How Can Chiropractors Defend Their License?

As a licensed professional your license is very important to your livelihood and you must protect it. You may be faced with a complaint or you may have a criminal action that you need to report to a licensing board that could result in potential disciplinary action. This can affect your license and thereby your livelihood. Often chiropractic services are reimbursed by insurance companies and a licensed action will affect that reimbursement. We want to protect your license and your livelihood. We represent numerous chiropractors before the board in Georgia. we have represented chiropractors who've been accused or have been convicted of various crimes and must report that to the Georgia Board.

In one case we were representing a chiropractor who was subject of a felony crime and imprisonment and we managed to get him suspension, followed by a probationary sentence so that he could return to his practice of chiropractic services even while under a criminal probation. We have also worked with chiropractors who have lost their license due to a criminal past and/or criminal convictions that have tried to regain it after a period of absence from practice.

There have also been cases where we have represented chiropractors with cases of boundary violations and in cases involving improper treatment of patients. These are the kinds of issues where you need guidance to get you through the process and make sure that your presentation before the Georgia Board is going to be smooth and effective. Your first impression is your best impression, and what you want to do if you were contacted by a board investigator. Do not speak with the board investigator - it is best to contact local council and get help immediately. At Levy Pruett Cullen we can assist you with this process. we have the experience and the knowledge to do it right. Give us a call!

How To Get a Dental License in Georgia

At Levy Pruett Cullen, we have represented many dentists in cases before the licensing board and applicants seeking to become licensed in the state of Georgia. Dentists can be the subject of many types of complaints - often filed by a patient, a patient's family, a former employer or an employee. These kinds of complaints are serious. The Georgia Board of Dentistry looks at every complaint filed.

There is a standard process that you will go through; The process includes the complaint phase, investigation phase and often investigatory interview. We urge you not to go meet with an investigator or go to an investigative interview without legal counsel. You will need help in guiding you through the process. These kinds of cases are cases of first impression. When you provide records, you need to make the best possible impact and provide your dental records in response to a board request. You need to make sure you put your best foot forward when you go to your interview, and you need to be properly preparation. You may think that all your years of training and education put you in a place to do this by yourself; but as you have invested in your career, we have invested in ours. We know how to guide you through the process better than you will be able to find from doing your own research and trying to handle it yourself.

We also assist in a lot of applicants seeking licensure in the state of Georgia. There are laws and rules that you must meet to become licensed in the state of Georgia. Often, applicants from other states may have been educated some years past and not meet the current requirements; Or they do not meet the current requirements because of how they handled their examinations or dental examination. We have worked with numerous dentists to obtain licensure in the state of Georgia by seeking a rule variance or waiver. We're looking to see if the board has issued an initial decline of licensure and whether there's a means to appeal that denial that has been successful in our other attempts to assist dentists trying to get licensed in the state of Georgia. If you are a dentist facing a potential licensing action or criminal action, or seeking licensure here in the state of Georgia, we can assist you. We are have years of experience in how to guide you through the process and get you the best possible result.

How Important Is Your Nursing License?

Your nursing license is your livelihood. It may be the biggest asset you have—even more than your house—because your nursing license is going to carry you through your career. It is the means by which you support yourself, your family, and achieve the other goals you have in life. You need to protect it. And you need sound advice to make sure that you keep your nursing license without disciplinary action.

Many nurses face licensing board actions that are brought on by your employers, or complaints by patients other employees. These cases are serious cases. Allegations like these and of drug discrepancies could potentially result in a license disciplinary action or worse, a potential criminal action. You need to be cautious in those situations.

It is important to seek sound legal advice regarding how to deal with these situations. Any time a nurse is fired from employment in the state of Georgia, there's a requirement for them to report to the Georgia Board of Nursing. The Georgia Board of Nursing takes these reports extremely seriously. Reports of drug diversion are very, very serious as well. These reports are reviewed by the board and often sent for criminal prosecution.

At Levy Pruett Cullen we are familiar with how the board processes these types of cases. Cases generally begin with a complaint then go to investigation. It sometimes calls for investigative interviews and very often results in disciplinary action. If you are charged with a drug-related offense or a drug discrepancy, you may face the possibility of being sent for an evaluation and/or your case could be sent for potential criminal prosecution. You need action quickly to forego all these types of negative outcomes. It may be that this is an honest mistake, and if that is the case, then you need intervention quickly to stall what could come next. Often, nurses and other healthcare professionals are sent for treatment or evaluation that may or may not be appropriate due to the circumstances. It's all a matter of proof and evidence. We are well qualified to fully evaluate your case and provide you with good sound advice as to how to deal with these issues and best protect your license and your livelihood.

