Attorneys with the NYC-based healthcare law group of Joseph Potashnik and Associates, PC have been providing professional counseling to licensed mental health professionals facing all sorts of legal issues from Medicaid, Medicare, and private insurance audits to professional license defense before the Office of Professional Discipline to criminal defense.

Becoming a licensed and practicing psychologist in New York City and New York State requires many years of advanced and involved training. More than this, it requires a patient and resilient personality. This profession only works for you if you are both internally strong and stable as a rock while still compassionate and caring. This is because you are helping to treat troubled patients who possess a staggering range of mental, emotional, occupational, or behavior problems and issues. That is why you strive to come up with a regimen of care that helps to solve or at least to lessen the impacts of various mental and emotional disorders and problems by employing group or individual forms of counseling.

After you have invested so much of your own time and money for training, and your personal ability, talent, and touch into helping people in this capacity, you do not want to suddenly have it all taken away from you. This becomes increasingly likely as a greater and greater number of Americans are turning to psychologists to obtain both therapy and balance in their lives. Your professional stakes higher than ever now. As a psychologist, you can be brought in to help out people who demonstrate actions that may eventually cause devastating results for both them personally as well as the people around them. It is an awesome responsibility.

All of this is to say that an unstable patient could come to the conclusion most unfairly that you did not live up to these incredibly high expectations and standards of the psychologist profession. They may claim some type of violation of the state board or the expected code of conduct for the industry. In this case, you could become the victim of a complaint to the board or worse.

In the event that this should occur, any complaints lodged against you will eventually be reviewed by someone or a board within the state’s enforcement division. It will be their task to investigate the case and to go through the complex procedures involved. This would likely entail document review and relevant person interviews at the least.

Should the board then determine that there is potential probable cause involved, your case will then go to panel for disciplinary review. It is possible that a sit down conference will be held whereby all parties come to a resolution at this point. Otherwise, your case becomes one that is contested and may drag out for a year or even longer. Extricating yourself, your reputation, and any remaining portion of your cherished practice from this mess will require the expert services of a capable New York City psychologist defense attorney. It is foolhardy to endure this struggle without professional legal counsel.

Medicaid, Medicare, and Insurance Audits and Overpayment Demands

One of the common problems faced by mental health professionals operating their own practices are inadequate billing practices, which can result in serious consequences. Most psychologists are busy serving their patients; they are generally not well educated in the intricacies of medical billing and underlying policies.

The following issues are amongst the most common triggers of insurance audits and investigations prevalent in the mental health field:

• Missing recipient records
• No documentation of clinical service
• Missing, late, or inadequate individual treatment plans
• Missing documentation of individual treatment plan review
• Brief visits billed as regular or extended visits
• Missing progress notes
• No explanation of benefits (EOB) for Medicare patients
• Improper Medicaid billing for Medicare Crossover Recipients
• No EOB for third party health insurance covered service
•  Improper Medicaid Billing for third party health insurance recipients
• Billing for unauthorized services
• Incorrect use of the modifier adjustment
• Billing for services provided by unauthorized, unclicensed, or un-enroled providers such as trainees and interns

Psychology License Defense Investigations and Charges

There are so many different reasons that psychologists may be brought up for disciplinary review or action. The end result can easily be sanction for you the licensee or even revocation of your professional license. Among the various charges for which you will require the help of a good lawyer are:

• Patient Psychologist Sexual Relations or Contact
• Violation of Confidentiality Rules With a Patient
• Violations of Boundary Involving Loaning Money, Employing Patients, or Casual Relationships
• Delivering Unlicensed or Untrained-For Services
• Allowing or Managing a Practice Without a License
• False Advertising
• Abuse or Dependence on Drugs or Alcohol
• Inappropriate Sharing of the Psychologists’ Problems or Personal Self Treatment
• Negligent, Unethical, and Unprofessional Behaviors or Acts
• Criminal Conviction or Arrests
• Outside of the State Disciplinary Action
• Falsification of Psychology Board Renewals or Initial Applications

Once a complaint of this nature has been filed with the state board, cases are then opened. Literally any person in the general public is able to file such a complaint, be it a former or current patient, former or current employee, family member of a former or current patient, or subsequent therapist. Serious cases such as boundary violations, sexual misbehavior, or gross negligence are often assigned straight away to state board-employed investigators for immediate examination.

At the stage when you are first contacted by the investigator or investigator’s office, or when you are offered a Consent Order, contact our attorneys to help you before things deteriorate any further. As a trusting person, you might feel that there is no harm that can be done in meeting voluntarily regarding the complaint to discuss your side of the story. Nothing could be farther from the truth. Such a meeting is never intended to be a forum for you to share your take on the complaint or your version of events. Without legal protection at such a meeting to bear witness to the interview, your statements may be twisted and cleverly turned against you at a later point in a hearing or subsequent action that is taken against you.

There is no good reason to go it alone legally. Should you learn that you are actively being investigated, or that your license is considered to be at stake in any proceedings, our firm is available to help you. We are well-practiced, versed, and experienced in dealing with all types of defense of professional and medical licenses, as well as ethical or professional issues and problems that you as a psychologist provider may face. We also specialize in psychologist criminal misconduct defense cases. Call us today at Joseph Potashnik and Associates to obtain the help that you deserve with respect to your professional rights. As the leading law firm for healthcare practitioners and providers, we can assist you in avoiding censure or the suspension of your psychologist license.