Dental Lease “Use” Clauses Can Grow or Cripple a Practice

A “use” clause is a term in a dental lease agreement that defines how a provider can use the leased space. In other words, a use clause defines the activities one can undertake and what services one can provide in a leased space. A use clause will typically also define the landlord’s control over the use of the leased space and the consequences for failing to abide by the use clause. A use clause typically works together with an “exclusivity” clause.

Despite its importance, use language is often overlooked by tenants because tenants don’t think it has as great an impact as it does, or tenants don’t seek legal advice and come to understand its significance. As a tenant, it is critical to review use language. A broadly defined use clause can facilitate the growth of a dental practice. Whereas a narrowly defined use clause can cripple it.

Consider: You are a general dentist who has offered general dentistry services for many years. You see an opportunity to grow and expand your business by adding and providing new services. You’ve decided that you want to bring an orthodontist and cosmetic dentist into your practice so that your business can be a one-stop shop.

Which use clause will allow you to grow your business? Which use clause will stop you from expanding?

  •  “for oral health and any and all other related activities”

OR

  •  “for general dentistry only”

If your lease contains the second clause, your opportunity for expansion is severely limited. And, if you choose to expand your services anyway, your landlord could terminate your lease and seek damages for breach of contract, depending on the lease terms.

The moral of the story is: Don’t underestimate the importance of the use clause in your dental lease!

The Question of the Week: Who Owns Your intellectual Property?

intellectual property law

intellectual property lawBy: Steven Boyne

THE FRACTIONAL GENERAL COUNSEL

This question is a redundant question, if it is my intellectual property, then by definition – I own it.  True, but this question raises important issues that employers need to worry about – ownership of intellectual property.  The general rule is that if your employees create intellectual property while they are working for you, the employer will own it.  So, for example, if your office manager takes some pictures around the office and creates personal bios of your employees and puts that information on your website then you own that information.  However, what if they created that information at night while they were not at work and technically you were not paying them?  Well, now we are getting into a greyer area.  So, my recommendation is to avoid this issue, by updating your HR manual to state that you own the intellectual property, and not your employees. Continue reading

Can I Provide in-home or mobile IV Therapy?

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By: Chase Howard

IV hydration therapy has many applications and purposes. In the most common cases, the purpose is for post-surgery recovery or wellness optimization. IV therapy businesses that want to offer a more concierge type of service by offering mobile or in-home services, need to be aware of Florida home health agency laws and regulations.

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PLLC v. LLC: What’s The Difference?

healthcare business llc

healthcare business llcBy: Chase Howard

In most cases, the limited liability company, or LLC, is the preferred business structure for a wide variety of healthcare businesses. If you’re a licensed professional, you can also use the professional limited liability company, or PLLC for your healthcare practice or business. While generally these two entity types are the same, there’s a small difference to be aware of when organizing the company.

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Weave Compliance Into Your Practice For 2021

fhlf regulatory compliance

fhlf regulatory complianceBy: Jeff Cohen

A recent Department of Justice $500,000 settlement with a cardiology practice underscores the need for ensuring tighter compliance by medical practices.  There, the practice billed Medicare for cardiology procedures for which interpretive reports were also required.  Medicare paid for the procedures, but upon audit, CMS could not find the requisite interpretive reports.  The False Claims Act case settled for $500,000, but it’s likely that (1) the reimbursement by Medicare was far less, and (b) the legal fees behind the settlement weren’t too far behind the settlement amount!  Had the practice self-audited each year, would they have found the discrepancy?

Medical practices have felt the weight of price compression and regulatory load more than probably any segment in the healthcare sector.  They are doing far more for far less.  And regulations expand faster than viruses!  Hence, many have a strategy of regulatory compliance that can best be characterized as a combination of facial compliance (“We bought the manual and put it on the shelf”) and hope (“They’re not really serious about this, are they?”).  Unless you’re part of a practice of more than 20 doctors, it’s likely that you can do more to ensure regulatory compliance.

