Health law is the federal, state, and local law, rules, regulations and other jurisprudence among providers, payers and vendors to the healthcare industry and its patient and delivery of health care services; all with an emphasis on operations, regulatory and transactional legal issues.
With the passage of autonomous practice ability for nurse practitioners in Florida this year, many are wondering how this will affect the healthcare industry in Florida. In a traditional sense, rural and underserved areas should have the opportunity for growth in healthcare providers. The autonomous practice law removes restrictions on certain nurse practitioners, granting them the ability to practice in primary care practice settings without worrying about supervision restrictions. Outside of that, the application of the new law can expand healthcare business offerings and abilities. read more
You do everything right. You’re careful to dot your i’s and cross your t’s. Compliance is hard-wired because you’re in an industry that’s highly regulated and you’ve built into your operations a series of compliance checks and balances. However, even with strong controls in place, compliance efforts sometimes fall short– and whether you’re a physician group, a pharmacy, a durable medical equipment company, a home health agency, or any other health care provider, someday you might find yourself face-to-face with law enforcement officials or regulatory enforcement authorities. What do you do? How do you assure the most successful outcome with minimal business disruption?
Compliance is the foundation to mitigating the risks inherent in any health care operation. Compliance can reduce the likelihood that regulators or law enforcement suddenly appear on your doorstep. But preparation for emergencies and uncertainties is the key to reducing the risk that non-compliance leads to lengthy business interruption. Although you may be saying “if”, you really should be thinking and acting more like “when”. It costs everything to be ill-prepared and it costs very little to be well-prepared. The following preparation can prevent much of the uncertainty that arises in these cases.
POLICIES AND PROCEDURES
First and foremost, make sure you have well-developed policies and procedures for what to do in such instances. You should review these policies and procedures with your employees regularly, focusing on the importance of compliance. Out of fear and uncertainty, employees can do things that create unnecessary challenges. Educating them as to what their rights and responsibilities are will mitigate those risks. Make sure your policies and procedures include the designation of who is in charge (“person in charge”) when the government does show up. read more
If you are a doctor who needs needs expert assistance with debt collection, contact Florida Healthcare Law Firm and partner with healthcare recovery attorneys who can easily resolve pay or issues.
Debt collection for doctors, medical practices and hospitals has never been easy. Payor issues have always been a battle, and the statistics bear that out. How big a deal is bad medical debt? A leading financial services company found that in 2009, about 44% of consumers had racked up some type of medical debt. By 2020, that number increased to 61%, particularly in the wake of Covid-19. Consumers are in the red for medical procedures and doctor visits, but with more and more patients delaying elective surgeries—the bread and butter of hospital revenue—hospital executives are counting on collecting on bills to insulate their finances. Going after that money is going to get tougher; analysts predict U.S. consumers will likely owe about $115 billion in medical expenses by the end of 2020. What about securing government funded assistance, aka Medicaid? This is an important issue for physicians. How can doctors make good on what’s owed them? Hiring a sharp, experienced team player from Florida Healthcare Law Firm, the best healthcare recovery attorney team in the industry, is a wise solution. We collectively boast 150 years’ experience solely in medical-related legal issues so we’re not only on your side, we know your business.
In addition to securing third-party funds or negotiating debt from uncooperative patients, a healthcare practice attorney is your partner as you manage your practice or facility. Our skilled team works side by side with you on a variety of issues that may be taking up unnecessary time from your busy schedule. We specialize in medical legalities so we know the current regulations, trends and issues you are facing. Statewide and nationally, we are at the forefront of payor issues, compliance, hiring and firing, business operations and transactions, telemedicine, technology, durable medical equipment and much more. We are a unique boutique firm that delves into each issue with a depth and breadth of knowledge that our competitors don’t have.
So when you’re looking for a Florida health law attorney who has handled everything from orchestrating bond-financed $90 million medical facilities to ensuring financial raises and providing advice on daily operations for maximum efficiency in a tiny practice, you can count on our seasoned team to represent you. We offer flat-fee pricing and a money-back guarantee. That’s how sure we are that we can help you reach your goals. Contact Florida Healthcare Law Firm for a free consultation today.
