Tag Archives: Michael V Favia and Associates

Licensed healthcare professionals can also suffer and recover from opiate abuse and addiction

Opiate addiction is something that can sneak up on good people who might not realize they are becoming dependent on painkillers. People from all walks of life are prescribed an opiate or opioid narcotic for pain management following for injuries and chronic conditions. Like other addictions, an opiate use can turn into abuse and reliance on the drugs. Many people who suffer from opiate abuse and addiction report that they did not think they had a problem and would go for days without using opiates, assuming they were able to stop at any time.

Healthcare professionals may have a unique risk of opiate abuse and addiction

Physicians and healthcare professionals may be particularly likely to manage their own use of opiate narcotics and one day realize they are on the way to or are already hooked. For many, the opiates seem to sneak up on them without the user noticing anything because the neurotransmitters in the brain and the systems affected by opiate drugs are altered; the user is not thinking normally.

The healthcare industry can be notably stressful and physicians and professionals must be disciplined and resilient to that which might be too difficult for others to manage daily. Knowing you may be a tough doctor or nurse might give you the illusion that you may be in a better position to get the use of opiates under control, even though you might not be able to manage the addiction on your own.

The causes of opiate addiction are variable among several factors, some of which might not be within the control of the individual experiencing addiction.[i]

  • Genetic: Some of us are pre-disposed to addiction through our genetic makeup. When immediate family members and close relatives have addictions, those close in relation are often more likely to also suffer from abuse and addiction. This is not always the case, however and within a family some may “have the gene” while others do not.

 

  • Biological: Some of us naturally lack the endorphins necessary to trigger the right responses in our brains and central nervous systems, impacting our physiology. When introduced to our systems, certain people respond very well to opioids to remedy an underlying neurotransmitter deficit.

 

  • Environmental: What we experience as children can significantly influence our likelihood of certain behaviors as adults. The children who grow up with substance abuse and addiction are more likely to use substances and are more prone to addiction themselves.

 

  • Psychological: In the event one may be suffering from a mental illness or disorder, one may not be thinking clearly when using addictive narcotics to self-medicate other symptoms. There is a common correlation between mental health and propensity for addiction.

Opiate abuse and addiction can be cured and underlying causes and symptoms can be addressed.

Licensed professionals with their livelihood on the line may be more likely to cover up the use, abuse or addiction to opiates. The last thing any physician or nurse wants is to be questioned as to their fitness to practice. Individuals with addiction might be under the effects of narcotics to the extent that they are not making otherwise clear decisions, while some others may be better able to catch and cure a problem.

Too often people fear being looked at like a failure or a weak person. It is important to realize that opiate abuse and addiction is a temporary illness which may not have been avoidable based on causes that are not the healthcare professionals’ fault.

Being proactive with opiate abuse and addiction issues can save a healthcare professional’s career.

In many cases there are options for healthcare professionals to self-report a struggle with abuse or addiction. Being the first to notify your professional licensing and regulatory body, and with representation by a professional licensing attorney, physicians and nurses are likely to experience better results and a reduction in the risk of discipline or adverse action taken against them.

About us: Michael V. Favia & Associates, P.C. is a health law, litigation and licensing firm in Chicago representing individuals, healthcare professionals and organizations with civil legal matters as well as professional licensing and regulation.

Chicago health law and litigation attorney Michael V. Favia and his associates in several locations and disciplines, advise and represent private individuals as well as healthcare professionals in all types of litigation and administrative matters involving licensing and regulatory agencies.

Michael V. Favia and Associates, P.C. represents individual physicians and health care organizations in the Chicago area with a variety of legal matters. With offices conveniently located in the Chicago Loop, Northwest side and suburban meeting locations, you can schedule a discrete meeting with an attorney at your convenience and discretion. Michael V. Favia & Associates is available at (773) 631-4580. Please visit www.favialawfirm.com and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter. You can also review endorsements and recommendations for Michael V. Favia on his Avvo.com profile and on LinkedIn.

 

[i] Mount Regis Center website, Opiate Abuse & Addiction Effects, Signs & Symptoms.

ISBA lawsuit seeks injunction of IDFPR discipline of two attorneys for unauthorized real estate appraisal practice

Illinois Professional Licensing Consultants 5Two Illinois attorneys face potential prosecution by the Illinois Department of Financial and Professional Regulation (IDFPR) but the Illinois State Bar Association (ISBA) filed a lawsuit seeking an injunction and declaration that IDFPR lacks the authority to regulate certain practices.

