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Telemedicine law and telehealth law is driven at the federal level, but mostly at the state level, since the developing areas of law are more dynamic at the state level than they are at the federal level.  For instance, the Florida Telehealth Advisory Council is recommending that telehealth capabilities be expanded and that insurance reimbursement for telehealth services be compelled.  If the Council’s recommendations are adopted by Florida legislators, it will be the most forward moving telehealth law in the country.

We are committed to advising teleheatlh providers and telemedicine providers and related telehealth vendors of all kinds, both within Florida and around the country.  Given our extensive experience and exclusive focus on healthcare law, we see where healthcare is headed; and we are working closely with many around the country who have caught the wave of telehealth.

DME Scheme of Greed Knows No Bounds

February 22nd, 2022 by

Durable Medical EquipmentBy: Susan St. John

In yet another take-down of an illicit scheme to defraud the Medicare Program and ChampVA, as well as other insurers, Patsy Truglia has been sentenced to 15 years in federal prison. He has also had assets forfeited since these assets were acquired with money from his ill-gotten fraud scheme. In total, Mr. Truglia and his co-conspirators collected approximately $18.5 million from Medicare, ChampVA, and insurance using a scheme of telemarketing, telemedicine, and multiple DME providers or “store fronts.”

The scheme used telemarketers to collect beneficiaries personal and medical information to create orders for DME products such as knee, back, and wrist braces. These orders were then provided to telemedicine practitioners for signature – often without a valid telehealth communication. In essence, there was no attempt at having a practitioner exercise independent judgment as to the medical necessity of these DME products. Instead, these practitioners were paid for their signatures on the pre-filled order forms as part of the “scheme of greed.” From January 2018 to 2019, this scheme of greed resulted in approximately $12 million in payment to Truglia and his co-conspirators. read more

COVID Home Health Care Trend Here to Stay

May 17th, 2021 by

With governments locking down communities to combat the COVID-19 pandemic, health care providers and practitioners scrambled to find ways to deliver care to patients at their homes or residences. CMS relaxed restrictions on providing health care via telehealth, allowing for all Medicare patients to receive care via two-way, audio and video communications, and even via telephone calls notwithstanding that patients may not reside in rural zip codes. Hospitals pivoted to providing services to patients in their homes, again using telehealth modalities or by deploying practitioners to a patient’s home. Skilled nursing facilities also adopted strategies of keeping patients in their homes, deploying needed skilled caregivers to the patient. And while home health services may have hit a lull in the first couple months of the pandemic, services provided by home health agencies soon started to soar. Home health agencies started to become busier than ever, with many providers reporting overall growth due to demand to receive services at home instead of hospitals, skilled nursing facilities or nursing homes. read more

A DME Fraud of Epic Proportions

February 8th, 2021 by

dme telemedicine fraudBy: Michael Silverman

Almost two years after “Operation Brace Yourself” regarding purported telemedicine and orthotic bracing fraud made national headlines, on February 4, 2021 the Department of Justice Announced that a major player in that fraud – Florida businesswoman Kelly Wolfe – recently pled guilty to criminal health care and tax fraud charges.

Operation Brace Yourself was a 2019 crackdown on the illegal use of telemarketing and telemedicine to generate fraudulent claims for DME orders, whose reach spanned continents and ultimate implications defrauded taxpayers out of billions of dollars.

According to the Department of Justice Press Release and Settlement Agreement, Mr. Wolfe was seemingly a significant mastermind in establishing hundreds of DME companies that went on to defraud US taxpayers and Medicare beneficiaries.

Here are some highlights of the recently signed Settlement Agreement between the United States DOJ, Kelly Wolfe and her company Regency, Inc. read more

Telemarketing & Telemedicine PSA/ALERT: You May Be Breaking the Law If…

October 22nd, 2020 by

telemedicine lawsTelemarketing & Telemedicine PSA/ALERT:

You might be breaking the law if:

  • Potential customers are being ‘cold called’;
  • Paying marketers per lead, or ‘backing in’;
  • Anyone other than the patient and/or their insurance company pays for the full cost of the telemedicine visit;
  • Customers have no financial responsibility;
  • Telemedicine visits are not conducted with appropriate technology;

read more

Interpreting Telehealth Law in Florida Has Never Been Easier

September 13th, 2020 by

Telehealth Law FloridaFor medical practices and professionals who need guidance interpreting telehealth law in Florida, contact Florida Healthcare Law Firm, where legal advice for healthcare professionals is our sole focus.

As in most corners of the country, the practice of telehealth is in full swing, especially during this unprecedented year of Covid-19 ramifications. Most physicians completely support and embrace the notion of virtual office visits and have been utilizing these innovative methods even more so since the pandemic’s onset this past spring. The challenge for most physicians, dentists, ancillary facilities and hospitals, however, lies not in the ability of their professionals to fulfill virtual appointment requirements, but in insurance companies’ willingness to pay for it, according to many legal scholars. This is why most healthcare professionals agree that healthcare law experts have never been so important throughout the nation, and Florida is no exception. That’s where Florida Healthcare Law Firm comes into play. With a team that collectively brings 150 years’ experience to the field of medical legal services, our staff can help busy doctors and hospital administrators interpret the complexities of virtual regulations and negotiate within legal parameters so their rights are upheld. The worry of insurance companies outwitting healthcare providers need not be an issue, so healthcare workers can get back to their business of focusing on what’s most important: their patients.

