The Law Office of Preeti K. Bajwa

HIPAA AND HITECH – WHAT ARE THESE REGULATIONS?

admin2 — Thu, 10 Nov 2011 18:35:46 +0000

In my practice as a healthcare defense attorney, I find that many providers have some knowledge of HIPAA and HITECH but do not understand the nitty-gritty of these legislative pieces. It is incumbent on the provider to know these regulations and abide by them as failure to do so can result in civil and even criminal penalties.

In 2009, the American Recovery and Reinvestment Act (ARRA) amended the HIPAA Privacy & Security Rules by establishing the HITECH Act. The Health Information Technology for Economic and Clinical Health Act (HITECH) expands privacy and security provisions, including:

- Required Notification for Security Breaches
- Required Accounting of Disclosures Involving Electronic Health Records
- The Minimum Necessary Rule
- Increased Enforcement
- Expansion to Business Associates
- Prohibitions on Sale of Electronic Health Records or PHI
- Access to Information in Electronic Format

Thus, with the drive to go to complete electronic healthcare records comes another set of regulations which must be heeded. Our office can assist healthcare providers in reaching the required security levels of HITECH and HIPAA.

In the meantime, if you have any questions or concerns regarding healthcare defense, please feel free to contact me directly.

HIPAA AND ELECTRONIC HEALTHCARE RECORDS

admin2 — Tue, 08 Nov 2011 18:34:46 +0000

The Health Insurance Portability and Accountability Act (HIPAA) security rule was drafted to provide security over client’s personal information. At the same time, it was also designed to enable greater availability of the patient’s health information for use by qualified health professionals. Although the security rule specifically protects electronic protected health information (EPHI), information that is not defined as “electronic” is still covered by the HIPAA Privacy Rule.

Recently, the Obama administration passed legislation that would require all medical providers to provide electronic healthcare records in their facilities. This must be accomplished by 2014. Thus, it is imperative that providers have their bases covered in the conversion to electronic healthcare records.

The security rule establishes requirements for covered entities, including:
- Ensure confidentiality and availability of EPHI
- Protect against anticipated threats or hazards to security
- Protect against unauthorized use
- Ensure workplace compliance

Failure to abide by the HIPAA security rule can and will result in criminal liability and civil sanctions against healthcare providers. That is why it is of utmost importance that healthcare providers have systems in place that maintain HIPAA requirements. It is incumbent on the provider to hire the right people to comply with healthcare regulations.

Our firm specializes in healthcare-related regulation and can assist providers in ensuring compliance with HIPAA and other healthcare regulations.

In the meantime, if you have any questions or concerns regarding healthcare defense, please feel free to contact me directly.

HIPAA AND CRIMINAL LIABILITY – WHY YOU MUST COMPLY

admin2 — Fri, 04 Nov 2011 18:34:32 +0000

The Health Insurance Portability and Accountability Act (HIPAA) was established in 1996 as a means to protect health insurance coverage for workers and their families in the event one loses or changes his/her job. It is also meant to improve the efficiency and effectiveness of the national healthcare system by promoting the use of an electronic data exchange facility.

This year, the U.S. government imposed a $4.3 MM fine against a health corporation for violating the HIPAA Privacy Rule. This action was the first of its kind in the U.S. The US Department of Health and Human Services Office of Civil Rights (OCR) found that Cignet Health had violated the privacy rules of HIPAA by denying patients access to their own medical records. Cignet further failed to respond to the OCR’s demands for release to over 41 patients, as well as failed to respond to OCR’s subpoena. The court ruled that the company engaged in “willful neglect to comply with the Privacy Rule.” OCR Director Georgina Verdugo stated, “The U.S. Department of Health and Human Services will continue to investigate and take action against those organizations that knowingly disregard their obligations under these rules.”

Over the next few blogs, I will cover other information regarding HIPAA and health insurance fraud, as well as recent trends and issues surrounding this topic.

I am Preeti Bajwa and I pride myself on providing exceptional legal representation with concern, care and empathy towards all my clients. Because of my aggressive stance on overcharged crimes, I am not afraid to set matters for trial and fight the case for my clients. Each client can be assured that you will receive personalized services directly from me.
In the meantime, if you have any questions or concerns regarding healthcare defense, please feel free to contact me directly.

