Florida Healthcare Business Operations

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Healthcare clinics provide a service to the community, but at their core, they are also businesses.

Businesses that are poorly run will soon find themselves in trouble: losing money, facing sanctions due to non-compliance with state and local regulations, and ultimately filing for bankruptcy.

At Florida Healthcare Law Firm, we help healthcare businesses improve their operations, creating standards of practice that support their day-to-day operations at all levels and help ensure ongoing harmony with federal and state statutes regarding healthcare practice.

What Are Healthcare Business Operations?

Healthcare business operations include all the functions that happen throughout the day and on a weekly, monthly, or annual basis that contribute to the financial and legal health of the institution.

This is a broad definition, but the truth is that business operations in healthcare clinics encompass a range of practices from the medical care itself to management of the backend of the business to management of human resources.

The categories included in healthcare business operations generally are as follows:

  • Administrative operations
  • Financial operations
  • Legal management
  • Quality improvement

For most healthcare businesses, this is just a starting point, however, as more categories will be added based on the offerings and services provided by the business. For example, if patients are treated in person on site, categories will be added that support best practices for medical and patient care.

Do We Need a Business Operations Manual for Healthcare Clinics?

There are documents designed to support healthcare clinics and other healthcare businesses in creating standards of practice that help them, but it is generally necessary for healthcare businesses to create their own business operations manual.

While some statutes, regulations, and industry standards apply across the board, most healthcare businesses, especially clinics who work directly with patients, will require very specific actions in order to protect patient data and provide the best possible medical care.

In most cases, it is recommended to begin the process of building a unique business operations practice by looking at available manuals. Know that the process will not be complete until it has been thoroughly vetted by a professional who knows and understands the expectations for that particular business.

Florida Healthcare Law Firm Supports Healthcare Leaders in Business Operations

At Florida Healthcare Law Firm, we make it our business to keep up with ever-changing standards and regulations in the state of Florida and at a federal level that impact healthcare clinics and businesses.

We can help you to create and implement business operations and standards of practice that support a thriving healthcare business or clinic and the professional growth of all involved.

If, for some reason, there is already litigation underway due to a breach of statutes or regulations, we can assist with correcting this situation and helping to prevent a recurrence.

Contact Florida Healthcare Law Firm today for a consultation.

Arbitration in Healthcare

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Healthcare arbitration agreements are increasingly common in Florida, as they are across the country. In fact, they are popular across a number of industries in which malpractice or other legal complaints can be frequent, frivolous, and cost-prohibitive to the business providing the service.

Should you include a medical arbitration agreement form in the stack of paperwork that you give to new patients?

What Is an Arbitration Agreement in Health Care?

Simply, an arbitration agreement in the context of health care provision is an agreement that a patient would sign stating that before they would bring any alleged malpractice or legal claims to court, they would first agree to sit down to arbitration, the results of which would be binding to all parties.

Arbitration generally includes the patient (or the plaintiff) and the health care organization or medical profiler (also the defendant) as well as a neutral third party. The three parties work together to share information and come up with an equitable solution. Because of the arbitration agreement, that solution would be binding to all involved.

Why Would an Arbitration Agreement Be Good for a Medical Provider or Healthcare Organization?

Medical malpractice suits are a woeful reality in the healthcare industry, and many medical personnel and healthcare organizations suffer financially when patients bring frivolous and/or unfounded lawsuits in the hopes of a quick payout.

The truth is that it is often cheaper to write a check to end litigation even if there is little to no cause than it is to fight it out in court. Because few medical providers want to go through the bitter experience of paying money when there is no actual medical malpractice, many are starting to require that all patients sign an arbitration agreement in advance of care.

Do Arbitration Agreements Remove the Risk of Medical Malpractice Court Cases?

No. Nothing is bulletproof when it comes to contracts. While an arbitration agreement may be able to stop most potential medical malpractice claims before they go to court, protecting all participants’ privacy in the process, there is still the possibility of the issue going to court.

This may happen if:

  • There is an ongoing and legitimate issue or a class-action case that cannot be fully addressed in arbitration, AND
  • The agreed upon solution in arbitration is not fair or equitable to the patient OR
  • An agreement cannot be reached during the course of arbitration despite best efforts.

The case may or may not be thrown out of court based on the arbitration agreement, but it doesn’t necessarily stop someone from trying to take the case to the next level.

