Ketamine is a substance growing in popularity as a treatment for, among other things, depression and pain management. Ketamine clinics are quickly increasing in popularity. Why Ketamine-Assisted Therapy Has Gone Mainstream, Forbes (Oct. 18, 2021). Our healthcare and business law firm assists clients in understanding the rules and requirements around opening and operating Ketamine clinics, understanding the unique issues that face innovative clinics where no clear guidance or oversight has yet been established. With this post, Total Health Law intends to present three considerations for a provider thinking about opening a Ketamine clinic in Georgia. If you have questions regarding this blog post, opening a Ketamine clinic, or operating your existing Ketamine clinic, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, firstname.lastname@example.org. You may also learn more about our law firm by visiting www.hamillittle.com.
As a healthcare and business law firm, we work with many physicians employed by Federally Qualified Health Centers, or “FQHCs.” Working at an FQHC offers certain benefits and protections to providers. One such benefit is that individual providers are generally protected from civil malpractice lawsuits. Although our firm does not litigate medical malpractice actions, we work with physicians who are accused of malpractice within an action involving FQHCs to minimize damage to the physician’s reputation and record, particularly regarding reporting to the National Practitioner Data Bank (“NPDB”). This post intends to outline what a physician working at an FQHC needs to know if an individual brings a malpractice action. If you have questions regarding this blog post, the NPDB, or FQHC-related matters, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, email@example.com. You may also learn more about our law firm by visiting www.hamillittle.com.
Suit Against the United States Not Individual Doctors or Practices
The first thing to note is that if you are a physician for most FQHCs and a patient wishes to sue alleging medical malpractice, you—as the physician—and the health center are generally protected from being named in a lawsuit.
Why is that? Continue reading ›
Last week, our blog post discussed the general rules permitting telemedicine in Georgia. Often, our healthcare and business law firm’s provider clients who conduct telemedicine also need to understand the requirements around prescribing controlled substances based on telemedicine visits. This post intends to outline some of the relevant prescribing rules in Georgia and the exceptions due to the Public Health Emergency (PHE) created by COVID-19. This post intends to outline some relevant Georgia rules and regulations relating to telemedicine. If you have questions about telemedicine or prescribing 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, firstname.lastname@example.org. You may also learn more about our law firm by visiting www.hamillittle.com.
Georgia Rules on Prescribing Controlled Substances via Telemedicine
As discussed in our prior blog post on the general telemedicine rules, we look to the Medical Board’s rules on Unprofessional Conduct, among other rules, to decipher what is allowed in Georgia. Rule 360-3-.02 defines Unprofessional Conduct to include subsection (5), which provides that Unprofessional Conduct could include: “Prescribing controlled substances . . . and/or dangerous drugs . . . for a patient based solely on a consultation via electronic means with the patient, patient’s guardian or patient’s agent.” As such, the general rule prohibits prescribing controlled substances via a telemedicine consult. However, the rule does “not prohibit a licensee from prescribing a dangerous drug for a patient pursuant to a valid physician patient relationship in accordance with O.C.G.A. § 33-24-56.4 or a licensee who is on-call or covering for another licensee from prescribing up to a 30-day supply of medications for a patient of such other licensee nor shall it prohibit a licensee from prescribing medications when documented emergency circumstances exist.” Rule 360-3-.02(5). There are other exceptions related to specific Schedule II controlled substances.
Welcome to the second installment of our business and healthcare law firm’s monthly medical board meeting review, focusing on the Georgia Composite Medical Board (“Medical Board” or “GCMB”). As a healthcare law firm with 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. 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, email@example.com. You may also learn more about our law firm by visiting www.hamillittle.com.
A main theme during the introductory Executive Director’s Report involved preventing and responding to sexual misconduct in the healthcare field. The Board was presented with an article, “State Medical Board Recommendations for Stronger Approaches to Sexual Misconduct by Physicians,” available here. The Board also discussed House Bill 458, which passed the House and Senate and goes into effect on January 1, 2022. A blog post examining HB 458 in more detail is forthcoming from Hamil Little.
