All posts by cobe0710

CARES Act: Financial Relief for Doctors and Other Small Business Owners as a result of COVID-19

The CARES (Coronavirus Aid, Relief and Economic Security) Act was enacted into law on March 27, 2020 to help provide financial stability and relief for individuals and businesses affected by COVID-19. While the bill is very broad and addresses a number of areas and industries, we believe the following are important to highlight for our healthcare clients at this time, especially as many doctors struggle to meet payroll and other overhead obligations.

As just one example, many dentists have temporarily closed their offices completely, while others are only seeing patients on an emergency basis. However, even though the office is closed, and the revenue has stopped, expenses will continue to accrue. Although there may be some reductions in expenses like utilities and supplies, rent will still be due.

Additionally, given the close relationships doctors have built with their staff over time and the need to retain quality employees, many doctors have decided to continue paying staff while they are partially or completely closed. Without assistance, this can create a significant burden on the doctor, which is where the CARES Act comes in.

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The Key Federal Statutes Regulating Doctors

Healthcare regulations seem to grow more complex with every passing year.  Doctors are expected to know, and comply with, an alphabet soup of federal statutes and associated regulations governing everything from employment to patient privacy to personal finances, and everything in between.  In order to simplify matters, we have prepared the following summary of the federal statutes we most often encounter in our practice. 

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Health Care Rounds: De-Mystifying The Business of Healthcare Delivery Systems

The business of healthcare has become increasingly complex over the last ten years, with developments such as the emergence of Accountable Care Organizations (ACOs), the passage of the Affordable Care Act and present uncertainty over its future, and the accelerated implementation of telemedicine.

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Making Sure Everyone Is On The Same Page: Letters Of Intent

When you are buying or selling a healthcare practice, even simple, straightforward transactions can become needlessly complex.  Miscommunications and misunderstandings over key terms of the transaction can emerge, requiring the parties to spend unnecessary time, energy, and money on attorneys’ fees to resolve disputes.  One of the best ways to avoid, or at least minimize, these misunderstandings is through a letter of intent, also sometimes referred to as a memorandum of understanding or a term sheet.

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Concierge Medicine: The Return of the House Call

Many physicians, frustrated by the bureaucracy of modern medical practice, the financial pressure to shorten appointments and limit face time with patients, and the delays and hassle of dealing with health insurers for reimbursement, are increasingly turning to concierge medical practices as an alternative.  Under this business model, patients pay a set annual fee for unlimited (or nearly unlimited) access to a private primary care physician, many of whom will even make house calls for minor illnesses, injuries and physicals.

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Associates: Independent Contractor or Employee

When hiring associates, doctors understandably want to limit costs as much as possible.  One of the ways in which doctors often try to reduce costs is by categorizing associates as independent contractors, rather than as employees.  While classifying an associate doctor as an independent contractor is an appealing option, there can be substantial consequences for improperly categorizing an associate as an independent contractor when they should be categorized as an employee.

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Terminating The Dentist-Patient Relationship

The majority of your patients are likely conscientious about honoring appointments, compliant with your treatment decisions, and pleasant with you and your staff.  However, every practice has its share of problem patients: those patients who repeatedly no-show to appointments or cancel at the last minute, who refuse to follow even simple instructions, or are just plain difficult to deal with..  Although it is always best to try to work through any issues with the patient, there may come a point when you conclude that it is simply better for everyone to terminate the treating relationship with the patient.

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Key Provisions In Associate Dentist Agreements

Many dentists, particularly doctors who have recently graduated from dental school, choose to become associates at larger practices, rather than open their own clinic or partner with another dentist.  Structured correctly, this can be a mutually beneficial relationship, under which the owner-doctor can increase his or her practice’s client base, revenue, and profitability, while the associate doctor can gain more experience, both in providing direct patient care and in the practical operation and administration of a dental practice, which he or she can then use as a future practice owner.

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Associate Buy-In Agreements

Owning a practice right out of dental school can be a daunting endeavor.  Although dental school may prepare you for clinical practice, often little or no attention is paid to the administrative responsibilities of running a practice.  In fact, a 2013 survey conducted by the American Dental Education Association (ADEA) showed 95% or more of graduating dental students believed that their education adequately prepared or well-prepared them in the areas of patient evaluation and diagnosis; radiology; and operative and restorative dentistry, whereas less than half believed their education had prepared them for practice administration.[1]

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PCI DSS Compliance: The Other Privacy Rules

In previous posts, we covered the ins and outs of HIPAA and its four general rules: Privacy, Security, Breach Notification and Enforcement.  In this post, we discuss the Payment Card Industry Data Security Standard (“PCI DSS”), an often overlooked privacy standard that, while overlapping somewhat with HIPAA, is a completely separate set of standards that govern security over your patient’s credit cards.

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