense of a complaint or investigation regarding breach of medical confidentiality.

If you are a pharmacist, own a pharmacy, are a massage therapist, own an assisted living facility (ALF), are a mental health counselor or a social worker, or you are one of the many other types of health care professionals who HPSO insures, it should be fairly easy to find experienced health lawyers to represent you, especially in Florida.

Our firm and our attorneys, including George F. Indest III, Michael L. Smith, Joanne Kenna, Carole C. Schriefer, Lance O. Leider, Christopher E. Brown and Danielle M. Murray, routinely represent licensed health care professionals, interns and students in all types of administrative investigations and hearings and in defending lawsuits and other actions that have been filed.  We also represent health facilities in license defense, survey complaints and administrative hearings.  We represent them throughout Florida, from Pensacola, to Jacksonville, to Key West.  We also occasionally represent them in other states, as well.  We accept HPSO Insurance assignments.

Free Legal Advice: Get Insurance Immediately.

It is very important for every health professional to carry insurance that covers any investigation, complaint or administrative hearing that might be filed or opened against your license.  You may think that you are covered for this by your employer, but you are not.  If your employer contradicts this, ask for a statement in writing that your employer will pay for your legal defense for any such matter arising during your employment.

What typically happens, especially in the case of a hospital employee, nursing home employee, pharmacy employee or corporate employee, is that the employer is the one who terminates the employee and then files a complaint with the DOH.  The DOH then opens an investigation against the health professional.  The employer is not going to pay your legal defense costs if the employer has reported you.

You may very well be out of work, out of money and face an investigation and complaint that could terminate your professional license and career.  You should not take this chance.  Insurance such as HPSO Insurance is inexpensive and reliable.  Buy it while you can afford it. After the actions have occurred, it is too late.

Find an Experience Health Law Attorney in the Event of an Investigation.

Also, you should immediately contact an experienced health law attorney if you are telephoned or visited by any investigator, or if you receive a letter advising you that an investigation has been opened regarding your care.  Call immediately for advice before you speak with an investigator or provide any documents or statements of any kind.

You cannot and should not seek “legal advice” on what to do from the investigator, from a DOH employee, from your professional board or from any attorney representing any of them.  They are not your friends.  They are on the side against you. You should definitely not take any advice from them.

Do Not Skimp on Insurance Coverage.

If you have good insurance, it will pay for your legal expenses from the very beginning, so use it.  However, beware of cheap insurance policies from professional associations that do not provide any coverage for disciplinary complaints and licensure investigations.  Always check to be sure this is covered.  Get it in writing.  With some companies you have to pay an extra premium to obtain this coverage.  With some insurers, they do not offer it, and you have to purchase a completely separate policy covering just this.  It is worth it!  Do it!

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

Our firm regularly represents pharmacists, massage therapists, mental health counselors, registered nurses, assisted living facilities, home health agencies, nurse practitioners, lab technicians, occupational therapists, physical therapists, social workers, physician assistants, psychologists and other health professionals in many different legal matters.

Services we provide include representation before your professional board, in DOH investigations, in administrative hearings, in civil litigation, in defense of malpractice claims, in professional licensing matters, in defense of allegations concerning HIPAA privacy violations and medical record breaches, in Drug Enforcement Administration (DEA) actions, and in many other matters.

We routinely represent physicians, dentists, nurse practitioners, and others in defending against malpractice claims, civil lawsuits, administrative complaints, peer review actions, DOH investigations, Medicare audits, Medicaid audits, and other matters. In cases in which the health care professional has professional liability insurance or general liability insurance which provides coverage for such matters, we will seek to obtain coverage by your insurance company and will attempt to have your legal fees and expenses covered by your insurance company.  If allowed, we will agree to take an assignment of your insurance policy proceeds in order to be able to submit our bills directly to your insurance company.

We also defend health professionals and health facilities in general litigation matters and business litigation matters.

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

Comments?

Do you have professional liability insurance? Why or why not. Please leave any thoughtful comments below.

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.

What Happens at a Board of Nursing Meeting?

George F. Indest III is Board Certified by The Florida Bar in Health Law

George F. Indest III is Board Certified by The Florida Bar in Health Law

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

The Florida Department of Health has many boards which regulate various licensed health care professions. One of the boards that makes up the Department of Health is the Board of Nursing. The Board of Nursing regulates the nursing profession.

The Board of Nursing holds public meetings in which it conducts all of its business. These meetings are scheduled in advance. Notice of when and where they are going to be held is available on its website usually several months in advance. The Board of Nursing rotates its meetings around the state, each time meeting in a different major city. Therefore, one meeting may be help in Jacksonville, the next meeting may be held in Ft. Lauderdale, and the next meeting may be held in Orlando.

The Board of Nursing is required by law to publish its agenda ahead of time so that the public is aware of matters that may come up in the event they want to attend the meeting. Usually these are published from 20 to 30 days ahead of time. Board of Nursing meetings are very interesting. Usually, nursing schools will require their students to attend, if the meeting is held near them.