Should I Include an Arbitration Agreement in My Required Forms?

An arbitration agreement is always a good idea, but like all contracts, it is only as strong as its wording and scope. Contact Florida Healthcare Law Firm today to set up a consultation and create a strong medical malpractice arbitration agreement that is right for your business and your needs.

Facebook Advertising No-No’s for Healthcare Businesses

Amanda Howard, Esq.

Facebook has a long list of things it doesn’t allow to be posted. While some things are obvious, others are not. And what gets flagged may be confusing to posters. That’s not surprising, as Facebook is known for using bots to review ads for denial or approval. The problem with using bots is that bots may flag suspicious information, and only a human can understand the true context of it. Fortunately, if you appeal a decision to deny your ad, Facebook will usually allow for human review. To bypass this and just for better practices, before your practice or business posts an ad on Facebook, be aware of what’s not allowed on Facebook to lessen your chances of being denied:

  1. You generally can’t talk about drugs. Illegal drugs are an absolute no-no, and so are prescription drugs. Talk about over-the-counter drugs is subject to strict guidelines.
  1. Facebook blocks “adult content” and “adult products and services.” Facebook has rejected ads related to sexual health issues, including reproductive health products/services, in some instances with good reason and others not. This is a situation in which making sure a bot isn’t the final decision-maker is important. 
  2. Facebook blocks “unsafe substances,” including anabolic steroids, DHEA, Ephedra and human growth hormones. While some of these substances are illegal, others, like DHEA, are not and help produce hormones which some individuals may medically need.  
  3. Facebook blocks “negative ad experiences,” meaning ads can’t draw attention to beauty or health conditions as such wording or imaging may create unexpected experiences.
  4. Facebook blocks sensationalized language and language bait. Be wary of posting ads that say things like “7-ways to change your life” or “5 ways to cut 1 lb a day.”
  5. Facebook also blocks personal attributes, such as an ad that talks about physical or mental health or condition. Stay away from wording like “Have you been diagnosed with cancer? Come to our clinic for treatment.”

Get Help

As a boutique law firm dedicated to supporting the healthcare community, our goal is to help healthcare professionals and businesses comply with all laws so that they can be safe in their profession and practices.If you would like to learn more about advertising as it relates to your practice or business and get advice on how to proceed, contact us at Florida Healthcare Law Firm to set up a consultation today.

Zoning & Use Issues For Healthcare Practices

Amanda Howard, Esq.

If you’re thinking about starting your healthcare practice from the ground up or purchasing an established practice and its real estate, zoning and use issues should be on your mind. It’s critical to understand what activities are allowed to be done, and perhaps more importantly, what activities are NOT allowed to be done on your soon-to-be property and the restrictions your building may be subject to. To figure these things out, you can research appropriate building codes and zoning information on your county’s property appraiser website and use interactive maps or obtain a zoning report or request a letter from your local planning and zoning office, which will summarize existing code requirements and highlight areas of potential non-compliance. In cases where a particular zone does not permit healthcare facilities, a zone change may be possible (but that’s a topic for another time).

Some questions that are important to ask in determining whether a particular property is suitable for your practice are as follows:

  1. Is zoning impacted by county or city regulations?
  2. What is your type of practice defined as under county or city zoning regulations?
  3. Which districts or areas permit your type of healthcare practice?
  4. Must your practice be outside of residential areas?
  5. Is your practice limited to a certain amount of square feet?
  6. Is your building subject to certain aesthetic requirements?
  7. Is there a setback requirement for your building?
  8. Can the services you provide only be provided during certain hours?
  9. How much parking is your practice allotted?

These questions may never cross a buyer’s mind. However, not knowing their answers and others may cause a major headache during the closing process and potentially even kill a deal to purchase a property. That’s why it’s important to get advice from a professional.

Get Help

As a boutique law firm dedicated to supporting the healthcare community, our goal is to help healthcare professionals comply with all laws so that they can be safe in their profession and practices.If you would like to learn more about zoning and use issues and get advice on how to proceed, contact us at Florida Healthcare Law Firm to set up a consultation today.

Holistic Dentistry – What is it and what’s happening in the industry?

Holistic, or Biological, Dentistry is dentistry that takes a whole-body approach to oral healthcare. This type of dentistry emphasizes prevention and conservation through lifestyle changes and non-pharmaceutical treatments. It discourages early invasive surgeries, mercury, fluorides, and other “toxins”. Biological dentists may be members of the International Academy of Biological Dentistry and Medicine.

