Physician Practices

Reducing the Negative Impact of Inaccurate NPDB Reports

July 23, 2021 | Little Health Law

D1432441-e1627053044153 Our 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@littlehealthlaw .com. You may also learn more about our law firm by visiting www.littlehealthlaw .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.

Georgia Medical Board May Monthly Meeting Minutes Review

July 16, 2021 | Little Health Law

iStock_000033418316_Medium-e1626470315777 Welcome 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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.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.

3 Options Healthcare Professionals Have to Form Professional Entities in Georgia

January 26, 2021 | Little Health Law

As a healthcare and business law firm, we have many clients who wish to not only practice medicine but own their own businesses. After developing a name for their business and generally new-practice-startup-01-1 outlining the mission and purpose of the business, the next step for our healthcare business clients is to determine what kind of entity they want to create. This post intends to generally outline three options in Georgia for healthcare professionals wishing to create an entity for the purpose of providing professional services.

Limited Liability Company

Although some states offer a Professional Limited Liability Company (“PLLC”) option, Georgia does not. Instead, the Georgia Code includes a caveat expressly allowing professionals to create Limited Liability Companies (“LLCs”) for the provision of professional services. Specifically, O.C.G.A. § 14-11-1107(f) states:

3 Facts About Pain Management Clinics in Georgia

January 19, 2021 | Little Health Law

As a healthcare and business law firm, we have many clients who participate in or wish to participate in pain management clinics. Pain management clinics are a controversial topic. Although image-1-8-300x200 useful when managed correctly, these clinics are widely thought to be part of the cause for the opioid epidemic. Georgia citizens suffered and continue to suffer from the opioid epidemic, but, in 2013, Georgia took a large step toward reducing the drug problem by enacting House Bill 178 (“HB 178”) known as the Georgia Pain Management Clinic Act. Before any of our clients become involved with a pain management clinic in Georgia, we immediately advise them of the following three facts.

The Role of the Georgia Composite Medical Board

HB 178 created a section in the Georgia Code placing pain management clinics under the purview of the Georgia Composite Medical Board (“GCMB”). As such, pain management clinics require registering and applying with the GCMB. The application requires providing information about each owner, principal, manager, agent, and licensed health care worker. The GCMB will review each person or entity and ensure each passes a background check and otherwise complies with the governing laws and rules. Once approved by the GCMB, the registrant will receive a pain management clinic license number. The GCMB strongly recommends not practicing in or operating a pain management clinic until receiving the pain management clinic license number.

Ringing in the New Year in Compliance with the Equal Pay Act

December 31, 2020 | Little Health Law

Welcome to the fifth and final of our business and healthcare law firm’s holiday-themed blog posts. We hope you have enjoyed this holiday season so far and have a great time ringing in the new new-years-eve-hero-300x300 year tonight. Happy 2021!

Many of our healthcare provider and healthcare business clients own their businesses and employ many individuals. Being an employer carries with it numerous statutory and regulatory obligations. As legal counsel, we often take the role of advising our healthcare employer clients on employment matters. Herein, we discuss the requirements placed on employers by the Equal Pay Act (“EPA”), which attempts to eliminate gender discrimination in pay.

At 29 U.S.C. § 206(d)(1), the EPA provides: “No employer having employees subject to any provisions of this section shall discriminate . . . between employees on the basis of sex by paying wages to employees in such establishment at a rate less than the rate at which he pays wages to employees of the opposite sex in such establishment for equal work on jobs the performance of which requires equal skill, effort, and responsibility, and which are performed under similar working conditions.” To avoid violating the EPA, it is useful to analyze what must be proven if an employer is accused of violating the EPA.

“The Theme I’ve Been Waiting for All My Life”: CMS’ Proposed Rule Promoting Electronic Access to Health Information

December 11, 2020 | Little Health Law

Welcome to the third of our business and healthcare law firm’s holiday-themed blog posts. This week’s post is inspired by my favorite holiday movie, A Christmas Story, and the eloquent words websiteshowart15167-300x300 Ralphie wrote: “A Red Ryder BB gun with a compass in the stock, and this thing which tells time.” Analyzing Ralphie’s literary genius, he gave Miss Shields three enticing facts: the main description, a vital component, and an interesting addition. Following suit, I will provide three enticing facts of CMS’ new proposed rule.

