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Drug Waste A Big Money Issue & How Providers Can Recoup The Cost of Unused Drugs on Medicare Part B Claims

by admin on April 21, 2021 No comments

drug wasteBy: Zach Simpson

In today’s practices there are many circumstances that call for the discarding of unused portion of drugs, and because of this drug waste can be a big-money issue for many practices. A perfect example is Botox which must be used within five hours of reconstitution, and if it is not used within that timeframe the only option a provider has is to discard the unused supply. What many providers may not be aware of though is that money can be recouped for drugs that have been discarded. The aim of this article is to educate providers that when applicable they may report drug waste in addition to the drug and its administration for Medicare Part B claim reimbursement.

How to Properly Report

For a provider to recoup and report the drug waste they must report the administered drug using the appropriate HCPCS Level II supply code, and the correct number of units in box24D of the CMS-1500 form. As a second line-item providers will want to enter all of the wasted units. It is very important to ensure that the provider documentation verifies the exact dosage of the drug injected, and the exact amount of and any reason for waste. Be aware If the provider did not assume the cost of the drug or administer the drug to the patient they may not bill for the unused portion.

In addition to listing the wasted units as a second line-item certain local contractors may require you to use the modifier JW Drug amount discarded/not administered to any patient to identify an unused drug from single-use vials or single-use packages that are appropriately discarded. Be aware that is inappropriate to use the modifier JW with an unlisted drug code. Therefore, it is imperative to be aware of the local contractor requirements, and appropriate drug codes.

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4 Questions to Ask Before Buying Medical Malpractice Insurance in Florida

by admin on April 13, 2021 No comments

As a medical professional, it’s crucial to protect yourself when things go wrong. Most people get that protection through medical malpractice insurance coverage. Florida has very specific rules and regulations about your plans, and ignorance isn’t a defense. If you break the rules, you will be liable.

Working with an expert is always wise, when you’re hoping to buy medical malpractice insurance. Florida Healthcare Law Firm specializes in helping clients buy the right policies at the right time.

These are four questions we can help you answer:

1. Do I Need Medical Malpractice Insurance in Florida?

Most doctors, surgeons, and other healthcare professionals need some kind of insurance coverage. But there are exceptions.

For example, if you’re a medical professional employed by a federal agency, you may not need coverage. The federal government will handle that for you. Similarly, some private companies offer coverage during employment negotiations.

A lawyer can walk through your agreements and help you understand when you absolutely must buy.

2. What Kind of Insurance Do I Need?

The American College of Physicians points out the baffling array of shopping choices available to anyone looking for malpractice insurance.

Those choices include:

  • Type. Claims-made policies cover incidents that took place when the policy is in effect, and the policy must be in effect when the claim is filed. Occurrence policies cover events that took place when the policy was in effect, no matter when the claim is filed.
  • Expenses covered. Some policies will take care of everything. Others leave out fees related to punitive damages and liability for sexual misconduct.
  • Risks covered. If you’re exposed due to cyber issues, some policies will pay and others will not.

A lawyer can walk through these issues and help you make a smart choice.

3. Am I Getting a Good Deal?

Shopping for coverage isn’t easy when you’re also caring for patients. Looking for the right mix of costs and benefits can eat away at the time you need to do your job.

Lawyers look at policies day in and day out, and they’re adept at helping their clients make smart purchase decisions.

4. Does This Policy Meet Florida Statutes?

Florida laws require medical professionals to have coverage, but the language in these bills is complex and hard to parse. A medical professional could get coverage, only to find that it’s not enough to meet the requirements in those bills.

And statutes are filled with requirements regarding escrow accounts, and those can be separate from malpractice coverage.

A lawyer can help to address those issues too. After a supervisory look, a legal professional could help ensure that the policy you buy, and other steps you make, are fully compliant with the law.

At Florida Healthcare Law Firm, we’re prepared to look over any policy you’re considering and counsel you on your purchase decision. Contact us to find out more.

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How Often Should Chiropractors Have Their Patients Sign A New Advance Beneficiary Notice (ABN)?

by admin on April 12, 2021 No comments

chiropractor abnBy: Zach Simpson

Over the years I have come to grasp that ABNs although very useful are quite difficult to implement appropriately for chiropractic practices. My goal for this article is to help practices understand how often ABNs should actually be signed by their Medicare beneficiary patients. A question I am typically asked about ABNs is when should a patient sign a new one? Many offices have the misconception that a new ABN should be signed by Medicare beneficiaries at the beginning of each year which is not the case.

