Articles Posted in Physician Practices

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nurses-and-docs-e1681928313827Our healthcare and business law firm often represents medical practices, including primary care practices, specialty practices, and med spas, in the initial set up phase of their practice.  Whether a Management Services Organization (“MSO”) is necessary or advisable for your practice usually requires a detailed review of your business structure and state laws.  If an MSO is advisable for your practice based on the Corporate Practice of Medicine (“CPOM”) doctrine in your state, this post provides 3 key provisions that should be within your Management Services Agreement (“MSA”).  If you have medical practice set up or MSO questions 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.

As discussed in previous blog posts, including 2 Facts About Management Services Organizations (MSOs) and Med Spas, Management Services Organizations can be useful in CPOM states to provide all non-medical functions of the business while contracting with the Physician Entity to provide all medical functions. The MSA that outlines this agreement is typically a lengthy and involved document, but here are three key provisions that should be contained within the agreement: Continue reading ›

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HealthcareImage_062618-700x525-1-e1682709849274Our healthcare and business law firm often represents medical practices, including primary care practices, specialty practices, med spas, and IV hydration clinics, in the initial set up phase of the business.  Related to questions about the Corporate Practice of Medicine (“CPOM”), a common question we are asked is: “Do I need an MSO”?  This is not always an easy question to answer.  There are many reasons why an MSO may be a useful tool for your practice.  For instance, it may reduce the risk of violating your state’s CPOM doctrine, it may increase regulatory compliance, or it may assist you in exit planning.  This post specifically focuses on how MSOs may be useful in the context of the CPOM doctrine.  If you have medical practice set up or CPOM/MSO questions 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.

Two facts about MSOs and Med Spas:

Fact 1:     Most med spas and IV hydration clinics offer services defined as the practice of medicine and, thus if there’s a CPOM doctrine in your state, it’s likely triggered.

If you own a med spa or IV hydration clinic, I can almost guarantee you are offering services that are considered the practice of medicine. Continue reading ›

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nurses-and-docs-e1681928313827Our healthcare and business law firm often represents medical practices, including primary care practices, specialty practices, and med spas, in the initial set up phase of their practice.  A main question we are asked is: What’s the Corporate Practice of Medicine (CPOMs) Doctrine and does it mean I have to have an MSO?  This is not always an easy question to answer.  The CPOM doctrine essentially encapsulates the following sentiment: We don’t want non-physicians, including corporations, practicing medicine so non-physicians cannot own medical practices.  There is quite a bit of nuance to add to that explanation, but that’s the main idea behind the doctrine.  This post provides 3 initial questions to consider relating to the CPOM doctrine.   If you have medical practice set up or CPOM questions 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.

Question 1: Am I practicing medicine?

This is not always an easy question to answer, even though common sense would say it should be.  Each state’s idea of what constitutes the practice of medicine is drastically different. Continue reading ›

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1651676570_Transworld-May-Blog-Header950x460-e1686600049528Our healthcare and business law firm often represents medical practices, including primary care practices, specialty practices, and med spas, in employment matters.  At some point, each medical practice deals with the situation where an employee becomes unable to perform due to an injury or prolonged illness.  For instance, an esthetician breaks her hand and can no longer perform essential services of her position.  Or a staff member has a serious illness that requires them to stay home for three weeks.  Our medical practice clients are always sympathetic and want to take care of their employees, but they also have to balance that interest against the interest of running a business.  That leads them to ask us: What should I do?  This post provides four considerations for a medical practice if an employee is unable to perform due to an injury or illness.  If you have employment questions 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.

  1. If the injury happened on the job, does your workers compensation policy provide a benefit? 

Workers’ compensation requirements differ state to state. Continue reading ›

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IV-Therapy-1-e1699043729176Our healthcare and business law firm works with healthcare providers and businesses to  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.  In 2022, the Alabama Board of Medical Examiners (“Medical Board”) conducted an investigation into ten businesses advertising retail IV hydration therapy services.  The investigation revealed that many IV therapy businesses allowed unqualified people to treat patients.  Although IV therapy is relatively safe, there are still risks, such as harm to the patient’s kidney.  Because there were no rules or regulations directly governing IV therapy businesses, the Medical Board issued a declaratory ruling.  This blog post summarizes the Medical Board’s answers to three key questions relating to retail IV Therapy practices in Alabama.  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@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

  1. Is IV Hydration Therapy the Practice of Medicine?

Yes, “the diagnosis of the patient’s condition and the recommendation of IV therapy constitutes the practice of medicine.”  It is a Class C felony for a person to practice medicine or osteopathy without a medical license.

  1. Who can evaluate, diagnose, treat, and prescribe IV Therapy?

Continue reading ›

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laser-hair-removal-service-e1698438994608Our 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.

