Category Archives: In the News

The field of health care is frequently in the news with technology updates, privacy breaches, innovative procedures, malpractice claims, etc. Learn more about the happenings of health care providers (physicians, nurses, dentists, hospitals, nursing homes, pain management clinics, medical students, mental health counselors, etc.) in Florida and around the United States.

Apopka Woman to Serve 18-Month Prison Sentence After $47K Medicaid Scam

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

IndestAn Apopka businesswoman was recently sentenced to 18 months in prison after she was found guilty of a Medicaid scam. According to the Florida Attorney General’s Office, Shanqual Marshall-Gunn was arrested in September on suspicion of submitting more than $47,000 in fraudulent Medicaid claims.

Company Provided Targeted Case Management Services (TCMs).

Marshall-Gunn owned Second Chances TCM, Inc. TCMs are intended to provide Medicaid recipients who have mental-health disorders with connections to resources in their community, and to assist them in leading a more normal life. Prosecutors said Marshall-Gunn gave employees and clients kickbacks when they submitted referrals to her company.

Three of her employees were also arrested in September 2014 for billing Medicaid for targeted case management services that were fraudulent or not authorized.

Marshall-Gunn Entered a No Contest Plea.

Media reported that court records show Marshall-Gunn entered a no contest (or “nolo contendere”) plea and was found guilty of Medicare fraud, a second-degree felony. Circuit Court Judge Jenifer Davis sentenced Marshall-Gunn on July 2. Davis also ordered Marshall-Gunn to serve five years of probation.

In addition, she cannot work for any Medicaid provider and must pay more than $47,000 in restitution.

The Investigation Was Conducted by the Medicaid Fraud Control Unit.

The investigation was conducted by Attorney General Pam Bondi’s Medicaid Fraud Control Unit (MFCU). And it was prosecuted by the Attorney General’s Office of Statewide Prosecution.

Bondi’s MFCU investigates and prosecutes providers that intentionally defraud Florida’s Medicaid program. According to Bondi’s MFCU press release in this case: “From January 2011 to August 2014, Attorney General Bondi’s MFCU has obtained more than $460 million in settlements and judgments.”

To read the press release, click here.

To read more about the MFCU, click here.

Comments?

Have you ever been a victim or suspect of Medicaid fraud? Please leave any thoughtful comments below.

Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations and other Legal Proceedings.

Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Health Care Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.

The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (ALFs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

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

Sources:

Attorney General’s Press Office. “Four Central Florida Residents Arrested for Medicaid Fraud.” (Sept. 5, 2014). WCTV. From: http://www.wctv.tv/home/headlines/Four-Central-Florida-Residents-Arrested-for-Medicaid-Fraud-274154191.html

Connolly, Kevin P. “Apopka woman sentenced to prison for 18 months after Medicaid scam.” Orlando Sentinel. Print.

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: Medicaid, Medicaid fraud, defense attorney, Medicaid investigation, defense lawyer, defense counsel, Medicaid claims, fraudulent claims, home health care, criminal defense, health law criminal defense, health law criminal representation, criminal representation, Medicaid Fraud Control Unit, MFCU, targeted case management provider, TCM, Florida’s Medicaid program, overbill Medicaid, Medicaid scam, Medicaid fraud defense attorney, Medicaid fraud defense lawyer, Medicare, Medicare fraud, Medicare Investigation, overbill Medicare, health care fraud, Florida Attorney General, The Health Law Firm

“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 © 1996-2015 The Health Law firm. All rights reserved.

Medical Staff Involved in Peer Reviewers Can Receive Compensatory and Punitive Damages for Violations of their Confidentiality: Part 1 of 2

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

6 Indest-2008-3An important decision was delivered by the Supreme Court of New Mexico involving peer reviewers’ statutory right to confidentiality. In the decision, the New Mexico court allowed peer reviewers to recover compensatory and punitive damages resulting from confidentiality violations. The court recognized that peer reviewers are members of the class protected by the peer review statute in New Mexico. Thus, the court stated, they deserve remedies for violations of their confidentiality right. To view the New Mexico Peer Review Statute, click here.

Yedidag v. Roswell Clinic Corp., the New Mexico Case.

Dr. Emre Yedidag was an employee of Roswell Clinic Corp. and Roswell Hospital Corp. During a peer review of another employee, Dr. Akbar Ali, Dr. Yedidag allegedly “verbally attacked” Dr. Ali when he questioned the physicians’ involvement in a patient’s death. The hospital subsequently terminated Dr. Yedidag’s employment for “unprofessional conduct.” In response, Dr. Yedidag filed a complaint against the hospital for utilizing confidential peer review information to support his termination.