First, the shortened name of the rule is: “Reducing Provider and Patient Burden by Improving Prior Authorization Processes and Promoting Patients’ Electronic Access to Health Information.” According to CMS, the purpose of the proposed rule is “[t]o drive interoperability, improve care coordination, reduce burden on providers and payers, and empower patients.” The ingenuity of the proposed rule stems from the fact that it is not only designed to grant patients better access to their records; it is designed to grant all vital parties’ necessary access to records—meaning patients, payors, and providers.

Second, the new rule requires each payer to use an Application Programming Interface (“API”) that allows each payer’s system to communicate with other payers. The new rule also does not require patients to request the transfer of claims data. As such, a patient’s new payer will have access to all of his or her claims data almost immediately upon enrollment. Importantly, on the new API, payers can send “patient claims, encounter data, and clinical data directly to providers[].” Verma, Seema, Reducing Provider and Patient Burden and Promoting Patients’ Electronic Access to Health Information, CMS.gov (Dec. 10, 2020).

Let’s Talk Turkey…Considering Federal Age Discrimination Laws Before Reducing Your Healthcare Work Force

November 25, 2020 | Little Health Law

Welcome to the first of our holiday-themed (at least in title) blog posts. As we approach the holidays at the conclusion of a financially challenging year, cost savings may be on the minds of many index healthcare business owners. Healthcare employers may be considering—or have already considered—measures to save money and reduce payroll. 2020 was a difficult year for most businesses, and reducing payroll is an oft-appealing way to reduce expenses. Frequently, a business’s highest paid earners are also among the older employees. That fact prompts a look at the Age Discrimination in Employment Act of 1975 (“ADEA”) prior to making any employment decisions, such as eliminating positions.

For healthcare employers with 20 or more employees, the ADEA governs and makes it an unlawful employment practice to “discharge any individual or otherwise discriminate against any individual with respect to [her] compensation, terms, conditions, or privileges of employment, because of such individual’s age.” 29 U.S.C. § 623. The regulations create a protected class for individuals who are “40 years or older.” 29 C.F.R. § 1625.2. To be certain, the ADEA and accompanying regulations do not require preferential treatment of employees over 40, and “[f]avoring an older individual over a younger individual because of age is not unlawful discrimination.” Id.

An employee establishes a prima facie case of age discrimination by showing he or she “was (1) a member of the protected age group, (2) subjected to an adverse employment action, (3) qualified to do the job, and (4) replaced by or otherwise lost a position to a younger individual.” Johnson v. Unified Gov’t of Athens-Clarke Cnty., 209 F. Supp. 3d 1335, 1341–42 (M.D. Ga. 2016). The fourth prong, however, is generally not satisfied when it comes to position eliminations because the older employee was not replaced by anyone. See Mazzeo v. Color Resolutions Int’l, LLC, 746 F.2d 1264, 1271 (11th Cir. 2014). The law accounts for this by altering the fourth prong in “reduction in force” cases, requiring the employee to “present sufficient evidence from which a reasonable jury could find that the employer intended to discriminate on the basis of age through its employment decision.” Zaben v. Air Prods. & Chems., Inc., 129 F.3d 1453, 1459 (11th Cir. 1997). One such “method of establishing a nexus between age discrimination and adverse employment action is by statistical proof of a pattern of discrimination.” Pace v. S. Ry. Sys., 701 F.2d 1383, 1388 (11th Cir. 1983).

What Are Your Options When a Negative Reference Costs You a Job?

October 12, 2020 | Little Health Law

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 practice. 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

Georgia Schools and Businesses Post Warning Signs to Avoid Liability Under COVID-19 Pandemic Business Safety Act

September 2, 2020 | Little Health Law

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.

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.

Flattening the Curve Through Telemedicine

April 20, 2020 | Little Health Law

Telemedicine has new and profound importance due to the COVID-19 crisis. “Virtual” healthcare preserves patient protective equipment that would otherwi image_4-e1587393250939 se 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.