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Is Your Office Utilizing An Outdated Advanced Beneficiary Notice of Non-Coverage Form?

April 22nd, 2021 by

medicare abnBy: Zach Simpson

Does your office treat Medicare or Medicaid beneficiaries? If so, this article is vital to you and your staff. The first question that I want all of you to ask yourself is if your practice treats Medicare or Medicaid beneficiaries do you know what an ABN is, and why they are vital for your practice? The acronym ABN stands for Advance Beneficiary Notice of Non-coverage. ABNs safeguard your practice’s right to collect on non-covered services (other than statutorily excluded services) from patients who have Medicare or Medicaid. Multiple organizations I have worked with throughout my career had never been informed about ABNs or had never been properly educated on how utilize them. This article is intended to provide you and your practice with the most recent information regarding the renewed ABN form that became mandatory for use on January 1, 2021.

As of January 1, 2021, a new Fee-for-Service Advanced Beneficiary Notification of Non-coverage became effective until it expires on June 30, 2023. In the event that your practice has been utilizing the same ABN forms for years then listen up. read more

Take Florida Medicare Audit Seriously and Seek Legal Help from Pros

October 27th, 2020 by

If you are a physician, hospital administrator or other licensed healthcare providers working in the Sunshine State, then you are likely familiar with the routine, but still serious, Florida medicare audit. Many times, this can result in an overpayment of claims, which can be costly. You need to be armed with the tools and counsel that can avoid claim denials or overpayments…you need the team at Florida Healthcare Law Firm. From RACs to CERTs and Probes, we know the rules and regulations and make it our business to be on top of trends and changing requirements. Experience shows that if you are in the unfortunate predicament of being evaluated, it is much better to have an attorney present to ensure a successful outcome. What’s more, most experts agree that it is wisest to retain an attorney before the problem arises. You may be able to avoid the situation entirely. At the very least, we will ensure that you and your practice survive the process in one piece.

If you are visited by a Florida medicare auditor, we suggest you take the situation seriously. The extrapolation factor is a case in point. For example, even if only 40 claims are assessed with a 25% denial rate, this could be evidence enough for full denial of all claims from that period. Such drastic measures could be enough to shut down an entire practice. Don’t put yourself, your reputation and your livelihood in jeopardy. Contact us within 30 days of receipt of your demand letter. With 150 years’ collective experience, we can get the process started with a full diagnostic of your practice. We will guide you through and keep your business viable until a satisfactory result is achieved. And even if these pinpointed services aren’t used daily or weekly or even monthly, our full spectrum of resources, including free webinars and frequent healthcare legal blogs, are available to you 24/7. Protect yourself and contact Florida Healthcare Law Firm today to plan for and understand better the ramifications of claim assessment.

Healthcare Malpractice Insurance in Fl is Key for All Licensed Providers

October 27th, 2020 by

Outside of board-certified medical doctors, other licensed providers can benefit enormously from healthcare malpractice insurance in Florida. These licensed providers include physician assistants, osteopathic physicians, osteopathic physician assistants, advanced registered nurse practitioners, naturopaths, physical therapists, chiropractors, dentists, massage practitioners, acupuncturists and occupational therapists.

Even medical assistants can obtain coverage to protect themselves against being named individually in a lawsuit. At Florida Healthcare Law Firm, we can help all of these specialists realize the full power of this type of professional liability coverage and understand its benefits and parameters. Together, our team of attorneys offers 150 years’ experience delving into medical-related cases. This area is not simply part of what we do; it is everything we do. In the unfortunate event of a medical professional or hospital (or both) being named in a case of mistreatment of a patient, our seasoned legal staff will investigate the claim, provide legal representation and partner with you every step of the way until we reach a successful conclusions.

With a complimentary consultation, a money-back guarantee and flat-fee pricing, we approach each of our clients’ cases with a breadth and depth of knowledge in the field that makes us confident we will reach a winning situation for you. In the state, there are situations in which medical practitioners can forego liability coverage. But at what risk? Healthcare malpractice insurance in fl can be tricky. Our team helps you decode the rules of this coverage, determine if you need coverage and to what extent. As the medical field becomes more complicated, experts show that the need for coverage is increasing, especially to protect from financial devastation and human error and to supplement insufficient coverage from a professional’s employer. Let the capable team of Florida Healthcare Law Firm handle your decision to cover yourself and, if necessary, represent you should a claim arise. Contact us today for your free personal meeting.

