Articles Posted in Improving Your Practice

D1432441-e1632924477482Our 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, facilities with a peer review process, 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 or, even if accurate, inappropriately reported.  Inaccurate or inappropriate reports can have equally serious adverse impacts on a medical provider’s ability to practice as any correctly submitted NPDB report.  This post outlines the process for disputing a report that is inaccurate or inappropriately report. 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.

STEP 1: Dispute the Report with the Reporting Entity

The NPDB directs providers to contact the reporting organization before initiating a formal dispute with the NPDB.  Doing this is as simple as it sounds: contact the reporting entity, explain why the report is inaccurate or not reported in accordance with NPDB requirements, and request they correct or void the report.  If the report is accurate, yet a new action should have also been reported, you can also request that the reporting entity file a Revision-to-Action Report.  Although reporting entities have a duty to correctly report to the NPDB, entities can be sanctioned for not reporting.  As such, entities have an incentive to report if there is any question as to whether reporting is required.  Motivating an entity to modify a report to make it more factually accurate is a much easier feat than motivating an entity to void a report.  In our experience, entities have little incentive to void a report; they would rather the provider dispute the report to HHS and have HHS direct them to void the report. Continue reading ›

Amankora-Bhutan-–-Spa-Wellness-Aman-Spa-Paro-Amankora-Holistic-Massage-e1694207101902Our healthcare and business law firm works with healthcare providers and businesses to open cosmetic medical and wellness spas.  The medical spa entity has grown drastically over the past few years.  Some states and medical boards have developed laws and rules governing medical and wellness spas.  As medical and wellness spas continue to grow, we can anticipate more laws and rules governing medical and wellness spas.  On July 19, 2023, the Alabama Board of Medical Examiners (“Medical Board”) published changes to the rules governing the “Use of Lasers and Other Modalities,” which can be found in Chapter 540-X-11 of the Rules of the Medical Board.  The rule is broken down into many different categories.  This post provides an overview of the rule changes that are potentially applicable to medical spa practitioners.  If you have a question about the Alabama Medical Board’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.

Rule 540-X-11 “Guidelines for the Use of Lasers and Other Modalities Affecting Living Tissue” has been a rule in Alabama since 2007.  However, on March 16, 2023, the Medical Board passed changes and additions to the Rule, which became effective on July 17, 2023.  The deadline for compliance with the provisions is July 17, 2024. Continue reading ›

are-you-taking-too-many-supplements-1440x810-1-e1692129513681Our healthcare and business law firm works with many providers and other allied health professionals who are beginning their journeys of opening a Medical Spa.  Medical Spas have been growing in popularity across the country.  They are unique practices in that they involve many medical and non-medical procedures.  There are many factors to consider in opening a medical spa and/or IV hydration clinic, and this medical spa series focuses on key factors to consider when opening a medical spa in Georgia.  Although our healthcare law firm has assisted numerous clients in establishing a medical spa from the ground up, each client continues to present unique issues requiring our firm to research and analyze the nuances of each client’s intended setup.  This Georgia Medical Spa Series is intended to provide spas.

This post in the Georgia Medical Spa Series focuses on a newer treatment, nicotinamide adenine dinucleotide (“NAD+”), which is a newer treatment our clients have inquired about.  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.

  1. NAD+ is a dietary supplement.

NAD+ is currently a dietary supplement (not an “approved drug” by the Food and Drug Administration (“FDA”)).  “The FDA generally does not approve dietary supplement claims or other labeling before use.”  Questions and Answers on Dietary Supplements, FDA.gov.  As such, it is on the manufacturer and distributor to “ensur[e] that the dietary supplements it manufactures or distributes are not adultered, misbranded, or otherwise in violation of federal law.”  Id.

  1. NAD+ does not require a prescription in Georgia.

Continue reading ›

blog-2-lede-photo-e1656706286125At the beginning of COVID-19, telemedicine rules were softened on the state and federal level.  In a previous blog post, we discussed the softened Georgia rules during the COVID-19 State of Emergency in Georgia.   Unlike the federal Public Health Emergency that was recently lifted, the Georgia State of Emergency was lifted in early 2022.  But now that both the state and federal emergency-statuses are lifted, what does that mean for the telemedicine prescribing exceptions available during COVID-19?  This post intends to answer that question.  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.

Although Georgia has clear requirements for when telemedicine is generally allowed and what the general requirements are (which must, of course, be followed if prescribing is allowed), the only restriction on prescribing via telemedicine is with pain management drugs and controlled substances. Continue reading ›

idea_sized-kendal-l4ikccachoc-unsplash-e1688571047528As a healthcare and business law firm, many of our clients come to us with questions relating to the proper ordering and management of controlled substances.  As such, we wanted to take this opportunity to point out a recent update to the DEA’s Practitioner’s Manual.

The Drug Enforcement Administration (DEA) recently released an updated Practitioner’s Manual on June 14, 2023.  This is the first updated version of the manual since 2006. The Practitioner’s Manual provides guidance for all DEA registrants handling controlled substances—including behavioral health centers and physicians—on compliance with the Controlled Substance Act (CSA) and DEA regulations. The Practitioner’s Manual can be found here.

