DOJ Releases 2016 False Claims Act Recovery Statistics: Third Highest Annual Recovery Ever

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

On December 14, 2016, the U. S. Department of Justice (DOJ) released its annual False Claims Act (FCA) recovery statistics. It revealed that the DOJ obtained more than $4.7 billion in settlements and judgments from civil cases involving fraud and false claims against the government in fiscal year 2016. What this indicates to me is that, if all of these cases had been brought by individual relators, those relators could have shared in as much as $1.41 billion as their personal reward for the relator’s part of the recoveries. A whistle blower can receive up to 30 percent of the amount warded to the government, plus all attorney’s fees and costs, for bringing a successful False Claims Act case.

The Third Highest Annual Recovery.

Based on these statistics, 2016 took its place as the third highest annual recovery since the FCA was established in the 1800s. The fiscal year average jumps to nearly $4 billion since fiscal year 2009, and the total recovery during that period to $31.3 billion.

“Congress amended the False Claims Act 30 years ago to give the government a more effective tool against false and fraudulent claims against federal programs,” said Mizer. “An astonishing 60 percent of those recoveries were obtained in the last eight years. The beneficiaries of these efforts include veterans, the elderly, and low-income families who are insured by federal health care programs; families and students who are able to afford homes and go to college thanks to federally insured loans; and all of us who are protected by the government’s investment in national security and defense. In short, Americans across the country are healthier, enjoy a better quality of life, and are safer because of our continuing success in protecting taxpayer funds from misuse.”

Fraud in the Health Care Industry.

The DOJ recovered $19.3 billion in health care fraud claims from January 2009 to the end of fiscal year 2016. Additionally, 57 percent of the health care fraud dollars recovered in the 30 years since the 1986 amendments to FCA claims. Most of the false claims actions are filed under those whistle blower, or qui tam, provisions. Whistle blowers filed 702 qui tam suits in fiscal year 2016, and the DOJ recovered $2.9 billion in these and earlier filed suits in 2016. The government awarded the whistle blowers a total of $519 million during the same time period.

Click here to read the DOJ’s press release in full.

These DOJ fraud recoveries restore valuable assets to federally funded programs such as Medicare, Medicaid, and TRICARE, the health care program for service members and their families.

To read more on the importance of preventing health care fraud, click here to read one of my prior blogs.

If you find yourself at the center on an audit or investigation for health care fraud, don’t wait until it’s too late. Contact an experienced health law attorney. To find out how The Health Law Firm can help you, click here.

Contact Health Law Attorneys Experienced with FCA, Qui Tam or Whistle Blower Cases.

Attorneys with The Health Law Firm also represent health care professionals and health facilities in qui tam or whistle blower cases both in defending such claims and in bringing such claims. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters. We have represented doctors, nurses and others as relators in bringing qui tam or whistle blower cases, as well.

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

Richardson, Kalie. “DOJ Announces $4.7 billion in False Claims Act Collections – $2.5 billion in Health Care Alone.” AHLA Weekly. (December 15, 2016). Web.

Sheppard Mullin Richter & Hampton LLP. “DOJ Releases its 2016 False Claims Act Recovery Statistics.” The National Law Review. (December 15, 2016). Web.

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

Keywords: Florida health law defense attorney, qui tam defense lawyer, legal representation for allegations of health care fraud, legal representation for health care fraud investigations, health care fraud defense attorney, whistle blower attorney, AKS lawyer, Anti-Kickback Statute attorney, False Claims Act defense lawyer, FCA attorney, illegal kickbacks, DOJ settlement attorney, government health care fraud investigation defense attorney, health fraud and abuse allegations, health fraud attorney, FCA legal representation, relator attorney, legal representation for U.S. Department of Justice (DOJ) investigations, DOJ investigation defense attorney, False Claims Act (FCA) defense attorney, legal representation for FCA suit, legal representation for submitting false claims to the government, Medicare and Medicaid fraud defense lawyer, legal representation for Medicare and Medicaid fraud, The Health Law Firm reviews, Reviews of The Health Law Firm attorneys, whistle blower defense attorney, Florida qui tam whistle blower attorney, Colorado qui tam whistle blower lawyer, Louisiana qui tam whistle blower attorney, Kentucky qui tam whistle blower lawyer, Virginia qui tam whistle blower attorney, District of Columbia (D.C.) qui tam whistle blower lawyer, Florida False Claims Act (FCA) and civil monetary penalties attorney, Colorado False Claims Act (FCA) and civil monetary penalties lawyer, Louisiana False Claims Act (FCA) and civil monetary penalties attorney, Kentucky False Claims Act (FCA) and civil monetary penalties lawyer, Virginia False Claims Act (FCA) and civil monetary penalties attorney, District of Columbia (D.C.) False Claims Act (FCA) and civil monetary penalties lawyer
“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

East Texas Lab Agrees to Pay $3.75 Million to Settle False Claims Suit

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

On December 14, 2016, owners of an East Texas clinical laboratory who overcharged Medicare for falsified driving mileage bills have agreed to pay the U.S. government $3.75 million to settle a whistle blower’s False Claims Act (FCA) lawsuit. The suit was brought by a former employee, the U.S. attorney’s office announced.

Submitting False Claims.

Texas-based Elite Lab Services LLC (Elite) and its owners, Gerard and Suzanne Dengler, reportedly settled claims brought under the False Claims Act (FCA) by plaintiff Karen Malcolm. The Denglers admitted that from approximately 2010 to 2014 they submitted inflated employee mileage claims to Medicare and billed the government health agency knowing it does not pay for mileage claims in excess of actual miles driven.

