REGULATORY AND STATUTORY COMPLIANCE:

Health care practitioners, including physicians and dentists country wide routinely run afoul the state and federal regulatory agencies. The recurring given reasons which I hear for these generally avoidable circumstances is that the practitioner either “did not know” or “were not told” that their practice is in violation of either a state or federal statute, regulation, letter of opinion or case law which governs the nature of their practice.

Health care practitioners and dentists are imputed by law the knowledge of the laws and regulations under which they practice. All prior published opinions of the various Medical of Dental Board serve as notice of the Board’s stand and policy regarding specific issues. Recognition and knowledge of the regulatory authorities’ position with respect to each and every specific issue involving the physician’s and dentist’s practice is of paramount importance to ensuring that the practitioner does not violate the law and regulation of the states in which the practice is situated.

For example, in a particular instance, a physician represented by me was sold a “Bag of Goods” by attorneys and lay outfits promoting a general integrative practice structure. The attorneys and the promoting group made a fortune selling “boilerplate” legal packages and documents to chiropractors and physicians while holding the practice structure as legally compliant with the laws of every state where these practices were established. Upon these representations, the naive physician really believed that the proposed and promoted practice structure was legally compliant.
Because an attorney promoted the practice structure, the unsuspecting physician did not retain own separate counsel to review the proposal and the legal materials and to ensure compliance with the laws and regulation of every state where these practices were to be established. The unfortunate end result was that within a couple of years from opening the promoted practices in accordance with the “boilerplate” format, the practitioner ended up as a party defendant in multiple multi parti multi district and jurisdiction law suits commended by several insurance companies against many defendants involved in similar practice structures. Alleging that the medical practice structure violated the laws and regulations of the respective states where the law suits were brought, and further alleging that all claims for insurance reimbursement submitted by the practice were fraudulent, the insurers sought millions of dollars in damages against the practitioners for payments made. To boost the legitimacy of the civil cases, the insurers filed disciplinary complaints with the state authorities where the health care practitioner was licensed, alleging fraud based upon submission of claims under and improper practice structure.

In this example, the physician could have avoided the expensive aftermath of the promoted practice structure by simply hiring a personal attorney to research and write a compliance report regarding the legality of the structure, its medical care and the billing practices. With my help and representation, the physician ultimately prevailed against multiple civil law suits, disciplinary inquiries and the potential of multiple license revocations in three different states and successfully emerged in his business. This case scenario could have been avoided by a simple “legal practice and compliance audit” ensuring that the practice structure complied with the regulatory schemes of the
states where the promoted practice was established.

In the case of alternative, comprehensive and holistic health care practitioners (physicians and dentists), the statutory and regulatory provisions of each state in which they practice vary. Some states require that specific protocols and form consent orders be followed where alternative, complementary and/or holistic medicine and dentistry is practiced. Failure to comply with the mandate of these statutes and regulations renders the practitioner in violation of the law and subject to disciplinary proceedings for unprofessional conduct. In most cases compliance can be ascertained through a thorough reading of the laws and regulations applicable to the physician’s/dentist’s practice and through the preparation of specific consent orders targeting mandatory statutory or regulatory compliance. Regulatory and statutory compliance in every state is of outmost importance in avoiding unnecessary disciplinary repercussions and the costly defense of disciplinary proceedings

My firm offers full regulatory and statutory compliance audits and reports throughout the country. These preventative measure is an affordable and economic step in avoiding expensive administrative prosecutions for statutory and regulatory non compliance.


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