Who Has The Prosecution Called As Witnesses, and How Important Or Helpful Have These Witnesses Been?

admin2 — Tue, 01 Nov 2011 20:06:45 +0000

The Prosecution has called a small army of witnesses, who have presented a strong case for both causation and gross negligence. Murray’s credibility has effectively been called into question. First, Jackson’s resident security staffer testified that Murray asked him to bag up miscellaneous supplies, which an investigator later retrieved in Jackson’s closet. The bags contained vials of Propofol and other drugs, along with miscellaneous supplies. Worse, the security staffer claimed that Murray told him to call 911 only afterwards. This evidence tells jurors that Murray knew he did something wrong and put self-interest first during Jackson’s critical situation. Murray’s motivations will need to be clarified by the Defense.

Second, four witnesses (paramedics and UCLA physicians) testified that Murray never mentioned Propofol to any of them and, futher, Jackson was clinically dead upon the arrival of paramedics to his home. Jurors will infer the same conclusions described above, and they will also interpret Jackson’s death under Murray’s care as proof of causation. Murray will need to counter the assertion that paramedics were ready to call death but Murray pressured them not to. He will also need a good response to the claim that Murray failed to mention the word “Propofol” to any of these four witnesses. Murray did tell the UCLA E.R. doctor that Lorazepam triggered the cardiac arrest, which the Defense should emphasize to show both the reason for the omission and the strength of the argument that Propofol was the cause of death.

Third, Murray’s personal and professional contacts and several investigators established that Murray purchased Propofol regularly and in increasing amounts, gave Jackson daily doses during Jackson’s final months, and spent six nights a week in Jackson’s home. One of Murray’s romantic interests (the Prosecution called four, successively) testified that, during a phone call on June 25, 2009, Murray stopped speaking for a period of several minutes at 11:50am and she heard coughing and mumbling in the background. A tape of Murray’s interview with LAPD was played, and jurors heard Murray state that he delivered the Lorazepam via IV periodically all morning, administered 25mg of diluted Propofol at 10:50am, left the room for two minutes at 11:00am, and returned to find Jackson unconscious. In these statements, the jurors find support for prosecutorial allegations that Murray was fully informed and actively participatory in Jackson’s drug abuse. They will also find Murray devoid of credibility if they heard about the People magazine account or anything like it. Murray can emphasize the inconsistencies in the timeline, arguing in favor of either a living Michael Jackson at 11:50am or a lack of credibility in the suggestion that Murray was present when the cardiac arrest commenced.

Fourth, multiple expert witnesses enumerated a variety gross deviations from medical norms that Murray committed, such as administering Propofol outside of a hospital, failing to monitor Jackson with standard medical equipment, and failing to respond to the cardiac arrest with proper drugs, CPR technique, or immediate emergency call. The jury also heard expert testimony that whether Propfol or Lorazepam killed Jackson, and regardless of who administered either drug, Murray’s negligence was so egregious that it supported a finding of involuntary manslaughter either way. If accepted by jurors, the expert’s conclusions will compel the jury to reach a verdict that Murray is guilty as charged. Obviously, Murray must provide credible expert testimony to counter these assertions.

The case is on hold as of October 19, 2011, due to a death in the family of the Prosecution’s final expert witness. Soon, Dr. Murray’s attorneys will call their witnesses. The Prosecution’s witnesses have revealed several especially vulnerable points in the Prosecution’s argument, which Murray needs to seize upon. For example, Propofol blood concentrations were negligibly low in the vitreous humour. Although other sample sites showed higher levels, the vitreous humour, due to post-mortem blood redistribution, is considered a more reliable indicator. This evidence supports Murray’s claim that he delivered 25mg of diluted Propofol over 3-5 minutes, which both the Prosecution’s forensic pathologist and UCLA E.R. doctor conceded as unlikely to have caused cardiac arrest 10 minutes later. There were also concessions concerning Lorazepam. Jurors heard that it can be used for treating insomnia, and its presence in Jackson’s blood was within the therapeutic range. In Murray’s taped interview, jurors also heard Murray describe that he used Lorazepam to wean Jackson off the more dangerous Propofol, which Jackson had learned how to self-administer despite Murray’s express disallowance. All in all, the Defense has a hard row to hoe, but there is still a case to be made for reasonable doubt, by hammering the uncertainties into the juror’s minds, presenting persuasive experts, and re-characterizing Murray as a concerned and responsible doctor.