According to court documents, the defendants employed phlebotomists who traveled around East Texas to collect blood samples and transport those samples back to Elite for lab services. For several years, the defendants at Elite knowingly submitted or caused to be submitted inflated mileage calculations beyond the actual distances driven by the employees.

The Whistle Blower.

In 2014, the whistle blower Malcolm, filed the suit alleging that Elite had defrauded Medicare. She claimed that she approached the Denglers in the spring of that year to voice concerns about the billing practices, but the issue was not corrected. She then resigned from the company as a result. The U.S. Attorney’s Office revealed that the government intervened in the suit for purposes of the settlement.

In an agreed final judgment, the parties said that the defendants relinquished and waived all right and title to more than $2.5 million in cash held in a collection of several financial accounts and sales of real property that they owned to satisfy the settlement in the instant case.

As a result of the deal, Malcolm will receive a 21 percent share of the recovery, totaling $787,500, authorities said.

Medicare and Medicaid fraud cases brought on by whistleblowers are unfortunately becoming more common. To read about the serious repercussions of cases like this, click here to read one of my prior blogs.

Contact an Experienced Health Law Attorney to Assist in Whistleblower/Qui Tam Cases.

If you have knowledge of false claims being filed against Medicare, Medicaid, TRICARE/CHAMPUS or any other type of government program, please contact us, and we will be happy to assist you. Our law firm represents health professionals and health care organizations almost exclusively. Yet, we have been involved in a number of whistle blower/qui tam cases, in which we represent the person who files the claim, as well as in defending them in certain cases.

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

Sources:

Wolf, Alex. “East Texas Lab Pays $3.75M For Falsified Medicare Billing.” Law360. (December 14, 2016). Web.

“Tyler lab, owners to pay $3.75 million for filing false Medicare claims.” Longview Business Journal. (December 14, 2016). Web.

“East Texas lab company, owners to pay $3.75M for false Medicare claims.” KLTV-ABC. (December 14, 2016). Web.

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

KeyWords: False Claims Act (FCA) attorney, legal representation for submitting false claims to the government, defense attorney, Medicare false claims defense lawyer, allegations of false billing, Medicare and Medicare fraud investigation defense attorney, consumer reports of false claims, Medicare audit defense lawyer, health care fraud defense attorney, whistle blower attorney, qui tam defense lawyer, legal representation for whistle blower suits, reviews of The Health Law Firm attorneys, The Health Law Firm reviews, qui tam relator’s attorney, qui tam defense attorney, Florida whistle blower case, Virginia Whistle blower case, Colorado whistle blower case, Louisianan Whistle blower case, complex healthcare litigation attorney
“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

Do You Know What A Compromised Physician or Health Care Provider Is?

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

What is a “compromised physician” or “compromised health provider”?  It may not be what you think it is.

This term is used from time to time to refer to health professionals, physicians and health facilities whose identities and billing numbers have been stolen and crooks are utilizing them to falsely bill Medicaid, Medicare, Tricare and health care insurance programs for services that were never performed.

Stolen Medical Identities

Every now and then, these “compromised healthcare providers” have their identifying information ordered into lists which are sold or exchanged from one criminal to the next. This may wind up causing thousands of false claims to be submitted using their identification.  This could cause millions of dollars in taxpayer money or in health insurance proceeds to be paid out to thieves.

The Centers for Medicare and Medicaid Services (CMS) maintains a list of compromised providers that is used to screen for any claim submitted under that providers identification, including prescriptions, orders for durable medical equipment, orders for home health services, orders for diagnostic tests and other services paid by a third party payer.  CMS estimates that there are approximately 5,000 providers whose medical identities have been stolen and used to submit false claims.  A physician may be on this list and not even know it until his or her claims start being denied.

In 2011, Cybil G. Roehrenbeck of the American Medical Association wrote a good article explaining the entire problem in detail.  I highly recommend that you review it and you can do so by clicking here.

Helpful Resources

CMS has published a “Fraud, Waste and Abuse Toolkit” to help physicians and other health care providers prevent the false use of their billing information.  It is titled:  “Health Care Fraud and Program Integrity: An Overview for Providers.”  It also has several other informational publications on how physicians and other health professionals can avoid identity theft.  You can access these publications by clicking here:


Contact Experienced Health Law Attorneys.

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

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

Sources:
Roehrenbeck, Cybil. “Physician Identity Theft.” ABA Health eSource. (October 2011). Web.

“Fraud, Waste, and Abuse Toolkit.” Centers For Medicare and Medicaid Services.(July 2016). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: health care fraud defense attorney, compromised physician list, compromised health provider attorney, The Health Law Firm reviews, The Florida Bar in Health Law, Medicare fraud defense attorney, The Health Law Firm, Medicaid fraud defense attorney, consumer reports of Medicare fraud, Centers for Medicare and Medicaid Services (CMS) audit attorney, Medicaid investigation defense lawyer, Medicare investigation defense lawyer, reviews of The Health Law Firm, legal representation for health care fraud charges, false claims act case legal representation, whistle blower claims attorney

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

 

Nursing Home and Hospital Accussed For Woman’s Death

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

The family of a mentally ill woman, Diane Rimert, who died of pneumonia, urged a Texas jury on December 1, 2016 to find a nursing home and a hospital liable for her death. The family alleged that the nursing home neglected her and that the hospital wrongfully recognized a do-not-resuscitate document that she signed while unable to care for herself.

The Patient Suffered From A Mental Illness.

Rimert lived with severe bipolar disorder and delusions. She lived the last years of her life in a Pennsylvania rehabilitation nursing home after she was arrested and involuntarily committed to a mental hospital.

Rimert Living In Poor Conditions In The Nursing Home.

