Health Law

Traditional oriental medicine helps pets, CAM helps diabetic patients

Posted on October 11, 2010
News from the Gulf is that CAM practices help diabetic patients; more locally, yoga is scientifically shown to improve mood.Chiropractic gets a boost but consumers are advised to test the chiropractor's credentials first: Chiropractor Programs – a New Adjustment to Complementary Medicine October 7th, 2010 | Author: admin   Find Chiropractor programs in the United States and Canada...

Research validates (duh) that massage therapy works

Posted on September 27, 2010
The profession of massage therapy still has practitioner and facility licensure but has come a long way from the day when it was outlawed as prostitution or peep holes were required.I had read the massage in the workplace enhances creativity and productivity, but does it really work? Does a good massage do more than just relax your muscles? To find out, researchers at Cedars-Sinai Medical Center in Los Angeles recruited 53 healthy adults and randomly assigned 29 of them to a 45-minute session of deep-tissue Swedish massage and the other 24 to a session of light massage...

Telemedicine inroads from California to Canada

Posted on September 23, 2010
California is one of many states enacting laws for telemedicine and tele-health. The American Telemedicine Association meets with respect to health care reform: Based on current projections, ATA 2010, May 16-18 in San Antonio, Texas will, once again, be the largest meeting on telemedicine and telehealth ever held...

Does my outpatient clinic need a facility license?

Posted on September 20, 2010
Whether your health care clinic needs a special permit or facilities license in your state is a question of local law that varies greatly depending on the state. The answer is not always that obvious. In New York State, for example, there are numerous rules for incorporation of a "hospital," including New York Public Health Law Section 2801-a: § 2801-a...

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Round Up The Usual Disclaimers

Posted on September 17, 2010
I have modified one of the famous closing lines from Casablanca, "round up the usual suspects," to "round up the usual disclaimers." Basically, one of the essential skills of any health care law attorney or business lawyer is breaking down a business problem into the relevant legal issues, and then tackling the legal issues one by one in a thorough analysis that is clear and helps the client make a critical business judgment...

Major California Attorney General Opinions Involving Business & Professions Code Section 650

Posted on September 17, 2010
Is it kickback? A fee-split? (One client kept referring to this as "flea-spitting."  Sorry, it's fee splitting.)  Sometimes, in addition to reviewing statutes and cases, it's helpful to review opinions by the state attorney general...

California Prohibits Kickbacks and Fee-Splitting

Posted on September 17, 2010
California law prohibits fee-splitting and kickbacks, but it does allow payments based on fair market value that are not tied to patient volume.  The key is "B&P 650." California Business & Professions Code Section 650 states: (a) Except as provided in Chapter 2...

California Self-Referral and Related Laws

Posted on September 17, 2010
Like many states, California law contains prohibitions against physicians referring patients to health care entities in which the doctors have a financial interest.  California law does parallel Stark in part. It is relevant setting forth the entire statute to ensure no provisions apply to the client...

Telemedicine laws allow entry into neurophysiology

Posted on September 16, 2010
If you haven't heard of teleneurophysiology, know that the word tele is going to become as ubiquitous in health care over the next few years as the e- in e-prescribing.Telemedicine news: Feedback from service users will provide insight into opportunities for improvement so that performance can be optimised...

Disclaimer as to Uncertain Nature of Law

Posted on September 13, 2010
Here is the "disclaimer as to uncertain nature of law" for legal memos involving anti-kickback, fee-splitting and self-referral. The disclaimer incorporates language from a regulatory agency, because this language mirrors the uncertainty inherent in even the best legal advice concerning self-referral / Stark, fee splitting, patient brokering, and kickbacks...

Mini-Stark statute addresses self-referral legal issues

Posted on September 12, 2010
New York has its own "mini-Stark" law addressing referrals to health care entities in which the referring practitioner has an ownership or other financial interest. Section 238-a of NYS Public Health Law is sometimes referred to as 'mini-Stark' as it somewhat parallels the federal law by the same name...

Legal Rules Restrict Scope of Practice Boundaries in Acupuncture

Posted on September 12, 2010
Every state has legal rules that restrict practice boundaries (scope of practice) for non-medical health care professionals, such as acupuncturists, chiropractors, nurses and psychologists. Practitioners and health care entities have to ensure they do not run afoul of these scope of practice legal rules...

Group Exception to Kickback Prohibition Under State Law

Posted on September 12, 2010
Health care entities and providers should know that New York has a "group" exception to its statutory anti-kickback provisions. New York's Complex Prohibitions Against Fee-Splitting, Kickbacks, & Self-Referral               New York law actually contains three different legal rules prohibiting fee-splitting, kickbacks, and self-referral...

Sample Disclosure Form for Self-Referrals

Posted on September 12, 2010
New York provides a sample disclosure form for self-referrals under its administrative rules.Here is the form.  Note that under 34-1.5, the disclosure form below applies to referrals for services other than the designated health services (such as clinical laboratory services, etc...

Health Care Referrals for Designated Health Services Raise State Law Issues

Posted on September 12, 2010
States as well as the federal government can prohibit health care referrals for designated health services in exchange for financial compensation or other forms of remuneration, or where the referring person has an ownership interest.In addition to its "mini-Stark" statute in Section 238-a of the Public Health Law, New York (for example) has these regulations: New York State Codes, Rules & Regulations (NYCRR), Title 10 (Health)             Part 34, Chapter II, the Administrative Rules and Regulations of the NYS Codes, Rules & Regulations ('NYCRR'), Title 10, deals with Health Care Practitioner Referrals and Laboratory Business Practices...