The Supreme Court of New Mexico did not agree with the hospital’s argument that the physician’s unprofessional conduct justified the doctor’s termination. The court held that the doctor’s questions were privileged, even if they were “uncivilized.” Also, the court ruled, the hospital may not use information from a peer review proceeding as a reason to terminate his employment. The court upheld an award to Dr. Yedidag of his compensatory and punitive damages. To read the case in its entirety, click here.

The New Mexico Supreme Court Estimated that the Peer Review Statute is too Lenient.

The Supreme Court of New Mexico also estimated that the criminal penalty imposed by the New Mexico peer review statute was “too lenient” to discourage violators. Therefore, allowing peer reviewers to sue violators will result in greater deterrence, the court ruled. The court held that peer reviewers’ confidentiality is a “mandatory rule of law incorporated into physician-reviewer employment contracts.”

Comments?

What are your thoughts on the Supreme Court of New Mexico’s ruling of compensatory and punitive damages for peer review violations? Please leave any thoughtful comments below.

Contact a Health Law Attorney Experienced in Representing Health Care Professionals.

At the Health Law Firm we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing home and any other health care provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

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

Source:

Stein, Alex. “Doctors Conducting Peer Review Can Recover Compensatory and Punitive Damages for Confidentiality Violations.” (February 21, 2015). From:
http://blogs.law.harvard.edu/billofhealth/2015/02/21/doctors-conducting-peer-review-can-recover-compensatory-and-punitive-damages-for-confidentiality-violations/

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

Keywords: Yedidag v. Roswell Clinic Corporation, peer review, defense attorney, defense counsel, defense lawyer, medical staff attorney, fair hearing attorney, peer review fair hearing, clinical privileges attorney, hospital clinical privileges, confidentiality right, compensatory damages, punitive damages, New Mexico peer review statute, healthcare law, healthcare attorney, healthcare lawyer, The Health Law Firm

“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 © 1996-2015 The Health Law firm. All rights reserved.

Report: Florida Received an F in Medical Pricing Transparency

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

6 Indest-2008-3In Florida, it’s difficult to compare prices for medical services and procedures because the various prices are not made public. In part because of this, a recent study by a health-care advocacy group gave Florida an F for transparencies in pricing.


What Did the Analysis Look For?

The report analyzed whether or not states have laws and regulations that require health prices be made public.

Only One State Received an A.

The only state to receive an A in the study was New Hampshire. This is because of its NH Health-Cost site. The site provides consumers prices based on geography, type of insurance and other factors for everything from a basic visit to complicated medical tests. Consumers are able to go on the site and compare prices.

Florida Was Not the Only State to Receive an F.

Every state except five received the lowest grade from the Catalyst for Payment Reform and the Health Care Incentives Institute. So, if F was the average grade, I guess that means that Florida actually only received a C. Maybe there should be a “No State Left Behind” policy.

Comments?

Would you have given Florida an F? Do you think every state should have a health-cost website? Please leave any thoughtful comments below.

Contact Experienced Health Law Attorneys.

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

Sources:

Kassab, Beth. “Hidden prices for health care earn Florida an F for transparency.” Orlando Sentinel. (July 16, 2015). Print.

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 attorney, health care lawyer, health care attorney, law, health law, health care law, medical services, physician attorney, health care defense attorney, health care defense lawyer, health care, health care coverage, health law attorney, health law lawyer, The Health Law Firm

“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 © 1996-2015 The Health Law firm. All rights reserved.

Promoting Research Subject Compliance: Six Tips for Investigators

LLA Headshot smBy Lenis L. Archer, J.D., M.P.H. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Investigators who manage clinical trials involving human subjects rely on their participants to comply with research study parameters. However, ensuring this compliance is much easier said than done. Following are several tips that researcher’s and principal investigators might employ to improve compliance.

When Research Subjects Don’t Follow the Rules.

Often, subjects in clinical studies don’t do as they are told. Surprise! Trial participants may self-report full compliance in a study’s direction and protocols, when in fact, they are not. Many research subjects fail to take drugs correctly by taking an improper dosage or taking the drugs at inappropriate times. It’s not that the subjects do not want to comply or desire to be deceptive. Often, it’s merely oversights or forgetfulness at play and the subject does want to be fully compliant.