Jeffrey D. Antonson of Adkerson Hauder & Benzey PC, an attorney for Rimert’s three adult children, told jurors in Dallas County that Rimert developed severe bedsores in her feet and lower half of her body, stating that this confirmed she had been neglected. The attorney claimed there was also proof that Rimert was left in her own excrement until her flesh began to decay and this took away her body’s ability to fend off pneumonia, he said.

Final Days.

Rimert was taken to Texas Health Harris Methodist Hospital, where she was left to die because she had signed what appeared to be a valid legal documents concerning her end-of-life decisions. She signed the documents when she first arrived at the nursing home when, it is alleged, she was mentally ill. The document stated that she did not want to be rescuscitated and gave her medical power of attorney to her neighbor rather than her children. She died in February 2012.

Attorney Anderson stated: “What makes sense here? Is a mentally ill woman — bipolar disorder, with psychosis, a woman who had delusions that she was different people — is she responsible for her own suffering and for her own death? Or is there one or more of the defendants sitting before you that is responsible for her suffering and her death?”

Attorney George Michael Stewart of Stewart Wiegand & Owens, PC, representing the nursing home, argued that Rimert was generally an uncooperative patient and although she was mentally ill, she was deemed competent when she signed the do-not-resuscitate and medical power-of-attorney documents. “Every patient in this country has the right to refuse treatment, mentally ill or not,” he said. “The reality is, this was her choice. She decided long ago that, ‘I didn’t want to be rescuscitated, I didn’t want feeding tubes’ … even if it wasn’t a rational decision for her, it was her right to make that decision.”

Stewart also stated that Rimert’s children, who are seeking compensation for the loss of their mother, had suffered serious abuse at her hand since they were small and were mostly estranged from her. Rimert always became violent and enraged in the presence of one of her sons, and she had last seen her daughter in 1996, he said.

Stewart said they lost their mother a long time ago to the mental illness, not pneumonia.


Comment by Editor

This is certainly a tragic case. And Ms. Rimert, if she really understood what she was signing at the time (and that is a big problem if counselors and intake coordinators in these institutions are not adequately explaining end-of-life decision documents to their new residents), it was her right to make the decision. The law presumes every person is competent until a court declares her to be mentally incompetent. But as ill as she apparently was, this seems to be a real question.


Contact Experienced Health Law Attorneys.

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

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

Source :

Lowery, Brandon. “Nursing Home, Hospital Caused Woman’s Death, Jury Told.” Law360. (Dec. 1, 2016). Web.

About the Author:
George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

 
KeyWords: reviews of The Health Law Firm, health care lawyer, representation for mental health professionals, The Health Law Firm reviews, health law attorney, legal representation for health care professionals, health care provider defense attorney, The Health Law Firm, mental health counselor defense attorney, psychologist defense attorney, legal advice for skilled nursing facilities, nursing home defense counsel, board of mental health counselors defense lawyer, board of psychology defense attorney, complex mental health litigation attorney, psychiatrist defense counsel, complex litigation on health care issues

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

News For Nursing Homes: Federal Government’s Attempt to Ban Nursing Home Arbitration Blocked

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

On November 7, 2016, a Mississippi federal judge temporarily blocked enforcement of the federal government’s proposed ban on mandatory arbitration in cases involving nursing homes. The order from U.S. District Judge Michael P. Mills granted a preliminary injunction sought by the American Health Care Association (AHCA) and prevents the ban from taking effect on Nov. 28.

The proposed rule, released by the Centers for Medicare & Medicaid Services (CMS), bans so-called pre-dispute binding arbitration clauses in nursing home contracts, which require patients and families to settle any dispute over care in arbitration, rather than through the court system.

To learn more about the rule, click here.

Click here to read the final rule issued by CMS.

Not Everyone Agrees With The Rule.

In Judge Mills’s order, he wrote that the CMS “does not have the authority to ban nursing home arbitration on general policy grounds,” even if the goal of protecting elderly Americans is a worthy one.

Additionally, Judge Mills added that CMS could conceivably justify the ban by citing its authority to protect the health and safety of nursing home residents. But, that would require “an exceedingly broad understanding of agency authority.”

Click here to read Judge Mill’s order in full.

AHCA, a top trade group for nursing homes, shared their disapproval of the ban and stated that they are happy with the outcome. “We believe federal law plainly prohibits CMS from issuing this arbitration regulation, and this injunction will halt implementation of the final rule until the court can consider the merits of the case,” the association said.

Contact Health Law Attorneys Experienced with Nursing Home Cases.

The Health Law Firm and its attorneys represent nursing homes and nursing home employees in a number of different matters including incorporation, preparing contracts, defending the facility against malpractice claims, licensing and regulatory matters, administrative hearings, and routine legal advice.

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

Sources:

Overley, Jeff. “BREAKING: Feds’ Ban On Nursing Home Arbitration Blocked.” Law360. (November 7, 2016). Web.

Corkery, Michael. “U.S. Just Made It A lot More Easier To Sue Nursing Homes.” The New York Times. (September 29, 2016). Web.

 

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

KeyWords: Nursing home arbitration cases, U.S. ban on mandatory arbitration for nursing homes, legal representation for American Health Care Association (AHCA) investigations, Centers for Medicare & Medicaid Services (CMS), legal representation for nursing homes, CMS investigation defense lawyer, Medicare and Medicaid defense attorney, reviews for The Health Law Firm, The Health Law Firm attorney reviews

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

Healthcare Providers Service Organization (HPSO) Insurance: Finding What’s Right For You

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

There have been multiple times when we have been told by the health professionals we represent, especially  advanced registered nurse practitioners (ARNPs), pharmacists, licensed mental health counselors (LMHCs), massage therapists and physical therapists that after they received a complaint regarding their license from the Florida Department of Health (DOH) they had a hard time trying to find an experienced attorney in Florida who would accept their professional liability insurance.  In this case, I am talking specifically about Healthcare Providers Service Organization (HPSO) Insurance.

