Texas Physician Defense Lawyer

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Texas Physician Defense Lawyer

If you are currently being subjected to an investigation of your medical license by Texas Medical Board or if you or your health care facility faces any other action involving your ability to practice in the field of health care, you need assistance from attorneys who understand both health care law and medical standard of care. You may receive notice from the Texas Medical Board by mail or by an investigator showing up at your office demanding records.

 

I am aware of many instances where the Medical Board Investigators show up unannounced with a Texas Medical Board subpoena which requires medical records be delivered immediately. The investigator demanded the records and would not leave without the records. . In effect, the Investigator was treating the administrative subpoena as a search warrant. The Texas Medical Board does not have independent enforcement authority for subpoenas and do not have search warrant authority.

 

A search warrant can only be issued by a judge, based on probable cause and sworn testimony. A proper search warrant will be in the nature of a court order and will be signed by a judge, not an administrative agency official. Any subpoena must allow a "reasonable" period of time to produce a copy of the record. At the first indication of a subpoena, search warrant, or investigation of any type, it is critical to retain an appropriately experienced health attorney to represent you before you respond.

 

I can help defend you in the following circumstances:

 

  • Responding to an TMB administrative subpoena or request for records,
  • Representing you at your office when a Texas Medical Board Investigator demand records,
  • ISC -Informal Settlement Conference / Show Compliance Hearings,
  • Temporary Suspension Hearings / Emergency Suspension Hearings,
  • State Office of Administrative Appeals –Contested Case Hearings,
  • Appeals,
  • Probation or Consent Order Violations,
  • HIPAA privacy violation,
  • CMS Medicare or Medicaid fraud accusations.

 

I have experience in representing physicians, and other health care providers in different cases involving allegations of over-prescribing narcotics and pain medications. These include criminal investigations by local police and law enforcement authorities, investigations by the U.S. Drug Enforcement Agency (DEA), and complaints against professional licenses by the Texas Medical Board. Having an attorney familiar with the medical standards of care and guidelines for prescribing narcotics and having access to expert medical and pharmacy professionals who can testify as expert witnesses in such cases is also crucial. We have represented professionals in administrative investigations and administrative hearings at both the state and federal level.

 

Another huge potential liability for physicians is the inappropriate use of social media and social networking. Physicians should never take photos or write any personal information about any patient on Facebook, Twitter, or any other internet web site for that matter. If a patient posts something on their Facebook or Twitter account, a Physician should not take this to mean that the patient is waiving his/her privacy rights. And a Physician should not “friend” patients on Facebook or respond to any patient postings as this too can get a nurse into trouble with the nursing board. Physicians need to keep in mind if they participate in any social media, the information travels very wide and far and becomes a permanent piece of information that can come back and haunt them for the rest of their career. If you are accused of a HIPAA privacy violation, call my office for a free consultation.

 

If you know you are being investigated for potential Medicare or Medicaid fraudulent activity, we will provide the strategic, aggressive defense necessary to protect your interests or career. If The Office of Inspector General (OIG) and Attorney General's Office (AG) contact you, consider legal representation. You can innocently allow OIG or AG office to obtain admissions that may lead to investigations and severe consequences, including penalties such as fines, exclusion from Medicaid and Medicare, and other career-shifting effects.

 

Medicaid fraud has become an alarming issue in the United States. Medicaid has identified certain billing procedures that may indicate cases of fraud. If a health care provider engages in these practices, Medicare and Medicaid can flag them and make inquiries into their actions. Few doctors commit fraud deliberately. However, many of the mistakes arise from the complexity that surrounds hospital billing systems. Small issues can easily be detected in the audits, and these can have dire consequences on the health care providers. If Medicaid suspects you of fraudulent activities or an improper billing system, they are obligated to make an inquiry. The inquiry begins by requesting certain documentation. The audit begins when something in your billing or coding systems is flagged. Once Medicaid looks into the documents and records you have submitted, they send a letter announcing an audit. Once the documents received have been submitted, the Medicaid auditors will determine whether further investigation is necessary.

 

For healthcare providers who find themselves being contacted by a recovery audit contractor, also known as an RAC. A RAC is compensated on a contingency-fee basis, which can lead to an increased number of audits due to supposed overpayments. In fact, research has shown an RAC will almost always uncover far more overpayments than underpayments. Along with scrutinizing standard Medicare claims, an RAC also examines Medicare Advantage plans, Medicare Prescription Drug plans, and Medicaid claims. Even though a healthcare provider is not required to have legal representation during an audit, going without it could prove very costly. Due to the appeals process related to an audit being very confusing and time-consuming to those who are unfamiliar with it, legal representation is a prudent choice.

 

During the course of their careers, most healthcare providers at some point find themselves appealing a decision made by the CMS. When this is the case, the services of a attorney will be needed in order to navigate the complexities of the case. Whether it’s in the form of a demand letter or an indication given on an Explanation of Benefits, or EOB, these appeals can become extremely complex. When this happens, a variety of options are available. One of the most common is having a hearing before an Administrative Law judge, which can be conducted in person, over the telephone, or even through videoconferencing. These hearings, due to their importance, almost always require a provider to have proper legal representation.

 

I know how important your ability to practice in the field of medicine is to you and other health care professionals, which is why I focus on helping clients just like you preserve their careers. I will mount an aggressive defense. However, an aggressive defense is not the same as litigation in the Court system. Knowing the difference between being aggressive and in engaging in expensive litigation is why you must have an experienced lawyer who knows how to face healthcare administrative bodies. Call my office today at 832-702-7599!

 

A DEEPER LOOK AT WHAT WE DO

When facing a medical legal issue you need someone who not only understands the law but understands the culture of medicine.

Texas Home Health Agency and Hospice License Defense

Health Law Administrative Defense

Irregular Behavior

Texas Nursing Board Representation

Texas Physician Defense Lawyer

Tommy E. Swate J.D.,MD. Medical License Lawyer

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832.702.7599

3663 N. Sam Houston Parkway E. Suite 640 Houston TX 77032

 

Reception@swatelaw.com

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