At Levy Pruett Cullen, we have represented hundreds of nurses and defended their licenses. We have represented nurses with cases regarding their applications; cases regarding alleged drug discrepancies; cases regarding patient complaints; and issues regarding their authority as an advanced practitioner.

We've also represented numerous allegations regarding impairment. With regard to impairment - if there's an allegation that you have an impairment issue, we know how to find resources that define the problem and then we will walk you through the process of dealing with the Board of Nursing to get you the best result possible. If you have a legitimate defense to some kind of alleged drug diversion issue, we will do our best to defend your license. We are so familiar with the different resources available and how to review these cases, and defend you against these cases. We can give you sound advice as to how to reach the best outcome for those kinds of allegations and protect you for your continued employment.

At Levy Pruett Cullen, we know how to handle these cases.

Do I Need a Lawyer?

If you're a physician, you've spent many years training to achieve your career goals. You have gone to undergraduate school, and you have gone to medical school. You have done an internship, a residency, maybe a fellowship and you have reached a good point in your career.

Why risk all that education and knowledge and the livelihood that you have created when you can call on someone who has that kind of experience that you need?

I can go on WebMD and look up how to address a medical issue, but is that going to give me the knowledge I need to address the problem? Similarly, if you have a legal issue you should call in a specialized legal expert.

There are nuances to a medical board investigation that you may not be aware of. There are ways to deal with a board investigator. There is a way to deal with a board investigation. There really needs to be control of the information that's provided from the board on your behalf. Physicians think, I'm smart enough, I can figure this out, and I can tell them my story. That is often not a good approach because physicians are geared in a different way and it may be that there are legal nuances that you are not familiar with. Nuances that you will not find in a web posting or looking up how to deal with the licensing board. You need an experienced legal counsel who knows how to handle these cases and will provide you with best advise possible. Why risk all those years of education and the livelihood that you have created for yourself. You need to call somebody with experience. At Levy Pruett Cullen, we have 25 years of experience in representing both the prosecution on the prosecution end and defending doctors with regard to their medical licenses - in criminal actions, in civil cases and before professional organizations as well as credentials hearings. You need an experienced legal counsel who will make sure to protect your license and your livelihood.

I'm Fran Cullen at Levy Pruett Cullen. I can work to protect your license and your livelihood and protect all those years that you've put into to your career.

$1.55 Million Settlement Underscores the Importance of HIPAA Business Associate Agreements

A stolen computer led to the North Memorial Health Care of Minnesota paying $1.55 million for a potential violation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules.

North Memorial Hospital was charged with two HIPAA Privacy and Security Rule violations subsequent to an U.S. Department of Health and Human Services Office of Civil Rights (OCR) investigation. The investigation was initiated after a laptop was stolen from a North Memorial Hospital employee's car.

Specifically, OCR alleged that North Memorial did not having a business associate agreement in place, and was not performing due diligence on risk analysis as required in HIPAA's Privacy and Security Rules.

In particular, OCR alleged that North Memorial did not have the proper agreements in place to let a third party handle payment and health care operations, and North Memorial allowed Accretive Health Inc. - a hospital debt collection company - to access North Memorial's hospital database. Accretive had access to electronic protected health information (ePHI) of 9,497 patients, as well as access to hard copies of protected health information.

Jocelyn Samuels, HHS's OCR director, said North Memorial did not meet two basic requirements of HIPAA. First, North Memorial did not have a business associate agreement in place with Accretive, and second, North Memorial did not have "an accurate and thorough risk analysis that addresses their enterprise-wide IT infrastructure" as required by HIPAA.

The official announcement from HHS states, "The investigation further determined that North Memorial failed to complete a risk analysis to address all of the potential risks and vulnerabilities to the ePHI that it maintained, accessed, or transmitted across its entire IT infrastructure - including but not limited to all applications, software, databases, servers, workstations, mobile devices and electronic media, network administration and security devices, and associated business processes."

In addition to the payout, North Memorial has to develop a risk analysis and management plan that meets the requirements of HIPAA's security rules. North Memorial must also train its employees to use and follow the new plan.

Under the agreement, North Memorial and OCR stipulated that North Memorial did not commit any wrongdoing. The full resolution agreement may be read here.

How to Stay Compliant

To avoid a similar outcome from happening to you or your healthcare company, HHS offers a sample Business Associate Agreement, as well as a Risk Assessment guide. Sample business associate agreement here. Here is a risk assessment guide from HHS.

If you or your company are concerned about compliance, if you need assistance with compliance, or find yourself subject to an OCR audit, contact the Medicaid team at Levy Pruett Cullen today.

