Dangerous Dentistry: What One Connecticut Dentist Did That Got His License Suspended

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

Connecticut officials have suspended the license of an Enfield, Connecticut, dentist after a patient apparently died in the dentist’s chair on February 17, 2014. In a single visit the dentist allegedly attempted to extract 20 teeth from a 64-year-old woman who had prior health issues on record. One of the dental assistants reportedly begged for the procedure to be cut short after the patient began gurgling and lost consciousness. CPR was performed on the unresponsive patient before she was transported to a local hospital where she was pronounced dead.

According to WGGB ABC40, the dentist faces a hearing before the Connecticut State Dental Board on June 18, 2014.

To read the article from WGGB ABC40, click here.

A Repeat Offender.

The state of Connecticut alleges that in addition to the botched extraction, the dentist also failed to properly respond when the patient’s oxygen levels dramatically dropped. According to New York Daily News, state records show a four-count petition claiming that the dentist “deviated from the standard of care in that he did not timely and/or properly respond to (the patient’s)… respiratory distress and/or cardiopulmonary distress.” The patient’s official cause of death is yet to be formally determined.

The dentist’s license, issued by the state of Connecticut in 2003, was suspended April 21, 2014, pending the hearing. This is not the first legal run-in for the dentist. According to New York Daily News, in December 2014 the dentist was performing a procedure when his patient began to “aspirate the throat pack” and was rushed to a nearby hospital. The patient in this case spent six days in the hospital with heart and lung damage.

The dentist was also sued for malpractice by a former employee in 2009. Shoddy dental work was cited as the claim. The ruling ended in an out-of-court settlement. To read more from the New York Daily News article, click here.

Take ESOs Seriously.

An emergency suspension order (ESO) can be issued when a healthcare professional is posing a threat to the public. In this case, the dentist had a lengthy past of legal issues that would inevitably draw attention to his practice as a hazard. It is important to note that when a practitioner exhibits a pattern of reckless behavior numerous times, an ESO commonly follows thereafter. When an ESO is issued, a practitioner must immediately cease all practice until the suspension is lifted. Even an alleged case of malpractice can deem a healthcare practitioner an ESO. Receiving an ESO is a very serious matter. Many healthcare practitioners tend to overlook the severity of this action. You need to consistently practice proper ethics and install a system of checks and balances within your office to ensure the protection of your practice and license.

As a professional, you should take any and all necessary precautions to protect your license and reputation. Proactively avoid any irregular behaviors or fraudulent actions that could put your license at risk. If you find yourself in a situation where you are served an ESO it is vital that you immediately hire a professional and experienced healthcare attorney to represent you. If it’s a matter of not being able to afford the expenses in hiring an attorney, look at it this way: your livelihood is on the line, you can’t afford NOT to.

Anytime you suspect a claim or a complaint may be filed against you, immediately hire an attorney experienced in such matters.

Comments?

Emergency suspension orders are a common concern for healthcare professionals and their careers. What types of regulations, guidelines or practices do you mandate in your office in order to avoid a potential crisis such as an ESO? Do you have any personal experiences in dealing with ESOs? Please leave any thoughtful comments below.

Contact Health Law Attorneys Experienced with Emergency Suspension Orders and Other Licensure Actions.

The attorneys of The Health Law Firm are experienced in handling licensure and disciplinary cases, including emergency suspension orders, administrative complaints, investigations, administrative hearings, investigations, licensing issues, settlements and more. If you are currently facing adverse action by the DOH contact one of our attorneys by calling (407) 331-6620 or (850) 439-1001. You can also visit our website for more information at www.TheHealthLawFirm.com.

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

Sources:

“Conn. Suspends Enfield Dentist’s License After Patient Death.” WGGB ABC40. (May 19, 2014). From: http://www.wggb.com/2014/05/19/conn-suspends-enfield-denists-license-after-patient-death/

Goldstein, Sasha. “Connecticut Dentist Suspended After Patient Dies While Having 20 Teeth Pulled in One Visit.” New York Daily News. (May 27, 2014). From: http://on.flatoday.com/1vBJZAd

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

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

 

 

Dentists: Call The Health Law Firm Attorneys From Representation in Short-Notice Depositions and Hearings

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

Our attorneys often receive calls from dentists and other health professionals regarding the possibility of representing them on short notice at a Board of Dentistry hearing, or at a deposition related to a health care matter.