How Is Dr. Murray Defending Himself, and How Viable Are The Defenses He Has Raised?

admin2 — Fri, 28 Oct 2011 20:05:23 +0000

So far, Murray’s defensive efforts have been largely restricted to challenging the evidence brought by the Prosecution. This is so because the Prosecution has not yet finished calling all of its witnesses. Broadly speaking, Dr. Murray’s best defense is to create reasonable doubt, which Prosecutors must overcome to win. Specifically, jurors must have reason to doubt either that Murray caused Jackson’s death or that he was engaged in grossly negligent conduct at the time. Thus far, Murray’s legal team (he has retained four attorneys) has focused on the scientific evidence. They seemed to have shied away from available strategies that attack Jackson or his family, such as Jackson’s well-documented drug abuse history and the pressures exerted on law enforcement by Jackson’s family.

Prosecutors told jurors that “Conrad Murray repeatedly acted with gross negligence, repeatedly denied care appropriate care to his patient, Michael Jackson.” Murray’s lawyers have elicited some helpful testimonial evidence from the Prosecution’s witnesses on cross-examination. These equivocal witnesses could give jurors reason to doubt that Murray acted with the requisite gross negligence. Jurors have heard that Lorazepam was prescribed as a sleep aid, and that that is one legitimate use of the drug. There is some evidence that the Lorazepam blood concentrations in Jackson were within the therapeutic range. Further, jurors have heard Murray (in a recording of an LAPD interview, 48 hours after Jackson’s death) stating that he was trying to wean Jackson off of Propfol with Lorazepam. In light of the evidence, jurors have reasons to doubt that Murray’s treatment of Jackson with Lorazepam was grossly negligent. However, Lorazepam was not listed as the cause of death by the coroner, so Propofol has taken center stage so far. Murray’s attorneys have announced that they will contest the coroner’s official finding on this point. This could work, but it will depend on how well the Defense’s expert witnesse are received by jurors.

Assuming that jurors agree that Propofol was Jackson’s cause of death, Murray’s defense is that he only gave Jackson 25mg of diluted Propofol over 3-5 minutes, and then he observed Jackson in stable condition for 10 minutes and subsequently left the room. On cross-examination, some of the Prosecution’s witnesses have conceded that that is not a lethal amount, and all of the Prosecution’s witnesses have conceded that, after 10 minutes, Propofol’s effects would be negligible or very diminished. However, the Prosecution disputes the amounts and timeline cited by Dr. Murray, and the Prosecution claims that the toxicology report supports their views. Murray’s lawyers initially theorized that Jackson orally ingested an additional, fatal dose while Murray left the room. This has been problematic, because Murray also says Jackson was asleep when he left the room, so the Prosecution has had modest success in ridiculing the theory. Recently, Murray’s team dropped their original theory that Jackson orally ingested the Propofol, telling the court that it was not supported by the science. The Defense is still expected to argue that Jackson self-administered additional Propofol, and they will probably say Jackson did so intravenously. There is record evidence that Jackson knew how to do this, and also that, if Murray left the room ten minutes after delivering 25mg of Propofol, Jackson could have awoken just as Murray stepped out. This could work, but that will require that jurors find Dr. Murray personally credible.

Assuming that the Defense can leave jurors with reasonable doubt on the causation or the gross negligence element, Dr. Murray cannot be found guilty. The gross negligence element specifically requires that Murray acted with gross negligence while performing some act that involved a high risk of death or great bodily harm. The Defense has yet to give jurors reason to doubt the Prosecutions claim that Murray’s use of Propofol in Jackson’s home was both negligent and involved a high risk. Specifically, jurors have heard that Murray was grossly negligent, because Propofol should be used only in a hospital setting, Murray failed to sufficiently record or monitor Jackson’s vital signs, Murray failed to lock up Propofol such that Jackson would even have the potential to self-administer, and so on. Unless the Defense plans to concede this point, they must present expert testimony to rebut the Prosecution’s expert witnesses, who all told jurors that Dr. Murray’s course of treatment was an inexcusable deviation from standard protocols.