At issue in the ISBA complaint filed July 11, 2017 in the Circuit Court of Cook County, is whether the IDFPR acted with authority and appropriately when the Department initiated formal administrative prosecutions of two attorneys in April of this year. The IDFPR alleges that he attorneys engaged in the unauthorized practice of real estate appraisals in two different property tax assessment cases.

Illinois regulates real estate appraisals

The Real Estate Appraisal Licensing Act of 2002 is the controlling law on the regulation of real estate appraisers in Illinois. The legislative intent section of the statute reads in part, “The intent of the General Assembly in enacting this Act is to evaluate the competency of persons engaged in the appraisal of real estate and to license and regulate those persons for the protection of the public.[i]” The IDFPR uses its administrative rules and guidelines in issuing professional licenses to practice real estate appraisals.

At issue is whether the IDFPR was proper in disciplining the two attorneys for practicing real estate appraisal without a license to do so.

Meanwhile, it is a common practice for real estate attorneys to represent their clients before the bodies hearing challenges to real estate tax assessments and valuations. Property owners have a right to challenge the appraised value of their property and reduce their tax burden. The two attorneys in this case filed briefs supporting their clients’ tax challenges to the Property Tax Appeals Board and the DuPage County Board of Review. In its news release on point, the ISBA states, “Neither lawyer purported to submit an appraisal or act as an appraiser.[ii]

The court is likely to receive briefed arguments focused on the scope of the authority of the IDFPR, and what power the Department may have to determine what specific conduct gives rise to a violation. The ISBA contends, “the IDFPR lacks authority to prosecute, discipline, or sanction lawyers for engaging in the practice of law by advocating on behalf of clients in real estate tax assessment proceedings.[iii]

Takeaways for all professionals in Illinois

It is important in any profession to be aware of and compliant with state laws and regulations of professions. Prior to the enactment of The Real Estate Appraisal Licensing Act of 2002 an individual might have been actively engaged and working as a real estate appraiser when the law passed, then requiring the individual to obtain a license from the IDFPR. The regulation of professions may change and adapt with state law and public policy.

Just because one license may be broadly applicable, such as a license to practice law, it does necessarily mean that such licensure applies ubiquitously; regulatory bodies have authority to determine the scope of a professional practice. In this case, the limits of IDFPR authority are being tested.

As there are new developments in this case we will share that news, as many are interested in the outcome of this lawsuit.

About us: Michael V. Favia & Associates, P.C. is a health law, litigation and licensing firm in Chicago representing individuals, healthcare professionals and organizations with civil legal matters as well as professional licensing and regulation.

Chicago health law and litigation attorney Michael V. Favia and his associates in several locations and disciplines, advise and represent private individuals as well as healthcare professionals in all types of litigation and administrative matters involving licensing and regulatory agencies.

Michael V. Favia and Associates, P.C. represents individual physicians and health care organizations in the Chicago area with a variety of legal matters. With offices conveniently located in the Chicago Loop, Northwest side and suburban meeting locations, you can schedule a discrete meeting with an attorney at your convenience and discretion. Michael V. Favia & Associates is available at (773) 631-4580. Please visit www.favialawfirm.com and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter. You can also review endorsements and recommendations for Michael V. Favia on his Avvo.com profile and on LinkedIn.

 

 

 

[i] PROFESSIONS, OCCUPATIONS, AND BUSINESS OPERATIONS

(225 ILCS 458/) Real Estate Appraiser Licensing Act of 2002.

[ii] ISBA, Illinois Lawyer Now, ISBA Files Complaint to Enjoin IDFPR Prosecution of Lawyers.

[iii] See HNii above.

PODCAST: Healthcare IT and revenue cycle management solutions and safeguards

craig evansToday’s interview with healthcare consultant, Craig Evans, focuses on healthcare information technology and revenue cycle management. In the patient billing and payment systems there are opportunities to increase efficiency and return on investment which can also benefit healthcare providers with regulatory compliance and reducing the risk of errant and fraudulent medical billing through the implantation of proper healthcare practice management software.

Please use this link to listen to the podcast

Topics covered in this 30-minute interview:       

  • What are the challenges and opportunities in the healthcare revenue cycle?
  • What can healthcare practices do about patient high deductible insurance plans?
  • How can healthcare providers reduce their claim rejection rates?
  • What kinds of data should practice managers be analyzing to best manage the revenue cycle?

