Provider Agreements
o be a network provider, you know that health plans require you to sign written agreements that govern the relationship between the provider and the plan.
Read MoreAuthor: Adrienne Hersh, JD, ICS Legal Counsel
Your Scope of Practice
Chiropractic physicians in Illinois enjoy one of the broadest scopes of practice in the country. However, D.C.s sometimes encounter a lack of understanding or outright misinformation as to procedures they are authorized to perform especially diagnostic procedures.
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Self-Referral and Anti-Kickback Laws
Much has been written about “self-referrals” and “kickbacks” in health care. Stated simply, health care providers may not make referrals to entities in which they have a financial interest, and they may not pay for referrals or receive “kickbacks” (commissions) for referring patients to other providers.
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HIPAA Changes – Omnibus – September 23, 2013
You may have heard about the “Health Information Technology for Economic and Clinical Health (HITECH) Act” and its impact on physician practices. The HITECH law is significant to physician offices because it comprehensively affects HIPAA rules on privacy, security, breach notification, and enforcement.
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Social Media and the Physician
Social media can serve as an effective tool for marketing, communication, education, and information sharing. However, unlike ordinary businesses, health care practices must comply with unique privacy and ethical rules when using these tools.
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Group Coupon and Vouchers
The Medical Practice Act states that a physician, “may not directly or indirectly divide, share or split a professional fee or other forms of compensation for professional services with anyone in exchange for a referral or otherwise.” 225 ILCS 60/22.2. This provision prohibits a physician from paying any source for referring a patient, or from accepting payment in exchange for referring a patient to another provider.
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Limited English Proficiency (LEP)
The Civil Rights Act of 1964 prohibits discrimination based on national origin. Based on this law, the U.S. Department of Health and Human Services has determined that physicians and other providers who receive Medicare, Medicaid, and other federal health plan payments must take “reasonable steps to provide meaningful access” to services to persons with limited English proficiency (LEP), defined as persons who speak English less than “very well.”
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Specialty Certifications and Requiring the “D.C.”
If you intend to use a specialty designation, be prepared to document that it was obtained through an accredited, post-graduate training program, preferably recognized by the American Chiropractic Association.
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