Which Criminal Law Is Dr. Murray Charged With Violating, and What Are The Consequences If He Is Convicted?

admin2 — Tue, 25 Oct 2011 20:04:01 +0000

On February 8, 2010, prosecutors filed a criminal complaint charging Dr. Murray with one count of involuntary manslaughter, in violation of section 192(b) of the California Penal Code. To get a conviction, the Prosecution will have to prove that Dr. Murray killed Michael Jackson. They will also have to prove that Dr. Murray killed Jackson either (1) during the commission of an unlawful act, or (2) during the commission of a lawful act that both (a) involved a high risk of death or great bodily harm and (b) was performed recklessly or with gross negligence. (In opening arguments, Prosecutors identified option (2)(b) as their choice, claiming gross negligence on the part of Dr. Murray.)

Penal Code section 192 also defines the various punishment options, in the event that Murray is convicted. Theoretically, Dr. Murray could be put on formal probation with up to one year in county jail. However, Prosecutors are expected to seek the maximum term of imprisonment, which is four years in a California state prison. The statute also provides for a fine of up to $10,000, as well as revocation of professional licenses. The California Medical Board immediately made a public statement in February 2010, before the trial had even began, explaining that they were filing papers to revoke Dr. Murray’s license. At the same hearing, an L.A. Superior Court judge restricted Dr. Murray’s license to practice until further notice, telling Murray, “I don’t want you sedating people.”

Dr. Murray’s problems do not end there. Most states’ licensing agencies will initiate adverse action on a professional’s license on the basis of an adverse action in any other state. Therefore, Dr. Murray stands to be effectively banned from the practice of medicine in the United States. As a convicted felon, Dr. Murray would also be banned from owning a firearm and voting. (California felons may restore voting rights after completion of parole.) Additionally, a civil suit could lead to a crushing award of money damages, which Dr. Murray would pay to Jackson’s family. (A wrongful death claim was filed on the one year death anniversary, by Jackson’s father.) Personally and professionally, Murray’s reputation will never be the same; neither will his personal finances.

Why Is Michael Jackson’s Physician, Conrad Murray, Being Charged For Jackson’s Death?

admin2 — Sat, 22 Oct 2011 20:03:46 +0000

On Thursday, June 25, 2009, Michael Jackson’s death shocked the world. The King of Pop was only fifty years old when he died of cardiac arrest in his Los Angeles mansion. Rumor had it that prescription drugs were the cause. By Friday, ABC News was already quoting a senior law enforcement official as stating that Jackson was “heavily addicted” to OxyContin and receiving “daily doses” of Demerol. On Saturday, the LAPD conducted a three-hour “interview” with Dr. Conrad Murray, ostensibly wrote prescriptions for the drugs that were rumored to have led to Jackson’s untimely demise. Dr. Murray had been hired to accompany Jackson for a series of summer concerts, and he was immediately under media-intensive scrutiny. On Monday, People magazine published Dr. Murray’s response to “days of speculation about his role in the final hours,” as spoken through the doctor’s lawyer, Ed Chernoff.

Mr. Chernoff told People that the doctor had neither injected Jackson with Demerol nor had he ever prescribed OxyContin to the late singer. Jackson had asked Dr. Murray to stay overnight at the Jackson mansion after a June 24th rehearsal for an upcoming tour. By noon the following day, Jackson had not emerged from his bedroom, so Dr. Murray became concerned and entered the room. Murray found the singer unconscious but with a faint pulse, and so he unsuccessfully performed CPR for several minutes. Then he tried to call 911 but couldn’t get a line out, due to security arrangements in the house. Murray thought of using his cellphone but realized he didn’t know the Jackson’s street address, so he screamed out for help. Nobody answered, so Murray located resident staffers, one of whom he instructed to call in the emergency. Emergency responders have since confirmed a 12:21pm 911 call, and paramedics reached Jackson five minutes later. An ambulance took Jackson to UCLA Medical Center, where he was pronounced dead at 2:26pm.