Craig Evans helps healthcare practices streamline and maximize billing operations, select electronic medical records systems and start new ventures. With 30 years’ experience, his independent and hospital-based providers benefit from a broad-based yet detailed understanding of workflow and reimbursement challenges. Craig Evans works with Ebix, Incorporated as a Regional Business Development Executive.

To connect with Craig Evans please call the Illinois Professional Licensing Associates by dialing (773) 631-4850.

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Michael V. Favia & Associates are available to advise and represent healthcare professionals and the general Chicagoland community with a variety of legal issues. With offices conveniently located in the Chicago Loop, Northwest side and suburbs, you can schedule a discrete meeting with an attorney at your convenience and discretion.

For more about Michael V. Favia & Associates’ professional licensing work, please call (773) 631-4580, visit www.IL-Licensing.com and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter. You may also connect with Attorney Michael V. Favia on LinkedIn and on Avvo.com where you may also read client endorsements and reviews.

 

Insulating your healthcare practice from fraud takedowns

Takedowns are a practice used by federal prosecutors to send a deterrent message to certain industries where the incidence of fraud and criminal activity may be widespread. When federal law enforcement conducts takedowns, they work with law enforcement nationwide and execute the takedowns at the same time. When these takedowns occur simultaneously, there is little warning before an investigator contacts individuals suspected or reported to be engaged in illegal conduct. The healthcare industry is a focus of federal investigators following tips on Medicare fraud. From over billing to treating non-existent or non-qualified patients, Medicare fraud is a compelling problem and task forces are organized and specialized in investigating claims and preparing for nationwide takedowns. Some in the industry predict, based on an increase in enforcement activity, that the Chicago area could be a target for takedowns during the summer of 2017.

The opportunity to insulate your healthcare practice from civil and criminal liability

Awareness of the focus on healthcare fraud leads to an opportunity for healthcare administrators and professionals to review their practices, the trends in fraud, and make any changes to the organization to prevent being targeted in enforcement investigations.

The resources used in using healthcare lawyers to perform health-care fraud and compliance audits are well allocated when the alternative significant civil and criminal fines and penalties could be assessed against your healthcare organization if an investigation leads to adverse findings.

Your healthcare attorney can audit your healthcare systems and help you maintain compliance with federal laws and regulations. Everyone in your administration should be aware of compliance and anti-fraud measures. Being able to demonstrate this preventative practice may be essential in the event of an investigation.

What happens if an investigator visits you and informs you of inquiry

How your hospital or medical practice responds to an initial inquiry of an investigator is imperative. Ahead of time, you should know a healthcare attorney you can contact immediately and you should be aware of how they will advise and represent you if necessary. Even if you believe that your practice is compliant and not in any risk, it is not a good idea to represent yourself without a lawyer when visiting with and responding to investigators.

Your attorney may help satisfy the investigators concerns uniquely, where they know what kind of questions they may ask and how to best communicate your compliance and anti-fraud efforts.

If an investigator contacts you it is important to be polite and offer to assist and comply with their requests. You may ask them for contact information you will give to your attorney to also assist. You do not need to answer any of their questions without your lawyer present. A professional investigator will be accustomed to the request for legal counsel and you should not worry about that looking like any suggestion or admission of wrongdoing or guilt.

About us: Michael V. Favia & Associates, P.C. is a health law and litigation firm in Chicago representing individuals, healthcare professionals and organizations with civil legal matters as well as professional licensing and regulation.

Chicago health law and litigation attorney Michael V. Favia and his associates in several locations and disciplines, advise and represent private individuals as well as healthcare professionals in all types of litigation and administrative matters involving licensing and regulatory agencies.

Michael V. Favia and Associates, P.C. represents individual physicians and health care organizations in the Chicago area with a variety of legal matters. With offices conveniently located in the Chicago Loop, Northwest side and suburban meeting locations, you can schedule a discrete meeting with an attorney at your convenience and discretion. Michael V. Favia & Associates is available at (773) 631-4580. Please visit www.favialawfirm.com and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter. You can also review endorsements and recommendations for Michael V. Favia on his Avvo.com profile and on LinkedIn.

