When DHHS Comes Calling – Lamson Dugan & Murray LLP

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Phil Puccio

Any licensed health care provider dreads receiving this certified letter from the Nebraska Department of Health and Human Services, Investigations Division return address. Even opening the letter does not help: “Dear Sir or Madam, we are collecting information on a complaint that has been filed against you. The complaint claims that you blah, blah, blah. Please send your written reply to this office no later than 14 days after receipt of this letter.”

Great. What now? Here are a few suggestions:

  1. No panic. You are still in the appeals review phase of the process. This means that the ministry collects information and decides whether to open a formal investigation. Of the 2,111 complaints received by the DHHS in 2011, only 882 or 42% were formally investigated. A satisfactory response to the complaint can still contain the pass.
  2. Notify your insurance carrier. Most insurance carriers offer limited coverage for DHHS exams. You can pay for a lawyer and costs up to a limited amount. Use this service, the sooner the better.
  3. Get a lawyer. Whether your insurance company provides you with one or not, you should consult an attorney from the start. They can work with DHHS to extend your response time, help gather information to formulate a response, and write a complete and compelling response to the complaint. Depending on the severity of the complaint, they may recommend hiring an independent expert to review the case and provide an expert opinion to support your care. You can coordinate a strong defense while continuing to practice your profession.
  4. DO NOT put the letter on the pile on your desk only to pick it up again on the 13th day and scribble a reply. All of these complaints must be taken seriously and dealt with promptly.

Even if DHHS decides to open a formal investigation, all is not lost. An investigator will be assigned to the case who will contact you for more information and to schedule an interview. You will definitely want a lawyer to assist you in preparing for this interview and to attend the interview with you.

Once the examination is complete, it will be presented to the professional board responsible for your particular profession. The board reviews the investigation and gives the public prosecutor a recommendation on how to proceed. This can be anything from a recommendation not to take any further action to a recommendation for a temporary immediate suspension with a disciplinary action to seek revocation.

While the attorney general’s office generally follows the committee’s recommendation, it is ultimately up to them to determine the appropriate course of action. If the Attorney General makes a request for disciplinary action, you have the right to have the challenged case heard by a hearing officer. The outcome of this hearing of the impugned case may be appealed to the District Court of Lancaster County and thence to the Nebraska Court of Appeals and the Nebraska Supreme Court.

As you can see, receiving that first letter can be the first step in a long and difficult process. But it doesn’t have to be. Take the appropriate steps to respond early on, and you’ll increase your chances of shortening the process.

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Original Source: https://www.ldmlaw.com/2022/05/when-dhhs-comes-calling/
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