With two decades of experience defending practitioners and healthcare providers from allegations of Medicare and Medicaid fraud (linked to page), improper coding or billing, accepting kickbacks, false medical claims, overbilling, improper coding practices, unnecessary medical treatment, altered documents, Department of Audits and Accounts (DOAA) recoupment, improper insurance collections and duplicate billings, or Prescription Drug Crimes, Levy Pruett Cullen is a law firm uniquely tailored to your needs.

Getting Ready for Phase Two HIPAA Audits

The federal Office of Civil Rights (OCR) is now in Phase 2 of a Health Insurance Portability and Accountability Act's (HIPAA) audit that will review policies and procedures adopted and employed by covered entities and their business associates.

OCR is a division of the Department of Health and Human Services tasked by the Health Information Technology for Economic and Clinical Health Act (HITECH) to audit covered individual and organizational providers of health services; health plans of all sizes and functions; health care clearinghouses; and a range of business associates of these entities for compliance with HIPAA's Privacy, Security, and Breach Notification Rules. OCR officials said the audit will help the federal agency find potential problems before they arise. OCR also hopes to refine its ability to advise healthcare organizations and contractors about handling confidentiality requirements of protected health information (PHI).

BACKGROUND

Periodic OCR audits are required by HITECH, which was passed in 2009. Covered healthcare companies, contractors and business associates that may have contact with secured records are subject to the audits to ensure compliance with the HIPAA Privacy, Security, and Breach Notification Rules.

Phase 1 audits occurred in 2011 and 2012. Phase 1 audits looked only at healthcare companies. Phase 2 will cover healthcare companies and business associates.

This round of audits is expected to consist of 200 desk and on-site audits. Most will be desk audits - audits focusing on document review. OCR anticipates that its desk audits should encompass two rounds, a first round for the healthcare agencies, and a second round for business associates. OCR notes that desk audits should be done by December, and on-site audits should begin later this year.

It is important to note that any healthcare company chosen for a desk audit may be selected for an on-site audit.

HOW THE AUDITS WORK

PRELIMINARY EMAIL

First, OCR will send an email to healthcare companies and business associates asking to verify contact information. This is referred to as a "pre-audit questionnaire." It will ask:

• Business size.
• Business type.
• Scope of operations.

OCR will use this information to create a pool of audit targets. The OCR plans to make the audit selections as representative as possible using size, sector and geographic location as criteria.

PHASE ONE - DESK AUDITS

Companies and business entities selected for the first round of desk audits will get an email from the OCR requesting documents and other information. The document request will focus on company HIPAA Privacy, Security, and Breach notification rules. Specific targets are:

• Risk analysis.
• Notice of privacy practices.
• Response to request for access to the PHI.
• HIPAA Security Rule risk analysis
• Implementing HIPAA policies and procedures.
• A breach notification process.
• Updated Notice of Privacy Practices that reflects HIPAA Final Rule modifications.
• Encryption on laptops and other devices with PHI.
• Updated inventory of devices with PHI and information system assets. This includes mobile devices.
• A physical security plan for every location with PHI.
• Regular staff training on PHI security, security and breach response policies.
• Patients' timely access to PHI.

Those selected for participation in Phase one have 10 business days to submit the requested documents through an audit-specific portal on the OCR website. OCR will review the submitted documents and come up with draft findings. These drafts will be shared with the audited entities, who will then have 10 days to respond to the initial report. Written replies will be included in the final audit, and the audited company will get a copy of the final report.

PHASE TWO - ON-SITE AUDITS

Those chosen for on-site audits will get an email notifying them of selection. The on-site audit will take three to five days, depending on the size of the entity. These audits will be more detailed and have a broader focus on compliance with specific HIPAA regulations.

A draft report will be sent to the audited entities, and they will have 10 days to respond with written comments. The audited company will get a copy of the final report.

If the audits find any serious issues, OCR may launch a compliance review.

OCR will not notify the audited entities when the reports are made generally available. However, a Freedom of Information Act (FOIA) request may require OCR to release audit notification letters and other audit information which could identify the audited health care companies and business associates.

GETTING READY FOR THE AUDITS

The protocols for the Phase 2 audits are listed on the Health and Human Services website linked here: on the OCR website.

Any entity and business associate that comes under HIPAA oversight needs to prepare for an audit.

Four Ways to Prepare for a Potential OCR Audit:

1) Make sure emails from OCR are not routed to the junk or trash folders. Emails will come from OSOCRAudit@hhs.gov. Have IT staff configure email protocols and filters to route emails from this address to the applicable inbox. Advise any business associates to do the same. OCR will, however, use public contact information for any selected entity that does not respond to the email request.

