image_4-e1631547014743Last week, our blog post discussed the general rules permitting telemedicine in Georgia.  Often, our healthcare and business law firm’s provider clients who conduct telemedicine also need to understand the requirements around prescribing controlled substances based on telemedicine visits.  This post intends to outline some of the relevant prescribing rules in Georgia and the exceptions due to the Public Health Emergency (PHE) created by COVID-19.  This post intends to outline some relevant Georgia rules and regulations relating to telemedicine.  If you have questions about telemedicine or prescribing 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.

Georgia Rules on Prescribing Controlled Substances via Telemedicine

As discussed in our prior blog post on the general telemedicine rules, we look to the Medical Board’s rules on Unprofessional Conduct, among other rules, to decipher what is allowed in Georgia.  Rule 360-3-.02 defines Unprofessional Conduct to include subsection (5), which provides that Unprofessional Conduct could include: “Prescribing controlled substances . . . and/or dangerous drugs . . . for a patient based solely on a consultation via electronic means with the patient, patient’s guardian or patient’s agent.”  As such, the general rule prohibits prescribing controlled substances via a telemedicine consult.  However, the rule does “not prohibit a licensee from prescribing a dangerous drug for a patient pursuant to a valid physician patient relationship in accordance with O.C.G.A. § 33-24-56.4 or a licensee who is on-call or covering for another licensee from prescribing up to a 30-day supply of medications for a patient of such other licensee nor shall it prohibit a licensee from prescribing medications when documented emergency circumstances exist.”  Rule 360-3-.02(5).  There are other exceptions related to specific Schedule II controlled substances.

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MM-0220-Telemedicine-iStock-e1581381176331-1024x814-1-e1631301250783Our healthcare and business law firm frequently receives questions asking about telemedicine rules in Georgia.  This post intends to outline some relevant Georgia rules and regulations relating to telemedicine.  Our next post will consider the rules around prescribing based on a telemedicine consult and how COVID-19’s Public Health Emergency impacts those rules.  If you have questions about telemedicine rules and regulations 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.

General Telemedicine Rules and Definitions

The Georgia Composite Medical Board (“Medical Board”) generally requires an in-person exam, but the Medical Board Rules allow telemedicine in certain situations.  To begin, the relevant definition of “telemedicine” is found in Georgia’s insurance code and defines “telemedicine” as:

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By: Brian Field

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With the ever-changing climate of technology, the Health Insurance Portability and Accountability Act (HIPAA) continues to make patient-centered modifications intended to protect personal health records. Key components to the most recent updates to HIPAA include prohibition of records withholding.

The inspiration for the recent changes come from the Office of Civil Rights (OCR) within the U.S. Department of Health and Human Services (HHS).  A goal of both entities is to protect the health of all Americans and ensure essential human services. The OCR continues to reinforce a focus on patients regarding health and health records by aiming to eliminate technical barriers and reducing or eliminating cost to patients.

Following HIPAA law changes can be daunting, but if there is one thing to keep in mind, it is that HIPAA prioritizes patients. The information below is a snapshot of what you should know as you navigate health records storage for your patients before, during, and after their care with you has ended:

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Employment-Agreement-scaled-600x400-1-e1628799705812All individuals and industries have been impacted by COVID-19. As relevant to most of our clients, the medical industry has been heavily impacted. In June 2021, the Physicians Advocacy Institute (“PAI”) released the results of a study entitled: “COVID-19’s Impact on Acquisitions of Physician Practices and Physician Employment 2019-2020.” If you have questions about selling or purchasing a practice or physician 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@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

A main takeaway from the study is that between January 1, 2019, and January 1, 2021, “48,400 additional physicians left independent practice and became employees of hospitals or other corporate entities – 22,700 of that shift occurred after the onset of COVID-19.” This is a 12% increase in the percentage of hospital-employed physicians over the two-year study period. Furthermore, during the two-year study period, there was a 25% increase in corporate-owned practices nationally.