If you have never attended a Board of Nursing meeting, you should. You should especially attend one of you have a pending Department of Health investigation against you. Attending a Board of Nursing meeting will give you a lot of insight into whether or not to elect an informal hearing if your case progresses past the probable cause panel stage. (See separate chapter in this Manual on DOH investigations and hearings).

Did you know that you can obtain continuing education units (CEUs) just for attending a Board of Nursing meeting? You can receive up to eight hours of CEUs for this. Just be sure to sign in on the sign-in sheet on the table in or outside the meeting room in order to record your attendance and obtain a CEU certificate.

Meetings are Open to the Public. 

Board meetings are open to the public. Notice of meetings are published in the Florida
Administrative Weekly. A draft agenda is available, on the board website, at least one week before the meeting and for public inspection during the Board meeting. Due to the fact that the Board’s meetings are quasi-judicial meetings the public is requested to refrain from applause, booing or other emotional outbursts. There are rare occasions in which the Board and its members will enter an executive session, this is a non-public session, to discuss issues which are confidential.

Organization of the Board of Nursing.

The business of the Board revolves around committee reports, staff and counsel reports, review of licensure and examination applications and discipline for violation of the Florida Nurse Practice Act, Board rules and other laws. Committee meetings typically occur on Wednesday evening and Thursday morning. The major committees of the Board of Nursing include: Practice, Legislative, Education, Continuing Education, ARNP, CNA Council and Credentials.

The full Board of Nursing meets on Thursday afternoon to hear committee reports and other board business and on Friday the Board meets to hear discipline cases. The individuals who are most active at the Board meetings are the chair, vice chair, board members, board counsel, prosecuting attorneys, IPN and the executive director.

A. Chair/Vice Chair

The chair is responsible for the organization and running of the Board meetings. The agenda is prepared by staff but the Chair may alter or reorganize the sequence of issues. The Chair seeks to keep the board on task and often summarizes discussion. Unlike some organizations, the Chair is a full member of the Board and is required to vote on all issues, unless the Chair is recused because she has a conflict of interest on the issue in which she is voting on. Just like any other member of the Board the Chair may make motions and second motions of others. The Chair will also seek clarification from counsel, board members, staff and others if requested. The Vice Chair performs these duties in the absence of the Chair.

B. Board Members

Members of the Board are required to vote on all issues, unless they are recused because of a conflict of interest. A Board member who sits on a probable cause panel may have already heard some evidence in disciplinary cases and, therefore, that member is automatically recused from voting on the case when it appears before the full Board. Board members review around 35,000 pages of scanned documents on CD-ROM prior to a Board meeting; documents received after the CD is made are distributed in paper form prior to the meeting. The documents typically included in the CD are applications for licensure, administrative complaints against an individual, investigative reports, orders, stipulations and other records. Orders are legal documents filed by the Board to take action against an applicant or licensee. A stipulation is a tentative agreement between the prosecuting attorney and the respondent; however, the Board must approve a stipulation before it can take effect. Board members determine severity of discipline using established guidelines; the cost of investigation is always included.

C. Executive Director

The Executive Director is the person responsible for the functioning of the Board office. The office staff prepares the agenda in concert with counsel and prosecuting attorneys, organizes and schedules the meetings and facilities, publishes notices, provides public copies of documents and maintains records of proceedings. The staff also processes applications for licensure or examination, maintains disciplinary files, reviews applications for new nursing programs, monitors statistics and prepares reports as requested. Other administrative and support staff may be present during the Board meetings.

D. Board Counsel

An Assistant Attorney General serves as legal counsel to the Board. Counsel responds to requests from the Chair to clarify requirements in Florida laws and rules which may affect the Board decisions. Counsel prepares draft documents for Board review, including proposed rules. Counsel will also inform the Board members of possible legal issues or implications of various courses of action being contemplated. Often, several different sections of laws may affect a decision and the discussion may become confusing. After the meeting, Counsel will prepare the final orders and other documents that are to be filed and sent to respondents.

E. Prosecuting Attorneys

These attorneys from Medical Quality Assurance (MQA) Enforcement (sometimes called
“Prosecution Services Unit”) review all disciplinary cases and prepare materials for Board review. Administrative complaints outline the alleged violations of the Florida Nurse Practice Act, rules of the Board and other laws. Investigative reports provide information from witnesses, records and others about the situations described in the administrative complaint.

If the respondent selects an informal hearing before the Board, the prosecuting attorney reads a summary of the administrative complaint and provides legal notification of procedures followed in notifying the respondent. However, if you choose an informal hearing, you are agreeing that all facts in the administrative complaint are true and you are guilty of the allegations; the only issue left undecided is what your punishment is to be. This is the equivalent of a guilty plea or a no contest plea in a court of law. You may have good defenses that could be raised in a formal hearing and you have procedural rights which may result in dismissal of the case. When in doubt, you should always request a formal hearing.

Please see the separate chapter in this Manual on disciplinary hearings.

Remember, even if you have signed the election of rights form and waived your right to a formal hearing and requested an informal hearing, if you get to the Board of Nursing meeting and change your mind, tell them that you are contesting the facts of the case, that you are contesting your guilt and that you want to withdraw your decision to have an informal hearing. It is very important that you do this if you are really innocent.

