Archive for the ‘Health’ Category

Florida Medicaid EHR Resources

Friday, September 16th, 2011

Since Florida has recently opened up its registration for the Medicaid EHR Incentive Program, we’ve come across some good resources and wanted to share.  Here’s a few links:

Eligible Professionals

Eligible Professionals–“Getting Started”–a webinar presentation (.pdf file)

Things You Need to Register (.pdf file)

Eligible Hospitals

Overview for Eligible Hospitals–presentation (.pdf file)

Things You Need to Register (.pdf file)

 

At Matthews Law Firm, P.A., we practice health law.

CCHIT Certification

Friday, August 26th, 2011

By now, most healthcare organizations realize that if they want EHR incentive payments, their EHR software needs to be certified.  With the explosion of healthcare organizations shopping for certified EHR products, the certification process has become a frequently asked question.  Exactly HOW do EHR products receive their certification?  WHAT practice areas are eligible for certification?

The CCHIT Certified® 2011 certification program is one of two distinct programs of certification offered by the Certification Commission for Health Information Technology (CCHIT®):

  • CCHIT Certified® 2011
  • ONC-ATCB 2011/2012

On the most basic level, when CCHIT is inspecting a product for review, they are looking at three areas: functionality, interoperability, and security.

CCHIT currently offers certification in the following six areas, plus optional certifications in the subcategories:

1. Ambulatory EHR

  • Child Health
  • Cardiovascular
  • Behavioral Health
  • Dermatology
  • Clinical Research
  • Women’s Health
  • Oncology

2.  Inpatient EHR

3.  Emergency Department EHR

4.  Behavioral Health EHR

5.  Long Term & Post Acute Care EHR

  • Skilled Nursing Facility
  • Home Health

6.  ePrescribing

Enterprise Certification Option

For applicants offering EHR product(s) in three specific 2011 certification domains–Ambulatory, Inpatient, and Emergency Department–CCHIT offers an optional Enterprise certification.  To obtain the optional Enterprise certification, applicants will be required to execute the Enterprise Test Script that demonstrates interoperability and integration between all three domains.  It is important to note that if at anytime any of the 3 core Ambulatory, Inpatient, or Emergency Department certifications expire, are revoked, or suspended, the Enterprise certification option will also be expired, revoked, or suspended at the same time.

Resources

To read the current CCHIT 2011 Certification Handbook, which provides much more detail on the certification process, click here. (76 page .pdf file)

To see an example of the certification criteria for Ambulatory EHR, go here.  To see the criteria for the sub-specialty of Child Health, go here.

At Matthews Law Firm, P.A., we practice healthcare compliance law.

(Disclaimer: This post is not intended as legal advice nor does it create an attorney-client relationship.)

 

Florida’s New ‘Power of Attorney’ Law

Thursday, August 25th, 2011

Ever executed a Power of Attorney (POA), or are you considering having one done in the future?   Are you about to become the agent for someone signing a POA?  Either way, you’ll want to make sure the attorney drafting the form is aware of the new changes in Florida’s POA law.  The new POA law goes into effect October 1, 2011.

The new law can be found in Chapter 709, Florida Statutes.

Some of the new aspects of the law include:

  • Defining terms (such as “agent”, “durable”, “incapacity”, “power of attorney”, and others)
  • Changes WHEN some POA’s can become effective.  Springing Powers of Attorney are no longer valid.  (A Springing POA is one that does not become effective UNTIL the principal becomes incapacitated.)
  • Adds new provisions to deal with reimbursement and compensation.
  • Provides more detail on the duties of an agent, including mandatory duties that cannot be waived, and default duties that can be waived.
  • Clarifies the authority of agents.  An agent may only exercise the authority specifically granted in the POA and any authority reasonably necessary to effectuate the express authority granted in the POA.

The new POA law, although making some broad changes, left certain aspects of the law unchanged.  For example:

  • The execution of a POA is still the same.  The POA must be signed by the principal and by two witnesses and be acknowledged by the principal before a notary public.
  • The qualifications of the agent remain the same.  The agent must be a natural person who is 18 years of age or older, or a financial institution that has trust powers, has a place of business in Florida, and is authorized to conduct trust business in Florida.

(Disclaimer: This post is not intended as legal advice nor does it create an attorney-client relationship.)