HPSO Insurance Helps With Expensive Legal Fees.

The healthcare professionals who are covered by HPSO Insurance have wonderful insurance coverage.  HPSO Insurance provides professional liability coverage that protects in the event of a lawsuit or negligence claim.  However, many times 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.

Get Insurance Now.

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.

Connect an Experienced Health Law Attorney if You are Contacted by an Investigator.

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.

Be Cautious of Cheap Insurance Policies.

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 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 http://www.TheHealthLawFirm.com.

About the Author: About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: Healthcare Providers Service Organization (HPSO) Insurance, professional liability insurance, health professionals, doctors, nurses, advanced registered nurse practitioners (ARNPs), massage therapists, licensed mental health counselors (LMHCs), social worker, assisted living facility (ALF), physical therapists, psychologists, defense attorney, defense lawyer, Florida defense attorney, experienced health lawyer Florida, experienced health attorney Florida, Florida defense lawyer, health facilities, Florida license defense, Florida Department of Health (DOH), DOH investigation, Agency for Health Care Administration (AHCA) investigation, AHCA complaint, administrative lawyer, administrative complaint, administrative hearings, administrative attorney

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

Nursing Malpractice Insurance

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

There are articles out there on why nurses should not buy professional liability insurance. However, in our opinion, there are many excellent reasons why every practicing nurse should carry professional liability insurance.

Most articles on this issue take the side that if a nurse has a professional liability insurance policy, this will give her a “deep pocket” and make her more likely to be sued in a medical malpractice case against a physician or a hospital. The authors of those articles also look at these issues as nurses are usually employees of hospitals and other healthcare entities and, therefore, their employers will provide a legal defense for them. This latter theory relies, in part, on the legal principle of vicarious liability or respondent superior, which means that the employer is liable for the negligence of the employee; therefore, the employer has a vested interest in defending the nurse from civil claims.

There are several important facts which these articles often overlook which, in our experience, strongly indicates that a practicing nurse should purchase her own professional liability insurance policy.

The Primary Reason for Coverage: To Provide Legal Defense for a Complaint Against the Nurse’s License.

The primary reason that a nurse should purchase a professional liability insurance policy is that this type of insurance usually includes coverage for legal defense of licensing and disciplinary action commenced against a nurse. Although most nursing liability insurance includes this coverage automatically, some policies may not. Some insurance companies may offer this type of coverage separately to be purchased for a small additional premium payment.

License defense coverage pays the legal fees and costs associated with defending a nurse when an investigation is initiated that may result in action against her nursing license or disciplinary action against the nurse. Coverage is usually available from the time the nurse receives written notice than an investigation by a state agency has been initiated. It will also cover formal complaints made against the nurse, informal hearings before the Board of Nursing, and formal administrative hearings before an administrative law judge.

Since such investigations, complaints, and administrative action may be opened based on such events as patient complaints, hotline calls, Code 15 reports, nursing home and home health agency surveys, abuse investigations by the Department of Children and Families (DCF), newspaper articles, copies of lawsuits, and many other sources. It is far more likely that a nurse will be involved in one of these types of actions than that a nurse will ever be sued for nursing negligence.

How A Professional Liability Policy Protects the Nurse.

As noted above, an investigation against a nurse’s license may arise from a number of different sources. Statistics provided by the Medical Quality Assurance Division of the Department of Health (DOH) indicate that for the one year period from July 1, 2001 through June 30, 2002, a total of 1,142 investigations were initiated against nurses. For the one year period from July 1, 2002 through June 30, 2003, a total of 1,302 DOH investigations were initiated. Figures were not available on the number of nursing malpractice lawsuits that were initiated during the 2001-2002 period. However statistics obtained from the Department of Health indicate that during the period from 2002 through 2003, only 51 suits for nursing negligence were filed against nurses. We could locate no statistics that indicated the number of notices of intent to initiate malpractice litigation that may have been served on nurses during this period of time; however, a defense for the nurse in these cases would also be covered by such policies. These statistics indicate that a nurse is more likely to be involved in one of these types of licensing actions rather than a lawsuit alleging nursing negligence. These figures show that a DOH investigation is 26 times more likely against a nurse than a malpractice lawsuit.

Professional liability policies which provide coverages for licensure defense will usually provide compensation to the nurse for her out-of-pocket expenses (travel, postage, etc.) that she herself incurs as well as lost wages because of working time missed for hearings, depositions, etc. However, the maximum coverage available under such policies for licensure defense is usually limited. Usually coverage for licensure defense in most policies for nurses is between $10,000 and $15,000. This amount will usually be sufficient to provide for most of the legal fees and costs involved in defense of such a case and will usually be enough for the nurse to be able to afford to hire a highly qualified, experienced healthcare attorney, familiar with nursing law, to represent her.

Does Vicarious Liability Actually Absolve the Nurse From Liability?

The assumption that vicarious liability or the legal doctrine of respondeat superior protects a nurse against a medical negligence claim is a mistaken one. If the employer provides legal representation, the attorney representing the nurse will almost always be the same attorney representing and being paid by the hospital or employer.

In many circumstances, the nurse may conclude that her interests are contrary to those of the hospital or employer, which could result in the attorney hired by the hospital withdrawing from further representation of the nurse. Additionally, it may be necessary for the nurse to raise evidence showing that the injury was caused by another nurse or hospital employee, in order to defend herself. It is doubtful that an attorney representing the employer or hospital would raise this defense since it would prove liability against the employer hospital.

