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Your reputation as a medical provider is a commodity you must protect, especially regarding your aptitude for providing patient care.  Of course, you may not be a perfect fit at every medical indexpractice.  When that happens, your employment may end, and you seek other employment.  No harm, no foul.

But what happens when your past employer provides a negative reference to your prospective employer?  Worse still, what if the reference falsely criticizes your competence as a medical provider?  And what if that false reference costs you the position?  Your past employer may be guilty of engaging in improper behavior providing you a remedy at law.

Defamation

If you are a non-physician owner of a medical practice, you may wonder what requirements govern the process of closing your small business.  Our Georgia-based business and healthcare law firm doctor-with-closed-sign-icon-300x233assists medical practice owners with set up, a variety of business transactions, dissolutions and wind-down of the business.  Medical licensing rules do not necessarily govern the non-physician owner, but there are potential obligations all owners should be aware of.

First, Retain Patient Medical Records.

Assuming the medical practice owns at least certain patient medical records, Georgia law requires the medical practice to maintain medical records for ten years from the date of creation and make those records available to patients upon request.  O.C.G.A. § 31-33-2(a)(1)(A).  There are exceptions to the ten-year rule.  For instance, a provider who is retiring or selling his or her practice is excepted if the provider completes certain tasks, including notifying the patients of the impending retirement or sale and offering to provide each patient’s records to another provider of the patient’s choice and, if requested, the patient. O.C.G.A. § 31-33-2(a)(1)(B)(i).  There are possible vendors with whom you may contract to assume this responsibility, if desired.  And if the medical records are electronic medical records (“EMR”) controlled by a third-party vendor, the vendor’s contract should be carefully reviewed and followed, subject to Georgia law requirements.

As Georgia schools and other businesses respond to open and operate safely in the face of the COVID-19 Pandemic, many are posting warning signs consistent with a new law in the state passed to protect them from liability.https://www.healthcarelaw-blog.com/files/2020/09/ewscripps.brightspotcdn.com_-300x169.jpg

Georgia-based Business and Healthcare Law Firm

This summer, Georgia joined many other states in passing a law to protect businesses including healthcare facilities and workers from liability from lawsuits brought by individuals or their survivors related to infections from or exposure to COVID-19 in visiting the premises of or obtaining healthcare services or personal protective equipment from those facilities, entities or individuals.  Senate Bill 359, signed by the Governor on August 5, 2020 provides that no healthcare facility or provider, entity or individual shall be liable for damages in an action involving a “COVID-19 liability claim” unless the claimant proves the actions of the healthcare facility, entity or individual resulted from gross negligence, willful and wanton misconduct, reckless or intentional infliction of harm.

On March 27, 2020, Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act, a $2 trillion relief act to provide financial support for individuals, businesses and CARES-ACT-close-scaled-e1585882477755-300x195government organizations that experienced revenue losses from COVID-19. The purpose of the Act is to offer financial relief and to establish telehealth benefits for patients needing non-COVID-19 services. Section A of the Act authorizes programs for relief and contains information about mandatory spending provisions, while section B contains provisions regarding discretionary and emergency appropriations. Over the next few weeks, this blog will discuss recent changes to the CARES Act, and the impact that those modifications are having on hospitals and physician practices. This post provides a brief overview of the CARES Act, as well as the attestation process that providers must follow upon receiving funds.

The Provider Relief Fund

The federal government partnered with United Health Group to disburse funds to providers from the Center for Medicare & Medicaid Services (CMS), through the Provider Relief Fund (the “Fund”). This $175 billion fund provides monetary relief for hospitals and healthcare providers on the front lines of the coronavirus response in the form of grants. The grants may be used for necessary expenditures due to the COVID-19 public health emergency and other expenses related to the Coronavirus that were not already part of an approved state or government budget.

About 20% of United States tax dollars are spent on heathcare.  Naturally, reducing improper payments has been a priority of CMS. Thus, all medical practice managers and healthcare providers should be aware of CMS’s process of contracting with Uniform Program Integrity Contractors (UPIC’s), private entities hired by CMS Health-Audit-300x200to audit providers suspected of fraud. UPIC contracts combine Zone Program Integrity Contractors (ZPIC’s) and Medicaid Integrity Contractors (MIC’s) to coordinate Medicare and Medicaid auditing. UPIC’s focus primarily on Medicare claims, and seek to distinguish between provider billing errors or fraud.

UPIC Audit Lawyers

Our business and healthcare law firm follows legal trends in the healthcare industry.  UPIC’s are private sector organizations that review Medicare claims in order to assist the government in recovering overpayments to healthcare providers.  UPIC audits are often generated through data analysis or by review of consumer complaints and most often target specific healthcare providers. UPIC’s conduct screening, medical reviews, and investigations, while also implementing remedies and collaborating with state and local governments to ensure compliance with payment guidelines. UPIC’s are organized regionally, with Georgia and South Carolina falling in District 4 and managed by Safeguard Services.  In recent years, home health agencies, DME companies, therapy clinics, and laboratories have been targets for fraud investigations through extensive audits.