2) Prepare a list of business associates. OCR will ask for this. Every covered health care business and business associate should evaluate compliance with HIPAA's Privacy, Security, and Breach Notification Rules with a regular self-inspection covering:

3) Make sure the audit response team is ready. Any entity selected for the audit only has 10 days to reply to the request for information and 10 days to reply to any draft findings. The team has to be ready to go.

4) Have a data mapping exercise. Identify PHI storage and track data flow within the healthcare company and applicable business associate (or associates). This will help identify weak points in HIPAA compliance areas.

Even if a health care company is not chosen for an audit, these exercises are helpful. They show how prepared a health care company is and how well it complies with HIPAA regulations.

It is important to comply with HIPAA's guidelines, audits notwithstanding. If you need assistance, or find yourself subject to an OCR audit, contact the Medicaid team at Levy Pruett Cullen today.

With two decades of experience defending practitioners an healthcare providers from allegations of Medicare and Medicaid fraud (linked to page), improper coding or billing, accepting kickbacks, false medical claims, overbilling, improper coding practices, unnecessary medical treatment, altered documents, Department of Audits and Accounts (DOAA) recoupment, improper insurance collections and duplicate billings, or prescription drug claims, Levy Pruett Cullen is a law firm uniquely tailored to your needs.

Georgia Supreme Court Holds Lead Paint Excluded by Absolute Pollution Exclusion

The Georgia Supreme Court recently held in Georgia Farm Bureau Mutual Insurance Co. v. Smith et al., No. S15G1177 (Ga. March 21, 2016), that lead paint unambiguously qualifies as a pollutant and that personal injuries from ingesting the paint were excluded from coverage by the plain language of the commercial general liability (CGL) policy’s absolute pollution clause.

In this case, Amy Smith, individually and as next friend of her daughter, sued her landlord, Bobby Chupp, for injuries her daughter sustained after ingesting lead paint. The rental home was insured by Chupp under a CGL policy issued by Georgia Farm Bureau Mutual insurance Company. Georgia Farm Bureau argued the policy’s absolute pollution exclusion clause excepted coverage.

Pollution exclusion clauses were originally developed by insurers as a response to environmental regulations enacted by Congress in the 60’s and 70’s and were directed specifically at environmental pollutants. These clauses were later broadened to exclude pollution beyond the natural environment to pollutants originating from places such as the rental property at issue in this case. The broadened clauses are known as “absolute exclusion clauses.”

Georgia courts have repeatedly upheld such clauses and found they extend beyond traditional environmental pollution to include for instance, carbon monoxide leaking from a furnace in a rental home, asbestos released from floor tiles during renovation, and smoke emanating from the premises. Importantly, Georgia courts enforced absolute pollution exclusion clauses without requiring the specific pollutant to be explicitly identified in the policy.

In the Smith case, the Georgia Supreme Court looked to the plain language of the policy and found lead paint to be unambiguously qualified as a pollutant as defined in the policy, even though it was not specifically named in the policy. The policy language upheld by the Georgia Supreme Court and which should be kept in mind when drafting absolute pollution exclusion clauses is as follows:

This insurance does not apply to:
(f) Pollution (1) “Bodily injury” or “property damage” arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of “pollutants: (a) At or from any premises, site or location which is or was at any time owned or occupied by, or rented or loaned to, any insured

Pollution was defined as “any solid, liquid, gaseous or thermal, irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste.”

The Smith case was a big win for Georgia insurers and further fortified that the plain language of the policy controls policy coverage.

New Florida Law Impacts Opioid Prescription Painkillers

A study published by JAMA Internal Medicine compares prescription painkiller data in Florida and Georgia from July 2010 to September 2012 to show a significant decrease in the prescribing of oxycodone. Before a 2010 law aimed at regulating pain management clinics, South Florida was a serious player in the nation black market for prescription painkillers. In 2010, Florida doctors sold almost 46 million oxycodone tablets. In 2011-after the law went into effect-that number dropped to 1.2 million pills, a 97% decrease.

Under the new law, clinics have to register with the state, and doctors can no longer dispense opioid prescription painkillers from their offices. Before the law, doctors in storefront clinics could sell drugs to walk-in patients carrying cash. In addition to tougher laws, Florida also implemented the Prescription Drug Monitoring Program to provide healthcare professionals with a more comprehensive look at patients' prescription drug histories.

Authors of the study believe that the data shows a promising drop after the state law went into effect. Dr. Lainie Rutkow, an associate professor at the John Hopkins School of Public Health told WLRN News, "the declines that we saw were equal to something in the range of 500,000 5 mg tabs of Vicodin per month."