We Take Last Minute Cases.

Some law firms may refuse to represent a client at a hearing unless given advance notice. In a perfect world, we would prefer to have a sufficient amount of time to prepare for a case in order to provide our clients with the best representation. However, we know the alternative is that the client either gets legal representation with little advance notice or has to go without having legal representation and suffer the consequences.

We may have to refuse a case as well. For instance, if we believe the case is too complex for us to represent you effectively or that any legal representation would be completely futile. This situation does not happen often.

Trust an Experienced Health Law Attorney in Administrative Proceedings.

We’ve heard of some dentists trying to represent themselves. Laypersons, meaning nonlawyer, unaware of such complex matters as the Administrative Procedure Act, the Rules of Civil Procedure, the Rules of Evidence, the Florida Administrative Code (F.A.C.) Rules which the Board of Dentistry and the Department of Health (DOH) have enacted may quickly be overwhelmed. Often the individual may only figure this out days or weeks before the final hearing.

The inexperienced individual, or even the inexperienced attorney, in these matters can fall into a number of procedural traps that damage an effective defense. This can be advising the individual to talk to the DOH investigator, filing an unnecessary answer to an Administrative Complaint, forgetting or not knowing that the client’s right to be free of self-incrimination applies in this type of case and many, many others.

Procedural Mistakes Can Hurt Your Defense.

Simply having an experienced attorney representing you at a hearing or Board of Dentistry meeting will help you to avoid mistakes that damage your case and assist in preserving your rights for an appeal. In some cases, it may even be possible to obtain a change in forum to obtain a better result. For example, many laypersons do not know that if you elect an informal hearing before the Board of Dentistry, you have waived your right to prove you are innocent by contesting the facts alleged against you.

What few people know is that you can ask at the informal hearing before the Board of Dentistry to contest the facts, to prove you are not guilty of the charges, and to have the hearing converted to a formal hearing. A formal hearing will be in front of a neutral Administrative Law Judge (ALJ) and you have a great many more procedural rights than you have at an informal hearing. However, we still recommend that you have an experienced health lawyer represent you at a formal hearing.

Professional Liability Insurance Might Even Pay for Your Legal Fees.

If you are a dentist who has a professional liability insurance policy, especially one with the larger national companies, these often provide legal coverage for depositions. This is primarily because the outcome of the deposition may include having you named as a defendant in a professional liability or negligence law suit or having disciplinary charges filed against you.

One of the first things you should do if you receive a subpoena or a notice of a deposition is to contact your professional liability insurance carrier and see if it will pay for an attorney to represent you. For example, Healthcare Providers Service Organization (HPSO), CPH & Associates, Dentists Advantage and many other malpractice insurance companies provide excellent deposition coverage.

The second thing you should do is to call an experienced attorney and schedule a consultation. Even if you cannot afford to retain the services of the attorney for the actual deposition, a consultation may assist you in properly preparing.

Consult With An Attorney Experienced in the Representation of Dentists.

We routinely provide deposition coverage to dentists, dental hygienists and other health professionals being deposed in criminal cases, negligence cases, civil cases or disciplinary cases involving other health professionals.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing dentists and dental hygienists and other health professionals in investigations and at Board of Dentistry hearings. Call now or visit our website www.TheHealthLawFirm.com.

Comments?

Have you ever had an informal or formal hearing before the Board of Dentistry? What was the experience like? Please leave any thoughtful comments below.

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

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999. 

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Florida Medicaid Audits Dental Claims

MLS02PJGBy Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law

The Agency for Health Care Administration (AHCA) is auditing Medicaid claims submitted by dental providers in Florida. AHCA is auditing dental practices looking for claims that were not billed in compliance with the Florida Medicaid Dental Services Coverage and Limitations Handbook. AHCA’s audits are focused on claims that are billed too frequently, claims that are billed on the same date of service as a redundant code, and claims that have been unbundled when they should have been billed as part of a comprehensive code.

Specific Dental Codes Being Audited.

Dental providers that are the subject of these audits may not learn of the audit until they receive the Preliminary Audit Report. It is extremely important to immediately retain experienced health care counsel if you receive a Preliminary Audit Report so that a timely rebuttal with additional documents can be submitted. The audits are performed by the AHCA based entirely on the claims submitted by the provider.