Telemedicine has new and profound importance due to the COVID-19 crisis.  “Virtual” healthcare preserves patient protective equipment that would otherwiimage_4-e1587393250939se be used and allows physicians to manage chronic illnesses remotely, without the in-person interaction that exposes provider and patient to the risk of spread. This increased reliance on telemedicine has prompted state and federal legislative bodies to pass new rules and guidelines to promote access to telehealth services by reducing costs, increasing availability, and promoting relationships between healthcare providers and their patients.   Our Georgia-based business and healthcare law firm follows regulatory developments that impact healthcare providers.  As of the date of this post, seven states (Arizona, Florida, Kansas, Maine, New Jersey, Oregon, and Utah) have waived restrictions on telehealth. More relaxation of telehealth rules may be expected.

 New Regulations: an Overview

Virtual medicine is expected to aid in slowing the spread of coronavirus by limiting contact between individuals.  New telemedicine regulations encourage video and audio conversations between providers and their patients.  Telemedicine platforms can serve a variety of functions, some assist with managing patient triage, while others provide alerts to providers and patients in regard to medication management.  Other platforms allow for effective monitoring of chronic illnesses for patients, even with the strict social distancing guidelines that are currently in place. Thus, as part of an effort to allow healthcare providers to better support each other and their patients, the federal government has reduced the regulatory hoops that have previously limited access to Telehealth services. The CMS Fact Sheet discusses in depth the changes that have been made to provide virtual services.

Hamil-Little-Business-Interruption-Insurance
Business interruption insurance is especially important for small businesses and companies that rely on physical locations to carry out day-to-day activities associated with their organizations.  Our business and healthcare law firm represents medical practices and other businesses with regard to insurance coverage disputes.  Filing a business interruption claim can be the best way to recover income loss and damages that occur as a result of a reduction or cessation of business operations. As the COVID-19 pandemic, continues to create disruption and financial uncertainty for business owners, insurance companies’ reluctance to cover interruption claims has initiated state responses to protect businesses from losses stemming from closures, seizure of ordinary business operations, and supply chain interruption.

Georgia-based Insurance Coverage and Business Litigation Attorneys

A March 6 article in the Wall Street Journal reported that U.S. insurance companies already have rejected claims submitted for coverage of business interruption related to the Coronavirus.

pills-2-300x225Today, the United States Department of Justice announced by press release its formation of Operation Synthetic Opioid Surge (S.O.S.).  An objective of SOS is the reduction of dangerous opioids in particular areas of focus, to identify wholesale distribution networks, and to locate suppliers.

The Opioid Crisis

Opioids are medications that affect the nervous system and/or specific receptors in the brain, for the purpose of reducing pain.  In the late 1990s, based on assurances from the pharmaceutical industry that patients were not likely to become addicted to pain relievers, physicians began to prescribe opioids at a higher level than in prior years.  Increased prescriptions led ultimately to widespread misuse of opioids.  Later, it became clearer to the medical community that opioids can be highly addictive.

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small-bottle-and-dropper-1473970-300x226House Bill 1, Haleigh’s Hope Act, went into effect on April 16, 2015. HB 1 makes it lawful to possess up to 20 fluid ounces of low-THC oil, commonly known as “medical marijuana.” On May 8, 2018, Governor Deal signed House Bill 65, which expanded the conditions medical marijuana could be used to treat. As a consequence of HB 65’s expansion, it is likely that more employees will be allowed to possess and use medical marijuana.

Does this mean that you must permit your employees to possess and use medical marijuana while at work, and if you terminate their employment, you are committing disability discrimination?

Not exactly.

gavel-952313-mOur Georgia and South Carolina healthcare law firm has learned that the United States Department of Justice issued a press release announcing a resolution by settlement of fraud and abuse allegations levied against a Detroit physician, Gerald Daneshvar M.D.  Due to our focus on healthcare law, our law firm follows legal developments in the healthcare industry.

Dr. Daneshvar was criminally charged and, following a two-week jury trial, convicted of one count of conspiracy to commit health care fraud.  His alleged co-conspirators and co-defendants were Stephen Mason, M.D. and Leonard Van Gelder, M.D.  Mason and Gelder plead guilty to conspiracy to commit health care fraud.  These doctors were alleged to have worked for Lake MI Mobile Doctors, which provided physician home visits to homebound patients who were Medicare beneficiaries.  However, according to the Government’s evidence at trial, Dr. Daneshvar billed Medicare for patient visits where the patient was not really sick or homebound and, along with his codefendants, conspired to bill Medicare at the highest rates even though the patient visits were short or unnecessary.  For doing so, these physicians received greater compensation from Mobile Doctors.

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