Biological dentistry focuses on a mouth-body connection, rather than just simply treating the explicit issue a patient may face. Biological dentistry focuses on reducing inflammation, stress, and non-natural products while emphasizing whole body wellness.

What principles identify biological dental practices?

  1. Mercury-free and mercury-safe
  2. Fluoride-free
  3. Focus on whole-body health
  4. Chemical free whitening
  5. Focus on prevention
  6. Most natural and least invasive
  7. Avoids root canals
  8. Biocompatibility testing for dental materials
  9. Emphasis on nutrition and nutritional counseling
  10. Ozone therapy

How does holistic dentistry differ from traditional dentistry as it pertains to the law? Not at all, in reality. The practice of holistic dentistry is governed by the Florida Board of Dentistry still and all such laws and regulations apply, including Florida’s prohibition on the corporate practice of dentistry (I.e., the ownership of a dental practice by a non-dentist).

The same applies to entity selection – licensed dentists can choose to operate under a “PA” or PLLC”.

You could also add on additional services to your dental practice that might be considered medical, so long as you engage the appropriate licensed providers to deliver those services. For example, While most medspas provide full body aesthetic treatments, Dentists are limited to providing treatments that are with her or his scope of practice. For example, Botulinum Toxin-A may be prescribed by a dentist, but is limited to the face and neck of patients. This also means that for nurse practitioners working under the supervision of a dentist, they too are limited in practice. While certain other treatments don’t require any specific medical license or training, dentists should evaluate the type of treatments they wish to provide or supervise to ensure it is within their scope of practice.

The growth and acceptance of biological dentistry is going to continue to expand and dentists should position themselves to incorporate these practices in into their practice as they look to grow and possibly sell in the future.

What Is a Certificate of Good Standing in Florida?

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A Florida certificate of good standing is a piece of paper that provides proof that you are doing all the right things in your business according to the state.

Officially known in Florida as a Certificate of Status, this PDF document can be submitted to companies you work with in other states to let them know that you do exist, are up-to-date on all your fees and licenses, owe no taxes, and are legally allowed to do business.

While this is not a requirement in the state of Florida, it is not difficult to obtain and can lend credence to your standing in the healthcare field, especially if you hope to enter into partnerships with other healthcare companies in Florida or out of state.

A Certificate of Status can also be helpful as you set up a business bank account in the state of Florida, especially if your business is new and has little documentation to show that it exists.

How to Get a Certificate of Good Standing in Florida

Getting a Florida LLC certificate of good standing or a Florida corporation certificate of good standing is a simple process that can be completed entirely online as long as you have a credit card or debit card to pay the fees associated with processing the document.

To begin, you will need to find your 6-digit or 12-digit document number. This number is connected to your business registration in the state of Florida and helps them to determine that you are in fact a legitimate business registered in the state.

To find your document number, go to the Florida Secretary of State’s Division of Corporations page and enter the legal name of your business in the search bar under “Search for Corporations, Limited Liability Companies, Limited Partnerships, and Trademarks by Name.”

With your credit card or debit card and your document number, you will go to the Florida Department of State website and click the button that says “Order a Certificate of Status.”

Next, you will do the following:

  • Enter your 6-digit or 12-digit document number when prompted.
  • Provide your email address in the appropriate block.
  • Pay for the fees associated with obtaining a Certificate of Status in Florida.
  • Look for an email in the next week from the Department of State that includes a PDF of your Certificate of Status.

It could take up to 7 business days to process, so if you require a more rapid turnaround, you will need to file in person, which will allow you to get a copy of your Certificate of Status that day.

Problems With Securing Your Certificate of Status?

If you are struggling with getting your Certificate of Status in the state of Florida, contact us at Florida Healthcare Law Firm for assistance.

No Surprise Act AKA Good Faith Estimates

The Centers for Medicare & Medicaid Services (“CMS”) effective January 1, 2022 has ramped up the new No Surprise Act (“NSA”) or often called the “Good Faith Law”. This law shall apply to group health plans, health insurers, health care providers and health care facilities (“Providers”). The NSA requires health care providers to be proactive and reactive as it relates to providing patients who are self-pay or shall receive out-of-network bills from their health insurance a pre-bill outlining the services they are intending to receive and could potentially receive.