Some of the most significant updates include the following:

Registration Requirements

Generally, every practitioner who dispenses, which includes by definition administering and prescribing, controlled substances in schedules II through V, must be registered with DEA.  To register or reregister as a practitioner, a DEA Form 224 or Form 224a, respectively, must be completed.  The manual includes clarifying information about how practitioners can order, use, fill out, copy, store, cancel, and return the DEA Form 222 used to order, distribute and transfer Schedule I and II controlled substances. The manual also incorporates the optional Controlled Substance Ordering System (CSOS) as a viable alternative to the paper Form 222. Continue reading ›

What-is-an-Opioid-e1687291586956Our healthcare and business law firm works with many physicians in Georgia who are facing mental health and substance abuse difficulties.  Sometimes those difficulties bleed into work and can cause work and/or licensure issues.  Georgia offers an incredible resource dedicated to physician recovery in a way that protects Georgia citizens and minimizes career concerns for the physician—the Georgia Professional Health Program (“PHP”).  This post provides 3 Facts about the Georgia PHP.  If you are experiencing or are concerned about ramifications of a potential addiction or mental health disorder, in addition to seeking medical help, we recommend contacting an experienced attorney who can assist you through this difficult process and help minimize potential licensure and career impacts.  If you have questions regarding this blog post or would like to speak with counsel regarding physician licensure, 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. The Georgia PHP was started in 2012

The Georgia PHP “is a nonprofit organization formed in 2012 to assist all licensees of the Georgia Composite Board of Medical Examiners and in 2022 the Georgia Board of Veterinary Medicine who develop potentially impairing conditions, mental illnesses, substance abuse and other addictive disorders.”  The Georgia PHP does not provide treatment, but, rather, conducts an initial triage, refers to in patient or outpatient treatment (if appropriate), and monitors the quality of the treatment.  The Georgia PHP’s #1 goal is to protect Georgia citizens.  It’s #2 goal is to advocate for Georgia physicians. Continue reading ›

Naturopathy-Physician-1-e1686066389978Our healthcare and business law firm works with many providers and other allied health professionals apply for and obtain licensure in Georgia.  Holistic medicine has grown in popularity and accessibility, which has led to an increase in functional medicine practices around the country.  Relatedly, the practice of naturopathy also appeals to many consumers.  The question we are periodically asked is whether Georgia allows naturopathy practitioners to practice naturopathy in Georgia.  The post provides a general overview of the answer to that question.  If you have questions regarding this blog post or would like to speak with counsel regarding becoming licensed in Georgia, 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.

1950 Act Repealed in 1956

In 1950, Georgia established legislation allowing for licensing as a “naturopathic practitioner.”  However, after only six years, the legislation was repealed.  Thus, since 1956, there is no naturopathic license in Georgia.  Such practice may still be allowed, unless it is considered to wade into the waters of other licenses, which it is.

Practicing Naturopathy is Considered the Practice of Medicine

In an official opinion in 1981, the Georgia Attorney General’s Office issued an official opinion stating that naturopathy practice falls within the Georgia Medical Practice Act’s definition of “the practice of medicine,” and does not fall within any established exceptions.  Continue reading ›

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 ›

13150124_G-e1683216085435Our healthcare and business law firm works with many providers and other allied health professionals who are beginning their journeys of opening a Medical Spa.  They have been growing in popularity across the country.  Medical Spas are unique practices in that they involve many medical and non-medical procedures.  There are many factors to consider in opening a medical spa, and this series focuses on key factors to consider when opening a medical spa in Georgia.  Although our healthcare law firm has assisted numerous clients in establishing a medical spa from the ground up, each client continues to present unique issues requiring our firm to research and analyze the nuances of each client’s intended setup.  This Georgia Medical Spa Series is intended to provide a useful overview of some key laws, rules, and regulations impacting medical spas.

This post in the Medical Spa Series provides examples of common OSHA violations for medical practices.  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.

OSHA maintains a list of Frequently Cited OSHA Standards, which can be narrowed down by industry/NAICS code.  There is not a specific med spa code, but there is a code for health care and social assistance (NAICS Code 62). Continue reading ›

HealthcareImage_062618-700x525-1-e1682709849274Our healthcare and business law firm works with many providers and other allied health professionals who are beginning their journeys of opening a Medical Spa.  Medical Spas have been growing in popularity across the country.  They are unique practices in that they involve medical and non-medical procedures.  There are many factors to consider in opening a medical spa, and this medical spa series focuses on key factors to consider when opening a medical spa in Georgia.  Although our healthcare law firm has assisted numerous clients in establishing a medical spa from the ground up, each client continues to present unique issues requiring our firm to research and analyze the nuances of each client’s intended setup.  This Georgia Medical Spa Series is intended to provide a useful overview of some key laws, rules, and regulations impacting medical spas.

This post in the Medical Spa Series focuses on General OSHA standards.  The next post outlines the most common OSHA violations for medical practices.  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.

The Occupational Safety and Health Administration (OSHA) is part of the United States Department of Labor of Labor.  22 states have a OSHA-approved State Plans covering private sector and state and local government works, 7 states have OSHA-approved State Plans covering only state and local government workers, and the rest of the states operate under federal OSHA jurisdiction.  “State Plans,” OSHA.gov.  Georgia is under federal OSHA jurisdiction covering most private sector workers (not state and local government workers). Continue reading ›

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