Sometimes a stipulation (also called a settlement agreement, and which is similar to a plea bargain in a criminal case) is agreed to between the parties. The Board must still approve the stipulation before it becomes final. If the Board of Nursing rejects a stipulation you have agreed to, it may make you a counter-offer that contains more punishment. Always ask for time (at least a week) to think about the counter-offer. If the Board rejects the stipulation, you will then have the right to a formal administrative hearing to determine your guilt r innocence. You may want to do this.

If a respondent disputes the facts of a case, for example, if the Respondent wants to argue that he is really innocent of the charges, then a hearing before an administrative law judge (ALJ) will be held. When in doubt, you should always request a formal hearing.
Please see the separate chapter in this Manual on formal administrative hearings. The ultimate findings of the ALJ after the formal hearing will be sent to the Board for final action.

F. Respondents

There are two typical respondents that appear before the Board. The first type of respondent is an applicant for licensure or examination. These persons may have discipline in another state, positive findings during criminal background screening, deficiencies in education or other credentials. The Board reviews these cases to determine if the applicant can be approved for licensure or examination. If your application is going to be heard at a Board meeting it would be extremely wise to appear before the Board, should they want to ask you any questions, with a qualified attorney certified in health law.

The second type of respondent that typically appears before the Board is a licensee who has had a complaint filed against them for violation of the Nurse Practice Act, rules of the Board or other laws and rules. Some respondents may be required to appear before the Board; however, in most cases the choice is up top the respondent. An attorney may appear for the respondent; if the respondent chooses to be represented by an attorney it is best to have an attorney who has been certified in heath law and has
represented other nurses in disciplinary proceedings before. A respondent may also bring a witness to appear on their behalf. All respondents and witnesses are sworn under oath.

G. Intervention Project for Nurses (IPN)

Representatives from IPN are present Board meetings to provide reports on individuals enrolled in the program. In addition, if the Board orders a respondent to be evaluated by IPN, information about the process is immediately available. IPN provides evaluations and consultant services for nurses or candidates for licensure. Most services revolve around drug and alcohol abuse but may also include mental health or behavioral problems and psychological testing. See separate chapter in this Manual for more detail on IPN.

The Board of Nursing Meetings are Open.

The Board of Nursing is required to hold all of its meetings in a manner which is open and
accessible to the public. These Board meetings revolve around committee reports, staff and counsel reports, issues of interest to nurses, nursing practice issues, review of licensure and examination applications and discipline for violations of the Florida Nurse Practice Act, Board rules and other laws and regulations. You will learn quite a lot about your profession and how it is governed in the state of Florida by attending a Board of Nursing meeting. There is bound to be one near you soon.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, Department of Justice (DOJ) 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: 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.

 

Almost 19% of Nurse Aides Charged with Abuse and Neglect, had Prior Criminal Records

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

A report released by the Department of Health and Human Services (HHS) Office of Inspector General (OIG) on October 5, 2012, found that nineteen percent (19%) of long-term care nurse aides who were found guilty of on-the-job abuse, neglect or property theft in 2010 had prior criminal records that would have showed up on a background check.

Click here to read the entire report from the HHS OIG.

Report is Part of the Affordable Care Act Background Check Program.

Section 6201 of the Affordable Care Act establishes a background check program. This voluntary program gives grants to states that support nursing home employee background checks.

The report was released to assess the ability of the background check program to help decrease the number of neglect, abuse and misappropriation of resident property cases.

Majority of Nurse Aides Convicted of Burglary, Larceny and Other Crimes.

Out of 1,611 nurse aides charged with abuse, neglect or property theft in 2010, 300 nurse aides had at least one prior criminal conviction. The Inspector General (IG) found the majority of disciplined nurse aides with records had been convicted of burglary, larceny or other crimes against property.

Of the 300 nurse aides, 170 of them had at least one conviction prior to their date of registration as a nurse aide. The remaining 130 nurse aides, each had at least one conviction after the date of their registration.

In a National Public Radio (NPR) story, a nursing professor from the University of California, San Francisco, said she is “most disturbed by the fact that nursing homes had hired some aides who’d been convicted of serious crimes.”

Click here to read the NPR article.

Contact Health Law Attorneys Experienced in Representing Nurses and Nurse Aides.
The Health Law Firm’s attorneys routinely represent nurses and nurse aides 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 http://www.TheHealthLawFirm.com.

Comments?

As a nurse, nursing aide or any other health professional, what do you think of this report? Please leave any thoughtful comments below.

Sources:

Schultz, David. “Among Disciplined Nurse Aides, Criminal Records Turn Up.” NPR. (October 11, 2012). From: http://www.npr.org/blogs/health/2012/10/11/162636910/among-disciplined-nurse-aides-criminal-records-turn-up

Wright. Stuart. “Criminal Convictions for Nurses Aides With Substantiated Findings of Abuse, Neglect, and Misappropriation.” Department of Health and Human Services Office of Inspector General. (October 5, 2012). From: http://www.thehealthlawfirm.com/uploads/Criminal%20Convictions%20for%20nurses%20aides.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. http://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.

 

North Florida 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 Charged with 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.

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.