Texas Health Care Law Blog

Do not let substance abuse abscond with your health care license

For years, you led a double life, and no one knew about it. Not even your spouse. As a well-respected physician, you helped people, did your best to solve their health problems and guided them through their most challenging journeys. But you also had a substance abuse problem. It did not affect your job, or so you thought.

The signs were there, though. Irritability, changes in personality, difficulty with work-related matters, having trouble getting along with colleagues, and sloppiness in your work. It all came crashing down when a fellow physician uncovered an egregious error on your part, and quickly remedied it. You have been exposed as an alcoholic and prescription drug addict. Now, the Texas Medical Board intervenes, and you face disciplinary action and the loss of your professional license.

Steps to take to help your health care practice avoid fraud

Our nation’s health care system has grown more complicated. And with these complexities come increased chances for illegal and negligent activity within health care organizations. With this in mind, health care providers must take it upon themselves to prevent fraudulent activity before it happens.

Your practice, employees, livelihood and reputation must be protected. If not, you could lose all of them as well as your professional license. Crucial safeguards in place can help prevent illegal activities, so you need to be pro-active.

What is health care fraud?

In a perfect world, sick people would get the help they need, and no one would have to worry about the cost. The reality is, health care is a business. Like any business, a health care provider should expect reimbursement for providing their services.

There’s nothing wrong with pursuing what you’re entitled to through an insurance or Medicaid claim. However, a careless or inattentive approach could result in you facing charges of health care fraud.

Dallas dentist ordered to pay $12 million for Medicaid fraud

In a Medicaid fraud case that has lasted for more than a decade, disgraced Dallas dentist Richard Malouf must pay Texas an estimated $12 million. In a major government rip-off, Malouf fraudulently billed Medicaid for dental services that were provided by another dentist.

The founder of orthodontist chain All Smiles Dental Center, Malouf made more than 1,800 false billings. The Texas Office of the Attorney General made the announcement on May 14. The federal investigation into Malouf's business began in 2008 related to services provided to patients.

Doctors, nurses face severe disciplinary actions for misconduct

Health care professionals have always been in high demand, but even more so during the current COVID-19 pandemic that has gripped the world. But even in times like these, some doctors and nurses face disciplinary actions that could lead to professional sanctions, including practice-related restrictions, suspensions and loss of their license.

As a physician, physician’s assistant, nurse or other health care professional, you worked diligently and with integrity to obtain and maintain your license, while helping patients recover from maladies that drastically affected their lives. But, now, you face a different kind of malady, fighting for your reputation and attempting to deflect any personal, financial and career consequences that come with it. When facing regulatory agencies, you must understand that the stakes are high.

HIPAA violations could put your medical license at risk

The Code of Ethics that many medical professionals adhere to covers a wide range of issues. They require medical professionals to provide the best possible care to every patient, be professional and protect a patient’s privacy.

Parts of this code also became federal law when the Health Insurance Portability and Accountability Act (HIPAA) passed. This law established the Privacy Rule, which protects patients’ health information.

Even good-faith billing errors often quickly pay fines

A Massachusetts hospital recently settled a federal lawsuit over allegations that it billed Medicare and Medicaid for medically unnecessary tests.

But to many, tests like these may seem easy to order accidentally or without knowing they could be medically unnecessary. That is, a good-faith error may mean unnecessary tests and it is common for medical providers to pay the fines without a fight.

3 regulatory issues the health care industry currently faces

The health care industry is no stranger to stringent federal regulations. They are often put in place to hold medical professionals accountable and protect patient interests.

Unfortunately, many industry workers feel some regulations do the exact opposite of what they’re supposed to, which is to increase the quality of patient treatment. According to a recent report, many physicians find it frustrating to use complex and expensive efficiency systems, as they’ve often created daunting barriers for doctors providing patient care.

New regulations spark discussion over medical data privacy

Americans could soon access their medical history just as fast as they order takeout. But new rules regarding electronic medical data have sparked debate over whether easier access would hurt or help consumers.

The current fight comes from new information-sharing policies from the federal government, which would allow health care providers to send medical information to third-party apps once a patient gives their consent.

Stop nursing home neglect before it starts at your facility

According to the Center for Disease Control and Prevention website, more than 1.3 million Americans occupy more than 15,000 nursing homes throughout the nation. As the baby boomer generation ages, these numbers will skyrocket. Their families will want them to receive the best care, and—unlike previous generations—their families will be much more fluent in researching what is and is not acceptable.

As a health care provider, we know that you want what’s best for those in your care as well. However, with a busy staff and patients who often struggle with conditions that affect memory and bodily functions, things can get challenging.

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