Keep Up to Date with Medical Malpractice Insurance for Doctors in Florida

October 27th, 2020 by

Most physicians and health care providers know that coverage for liability claims as a result of treating patients is essential…a no-brainer. In fact, the AMA reports that by the age of 55, more than 65% of physicians have been the target of at least one lawsuit. Factor into this equation the time, cost and heartache, and most professionals agree the coverage is well worth it. Yet, the demands of a physician’s schedule can make it difficult to navigate the nuances of medical malpractice insurance for doctors in Florida and throughout the nation.

That’s why Florida Healthcare Law Firm is here to help. We are a comprehensive firm of attorneys who specialize in only one thing: researching, counseling and representing healthcare providers and hospitals. We don’t dabble in healthcare; we know the field inside and out. Collectively, our 150 years’ experience has proven itself time and time again with success stories from professionals who represent a myriad of healthcare specialties. From solo practices to $90 million facilities, our clients come to us with diverse challenges, and we deliver spectacular results with transparency, innovation and expertise that is unparalleled in the industry.

First off, it is important to note that there are no loopholes that allow physicians to work without medical malpractice insurance in Florida. Physicians must carry up to $100,000 in coverage and up to $250,000 in order to have hospital privileges. To the untrained legal eye, the intricacies of these document can be tricky, so our staff is ready to interpret and prepare you before any incident occurs. We advise you on ways to avoid legal suits, including 1) knowing how to document actions, 2) knowing what you can and cannot say when you are speaking with patients, peers and indemnity companies and 3) knowing how to keep working during the law suit. We offer complimentary consultations, webinars and ongoing 24/7 support once you begin working with us. In addition, our services, include telemedicine, payor issues, dental and pharmacy law, regulatory compliance, business transactions, hiring and firing issues. Let us exceed your expectations and protect your reputation. Contact Florida Healthcare Law Firm today.

Florida APRN Independent Practice Update

July 3rd, 2020 by

APRN independent practiceBy: Chase Howard

In March, the Florida Legislature passed multiple bills that would allow advanced practice registered nurses (APRN) to practice independently of physicians in the delivery of primary care practice. The law, however, went into full effect on July 1. Still, the law did not automatically grant autonomous practice to all nurse practitioners. Rather, an application process is still needed, as well as final regulations governing the new law.

In June, the Florida Board of Nursing voted to move forward with the drafting of rules and the application process to be designated as an independent practice Nurse Practitioner. This process usually takes three months to complete before it is open for practitioners to apply. The Board also voted to define “primary care practice” to include “health promotion, disease prevention, health maintenance, counseling, patient education, and diagnosis and treatment of acute and chronic illnesses in a variety of healthcare settings.”

Until final rules are decided, a nurse practitioner will at least need to meet the following requirements: read more

Access to Care via Telehealth Increases Again in Second Round of Changes Due to COVID-19

May 1st, 2020 by

By: Susan St. John

Access to telehealth for Medicare beneficiaries was further increased by the Trump Administration April 30, 2020. These new changes allows all health care professionals eligible to bill Medicare for services to provide services via telehealth communications and to bill the Medicare program for such services. Additionally, certain services may now be provided using audio technology only.

For a list of services eligible for reimbursement by the Medicare Program, including services requiring audio technology only, download here. There are approximately 180 different codes reimbursable by Medicare if provided via telehealth communications.

What Nurse Practitioner Practice Expansion Means for Doctors

March 27th, 2020 by

nurse practitioner practiceBy: Jeff Cohen

The issue of scope of practice is front and center in Florida right now with the expansion of what nurse practitioners (and nurse midwives) are legally permitted to do.  The newly enacted 464.0123 allows for qualified APRNs (there is specific criteria) to practice independent of a supervising physician in the following areas of medicine–primary care, family medicine, general pediatrics, and general internal medicine.