The use of opioid prescription painkillers is a major public health concern. According to a July 2014 report from the Center for Disease Control, 46 people per day die from overdose of prescription painkillers in the Unites States.

Read more about the Florida opioid law and its effects here or contact one of the Atlanta Medicare Fraud Lawyers at Frances Cullen, P.C. so we work together to defend your right to practice medicine.

6 Tips Pharmacist Can Use to Stay Vigilant

Prescription narcotic drug abuse is on the rise in Georgia. Sadly, three-quarters of the accidental drug-related deaths in Georgia were from prescription drug overdose, according to a report from The Georgia Bureau of Investigation's Medical Examiner Office. The narcotics are almost always obtained with a prescription.

Identifying patients that exhibit drug-seeking behavior has become a major issue for medical professionals. Likewise, prescription theft is also on the rise, and pharmacists should be vigilant for this method of drug acquisition.

Simply stated, a prescription does not mean a pharmacist is clear.

Federal law states that "The responsibility for the proper prescribing and dispensing of controlled substances is upon the practitioner, bit a corresponding responsibility rests with the pharmacist who fills the prescription." Title 21, Code of Federal Regulations, §1306.04(a)).

In short, you as a pharmacist are responsible. You could be charged with a felony count of "knowingly and intentionally distributing controlled substances" in an illegal manner.

To this end, it is important to know that you are not required to fill a prescription of "doubtful, questionable or suspicious origin." (DEA rule) The Texas pharmacy board has this brochure that explains your rights in more detail under federal regulation and law.

Also, here are a few tips to help you stay vigilant:

• Do you know the person getting the prescription? Do you know the person picking it up?
• Does the person request early refills?
• Is the person getting prescriptions from several medical care providers?
• Is the person getting the prescription local or from a long way off?
• Is the health care provider sending in an unusual number of narcotics prescriptions?
• Does the prescription come from a long distance from the pharmacy?

No doubt you can come up with some other telltale indicators of possible abuse.

As part of the education effort, the Georgia Pharmacy Foundation has joined forces with other groups to support the Medical Association of Georgia's Think About It Campaign at rxdrugabuse.org.

Advise your customers about approved disposal locations for expired medications. You can get a list of drop points at police and sheriff's departments across the state at http://www.stoprxabuseinga.org/.

The ramifications of prescription drug abuse are wide ranging and, as a pharmacist, you play an important role in preventing drug abuse. Also, as the state and federal government struggle to find ways to slow the flow of prescription drugs to abusers, it is important to stay abreast of current laws and regulation to ensure that you remain compliant.

Physician Convicted of Patient’s Drug Overdose Gets 30 Years to Life

A California doctor was handed 30 years to life in the death of three patients who overdosed and died. The overdoses happened when the three adults abused prescription medication while away from the doctor's office.

Dr. Hsiu-Ying "Lisa" Tseng was found guilty of second-degree murder by a Los Angeles jury last year.

Naturally, as a doctor, Dr. Tseng has a responsibility to her patients. This duty should not, however, exceed the scope of what a physician may control, and this decision may set an incredibly dangerous precedent.

This precedent, however, is what some family members of the deceased hoped for. "I really hope this sets a precedent that will allow other dirty doctors to be prosecuted," said April Rovero, mother of one of the three who died. "We feel that finally we have justice."

In the sentencing hearing on Friday, Feb. 12, 2016, Superior Court Judge George G. Lomeli said Dr. Tseng attempted to blame other people for what happened. "It seems to be an attempt to put the blame on someone else," he said. "Very irresponsible."

As the LA Times stories point out, this case is troublesome. "Tseng, 46, who was a general practitioner, is among a small but growing number of doctors charged with murder for prescribing painkillers that killed patients. A Florida doctor was acquitted of first-degree murder in September," wrote report Marisa Gerber.

It is certainly lamentable that these three people died, but holding a medical professional responsible for abuse of medications they prescribe may have wide-ranging, unintended consequences that may impact doctors who prescribe with the best of intentions.

The growing trend of trying to hold doctors accountable for patient behavior beyond the scope of the physician's control is quite serious. If you hold any professional license and you are charged with a crime linked to that license, you need to fight it.

Physicians and health care providers, in particular, must consider the implications of criminal allegations beyond just criminal court, as mere allegations of wrongdoing may give rise to issues with several state and federal licensing entities. Since the right to practice medicine hinges on state licensure, and the right to prescribe medications depends on DEA certification, it is crucial to consider criminal allegations from multiple angles. If you are charged with a crime contact an Atlanta healthcare attorney at Levy Pruett Cullen. We understand the unique demands of defending licensed health care professionals.