Many employers will not provide legal representation if the matter involves licensing or disciplinary action against the nurse. This could force the nurse to fund all the fees and costs associated with her defense. However, some larger corporations with good risk management programs will provide the nurse with legal representation for such matters.

For example, the authors of this article have represented large national hospital chains and nursing home chains, as well as a local independent nursing home, which routinely provide legal representation for nurses accused of wrong-doing who have a complaint filed against them with the Board of Nursing, Department of Health, or the Department of Children and Families. The authors have also been retained as independent outside counsel to represent nurses by large national nursing home chains and hospital chains when it was felt that there might be a conflict of interest between the corporation and the nurse. This situation might arise, for example, if the nurse is suspected of having committed a criminal act or an intentional act that might also result in civil liability or discipline against the nurse.

If you are an agency nurse, a home health agency nurse, a nursing home nurse, an independent duty nurse, or you are not employed by a large hospital chain, then you should consider nursing liability insurance mandatory. It appears that complaints of negligence against nurses working in these positions are far more likely. This may be because of the high turnover of nurses in some types of healthcare facilities (such as nursing homes), or because when the incident is investigated, the nurse is no longer employed there (for example, in the case of an agency nurse). Additionally, agency nurses may only work in facility for a short period of time making them less familiar with the facility’s policies and procedures, and not a part of the permanent team of nurses who may have established relationships with each other and are more likely to cover for each other.

As mentioned above, a number of different proceedings may be covered by the licensure defense coverage provided for in professional liability insurance. These proceedings may include an investigation by the Department of Health based on a patient complaint or Code 15 report; an abuse investigation (abuse of a child, abuse of a developmentally disabled or vulnerable person, or abuse of an elderly person) by the Department of Children and Families (DCF); allegations of nursing negligence or abuse being investigated by a state “surveyor” by the Agency for Health Care Administration (AHCA); an investigation into allegations of Medicaid over-billing or fraud; an investigation by the Agency for Health Care Administration or on the Attorney General’s State-wide Medicaid Task Force; and allegations of improper Medicare billing or fraud.

A nurse might be involved in a Medicaid fraud investigation, for example, in the case of an Advance Registered Nurse Practitioner (ARNP), Certified Registered Nurse Anesthetist (CRNA) or Certified Nurse Midwife (CNM) who has her own provider identification number and is allowed to bill as part of a group practice or independently. This might also occur, for example, in the case of a nurse working for a home health agency which receives its reimbursement for the nurse’s services from Medicare or Medicaid. We have represented nurses in each of these types of cases.

Cost of Professional Liability Coverage is Minimal.

High limits of coverage for nursing malpractice insurance coverage are usually available. Most nursing liability insurance policies provide at least $1,000,000 in coverage. If sought by physicians, this high limit of coverage may be very expensive or often is not available, at all. This professional liability coverage should afford the nurse ample protection in any malpractice case that might be filed against her. When counseling physician clients regarding asset protection, we routinely advise them that the best asset protection is having and maintaining good professional liability insurance coverage. There is no reason that this should not apply to a nurse who may have property, savings or other assets she desires to protect.

Nurses can purchase liability coverage rather inexpensively. For example, an excellent insurance policy providing coverage for nurses is available through the Nurses Service Organization (N.S.O.) for less than $100 per year. Professional liability coverage provided by this type of insurance represents a bargain at these rates.

Focusing on Protecting the Nurse’s Individual Interests.

Perhaps most importantly, the nurse should have an attorney focusing on her interests only in defending her against any type of negligence or licensing complaint. A nurse with her own professional liability insurance coverage will be able to hire a separate, independent attorney, and often the insurer will allow her to pick her own attorney.

Additionally, it has been our experience that it is better to have several different defense attorneys actively involved in a case rather than to have only one, when defending multiple parties. Having several defense attorneys involved means that the attorney representing the plaintiff (or person filing the claim) has to work much harder in order to prove her case. During the discovery process, each defense attorney is allowed to separately question both fact and expert witnesses. Each separate defense attorney is allowed to file discovery requests. Each separate defense attorney participates in the filing of motions. Relevant facts or issues that are overlooked by one attorney may be picked up by other defense attorneys. A cohesive defense with a unified strategy stands a greater chance of prevailing both before and at trial.

Important Considerations When Purchasing Liability Protection.

When deciding on which professional liability to purchase, the nurse should inquire as to the extent of coverage for licensing in disciplinary defense coverage. Some professional liability insurers have a “broad form” of coverage which may provide legal defense for the nurse in almost any type of administrative action. This might include, for example, defense of a discrimination complaint filed against the nurse with the Florida Commission on Human Relations (FCHR) or the U.S. Equal Employment Opportunity Commission and for Medicare and Medicaid complaints. Other companies limit coverage to only actions that may result in disciplinary action against the nurse’s license. The nurse should always attempt to get the broadest coverage available for disciplinary defense and licensure defense coverage.

Additionally, the nurse should inquire as to whether or not she will be allowed to select her own attorney. Many insurance companies have contracts with certain law firms to provide legal services on their cases for a reduced fee. The insurance company may require you to use one of its own contracted attorneys, or even one of its in-house attorneys which it employs directly. Given the limited number of attorneys with experience at handling nursing law issues and trying malpractice cases, the nurse should attempt to obtain coverage through a company which allows her to choose her own attorney.