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Meaningful Use for Eligible Professionals

Wednesday, August 24th, 2011

At Matthews Law Firm, P.A., we practice healthcare compliance law, including legal issues which arise with the EHR Incentive Program.  Some of those issues involve advising clients about EHR meaningful use requirements.

In Florida, Medicaid eligible professionals (EP’s) do not have to demonstrate meaningful use in their first payment year. They only have to demonstrate that they have adopted, implemented, or upgraded certified EHR technology.

In order for an eligible professional to receive payment in the second year of participation, they will have to attest to meaningful use of certified EHR for a continuous 90-day period. In subsequent years, the meaningful use reporting period is the entire calendar year.

What do EP’s have to do in order to show meaningful use?

To qualify for an incentive payment, EPs must meet 20 of the 25 meaningful use objectives identified by CMS.  There are 15 required core objectives an EP will have to show in order to receive incentive payments (starting with the 2nd payment).  The remaining 5 objectives may be chosen from the list of 10 Menu Set Objectives.

Resources

In Florida, AHCA has a great website which can help explain each of the core objectives of meaningful use. (Go about halfway down the page under the ‘Eligible Professionals’ subsection.)

For a chart which summarizes the meaningful use core objectives and measure sets, go here. (This is a useful chart because it links to each meaningful use objective and explains each one in detailed format.)

(Disclaimer: This post does not constitute legal advice nor does it create an attorney-client relationship.)

At Matthews Law Firm, P.A., we practice healthcare compliance.

EHR Incentive Programs

Friday, July 29th, 2011

With the exception of dually-eligible hospitals, providers can only participate in one of the EHR Incentive Programs—Medicare or Medicaid—each year.  This blog (with the assistance of some CMS resources) will outline key differences between the Medicare and Medicaid EHR Incentive Programs.

Eligible Participants in the Medicare EHR Incentive Program

  • Doctors of medicine or osteopathy
  • Doctors of dental surgery or dental medicine
  • Doctors of podiatry
  • Doctors of optometry
  • Chiropractors
  • “Subsection (d) hospitals” in the 50 states or DC that are paid under the Inpatient Prospective Payment System (IPPS)
  • Critical Access Hospitals (CAHs)
  • Medicare Advantage (MA-Affiliated) Hospitals

Eligible Participants in the Medicaid EHR Incentive Program

  • Physicians (primarily doctors of medicine and doctors of osteopathy)
  • Nurse practitioners
  • Certified nurse-midwives
  • Dentists
  • Physician assistants who furnish services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant
  • Acute care hospitals (including CAHs and cancer hospitals) with at least 10% Medicaid patient volume
  • Children’s hospitals (no Medicaid patient volume requirements)

Dually-Eligible Hospitals
If you represent a hospital that meets all of the following qualifications, you are dually-eligible for the Medicare and Medicaid EHR Incentive Programs:

  • You are a subsection(d) hospital in the 50 U.S. States or the District of Columbia, or you are a CAH; and
  • You have a CMS Certification Number ending in 0001-0879 or 1300-1399; and
  • You have 10% of your patient volume derived from Medicaid encounters.
Resources

(Disclaimer: This post is not intended as legal advice nor does it create an attorney-client relationship.)

Florida Medical License–Common Patient Complaints

Thursday, July 28th, 2011

At Matthews Law Firm, P.A., we practice health law and deal with medical licensing issues in Florida.  A common question we receive from those in the field is ‘What are the most common patient complaints filed with the department?’

Typically, when a patient files a complaint with the Department of Health, the reasons include one or more of the following (note: this is NOT an exhaustive list):

 

  • Quality of care
  • Misdiagnosis of condition
  • Substance abuse
  • Advertising violation
  • Unlicensed practice
  • Inappropriate prescribing
  • Sexual contact with patient
  • Insurance fraud
  • Misfilled prescription
  • Excessive test or treatment
  • Failure to release patient records
  • Impairment/medical condition
  • Patient abandonment or neglect

Usually, the department will not get involved with the following types of complaints:

  • Fee disputes
  • Billing disputes
  • Personality conflicts
  • Bedside manner or rudeness

Being aware of the most common patient complaints can help a health practitioner adhere to proper standards of care and better protect his or her medical license.

(Disclaimer: This post is not intended as legal advice nor does it create an attorney-client relationship.)

