georgia corporate practice of medicine

(Business & Professions Code 2052 and 2400.). Its servants, though professionally trained and duly licensed to practice, owe their primary allegiance and obedience to their employer rather than to the clients or patients of their employer. Reg. While medical practice allows nurses to perform certain procedures, that doesn't mean a doctor can be relieved of their responsibilities. This is typically accomplished by a management services agreement between the Professional Medical Corporation and MSO. Subsequent case law is sparse and other authorities provide limited guidance on the applicability of the CPOM doctrine. Private equity and other non-doctor investment in U.S. healthcare has grown significantly over the past decade thanks to investors who have been keen on getting into a large market with potentially high returns. For example, in Georgia: All this suggests that Georgia has a strong prohibition against Corporate Practice of Medicineat least for the moment, as these legal rules can be in flux. Advantages to Allowing the Corporate Practice of Medicine. _______________________________________________. Further to the guiding/ non-exhaustive lists provided above, in these cases, there must be a clear distinction between who is providing professional services and who is providing the management services. State law prohibitions against corporate practice of medicine come in to flavors: The distinction between the strong and weak versions can be particularly important when designing an MSO (management services organization) structure. As we noted, whenever you find Corporate Practice of Medicine concerns, youre likely to also find state law prohibitions against fee-splitting, kickbacks, conflict of interest, patient exploitation, and so on. InNeill, the Pennsylvania Supreme Court ruled that a corporation is prohibited from engaging in the practice of optometry and may not employ optometrists for the rendering of such services to the public. However, two more recent cases applying Pennsylvania law (albeit by non-Pennsylvania courts), further caution about the structure of these private equity (or other non-licensed entities or people) and medical and dental arrangements. The American Health Law Association (AHLA) Corporate Practice of Medicine survey more thoroughly examines the variation of practice restrictions by each state as they relate to behavioral health providers, chiropractors, and other types of health care professionals. Medical Groups, Medical Centers Because of the limitations of the weak Corporate Practice of Medicine model, for some healthcare ventures, it makes sense to use one modelbased on the strong version of Corporate Practice of Medicineacross states. As a general breakdown, the following states follow the CPOM: Arizona Arkansas California Colorado Connecticut Georgia Illinois Indiana Iowa Kansas Kentucky Louisiana Maryland Massachusetts Michigan Minnesota Montana Nevada New Jersey New York North Carolina North Dakota Ohio Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Washington West Virginia Wisconsin. The corporate practice of medicine doctrine (CPOM) is a complex ruling that can easily result in legal problems if not followed accordingly. Review the organizations application for recognition as an organization exempt under IRC Section 501(c)(3). Because providers are often paid separately for their services in the current fee-for-service environment, there is little need for the exceptions related to management, organization, or fee-splitting. Ask the Parent of the applicant to provide the following written representations: The Parent's SCA with the physician shareholder is enforceable at law and in equity., The Parent will not suffer or permit the physician shareholder (together with all successors, heirs and assigns of the physician shareholder and all subsequent designees holding the corporation's stock) to financially benefit in any manner, directly or indirectly, from the physician shareholder's legal ownership of the stock of the corporation as the designee and fiduciary of the Parent., The Parent will expeditiously and vigorously enforce all its rights in the shareholder control agreement and will pursue all legal and equitable remedies to protect its interest in the assets and stock of the corporation., Carefully review all organizational documents. Seeking the advice of knowledgeable and experienced professionals is imperative before taking any such steps. 43-34 and 34A) is the statutory authority (law) that establishes the Georgia Composite Medical Board, the Medical Practice Act, and the Patient Right to Know Act (Physician Profile). This is good news if you are planning a multi-state or national model of health and wellness services, whether through physical healthcare clinic sites or digital health or mobile health (telemedicine, etc.). State licensure laws, including fee-splitting and the Corporate Practice doctrine, can complicate that collaboration. The MSO model allows non-MD (non-physician) entrepreneurs to create a robust business model for the healthcare venture in which they do not partner or share professional fees with the medical doctors, but rather take an MSO or management fee in exchange for their management and marketing efforts. An official website of the State of Georgia. A majority of states restrict the practice of medicine and dentistry by entities that are not owned and controlled by the relevant licensed professionals. The PSC should maintain its own charity care policy for its activities to further the exempt purpose of the Parent. While a physician may consult with unlicensed persons in making the business or management decisions described above, the physician must retain the ultimate responsibility for, or approval of, those decisions. Legal Intelligencer article by Lamb McErlane PC Health Law Attorneys Vasilios J. Kalogredis and Rachel E. (Lusk) Klebanoff. We have seen many try to navigate the CPOM doctrine waters and not survive the rocky seas. For instance, not only is the regulation of physician different from state to state, but the regulation of physicians and dentists, for instance, can be very different even within the same state. The premise underlying the doctrine was that it would protect patients from potential abuses because commercialized medicine would ultimately divide a physicians loyalty between profits and the delivery of quality patient care. Biotechnology & Life Sciences The physician owner had no control over any decisions made by the medical practice, nor did the physician owner appear in charge of any of the practice profits or design. Contact us online or call us today for more information on how the CPOM Doctrine impacts your existing or emerging practice. Lets just say that these are appropriate arenas for MSO involved. The court held that the . 