How do we make this happen so easily? In short, it’s our sole focus. As we say, our team “doesn’t dabble in healthcare [legal service]; it’s the only thing we do.” As an active part of our client’s team, we work with healthcare practitioners every step of the way to increase understanding, educate and partner to achieve your goals and, ultimately, your success. We have found that medical providers often face challenges in interpreting the ever-changing legal state and federal regulations that govern telemedicine. Confusion can arise in the areas of practice standards, medical records, scope of practice, registration, venue, reimbursement of fees, exemptions and review of fees. But this field of the law is our area of expertise. We can counsel you in services ranging from diagnosis to consultation, treatment and patient care management. We also are up to date on regulations regarding medical data, health education and public health. Trust our skilled and experienced team to know what’s happening in Florida, the most critical changes implemented by the state’s advisory council and the expanding capabilities of telemedicine as they evolve. We are available for your support 24/7. Contact Florida Healthcare Law Firm today for your first free consultation and find out how we can ease your legal burdens.

The DME Industry and the COVID-19 Pandemic: What’s Changed & What Hasn’t

August 10th, 2020 by

By: Michael Silverman

On January 31, 2020 the US Department of Health and Human Services (“HHS”) declared a public health emergency surrounding the COVID-19 coronavirus pandemic, which was renewed again for a period of 90 days effective July 25, 2020.

In an attempt to focus on patients over paperwork and to remove obstacles from access to patient care, HHS relaxed or suspended certain healthcare provider requirements. Several such changes directly impact current or prospective providers of durable medical equipment (“DME”) to Medicare Part B beneficiaries.

Here’s a high-level breakdown of some of those changes: read more

Florida State Surgeon General’s Emergency Order 20-011 Continues to Allow Out-of-State Practitioners to Offer Telehealth Services to Persons in Florida

July 9th, 2020 by

telemedicine extensionBy: Susan St. John

On June 30, 2020, State Surgeon General, Scott A. Rivkees, M.D., issued Emergency Order (“EO”) 20-011, which further extends EO 20-002 until the expiration of the Governor’s Executive Order No. 20-52, or any extensions thereof. Thus, EO 20-011 continues to allow out-of-state MDs, DOs, APRNs and PAs, to offer telehealth services to persons in Florida.

EO 20-011 continues to allow Florida licensed controlled substance prescribers (MDs, DOs, APRNs, PAs) to issue renewal prescriptions of controlled substances for non-malignant pain for existing patients. Additionally, EO 20-011 extends a qualified physician’s ability to recertify an existing qualified and certified patient’s continued use of medical marijuana using telehealth services. These further extensions are also tied to the expiration of Executive Order 20-52 and any extension thereof. read more

The Top 5 Legal Concerns When Developing a Healthcare App

June 10th, 2020 by

creating a healthcare appBy: Steven Boyne

Today no one can live without a smart phone, and we interact with the rest of the world through a series of apps that reside on our handheld devices.  From the healthcare perspective many large healthcare institutions and private companies have developed a myriad of healthcare related apps that currently reside in Apple’s App Store and  Googles Play Store.  You can measure your heart rate, get clinical advice, view your records, check on your health insurance coverage, make appointments and virtually interact with many different types of healthcare providers.  But even in today’s hyper-electronic society it took COVID-19 to really cause an explosion in telehealth, so what does that tell us?  There is a lot more room for expanding electronic interactions with patients and clients through Apps.  So, here are the top five legal concerns should you address when you develop a Healthcare App: read more

Florida State Surgeon General’s Emergency Order 20-009 Continues to Allow Out-of-State Practitioners to Offer Telehealth Services to Persons in Florida

June 2nd, 2020 by

By: Susan St. John

State Surgeon General, Scott A. Rivkees, M.D., issued Emergency Order (“EO”) 20-009, which extends EO 20-002 and continues to allow out-of-state MDs, DOs, APRNs and PAs, to provide telehealth services to persons in Florida. EO 20-009 is set to expire June 30, 2020, unless otherwise extended.

Further, EO 20-009 continues to allow Florida licensed controlled substance prescribers (MDs, DOs, APRNs, PAs) to issue renewal prescriptions of controlled substances for non-malignant pain for existing patients. Additionally, EO 20-009 extends until June 30, 2020, a qualified physician’s ability to recertify an existing qualified and certified patient’s continued use of medical marijuana by using telehealth services. read more

Avoiding HIPAA Violations During COVID-19

May 27th, 2020 by

telehealth laws after covid-19By: Steven Boyne

The COVID-19 virus has and will probably continue to change the way healthcare providers and business associates interact and help their patients. As many providers are aware, a HIPAA violation is a serious issue, and can cost a healthcare entity large amounts of time and money to respond to any regulatory investigation. Recognizing that the COVID-19 pandemic has strained every corner of the economy and is THE MOST IMPORTANT issue for almost every industry, the federal government has rolled back some HIPAA protections. It is unclear how long these rollbacks will last, and it is possible that some of them may be permanent, but for now healthcare providers and their business associates can take some comfort that they can focus on delivering care and not dealing with overly burdensome regulations and investigations. The major changes include:

  • Telehealth. Changes include allowing physicians and other healthcare providers to offer telehealth services across State lines, so State licensing issues should not be a concern. Additionally, Providers are essentially free to choose almost any app to interact with their patients, even if it does not fully comply with the HIPAA rules. The HHS allows the provider to use their business judgment, but of course, such communications should NOT be public facing – which means DO NOT allow the public to watch or participate in the visit!
  • Disclosures of Protected Health Information (PHI). A good faith disclosure of such information will not be prosecuted. Examples include allowing a provider or business associate to share PHI for such purposes as controlling the spread of COVID-19, providing COVID-19 care, and even notifying the media, even if the patient has not, or will not grant his or her permission.
  • Business Associate Agreement (BAA). As most healthcare providers know, a BAA agreement between a provider and an entity that may have access to PHI is required by law. During the COVID-19 pandemic, the lack of a BAA is not an automatic violation.

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