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Forward Looking: How to Prepare for 2021

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We’ve all learned a lot in 2020, but are we prepared for what 2021 will bring? The change of the calendar won’t make the pandemic go away, but you can prepare your medical practice.

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Tips For Chiropractors Integrating Their Practices

fhlf chiropractor integration tips

fhlf chiropractor integration tipsBy: Jeff Cohen

Inspired by many medical integration consultants and coaching organizations, chiropractors have vigorously pursued medically integrating their practices in the past handful of years.  Led by both the desire to provide effective healthcare solutions and to capture more of the healthcare dollar that their patients are already spending (elsewhere), chiropractors are smart to consider it…slowly!

Too often, there are stories of chiropractors who felt both excited and pushed to sign on the dotted line at integration seminars, only to find later on that (1) the advice they got upset their lawyers, (2) they didn’t understand the complexities and risks that accompanied their practice expansion, and (3) it didn’t work!  What are some of the greatest areas of disappointment for those where the integration didn’t go smoothly?

A. Using integration to fix an underlying business problem. For instance, if you’re medically integrating your chiropractic practice because your chiropractic patient volume has fallen off, first try to understand why your core business is down.  For instance, do you actively pursue marketing?  Is it effective?  What about someone inside your organization who is responsible for sales?  Do you have someone comfortable offering what you provide and talking money? Since it’s typical for medical integration patients to come from your core chiropractic business, a down chiropractic business will not deliver the patients needed to support a robust medical integration line of services and products; and

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Patient Brokering & Money Laundering: Bieda Arrests Raise Serious Issues

patient brokering arrest treatment center toxicology lab ownership

patient brokering arrest treatment center toxicology lab ownershipThree family members involved in owning an addiction treatment center and/or a toxicology lab were charged in July with patient brokering and money laundering in an alleged scheme involving roughly $2 Million.  The allegations arise out of a complex corporate enterprise involving at least four companies and some common ownership between the treatment center and lab.  While it’s premature to assume that the defendants did anything illegal, there are some interesting things in this case:

Complexity Invites Suspicion.  Every business owner in the addiction treatment and toxicology lab space knows three things:  (1) it’s extremely regulated, (2) law enforcement has an especially sharpened focus on these industries, and (3) insurance companies are very suspect of any situation involving either industry, especially when there is any common ownership.  So why then would one construct an enterprise that even “looks” complex or tricky?  It intensifies suspicion in an already highly scrutinized business space.  This is clearly one of the points of focus in this case.  There’s an old saying woven into the mind of every experienced healthcare lawyer:  if something can’t be done directly, it can’t be done indirectly.  Time will tell if anything in this case was wrong or if there are any good reasons for the corporate structure, but the complexity of the corporate structure certainly invites suspicion. Continue reading

You Don’t Know What You Don’t Know – Acupuncturist Employment Contracts

acupuncture doctors floridaBy: Chase Howard

Thinking about joining an integrated or group practice? The average employment contract exceeds twenty pages, not including exhibits. While some parts might seem simple and non-legalistic, many simply do not contemplate important terms that have serious impacts on Acupuncturists daily lives. An employment contract is the most significant financial decision of an Acupuncturists lifetime. The same can be said for each subsequent contract, which means that understanding, and negotiating, your contract is the most valuable investment you can make prior to entering into a contract.

To understand what’s in your employment contract, simply read it over a few times. To understand not only how those terms affect you, but also what isn’t in your contract, hire an experienced health care lawyer. While it’s important to understand what is in your employment contract, it’s equally as important to know what is missing from the contract and what to ask in regards to what is included. The below list considers terms that are important both during and after employment.

The following are nine items you should consider including in or asking about your contract:

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Lease Considerations – Acupuncture Practices

real estate lease for medical building

real estate lease for medical buildingBy: Chase Howard

Reviewing a lease prior signing will save you extreme headache and cost in the long run. Landlords tend to act as if they have all of the power in negotiations and will make their own rules along the way. Lease negotiations are complex and involve significant business and legal considerations.

Here are guidelines to ensuring that your lease is reasonable and fair:

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