Medicare only requires that the ABN form be completed before the first spinal chiropractic manipulative treatment is rendered for maintenance, wellness, palliative, and/or supportive care. Until one of the following takes place the ABN remains active:

  • In the event a new condition or active treatment is initiated the current ABN would be rendered invalid because the active treatment would likely meet Medicare’s medical necessity guidelines and be considered eligible for payment again; or
  • The current ABN on file is more than twelve (12) months old. In the event the ABN is more than twelve (12) months old an updated ABN must be signed in order to continue maintenance care. Once the new ABN is signed it shall be valid for twelve (12) more months or until another active treatment is initiated.
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3 Ways a Florida Medical License Attorney Can Save Your Practice

by admin on April 9, 2021 No comments

Chances are, you hope you’ll never need the help of a Florida medical license lawyer. You just want to serve your patients with dignity and honor, without ever taking a break to deal with a lawsuit or legal complaint.

Unfortunately, even with the best Florida physician malpractice insurance program available, you may need legal help to save your business.

Here are just three ways in which a Florida medical license lawyer could help you:

1. Prevent Common Problems

Medical errors are unfortunately common. More than 250,000 deaths due to medical errors happen in the United States each year. Some aren’t preventable, but others are.

You may experience moments of uncertainty, where a choice could cause an error. A Florida medical license attorney might help if you’re dealing with:

  • Contract issues. Are you working long hours with no breaks? Is a lack of sleep impacting your work?
  • Interpersonal problems. Is workplace harassment impacting your ability to care for patients?
  • Licensing concerns. Are you able to attend continuing education classes to stay abreast of the latest developments?

Addressing any of these issues could keep common malpractice issues from occurring.

2. Represent Your Interests in Court

If you are facing a case, you’ll need a Florida medical license attorney more than ever. The consequences can be severe.

For example, one Florida pharmacist faced penalties of up to 20 years in prison and a $250,000 fine. A lawyer could help defend you in a case like this and ensure you’re not punished for something you just didn’t do.

3. Clear Your Name

Plenty of websites allow consumers to search for malpractice claims against doctors. Presumably, the sites allow these patients to get better, safer care. As a doctor, they can ruin your reputation.

A talented medical license lawyer can work hard to defend your good name, so a frivolous lawsuit won’t stall your practice for a lifetime.

At Florida Healthcare Law Firm, we have a team of talented lawyers waiting to help you. Contact us to find out more.

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A Quick Refresher On Medicare’s Requirements For Self-Reporting & Returning Overpayments

by admin on April 8, 2021 No comments

By: Zach Simpson

With the current healthcare environment many providers looked to alternative methods of treating patients and achieving outcomes this past year due to the pandemic. To meet the needs of their patients, and their financial obligations many providers implemented services that were not customary to their practice, or their billing departments. As is the case for any office that begins to provide something new there is always the potential for error in any aspect of the practice involved with the patient or claim. Therefore, I believe it is a great time to refresh providers on the procedures for reporting and returning Medicare overpayments as they are discovered moving forward.

As many of you are aware in 2016 the Centers for Medicare and Medicaid Services (CMS) published a final rue pursuant to Section 1128J(d) of the Social Security Act (the Act), as amended by the Affordable Care Act, that requires Medicare Parts A and B health care providers to report and return overpayments 60 days after the date an overpayment is identified, or the due date of any corresponding cost report, if applicable, whichever is later. If credible information indicates that an overpayment exists, the rule requires that a reasonably diligent inquiry must be performed.

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5 Easy Steps To Implement An ABN Into Your Practice’s Standard Procedures

by admin on April 7, 2021 No comments

adding abn to your medical practiceBy: Zach Simpson

Due to the increasing number of forms being required these days it is all too common for practices to get lost in the vast terminology, rules, and coding requirements that have to be followed as well. An area that practices have one of the most difficult times with is operationalizing the issuance of an ABN properly. I am frequently asked to consult for practices that ask who does which part, when, and with whom in regards to ABNs? In other instances, many practices I have worked with simply make the mistake that they can solve the complexities of trying to understand the nuances of how to properly utilize ABNs by deciding to issue ABNs to every Medicare patient for every service which is not a viable option either. The solution that many offices try that I just described is called issuing blanket ABNs, which in turn may cause Medicare to invalidate all issued ABNs from the practice, including those that may been appropriate which is why it is very important that blanket ABNs are never issued.

One thing in common with practices that issue ABNs in a proper manner is that they all have a process in place for identifying potential denied services prior to delivering them. To many practices this may sound easy, but to ensure that your practice is as effective as possible it will take some claims data analysis to ensure that your practice is capturing all potential opportunities for ABN issuance. The aim of this article will be to provide practices with 5 steps that will make ABN issuance easier.

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3 Types of Transactions That Require a Business Law Lawyer

by admin on April 6, 2021 No comments

Business law lawyers play an important role in protecting healthcare organizations. Through their work and expertise, lawyers ensure that executives make their concerns and demands well known. And lawyers also ensure that contracts are solid and clear, so everyone knows what to expect.

