Articles Posted in Healthcare Information

health-medical-e1680627379406Our healthcare and business law firm works with healthcare providers and businesses like  IV hydration therapy practices.  The IV hydration therapy industry has grown drastically over the past few years.  Some states and medical boards have developed laws and rules governing IV Hydration Therapy practices.  On August 15, 2023, the South Carolina Board of Medical Examiners, Pharmacy, and Nursing published a joint opinion on Retail IV Therapy Businesses.  The language used and sanctions referenced reveal that the South Carolina Boards are critically reviewing IV therapy businesses.  At one place in the 10-page opinion, the Pharmacy Board compared the “patient-drive menu” in many IV therapy practices “to a fast-food restaurant.”  Reading between the lines of the advisory opinion, it is likely each board will begin cracking down on IV therapy practices.  A full version of the Advisory Opinion is available here. We recommend you read the entire opinion if you have or are starting an IV therapy business in South Carolina.  This blog post starts our review of the Advisory Opinion and outlines whether IV therapy is the practice of medicine.   Forthcoming blog posts will dive deeper into different aspects of the opinion.  If you have a question about South Carolina’s 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.

  • What lead to this opinion?

After reviewing the opinion, it is clear that each South Carolina board believed this opinion necessary for four main reasons: Continue reading ›

HealthcareImage_062618-700x525-1-e1682709849274Our healthcare and business law firm works with healthcare businesses to assist in compliance matters, including the Health Insurance Portability and Accountability Act (“HIPAA”) and the Health Information Technology for Economic and Clinical Health (HITECH) Act.  The HITECH Act was designed to strengthen HIPAA in many ways.  A question our healthcare business-owning clients often have is whether patients with insurance can choose to pay cash instead of billing to insurance.  This post focuses on what the HITECH Act states on this subject.  If you have a question about the HITECH Act 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.

  • Summary of Self-Pay Rule

Congress passed the HITECH Act in 2009. It provides in part that health care providers must honor a patient’s request—even an insured patient’s request—to pay out-of-pocket for services, and thus not have their Protected Health Information (“PHI”) shared with third parties like billers or insurers—if the patient requests it. The patient, however, must pay in full 42 U.S.C. 17935(a). Continue reading ›

Legal-cases-and-rulings-lower-courts-FHPAF-scaled-e1695156255815Our healthcare and business law firm consistently works with physicians who are dealing with complications resulting from adverse reporting to the National Practitioner Data Bank (“NPDB”) as well as entities in deciding what reports may be appropriate for certain situations.  Whether you are on the side of the provider or reporting entity, it is important to understand the types of NPDB reports that are permitted.  This post outlines the four types of reports. If you have a question about the NPDB 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.

Each reporting organization has the ability to submit four types of reports: an Initial Report, a Correction Report, a Void Report, and a Revision-to-Action Report.

Initial Report

An Initial Report is the first report of a medical malpractice payment, adverse action, or judgment or conviction that is submitted by a reporting entity to the NPDB.  Copies of an initial report are provided to the subject and reporting entity.  Certain reports must also be reported to an appropriate state licensing board.    Continue reading ›

hearing-loss-older-adults-inline-e1688417272253Our healthcare and business law firm works with numerous medical practices in compliance and regulatory matters.  Many medical practices are unaware of the requirements of the Americans With Disabilities Act (“ADA”), and in particular the requirements to accommodate individuals with auditory disabilities (including individuals who are deaf or hard of hearing).  The ADA does not just prevent disability discrimination by employers.  Title III of the ADA applies to “public accommodations.”  A public accommodation is a business that is open to the public or provides goods or services to the public and specifically includes a “professional office of a health care provider.”  28 CFR 36.104; Guide to Disability Rights Law, ada.gov.   This post provides an overview of the ADA’s auxiliary aids and services requirements and how they apply to medical Practices.  If you have questions regarding this blog post or would like to speak with counsel regarding your medical 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.

  1. Medical Practices Must Take Proactive Steps in Certain Situations

The general auxiliary acts and services rule applicable to medical practices is: “No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any private entity who owns, leases (or leases to), or operates a place of public accommodation.”  28 C.F.R. 36.201.   As related to auxiliary aids or services, full and equal enjoyment means (a) a patient cannot be refused access because of his/her disability, (b) effective communication modalities (i.e., auxiliary aids or services) are required, and (c) when necessary to accommodate a patient’s needs, the practice must reasonably modify policies, physical space, and procedures.  28 C.F.R. Part 36. Continue reading ›

aba-therapist-play-therapy-young-boy-e1690574727628Our healthcare and business law firm works with many behavioral health providers in establishing and operating their ABA associated businesses.  We have a particular focus on such companies and will be producing a series of helpful articles to assist providers in navigating various operational and business hurdles to ensure they are able to effectively treat their patients.

If you have questions regarding this blog post or would like to speak with counsel regarding opening your medical spa 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.