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medical-doctor-1314902-mIn our previous post reviewing the Georgia Composite Medical Board’s (“Medical Board” or “GCMB”) June Monthly Meeting Minutes, we touched on the Medical Board’s acknowledgment of House Bill 458. Herein, our healthcare and business law firm analyzes more thoroughly the new law and its impact on Georgia physicians and the Medical Board. If you have licensing or other GCMB 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@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

HB 458 amends Title 43 of the Official Code of Georgia in varied ways to accomplish the following goals:

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imagesWelcome to the second installment of our business and healthcare law firm’s monthly medical board meeting review, focusing on the Georgia Composite Medical Board (“Medical Board” or “GCMB”).  As a healthcare law firm with physician clients, it is our duty to stay up to date with the Medical Board’s positions and changes so as to better inform our clients. If you have licensing or other GCMB 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@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

The Medical Board met on June 3, 2021 via video teleconference.  The June monthly meeting minutes are available here.  The Medical Board also publicly releases public orders and agreements each month.

Meeting Minutes

A main theme during the introductory Executive Director’s Report involved preventing and responding to sexual misconduct in the healthcare field.  The Board was presented with an article, “State Medical Board Recommendations for Stronger Approaches to Sexual Misconduct by Physicians,” available here.  The Board also discussed House Bill 458, which passed the House and Senate and goes into effect on January 1, 2022. A blog post examining HB 458 in more detail is forthcoming from Hamil Little.

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D1432441-e1627053044153Our 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 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. Inaccurate or incomplete reports can have equally serious adverse impacts on a medical provider’s ability to practice as any correctly submitted NPDB report. This post outlines steps practitioners or counsel can take to help minimize the adverse impact of such inaccurate 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@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

Submitting a Statement

The NPDB allows practitioners to submit statements at any time to explain or supplement a report. According to the NPDB, the statement is the provider’s “opportunity to provide additional information [the provider] would like included with the report.” A statement does not correct or void a reporting by a medical board, but it is a useful tool for a provider to explain an adverse licensure action when that is necessary. This is a way to tell the practitioner’s side of events. Although the statement may be limited in its impact, it can be particularly useful to submit a well-drafted statement while waiting for the often-lengthy dispute resolution process to conclude. Statements can also be submitted or edited at any time, so the efficiency of a statement makes it a useful tool.

Disputing the Report

If the practitioner wishes to take the matter beyond submitting an explanatory statement, the practitioner must make an important decision: work through the NPDB or go straight to the source (the reporting organization). In our business and healthcare law firm’s experience, we have had more success working with the reporting entity directly to resolve reporting disputes. In fact, the NPDB directs providers to contact the reporting organization before initiating a formal dispute with the NPDB.

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iStock_000033418316_Medium-e1626470315777Welcome to the first installment of our business and healthcare law firm’s monthly medical board meeting review, focusing on the Georgia Composite Medical Board (“GCMB” or “Medical Board”).  As a healthcare law firm with many physician clients, it is our duty to stay up to date with the Medical Board’s positions and changes so as to better inform our clients. We hope that by providing a review of the Medical Board’s monthly meeting minutes, our readers and provider clients will be able to better navigate the Medical Board successfully. If you have licensing or other GCMB 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@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

The Medical Board meets once a month to uphold its directives under the Medical Practice Act, which allow the Medical Board to do, among other things, the following: review applications for licensure, interview applicants when necessary or requested, investigate complaints, discuss proposed rules and rule modifications, review and publish public orders, and allow for committee meetings.

  • May Meeting

The Medical Board met on May 6, 2021 via video teleconference.  The May monthly meeting minutes are available here.  The Medical Board also publicly releases public orders and agreements each month.