Our 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”). Certain entities, including medical licensure boards and medical malpractice payers, have a duty to report specific actions or events to the NPDB. Any practitioner who has had the misfortune of having an action reported to the NPDB is likely aware of the negative impact such a report can have on his or her ability to practice. Sometimes, however, the information reported to the NPDB is inaccurate in whole or in part. Inaccurate or incomplete reports can have equally serious adverse impacts on a medical provider’s ability to practice as any correctly submitted NPDB report. This post outlines steps practitioners or counsel can take to help minimize the adverse impact of such inaccurate 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, firstname.lastname@example.org. You may also learn more about our law firm by visiting www.hamillittle.com.
Submitting a Statement
The NPDB allows practitioners to submit statements at any time to explain or supplement a report. According to the NPDB, the statement is the provider’s “opportunity to provide additional information [the provider] would like included with the report.” A statement does not correct or void a reporting by a medical board, but it is a useful tool for a provider to explain an adverse licensure action when that is necessary. This is a way to tell the practitioner’s side of events. Although the statement may be limited in its impact, it can be particularly useful to submit a well-drafted statement while waiting for the often-lengthy dispute resolution process to conclude. Statements can also be submitted or edited at any time, so the efficiency of a statement makes it a useful tool.
Disputing the Report
If the practitioner wishes to take the matter beyond submitting an explanatory statement, the practitioner must make an important decision: work through the NPDB or go straight to the source (the reporting organization). In our business and healthcare law firm’s experience, we have had more success working with the reporting entity directly to resolve reporting disputes. In fact, the NPDB directs providers to contact the reporting organization before initiating a formal dispute with the NPDB.
Welcome 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, email@example.com. You may also learn more about our law firm by visiting www.hamillittle.com.
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
On May 1, 2020, the Centers for Medicare and Medicaid Services (“CMS”) published final rule CMS-9115-F known as the Interoperability and Patient Access final rule. “This final rule is the first phase of policies centrally focused on advancing interoperability and patient access to health information.” 85 Fed. Reg. 25511. CMS states that this rule “puts patients first by giving them access to their health information when they need it most, and in a way they can best use it.” Policies and Technology for Interoperability and Burden Reduction, CMS.gov. The rule requires coordinated communication between patients, providers, and payers. These changes largely require the use of improved and updated technology, and CMS provides implementation support here. Although many of the requirements under the final rule went into effect on January 1, 2021, because of the hardships posed by COVID-19, “CMS will not enforce these requirements until July 1, 2021.” Id.
Payors carry the brunt of this regulatory change. Without detailing all requirements under the rule, a few are as follows. CMS-regulated payors must maintain a secure, standards-based application programming interface (API) that will support the exchange of patient electronic health information (“EHI”). These payers must also maintain a patient-facing API allowing patients to access their EHI, including information about claims and costs, and make provider directory information publicly available through an API. Further, payors are required to implement a process for exchanging data, which is not required until January 1, 2022.
Governed hospitals will soon have a duty to send event notifications of a patient’s hospital “admission, discharge, and/or transfer to another healthcare facility or to another community provider or practitioner” to “improve care coordination.” Interoperability and Patient Access Fact Sheet, CMS.gov (Mar. 9, 2020). CMS-regulated providers are encouraged to register all interoperability digital contact information through the National Plan and Provider Enumeration System (NPPES). A list of providers who fail to do so will be publicly available as a way to incentivize compliance. Landi, H., CMS’ New Interoperability Rule Requires Major Changes for Payers, Hospitals. Here are 6 Key Elements, Fierce Healthcare (Mar. 9, 2020).
Welcome to the fifth and final of our business and healthcare law firm’s holiday-themed blog posts. We hope you have enjoyed this holiday season so far and have a great time ringing in the new year tonight. Happy 2021!
Many of our healthcare provider and healthcare business clients own their businesses and employ many individuals. Being an employer carries with it numerous statutory and regulatory obligations. As legal counsel, we often take the role of advising our healthcare employer clients on employment matters. Herein, we discuss the requirements placed on employers by the Equal Pay Act (“EPA”), which attempts to eliminate gender discrimination in pay.