The People article did not sway the currents of public opinion, which were decidedly not in Dr. Murray’s favor. One day after Jackson’s death, the New York Times unflatteringly introduced Murray to the public as a “cardiologist [who has] lived in numerous homes over the last decade in several states, filed for personal bankruptcy in 1992 in California and has five tax liens against him for hundreds of thousands of dollars.” Other reports characterized him as a womanizer and deadbeat dad. Seven days after Jackson’s death, Deepak Chopra, celebrity doctor and long-time Jackson friend, impliedly berated Dr. Murray in a fierce statement about “drug-pushing doctors, with their co-dependent relationships with addicted celebrities.” On the same day, Governor Jerry Brown, then state Attorney General, told the Los Angeles Times he was bringing federal authorities into his investigation, which was focusing on prescription drugs. President Obama also chimed in that day, holding an on-camera interview with the Associated Press to counter assertions that he had not seemed “respectful enough” to the death of Michael Jackson. Once jury selection began on September 8, 2011, 187 out of 187 potential jurors were unsurprisingly familiar with the case.

Eight days later, Jackson’s father told ABC News that he suspected “foul play” in his son’s death. The Chief Investigator at the L.A. County Coroner’s office had already announced that there was no evidence of trauma or foul play, and the LAPD’s Deputy Chief had stated that “nothing suggests criminality” and that the homicide division had been assigned to the case only because of its high-profile nature. Reverend Jesse Jackson, speaking for the Jackson family, demanded a second autopsy that would focus on Dr. Murray: “When did the doctor come? What did he do? Did he inject him? If so, with what? Was he on the scene twice? Did he use the Demerol? It’s a very powerful drug. Was he injected once? Was he injected twice?” By August 23, 2009, the County Coroner had changed course and ruled the death a homicide from overdose—“Propofol and Lorazepam were . . . the primary drugs responsible.” By the end of the week, LAPD officials told the media that the case would be referred to the District Attorney for criminal charges.

Citrus Heights Attorney

admin — Tue, 13 Jul 2010 23:25:05 +0000

Citrus Heights is located in Sacramento County, CA and has a population of roughly 89,000. The city is unique among many cities in California in that it has a very high seismic stability rate compared to other cities in the area.
The seismic stability established Citrus Heights as a relative oasis considering the amount of damage powerful earthquakes can cause to a city.

Vehicular crime in Citrus Heights, CA, has been on the decline since legislation was passed to lower the speed limits. However, the decreased speed limits also increase the amount of offenders arrested in Citrus Heights for DUI.If you are looking for a Citrus Heights Dui lawyer, our firm is able to provide you with quality legal counsel in the case you are charged with Driving under the influence.

The Citrus Heights police force consists of approximately 120 officers who are ready to arrest people who commit felonies in the Citrus Heights area at any times. If you are in need of a Citrus Heights Criminal attorney, or a Citrus Heights criminal defense attorney, contact our law firm. Our firm is located in downtown Sacramento ,California.

Sacramento DUI Attorney Video

admin — Mon, 05 Jul 2010 21:49:36 +0000

Here is the first of a series of videos we are creating to highlight our firm. Please let us know what you think! Our law firm is located in Downtown Sacramento, and we are actively taking on DUI & Felony cases now. Contact our firm to learn more!

Orangevale Criminal Defense Attorney

admin — Mon, 05 Jul 2010 20:23:13 +0000

If you have recently been arrested in Orangevale, CA., and are in the market for an Orangevale Criminal Defense Attorney, our firm has what you are looking for.

To familiarize you with the city of Orangevale, we will provide you with some of the demographics of the city. The 2000 census tallied the population of Orangevale to be 26,705 people. The city is located about 25 miles northeast of Sacramento. Orangevale is known for its rolling hills and view of the the beautiful Sierra Nevada mountains and its foothills. The city of Folsom and Folsom Lake are also some popular sites that are nearby the city.

The Orangevale Criminal attorney's in our firm are some of the best criminal defense lawyers in the state of California. Our office is located near Sacramento, Ca., and even though Orangevale is a fairly small city in comparison to the more popular larger cities, don't think for an instant that you will receive anything less than the utmost professionalism, ethical, and fair representation from your Orangevale DUI Lawyer hired from our firm. Our firm proudly announces that we offer the best in your defense.