Some of the specific procedure codes included in the audits are:

- D0120,
– D0272,
– D1110,
– D1120,
– D1203,
– D1330,
– D0150,
– D0210,
– D0330,
– D4355, and
– D4341.

Take Preliminary Audit Reports Seriously.

Every dental provider that receives a Preliminary Audit Report from AHCA has a limited time to respond to the audit. AHCA may also impose sanctions and assess costs against dental providers in these audits. Any dental provider that receives notice of an audit by the Agency should contact legal counsel experienced in these matters without delay.

Click here for a previous blog on tips for responding to an AHCA audit.

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

Our firm also routinely represents physicians, dentists, orthodontists, medical groups, clinics, pharmacies, home health care agencies, nursing homes and other health care providers in AHCA investigations, audits and recovery actions, as well as Medicare and Medicaid investigations, audits and recovery actions.

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

Comments?

Have you ever received a Preliminary Audit Report from the AHCA? Did you know how to respond? Please leave any thoughtful comments below.

About the Author: Michael L. Smith, R.R.T., J.D., is Board Certified by The Florida Bar in Health Law. He 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 Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2014 The Health Law Firm. All rights reserved.

Florida Dentist Performs Disappearing Act With Patients’ Money

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

A Pensacola, Florida, dentist has disappeared, with his patients’ cash, and now the Escambia Sheriff’s Office is looking for both, according to a number of news sources. According to the Pensacola News Journal, the dentist closed his practice months ago without alerting his patients or performing services for which they had already paid. On January 23, 2014, the sheriff’s office sent out a request for former patients of the dentist to come forward.

Click here to read the Pensacola News Journal article.

Dentist’s Checkered Past.

According to the Florida Department of Health (DOH), in 2003 and 2006, the dentist had disciplinary actions taken against him by the Florida Board of Dentistry. The Board ruled that the dentist was negligent and failed to meet minimum standards of dental performance for misdiagnosing a patient and failing to correct the patient’s dental issues. The Board also ruled that the dentist misrepresented himself as an orthodontic specialist, when he was a general practice dentist practicing in the area of orthodontics. Click here to view the discipline cases.

Currently, the DOH website lists the dentist’s license as active.

Victims Paid for a Number of Services Never Performed.

According to the Escambia Sheriff’s Office, a number of former patients have already come forward. They claim they paid for braces, dentures and other orthodontic work that was never performed. The sheriff’s office is looking for other former patients. The ABC station in Pensacola is reporting that these victims are organizing themselves on a Facebook group.

Click here to watch the news story.

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

Our firm also routinely represents physicians, dentists, orthodontists, medical groups, clinics, pharmacies, home health care agencies, nursing homes and other health care providers in Medicare and Medicaid investigations, audits and recovery actions.

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

Comments?

What do you think of this story? Please leave any thoughtful comments below.

Sources:

Robinson, Kevin. “ECSO: Investigators Seeking Victims of Disappearing Dentist.” Pensacola News Journal. (January 23, 2014). From: http://www.pnj.com/article/20140123/NEWS11/140123006/ECSO-Investigators-seeking-victims-disappearing-dentist?nclick_check=1

Fernandez, Jenise. “Updated: Orthodontist Disappearance Investigation.” WEAR. (January 23, 2014). From: http://www.weartv.com/news/features/top-stories/stories/updated-orthodonist-disappearance-investigation-40700.shtml

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

 

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999. 

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

New Hampshire Dentist Indicted on 189 Counts of Medicaid Fraud

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

On December 20, 2013, a New Hampshire dentist was indicted on 189 counts of Medicaid fraud, according to a number of news sources. The dentist is alleged to have made false claims to the New Hampshire Medicaid office for procedures such as oral exams, X-rays, tooth extractions and orthopedic treatments performed between 2008 and 2013. According to the Concord Monitor, the dentist faces a maximum sentence of 1,323 years in prison. However, it is unlikely the dentist will receive such a long sentence. It is even more unlikely that he will serve the entire sentence, even if he does receive the maximum.

To read an article from the Concord Monitor, click here.

Medicaid Fraud Control Unit of the New Hampshire Attorney General’s Office Brought Charges.