Although the Medical Board made many changes, an important change to the rules is that these rules apply to many cosmetic lasers including cryotherapy, infrared lasers, radiofrequency micro-needling, Class III lasers that work on heat-based targeting of skin and collagen.  The Medical Board made many changes to Rule 540-X-11.  The Medical Board made many notable changes to the rule that may apply to med spa practitioners, including as follows:

Continue reading ›

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woman_receiving_skin_resurfacing_treatment_657671370-e1696966883317Our 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.  A previous post provided an overview of the rule changes that are potentially applicable to medical spa practitioners.  This post focuses on important rules that apply to Non-Laser Skin Rejuvenation procedures.  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.

As mentioned in the previous blog post, the use of Lasers/Pulsed Light Devices (“LLBDs”) for cosmetic purposes is considered “the practice of medicine” in Alabama.  Level 1 and Level 2 Delegates can perform certain LLBDs only if allowed by the rules, which go fully into effect on July 17, 2024.  This post focuses on the new rules governing Non-Laser Skin Rejuvenation. Continue reading ›

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health-medical-e1680627379406Our healthcare and business law firm consistently works with physicians who are dealing with complications resulting from adverse reporting to the National Practitioner Data Bank (“NPDB”).  A previous blog post outlines the process for disputing an NPDB report.  Although difficult, our law firm has had success in appeals to HHS resulting in void reports. This post provides more information about the process of disputing a report directly with HHS and what occurs with a successful resolution.  If you have a question about the NPDB 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.

Initiating the Dispute with HHS

As mentioned in our previous blog post, Two Steps to Dispute an NPDB Report, after attempting to resolve a dispute with the reporting entity, a provider can elevate the dispute by submitting a dispute to the Secretary of the U.S. Department of Health and Human Resources (“HHS”).  HHS’s jurisdiction to review reports is strictly limited, such that it can only review: (a) “if the report was submitted in accordance with reporting requirements”; (b) “if the reporting organization is eligible to report the information”; and (c) “if the report accurately depicts the action taken by the reporting organization and basis for the action in the organization’s written record.”  It is important to frame the request in a way that allows HHS to agree and exercise its jurisdiction.  For example, in a recent matter our firm worked on, our client resigned from employment while the entity was conducting an investigation into matters relating to our client. Continue reading ›

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Legal-cases-and-rulings-lower-courts-FHPAF-scaled-e1695156255815Our healthcare and business law firm consistently works with physicians who are dealing with complications resulting from adverse reporting to the National Practitioner Data Bank (“NPDB”) as well as entities in deciding what reports may be appropriate for certain situations.  Whether you are on the side of the provider or reporting entity, it is important to understand the types of NPDB reports that are permitted.  This post outlines the four types of reports. If you have a question about the NPDB 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.

Each reporting organization has the ability to submit four types of reports: an Initial Report, a Correction Report, a Void Report, and a Revision-to-Action Report.

Initial Report

An Initial Report is the first report of a medical malpractice payment, adverse action, or judgment or conviction that is submitted by a reporting entity to the NPDB.  Copies of an initial report are provided to the subject and reporting entity.  Certain reports must also be reported to an appropriate state licensing board.    Continue reading ›

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D1432441-e1632924477482Our healthcare and business law firm consistently works with physicians who are dealing with complications resulting from adverse reporting to the National Practitioner Data Bank (“NPDB”).  Certain entities, including medical licensure boards, facilities with a peer review process, and medical malpractice payers, have a duty to report specific actions or events to the NPDB. Any practitioner who has had the misfortune of having an action reported to the NPDB is likely aware of the negative impact such a report can have on his or her ability to practice.  Sometimes, however, the information reported to the NPDB is inaccurate in whole or in part or, even if accurate, inappropriately reported.  Inaccurate or inappropriate reports can have equally serious adverse impacts on a medical provider’s ability to practice as any correctly submitted NPDB report.  This post outlines the process for disputing a report that is inaccurate or inappropriately report. If you have a question about the NPDB 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@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

STEP 1: Dispute the Report with the Reporting Entity

The NPDB directs providers to contact the reporting organization before initiating a formal dispute with the NPDB.  Doing this is as simple as it sounds: contact the reporting entity, explain why the report is inaccurate or not reported in accordance with NPDB requirements, and request they correct or void the report.  If the report is accurate, yet a new action should have also been reported, you can also request that the reporting entity file a Revision-to-Action Report.  Although reporting entities have a duty to correctly report to the NPDB, entities can be sanctioned for not reporting.  As such, entities have an incentive to report if there is any question as to whether reporting is required.  Motivating an entity to modify a report to make it more factually accurate is a much easier feat than motivating an entity to void a report.  In our experience, entities have little incentive to void a report; they would rather the provider dispute the report to HHS and have HHS direct them to void the report. Continue reading ›

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