Icenogle & Associates, LLCSouthern WI Health Care Lawyer | Icenogle & Associates, LLC2024-02-14T02:54:29Zhttps://www.icenoglelaw.com/feed/atom/WordPressOn Behalf of Icenogle & Associates, LLChttps://www.icenoglelaw.com/?p=467762024-02-14T02:54:29Z2024-02-14T02:54:29ZFederal rules limit information sharing
It is important for medical professionals to communicate with one another. The proper sharing of medical information can lead to more accurate diagnostic outcomes and could help medical professionals identify those engaged in drug-seeking behavior. However, healthcare providers must be very careful to protect the privacy of individual patients.
For decades, the Health Insurance Portability and Accountability Act (HIPAA) has restricted what information healthcare professionals share with each other and the public. Healthcare providers could potentially run afoul of HIPAA with the information that they share on social media after a long shift or an interaction with a particularly difficult patient.
What does HIPAA prohibit?
HIPAA prevents medical professionals from identifying the patients in their care or sharing information that would allow others to identify a patient and know what medical issues they have experienced. A nurse could potentially talk about a frustrating shift in which a patient vomited all over their clothing without violating HIPAA.
However, they would not be able to share any information identifying who that patient is. There is a very fine line between sharing a humorous anecdote or venting and overtly violating a patient's right to privacy. Sometimes, workers with no bad intentions could end up accused of a HIPAA violation. Particularly if they travel in the same social circles as a patient, something that they shared online might eventually reach a patient or someone who knows that patient. Allegations of privacy violations could follow shortly thereafter.
HIPAA violations can result in both financial and licensing implications for a healthcare professional. As such, ensuring proper compliance with HIPAA, and responding proactively to allegations of violations, may help healthcare professionals protect the investments they have made in their careers.]]>On Behalf of Icenogle & Associates, LLChttps://www.icenoglelaw.com/?p=467752023-11-13T15:17:03Z2023-11-13T15:17:03Zobtaining a Wisconsin professional license often requires undergoing testing and a background check. Licensed professionals also typically need to commit to continuing education to ensure they remain informed of developments in their area of expertise.
Whether someone is an airline pilot or a nurse, they may worry that conflict with their spouse could put their career at risk. After all, most state licensing authorities allow members of the general public to initiate complaints that can trigger a professional investigation and possibly penalties for certain professionals.
Could allegations made during divorce proceedings impact someone's career?
Discipline won't occur without real evidence
The exaggerated stories people share about divorce ruining someone's life are often full of half-truths and hyperbole. Yes, a vindictive spouse is in a position to share information with the public that could damage someone's reputation. It is also true that some people will make patently untrue statements in the hopes of influencing what happens in divorce court. Others may try to punish their spouses for their perceived marital failings by attacking their social relationships or their careers.
For example, one spouse might claim in family court that the other is an alcoholic when in reality they only ever drink socially and do not have a habit of coming home intoxicated. People may raise those claims in the hopes of obtaining more favorable custody terms, but the courts generally demand corroborating evidence.
The same is thankfully true of the licensing boards that manage different professions. They will not take unsubstantiated claims very seriously. There needs to be evidence of substance abuse, criminal activity or other forms of misconduct for state licensing boards to investigate accusations made by an angry spouse and take disciplinary action against an individual.
Those who worry that their spouses may engage in misconduct to deprive them of career opportunities in the future might want to avoid certain behaviors during divorce and gather documentation validating their claims that they consistently adhere to appropriate professional standards for their industry. If a disciplinary hearing is necessary, the professional worried about their license will typically have the right to bring a lawyer to that hearing just as they would to any matter handled in criminal court.
Understanding the impacts that accusations and divorce testimony can have on someone's career can help people feel more confident about filing for divorce in Wisconsin and about seeking legal guidance about their concerns accordingly.]]>On Behalf of Icenogle & Associates, LLChttps://www.icenoglelaw.com/?p=467692023-08-12T02:08:10Z2023-08-12T02:08:10Zaccused of Medicare fraud can face numerous penalties should they plead guilty or get convicted of such offenses. Although physicians and their support staff may view such allegations as minor, victimless crimes, the reality is that the following penalties are possible in the event of a conviction.
Jail time
It is quite common for Medicare fraud charges to result in federal criminal charges and then incarceration in federal facilities. Those accused of violating billing rules for the Medicare program could face months or even years in state custody after a conviction. Federal charges might even mean that someone will serve their sentence in a facility in another state and have very limited contact with friends and family.
Financial consequences
It is very common for Medicare billing fraud charges to result in both fines and an order of repayment. Those that engaged in fraud or financially profited from it may have an obligation to repay the state. After serving a prison sentence, the individual convicted may have to commit a large amount of their income to repay the full amount of the benefits fraudulently received from the Medicare program.