According to an article in the Union Leader, the Medicaid Fraud Control Unit (MFCU) of the state Attorney General’s (AG) Office handed down the charges against the dentist. Most of the indictment alleges that the claims made by the dentist were unjustified based on treatment records. The dentist is also accused of billing the Medicaid program for individual services he was already being reimbursed for under a lump-sum treatment plan.

The dentist was also allegedly indicted on nearly 30 counts of falsifying evidence. According to the Union Leader, once the dentist found out he was being investigated, the dentist allegedly attempted to alter his medical records.

According to his attorney the dentist plans to plead not guilty at his arraignment on January 15, 2014.

Click here to read the entire Union Leader article.

Poor Documentation or Fraud?

When we look at cases of this nature, we always ask was this just a case of poor documentation or was it intentional fraud? Was this a case of an incompetent biller or was it intentional submission of false claims? In many cases, poor administration or poor documentation can explain what may look like fraud to a regulator or prosecutor.

Tips for Responding to a MFCU Investigative Subpoena.

The MFCU is in charge of investigating and prosecuting health care providers suspected of defrauding the state’s Medicaid program. When the unit opens a case against a provider, the first step is usually the issuance of an investigative subpoena, requesting specific records. It is important to remember that the MFCU would not be involved unless criminal fraud was suspected. This is not a routine audit. Click here to read practice tips on how to properly respond to a subpoena.

Fraud Charges Should be Taken Seriously.

We have been consulted by many individuals similar to the subject of this story, both before and after criminal convictions for fraud or related offenses. In many instances, we are convinced that the person is actually not guilty of fraud. However, in many cases those subject to Medicaid or Medicare fraud audits and investigations refuse to acknowledge the seriousness of the matter or they decide not to spend the money required for a top quality attorney to defend them.

If you are accused of Medicare or Medicaid fraud, realize that you are in the fight of your life. Your liberty, life and profession are at stake. You need to hire the absolute best criminal defense attorney available who has experience in defending such cases to represent you.

If you win and are acquitted, at least you still have a professional license and can start over. However, if you lose, you will most probably be in prison for years. You will lose your license. You will be excluded from Medicare. You will be a convicted felon. You will have nothing and will have no way of starting over successfully.

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

Our firm also routinely represents physicians, dentists, orthodontists, medical groups, clinics, pharmacies, home health care agencies, nursing homes and other health care providers in Medicare and Medicaid investigations, audits and recovery actions.

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

Comments?

Have you heard of the MFCU? How would you respond to a subpoena from the MFCU? Please leave any thoughtful comments below.

Sources:

Blackman, Jeremy. “Manchester Dentist Faces 1,300 Years in Medicaid Fraud Scheme.” Concord Monitor. (December 30, 2013). From: http://www.concordmonitor.com/home/10005460-95/manchester-dentist-faces-1300-years-in-medicaid-fraud-case

Siefer, Ted. “Manchester Dentist Indicted on 189 Counts of Medicaid Fraud.” Union Leader. (January 1, 2014). From: http://www.unionleader.com/article/20140101/NEWS03/140109940

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

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Florida Board of Dentistry Warns About Responding to or Consulting with Individuals Over Internet About Dental Issues

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

At the Florida Board of Dentistry meeting held on November 15, 2013, one of the committee chairs discussed an issue that has arisen nationally that is causing dentists legal problems. The issue arises when individuals contact a dentist over the internet seeking “information” on a dental condition or problem, and possible actions or procedures that can resolve these issues.

The concern with this is that the dentist may actually be diagnosing a dental condition or problem the individual has. The bigger concern is that if the individual contacting the dentist for information is in a different state from the one in which the dentist is licensed. Then the dentist is actually practicing dentistry in the state in which the individual is located.

In this blog I will discuss some of the issues a dentist can encounter when diagnosing a condition or problem over the internet. I will also talk about ways a dentist can reduce his or her risk.

Issues Dentists Can Face When Diagnosing a Condition Over the Web.

This can cause a myriad of different problems for the dentist involved in these situations:

1.  By diagnosing in a state in which the dentist is not licensed, he or she is engaging in the unlicensed practice of dentistry in that state. This can lead to criminal charges in that state and disciplinary actions in the state where the dentist is licensed.