For the most up-to-date knowledge of state and federal regulations, consult with Florida Healthcare Law Firm and discover how our seasoned medical attorney team will be your practice’s best source of business information.
As seasoned legal counselors, we know that ‘lawyer up’ can have negative connotations. But if you want to get serious about the countless and ever-changing regulations that are spinning around your practice—especially this year—then the only way to stay up to date on trends, policies, regulations and compliance is to hire the best possible medical attorney you can find: the experienced experts at Florida Healthcare Law Firm. From regulatory compliance to business operations, transactions, telemedicine, laboratory compliance, pay or issues and even dentistry and pharmacy, we can help educate you and guide you as you make important business decisions. We don’t work with a handful of physicians or hospitals; we work solely with doctors and facilities like yours. We are specialists in our field, and we guarantee that the business end of your job will become a whole lot easier with us as your partner.
In addition to working side by side with each of our clients, we also offer ongoing education events. These include our recent webinar on business lessons learned in 2020 that can guide you in the future, and our upcoming January webinar on what your office needs to know as you prepare for Covid vaccination in the new year. Pharmacists may be interested in our February webinar about protecting your business from risky prescriptions. The menu of classes is always relevant—led by our Florida medical attorney team who are experts in the field, with 150 years’ collective experience behind them. We also post regular blogs on specific topics, including trademarks in the state, malpractice issues, estate tax planning, self-referral statutes and telemedicine contracts.
As the leading health care law attorney Florida has to offer, we pride ourselves in the core values that set us apart from the competition. First our advice is speedy and cost-effective; we don’t drag our feet and we don’t overprice. In fact, we guarantee results before we are paid. We communicate openly and honestly with clients—no misunderstandings, nothing concealed. We’re not afraid to take educated chances, seeking innovative ways to serve you. Finally, we hold ourselves accountable and stand behind every decision we make. If the outcome isn’t what you expected, we make it right. Why not partner with a stellar legal team that will be your biggest champion and your best source of business education. Contact Florida Healthcare Law Firm today.
On January 1, 2021, every hospital in the United States (with very few exceptions) will be required to post clear, accessible pricing information online about the items and services they provide. These “standard charges” must be provided in two ways: first, as a comprehensive list of all items and services offered by the hospital in a machine readable format; and second, as a display of “shoppable services” in a consumer friendly format. According to CMS, the stated goal of the new rule is to empower patients “with the necessary information to make informed health care decisions.”
With the first requirement, the list must include gross charges, discounted cash prices, payor-specific negotiated charges, and de-identified minimum and maximum negotiated charges. The items and services covered are basically anything for which the hospital has established a standard charge, regardless of location or whether the item or service is provided on an inpatient or outpatient basis. These include, but are not limited to, supplies, surgical implants, procedures, room and board, and professional charges.
A recent Department of Justice $500,000 settlement with a cardiology practice underscores the need for ensuring tighter compliance by medical practices. There, the practice billed Medicare for cardiology procedures for which interpretive reports were also required. Medicare paid for the procedures, but upon audit, CMS could not find the requisite interpretive reports. The False Claims Act case settled for $500,000, but it’s likely that (1) the reimbursement by Medicare was far less, and (b) the legal fees behind the settlement weren’t too far behind the settlement amount! Had the practice self-audited each year, would they have found the discrepancy?
Medical practices have felt the weight of price compression and regulatory load more than probably any segment in the healthcare sector. They are doing far more for far less. And regulations expand faster than viruses! Hence, many have a strategy of regulatory compliance that can best be characterized as a combination of facial compliance (“We bought the manual and put it on the shelf”) and hope (“They’re not really serious about this, are they?”). Unless you’re part of a practice of more than 20 doctors, it’s likely that you can do more to ensure regulatory compliance.
Becoming a DMEPOS provider enrolled with Medicare is no small feat or undertaking. Whether you’ve started the business from ‘scratch’ or purchased an existing entity, you need to ensure that investment is protected through active and ongoing compliance measures.
To that end, I recently hosted a webinar with Matthew Gruskin, Credentialing Director at Board of Certification (“BOC”) to discuss some of the steps necessary to do so. A copy of our presentation is available here.