The most important reason to purchase professional liability insurance is for the licensure defense coverage. A nurse does not want to risk losing her nursing license because she was unsuccessful at defending an investigation against her license or did not have the resources to do so. Since there are far more complaints filed each year against nurses’ licenses than here are nursing malpractice lawsuits, it is far more likely that a working nurse will need legal defense of a licensure complaint investigation.

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 http://www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords:  Healthcare Providers Service Organization (HPSO) Insurance, HPSO Insurance, Massage therapy, massage therapist insurance, massage therapists, investigation of massage therapist, Florida massage laws, massage therapy board licensing complaints, Department of Health, DOH, investigation, investigator, licensure defense, defense lawyers, defense attorney, administrative complaint, administrative licensure investigation, administrative hearing, Florida health law attorney, health care attorney, massage therapist lawyer, massage therapist attorney

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

Don’t Take Away From Your Professional Reputation. Make Sure Your Correspondence Is Professional: 30 Tips (Part 3 of 3)

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

This is Part 3 of a 3 part series on this issue.

I continue with my tips for preparing good, professional correspondence.

19.    In longer correspondence, use section headings (in bold or underlined) or headings for each issue, to better organize it. Think of these as road signs on a long road.  They help the reader to know where he or she is at any given time.

20.    When using headers, skip two lines before the header and one line after the header. This helps to set off the new section and header and show a definite division.

21.    Keep your language objective and professional.  Do not ever use profanity [Oops, I just went back and removed the word “damn” I used above.]  Do not ever use any comments even remotely resembling racism, sexism, or antisemitism or prejudice.  Do not be sarcastic.

22.    Be direct and concise in your language.  To the greatest extent possible, use the same terminology and wording that the other party uses, or has used, or whatever statutes, regulations or governing documents with which you are dealing use (but also, be sure you know what the words and terms mean).

23. If you intend to request a formal hearing say “I request a formal hearing.”  If you want a refund, state:  “I request a full refund.”  If you want to appeal the decision, state:  “I want to appeal the decision.”  Don’t be wishy-washy or vague.  For example, don’t say, “I am looking for an attorney to file an appeal for me,” when what you mean to say is “I appeal the decision” or “I request an appeal.”

24.    If there are any deadlines by which you must respond, be aware of these and make sure your response is received by that date.  Remember “received” means “actually received” by the correct person (or office) at the correct address.  It does not mean “mailed by” or “postmarked by.”  If you have correspondence or a document to which you a response must be received by a certain date, you need to make sure it is in the receiving person’s hands by that date, even if you must hand carry it.

25.    In closing your correspondence conclude by stating what action is next, whether this is action you intend to take, or action you are requesting the other party to take.  For example:  “I expect to hear from you within ten days as to whether you grant my request or not.”  “Please contact me with hearing dates within the next fourteen days.”  “I will forward you a refund within five days.”  “I will send you my records within five days.”

26.    Always advise the other party of exactly how they should contact you;  provide multiple means of contacting you.  If you are very busy or have an assistant who is authorized to act for you, provide that person’s name and contact information, as well.  Then be available to receive the return communication(s).  Don’t give telephone numbers you never answer.

27.    In dealing with dates and deadlines, remember that ten days is ten days;  fourteen days is fourteen days, twenty-one days is twenty-one days.  Made up rules such as “weekends and holidays don’t count” are just that, made up (outside of formal legal proceedings).  If the other party has given you “fourteen days to respond,” this means fourteen days from the date on the letter, unless specifically stated otherwise.  Fourteen days means fourteen days, unless it is specifically stated otherwise (e.g., “you have fourteen business days to reply”).

28.    Include a professional closing above your signature.  This should be “Sincerely,” “Sincerely yours,” “respectfully submitted,” or some other professional closing.

29.    In your signature block, include your full typed name, with credentials and title or position listed.  For example, your full name, followed by your degree and other credentials (e.g.,  “John J. Smith, M.D., F.A.A.C.P.”) should be on the line immediately below where you sign.  Next should be listed your position within your organization (if applicable) (e.g., “Chair, Pediatrics Department”).

30.    If you have enclosures, list them at the end of the correspondence, giving a brief or shortened description and numbering them.  List and number them in the order you discuss them in your correspondence.  Be sure they are properly organized, labeled and divided, especially if any are lengthy.

Following these simple rules most people learn in middle school will help to keep your correspondence professional looking and in conformity with what most professionals see on a daily basis.

Contact Experienced Health Law Attorneys.

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

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

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: The Health Law Firm, legal representation for health care physicians, reviews of The Health Law Firm, tips for professional correspondence, The Health Law Firm attorney reviews, legal representation for nurses, professional correspondence for a legal dispute, owners of health care businesses defense attorney, physicians defense lawyer, 30 tips for professional correspondence, The Health Law Firm reviews

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

Don’t Take Away From Your Professional Reputation. Make Sure Your Correspondence Is Professional: 30 Tips (Part 2 of 3)

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

This is Part 2 of a 3 part series on this issue.

I continue with my tips for preparing good, professional correspondence:

5.    Use titles or honorifics.  In the “business address” of your correspondence, always use the complete name of the person to whom you are writing (if known) together with that person’s honorific or professional title (e.g., Mr., Ms., Dr., Nurse, Prof., Dean, etc.).  This shows both respect and professionalism.

6.    Always use the complete mailing address, including title, of the person to whom you are sending it.  In the business address of your correspondence include not only the person’s name and honorifics, but title or position and division within the institution or organization to which you are sending it.  In the case of large organizations, you should include the building and suite or room numbers and any internal routing codes, designations, “mail stops” or other organizational routing codes, that the agency or business you are writing requires to route its mail internally.  Large organizations, especially government agencies, all have large mail rooms which sort and route all mail the organization receives from any source.  Correct internal routing codes will help ensure that your correspondence gets to the correct person or official in a timely manner.