Self-Pay

Self-Pay patients apply to a wide range of medical providers; therefore, the importance of this law is crucial for providers accepting cash patients. The provider will be required to transmit to patients itemized disclosures of the services offered at the facility, these disclosures are called “Good Faith Estimates”. A Good Faith Estimate will include various detailed terms that a patient must have upon request, or a provider will be required to inform a patient that said estimate is available to them when inquiring about services. The disclosure will be required at the front desk and on the providers website.

Out-of-Network

If a provider treats patients who have insurance coverage and is not in network with said insurance plan, the provider is subject to and will have to abide by the NSA.

The driving complaint by patients that lead to the institution of the NSA was surprise medical bills, which are essentially caused by balance billing. Balance billing occurs when a provider bills an amount or difference not covered by an insurance plan. Under the NSA, providers will have to implement the proper disclosure requirement of this practice, which must be presented to patients prior to the treatment. Providers will be required to obtain notice and consent forms signed by patients authorizing any additional billing not covered by the out-of-network coverage prior to providing said treatment.

Does Not Apply To

The NSA will not apply to vision or dental insurance plans which are solitary plans. However, if the vision and dental is an added benefit to a health plan it will be covered. The NSA will not apply to balance billing practices for those in the ground ambulance business. Providers who service Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE shall not apply to NSA.

Penalties for Non-Compliance

A patient shall be allowed to dispute any bill charge in excess of $400 personally or through an independent third party, a “dispute resolution entity”, which shall determine the amount owed by the patient. An email shall be sent to the provider stating that a dispute has arisen, and the provider will be required to upload certain documentation surrounding the dispute. During a dispute resolution period, providers will not be allowed to move the bill into collection or threaten collection, if collection is already ongoing it shall be paused, late fees on the unpaid bill shall not be collectable, and any threats of retaliation against the disputing patient shall not be permitted. However, providers shall have the option to settle the claim with a patient directly abiding by the above, upon executing a settlement form. Failure to adhere to the NSA shall result in penalties up to $10,000 per violation.

Selling Your Practice – Dental

selling a healthcare business

After years of practice, its time to plan for the next step in your career. Whether that be immediate retirement or a short transition, preparing early on can not only maximize the value of your practice but can help set expectations of the buyer early on to ensure a smooth transition.

Selling your dental practice requires you to give up something that you’ve spent years building, including relationships with patients and staff. For many, it’s a big component of their retirement plan. For others, it’s a slower route to full-time retirement.

What should you consider leading up to listing your practice for sale?

  1. Financials – the purchase price tends to be the most important item for sellers. Months before you even sell, it’s important to get with your practice accountant or advisor to begin to run numbers. One key overlooked item is for practice owners that own the practice real estate. Many dental practice owners pay rent to their real estate company at a rate far below fair market value. When it comes time for a buyer to evaluate, they see that the practice is producing higher numbers and paying low rent, which might lead to a higher practice price, but in turn leads to a much lower rent for years to come.
  2. Understanding the transaction – there are two types of buyers: large groups (i.e., private equity, DSOs) and individual doctors. A sale between two individual doctors can sometimes mean less paperwork, lower purchase price, and limitations based on the buyer’s lender. Individual buyers do not have endless cash to pay over and above what the practice is valued it. Lenders can also create limitations on how much the buyer can spend on the lease, employees, and the seller’s employment compensation throughout a transition. Usually, those transitions are less of a time commitment for the seller after the sale. For large groups, they can usually spend significantly more than what the practice is “valued” at. They also have more wiggle room with other expenses. The trade off, however, is the requirement for transition services for a longer period, which usually includes a “holdback” of a portion of the purchase price in exchange for a minimum amount of time spent “transitioning” the buyer into the practice. These larger groups tend to require significantly more in the way of legal documents (longer purchase agreements, corporate documents, leases, employment documents). On average, prepare for a three to six month process (and many times longer) for the sale to finalized. If real estate is being purchased as well, that could expand the time frame. It’s key to include your professional team early on in order to prepare and avoid too many delays.
  3. Think about what you want – money is an easy choice but choosing a practice buyer that fits as many of your needs and desires sometimes is more important and leads to a smoother transaction. If the buyer isn’t giving you what you want, then the purchase price might not be the most important piece of the puzzle. Make a list about what you desire for employment after the sale, what your property might be leased for, what you want as far as receiving value in the purchase price (all cash, cash plus equity in the buyer, etc.).

