how-telehealth-regulation-changes-are-making-care-more-accessible-722x406-1-e1657306723291Our healthcare and business law firm previously published a blog post on the federal telemedicine rules.  Both Federal and State rules govern the provision of telemedicine.  Each state’s rules governing telemedicine are different, but the applicable laws and rules are generally found in the state medical board’s rules, insurance code, and when applicable, Medicaid rules.  This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in Texas.  This post does not discuss telemedicine prescribing rules or Medicaid rules.  If you have questions about telemedicine rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

Texas Rules

Texas’ rules governing telemedicine are found in the Texas Administrative Code and Texas Occupational Code.  Below is an overview of some requirements currently in Texas governing the practice of telemedicine. Continue reading ›

AAC-pic3-e1657233605933 At the 2022 Annual Augusta Arts Awards Dinner held in June, Hamil Little Partner Lee Little led her final meeting as President of the Greater Augusta Arts Council and passed the role to incoming President Rhian Swain. The event honored many individuals and groups whose talents and contributions are crucial to the arts community in Augusta. Ms. Little awarded the President’s Award – recognizing outstanding work in the arts in Augusta – to Russell Joel Brown, who performed a medley of songs at the event.


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An Augusta native, Russell Joel Brown has come home to Augusta from the “Big Apple”, New York City, where he was an actor, singer, and dancer for Broadway shows. He appeared on Broadway and international tours of Disney’s “The Lion King”, “Smokey Joe’s Café”, “The Scarlet Pimpernel”, “Big River” and “Ain’t Misbehavin’”. Also to his credit, he sang for the funerals of such luminaries as Thurgood Marshall, Arthur Ashe, Cab Calloway, and Dizzy Gillespie. He holds a Bachelor of Arts degree from Morehouse College.

Since returning to Augusta, he continues to impact the lives of children and adults alike by supporting non-profits in raising much-needed funds. The Jessye Norman School of the Arts, Lucy Craft Laney Museum of Black History, Colton Ballet Company, and many others have benefited from Mr. Brown’s fundraising concerts. Between 2002 and 2005, his one-man show, From Mozart to Motown, sold out the 850-seat Imperial Theater 5 times. His tour de force performance as Coalhouse Walker, Jr. in “Ragtime” was the talk of the 2019 theatrical season.

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Our healthcare and business law firm previously published a blog post on the federal telemedicine rules and the general Georgia telemedicine rules.  Both Federal and State rules govern the provision of telemedicine.  Each state’s rules governing telemedicine are different, and there are specific rules around prescribing medicine from a telemedicine visit.  A previous post provided an overview of Georgia’s telemedicine rules.  This post focuses specifically on Georgia’s telemedicine prescribing rules.  If you have questions about telemedicine rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

Georgia Telemedicine Rules for Prescribing

The general restrictions on prescribing via telemedicine is with (a) pain management and (b) controlled substances.  As such, if the requirements to allow telemedicine are met, the provider can prescribe any medically necessary medications therefrom.  The restrictions come into play if those medications are controlled substances. Continue reading ›

blog-2-lede-photo-e1656706231616Our healthcare and business law firm previously published a blog post on the federal telemedicine rules.  Both Federal and State rules govern the provision of telemedicine.  Each state’s rules governing telemedicine are different, and there are specific rules around prescribing medicine from a telemedicine visit.  A previous post provided an overview of Alabama’s telemedicine rules.  This post focuses specifically on Alabama’s telemedicine prescribing rules.  If you have questions about telemedicine rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

 

Alabama Rules on Prescribing Based on a Telemedicine Visits

A physician may prescribe medications via telemedicine so long as it would otherwise be authorized under applicable state and federal law.  All telemedicine services provided must comply with all federal and state laws and regulations applicable to such services, including HIPAA, and the physician must take reasonable precautions to protect the privacy and security of all verbal, visual, written, or other communications involved therein. Ala. Code § 34-24-705. Continue reading ›

csm_FlatDesign-Telework_c532b56131-e1645230859515Our healthcare and business law firm previously published a blog post on the federal telemedicine rules.  Both Federal and State rules govern the provision of telemedicine.  Each state’s rules governing telemedicine are different, but the applicable laws and rules are generally found in the state medical board’s rules, insurance code, and, when applicable, Medicaid rules.  This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in Alabama.  This post does not discuss telemedicine prescribing rules.  If you have questions about telemedicine rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

Alabama Rules Prior to July 11, 2022

Telemedicine authority in Alabama is new.  In fact, the law discussed herein (Act No. 2022-302) does not go into effect until July 11, 2022.  Prior to the enactment of Act No. 2022-302, there was little to no authority regulating telemedicine versus traditional in-person medical practice, and physicians were held to the same standard of care, regardless of treatment modality, regarding such matters as the establishment of a physician-patient relationship and the prescribing of controlled substances and other medications. Prior to the enactment of Act No. 2022-302, physicians treating Alabama citizens via telemedicine had to have the medical license and controlled license of an Alabama physician and were held to the same standards as in-person treatment. See, e.g., Ala. Admin § 540-X-9-.11.  Regarding prescribing controlled substances, telemedicine physicians were required to adhere to all federal and state statutes, and federal regulations currently require a previous in-person examination before prescribing controlled substances via telemedicine, except in a declared health emergency.  Id.

