blog-2-lede-photo-e1656706286125At the beginning of COVID-19, telemedicine rules were softened on the state and federal level.  In a previous blog post, we discussed the softened Georgia rules during the COVID-19 State of Emergency in Georgia.   Unlike the federal Public Health Emergency that was recently lifted, the Georgia State of Emergency was lifted in early 2022.  But now that both the state and federal emergency-statuses are lifted, what does that mean for the telemedicine prescribing exceptions available during COVID-19?  This post intends to answer that question.  If you have questions about telemedicine 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.

Although Georgia has clear requirements for when telemedicine is generally allowed and what the general requirements are (which must, of course, be followed if prescribing is allowed), the only restriction on prescribing via telemedicine is with pain management drugs and controlled substances. Continue reading ›

aba-therapist-play-therapy-young-boy-e1690574727628Our healthcare and business law firm works with many behavioral health providers in establishing and operating their ABA associated businesses.  We have a particular focus on such companies and will be producing a series of helpful articles to assist providers in navigating various operational and business hurdles to ensure they are able to effectively treat their patients.

If you have questions regarding this blog post or would like to speak with counsel regarding opening your medical spa practice, 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.

Introduction

Payment and claims audits for ABA providers are becoming increasingly more common given the rising number of patients being cared for with autism and related disorders. For most ABA providers, an audit is no longer a probability but a certainty. Continue reading ›

GettyImages-1296010644-e1689271225783At the beginning of COVID-19, telemedicine rules were softened on the state and federal level.  In a previous blog post, we discussed the Medicare and Ryan Haight Act rules during the COVID-19 Public Health Emergency (“PHE”).   The PHE was lifted on May 11, 2023, and there is no final rule modifying the Ryan Haight Act, so that leaves the question:

Do we go back to the strict Pre-Covid-19 telemedicine rules

This post intends to answer that question.  If you have questions about telemedicine 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.

  • Pre-COVID-19 Federal Prescribing Rules

Under the federal Ryan Haight Act, prescribing controlled substances generally requires that the Practitioner/prescriber conduct at least one in-person medical evaluation of the patient.  21 U.S.C. Sect. 829(e) (“Controlled substances dispensed by means of the Internet”).    This is still the law on the books, but, as you’ll see below, there are still COVID-era exceptions in place as well as proposed rules to modify this law (nothing is final yet so it’s important to know the current law). Continue reading ›

idea_sized-kendal-l4ikccachoc-unsplash-e1688571047528As a healthcare and business law firm, many of our clients come to us with questions relating to the proper ordering and management of controlled substances.  As such, we wanted to take this opportunity to point out a recent update to the DEA’s Practitioner’s Manual.

The Drug Enforcement Administration (DEA) recently released an updated Practitioner’s Manual on June 14, 2023.  This is the first updated version of the manual since 2006. The Practitioner’s Manual provides guidance for all DEA registrants handling controlled substances—including behavioral health centers and physicians—on compliance with the Controlled Substance Act (CSA) and DEA regulations. The Practitioner’s Manual can be found here.

Some of the most significant updates include the following:

Registration Requirements

Generally, every practitioner who dispenses, which includes by definition administering and prescribing, controlled substances in schedules II through V, must be registered with DEA.  To register or reregister as a practitioner, a DEA Form 224 or Form 224a, respectively, must be completed.  The manual includes clarifying information about how practitioners can order, use, fill out, copy, store, cancel, and return the DEA Form 222 used to order, distribute and transfer Schedule I and II controlled substances. The manual also incorporates the optional Controlled Substance Ordering System (CSOS) as a viable alternative to the paper Form 222. Continue reading ›

med-spa-fountain-of-you-melbourne-fl-brevard-county-e1686943955555Our healthcare and business law firm works with many providers and other allied health professionals who are beginning their journeys of opening a Medical Spa.  Medical Spa’s have been growing in popularity across the country.  Medical Spas are unique practices in that they involve many medical and non-medical procedures.  There are many factors to consider in opening a medical spa, and this medical spa series focuses on key factors to consider when opening a medical spa in Georgia.  Although our healthcare law firm has assisted numerous clients in establishing a medical spa from the ground up, each client continues to present unique issues requiring our firm to research and analyze the nuances of each client’s intended setup.  This Georgia Medical Spa Series is intended to provide a useful overview of some key laws, rules, and regulations impacting medical spas.

This post in the Medical Spa Series answers the question of what the role of a dentist can perform in a medical spa.  If you have questions regarding this blog post or would like to speak with counsel regarding opening your medical spa practice, 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.

  • Dentists can prescribe and administer injectable pharmacologics

In Georgia, dentists are able to perform many medical spa treatments, including injecting Botox and fillers, but only when certain requirements are met. Continue reading ›

What-is-an-Opioid-e1687291586956Our healthcare and business law firm works with many physicians in Georgia who are facing mental health and substance abuse difficulties.  Sometimes those difficulties bleed into work and can cause work and/or licensure issues.  Georgia offers an incredible resource dedicated to physician recovery in a way that protects Georgia citizens and minimizes career concerns for the physician—the Georgia Professional Health Program (“PHP”).  This post provides 3 Facts about the Georgia PHP.  If you are experiencing or are concerned about ramifications of a potential addiction or mental health disorder, in addition to seeking medical help, we recommend contacting an experienced attorney who can assist you through this difficult process and help minimize potential licensure and career impacts.  If you have questions regarding this blog post or would like to speak with counsel regarding physician licensure, 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.