2.  Cases have arisen where incorrect diagnoses have been rendered because the individual failed to provide complete information and the dentist failed to physically examine the individual or follow other procedures normally followed.

3.  There have been instances where such individuals have filed complaints or claims against dentists for providing them information upon which they relied.

4.  In most cases, a dentist’s professional liability (dental malpractice) insurance will not cover professional negligence in another state.

Recommendations to Reduce Risk.

I recommend that dentists take the following steps to help reduce risk if involved in providing information to non-patients over the internet or in the media (radio, television, newspaper, etc.):

1.  Make sure that you have proper warnings and disclaimers that are included in every such e-mail communication or listserv communication you make. Include:

A.  Include the state in which the dentist is licensed/practicing and state that the communication is not considered to be diagnosing, prescribing, treating or practicing any profession in any other state or jurisdiction.

B.  Include a disclaimer or statement in every e-mail listserv or other communication with non-patients that you are providing general information for educational purposes only and the individual must see and follow the advice of a dentist in his or her geographic area to make any diagnoses.

C.  Include that the person receiving the information cannot rely on it for treatment purposes since an actual physical examination must take place before any reliable information/recommendations can be made in any individual’s case.

2.  Inquire with your professional liability insurer or agent to ask about “broad form coverage” and attempt to obtain coverage that includes educational activities, marketing activities and other similar activities. Make sure the broad form coverage also covers these activities in different states.

3.  Make sure your professional liability insurance provides coverage for legal expenses involved in defending against administrative complaints and investigations initiated by any state or federal agency that could result in disciplinary action against you or your license. You probably need at least $25,000 in coverage for this. However, $50,000 or $75,000 in coverage for such matters is preferred. Buy this coverage separately if necessary. Lloyd’s of London provides such coverage separately.

4.  Find out where the individual contacting you resides or is communicating from. Require complete information, including complete name, address and telephone numbers.

5.  Be extremely reluctant to criticize care, services, procedures, materials or appliances used or prescribed by other dentists.

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

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

Comments?

Have you ever been asked to consult with a patient over the internet? Did you know all of these issues could up? Please leave any thoughtful comments below.

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

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Florida Board of Dentistry Warns About Responding to or Consulting with Individuals Over Internet About Dental Issues

1 Indest-2008-1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

At the Florida Board of Dentistry meeting held on November 15, 2013, one of the committee chairs discussed an issue that has arisen nationally that is causing dentists legal problems. The issue arises when individuals contact a dentist over the internet seeking “information” on a dental condition or problem, and possible treatment or procedures that can resolve these issues.

The concern is that the dentist may actually be diagnosing a dental condition or problem the individual has. The bigger concern arises if the individual contacting the dentist is in a different state from the one in which the dentist is licensed. Then the dentist is actually practicing dentistry in the state in which the individual is located.

In this blog I will discuss some of the issues a dentist can encounter when diagnosing a condition or problem over the internet. I will also talk about ways a dentist can reduce his or her risk.

Issues Dentists Can Face When Diagnosing a Condition Over the Web.

Diagnosing a non-patient over the internet can cause a myriad of different problems for the dentist involved, including these situations:

1. By diagnosing in a state in which the dentist is not licensed, he or she is engaging in the unlicensed practice of dentistry in that state. This can lead to criminal charges in that state and disciplinary actions in the state where the dentist is licensed.

2. Cases have arisen where incorrect diagnoses have been rendered because the individual failed to provide complete information, and the dentist failed to physically examine the individual or follow other procedures normally followed.

3. There have been instances where such individuals have filed complaints or claims against dentists for providing them information upon which they relied.

4. In most cases, a dentist’s professional liability (dental malpractice) insurance will not cover professional negligence in another state.

Recommendations to Reduce Risk.

I recommend that dentists take the following steps to help reduce risk if involved in providing information to non-patients over the internet or in the media (radio, television, newspaper, etc.):

1. Make sure that you have proper warnings and disclaimers that are included in every such e-mail communication or listserv communication you make.

A. Include the state in which the dentist is licensed/practicing and explain that the communication is not considered to be diagnosing, prescribing, treating or practicing any profession in any other state or jurisdiction.

