Healthcare Information

Understanding a Prepayment Review

April 6, 2023 | Little Health Law

self-employed-health-insurance-deduction-feature-1280x720-1-e1680719330392 Our healthcare and business law firm often assists medical practices in responding to medical record and coding audits initiated by private and governmental payors. If a payor believes there are consistent concerns with a medical practice’s claims, the payor may place the practice under a prepayment review process. This process can be very concerning to a practice and, in some cases, can place a practice at risk of shutting down. If you have questions about an insurance audit or prepayment review process 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.

Standard Claims Reimbursement Process

Generally, once a medical practice establishes a relationship with a payor, the practice can submit claims electronically that are paid without requiring individual review. Generally, supporting documentation is not required to be submitted along with the claim. Continue reading ›

3 Tips for Responding to an Insurance Audit

April 4, 2023 | Little Health Law

health-medical-e1680627379406 Our healthcare and business law firm often assists medical practices in responding to medical record and coding audits initiated by private and governmental payors. Responding to each payor is unique. The way I might respond to a private payor may differ from how I respond to a government payor. This post, however, provides a few tried-and-true tips to consider when faced with an audit. If you have questions about an insurance audit 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.

Tip 1- Hire Counsel

Although this sounds self-serving, it is not. Attorneys who are experienced assisting medical practices with responding to insurance audits are well worth their cost. Continue reading ›

Off-Label Treatments and Medications and Informed Consent

March 30, 2023 | Little Health Law

5061-dreamstime_m_28850408-e1680196937118 Our healthcare and business law firm often assists provider and medical practice clients with preparing informed consents. Many clients offer treatments in an off-label use and question whether informed consents are necessary for such use. Currently, there is no FDA requirement to get a patient’s informed consent, but it may be beneficial for your practice to implement off-label informed consents. If you have questions about patient consents 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 Does “Off Label” Mean?

Off label means providing treatment and prescribing medications for conditions or using a dose different than what the FDA has approved. To become an approved use of a drug or treatment, the FDA must “conduct a careful evaluation of its benefits and risks for that use” and ensure that use “is supported by strong scientific data.” Continue reading ›

Florida State Telemedicine Rules

January 12, 2023 | Little Health Law

MM-0220-Telemedicine-iStock-e1581381176331-1024x814-1-e1631301250783 Our healthcare and business law firm previously published a blog post on the federal telemedicine rules. Both Federal and State rules govern the provision of telemedicine. Each state’s rules governing telemedicine are different, but the applicable laws and rules are generally found in the state medical board’s rules or position statements, insurance code, and when applicable, Medicaid rules. This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in Florida. This post does not discuss telemedicine prescribing rules or Medicaid rules. 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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Florida Rules

The Florida telehealth rules are set out in Florida Statute 456.47, which was modified in 2022 through Senate Bill 312. Florida allows a limited telemedicine license for those without a full medical license, but, in general, the same rules apply regardless of whether a provider has a full medical license or limited telemedicine license. Continue reading ›

Tennessee State Telemedicine Rules

September 2, 2022 | Little Health Law

Our healthcare and business law firm previously published a blog post on the federal telemedicine rules. Both Federal and State rules govern the provision of telemedicine. Each state’s rules governing telemedicine are different, but the applicable laws and rules are generally found in the state medical board’s rules, insurance codes, and when applicable, Medicaid rules. This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in Tennessee. This post does not discuss telemedicine prescribing rules or Medicaid rules. 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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Tennessee Rules

Telemedicine is authorized in Tennessee and the rules governing telemedicine are found in the Tennessee Code and Tennessee Rules and Regulations. Below is an overview of requirements currently in Tennessee governing the practice of telemedicine. Continue reading ›

Texas State Telemedicine Prescribing Rules

August 29, 2022 | Little Health Law

iStock-1014086596-1000x500-2-e1661804634296 Our healthcare and business law firm previously published a blog post on the federal telemedicine rules. Both Federal and State rules govern the provision of telemedicine. Each state’s rules governing telemedicine are different, but the applicable laws and rules are generally found in the state medical board’s rules, insurance code, and when applicable, Medicaid rules. This post focuses specifically on Texas’s telemedicine prescribing rules. Our firm previously posted an overview of Texas’s general telemedicine rules. 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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Texas Rules on Prescribing Based on a Telemedicine Visit