 

PODCAST: Appealing adverse final rulings in healthcare discipline, discharge and termination

Today’s podcast interview with attorney Michael Cohen, focuses on his work with attorney Michael Favia in defending healthcare professionals and appealing adverse decisions from any state agency final ruling affecting involving discipline, discharge and terminations. There are many compelling reasons to file an appeal of a ruling affecting your healthcare career. Attorneys Cohen and Favia work as a team to fight for the professional being disciplined or terminated. USE THIS LINK TO LISTEN ANYTIME

Topics covered in this 30-minute interview:

  • Common elements in reportable healthcare discipline, discharge and termination cases;
  • Describing usual procedural processes leading to an appealable final ruling and decision;
  • The measurable impact of healthcare discipline or termination on a local and national level;
  • What to expect in appealing an adverse discipline, discharge or termination ruling.

Michael B. Cohen is a partner in the Chicago office of Quintairos, Prieto, Wood & Boyer, P.A. Mr. Cohen represents clients in a wide variety of civil and criminal litigation matters, both state and federal at the trial and appellate levels, focused on complex commercial litigation. His litigation practice includes the areas of appellate law, bankruptcy, civil rights, commercial, constitutional, criminal, employment, estates and trusts, insurance coverage, medical malpractice defense, personal injury actions, privacy, professional liability, and real estate.

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Michael V. Favia & Associates are available to advise and represent health care professionals and the general Chicagoland community with a variety of legal issues. With offices conveniently located in the Chicago Loop, Northwest side and suburbs, you can schedule a discrete meeting with an attorney at your convenience and discretion.

For more about Michael V. Favia & Associates’ professional licensing work, please call (773) 631-4580, visit www.IL-Licensing.com and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter. You may also connect with Attorney Michael V. Favia on LinkedIn and on Avvo.com where you may also read client endorsements and reviews.

The Illinois Department of Financial and Professional Responsibility investigates cases that can lead to discipline.

Medicare fraud bust in Illinois leads to 6 and ½ year sentence

The biggest problem facing Medicare fraud might be the arrogance of people who get away with bad acts for too long. Meanwhile, with the cooperation of law enforcement agencies using technology and skill, fraud schemes are frequently shut down and bad actors are prosecuted. In some cases, someone on the inside is the whistleblower who notifies authorities. In this case, the nurses who challenged fraudulent behavior were treated poorly and terminated. Several former employees filed whistleblower lawsuits leading to the investigation, arrest and prosecutions in this major Medicare fraud case.

The $90 million Medicare fraud scheme

In this case, Seth Gillman, Chicago businessman and mastermind of this fraud scheme exploited terminally ill patients in Illinois in the $20 million Medicare fraud. Gillman was convicted and sentenced to 6 ½ years in federal prison.

The Chicago Tribune reports, “By paying kickbacks to nursing homes and giving bonuses to employees who took part in the fraud, Gillman built his Passages Hospice LLC into the largest such company in Illinois, serving terminally ill patients in 89 countries and billing Medicare more than $90 million from 2008-2012, government records show.[i]

Unfortunately, Passages Hospice did not provide the care consistent with what Medicare paid in claims submitted for patient services. Meanwhile, Gillman lived a lavish lifestyle, excessive even for a licensed attorney and nursing home administrator. To the U.S. District Court Judge, Gillman stated, “I betrayed the trust of Medicare and I besmirched the integrity of hospice all together…I was stupid and I was wrong.[ii]

Investigation and discovery of Medicare fraud schemes

Why would anyone want to be the whistleblower? When an individual with “clean hands” contacts and works with the investigation of Medicare fraud schemes, they may be removing themselves from the eye of the investigators. Since many of the common Medicare fraud schemes are complex, there are multiple people involved. Therefore, investigators might be looking at everyone involved in a healthcare operation, when there is a suggestion of wrongdoing. It may be easier to report the fraud than be accused of being a part of it or helping with a cover-up.

Another reason people report fraud is they may be able to recover a percentage of fines assessed and paid in connection with the Medicare fraud prosecution.  This is called Qui Tam and our article on point explains the process. See Dr. Whistleblower: Reporting $10 million in a Medicare billing fraud scheme, could share in recovery.

If you or another suspect there may be wrongdoing occurring in a health-related practice or care facility, it is a good idea to talk to a health law and litigation lawyer to figure out where you may stand in the event there is a current or pending investigation. You might also be a proper person to file a whistleblower lawsuit. You might also be an individual responsible for others below you who you believe may be engaged in wrongdoing. Likewise, it is imperative to secure experienced legal counsel.

About us: Michael V. Favia & Associates, P.C. is a health law and litigation firm in Chicago representing individuals, healthcare professionals and organizations with civil legal matters as well as professional licensing and regulation.