While a business law lawyer could help you with almost any type of problem, three issues tend to dominate our work at Florida Healthcare Law Firm.

3 Common Changes We Handle

When you’re working as a business law lawyer in Florida, you’re typically dealing with dozens of different clients with unique wants, needs, and capabilities. But strip away superficialities, and these clients tend to struggle with the same types of issues.

In our office, our business law lawyer team typically helps healthcare organizations with:

  1. Acquisitions. Imagine this: You’ve just read about small pharmacies getting squeezed due to changes in Florida Blue plans. You’d like to buy one of these businesses. A business law lawyer could help you draft up an enticing and enforceable offer.
  2. Partnership shifts. You started your business with a co-owner, and now that person wants to retire. A lawyer could help you craft an exit strategy and draw up new paperwork to change ownership legally.
  3. Mergers. In healthcare, these deals are often huge. For example, the Teledoc and Livongo merger was worth $18.3 billion. A business law lawyer could ensure no mistakes are made in these high-stakes deals.

How to Work With a Business Law Lawyer

A legal professional is there to advise, guide, and protect you. Everything you share is protected. Hire someone you trust, so you can disclose documents and trade secrets freely without worry of theft or retaliation.

In addition to open communication, business law lawyers in Florida appreciate your discretion. If a lawyer is handling your case, don’t talk with the other party or the press. Let your team protect you and do the work you’ve hired them for.

If you’re ready to work with a discrete, professional team of business law lawyers in Florida, contact us at Florida Healthcare Law Firm. We work exclusively within the healthcare field, and we’re ready to start now. Contact us.

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The Question of the Week: Who Owns Your intellectual Property?

by admin on April 5, 2021 No comments

intellectual property lawBy: Steven Boyne

THE FRACTIONAL GENERAL COUNSEL

This question is a redundant question, if it is my intellectual property, then by definition – I own it.  True, but this question raises important issues that employers need to worry about – ownership of intellectual property.  The general rule is that if your employees create intellectual property while they are working for you, the employer will own it.  So, for example, if your office manager takes some pictures around the office and creates personal bios of your employees and puts that information on your website then you own that information.  However, what if they created that information at night while they were not at work and technically you were not paying them?  Well, now we are getting into a greyer area.  So, my recommendation is to avoid this issue, by updating your HR manual to state that you own the intellectual property, and not your employees. 

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Hospital Administrators: Is a Florida Employment Lawsuit Headed Your Way?

by admin on April 1, 2021 No comments

As a hospital administrator, it’s your job to keep your facility free from scandal. If you must consult with Florida medical attorneys, you’re likely dealing with a problem already in progress or one you’re trying to prevent.

It’s time to look closely at Florida employment lawsuits. At Florida Healthcare Law Firm, we’ve seen renewed interest in this type of case, and we want to ensure that all hospital administrators know the risks involved.

Why Florida Employment Lawsuits Are Rising

When jobs are plentiful, and talent is scarce, lawsuits tend to arise. Healthcare is currently facing this predicament.

By 2033, the United States will face a physician shortage of up to 139,000. Some Florida communities are already feeling the pinch. Available doctors have job offers in minutes, and some hospitals end up in bidding wars to get the talents they want.

When you’re negotiating employment benefits on the fly, mistakes are made. Each one can lead to a costly lawsuit.

Doctors who know they have other offers can try to jump out of contracts that aren’t tight. If you’re running an organization where 30 percent of your doctor’s capacity is consumed by paperwork, you could be losing doctors in this manner.

Prevent a Florida employment lawsuit by:

  • Hiring Florida medical attorneys. Have an expert walk through your contracts before they’re signed.
  • Moving deliberately. Don’t authorize any benefits shifts or changes without talking to counsel first.
  • Listening carefully. Check in with your hires frequently, and work to address their concerns before they’re tempted to quit.

Florida Medicare Fraud Cases Rising Too

The Resident Physician Shortage Reduction Act of 2019 is meant to increase Medicare support to address the physician shortage. It could lead to more fraud cases.

New resident recruitment should be addressed with the same care you’d give to a full-time hire. Get lawyers involved early to avoid late-stage lawsuits.

At Florida Healthcare Law Firm, our Healthcare Business Operations team is ready to help you with recruitment and retention agreements. And should you face a lawsuit, we’ll be right with you until it’s resolved. Contact us to find out more.

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Buying a Dental Practice? Here’s What to Consider

by admin on March 30, 2021 No comments

tips for buying a dental practiceBy: Chase Howard

Whether you’ve been in practice for years or you’re just graduating, buying an existing dental practice can be a great way to quickly enter into an already established patient base without the pains of starting up from scratch. While it may seem like a daunting task, the right team can make the purchase transaction flow as smoothly as possible. Here’s a list of important things to consider when negotiating the purchase.

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