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Florida Statutes, state that any physician "who knows or has reasonable cause to suspect" that a child or elderly person is abused, abandoned or neglected must report this fact to the Department of Health (for purposes of defining an elderly person, the statute refers to those of age 60 or older). The report must be made to the department's central abuse hotline on the single statewide toll-free telephone number 1-800-962-2873. It should also be noted that the physician's name will be held confidential and will not be given to the accused. Sections 415.107(1) and 39.201, F.S. The physician’s name may only be used by department employees actually involved in the investigation, law enforcement agencies, and the state's attorney's office. Sections 415.107 and 39.202, F.S. Similarly, any physician required to report or investigate cases of suspected child abuse, abandonment, or neglect who has reasonable cause to suspect that a child died as a result of the above shall report his or her suspicion to the appropriate medical examiner. Section 39.201(3), F.S. With regard to the elderly, “abuse” is defined to mean “any willful act or threatened act by a caregiver that causes or is likely to cause significant impairment to a vulnerable adult’s physical, mental or emotional health.” “Neglect” is defined to mean “the failure or omission on the part of the caregiver to provide the care, supervision, and services necessary to maintain the physical and mental health of the vulnerable adult, including, but not limited to, food, clothing, medicine, shelter, supervision, and medical services, that a prudent person would consider essential for the well-being of a vulnerable adult. Section 415.102, F.S. With regards to children, "abuse" is defined by Section 39.01(2), F.S., to mean “any willful act or threatened act that results in any physical, mental, or sexual injury or harm that causes or is likely to cause the child's physical, mental, or emotional health to be significantly impaired.” "Neglect" is defined by Section 39.01(47), F.S., as occurring “when a child is deprived of, or is allowed to be deprived of, necessary food, clothing, shelter, or medical treatment or a child is permitted to live in an environment when such deprivation or environment causes the child's physical, mental, or emotional health to be significantly impaired or to be in danger of being significantly impaired.” Finally, Section 39.01(1), F.S., defines "abandoned" to mean “a situation in which the parent or legal custodian of a child or, in the absence of a parent or legal custodian, the caregiver responsible for the child's welfare, while being able, makes no provision for the child's support and makes no effort to communicate with the child, which situation is sufficient to evince a willful rejection of parental obligations.” With regard to spousal abuse, there is no statute which directly requires a physician to report suspected spousal abuse. Nevertheless, Section 790.24, F.S., requires a physician who knowingly treats "a gunshot wound or life-threatening injury indicating an act of violence" to report the wound to the local sheriff. Significance must be attached to the use of the word "knowingly" in this statute, as it requires a physician to have actual knowledge of the violence, as opposed to having a mere suspicion. In addition, the physician must be treating the wound resulting from the violence, and may not report a wound discovered during treatment for another ailment. Should the physician knowingly treat such a wound, the physician is obligated to report this fact to the sheriff's department. This article is presented for educational purposes only and should not be taken as a substitute for legal advice, which should be obtained from personal legal counsel. Nevertheless, the FMA hopes that the information provided here and in its other publications continues to assist physicians in answering many of their most common legal questions allowing them to treat patients, instead of addressing legal concerns. Last Update: October 2005 COLLECTION OF DECEASED PATIENT'S BILLS Contrary to a popular misconception, a person's debts do survive that person's death. Nevertheless, many physicians find it difficult to collect the debts owed by deceased patients, not knowing whether the insurance company, decedent's estate, or spouse is liable for the unpaid bills. Fortunately, to varying degrees, all three may be sources of recovery by the physician. Although obtaining payment directly from the health insurer is the preferable method of receiving payment, several health insurers expressly forbid any assignment of benefits to non-network providers as a method of inducing network participation. Nevertheless, a physician should ask patients to assign benefits directly to the provider. By doing so, the physician, to the extent allowed by the patient's health insurance contract, will receive payment directly from the insurer. Moreover, even if the insurer does not accept assignment, the executed form could be useful in determining the intentions of the patient at a later date. To the extent, however, that the insurer does not accept assignment or does not pay the full charge, the physician is entitled to payment by the patient's estate. To file a claim against the estate, a physician must file the claim in the county in which the patient was domiciled no later than three months after the estate publishes its Notice of Administration or thirty days after receiving direct notification from the estate. As creditors' claims must be satisfied before any of the estate's assets pass to the heirs, a physician's claim will be paid if it is proper and the estate has sufficient assets. If the estate's assets are insufficient, the physician may wish to seek recovery from the patient's spouse. Historically, a husband was responsible for his wife’s necessary debts, such as medical bills, regardless of whether he had contracted for such liability. Under this common law doctrine, however, a wife was not similarly responsible for her husband’s necessaries unless she had specifically assumed such responsibility via a written instrument. This inequality led the Supreme Court to abrogate the doctrine of necessaries and rule that neither husband nor wife are responsible for the debts of the other. Connor v. Southwest Florida Regional Medical Ctr., Inc., 668 So.2d 175 (Fla. 1995). Liability is still present, however, where one spouse has expressly obligated himself/herself for the other’s debt. It should also be noted that the physician may also be able to recover from either spouse if that spouse has been "unjustly enriched" by receiving insurance proceeds which the spouse has not forwarded to the provider. Unfortunately, most of these recovery techniques require legal intervention. Therefore, in order to avoid such legal entanglements, it is recommended that the physician obtain an assignment of any insurance proceeds. This article is presented for educational purposes only and should not be taken as a substitute for legal advice, which should be obtained from personal legal counsel. Nevertheless, the FMA hopes that the information provided here and in its other publications continues to assist physicians in answering many of their most common legal questions allowing them to treat patients, instead of addressing legal concerns. Last Update: October 2005 COLLECTION OF OUT-OF-STATE DEBTS For many physicians the collection of debts from patients is one of the most tedious and difficult portions of practicing medicine. Unfortunately, the difficulty of collecting payment for services is compounded when the patient is only visiting the state of Florida, and has insurance from another state. In these instances, payments for services frequently are sent directly to the patient, notwithstanding a valid assignment executed by the patient in the physician's office. Unfortunately, the laws of many states, including Florida, do not require an insurance company to honor an otherwise valid assignment of benefits. In fact, many insurance companies refuse to honor any assignment benefiting a physician who is not a member of the insurance company's preferred provider panel; this practice is used to coerce physicians