B. Include a disclaimer or statement in every e-mail listserv or other communication with non-patients that you are providing general information for educational purposes only, and the individual must seek and follow the advice of a dentist in his or her geographic area to make any diagnoses.

C. Include that the person receiving the information cannot rely on it for treatment purposes since an actual physical examination must take place before any reliable information/recommendations can be made in any individual’s case.

2. Inquire with your professional liability insurer or agent to ask about “broad form coverage” and attempt to obtain coverage that includes educational activities, marketing activities and other similar activities. Make sure the “broad form coverage” also covers these activities in different states.

3. Make sure your professional liability insurance provides coverage for legal expenses involved in defending against administrative complaints and investigations initiated by any state or federal agency that could result in disciplinary action against you or your license. You probably need at least $25,000 in coverage for this. However, $50,000 or $75,000 in coverage for such matters is preferred. Buy this coverage separately if necessary. Lloyd’s of London provides such coverage separately.

4. Find out where the individual contacting you resides or is communicating from. Require complete information, including complete name, address and telephone numbers.

5. Be extremely reluctant to criticize care, services, procedures, materials or appliances used or prescribed by other dentists.


Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

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

Comments?

Have you ever been asked to consult with a patient over the internet? Did you know all of these issues could up? Please leave any thoughtful comments below.

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

 

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Connecticut Dentist Gets Drilled in Huge Medicaid Fraud Case

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

A dentist and owner of a number of clinics in Connecticut is feeling the pain of justice. According to a number of news sources, Gary Anusavice will spend the next eight (8) years in prison for targeting poor patients, performing unnecessary dental procedures and collecting $21 million in fraudulent Medicaid claims. He was sentenced on October 9, 2013.

To read an article on the dentist’s sentencing from The Hartford Courant, click here.

Dentist Must Forfeit Luxury Items.

On top of prison time, the dentist will have to pay $3.3 million in restitution and $1.9 million to the Internal Revenue Service (IRS) as a result of his Medicaid fraud scheme, according to The Hartford Courant. He was also ordered to forfeit his mansion, a 2008 Mercedes-Benz, a yacht and more than $91,000 in cash that was found in his home.

According to news reports, this is far from the first time he has been accused of defrauding the Medicaid program.

Dentist Previously Barred from Practicing in Massachusetts and Rhode Island.

According to an article in the Connecticut Post, the dentist had previous run-ins with authorities in Massachusetts and Rhode Island involving health care fraud. Both states allegedly stripped him of his dental licenses. He was also allegedly barred from participating in Medicaid in those states.

Since the dentist could no longer practice in those states, in 2008, he opened three dental groups in Connecticut, according to the Connecticut Post. In these new practices, it’s alleged he hired other dentists and offered them commissions for performing expensive procedures, paid patient recruiters to solicit poor neighborhoods, and provided shuttle services for patients. In two years, his Connecticut clinics received $21 million in Medicaid payments, according to the Connecticut Post.

Click here to read the Connecticut Post article.

In June 2013, the dentist pleaded guilty to health care fraud and tax evasion.

Being Barred from the Medicare and Medicaid Program Can have Devastating Effects.

Few health care practitioners really understand the significance of being excluded from the Medicare or Medicaid programs. Exclusion usually occurs as a direct result of disciplinary action being taken by the state board of medicine, board of nursing, board of dentistry, board of pharmacy or other health care licensing entity. To read more on the effects of exclusion from the Medicare or Medicaid programs, click here.

Take Fraud Charges Seriously.

If you are accused of Medicare or Medicaid fraud, realize that you are in the fight of your life. Your liberty, life and profession are at stake. You need to sell everything you own, borrow everything you can and hire the absolute best criminal defense attorney available who has experience in defending such cases to represent you.

If you win and are acquitted, at least you still have a professional license and can start over. However, if you lose, you will most probably be in prison for years. You will lose your license. You will be excluded from Medicare. You will be a convicted felon. You will have nothing and will have no way of starting over successfully.

Do not delude yourself. This is extremely serious. Be prepared to give up whatever you have if you can avoid a conviction.

Often Fraud Claims Can Give Rise to Large Rewards Paid to Whistleblowers.

Practically every state now has statues which allow a monetary recovery to be a person bringing a claim on behalf of the state for false Medicaid payments. These are modeled after the federal False Claims Act, used to reward whistleblowers or qui tam relators for recovers in Medicaid fraud cases.