Even more, assuming they meet the membership criteria for admission to a healthcare facility medical staff, they may admit patients, manage patient care, and discharge patients.  One of the only preserved connections with a physician established by the law is if the APRN practices at a healthcare facility, a transfer agreement including a physician is required.  Additionally, the new law establishes a Council On Advanced Practice Registered Nurse Autonomous Practice, two members of which are appointed by the Board of Medicine and an additional two appointed by the Board of Osteopathic Medicine.       read more

Florida Electronic Prescription Mandate

November 14th, 2019 by

Florida Electronic Prescription MandateBy: Michael Silverman

Attention Florida prescribers and dispensers – did you know that a new law mandating electronic prescribing goes into effect on January 1, 2020?

More specifically, Florida House Bill 831, which was signed by Governor DeSantis in June 2019, requires prescribers to generate and transmit all prescriptions electronically upon licensure renewal or by July 1, 2021, whichever is earlier, unless an exemption applies.

If a practitioner is licensed to prescribe a medicinal drug, and such practitioner either (i) maintains a system of electronic health records; or (ii) is an owner, employee or contractor of a licensed healthcare facility or practice that maintains a system of electronic health records and are prescribing in their capacity as an owner, employee or contractor of the licensed healthcare facility; then they must electronically transmit their prescriptions

Essentially, as of January 1, 2020, practitioners must transmit all prescriptions electronically upon the earlier of license renewal or by July 1, 2021, unless: read more

Hiring an Excluded Individual – Employer Beware!

November 13th, 2019 by

hiring an excluded individualBy: Dave Davidson

It’s probably fair to say that most healthcare providers are aware of the federal Anti-Kickback Statute and the Stark Law (and if you’re not, please call me immediately!).  Those two laws, along with the False Claims Act, are the sources of the huge fines and penalties that make the headlines for governmentally discovered “fraud.”  However, there are a number of other regulatory provisions out there that the Office of Inspector General (OIG) is regularly policing.

One of these laws, with its origins in the Social Security Act, is the prohibition against providers hiring individuals or entities who have been excluded from participation in governmental health care programs such as Medicare or Medicaid.  Hiring an excluded person or company can expose a provider/employer to Civil Monetary Penalties, which can result in significant financial hardship to the provider.  And although this may seem like a simple rule to follow, recent enforcement activity shows that it may be fairly easy for an excluded person to “fall through the cracks” and wind up as your employee. read more

The Risk Of Not Paying Attention to HIPAA Violations

October 30th, 2019 by

HIPAA, HIPAA violations, HIPAA compliance

By Jacqueline Bain

On October 23, 2019, the U.S. Department of Health and Human Services has imposed a civil money penalty of over $2 million against Jackson Health System in Florida for repeated HIPAA violations.

The HIPAA violations mentioned in the HHS Press Release include:
1-Loss of paper patient records in December 2012;
2-Loss of additional paper patient records in January 2013;
3-A media report containing patient information (a photo shared on social media);
4-Employees accessing the information of one patient without a job related purpose;
5- An employee’s improper access and sale of patient records in 2011.

“OCR’s investigation revealed a HIPAA compliance program that had been in disarray for a number of years,” said OCR Director Roger Severino. The state of the compliance program allowed for the failure of several HIPAA requirements, including provision of timely and accurate HIPAA breach notifications, performance of regular risk assessments, investigation of identified risks, audits of system activity records, and imposing appropriate restrictions on workforce members’ access to patient information. The government’s final determination is available here.

When a HIPAA breach is discovered and reported, the government will often take the time to review a covered entity’s history of compliance or non-compliance. This may include an investigation into prior issues, effectiveness of policies and procedures, and employee issues. Overlooking one suspected breach may result in the imposition of sanctions on any later breach. This is why it’s so important for a healthcare business to understand its HIPAA obligations and take them seriously.

When was the last time your business conducted a security risk assessment to understand its potential risk areas for security breaches? If you’ve never had one, or haven’t had one recently, the time is now to conduct one. “When was your last security risk assessment?” is often the first thing that the government will ask in response to a breach.

Federal fines for noncompliance with HIPAA are based on the level of negligence perceived by the Federal government at the time of the breach. Fines and penalties range from $100 to $50,000 per violation (or per record), with a maximum penalty of $1.5 million. Simply put, your healthcare business can’t afford to bury its head and hope that it won’t be hit.