Florida Medical License–Disciplinary Action in a Nutshell

Wednesday, July 27th, 2011

If you practice medicine in Florida, then you know just how important your medical license is.  Your career and livelihood are attached to that medical license.

That is why doctors and physicians need to understand the regulatory process of what happens when the Department of Health receives a complaint.

The Regulatory Process in a Nutshell

Once a complaint has been lodged, the regulatory process begins.  Some parts of the process are confidential, while other parts are public record.  If a panel determines there is no probable cause to proceed, the complaint is dismissed.  However, if probable cause is found, then the licensee (the doctor/physician) will need to decide whether to contest the charges at an administrative hearing before the Board or to enter into a settlement agreement.  For a great flowchart of the process, go here.

Possible Disciplinary Action

Disciplinary action can include a reprimand, fine, restriction of practice, remedial education, administrative cost, probation, license suspension or license revocation.

Resources

DOH Complaint Forms (scroll over “Complaint Forms” to see the list.)

How Complaints are Investigated

How Complaints are Prosecuted

(Disclaimer: This post does not constitute legal advice nor create an attorney-client relationship.  If you are having medical license issues, please contact a qualified attorney to assist you.)

CMS Quarterly Provider Update

Thursday, June 30th, 2011

The CMS Quarterly Provider Update has been updated to include recently published instructions and regulations for the dates 6/14/11-6/30/11.

To view the page, go here.

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When Pressure Becomes Compulsion–the ACA & Medicaid Funding

Wednesday, June 8th, 2011

As this blog is being written, oral arguments are being held at the 11th Circuit Court of Appeals in Atlanta on the Affordable Care Act. Many of us are familiar with the most controversial part of the law, the health insurance mandate.  However, there are other parts of the ACA that are also being challenged.  One example is whether Congress is allowed to cut Medicaid funding to states that do not expand their Medicaid programs according to the ACA.

In its brief, attorneys for the states made the following argument:

The Supreme Court has repeatedly assured States and federal courts that there are outer limits on the federal spending power and that there is a point where federal spending programs become ―so coercive as to pass the point at which pressure turns into compulsion. South Dakota v. Dole, 483 U.S. 203, 211 (1987) (quoting Steward Mach. Co. v. Davis, 301 U.S. 548, 590 (1937)). Without such a limit, the federal spending power threatens the entire constitutional structure — Congress can commandeer the States to any degree or impose any command that does not violate an affirmative constitutional prohibition by the simple expedient of attaching it to a pre-existing pool of federal money too large to decline.

The states lost on this argument at the District Court level.  Judge Vinson ruled that because Medicaid was a voluntary program, there was no compulsion.

An interesting article in yesterday’s Wall Street Journal (by Richard A. Epstein & Mario Loyola) also argues that the Medicaid provisions in the ACA should be stricken:

And yet the government is comparing this Medicaid requirement to a “voluntary” contract.  Does anyone believe that a person is entitled “voluntarily” to continue his journey so long as he pays for all poor people who use the roads?  The government’s action is plainly coercive because it necessarily conditions the exercise of one right upon the conscious surrender of a second….The constant backdrop of the federal taxing power makes a mockery of the claim that state participation under ObamaCare is voluntary.  The only way to prevent this grave intrusion on state autonomy is to strike down the Medicaid provisions of the health-reform law.

The question we are left to answer is at what point does pressure turn into compulsion?

 

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PHYSICIAN ASSISTANT LICENSING

Friday, June 3rd, 2011

Are you a physician’s assistant?  Ever wondered where the licensing rules come from?  In Florida, the licensing rules that apply to physician assistants can be found at 458.347 (7).  To read the full statute, go here.

Basically, a physician’s assistant must be at least 18 years of age.  Also, you must pass an exam.  Third, you must complete the application form and application fee.  This application form includes a certificate of completion of a physician assistant training program, a sworn statement of any prior felony convictions, a sworn statement of any previous revocation or denial of licensure or certification in any state, and two letters of recommendation.

The license must be renewed every 2 years.  The renewal requires paying a renewal fee and a including a statement of no felony convictions in the previous 2 years.

(Disclaimer:  This post does not constitute legal advice nor does it create an attorney-client relationship.  If you are having licensure issues, please contact our office to discuss your situation.)