Little Health Law Blog
Our healthcare and business law firm works with many providers who wish to create an entity under which they provide professional nursing or physician services. Before providing professional services through an entity, it is important to consider your state’s laws and rules governing the provision of professional services. Florida, for instance, passed the Health Care Clinic Act (“Act”) in 2003 and has made many revisions thereto over the years. The purpose of the Act was to strengthen the regulation of health care clinics “to prevent significant cost and harm to consumers” by “provid[ing] for the licensure, establishment, and enforcement of basic standards for health care clinics and [] provid[ing] administrative oversight by the Agency for Health Care Administration.” Fla. Stat. § 400.990. This post addresses two key components of the Health Care Clinic Act: (1) what qualifies as a “clinic,” and (2) what exemptions are there to the licensure requirement? If you would like to discuss ways to structure your practice 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.
(1) What qualifies as a “clinic”?
According to Fla. Stat. § 400.9905(4), “‘Clinic’ means an entity where health care services are provided to individuals and which tenders charges for reimbursement for such services, including a mobile clinic and a portable equipment provider.” “Tenders charges for reimbursement” specifically refers to submitting claims to third-party payors (such as Medicare, Medicaid, or commercial payors). If the practice is cash-only and does not bill to any third-party payors, then the practice does not qualify as a clinic and thus does not need licensure under the Health Care Clinic Act. The Act also does not contemplate (i.e., specifically include or exclude) practices that only provide telehealth services, so it is important to consider with counsel whether a telehealth-only practice is considered a clinic under the Act.
(2) What exemptions are there to the licensure requirement?
Yes—there are 17 exemptions! It is important to review the exemptions to see if any may apply to a specific clinic. If the clinic owners are certain an exemption applies, the clinic does not technically have to submit for a license exemption; however, commercial payors may require a “Certificate of Exemption” from the Agency for Health Care Administration. Some key exemptions are as follows:
(f) A sole proprietorship, group practice, partnership, or corporation that provides health care services by physicians covered by s. 627.419, that is directly supervised by one or more of such physicians, and that is wholly owned by one or more of those physicians or by a physician and the spouse, parent, child, or sibling of that physician.
(g) A sole proprietorship, group practice, partnership, or corporation that provides health care services by licensed health care practitioners under chapter 457 of the Florida Statutes [(acupuncture)], chapter 458 [(medical practice)], chapter 459 [(osteopathic medicine)], chapter 460 [(chiropractic medicine)], chapter 461 [(podiatric medicine)], chapter 462 [(naturopathy)], chapter 463 [(optometry)], chapter 466 ](dentistry)], chapter 467 [(midwifery)], chapter 480 [(massage therapy)], chapter 484 [(dispensing of optical devices and hearing aids)], chapter 486 [(physical therapy)], chapter 490 [(psychology)], chapter 491 [(social work, counseling and psychotherapy services)], or part I [(speech-language pathology and audiology)], part III [(occupational therapy)], part X [(dietetics and nutrition practice)], part XIII [(athletic trainers)], or part XIV [(orthotics, prosthetics and pedorthics)] of chapter 468, or s. 464.012 [(advance practice registered nurses)], and that is wholly owned by one or more licensed health care practitioners, or the licensed health care practitioners set forth in this paragraph and the spouse, parent, child, or sibling of a licensed health care practitioner if one of the owners who is a licensed health care practitioner is supervising the business activities and is legally responsible for the entity’s compliance with all federal and state laws;
Fla. Stat. § 400.9905(4). Importantly, notwithstanding the exemptions, “an entity shall be deemed a clinic and must be licensed under this part in order to receive reimbursement under the Florida Motor Vehicle No-Fault Law, ss. 627.730–627.7405, unless exempted under s. 627.736(5)(h).”
If you would like to discuss properly structuring a health care services business 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.