Participants’ Rule-Breaking Has Ethical and Regulatory Consequences.

The failure of participants to comply fully in a study can have devastating consequences. Chiefly, the results obtained by the study are compromised, which can affect the approval of the drug and its recommended dosage. In addition, important medical side effects may not be clearly identified.

Ultimately, the burden of these consequences will fall on the investigators, who could face sanctions for ethical and legal violations.

Here are Five Tips that Will Help Investigators Encourage Compliance in Study Subjects:

1. Increase Monitoring Measures – Incorporate ways to monitor subjects in your study design. While this may increase cost in the short term, ultimately the results of the study will be more accurate.

2. Provide Clear Guidance – Take the time to provide study participants with ample resources and guidance on how to remain in compliance during their study.

3. Remove the Fear Factor – Create an environment in which study subjects are comfortable reporting their noncompliance.

4. Learn from the Rule-Breakers – Make sure to gather lessons from individuals who are non-compliant. Take the time to ask questions that will assist in you in designing and conducting future clinical trials.

5. Be Honest – Investigators should never let their desire to be published or advance career prospects cloud their ethical and regulatory responsibilities. Provide accurate data regarding noncompliance and how noncompliance was remedied.

6. Implement Reminders – Implement systems to remind patients when regular activities (such as taking vital signs, recording symptoms or taking medications) are required. Implement systems of text messaging or telephoning patients for those that may be non-compliant.

Investigators, consider these tips to ensure that noncompliance of subjects does not have an oversized effect on your study results AND your reputation as a scientist.

Comments?

Have you ever participated in a study as a research subject? Do you think that intensified policing and guidance are effective strategies for reducing participant rule-breaking? Please leave any thoughtful comments below.

Contact a Health Care Attorney that is Experienced in the Representation of Clinical Research Compliance and Misconduct.

The Health Law Firm and its attorneys have experience in representing researchers, investigators, academicians and clinicians who are the subject of clinical research compliance and misconduct. The Health Law Firm and its attorneys also have experience in representing students, employees, researchers and investigators who report such matters including those who become the victim or reprisals and retaliation by the person against whom the report is made.

Sources:

Van Tassel, Katherin. “Guest Blogger Professor Rebecca Dresser: When Research Subjects Don’t Follow the Rules.” (Dec. 23, 2014). From:
http://lawprofessors.typepad.com/healthlawprof_blog/2014/12/guest-blogger-professor-rebecca-dresser-when-research-subjects-dont-follow-the-rules.html

Dresser, Subversive Subjects: Rule-Breaking and Deception in Clinical Trials, 41 J.L. Med. & Ethics829 (2012).

About the Authors: Lenis L. Archer is as 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.

IndestGeorge 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.


KeyWords:
Research compliance, clinical trials, human research subjects, research misconduct, research parameters, clinical research investigator, defense attorney, defense lawyer, health law, health care law, health law attorney, health care lawyer, health law firm, The Health Law Firm

“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 © 1996-2015 The Health Law Firm. All rights reserved.

Author Recommends Medicare Use ‘Procedural Triage’ to Eliminate Backlog of Appeals and Restore Faith in the System

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

IndestIn a recent law journal article being considered for publication, Author Matthew J. B. Lawrence of the Harvard University Petrie-Flom Center, makes some bold recommendations for Medicare. His hypothesis seems to be that the extremely long delay that health care providers now face in getting a Medicare appeal hearing might be negatively affecting these providers’ view of the fundamental fairness of the system. Currently, the backlog in obtaining a Medicare Appeal Hearing before an administrative law judge is up to approximately 27 months. Mr. Lawrence argues “procedural triage” may be in order.

Following is an abstract of this article:

Prior scholarship has assumed that the inherent value of a “day in court” is the same for all claimants, and so that when procedural resources (like a jury trial or a hearing) are scarce, they should be rationed in the same way for all claimants. That is incorrect. This Article shows that the inherent value of a “day in court” can be far greater for some claimants, such as first-time filers, than for others, such as corporate entities, and that it can be both desirable and feasible to take this variation into account in doling out scarce procedural protections. In other words, it introduces and demonstrates the usefulness of procedural triage.