Licensing and career consequences
Typically, those accused of Medicare fraud will have a very hard time securing a professional license in the future. State licensing authorities will often impose penalties on those convicted while they have a license and may refuse to grant a license to those with offenses related to the medical profession on their record. Additionally, any prospective future employers will very likely perform a background check and may choose to not hire someone who has a criminal record related to Medicare fraud. Those who have invested years of their lives and tens of thousands of dollars in their education can find themselves unable to secure employment or licensing in their chosen profession after a conviction.
The only sure way to avoid these life-altering penalties is to successfully defend against the criminal allegations someone faces related to medical billing practices. Fighting Medicare fraud and other white-collar criminal charges can give a professional a chance to preserve their freedom, their reputation and their career.
]]>On Behalf of Icenogle & Associates, LLChttps://www.icenoglelaw.com/?p=467582023-05-09T14:49:31Z2023-05-09T14:49:31ZCredible threats are the primary exception to the rule
Sometimes, those experiencing mental health disturbances may become a threat to themselves or others. Scenarios involving someone talking about harming another person or themselves may warrant a therapist taking action to notify authorities, reach out to intended targets or warn family members of someone's intention to harm themselves. In extreme cases, such threats may even warrant an involuntary hold at a psychiatric facility for evaluation purposes.
Unfortunately, the steps that a mental health professional takes out of a sense of obligation to their clients could end up harming their professional future. If circumstances do not meet the relatively high standard for breaching the confidentiality rule, then the professional could be at risk of legal action initiated by the patient and also the loss of their license.
For example, if a patient with a history of intrusive thoughts talked about a sudden idea they had to commit an act of violence, that likely wouldn't constitute a credible reason for concern unless they indicated that they had continued perseverating on the idea and had started to develop a workable plan to carry it out.
People may also discuss thoughts of self-harm or suicide without having true suicidal ideation, and it can be a challenge for mental health professionals to know when they must speak up and when they should respect their patient's confidentiality. Seeking legal guidance to learn more about the exceptions to confidentiality rules can help people feel more confident about acting to protect a patient or other people when mental health challenges may warrant the choice to speak up.
]]>On Behalf of Icenogle & Associates, LLChttps://www.icenoglelaw.com/?p=467572023-02-19T02:31:58Z2023-02-19T02:31:58ZHow are professional standards of care defined?
Professional standards of care function differently as applied to different circumstances. This means that standards of care can change depending on a number of different factors.
For example, the training of the doctor plays a role in the standard of care. A doctor that has a general medical license won’t provide as high of a level of care as a specialist in the field that treats the patient’s condition. For example, an oncologist will likely provide better care for a cancer patient than a general practitioner by virtue of their specialized training.
The technology available to the doctor also plays a role in the standard of care. Patients would expect better care from a doctor at a major medical center than they would from a rural doctor who has older and less sophisticated equipment.
The information the doctor has also affects the standard of care. A doctor who has access to a full medical history can make a better diagnosis and treatment plan than a physician who is treating an unconscious patient suffering an emergency.
Patients who perceive that they’ve been harmed because of a medical professional who has failed to meet professional standards of care may decide to take legal action. You have to be prepared to battle back against these claims because your livelihood could depend on your efforts. These claims must be handled swiftly and carefully, so be ready to do what you can to mitigate your risk of liability.]]>On Behalf of Icenogle & Associates, LLChttps://www.icenoglelaw.com/?p=467562022-11-09T20:43:40Z2022-11-09T20:43:40Zmake a complaint against you that could affect your license.
Anyone can initiate a complaint or investigation
Perhaps there is a patient who overheard you speaking about politics in the staff room and took personal issue with your beliefs, first trying to start a fight with you and then calling to complain about you later when you didn't react to their provocations. They could take their crusade against you a step further by filing a complaint with the state licensing board.
Perhaps your attempts at humor while caring for an ailing patient offended not the patient themselves but a family member present in the room during their treatment. It's also possible that those who work with you who have taken issue with you on some interpersonal level might exaggerate mistakes that you have made on the job or interactions between the two of you to file a complaint that puts your license at risk.
Allegations that imply cruelty, an inappropriate bias or other ethical failings could potentially cost you your license and therefore your career.
You always have the right to defend yourself
A complaint by an individual will typically result in an investigation, and that investigation might eventually lead to disciplinary action. You have the right to defend yourself in front of the board during disciplinary hearings, making use of that right will be a crucial step if you want to protect your license and your professional reputation.
Bringing in a lawyer to argue on your behalf might improve your chances of success, which is why many professionals choose to take this extra step because of how much they have invested in their profession so far. Recognizing how individuals could put your career at risk can help you better respond to complaints that could endanger your nursing license.]]>On Behalf of Icenogle & Associates, LLChttps://www.icenoglelaw.com/?p=467542022-08-15T20:31:45Z2022-08-15T20:31:45ZUpcoding
There are special billing codes designating hundreds of different medical procedures. Many of them take roughly the same amount of time and may even involve the same equipment or medical conditions.
Upcoding is a form of fraud that involves billing for a different procedure than what the medical facility actually provided. It may seem like a victimless crime because the patient received treatment and the facility provided that care, but the taxpayers are ultimately the ones who must pay the extra money for that more expensive, upcoded charge. Patients may recognize upcoding if they review their statements and could potentially bring the attention of authorities to the issue.
