Articles Posted in Healthcare Reform

tixeo-virtual-openspace-300x202Our 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 Medicaid rules.  This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in Georgia.  There are specific rules governing prescribing via telemedicine, which are not covered by this post.  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, You may also learn more about our law firm by visiting

Georgia Insurance Code’s Definition of Telemedicine

The Georgia Composite Medical Board (“Medical Board”) generally requires an in-person exam, but the Medical Board Rules allow telemedicine in certain situations.  The relevant definition of “telemedicine” is found in Georgia’s insurance code and defines “telemedicine” as:

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MM-0220-Telemedicine-iStock-e1581381176331-1024x814-1-e1631301250783Given the increased use of telehealth during the Public Health Emergency (“PHE”), the Centers for Medicare and Medicaid Services (CMS) passed a final rule modifying the rules around when Medicare will reimburse for mental health visits.  A previous blog post analyzed Federal laws and rules governing telehealth visits, including the general Medicare rules applicable during the PHE.  This post analyzes the changes to the Medicare telehealth reimbursement rules for mental health treatment that begin the day after the PHE ends.  Note, there are different rules when treatment includes for substance abuse disorders.  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, You may also learn more about our law firm by visiting

Essential Requirements Under Medicare’s New Rule

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medical-doctor-1314902-mIn our previous post reviewing the Georgia Composite Medical Board’s (“Medical Board” or “GCMB”) June Monthly Meeting Minutes, we touched on the Medical Board’s acknowledgment of House Bill 458. Herein, our healthcare and business law firm analyzes more thoroughly the new law and its impact on Georgia physicians and the Medical Board. If you have licensing or other GCMB questions 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, You may also learn more about our law firm by visiting

HB 458 amends Title 43 of the Official Code of Georgia in varied ways to accomplish the following goals:

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iStock_000033418316_Medium-e1626470315777Welcome to the first installment of our business and healthcare law firm’s monthly medical board meeting review, focusing on the Georgia Composite Medical Board (“GCMB” or “Medical Board”).  As a healthcare law firm with many physician clients, it is our duty to stay up to date with the Medical Board’s positions and changes so as to better inform our clients. We hope that by providing a review of the Medical Board’s monthly meeting minutes, our readers and provider clients will be able to better navigate the Medical Board successfully. If you have licensing or other GCMB questions 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, You may also learn more about our law firm by visiting

The Medical Board meets once a month to uphold its directives under the Medical Practice Act, which allow the Medical Board to do, among other things, the following: review applications for licensure, interview applicants when necessary or requested, investigate complaints, discuss proposed rules and rule modifications, review and publish public orders, and allow for committee meetings.

  • May Meeting

The Medical Board met on May 6, 2021 via video teleconference.  The May monthly meeting minutes are available here.  The Medical Board also publicly releases public orders and agreements each month.

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As patients, naturally we intend to go to the doctor to get well.  But there is a catch 22.  What if the trip to the doctor or the emergency room to be made well might cause us to get sick, or more sick? Or what if we make the doctor sick, impairing his ability to care for other patients?  Such risks have always existed to a degree, but nothing like today, during the Coronavirus pandemic.

Georgia-based Telemedicine Lawyers

The extraordinary, unprecedented COVID-19 pandemic and staggering fallout has cast new and very bright light on telemedicine and its potential efficacies in providing safe health care.  Above all, telehealth benefits include ability to provide healthcare without no risk of COVID spread, a serious health risk for both patient and healthcare practitioner to avoid that will necessarily attend both commuting and in-person interaction.  Telemedicine offers another way to “go to” the doctor and for the doctor to render care, free of the risk of virus spread.  Apart from all other advantages and conveniences of telemedicine, the paramount importance of health and safety (of both healthcare practitioner and patient) have never been underscored so forcefully.

medical-doctor-1314902-mAs technology improves the ability for providers to communicate, existing healthcare laws will continue to be put to the test. Now, a new call for care coordination is driving quality improvement initiatives for physicians and hospitals. In 2018, U.S. Department of Health and Human Services (HHS) launched its initiative “Regulatory Sprint to Coordinated Care,” to facilitate value-based healthcare and promote effective communication strategies between physicians. The Regulatory Sprint seeks to increase a patient’s ability to understand their treatment plan, promote coordination between providers, establish incentives for providers to coordinate efficient care, and encourage information-sharing between providers and facilities.