Do percentage-based, revenue-sharing arrangements between a clinic and its health care practitioners violate Stark, antikickback and fee-splitting laws?

Posted on September 12, 2010
Many medical spas, health care clinics, integrative medicine facilities, and wellness facilities are asking whether sharing revenues with practitioners violates the law and puts them in legal jeopardy. The answer is complex, simply because it depends on: the actual compensation arrangement being proposed the application of federal law (including Stark and anti kickback rules) to the extent it applies and state law governing self-referral, fee-splitting, kickbacks, and patient brokering Federal law contains numerous exceptions to Stark and "safe harbors" under anti-kickback law...

Health Care Provider Licensing Laws Spell Out Who Can Practice

Posted on September 11, 2010
Some states, such as New York, spell out clearly who can offer health care practices and the legal definitions for and boundaries of these practices.Below is a list of some relevant New York state statutes: New York State Health Care Provider Licensing Laws ...

New York's Strong Corporate Practice of Medicine Requires a Professional Corporation for Professional Services

Posted on September 11, 2010
Corporate practice of medicine rules can be quite complex, and range from "strong" to "weak" doctrines.Here is some legal research on the corporate practice of medicine doctrine in New York state:   All states require a license to practice 'medicine' and make it a crime to violate this requirement...

Alternative therapies for mesothelioma; homeopathy certificates

Posted on September 02, 2010
Homeopathy certificate programs abound - though non-licensed homeopaths still face considerable legal pressures including risk of prosecution for unlicensed practice of medicine.Meanwhile, alternative therapies for mesothelioma are profiled:   In addition to these treatments, a number of therapies from alternative medicine may be able to reduce symptoms of mesothelioma...

Texas amends its telemedicine rule

Posted on September 02, 2010
The Texas Medical Board has amended one its significant telemedicine rules.Now: § 172.12, Out-of-State Telemedicine License. Renames Special-Purpose Telemedicine licenses to Out-of-State Telemedicine licenses and limits their scope to the interpretation of diagnostic testing and reporting results to a physician fully licensed and located in Texas or for the follow-up of patients where the majority of patient care was rendered in another state...

Telemedicine business huge abroad

Posted on September 02, 2010
Brazil, Russia, India, China are making huge gains in the telemedicine market.According to one report: Telemedicine Market in Brazil, Russia, India, China (BRIC) is expected to reach a market size of $418.4 million by the year 2014, at a CAGR of 15...

Telemedicine used on mobile phones to enhance health care

Posted on September 02, 2010
Physicians and patients are increasingly moving into telemedicine models of health care. Witness this recent report of telemedicine use via mobile phone:   The night before his fourth birthday, Rohan Giare of Rockville rolled off his bed and gashed the bridge of his nose...

Fee Splitting and Kickbacks continue to challenge physicians

Posted on September 02, 2010
Fee-splitting and kickback issues pose challenge for medical clinics and wellness centers that include non-physician providers such as nurses, psychologists, chiropractors, acupuncturists and massage therapists.There is a lot of guidance online, some helpful and some confusing...

Corporate practice of medicine, fee-splitting, and other legal issues in the aesthetic medical practice and medspa

Posted on August 11, 2010
If you're opening a medical spa or an aesthetic medical practice, watch out for lurking legal issues.Corporate practice of medicine, fee-splitting, anti-kickback and other legal rules can ruin your aesthetic medical practice, medical spa, cosmetic medicine business, or integrative medicine clinic...

Vegan lawyer almost vegan

Posted on August 04, 2010
Is vegan an orthodoxy or can one be almost vegan like almost famous?Here's a recent note I wrote:   I am only 60% vegan, I'm not sure it's like 50% orthodox, I just try to stay away from milk, butter, eggs, honey, leather as much as possible but I don't insist on it life is complex and the baseline of society with regards to animals is inexplicably cruel, it is about making the healthiest choices while staying balanced and sane...

Drafting legal contracts for medical spa and integrative medicine clinics to address kickback and fee-splitting issues

Posted on August 03, 2010
Many business owners think that handling Stark, kickback and fee-splitting issues in the medspa or integrative care clinic is simply a matter of drafting standard contracts for independent contractors or employees. And on the surface, drafting contracts seems like a simple matter: just draft, and review!!!  The problem is the cost of getting it wrong...

Featured client: inegrative medicine and healing arts spa in San Fran

Posted on August 02, 2010
Cavallo Point has introduced integrative medicine at its Healing Arts Center & Spa.The program was designed and is directed by our client, Bradly Jacobs, MD, MPH, founding medical director at the Osher Center for Integrative Medicine at the University of California San Francisco and former Senior Medical Director at Revolution Health...

Acupuncture demonstrated efficacious for back pain again

Posted on August 02, 2010
Once again researchers are proving that acupuncture helps with back pain.U of Maryland reports: New England Journal of Medicine Article Examines Current Research and Recommends Treatment for Case Study Back pain is one of the most common reasons people see a physician, with nearly three-quarters of people in Western countries experiencing back pain at some point in their lives...

Complementary regulation in Canada very mixed

Posted on July 29, 2010
Canadian health law is often as muddled as U.S. law when it comes to homeopathy and traditional oriental medicine.CMAJ reports a "hodgepodge" of regulation of CAM in Canada: As Ontario drafts standards of practice for homeopathy and traditional Chinese medicine, the debate continues across Canada over whether or not it's necessary to regulate complementary and alternative medicine...

Anti-kickback intent changed by health reform bill

Posted on July 29, 2010
The Patient Protection and Affordable Health Care Act makes it easier for the government to prosecute under the federal anti-kickback statute. This is an excellent write-up from attorney Greg Piche of Holland & Hart through his health care blog...

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