Fiduciary responsibility should be a primary concern for healthcare businesses that work directly with patients. This good faith directive, however, is not always clear cut when it comes to an actionable response to patient needs or handling of their care.
Health Care Fiduciary Responsibilities
Healthcare fiduciary responsibility touches numerous areas of patient care. As a general rule, it simply means that the choices of a healthcare provider or business must prioritize the best interest and care of the patient as any reasonable person might do in the same situation.
Continuity of Care
One of the elements of fiduciary duty in healthcare for physicians or any ongoing care provider is the provision of continuity of care. Should a doctor be unable to provide continuity of care for a patient or there is any reasonable expectation that care will be interrupted, the doctor is required to let the patient know that as soon as possible, preferably before beginning a physician/patient relationship.
Fiduciary Funds
Perhaps one of the most important and highly scrutinized areas of healthcare fiduciary responsibility occurs in the context of fund management and health insurance fiduciary obligations.
Essentially, the concept of fiduciary duty in regard to billing insurance providers breaks down to honesty and transparency. Often, in a court of law, this is tested by asking some of the following questions:
- Was the treatment medically necessary, and if so, is that provable with appropriate tests, first line interventions, and results of care?
- Is the amount charged for that service reasonable within the industry? If it appears to be overpriced, is there evidence to demonstrate the need for that high cost?
- Was the treatment actually provided? If it was, was it provided to the patient billed for the service? Is there evidence to prove this?
- Did the patient fully understand the cost of the treatments provided before agreeing to the treatment plan? If so, were they made aware of the amount that they would be required to cover and agreed to this in advance? Were they also made aware of alternative options that may be less costly and the prognosis for each? Is there evidence for this?
Addressing Healthcare Fiduciary Responsibility in the Florida Courts
Healthcare costs, billing issues, and medical need (or not) of medical care provided (or not) are the most common foci of healthcare fiduciary cases in Florida courts.
Often, a proactive defense comes down to evidence of due diligence and placing the patient’s well-being above all else. If it can be proven that all billed services were required for the patient and that less expensive and/or equally effective treatment options were presented to the patient when appropriate, the provider acted suitably.
If you are facing legal issues due to an alleged breach of fiduciary responsibility, reach out to Florida Healthcare Law Firm today.