The Article demonstrates the real-world potential of procedural triage by showing how Medicare should use this new tool to address a looming administrative crisis that it is facing. In the methodological tradition of Jerry Mashaw’s seminal studies of the Social Security Administration, the Article uses its in-depth study of Medicare to develop a theoretical framework that can be used to think through where and how other adjudicatory processes should engage in procedural triage. The Article concludes by applying this framework to survey other potential applications for procedural triage, from the Department of Veterans’ Affairs to the Federal Rules of Civil Procedure.

Blog Editor’s Comments:

The main point of the justice system is that everyone deserves a “day in court.” In this document, Procedural Triage, Matthew J. B. Lawrence argues that the value of a day is different for all claimants; it can be greater for some, so we shouldn’t treat everyone alike. Lawrence suggests some individuals deserve to have a hearing more than others, but sometimes the system compromises that rule.

One thing this article does is show how useful procedural triage can be. “Procedural triage” being a system that makes all medical institutions who are enrolled in Medicare use statistical tools for peoples to retain their right to a full “day in court.” He suggests Medicare uses the tool to face its current administrative crisis. In the end, it would benefit due process in the entire system.

Comments?

What do you think about procedural triage? Do you agree that Medicare should use it? Please leave any thoughtful comments below.

Contact a Health Care Attorney Experienced with Medicare and Medicaid Cases.

Attorneys with The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program. We also handle Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S.

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

Sources:

Lawrence, Matthew J. B. “Procedural Triage.” Social Science Research Network. (June 17, 2015). From: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2619864

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: procedural triage, defense attorney, defense lawyer, medical lawyer, lawsuit, medical professionals, healthcare professionals, health care attorney, health care lawyer, The Health Law Firm, Medicare, court, litigation, day in court, procedural protections, Social Security Administration, adjudicatory, procedural justice, behavioral economics, adjudication, administrative process, civil procedure, due process, justice system

“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 © 1996-2015 The Health Law firm. All rights reserved.

Federal Health Officials Propose Medicare Paying Doctors to Discuss End-of-Life Issues

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Centers for Medicare and Medicaid Services (CMS) released a new plan for doctors to discuss end-of-life issues with their patients. The plan is part of the CMS annual Medicare physician payment rule. This comes six years after the original controversy when President Obama first announced his health care legislation.

Doctors Will Be Paid for Discussing Treatment Options with Elderly Patients.

In what can only be described as welcomed and needed relief, the rule would reimburse doctors for discussing living wills and end-of-life medical treatment options with older patients. The medical discussions include long-term treatment options, like heart transplants. It also handles advance care planning, including a patient who desires treatment for a condition that affects his or her decision-making. These are conversations already taking place, but physicians are not currently paid for them.

The Pressure is on Medicare.

Medicare reimbursement is extremely important for elderly and disabled persons. As the second-largest insurer, many private insurers also follow the same rules Medicare adopts. Their place in the end-of-life care has long been debated. Whether or not health care professionals should be reimbursed for hospice and end-of-life treatment talks has been the center of debate. Physician groups and patient advocates have been pushing the health program to pay doctors for these consultations.

Many advocacy groups, including the American Medical Association (AMA), support the proposal. The AMA believes it’s the patient’s choice to plan advance-care decisions. Research has shown that there are great benefits to elders in advance-care planning and having their end-of-life wishes known to others. Receiving timely knowledge from physicians and health professionals can result in better decisions and ease of mind.

Rules Previously Criticized as “Death Panels” by Ignoramuses.

Sarah Palin, the towering mountain of medical knowledge and intellectual analysis, who dragged down John McCain into defeat during the elections of 2008, previously denounced similar payment provisions in the past. Sparking a great deal of unnecessary controversy, Palin claimed the health care reform legislation would create “death panels.” As a result of these and other similar accusations, the provision was removed from the final Affordable Care Act legislation. This deprived elders of useful knowledge and deprived health care providers of payment for their services. To read more about the “death panel” controversy, click here.

Comments?

What do you think of end-of-life discussions? Do you think they should be in place? Should physicians be reimbursed?  Please leave any thoughtful comments below.

Sources:

Grier, Peter. “ ‘Death Panel’ Controversy Very Much Alive.” The Christian Science Monitor. (Aug. 21, 2009). From: http://www.csmonitor.com/USA/Politics/2009/0821/death-panel-controversy-remains-very-much-alive

Sun, Lena H. “Medicare Proposes to Pay Doctors to Have End-of-Life Care Discussions.” The Washington Post. (July 8, 2015). From:
http://www.washingtonpost.com/national/health-science/medicare-proposes-to-pay-doctors-to-have-end-of-life-care-discussions/2015/07/08/1d7bb436-25a7-11e5-aae2-6c4f59b050aa_story.html

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.