68-11-205 and 63-6-204 is a common law legal doctrine known as the "corporate practice of medicine" doctrine. Telemedicine Ventures, Healthcare M&A: Dos and Donts of Buying or Selling a Medical Practice, Californias New Scope of Practice Law for Nurse Practitioners - Part Two, FDA Issues Warning Letter to Company that Sells CBD Products Online and Through Social Media, 5 Key Stark and Anti-Kickback Legal Rules Youll Want to Know. What Is the Corporate Practice of Medicine? Expanded to cover a broader range of healthcare professionals, this edition contains the latest information on practice restrictions by state as they relate to behavioral health providers, dentists, chiropractors, optometrists, and more. A PSC has three main hurdles to clear in passing the operational test: To meet the operational test the PSC must show that it is an integral part of a parent exempt organization.4 An organization is an integral part if it provides services for, or carries on a function for the benefit and convenience of, the parent. Navigating New York Laws On Corporate Practice Of Medicine. The decisions described below are examples of some of the types of behaviors and subtle controls that the corporate practice doctrine is intended to prevent. The management company controlled the day-to-day operations of the medical practice, had responsibility for all financial matters, and had the right to seize control of the practice at any time through an undated resignation letter signed by the physician. a competing practice of medicine with Dr. Parikh . This includes evaluating or assessing the patient, treating, and obviously, prescribing. With the rise of private equity investments, medical practices should be mindful of their business structure and the role those without a medical license are playing in it. The corporate practice of medicine doctrine is a medical practice act aimed at protecting patients from deceptive behavior that might come with the private ownership of medical corporations by non-licensed individuals including: The commercialization of the practice of medicine The imbalance between patient obligations and stakeholder obligations Interference of a physicians medical judgment due to outside influences. The Parents charity care policy is not sufficient. The Parent limits its stock value to a nominal amount. Seek assurance that there is no such requirement. [email protected]. in your telemedicine venture? It cannot offer physical therapy services, speech services or any other professional services. Consider whether the applicant described, in detail, the methods and procedures through which the exempt parent controls the shareholder; If there are indicators of a lack of control by the exempt parent you should consider further development or consultation with counsel, if appropriate. 2009) and Warren J. Apollon, D.M.D., P.C. While California law does allow a percentage of gross revenues under certain conditions, generally, percentages raise enforcement issues. Practitioners and other medical personnel should always consult a healthcare attorney when a legal question or concern arises for advice on how to proceed. Healthcare providers must be careful to comply with the CPOM doctrine because violating these laws could result in a providers loss of license and repayment of all revenue for billed services to patients, insurance companies and the government, as well as other fines and penalties, including potential criminal issues. Substance abuse treatment centers must steer carefully when sending patients for labs. The medical practice was owned by a physician, and the management company was owned by the chiropractor. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). Georgia law provides a fairly typical definition of the "practice of medicine" (O.C.G.A., Section 43-34-21) as well as a prohibition against unlicensed practice of medicine (Section 43-34-22 (a)). Consistent with the premise underlying the CPOM doctrine, the Court reasoned: A corporation as such cannot possess the personal qualities required of a practitioner of a profession. Concierge Medical Practices Title 32 32-1454, 1455 (authorizing injunction against practice of medicine by one not licensed to practice or not exempt from licensing requirements) A.R.S. The applicant must describe in detail the methods and procedures through which the exempt parent controls the shareholder. Joshua Kaye. Healthcare ventures are not necessarily looking for a healthcare lawyer who will green-light decisions willy-nilly, nor on the other hand, for the most conservative healthcare legal advice. Are you handling corporate practice of medicine, licensing, fee-splitting . The Parent (not the shareholder) initiates all actions regarding the election and removal of the corporations board of directors. The crime is designated a felony, punished by a fine of $1,000 per violation or by imprisonment for two to five years, or both. Bear in mind that these are simply guidelines and should not be construed as exhaustive. Corporate Practice of Medicine (CPOM) application is far from simple, and adoption and enforcement vary by state. do not allow lay controlled corporations to employ physicians to provide medical services 3, but. Also, because it is allowed only to provide professional services, it can only manage the services that it provides. The official Administrative Rules are published separately from the law and further clarify the regulations form the OCGA and are specific to the professions licensed by the Georgia Composite Medical Board. Failing to do so may result in professional misconduct and/or unlicensed practice of the profession. The challenge is that the healthcare venture managed by able healthcare entrepreneurs wants to call the shots. And our healthcare lawyers have seen a thousand variations. By Steve Polyakov June 28, 2021, 5:57 PM EDT. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. INSIGHTS. v. OCA, Inc., 592 F.Supp.2d 906 (E.D. The Medical Board of California continues to receive complaints and inquiries about the law, and some repeating issues are presented here. Terms of Use, Disclaimer, and Privacy Policy, Strong form corporate practice of medicine doctrine. The PSC and the Parent should have safeguards in place to ensure that compensation of physician employees is reasonable. But it is not the law, simply a restatement of what the medical board interprets the law. For example, a MSO may, find jobs for licensed professionals; find licensed professionals for potential employers; and manage the services of licensed professionals, including providing services to the professional for a fee, e.g., scheduling or billing. To help clarify these muddy waters, the Medical Board of California (MBC) has stepped in and created a document containing Decision Making Criteria to make sure that the Professional Medical Corporation is not contaminated by any conflict of interest which may result in a breach of his medical judgment and practice. 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