Moving Your Practice

3 Considerations Before Offering Ozone Therapy at Your Med Spa

April 18, 2024 | Little Health Law

Our healthcare and business law firm works with many providers and medical practices to ensure compliance with state and federal laws, rules, and regulations for given procedures, treatments, and prescriptions. Providers have differing opinions on the use and efficacy of certain treatments. One such treatment is Ozone therapy. This blog post outlines considerations prior to introducing Ozone therapy to your medical and wellness practices’ offerings. If you need assistance understanding the full realm of considerations governing ozone therapy or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Consider the Food and Drug Administration’s Regulations

21 C.F.R. 801.415 is a regulation of the Food and Drug Administration (“FDA”), which provides: “Ozone is a toxic gas with no known useful medical application in specific adjunctive, or preventative therapy.” Further on the regulation provides: “A number of devices currently on the market generate ozone by design or as a byproduct. Continue reading ›

South Carolina Advisory Opinion on Retail IV Therapy Businesses: A Breakdown of the Opinion and Summary of Critical Information

November 20, 2023 | Little Health Law

health-medical-e1680627379406 Our healthcare and business law firm works with healthcare providers and businesses like IV hydration therapy practices. The IV hydration therapy industry has grown drastically over the past few years. Some states and medical boards have developed laws and rules governing IV Hydration Therapy practices. On August 15, 2023, the South Carolina Board of Medical Examiners, Pharmacy, and Nursing published a joint opinion on Retail IV Therapy Businesses. The language used and sanctions referenced reveal that the South Carolina Boards are critically reviewing IV therapy businesses. At one place in the 10-page opinion, the Pharmacy Board compared the “patient-drive menu” in many IV therapy practices “to a fast-food restaurant.” Reading between the lines of the advisory opinion, it is likely each board will begin cracking down on IV therapy practices. A full version of the Advisory Opinion is available here. We recommend you read the entire opinion if you have or are starting an IV therapy business in South Carolina. This blog post starts our review of the Advisory Opinion and outlines whether IV therapy is the practice of medicine. Forthcoming blog posts will dive deeper into different aspects of the opinion. If you have a question about South Carolina’s rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

What lead to this opinion?

After reviewing the opinion, it is clear that each South Carolina board believed this opinion necessary for four main reasons: Continue reading ›

Alabama’s New Laser Rules: Overview of Changes

September 8, 2023 | Little Health Law

Amankora-Bhutan-–-Spa-Wellness-Aman-Spa-Paro-Amankora-Holistic-Massage-e1694207101902 Our healthcare and business law firm works with healthcare providers and businesses to open cosmetic medical and wellness spas. The medical spa entity has grown drastically over the past few years. Some states and medical boards have developed laws and rules governing medical and wellness spas. As medical and wellness spas continue to grow, we can anticipate more laws and rules governing medical and wellness spas. On July 19, 2023, the Alabama Board of Medical Examiners (“Medical Board”) published changes to the rules governing the “Use of Lasers and Other Modalities,” which can be found in Chapter 540-X-11 of the Rules of the Medical Board. The rule is broken down into many different categories. This post provides an overview of the rule changes that are potentially applicable to medical spa practitioners. If you have a question about the Alabama Medical Board’s rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Rule 540-X-11 “Guidelines for the Use of Lasers and Other Modalities Affecting Living Tissue” has been a rule in Alabama since 2007. However, on March 16, 2023, the Medical Board passed changes and additions to the Rule, which became effective on July 17, 2023. The deadline for compliance with the provisions is July 17, 2024. Continue reading ›

Before You Voluntarily Surrender Your State Medical License, Consider That Medicare May Revoke Your Privileges or Exclude You

February 10, 2022 | Little Health Law

Medical-License-e1644515318522 For various reasons, licensed medical providers may choose to voluntarily surrender their state licensure. Sometimes, the provider does not intend to work in the state anymore and no longer wishes to maintain the licensure. Other times, the licensing agency may intend to discipline the provider and the provider chooses to surrender their license in lieu of receiving discipline. Surrendering your license, however, may have unintended consequences to include revocation of your Medicare privileges and instituting a Medicare enrollment bar. This post outlines what actions the Centers for Medicare and Medicaid (CMS) or one of its Medicare Administrative Contractors (MAC) may take in response to a provider surrendering their state licensure. A forthcoming post will outline potential options a provider may have if their Medicare privileges have been revoked. If you have questions regarding this blog post or wish to discuss your medical license or Medicare privileges, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

There are two main ways a CMS or a MAC can revoke a provider’s Medicare privileges after they voluntarily surrender their state medical licensure: Continue reading ›

Navigating Troubled Waters: Five Tips for Physician Practice Breakups and Departures

February 24, 2014 | Little Health Law

Medical practice breakups and physician departures are inevitable. Some are the result of professional or personal disputes, and others are simply the result of practical or economic realities or life events (disability, death, retirement, etc.). Whatever the circumstances, failing to carefully execute a plan for the breakup can quickly result in financial, legal, and emotional complications. All physicians and physician practices should anticipate the inevitable conclusion of any professional relationship.

1. Have a Good Contract

When a business relationship fails or otherwise ends, not having a properly done contract that fairly, accurately and precisely sets forth the parties’ respective rights and obligations will be a painful mistake, financially and otherwise. At the beginning of the marriage (or at least during the period that it is happy), the parties should carefully and thoughtfully construct a written agreement that states their meeting of the minds. That contract should also specifically set forth in reasonable detail a road map for the parties to separate when it is time for the relationship to conclude.