KeyWords: Medicare, federal health, health law, health law attorney, health law lawyer, end-of-life issues, The Centers for Medicare and Medicaid Services (CMS), CMS, Medicaid, healthcare, health care, health care attorney, health care lawyer, physicians, physician attorney, health care legislation, Affordable Care Act, ACA, medicine, the health law firm, death panel, death panel controversy, Medicare investigations, Medicaid investigations, elderly healthcare, senior health care, American Medical Association

“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 © 1996-2015 The Health Law firm. All rights reserved.

Individual Prescribers of Controlled Substances Should Know the CSA Requirements

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

Congress devised a regulatory system to help prevent prescription drug abuse and control both the legitimate and illegitimate traffic of controlled substances. The system makes it unlawful to manufacture, distribute, dispense or possess any controlled substance except in the manner authorized by the Controlled Substance Act (CSA). The CSA requires a practitioner to establish and maintain a legitimate doctor-patient relationship with the patient for whom he/she writes a prescription. It also requires the prescriber to issue a prescription only for a legitimate medical purpose within the usual course of professional practice. If a prescription is not issued in the usual course of the professional’s practice then the person issuing it shall be subject to penalties.


Recent Cases Against Individual Prescribers.

In October 2014, the Drug Enforcement Agency (DEA) revoked Dr. Fiaz Afzal’s registration after he had written prescriptions to 15 patients outside of the usual course of his professional practice. The government alleged he did not take sufficient or objective medical histories from the patients and often there was a lack of diagnosis to support continued prescribing of the controlled substances. Also, he failed to develop individual treatment plans and failed to consider remedies other than controlled substances. The DEA concluded that the physician violated the prescription requirement of the CSA, and was inconsistent with public interest.

In 2013, the DEA revoked Dr. Clair L. Pettinger’s registration after he allegedly issued nine prescriptions for controlled substances to undercover DEA agents who lacked legitimate medical needs. Dr. Pettinger’s revocation was upheld despite his introduction of evidence that the agents may have deliberately induced the prescriptions through symptomology deception. Even after the DEA suspended his registration, he apparently continued to prescribe. Evidence showed that he issued a prescription for hydrocodone after he acknowledged his suspended DEA registration. Thus, the DEA concluded his registration was inconsistent with the public interest.

Violations of the Controlled Substance Act.

The following have been found to constitute violations of the CSA in administrative hearings:

1. Performing an inappropriate, incomplete or no physical examination.
2. Not utilizing appropriate diagnostic testing.
3. Failing to devise and document a written treatment plan.
4. Failing to periodically reassess the effectiveness of treatments.
5. Continuing to prescribe controlled substances without attempting alternative therapies such as physical therapy.
6. Repeatedly prescribing without referring the patient to appropriate specialists such as neurologists, physiatrists, orthopaedic surgeons or neurosurgeons.
7. Failing to keep and maintain proper medical records.
8. Lack of diagnosis to support continued prescribing of a controlled substance.
9. Prescribing controlled substances to patients who lack legitimate medical needs.
10. Failing to take an adequate medical history from the patient.
11. Failing to consider remedies other than the prescription of controlled substances.
12. Failing to follow-up on contradictory symptoms relayed by the patient.

Comments?

What are your thoughts on the DEA’s decision and order? Please leave any thoughtful comments.

Contact a Health Care Attorney That is Experienced in the Representation of Health Care Professionals.

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 Drug Enforcement Administration (DEA), Federal Bureau of Investigation (FBI), Department of Health (DOH) and other 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.

Sources:

Government Publishing Office. 78 FR 61655 – Clair L. Pettinger, M.D.; Decision and Order. (October 3, 2013) From:
http://www.thefederalregister.com/2013/10/03/2013-24052.html

Government Publishing Office. 79 FR 61651 – Fiaz Afzal, M.D.; Decision and Order. (October 14, 2014). From:
http://www.gpo.gov/fdsys/granule/FR-2014-10-14/2014-24373

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

KeyWords: Drug Enforcement Administration, DEA, defense attorney, defense counsel, defense lawyer, Controlled Substance Act, CSA, Show Cause Order, DEA registration, health law, health care law, health law attorney, The Health Law Firm, administrative hearing, controlled substances class, controlled substances database

“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 © 1996-2015 The Health Law firm. All rights reserved.