Unbundling
Insurance companies set specific reimbursement rates for different treatments when they negotiate contracts with individual care providers.
There are certain things that often go together, such as the administration of local anesthesia before a minor surgical procedure, and the insurance company may pay slightly less for frequently-combined medical services than for each of those treatments when billed separately. If the insurance company or program negotiated a discounted cost for commonly-combined services, it is actually fraud to charge more by intentionally billing for each step of the treatment separately.
These minor changes to how the company handles billing could lead to thousands of dollars in revenue and possibly federal criminal charges against the people involved. Learning more about white-collar criminal charges can help those facing charges or worried about their circumstances.
]]>On Behalf of Icenogle & Associates, LLChttps://www.icenoglelaw.com/?p=467522022-05-05T19:16:47Z2022-05-05T19:16:47ZThe Health Insurance Portability and Accountability Act’s exceptions
According to HIPAA, there are patient confidentiality exceptions. Those exceptions are designed to prevent a patient from harming themselves or others. They’re also designed to allow medical professionals to share information for clinical purposes and to optimize patient care.
For example, a therapist may be able to break confidentiality if they are concerned that the patient is suicidal or has decided to harm someone else. In those cases, the provider may be legally obligated to contact the relevant authorities.
Any time someone’s medical history could pose a threat to the public, that information may be shared as well. For instance, if someone has a disease that could spread through the public and cause serious harm to others, HIPAA states that the medical professionals are allowed to reveal information to protect the community.
Clinically, information about a patient may be shared in discussions with colleagues or when attempting to move a patient to a different facility. Some clinical data may need to be exchanged to improve and optimize patient care.
In court, there are times when you may be asked to share information, but you need to be sure that you are legally able to do so without violating HIPAA laws. Any time that HIPAA is violated, there could be a risk to your license as a medical or healthcare provider. If you are facing a reprimand or legal action, it’s valuable to determine if you did or did not violate the patient’s rights.]]>On Behalf of Icenogle & Associates, LLChttps://www.icenoglelaw.com/?p=467422022-02-10T19:38:01Z2022-02-10T19:38:01Zdevelop substance abuse problems as they use alcohol to self-medicate for depression or in response to a recent divorce. Others might use alcohol to help them sleep or cope with back pain and joint issues caused by long shifts and demanding tasks associated with patient care.
Frequently using alcohol might eventually affect a nurse's job performance or their licensing.
There is no such thing as a functional alcoholic in a medical setting
When people talk about functional alcoholics, they refer to people capable of fulfilling all of their usual obligations while under the influence. Store clerks, teachers or custodial professionals could all potentially do their jobs while consuming alcohol.
While they may not do the best job possible, they won't necessarily put others at risk or lose their jobs because of poor performance. However, if nurses come to work while under the influence of alcohol or hungover from a long night of drinking, they could do a poor job of providing care for their patients. They could make simple mistakes, get easily distracted and otherwise compromise the standard of care that they provide.
Co-workers and patients alike could make complaints either to a nurse's employer or to the state licensing board if alcohol use starts to affect their work.
Criminal charges and complaints can affect your professional future
If someone that you work with reports you for drinking on the job, you could easily face a disciplinary hearing. The same could be true if you get arrested for impaired driving or other criminal offenses related to substance abuse.
Thankfully, provided that you acknowledge the issue, fight your charges and seek treatment, you may be able to defend your license and continue your profession even after facing complaints or criminal charges related to your alcohol use. Understanding what might endanger your nursing license can help you protect the investment you have already made in your career.]]>On Behalf of Icenogle & Associates, LLChttps://www.icenoglelaw.com/?p=467412021-11-09T21:10:04Z2021-11-09T21:10:04ZWhen does a therapist need to break confidentiality?
Normally, therapists are required to break confidentiality only in a few situations, such as if:
The therapist suspects abuse to a child, adult or elder
A qualifying court order has requested specific patient documents
The client has directly asked the therapist to share their notes or information
The patient is a direct threat to themselves or others
The patient is being investigated as a subject in a national security investigation
Breaking confidentiality is usually not something that a therapist wants to do, because doing so could put them at risk of being accused of violating HIPAA and other confidentiality contracts. The work that the therapist has done with the patient may also be at risk of coming undone if the patient no longer trusts that individual.
Interestingly, the professional ethical codes in medicine don’t specifically determine when therapists have to break confidentiality. Instead, the law determines times when it’s appropriate to do so. Ethically speaking, most therapists will maintain confidentiality even when it’s not necessary to do so. If confidentiality does have to be breached, it may be breached only as much as required to handle an investigation or case appropriately.
If you do have to break confidentiality, make sure you discuss it with your colleagues or employer before doing so. You may want to look into the legal implications of doing so before you do, too. That way, you can take steps to protect yourself and your license, so you can continue to help everyone you can.]]>