Are FL doctors and nurses being sent to rehab unnecessarily? Accusations: over-diagnosing; over-charging

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He’s a practicing Florida doctor, she’s a licensed mental health counselor. Both are staying in the dark out of fear of repercussions but speaking out about the state’s rehab program for doctors.

“There are some serious flaws in the system and I’m here firsthand to tell you that’s true,” said the physician.

“I think its purpose is to help people but it’s not doing that, it’s abusing them,” said the mental health counselor.

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In 2013, while applying to get her license to practice mental health in Florida, the mental health counselor we spoke with said she was thrust into a 5-year state contract with PRN for drug and alcohol addiction after admitting on her license application that she was hospitalized and treated for depression four years earlier.

“I felt humiliated and frustrated,” she said.

Frustrated doesn’t begin to explain how another practitioner felt about his journey in and out of the state’s rehab program.
After admittedly battling drugs and alcohol, he was 3-years clean in state rehab only to learn a routine drug screening tested “mildly positive,” for alcohol.

“I didn’t drink, I hadn’t had a drink in 3 years,” the doctor said.  “There isn’t a test in the world that we do that can’t have a false positive,” he said.

He disputed it, paid for additional drugs tests to prove his innocence and says he even spent another $500 to take a lie detector.

“It made no difference to them.  They said no, we have the original test and it’s positive so no matter what the retest shows we still think that you relapsed,” he said.

Relapse would have meant starting over in rehab and stopping his practice for 3 months.

 

“There’s no way I could have done that without completely ruining my practice.  I’m just not going to suffer consequences for something that I didn’t do,” the doctor said.

Both practitioners say while the  programs are necessary and a needed resource for practitioners struggling with addiction or mental health, they both believe PRN took its power too far.  They hired Sarasota-based attorney Steve Brownlee of Chapman Law Group.  He’s made a business out of defending doctors and nurses sent to these state contracted rehab programs.

“The impaired practitioner programs play a very important role but it seems like everyone who gets into the net, gets caught and there are a lot of people who don’t belong in that net,” he told us.

 

As of January 2017, there were approximately 928 practitioners enrolled in the state’s doctor rehab.  The nurse’s program was providing services to 1,216 individuals.   Individuals sent to these rehab programs are evaluated and recommended for the program by the same PRN or IPN-approved doctors who will treat them once they’re in the program.

“The doctor could be biased because they’re paid handsomely for the referral. There’s incentive to suggest the person is impaired,” he said.

“I hear a lot about some questionable cases,” said Dr. Jay Wolfson, Associate Vice President of USF Health in Tampa.  While Wolfson also says there is a critical need for programs like IPN and PRN in the state, he also believes the programs should be investigated by an independent third party.

“They operate very independently.  They become judge, jury and prosecutors,” he said. “It becomes a business as well as a service and that’s where it can get difficult,” Wolfson explained.

 

Medical professionals who enter the programs must pay for all treatment out-of-pocket which could add up to thousands of dollars each year.  There are also no standards on how much treatment can cost.  So one PRN-approved doctor can charge $250 for an evaluation while another doctor can charge $750 for a similar evaluation.  PRN’s medical director, Dr. Alexis Polles, told us in a statement that lab testing provided to practitioners in the program are “at or below the national average for similar toxicology testing. In fact, the State of Florida’s toxicology lab testing is among the lowest of similar programs,” she said.

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When asked about the allegations, PRN’s medical director Dr. Polles said “we vehemently deny strong-arming anyone into the state’s impaired practitioner program.  It is of utmost importance that our health providers understand the need to enter an evaluation process if they have a potentially impairing condition.” According to PRN’s Chief Administrative Officer, since 2012 the program has enrolled 737 practitioners and 854 practitioners, including 18 students, have successfully completed the PRN program.

In an annual compliancy report conducted last year by the FL Department of Health, files for 24 participants were reviewed randomly by FDOH staff and PRN was found to be in full compliance with all contractual responsibilities. In her statement Polles added, “PRN is independently audited annually for oversight and accountability.”

After one year, the state’s medical board agreed the mental health counselor we spoke to did not need to continue in the program’s drug and alcohol treatment program.

 

“It was a nightmare, a nightmare, I would not recommend PRN to anybody,” she said.  She also told us after all the drug testing and evaluations, she spent a total of $10,000 to get her license to practice mental health.  Had she waited 8 months to fill out her application, she could have bypassed PRN all together since it would have been over 5 years since her hospitalization and she would not have been obligated to disclose it.  She remains in treatment for depression and takes medication under a psychiatrists’ care.

While the doctor we spoke with continues his battle to prove he’s clean and ready to move on.

 

“I no longer trust them.  I am fighting for my reputation.  It’s been too hard to come back from where I was to let that go,” he said.

 

In May, PRN terminated its contract with the doctor for his failure to fulfill obligations of the program.  The doctor is now taking his case to the Board of Medicine who will ultimately determine his future in the state’s rehab program and whether he gets to keep his license to practice medicine.

A spokesperson for the FL Department of Health declined to respond to the allegations.  A spokesperson told us PRN and IPN are contracted vendors to the Department and serve as consultants.  “The Department would have no control over policies of PRN or IPN.”

Last session, lawmakers passed a HB 229

HB 229 – Health Care Practitioner Licensure

It adds some additional regulation to the state’s impaired practitioner programs.   Among the measures in that law prohibiting consultants like PRN or IPN from providing evaluations and treatment services.  The bill became law in May.

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3 thoughts on “Are FL doctors and nurses being sent to rehab unnecessarily? Accusations: over-diagnosing; over-charging

  1. it looks like a money making schemes. Drs and Nurses they figure make pretty good many (sometimes) and they will do anything to keep their license . So why not give them some hoops to jump in a flawed system. Hoops that put money into pockets of croonies. (Im sure you will find the companies contracted have a direct connection. AND Fla will then charge them for the ‘investigation” which amounts to witch hunting.

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  2. This news story serves to confirm what we already know about how healthcare providers are
    1) Funnelled into “rehab” and/or monitoring programs illegally, through ADA impermissible questions on licensure applications such as “have you been hospitalized for mental illness in the past 5 years”
    (see Mayo Clin Proc. October 2017 http://bit.ly/DyrbeADA) and 2) Corralled back into prolonged monitoring by the use of non FDA approved, oversensitive and inaccurate alcohol exposure testing that the US Substance Abuse and Mental Health Services Administration has stated must be used with extreme caution in healthcare providers because of the high potential for false positivity. (SAMSHA Advisory 2012 11:2 http://bit.ly/ETOHSAMSHA).
    Under the ADA, only evidence of CURRENT IMPAIRMENT can be used to discriminate against license applicants. This is supported by policies of the Federation of State Medical Boards (which are clearly being ignored in FL) and the American Psychiatric Association, as well as the AMA.
    If the facts are as alleged in the article, the physician in this case did everything that could possibly be done to prove the false positivity of the testing he was subjected to. I certainly hope he wins his medical board appeal and if not, a subsequent court case, and that this scam can be named and terminated, at least in FL. It could then serve as a model for victims in other states.

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