  1. The Georgia PHP was started in 2012

The Georgia PHP “is a nonprofit organization formed in 2012 to assist all licensees of the Georgia Composite Board of Medical Examiners and in 2022 the Georgia Board of Veterinary Medicine who develop potentially impairing conditions, mental illnesses, substance abuse and other addictive disorders.”  The Georgia PHP does not provide treatment, but, rather, conducts an initial triage, refers to in patient or outpatient treatment (if appropriate), and monitors the quality of the treatment.  The Georgia PHP’s #1 goal is to protect Georgia citizens.  It’s #2 goal is to advocate for Georgia physicians. Continue reading ›

1651676570_Transworld-May-Blog-Header950x460-e1686600049528As a healthcare and business law firm, we have many clients who participate in or wish to participate in pain management clinics.  A previous blog post of ours provided an overview of pain management clinics.  When it comes to selling a pain management clinic, there are certain questions to consider. This post provides a look into 3 questions to ask when selling your pain management and the answer to those questions.  Please note, there are numerous considerations when selling a medical practice that apply to pain management clinics as well, but this post focuses only on pain management considerations.  If you have questions regarding this blog post or would like to speak with counsel regarding selling your practice, 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.

In 2013, Georgia legislatures enacted House Bill 178 (“HB 178”) known as the Georgia Pain Management Clinic Act.  The act requires pain management clinics to obtain a license from the Georgia Medical Board and limits who can own pain management clinics.  These requirements add questions when it comes to selling a pain management clinic. Continue reading ›

Naturopathy-Physician-1-e1686066389978Our healthcare and business law firm works with many providers and other allied health professionals apply for and obtain licensure in Georgia.  Holistic medicine has grown in popularity and accessibility, which has led to an increase in functional medicine practices around the country.  Relatedly, the practice of naturopathy also appeals to many consumers.  The question we are periodically asked is whether Georgia allows naturopathy practitioners to practice naturopathy in Georgia.  The post provides a general overview of the answer to that question.  If you have questions regarding this blog post or would like to speak with counsel regarding becoming licensed in Georgia, 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.

1950 Act Repealed in 1956

In 1950, Georgia established legislation allowing for licensing as a “naturopathic practitioner.”  However, after only six years, the legislation was repealed.  Thus, since 1956, there is no naturopathic license in Georgia.  Such practice may still be allowed, unless it is considered to wade into the waters of other licenses, which it is.

Practicing Naturopathy is Considered the Practice of Medicine

In an official opinion in 1981, the Georgia Attorney General’s Office issued an official opinion stating that naturopathy practice falls within the Georgia Medical Practice Act’s definition of “the practice of medicine,” and does not fall within any established exceptions.  Continue reading ›

med-mal-featured-1-e1685565240921Our healthcare and business law firm works with many physician and other health care providers who own their own medical practice.  The Georgia Medical Board and Georgia Legislature, as well as many other state medical boards and legislatures, have noted concern with consumer confusion with the numerous titles held by non-physician health care practitioners.  For instance, “In a survey done a few years ago by the AMA, 39% of patients thought a Doctor of Nursing Practice was a physician and 11% weren’t sure. Half were either completely wrong or confused by a title. More than half (61%) thought a Doctor of Medical Science was a physician, which is completely incorrect.” M. Blackman, J. Commins, “Industry Stakeholders Divided on GA ‘Truth and Transparency’ Act,” Health Leaders Media (May 25, 2023).  This and other information caused the Georgia Legislature to act in an attempt to protect consumers from misunderstandings.  That change resulted in Senate Bill 197, known as the Health Care Practitioners Truth and Transparency Act, which was signed into law in May of 2023.  The bill made changes to the “Consumer Protection and Awareness Act,” O.C.G.A. Section 43-1-33.  Importantly, the legislatures concern here seemed to arise less from intentional or malicious misstatements from health care practitioners, and more from consumer misinformation/misunderstanding caused honestly by the numerous titles and credentials that may be held by practitioners that consumers do not understand.

This post identifies three key provisions with the Health Care Practitioners Truth and Transparency Act.  If you have questions regarding this blog post or would like to speak with counsel regarding laws that may impact you or your medical spa practice, 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.

  1. Expansion of Definition of and Rules for “Advertisements”

iStock-1056799938-e1684354865672Both concierge medicine and direct primary care practices have become popular alternatives to the traditional insurance medical practice model.  Direct Primary Care (“DPC”) practices generally cut insurance companies out from the provider-patient relationship.  Medicare offers unique considerations because participating and non-participating providers maintain certain responsibilities regarding Medicare beneficiaries, and many providers are hesitant to “opt out” of Medicare.  With this post, we intend only to highlight a few points to consider before accepting private pay from Medicare beneficiaries outside of copays.  If you have questions regarding this blog post or starting a concierge practice, 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.

 

Point 1- A Medicare-participating provider violates Medicare requirements by accepting private payment from a Medicare beneficiary for services that in whole or part constitute “covered services” as defined by Medicare.

Point 2- The federal Department of Health and Human Services (“HHS”) has established that requiring payment for non-covered services does not violate Medicare requirements. In fact, the HHS Office of Inspector General (“OIG”) states on its website: “It is legal to charge patients for services that are not covered by Medicare.”

Point 3- A complicating aspect of the seemingly simple rule is that whether a service is a “covered service” is determined solely by CMS, not by you.  Therefore, including language in a patient agreement such as “this fee does not cover any covered services”, though perhaps adequate to express an intention, does not prevent a practice/provider from being found to have violated Medicare rules. Continue reading ›

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