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 (AFLs), 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 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Why was it so simple for the dentist to move to another state and continue to defraud Medicaid after being previously reprimanded for the same crime? Please leave any thoughtful comments below.

Sources:

Mahony, Edmund. “Dentist in Massive Medicaid Fraud Case Sentenced to 8 Years.” The Hartford Courant. (October 9, 2013). From: http://www.courant.com/health/connecticut/hc-medicaid-fraud-1010-20131009,0,1388813.story

Mayko, Michael. “Fraudulent Dentel-Group Owner Sentenced.” Connecticut Post. (October 9, 2013). From: http://www.ctpost.com/local/article/Fraudulent-dental-group-owner-sentenced-4883112.php
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Florida Law Prohibits Control of a Dental Practice by a Nondentist

1 Indest-2008-1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Florida has long been a state that does not prohibit the corporate practice of medicine, unlike many other states. However, it does prohibit the corporate practice of dentistry.  The key provision in Florida law that establishes this is Section 466.028, Florida Statutes, but the Florida Board of Dentistry has also adopted administrative rules on this topic, as well.

What this means is that any corporation (or other type of business entity) that owns or operates a dental practice, under Florida law, must be one solely owned by and controlled by dentists. In this context, the term “dentists” means those licensed to practice dentistry in the state of Florida, with an active license.  Someone licensed in another state or who has a suspended or revoked license in Florida, would not meet that requirement.

Dentists Entering into Certain Types of Contracts Needs to Be Sure They Comply with the Law.

There may be certain types of contracts and agreements that a dentist or dental practice may legally enter into, especially ones that would provide administrative services or other types of non-professional services to the dentist.  These might include, for example, payroll services, staffing services (except for professional staff such as dental technicians), billing and collections services (provided the dentist retains final authority over such matters), marketing services, equipment leases (provided the dentists retains all control over the equipment), office leases, management services, or combinations of the above.  However, since any of these types of agreements may be worded so as to violate the law, a dentist should always have such an agreement reviewed in advance by his or her own experienced health attorney.  The dentist entering into any such contract must make sure he or she complies fully with the law.

Section 466.028(2), Florida Statutes, states that the purpose of the statute is to prevent any nondentists from attempting to influence or interfere with the professional judgment of the dentist.

Acts Prohibited by Law.

Acts specifically prohibited by the law include allowing a nondentist or business entity owned by a nondentist to:

1.    Employ a dentist or dental hygienist in the operation of a dental office;

2.    Control the use of any dental equipment or material while such equipment or material is being used for the provision of any dental services;

3.    Direct, control or interfere with a dentist’s clinical judgment;  and, specifically,

4.    Allowing any nondentist or organization owned by a nondentist to exercise control over:

a.    The selection of a course of treatment for a patient, the procedures or materials to be used as part of such course of treatment, and the manner in which such course of treatment is carried out by the dentist;

b.    The patient records of a dentist;

c.    Policies and decisions relating to pricing, credit, refunds, warranties and advertising; or

d.    Decisions relating to office personnel and hours of practice.

Violating Law is a Felony.

Any of these acts can result in disciplinary action against any licensed dental professional involved. More importantly, violation of this law is also a felony which may result in criminal prosecution for any person involved.  Contracts which violate the law are null and void.

Always have any contract relating to the operation of your dental practice reviewed by an experienced board certified health lawyer before signing it.

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

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

Comments?

Did you know about this Florida Law that prohibits control of a dental practice by a nondentist? Please leave any thoughtful comments below.

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

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

NAS Insurance (NAS) Attorneys, Lawyers and Defense Council in Florida

2 Indest-2009-1By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Often we learn after the fact that a health professional such as physicians, dentists and other health professionals has received NAS Insurance, has had a legal problem, and has not been able to locate an attorney or law firm that accepts this type of insurance. We have offices in Florida and Colorado, but we have attorneys licensed in Florida, Colorado, Louisiana, the District of Columbia, Virginia and other states.

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

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

The Health Law Firm Will Work with NAS Insurance or Your Insurance Company.

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

Contact Health Law Attorneys Experienced in Representing Dentist.

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

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

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

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

 

The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.