7.    Always use a salutation.  This is self-explanatory, but see below.

8.    In your “salutation,” always use the person’s last name with a title or honorific.  It is customary to use the term “Dear” in a salutation in formal writing, so this is permitted.  But you may leave it out.  For example, “Dear Secretary Jones:” or “Secretary Jones:” or “Dear Dr. Johnson:” is correct.  Never refer to the person by that person’s first name in any type of formal correspondence or correspondence that anyone else might read.  Never say:  “Dear Sue:” or “Sharon:”.  Even if you know these people well enough to call them by their first names, don’t do it in this situation;  it’s unprofessional and may be interpreted as “talking down” to the person.

9.    Always end your “salutation” with a colon, not a comma.  A comma is only used in informal communications to those you know well or socially, such as a letter to your mother or a note to your girlfriend.  Unless this is your mother or your girlfriend to whom you are writing, use a colon.  For example, “Dear Secretary Jones,” or “Dear Sue,” is incorrect.  “Dear Secretary Jones:” or “Ms. Smith:” is correct.

10.    Type your correspondence or have it typed for you.  Do not send handwritten letters in formal or professional matters.  Do not write on the other person’s correspondence or documents and send it back.  Prepare and send a professional looking letter or e-mail, even if you must pay someone to type it for you (and if you are sending an e-mail, I know you can type a little bit yourself, anyway).  To do otherwise is to show laziness, disrespect and unprofessionalism.

11.    Always use a type font in your correspondence (inlcuding e-mails) of at least 12 points (10 characters per inch).  Do not use a small, difficult to read type fonts, for example, the size of the type font that most e-mail software defaults to.  Smaller type fonts than 12 points become difficult to read, especially if scanned/rescanned, faxed/refaxed or copied/recopied.  Change the default font in your e-mail software or computer word processing software, if necessary.  You can do this, regardless of how difficult it may seem at first;  I know you can do it, because I can do it.  Make your professional correspondence easier to read, not more difficult to read.

12.    Never use unprofessional looking type fonts for your communications.  Stay away from script type fonts, italics or novelty type fonts.  These are notoriously more difficult to read and look unprofessional.  You are not publishing a flyer for a high school bake sale.  Times New Roman, CG Times and similar type fonts are more professional looking and easier for a person to read.  Use Courier or Letter Gothic type fonts if necessary.

13.    Keep the correspondence to which you are responding unmarked.  One reason to not write on or mark up the other person’s documents or correspondence is that you may need them as evidence in a court of law or a hearing some day.  Nothing looks less professional than a document you are trying to use as evidence when a different person has made handwritten marks all over it.  The impression is similar to one in which a child with a box of crayons has gotten to it.  You don’t want this or need this.  Show respect and self-control.  Keep the other side’s documents pristine.  They will look much better that way as your “Exhibit 1” in the court hearing.

14.    Use a good concise, descriptive reference line or subject line (often called the “re:” line).  Make it a very brief summary.  State what the content of your letter is about.  State if you are responding to a letter or document that you received from the “addressee” (the person to whom you are addressing your correspondence) of your letter.

15.    Include the recipient’s routing information.  If the intended receiver of your letter or correspondence (the “addressee”) included reference numbers, file numbers, account numbers, case name and numbers, a policy number, a routing number, or other similar information on its letter to you, repeat these back in the reference line of your correspondence.  This will help make sure that your correspondence gets routed to the correct file and recipient more timely.  This is especially crucial in large organizations and government agencies.

16.    The contents of the body of your correspondence should be easy to read and easy to understand.  To this end, be sure to use short sentences and short paragraphs.  Each paragraph should convey one idea. Use headers and section titles, if necessary, to organize your correspondence, especially if it is lengthy.  Remember, headings within your letter that help to organize it are like street signs in a busy city.  They will really help any subsequent reader (and this may be a judge or jury) to navigate his or her way through your letter.

17.    Be sure to skip a line between each paragraph and, preferably, indent the first line of each paragraph.  [Note:  Some writers will tell you not to indent the first line of each paragraph in professional correspondence.  However, I feel that this makes the correspondence more difficult to read, so I encourage indenting or tabbing in on the first line of each paragraph.]  This makes it easier on the reader and more likely that your ideas will not get lost in a crowd of words.

18.    Keep your paragraphs short and to the point.  Nothing turns readers off as much as a single lengthy paragraph written from margin to margin taking up the whole page.  I suppose some people may have never been taught what paragraphs are.  However, I am willing to bet that most were.

Contact Experienced Health Law Attorneys.

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

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

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: The Health Law Firm, legal representation for health care physicians, reviews of The Health Law Firm, tips for professional correspondence, The Health Law Firm attorney reviews, legal representation for nurses, professional correspondence for a legal dispute, owners of health care businesses defense attorney, physicians defense lawyer, 30 tips for professional correspondence, The Health Law Firm reviews

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

 

Don’t Take Away From Your Professional Reputation. Make Sure Your Correspondence Is Professional: 30 Tips (Part 1 of 3)

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

I review numerous letters, e-mails, memoranda, and other kinds of correspondence prepared by my physician and nurse clients over the span of my legal representation of them.  Frequently this is the result of a dispute with a hospital, a dispute with their peers or the medical staff, a dispute with an insurance company, a law suit filed by a patient, a complaint being investigated by the licensing agency, or another serious legal matter.

In several cases, way too many cases, such correspondence is unprofessional and defeats the purpose of the reason you are sending the correspondence.  At times it is so bad, it will be disregarded by the reader to whom it was directed. I have seen this from doctors, nurses, dentists, psychologists, owners of health care businesses, and many, many other highly educated professionals who really should know better.