2. Carefully Document the Termination of the Relationship

Whether or not the practice had proper preparation before a breakup or departure, both parties should carefully document the final resolution in writing. This is especially the case if the resulting departures necessitate any post-employment obligations such as unfinished payments, restrictive covenants, confidentiality agreements, etc. Important practice contracts and documents should be marshalled and carefully reviewed to determine what the parties’ respective rights and obligations will be in concluding the relationship, including:
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The Affordable Care Act Will Enhance Direct Practice Medicine Opportunities

December 28, 2013 | Little Health Law

The Affordable Care Act (ACA), widely known as “Obamacare,” will create new opportunities for primary care doctors (and some specialists) who weigh starting or converting to a direct primary care model. At first blush direct care medicine practices, also known as “concierge,” “boutique” and “retainer-based” practices, which charge patients a monthly or annual membership fee and tend to exclude (or limit) third party payer involvement (one of the strong points for pursuing the model), would seem limited as an opportunity by the ACA’s objective of getting everyone “insured.” But the opposite may prove to be the case. Actually, the ACA may drive a strong need for new concierge medicine doctors.

A New Era of High Deductibles

While a stated goal of the ACA is to decrease the number of uninsured Americans, a consequence of the ACA will likely be that many newly insured patients under plans obtained via the new insurance exchanges will soon realize that due to very high deductibles, much or all of the costs of treatment (i.e., all non-preventive care) incurred over the course of a year must be paid out of pocket by the insured. For a typical household in Richmond County, Georgia, for example, as of this writing there are 18 plans available via the exchanges: 7 “Bronze Plans,” 6 “Silver Plans,” 4 “Gold Plans,” and 1 “Platinum Plan.” For the Bronze Plans, the annual deductibles range from $4,000 to $6,300. It is widely expected that most people will seek to minimize their premiums and opt for one of the Bronze Plans, only two of which have annual deductibles of less than $5,000.

What will that mean? That will mean most doctor visits (excluding preventive care) will be paid out of pocket by the “insured” patients who presently may not realize what is in store for them by way of doctor bills. As the public becomes aware of how the ACA will actually work for them (i.e., even though they are “insured” they are writing checks for doctor bills), the appeal to consumers of concierge options will increase. As recently reported in the Wall Street Journal, “People with deductibles of $5,000 or more should think about how many times a year they typically see the doctor and for what, keeping in mind that annual checkups are free under the ACA. If doctor visits typically cost $150 and the patient has six appointments a year, a concierge practice offering the same services for $40 or $50 a month might be cheaper.” Pros and Cons of Concierge Medicine (November 1, 2013).
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Breaking Up is Hard to Do: Dividing Medical Practice Assets

November 28, 2013 | Little Health Law

Ending a professional relationship is not easy for anyone. But the demise of a healthcare business relationship among doctors often involves more risks, greater headaches, and more issues to tackle than non-healthcare businesses. Dividing up medical business assets is, for example, much more complex and involved than simply drawing a line down the middle of the office. Federal laws and regulations affecting healthcare providers pose significant business risks and adverse legal ramifications where the division of assets is not done properly. If you and other physician owners are leaving a practice, it is critical to ensure any division of big ticket items — e.g., medical equipment leases, practice branding, and electronic health records – is done in a legally compliant manner.

Most often, medical equipment in physician practices is leased. The leased status creates potential complications if multiple owners want a particular item or if, on the other hand, no one wants the accompanying financial obligations. Whichever side of the coin your practice breakup falls on, medical practice owners should take into account the depreciating value of the equipment when determining the division of assets. Sometimes, outstanding liabilities or personal guarantees that equipment may be subject to are mistakenly overlooked in the process of dividing assets. The division process should begin with an experienced consultant who can aid in the necessary number crunch and ensure fair and balanced allocation of value and financial responsibilities that attend leased equipment assets.

While a practice’s name and brand may not be easy to value with precision, the inherent value should be weighed and factored into the division of assets. As with any business, the reputation of a brand or identity is a key to success. A medical practice’s good reputation carries critical patient confidence, which is a valuable asset for any practitioner. When physicians choose to work in the same field and geographic area, the division of such an asset is problematic and may raise difficult business and legal issues.
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Things to Consider When Moving Your Medical/Dental Practice

January 31, 2013 | Little Health Law

Physicians and dentists often decide to choose a new place to practice. Sometimes it might be in the same area but a different part of town or it can be in another city or state. Whether you are considering opening a new office or simply relocating, it is extremely important to do your homework before making this decision.

Here are a few tips from an experienced Georgia health care lawyer to consider.

One of the primary factors in making this decision is physician density. In areas where there are not as many doctors, it will be far easier to cultivate a new patient base. This is especially true if there are no physicians in the area with your expertise. In areas saturated with doctors, you are provided with the opportunity to expand your area of expertise and set yourself apart from the others.

Another thing to consider is an area with high unemployment. This would mean the people in that area would be less likely to have insurance coverage. This would make them less likely to make routine visits. This may all change under the Patient Protection and Affordable Care Act (PPACA).

Nobody really wants to talk about the costs involved for medical malpractice but it is a decision that has to be faced if considering a move. If you are moving in the same city or same area, this is not of significant concern. However, if you are considering moving to another state or a smaller town, the costs of malpractice insurance could vary greatly.

Lastly, consider what your earnings will be in the area you are considering. Physician compensation in the Midwest is higher than the Southwest. In reality a reputable physician can make a good living in any area he or she chooses to go to. One way to get inside information is to visit with other doctors in the area considering that they might not be entirely honest with their answers.

Unfortunately there is no cookie cutter format for determining the best place for a physician to be; there are issues specific to each practice that will need to be answered. The bottom line is that an experienced physician or dentist will flourish and succeed in any area that they choose.
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Articles Posted in Moving Your Practice