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This is our third blog post on concierge medicine practices this month due to an increase in interest by our business and healthcare law firm’s clients.  Previous blog posts provided an overview of what concierge medicine is and an overview of compliance risks under Medicare.  This post continues the topic by discussing how commercial payors view concierge medicine practices.   If you have questions regarding this blog post or starting a concierge practice, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

As stated in our previous post, understanding the compliance risks associated with concierge medicine practices requires understanding a fairly easy and, perhaps, obvious concept: Providers cannot bill patients for services paid for by their insurance; a practice referred to as “double billing.”  The general rule is the same for Medicare and commercial payors. Continue reading ›

iStock_000033418316_Medium-e1626470315777Increasingly, our healthcare and business law firm’s clients are interested in opening concierge medicine practices.  Hamil Little’s last blog post provided an overview of what concierge medicine is with references to compliance risks.  This post outlines those very serious compliance risks for practices that treat Medicare patients and are not opted out of Medicare.  If you have questions regarding this blog post or starting a concierge practice, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

Understanding the compliance risks associated with concierge medicine practices requires understanding a fairly easy and, perhaps, obvious concept: Providers cannot bill patients for services paid for by their insurance; a practice referred to as “double billing.”  Applying that concept is easier said than done.  Consider the complexity in this: a concierge medicine practice requires a $200/month fee that includes “longer appointments,” which is a clear benefit to patients.  Assuming the appointment itself is covered by insurance, is the fact that it’s longer something that insurance does not cover?  Maybe, but maybe not.  There are ample examples of how complex this question is and, as it relates to Medicare, CMS and the Office of Inspector General (“OIG”) offer minimal guidance.

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new-practice-startup-01-1-300x225Both concierge medicine and direct primary care practices have become popular alternatives to the traditional insurance medical practice model.  In a previous post, we discussed direct primary care (“DPC”) practices, which are typically different from concierge medicine practices because DPC practices generally cut insurance companies out from the provider-patient relationship.  This post focuses just on concierge medicine practices, which generally offer members non-medical benefits while the patients, or their insurance companies, remain responsible for the cost of all office visits, medical services, medications, treatments, etc.  If you have questions regarding this blog post or starting a concierge practice, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

Although many states have specific rules on direct primary care practices, it is less common that there are state rules governing strictly concierge medicine practices, which are also referred to as retainer-based or boutique medical practices.  A forthcoming blog post will discuss compliance risks to consider with concierge medicine practices.  This post answers a few preliminary questions about concierge medicine.

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Medicare-Money-square_7_0-300x300There are numerous adverse actions that can be taken against a provider’s Medicare ordering and referring or billing privileges.  In general, however, deactivation is not considered such an “adverse action” that will reflect on the providers PECOS; however, it does “stop” your ability to use your Medicare privileges.  If you have experienced an adverse action on your privileges, such as your privileges being revoked or excluded, please investigate yourself or call counsel to understand the rules and strict deadlines around what to do to preserve your right to appeal the decision.  This blog post covers “deactivation” only.  If you have questions regarding this blog post or wish to discuss your Medicare privileges, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

What is a Deactivation of Medicare Privileges?  

The Medicare code defines “Deactivate” as “the provider or supplier’s billing privileges were stopped but can be restored upon the submission of updated information.”  42 C.F.R. § 424.502.  Importantly, “[t]he deactivation of Medicare billing privileges does not have any effect on a provider’s or supplier’s participation agreement or any conditions of participation,” but “[a] provider or supplier may not receive payment for services or items furnished while deactivated.”  42 C.F.R. §§ 424.540(c), (e).   Generally, on PECOS, the deactivation will not appear as an adverse action, but may appear in the history tab.

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Medical-License-e1644515318522For various reasons, licensed medical providers may choose to voluntarily surrender their state medical license.  Earlier this year, our healthcare and business law firm blogged about the repercussions of voluntarily surrendering a state medical license on the physician’s Medicare enrollment.  Our firm recently had success in challenging a Medicare MAC’s decision to revoke a client’s Medicare enrollment based on a voluntary surrender of a medical license, resulting in the rescission of the revocation decision.  Another usually unexpected repercussion may also be ineligibility for Board examination or loss of Board Certification status.  Losing board certification or being found ineligible for board certification is a serious matter with potentially far-reaching adverse consequences. This post outlines the American Board of Internal Medicine’s (“ABIM”) eligibility rules and steps to challenge such a decision.  If you have questions regarding this blog post or wish to discuss an adverse decision by the ABIM or strategize ways to overcome an adverse decision, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

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