Introduction

Payment and claims audits for ABA providers are becoming increasingly more common given the rising number of patients being cared for with autism and related disorders. For most ABA providers, an audit is no longer a probability but a certainty. Continue reading ›

1651676570_Transworld-May-Blog-Header950x460-e1686600049528As a healthcare and business law firm, we have many clients who participate in or wish to participate in pain management clinics.  A previous blog post of ours provided an overview of pain management clinics.  When it comes to selling a pain management clinic, there are certain questions to consider. This post provides a look into 3 questions to ask when selling your pain management and the answer to those questions.  Please note, there are numerous considerations when selling a medical practice that apply to pain management clinics as well, but this post focuses only on pain management considerations.  If you have questions regarding this blog post or would like to speak with counsel regarding selling your 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.

In 2013, Georgia legislatures enacted House Bill 178 (“HB 178”) known as the Georgia Pain Management Clinic Act.  The act requires pain management clinics to obtain a license from the Georgia Medical Board and limits who can own pain management clinics.  These requirements add questions when it comes to selling a pain management clinic. Continue reading ›

med-mal-featured-1-e1685565240921Our healthcare and business law firm works with many physician and other health care providers who own their own medical practice.  The Georgia Medical Board and Georgia Legislature, as well as many other state medical boards and legislatures, have noted concern with consumer confusion with the numerous titles held by non-physician health care practitioners.  For instance, “In a survey done a few years ago by the AMA, 39% of patients thought a Doctor of Nursing Practice was a physician and 11% weren’t sure. Half were either completely wrong or confused by a title. More than half (61%) thought a Doctor of Medical Science was a physician, which is completely incorrect.” M. Blackman, J. Commins, “Industry Stakeholders Divided on GA ‘Truth and Transparency’ Act,” Health Leaders Media (May 25, 2023).  This and other information caused the Georgia Legislature to act in an attempt to protect consumers from misunderstandings.  That change resulted in Senate Bill 197, known as the Health Care Practitioners Truth and Transparency Act, which was signed into law in May of 2023.  The bill made changes to the “Consumer Protection and Awareness Act,” O.C.G.A. Section 43-1-33.  Importantly, the legislatures concern here seemed to arise less from intentional or malicious misstatements from health care practitioners, and more from consumer misinformation/misunderstanding caused honestly by the numerous titles and credentials that may be held by practitioners that consumers do not understand.

This post identifies three key provisions with the Health Care Practitioners Truth and Transparency Act.  If you have questions regarding this blog post or would like to speak with counsel regarding laws that may impact you or your medical spa 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.

  1. Expansion of Definition of and Rules for “Advertisements”

iStock-1056799938-e1684354865672Both concierge medicine and direct primary care practices have become popular alternatives to the traditional insurance medical practice model.  Direct Primary Care (“DPC”) practices generally cut insurance companies out from the provider-patient relationship.  Medicare offers unique considerations because participating and non-participating providers maintain certain responsibilities regarding Medicare beneficiaries, and many providers are hesitant to “opt out” of Medicare.  With this post, we intend only to highlight a few points to consider before accepting private pay from Medicare beneficiaries outside of copays.  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.

 

Point 1- A Medicare-participating provider violates Medicare requirements by accepting private payment from a Medicare beneficiary for services that in whole or part constitute “covered services” as defined by Medicare.

Point 2- The federal Department of Health and Human Services (“HHS”) has established that requiring payment for non-covered services does not violate Medicare requirements. In fact, the HHS Office of Inspector General (“OIG”) states on its website: “It is legal to charge patients for services that are not covered by Medicare.”

Point 3- A complicating aspect of the seemingly simple rule is that whether a service is a “covered service” is determined solely by CMS, not by you.  Therefore, including language in a patient agreement such as “this fee does not cover any covered services”, though perhaps adequate to express an intention, does not prevent a practice/provider from being found to have violated Medicare rules. Continue reading ›

HIPAA-Breaches-Healthcare-Students-e1615468812558On April 11, 2023, U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced its plan to allow the Notifications of Enforcement Discretion issued under HIPAA and the HITECH Act during the COVID-19 Public Health Emergency (PHE) to expire on May 11, 2023.

Early on in the COVID-19 pandemic, the use of telehealth appointments increased dramatically in an effort to prevent the spread of COVID-19 as millions of doctors’ visits and health care examinations were often postponed or even canceled. OCR quickly recognized the critical need to assist the healthcare sector and the public in responding to this unprecedented crisis and in 2020 and 2021, published four Notifications of Enforcement Discretion in the Federal Register regarding how the Privacy, Security, Breach Notification, and Enforcement Rules under HIPAA would be applied to certain violations during the PHE. Continue reading ›

nurses-and-docs-e1681928313827Our healthcare and business law firm often assists physicians and other providers in obtaining and maintaining licensure.  Sometimes, physicians desire assistance to ensure a smooth process without having any occurrences to disclose.  The majority of the time, however, when we are hired to assist in licensure matters, the physician has a past or ongoing event that they need assistance with.  We usually begin by evaluating whether the occurrence must be, should be, or need not be disclosed.  One important question that is always present and concerning to many is the mental health question, which is also the first question on the Applicant Questionnaire section of the license application in Georgia.  There have been different iterations of this question over the years, and earlier this year, the Medical Board modified the questions once again.  This post explains the progression of this question in Georgia. If you need assistance applying for or maintaining licensure 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.

The mental health question on applications for licensure can be alarming to many physicians. Continue reading ›

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