Becoming “accredited” is a necessary precursor to being a Medicare Part B DMEPOS provider, and BOC is one of only nine Medicare approved DMEPOS accreditation organizations. Whether it’s through BOC or one of the other eight Medicare approved accreditation organizations, a DMEPOS business’s initial receipt of accreditation is really just a ‘first step’, insofar as if that accreditation is not maintained a DMEPOS supplier will lose their Medicare Part B billing privileges. Medicare’s DMEPOS Supplier Standard #22 specifically requires all enrolled providers to be accredited to receive and retain billing privileges.
A DMEPOS supplier must continue to abide by both Medicare’s DMEPOS Supplier Standards (which the National Supplier Clearinghouse is tasked with enforcing) and its Quality Standards (which accreditation organizations gauge compliance by) in order to stay in its good graces. Accreditation organizations conduct unannounced on-site surveys at least every three years and suppliers must also revalidate their enrollment with Medicare’s National Supplier Clearinghouse every three years, which results in an unannounced Medicare on-site visit. read more
It’s possible to keep your patients’ best interests first and have a stress-free healthcare regulatory compliance audit with the expert help of Florida Healthcare Law Firm, seasoned leaders in the field of medical business legalities.
How many medical practitioners look forward to their next healthcare regulatory compliance audit? Not many…probably because just about everything a physician or hospital needs to do requires following state and federal requirements. The road to comply can be a bumpy one, but it doesn’t have to be when you have a legal coaching staff on the sidelines to guide you through the entire playbook. That’s were Florida Healthcare Law Firm comes in. Our toolbox is deep. In particular, one area that we can navigate for you is the complicated state and federal anti-kickback statutes (patient brokering act). Self-referrals can be a sticky situation. Don’t be caught in a position that jeopardizes your reputation or your practice. We can give you our legal opinion, a brief explanation of the regulations or a full-blown analysis. In addition to anti-kickback advice, we can make sure you’re adhering to guidelines for fee-splitting, fraud and abuse, HIPAA and emergency medical treatment. We cross every ‘t’ and dot every ‘i’ to ensure you’re following the rules.
Sometimes, as a medical professional, you might not even know which issues are on the front-burner. You’re swimming in a sea of paperwork that’s squeezing out precious time caring for patients. In this case, you need the best health care law attorney Florida can offer, with 150 years’ combined experience on your side. We know how to weed out the top-tier issues. We understand their significance and can set up a legal plan for your practice or facility, so you don’t get caught playing catch-up. For payor problems to telehealth, hiring, firing, technology, pharmacy, dentistry, even acupuncture, we’ve got your back. Look to us not only for expertise, but for complete transparency, unparalleled value, warmth, respect, creativity and total responsibility for our actions and decisions. Why else would we guarantee success or your money back? Contact Florida Healthcare Law Firm and see how we exceed clients’ expectations every time.
Since the beginning of the COVID pandemic many healthcare businesses are exploring various ways to increase their referrals, and although exchanging fees and gifts in return for referrals may sound like an easy way to obtain additional business, there are state and federal laws that strictly prohibit such activities that are discussed in greater detail below.
Two of the most important laws that all physical therapists should be aware of are the Anti-Kickback Statute and the Stark Law which are used to ensure that medical decisions are not made based on financial incentives. However, each of the laws do have distinctions that you need to be aware of. read more
On October 6, 2020, the Unites States Attorney’s Office of the Western District of Louisiana announced that George M “Trey” Fluitt III of Monroe, Louisiana was indicted. The federal grand jury indicted the lab owner for paying bribes and kickbacks in violation of the Anti-Kickback Statute, resulting in improper Medicare billing of approximately $117 million. Fluitt was the owner and operator of Specialty Drug Testing, LLC and is alleged to have solicited paid kickbacks and bribes in return for patient DNA specimens and physicians’ orders for cancer genetic and pharmacogenetic testing. Medicare allegedly paid Specialty Drug Testing, LLC $28,726,299 as a result of the fraudulent claims. If convicted, the defendant faces up to five years in prison for each count of conspiracy to defraud a healthcare program. Fluitt also faces 10 years in prison for illegal kickbacks, a $250,00 fine, forfeiture and restitution.