Selling your practice is a huge part of your career. Preparing early on – months before you seek a buyer – will help tremendously in ensuring you find and match with the right buyer.

What Is the Good Samaritan Act?

A Good Samaritan is someone who stops to help a stranger in crisis simply because that person is in need.

In the past, when a healthcare professionals attempted to provide medical assistance to someone in a crisis, they put themselves at risk of litigation. Should the person they assisted decide that they don’t like the outcome of that help or they didn’t want it, they had the option to sue for damages.

With the passing of the Good Samaritan Act, medical professionals are now protected from litigious strangers and can feel free to assist when needed.

What Is the Good Samaritan Act?

The Good Samaritan Act is a piece of Florida legislation that protects medical providers from the consequences of their assistance should they stop to provide a stranger with medical care outside of a medical setting and without access to medical equipment.

For example, this means that if a medical provider is at a restaurant and someone has a medical emergency, they can step in and respond with medical care to the best of their ability until an ambulance arrives.

If the worst occurs and the patient does not have a positive outcome, the off-duty medical provider who assisted is not liable.

Are There Any Exceptions to the Good Samaritan Act?

Yes, there are a few, but not all are clearly defined. The first is that if a patient refuses medical care or help, the medical provider cannot continue. This is true in the medical setting as well, but it is only applicable when the patient is conscious.

Within the Good Samaritan Act, it also states that a medical professional who is off duty cannot be held liable for acting or not acting in response to a crisis as long as their choices would have been made by any “ordinary, reasonably prudent person.”

This is where the lines get hazy. One person’s definition of a reasonably prudent response may not be in agreement with someone else’s response. This means that it is possible for a medical provider to face charges if it is deemed that their attempt to help was not something that a reasonably prudent person might do to assist.

What if I Am Being Sued?

If you are a medical practitioner and facing a lawsuit based on your attempted treatment and care of a stranger outside of the medical setting, you have the option to respond. If you feel that the lawsuit is malicious or unfounded, contact Florida Healthcare Law Firm today to discuss how to respond, when to respond, and how to protect your career and your reputation in the process. We’re here to help make sure that you get the justice and support you deserve.

What Are the Marijuana Laws in Florida?

medical marijuana practice dispensary physician

Though many states across the country have chosen to decriminalize marijuana or make it legal for recreational use, the federal government still classifies it as a Schedule I substance with a high potential for abuse and without any accepted medical use.

Florida has chosen to step outside of the federal mandate by allowing for medical marijuana use across the state, but it has made no legal changes to decriminalize the drug in any way.

This means that healthcare professionals across the state need to be careful about the current rules and regulations around obtaining a medical marijuana card as well as what the penalties are for possessing more than is legally allowed.

What Are the Medical Marijuana Card Laws in Florida?

When it comes to obtaining a medical marijuana card, Florida medical marijuana laws are simple. To get a card, one must be diagnosed with a condition that is or is like AIDS, cancer, epilepsy, ALS, Crohn’s disease, Parkinson’s, MS, glaucoma, or other disorders that are characterized by high anxiety, chronic pain, or another symptom that has been shown to be managed by the use of any part of the marijuana plant.

There is also such a thing as a caregiver card. This card is given to someone who is not in need of medical marijuana personally but is allowed to purchase and carry the drug on behalf of someone who does have a medical marijuana card and may not be able to procure the drug themselves.

What Other Laws Does Florida Use to Manage Medical Marijuana Use?

Those who hold a medical marijuana card or caregiver card may possess up to 4 ounces of marijuana at any given time, but no more.

It is illegal to use marijuana in any public place unless it is a low-cannabis form or edible.

Despite holding a medical marijuana card, Florida law stipulates that it is still illegal to use or possess marijuana recreationally.

It is also illegal to possess more than the 4-ounce maximum.

What Are the Penalties for Breaking Florida Marijuana Laws?

Depending on the amount of marijuana in a person’s possession and whether or not they intend to sell the substance, the individual could get anywhere from 1 to 30 years in prison and up to a $200,000 fine.

Doctors who are found to be distributing medical marijuana cards without the proper certification or when it is not medically necessary can also face steep legal punishments, including fines, incarceration, and losing their ability to practice medicine. If you are facing charges of violating Florida medical marijuana laws while working as a medical provider, contact Florida Healthcare Law Firm to learn more about your options.