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As a healthcare and business law firm, we work with many employers and employees to navigate complex employment matters, oftentimes with an eye towards federal employment regulations. 021721125026-300x188 The COVID-19 pandemic has impacted employment in the United States.  Now that the Country is reopening and people are returning to work, a question on everyone’s mind is: “Can my employer require me to get the vaccine”?  The Equal Employment Opportunity Commission (“EEOC”) recently released guidance answering that question.  This post intends to outline the EEOC’s position; it does not address the potential impact of state and local rules on this topic.  If you have questions regarding this blog post, employment matters, or EEOC rules and regulations, you may contact us 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

The EEOC Hearing

To assist in developing its guidance, on April 28, 2021, the EEOC held a hearing to discuss the impact of the pandemic on workplace civil rights.  During the hearing, the EEOC heard from experts in economics, policy, disability rights, and many more.  The hearing transcript and audio is available here.  It may be important going forward to consider that the EEOC hearing was held before the CDC issued new guidance on May 13th pertaining to fully vaccinated individuals.

As a healthcare and business law firm, we work with many healthcare employers and employees to resolve employment disputes.  When disputes involve the civil rights of the employee, the Equal eeoc-gavel-new-300x250-1Employment Opportunity Commission’s (“EEOC”) administrative process may be triggered.  For instance, if an employee alleges discrimination based on sex or race under Title VII, the employee is required to file a Notice of Charge with the EEOC and allow the EEOC to review the charge for at least 180 days.  After 180 days passes, the EEOC may issue the complainant-employee a Notice of Right to Sue, and then, the employee may file a federal lawsuit.  Sometimes, however, the employee fears continued discrimination or retaliation from initiating the EEOC action.  Can the employee bring an injunction in federal court enjoining the employer from discriminating or retaliating? This post intends to outline the Eleventh Circuit’s stance on this question.  If you have questions regarding this blog post or employment matters, including unlawful discrimination in the workplace, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com.

At the outset, anti-discrimination laws generally provide equitable relief as a remedy.  See, e.g., 42 U.S.C. § 2000e-5(g)(1).  Further, the EEOC may move a federal court for an injunction pending the EEOC’s investigation.  As recognized by federal courts, the EEOC taking such an intervening step requires many moving parts.  In Drew v. Liberty Mut. Ins. Co., the Fifth Circuit painted a picture that that the complainant “would have to be fortunate enough for her complaint with EEOC so to divert the attention of the staff from its overwhelming burden of cases to distinguish it as one which demanded immediate attention, resulting in the preparation and filing of a suit by staff attorneys pending the usual course of processing the complaint before she would ever be able to act on her own to seek an end to the irreparable damage she was suffering.  480 F.2d 69, 74 (5th Cir. 1973).  This begs the question—can the private employee move for an injunction pending the EEOC action?

Circuit courts are split on this issue.  See David Tecson, Federal Remedies in Employment Discrimination Actions, at 6-7 (2007).  The Eleventh Circuit precedent comes from the Fifth Circuit case in Drew, which is binding on the Eleventh Circuit because it was decided prior to 1981.  In Drew, the court stated: “We conclude that in the limited class of cases, such as the present, in which irreparable injury is shown and likelihood of ultimate success has been established, . . . the individual employee may bring her own suit to maintain the status quo pending the action of the [EEOC]. . . .”  Although circuits and even district courts within the Eleventh Circuit have disagreed with this stance, the present rule is that in limited circumstances, the employee may move for an injunction pending the EEOC action.  As an example of disagreement, in McGee v. Puralator Courier Corp., 430 F. Supp. 1285, 1286-88 (N.D. Ala. 1977), the Northern District of Alabama disagreed with Drew in part because the EEOC requirement was a jurisdiction bar to bringing suit at that time.  In 2019, the Supreme Court resolved the jurisdictional split on that issue and found exhausting the EEOC process was not a jurisdictional bar.  Fort Bend Cnty., Texas v. Davis, 139 S.Ct. 1843 (2019).  In 1984, the Eleventh Circuit, after splitting with the Fifth Circuit, summarily affirmed a Northern District of Georgia case applying Drew to a case involving a federal employee.  Goza v. Bolger, 538 F. Supp. 1012, 1017 (N.D. Ga. 1982), aff’d, 741 F.2d 1383 (Table) (11th Cir. 1984).  Although there is disagreement over the ability of an individual to bring a suit for injunctive relief pending an EEOC charge, it seems that it is available in limited circumstances in the Eleventh Circuit.

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