Healthcare Fraud and Abuse Lawyers

The initiative highlights the importance of removing the barriers created by four federal healthcare laws: the Physician Self-Referral Law; the Federal Anti-Kickback Statute; the Health Insurance Portability and Accountability Act (HIPAA); and substance-disorder treatment rules stemming from 42 CFR Part 2. Previously, critics have claimed that the monetary penalty provisions within the statutes prevent providers from being able to adequately coordinate care. In response, HHS has proposed Stark Law and Anti-Kickback reforms.

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pills-2-300x225More than 2,000 opioid lawsuits are pending nationwide. A large portion of these lawsuits target drug manufacturing companies for their contributions to the opioid epidemic that is plaguing the country.

Georgia and South Carolina Pain Management Medical Practice Law Firm

For example, in one case earlier this summer in Oklahoma, a judge ordered Johnson & Johnson to pay $572 million for the company’s contribution to the opioid crisis. Furthermore, over the next few months, other courts will continue to handle cases as state governments work diligently to mitigate the impacts that the opioid epidemic has had within their jurisdictions. Although Big-Pharma companies are being targeted in litigation, however, retail pharmacies, large and small, are gatekeepers for opioid prescriptions. Given the role of pharmacies, they might be used effectively to combat the opioid epidemic. The role of retail pharmacies in the battle against opioid addiction is crucial, but not necessarily recognized by city governments. A new databank from the DEA tracks opioids at a local level, and makes it possible for pharmacies to band together in understanding unique trends within their own communities.

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balance-1172800-1-300x204This month, the abrupt closing of four Tennessee pain management clinics under investigation for state and federal health insurance fraud made headlines.  Those clinics, formerly affiliated with PainMD and rebranded as Rinova, closed last week.  Federal authorities alleged that PainMD and its parent company inflated profits by providing patients with unnecessary injections to be paid by federal health insurance programs.  Authorities of the state of Tennessee initiated their own investigation, with concerns that the conduct of clinic personnel may violate state law.

Georgia Pain Management and DEA Defense Law Firm

In the PainMD pain clinic investigations, not only were the companies and clinic administrators at risk for financial penalties and reputational harm in connection with potential fraud, but so were the health providers who worked at those clinics.  Three PainMD nurses were indicted on federal charges in connection with procedures provided at the Tennessee clinics under investigation.

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pill-shadows-1200049The exposure and concern surrounding the opioid epidemic is at an all time high. Notwithstanding the urgency of the issue itself, this publicity places increased pressure on the intervening parties—sub-agencies of the Department of Health and Human Services, Department of Justice (DOJ) and state Attorney’s General—to implement regimens that make a difference.  Our Georgia-based business and healthcare law firm follows developments that impact pain management physicians and medical practices.

At the Federal level, the DOJ is focused on taking steps to strategically intervene into physicians and pharmacies. Accordingly, the DOJ has expanded its enforcement to release a new tactic in the form of temporary restraining orders (TRO) against pharmacies that have violated the False Claims Act and the Controlled Substances Act. This tactic proved successful in a Tennessee District Court on January 13, 2019.

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pills-2-300x225In 2017, the Georgia General Assembly passed House Bill 249, implementing several changes to the Prescription Drug Monitoring Program (“PDMP”). Bill 249 held that:

  1. Beginning July 1, 2017, dispensers are required to enter prescription information for schedule II, III, IV, V controlled substances within 24 hours. This will give prescribers efficient access to information faster and allow the prescriber to make the best decision possible for patients.
  2. All prescribers will be required to register in the PDMP by January 1, 2018.
  3. Beginning July 1, 2018, prescribers are required to check PDMP before prescribing opiates or cocaine derivatives in Schedule II drugs or benzodiazepines.

The goal of the new PDMP was for physicians to be able to detect which patients were obtaining multiple prescriptions for highly addictive drugs and identify which practitioners were prescribing unlawful dosages.

Our Georgia-based business and healthcare law firm follows developments in healthcare law.  Shelia Pierce, the opioid program coordinator and director of the PDMP for the Georgia Department of Health, contends that enrollment into the program has been very difficult. While 24,000 physicians have enrolled, 1,100 Georgia physicians have ignored the new law and have not enrolled in the drug monitoring program. The Georgia Composite Medical Board has not determined how to impose punishment on those physicians. Each physician would need to have a case built on them, have documents assembled, call people in to testify, and hold individual hearings. The Attorney General’s office is currently trying to determine how to proceed against the violators.

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