At 29 U.S.C. § 206(d)(1), the EPA provides: “No employer having employees subject to any provisions of this section shall discriminate . . . between employees on the basis of sex by paying wages to employees in such establishment at a rate less than the rate at which he pays wages to employees of the opposite sex in such establishment for equal work on jobs the performance of which requires equal skill, effort, and responsibility, and which are performed under similar working conditions.” To avoid violating the EPA, it is useful to analyze what must be proven if an employer is accused of violating the EPA.
Welcome to the third of our business and healthcare law firm’s holiday-themed blog posts. This week’s post is inspired by my favorite holiday movie, A Christmas Story, and the eloquent words Ralphie wrote: “A Red Ryder BB gun with a compass in the stock, and this thing which tells time.” Analyzing Ralphie’s literary genius, he gave Miss Shields three enticing facts: the main description, a vital component, and an interesting addition. Following suit, I will provide three enticing facts of CMS’ new proposed rule.
First, the shortened name of the rule is: “Reducing Provider and Patient Burden by Improving Prior Authorization Processes and Promoting Patients’ Electronic Access to Health Information.” According to CMS, the purpose of the proposed rule is “[t]o drive interoperability, improve care coordination, reduce burden on providers and payers, and empower patients.” The ingenuity of the proposed rule stems from the fact that it is not only designed to grant patients better access to their records; it is designed to grant all vital parties’ necessary access to records—meaning patients, payors, and providers.
Second, the new rule requires each payer to use an Application Programming Interface (“API”) that allows each payer’s system to communicate with other payers. The new rule also does not require patients to request the transfer of claims data. As such, a patient’s new payer will have access to all of his or her claims data almost immediately upon enrollment. Importantly, on the new API, payers can send “patient claims, encounter data, and clinical data directly to providers.” Verma, Seema, Reducing Provider and Patient Burden and Promoting Patients’ Electronic Access to Health Information, CMS.gov (Dec. 10, 2020).
Welcome to the first of our holiday-themed (at least in title) blog posts. As we approach the holidays at the conclusion of a financially challenging year, cost savings may be on the minds of many healthcare business owners. Healthcare employers may be considering—or have already considered—measures to save money and reduce payroll. 2020 was a difficult year for most businesses, and reducing payroll is an oft-appealing way to reduce expenses. Frequently, a business’s highest paid earners are also among the older employees. That fact prompts a look at the Age Discrimination in Employment Act of 1975 (“ADEA”) prior to making any employment decisions, such as eliminating positions.
For healthcare employers with 20 or more employees, the ADEA governs and makes it an unlawful employment practice to “discharge any individual or otherwise discriminate against any individual with respect to [her] compensation, terms, conditions, or privileges of employment, because of such individual’s age.” 29 U.S.C. § 623. The regulations create a protected class for individuals who are “40 years or older.” 29 C.F.R. § 1625.2. To be certain, the ADEA and accompanying regulations do not require preferential treatment of employees over 40, and “[f]avoring an older individual over a younger individual because of age is not unlawful discrimination.” Id.
An employee establishes a prima facie case of age discrimination by showing he or she “was (1) a member of the protected age group, (2) subjected to an adverse employment action, (3) qualified to do the job, and (4) replaced by or otherwise lost a position to a younger individual.” Johnson v. Unified Gov’t of Athens-Clarke Cnty., 209 F. Supp. 3d 1335, 1341–42 (M.D. Ga. 2016). The fourth prong, however, is generally not satisfied when it comes to position eliminations because the older employee was not replaced by anyone. See Mazzeo v. Color Resolutions Int’l, LLC, 746 F.2d 1264, 1271 (11th Cir. 2014). The law accounts for this by altering the fourth prong in “reduction in force” cases, requiring the employee to “present sufficient evidence from which a reasonable jury could find that the employer intended to discriminate on the basis of age through its employment decision.” Zaben v. Air Prods. & Chems., Inc., 129 F.3d 1453, 1459 (11th Cir. 1997). One such “method of establishing a nexus between age discrimination and adverse employment action is by statistical proof of a pattern of discrimination.” Pace v. S. Ry. Sys., 701 F.2d 1383, 1388 (11th Cir. 1983).