Texas’ rules governing telemedicine are found in the Texas Administrative Code and Texas Occupational Code. Below is an overview of some requirements currently in Texas governing the practice of telemedicine. Continue reading ›

Texas State Telemedicine Rules

July 8, 2022 | Little Health Law

how-telehealth-regulation-changes-are-making-care-more-accessible-722x406-1-e1657306723291 Our healthcare and business law firm previously published a blog post on the federal telemedicine rules. Both Federal and State rules govern the provision of telemedicine. Each state’s rules governing telemedicine are different, but the applicable laws and rules are generally found in the state medical board’s rules, insurance code, and when applicable, Medicaid rules. This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in Texas. This post does not discuss telemedicine prescribing rules or Medicaid rules. 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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Texas Rules

Texas’ rules governing telemedicine are found in the Texas Administrative Code and Texas Occupational Code. Below is an overview of some requirements currently in Texas governing the practice of telemedicine. Continue reading ›

Georgia State Telemedicine Prescribing Rules

July 7, 2022 | Little Health Law

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Our healthcare and business law firm previously published a blog post on the federal telemedicine rules and the general Georgia telemedicine rules. Both Federal and State rules govern the provision of telemedicine. Each state’s rules governing telemedicine are different, and there are specific rules around prescribing medicine from a telemedicine visit. A previous post provided an overview of Georgia’s telemedicine rules. This post focuses specifically on Georgia’s telemedicine prescribing rules. 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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Georgia Telemedicine Rules for Prescribing

The general restrictions on prescribing via telemedicine is with (a) pain management and (b) controlled substances. As such, if the requirements to allow telemedicine are met, the provider can prescribe any medically necessary medications therefrom. The restrictions come into play if those medications are controlled substances. Continue reading ›

Alabama State Telemedicine Prescribing Rules

July 1, 2022 | Little Health Law

blog-2-lede-photo-e1656706231616 Our healthcare and business law firm previously published a blog post on the federal telemedicine rules. Both Federal and State rules govern the provision of telemedicine. Each state’s rules governing telemedicine are different, and there are specific rules around prescribing medicine from a telemedicine visit. A previous post provided an overview of Alabama’s telemedicine rules. This post focuses specifically on Alabama’s telemedicine prescribing rules. 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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Alabama Rules on Prescribing Based on a Telemedicine Visits

A physician may prescribe medications via telemedicine so long as it would otherwise be authorized under applicable state and federal law. All telemedicine services provided must comply with all federal and state laws and regulations applicable to such services, including HIPAA, and the physician must take reasonable precautions to protect the privacy and security of all verbal, visual, written, or other communications involved therein. Ala. Code § 34-24-705. Continue reading ›

HIPAA Breach Primer: Part 3—Reporting to HHS

October 27, 2021 | Little Health Law

freestock_1383571985-scaled-e1635348607461 Welcome to the third and final post in our three-part HIPAA Breach series! In the first post, HIPAA Breach Primer: Part 1—The Risk Assessment, we provided an overview of HIPAA requirements and how to conduct a Risk Assessment to determine the risk that a HIPAA violation occurred. In the second post, HIPAA Breach Primer: Part 2—Patient Notification, we outlined requirements and considerations when the rules require patient notification.

This post explores the last step—reporting the breach to the U.S. Department of Health and Human Services (HHS). Note, this post and series do not address state privacy laws or attendant state notification or reporting requirements upon a breach. If you have questions regarding this blog post, conducting a HIPAA risk analysis, your reporting and notification requirements under HIPAA, or other privacy-related matters, 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.

Timing of Report

If the Risk Assessment revealed that a HIPAA breach likely occurred, the next step is to think about what notice is required. In addition to notifying impacted patients, the Covered Entity (or, in some circumstances, Business Associate) must report the breach to the Secretary of HHS. If a breach affects 500 or more individuals, the timing for reporting to HHS is the same as for notifying patients—without unreasonable delay and in no case later than 60 days following a breach.