Patients often see the same medical practitioner, therapist, or dentist for many years. Indeed, many practicing professionals say one of the best parts of their job is developing relationships with clients and their families over time. But another less pleasant part of the job is ending relationships with patients. While licensed practitioners can decide to stop seeing a patient for a number of legitimate reasons, the practitioner must go about ending the practitioner-patient relationship carefully because failing to do so could lead to accusations of patient abandonment. Unfortunately, a patient with whom a practitioner is most likely to need to end a relationship may also be likely to be the kind of person to become litigious. In cases like this, it is essential to have the support of an Indiana professional license defense attorney.

Why Can a Medical, Dental, or Mental Health Professional End a Relationship with a Patient?

Practitioners have to end patient relationships for many years, often to protect themselves or their practice. The reasons a practitioner-patient relationship may be terminated include:

• The patient will not adhere to the treatment plan the practitioner prescribed
• The patient will not comply with office policy
• The patient subjects the practitioner or office employees to verbal abuse, physical abuse, or harassment
• The patient uses, displays, or otherwise inappropriately handles a firearm or other weapon at the office
• The patient cancels appointments, misses appointments, or refuses to come in for follow-up care
• The patient refuses to pay their bill
• The patient sexually harasses the practitioner or office employees

When a practitioner needs to end the patient relationship for these or any other reasons, he or she must make sure to do so in a way that does not subject him or her to accusations of abandonment. Practitioners need to ensure the patient has time to find another practitioner who can provide the same or similar care and provide the patient with written notice of the practitioner’s intent to terminate the relationship with the effective end date.

When a provider has been banned from receiving payments from Medicaid, Medicare, and other federal medical insurance programs, they are added to the List of Excluded Individuals/Entities (LEIE). The database was established in 1977 and is managed by Health and Human Services (HHS) Office of the Inspector General (OIG). It is critical that healthcare entities check the database to see if current employees, potential new hires, and contractors are entered into the database. Failure to conduct that check could have serious legal and financial consequences.

Who Is On the LEIE?

There are two categories for provider exclusions. Mandatory exclusions are those that are legally required and are added because the provider has been convicted of a felony. The types of crimes include:

• Medicaid or Medicare fraud

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According to regulations issued by the Indiana State Board of Nursing, all Advanced Practice Nurses (APN) are required to obtain continuing education in order to keep their nursing license in good standing with the state. Failure to meet this obligation could result in the Board taking action against an APN’s nursing license. Recently, The Law Offices of Joseph J. Bogdan, LLC has learned that more than 400 APNs will be served with orders to show cause for noncompliance with these audits. If you receive one of those orders, call our office right away.

APN Requirements and Audits

In Indiana, all APNs are required to obtain a minimum of 30 hours of continuing education. At least eight of those hours must be in pharmacology. All programs must be approved by a sponsor of continuing education for APNs who has obtained national approval. Advanced Practice Nurses are also required to retain all continuing education completion certificates to prove these requirements have been met should the Board audit the nurse.

Periodically, the Board will conduct random audits of APNs. The nurse will receive a written request from the board to provide it with documentation proving the thirty contact hours of continuing education have been completed, as well as a sworn statement between the APN and the licensed practitioner they work with that both parties are in compliance with collaborative practice agreement terms.

There is no denying that the healthcare billing system is a complex one, whether you are dealing with private insurance or government insurance, such as Medicare and Medicaid. There are multiple codes and processes to keep track of, which can be difficult because of the way things are always being updated and changed. Unfortunately, billing errors do occur. Even more unfortunate is that some of these errors can lead to allegations of healthcare billing fraud, putting a physician’s medical license – and even their freedom – in jeopardy.

What Are Examples of Healthcare Billing Fraud?

A physician or other medical provider can be accused of healthcare billing fraud if there is evidence that they intentionally manipulated the insurance billing system or coding to their advantage. One common type of fraud is referred to as upcoding. Upcoding occurs when a patient receives bills from the provider for services that are more expensive than the actual services they received.

Another type of healthcare billing fraud that occurs frequently is when a provider submits the same bill more than once to the patient’s insurance company for a service or procedure the patient only received once.

Technological advances have improved processes in multiple professions, including the medical profession. One significant change is how doctors and other medical professionals’ access and update patients’ medical records. No longer are patient histories, vital signs, symptoms, treatments, and other information written to medical records by hand. Instead, the majority of medical providers now use electronic health records (EHR). While this technology is supposed to be more efficient, there are still issues with accuracy and errors, which could result in professional complaints and even more serious ramifications.

What Are Electronic Health Records?

An electronic health record is a digital version of a medical chart that contains all of the information regarding a patient’s health. Some of the information the record contains includes:

• Patient demographics

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