Chicago health law and litigation attorney Michael V. Favia and his associates in several locations and disciplines, advise and represent private individuals as well as healthcare professionals in all types of litigation and administrative matters involving licensing and regulatory agencies.

Michael V. Favia and Associates, P.C. represents individual physicians and health care organizations in the Chicago area with a variety of legal matters. With offices conveniently located in the Chicago Loop, Northwest side and suburban meeting locations, you can schedule a discrete meeting with an attorney at your convenience and discretion. Michael V. Favia & Associates is available at (773) 631-4580. Please visit www.favialawfirm.com and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter. You can also review endorsements and recommendations for Michael V. Favia on his Avvo.com profile and on LinkedIn.

 

[i] Chicago Tribune, Hospice CEO gets 6 ½ years for fraud scheme, by David Jackson and Gary Marx, Mar. 7, 2017.

[ii] See HNi above.

Facing challenges in documenting medical care

Every healthcare professional knows that, at some point in their medical practice, they may be called on to defend patient care. When time passes and our ability to accurately recall information is diminished we should be able to rely on documentation of events to answer questions. There are practices you can adopt that can make it easier to make a good habit of properly documenting everything that happens before, during and after patient care.

Documenting everything is not the only key component to keeping proper records. Your medical record entries must be adequate representations of what happened. Imagine a jury reviewing records in a medical malpractice case, assume they do not spend much of their time reading medical records. How might they react to inadequate records? What may be obvious to you may not be to them. When others are charged with judging your credibility, the quality of your medical records can either enhance or diminish your credibility.

Examples of detrimental documentation practices, as identified in the recently article published by The Doctors Company, The Faintest Ink.[i]

  • Gaps and delays in documentation
  • Illegible entries
  • Dictation with blanks
  • Unflattering or judgmental patient descriptions
  • Entries appearing to vent negative feelings
  • Altered records and records missing documents or entries

To ensure proper documentation, each time and every time, the best practice is to develop a system for entering and recording information. Almost like a checklist, you can determine the rules and procedures for managing information. Identify details regarding when, where, how, what and why information is recorded. While it may seem like extra work, at some point your medical records could be under review and read in isolation of other information. Therefore, every single time it is helpful to identify why an entry is being recorded.

Features and benefits of good documentation habits

Increased communication with patients and increased continuity of care should increase understanding, decrease misunderstanding. In many medical malpractice cases, the root of the problem leading to a complaint can often be identified as failure in the communication process.

One way to improve communication is to use dictation equipment to make your patient notes. When you dictate notes right in front of patients you are more likely to read the details into the notes so that the patient can understand everything. If, on the other hand, you are making dictation and sound cryptic or unclear, a patient could become nervous and worried about not having a clear understanding of their doctor visit.

When making entries, beware of the easy mistakes that you can make when using forms and templates. A simple mistake in recording information on a form can cause problems. If there is an error in checking boxes on one form, could there be more errors on other forms? Making independent notes every time you record patient information better insures accuracy and credibility of information.

It is a good idea to audit and review medical records to ensure that documentation procedures are consistently used. In the audit process, a reviewer may detect entries that may require a second look. If there is an error or missing information, it is always best to make a new record and attach it as an addendum to the original. Do not change or alter records when there is active or pending litigation.

For more tips on documenting patient medical records or if you have questions about exposure and liability in the event of a patient complaint or claim for malpractice, please be in touch with Michael V. Favia and Associates, P.C.

About us: Michael V. Favia & Associates, P.C. is a health law and litigation firm in Chicago representing individuals, healthcare professionals and organizations with civil legal matters as well as professional licensing and regulation.

Chicago health law and litigation attorney Michael V. Favia and his associates in several locations and disciplines, advise and represent private individuals as well as healthcare professionals in all types of litigation and administrative matters involving licensing and regulatory agencies.

Michael V. Favia and Associates, P.C. represents individual physicians and health care organizations in the Chicago area with a variety of legal matters. With offices conveniently located in the Chicago Loop, Northwest side and suburban meeting locations, you can schedule a discrete meeting with an attorney at your convenience and discretion. Michael V. Favia & Associates is available at (773) 631-4580. Please visit www.favialawfirm.com and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter. You can also review endorsements and recommendations for Michael V. Favia on his Avvo.com profile and on LinkedIn.

 

[i] Source for article summary: The Doctors Company, The Faintest Ink, By Carol Murray, RHIA, CPHRM, Patient Safety/Risk Manager II.