When these documents are dictated and transcribed by a professional medical transcriptionist, they are usually formatted correctly and many of the errors I see are avoided.  However, when the health professional types his or her own document, that is when I see the most errors.

To avoid these errors that make your correspondence and professional communications look unprofessional, follow these tips.

Remember Why You Are Writing.

Remember, the basic purpose of your correspondence is to communicate ideas effectively.  In many cases, it will be to invoke your legal rights in certain situations (such as an appeal or a hearing request).  Sometimes it will be to attempt to persuade your hospital, your peers, or your employer to take certain action or to refrain from certain action.  Remember that your correspondence is often the first impression that the other side will have of you.  Do you want it to be an impression that you are sloppy, lazy, unprofessional, not knowledgeable, uneducated, or confused?

Whether you are communicating in a letter or via e-mail, these rules hold true.  In many (if not all) situations involving legal proceedings or legal issues, it is probably best to communicate via a letter sent by U.S. mail or some other reliable service (e.g., Federal Express, Airborne Express, DHL, etc.).  Even if you are transmitting your information via an e-mail, it is my suggestion to prepare it in the form of a paper letter (if your e-mail is not set up to insert your letterhead) and then scan it in and send it electronically.

I discourage legal communications via e-mail in serious matters because they are often difficult to obtain, isolate, and authenticate when you need them for hearings.  Additionally, they are rarely secure, often available to many others who shouldn’t see them and easily susceptible to being accidentally sent to others who should not see them at all.

Horror Stories of Unprofessional Correspondence.

Why do I feel this blog is necessary?  Because of all the horrible correspondence I have seen written by allegedly highly educated professionals, mostly physicians and nurses.  That’s why.

Here are just a few:

Physician never wrote a separate response to any charges or allegations made against him on any peer review documents.  He would just hand write (scribble, actually) his remarks on the bottoms and in the margins of whatever document he was sent to him and then send it back.

Nurse practitioner was required to respond to serious charges of negligence resulting in an adverse outcome to a patient.  She hand wrote, on unlined paper, a response letter that was not addressed to anyone, not dated, not signed and did snot state who was sending it.

The physician was required to provide his analysis of a patient’s case for peer review purposes.  His typed letter of three pages, single spaced, contained one long paragraph.  I used to work for a Medical Corps Admiral when I was a Navy JAG Corps officer.  He would just glance at such correspondence and state:  “I can tell this doctor doesn’t have any idea what he is talking about.”  Failing to follow good correspondence procedures will show others your thoughts lack organization and cohesion.

A health professional was required to complete an application for clinical privileges.  He wrote all of the answers by hand, not even staying within the lines on the form, writing over the questions and around in the margins of the application.  This is what he signed and turned in.  Believe me, this did not look very professional.

Physician was requested to respond to a medical staff inquiry from the hospital.  Her response came back typed in 22 characters per inch (cpi) size type font, almost too small to read.  Perhaps she was just trying to save a sheet of paper.  But many of us would have had to pull out a magnifying glass to be able to read it.  If you are actually trying to communicate your ideas, make your correspondence easier to read, not harder to read.

A dentist was notified of a pending complaint investigation being opened against her dental license.  She wrote her response to the charges back to the investigator, without using any business address or title, and began her response statement “Dear Sharon,”.  Do not treat others informally, especially in professional or formal situations.  You will be deemed to be unprofessional when you do so.

Tips for Good Professional Correspondence.

Here are some pointers on professional communications that should be followed in all of your professional written communications about business, professional or legal matters, even in e-mails. Please note, the terms below in quotation marks have certain defined meanings.  If you don’t know what these terms mean, look them up.

1.    Always remember that the reason you are sending the correspondence is to attempt to effectively and accurately communicate your position and ideas.  If you are trying to make your message indecipherable or difficult to understand, ignore these tips.  If you are trying to come across as someone who doesn’t give a damn about how he or she is perceived, ignore these tips.  If you want to come across as unprofessional, ignore these tips.

2.    Make sure you include your complete and correct “return address” and contact information.  This includes your physical or mailing address, telephone number, telefax number and e-mail address, so that the other party knows exactly how to reach you.  In cases where you already have this on your letterhead, be sure to use your letterhead.  Also, it appears more professional to create a letter head with the information in it and to use your new letterhead instead of having a professional business letter with a typed “return address.”  However, a typed “return address” is better than none.

3.    Don’t use someone else’s letterhead.  Don’t use your hospital, medical group or institutional letterhead for your own personal communications, unless you are the owner.  Use your personal letterhead (see above), instead.  If you are being accused of poor utilization review, unprofessional conduct, or personal use of hospital (or company) property, then using someone else’s letterhead just helps prove the charge against you.

4.    Date your correspondence.  Date your correspondence.  Date your correspondence.  Nothing shows a lack of professionalism and lack of attention to detail as sharply as undated correspondence.  It will certainly be difficult to prove when your letter or document was sent if you do not have a date on it.  A year or two later, it may be completely impossible to do so.

Contact Experienced Health Law Attorneys.

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

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

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: The Health Law Firm, legal representation for health care physicians, reviews of The Health Law Firm, tips for professional correspondence, The Health Law Firm attorney reviews, legal representation for nurses, professional correspondence for a legal dispute, owners of health care businesses defense attorney, physicians defense lawyer, 30 tips for professional correspondence, The Health Law Firm reviews
Don’t Detract From Your Professional Reputations. Always Ensure Your Correspondence Looks Professional: 30 Tips

 

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