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.
Review EOBs and determine where denials are originating and their root cause
While reviewing EOBs practices need to determine if a trend can be established that identifies the root cause for why claims are being denied. Trends can be established by asking if most denials are originating in your patient access and registration departments, or are denials occurring because of insufficient documentation, or due to billing or coding errors?
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.
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.
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.
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.
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.
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.
COVID is front and center in all aspects of everyday life and has shined light in the strangest of places that were usually in the dark. In healthcare the laboratory space has always taken a backseat to other sectors in terms of recognition and value. The current climate in the lab space has shifted and it is not an illusion, labs are front and center.
COVID has taken its toll on areas of the economy and investors are certainly one of the first to become aware of this situation. Clinical laboratories are currently an attractive acquisition target and the reasons are numerous, sectors like retail, entertainment and travel are performing poorly and investors are shifting their investment dollars into healthcare and technology. Investors are looking for growth and profitability and are finding it in healthcare. Mergers and Acquisitions (M&A) is nothing new in the lab industry, but now careful consideration is required when it comes to deciding the appropriate time to sell your lab.
There have been a rise in cases recently, in which practices that operate under a Health Care Clinic License have been brought under scrutiny by insurance companies trying to recoup funds through any means possible. In an effort to claw back funds insurance companies are beginning to claim that medical directors are failing to meet their statutory obligations under Florida Law which in turn can have serious monetary repercussions. Due to the clinics allegedly failing to meet their statutory obligations the insurance companies are filing suit to recoup any payments made while violating the Health Care Clinic Act obligations, and to stall any future payments due until such cases are heard.
By law, a medical director must be a health care practitioner that holds an active and unencumbered Florida license as a medical physician, osteopathic physician, chiropractic physician, or podiatric physician. The type of services provided at a clinic may dictate who would be able to serve as a clinic’s medical director, because a medical director must be authorized under the law to supervise all services provided at the clinic.
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
Laboratory buyers and sellers considering a sale or purchase should have knowledge of issues that can affect the transaction. Due diligence requires conducting measures that provide a buyer confidence that the laboratory for sale is being accurately represented by the seller.
The transaction requires consideration, communication and planning between all parties and their representatives. A thorough knowledge of laboratory compliance and rules and regulations is imperative as documentation and information that is provided and reviewed will more than likely change the pricing, value and terms of the deal.
Due diligence is required in any healthcare transaction and is performed so that both the buyer and seller fully understand the transaction. An effective and necessary tool regarding laboratory transactions is a due diligence checklist. The checklist will allow both sides to identify and address issues that may be neglected or overlooked. The categories that compromise a laboratory checklist should include, but are not limited to: read more
Thinking About Selling Your Practice? Preparation is key and the difference between a successful sale and seller’s regret.
Step 1: Call Your Financial Planner
Be sure that you can afford to leave the business
Most buyers will require a comprehensive non-compete and you should be certain that you are financially prepared to retire, sell, or move before signing any restrictions.
You will also want to ensure that you are planning for the income you are about to receive. Are there vehicles in place or options that are best to ensure the purchase price is put to its best use for you.
Consider post sale options if not retirement – are you going to be employed by the buyer? Are you selling to an associate and will phase out? Are you just moving and will need to find new employment/open a practice?
Step 2: Visit Your Accountant
Your business is only worth as much as can be defined on paper.
If a potential buyer cannot make sense of your accounts and assets, you may leave significant value on the table.
Get your financial history in order by reviewing tax returns, profit statements, AR reports, and payroll history for prior 3-4 years.
Clean up creative bookkeeping – you will have to promise the buyer that your financial statements are true and accurate.
Have your accountant help value assets of your business – or use an appraiser if necessary.
Discuss company structure – there may be restructuring needs or you may need to transition to a different structure for tax purposes.