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Medical Director Responsibilities in a Florida Healthcare Clinic

By: Marcus Leonard

The role of medical directors 

Apart from the thousands of screaming fans, the role of a medical director is analogous to the role of the head coach on your favorite sports team as both are undoubtedly invaluable to an organization’s success but are also required to absorb responsibility if expectations are not met. A medical director’s role is so vital because a licensed health care clinic in Florida may not operate or be maintained without the day-to-day supervision of a single medical or clinic director. In Florida, medical or clinic directors are paramount to facilities and clinics maintaining a high quality of care and operating while in compliance with the law.

 

By law, a medical director must be a health care practitioner that holds an active and unencumbered Florida license as a medical physician, osteopathic physician, chiropractic physician, or podiatric physician. It is important to note that a license that is suspended or has not been renewed is considered an encumbered license. The type of services provided at a clinic may dictate who would be able to serve as a clinic’s medical director. A medical director must be authorized under law to supervise all services provided at the clinic, therefore, a clinic that provides general health and wellness services cannot be supervised by a chiropractic or podiatric physician because of limitations to the scope of practice.

 

General responsibilities

Each clinic shall appoint a medical director or clinic director who shall agree in writing to accept legal responsibility for the following activities on behalf of the clinic. The medical director or the clinic director shall:

 

(a) Have signs identifying the medical director or clinic director posted in a conspicuous location within the clinic readily visible to all patients.

 

(b) Ensure that all practitioners providing health care services or supplies to patients maintain a current active and unencumbered Florida license.

 

(c) Review any patient referral contracts or agreements executed by the clinic.

 

(d) Ensure that all health care practitioners at the clinic have active appropriate certification or licensure for the level of care being provided.

 

(e) Serve as the clinic records owner.

 

(f) Ensure compliance with the record keeping, office surgery, and adverse incident reporting requirements. 

 

(g) Conduct systematic reviews of clinic billings to ensure that the billings are not fraudulent or unlawful.

 

This non-exhaustive list works as a general guideline of responsibilities that a medical director would follow to ensure that clinics and facilities are operating efficiently and within the defined legal parameters. Although the medical director’s responsibilities are immense, there are restraints to the role such as the number of clinics one medical director can supervise at any time. Additionally, geographic restrictions and rules governing a medical director’s presence at facilities help regulate medical directors’ duties. 

 

The risk for medical directors and their facilities

The role of a medical director includes several inherent risks including legal risks for professional liability, regulatory compliance, and board complaints. Failure of an appointed medical or clinic director to substantially comply with health care clinic responsibilities shall be grounds for the revocation or suspension of the license and assessment of a fine. In some cases, clinics may not be absolved from liability caused by a medical director. Health care clinics may be found liable for their medical directors’ failure to fulfill their statutory duties. Additionally, the health care clinic’s responsibilities cannot be met without an active, appointed medical or clinic director. Consequently, the law is clear in explaining that a health care clinic without a medical or clinic director is subject to revocation of licensing and the assessment of fines.

 

Conclusion  

As more clinics and health care facilities open, more licensed practitioners will be hoisted into the role of a medical director. This role requires navigation through a complex labyrinth of compliance and legal responsibilities. Whether you are a clinic in search of a new medical director or you are a physician who is considering serving as a one, Jones Health Law can lend a helping hand. Our firm is well equipped with knowledgeable and experienced health law attorneys who can assist you with any questions or concerns regarding the responsibilities and requirements of medical directors.

 

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It should be noted that I am not your lawyer (unless you have presently retained my services through a retainer agreement). This post is not intended as legal advice, it is purely educational and informational, and no attorney-client relationship shall result after reading it. Please consult your own attorney for legal advice. If you do not have one and would like to retain my legal services, please contact me using the contact information listed above.

 

All information and references made to laws, rules, regulations, and advisory opinions were accurate based on the law as it existed at this time, but laws are constantly evolving. Please contact me to be sure that the law which will govern your business is current. Thank you.

Can I Continue to Run a Medical Practice After the Sole Physician’s Death?

Authored by Marcus Leonard and Jamaal R. Jones, Esq.

Authored by Marcus Leonard and Jamaal R. Jones, Esq.

Inevitably, we will all pass away at some point in hopefully the distant future. Some of our deaths will be expected while others will come as a complete shock. Many people formulate a plan for after their passing and make arrangements accordingly for the succession of their personal and business affairs and belongings, while others do not. Occasionally, that deceased person happens to be the only physician in the medical practice. The staff and surviving family members have to quickly determine what their options are and whether they can legally continue to operate the practice without the physician.

Florida does not have the same Corporate Practice of Medicine Prohibitions as other states. In short, this means that you do not have to be a licensed medical doctor or doctor of osteopathy to own a medical practice. Many people erroneously believe that because of this fact they can continue to run the physician’s practice without taking any further action after she passes away. The Florida Health Care Clinic Act (the “Act”) requires that all health care clinics operating in Florida maintain a valid license by the State unless they fall within a statutory exemption. Also, if the health care clinic is cash-pay only and not accepting reimbursement from a commercial payor, Medicare or Medicaid then Florida law allows the business to continue to run without first obtaining the license. According to the Act, a “clinic” is defined as an entity which provides health care services to patients and bills third party payers for reimbursement for providing those health care services. Clinics that are “wholly owned by one or more licensed health care practitioners” are exempt from obtaining a health care clinic license. Thus, if a clinic is owned by a licensed health care practitioner who is supervising the services performed at the clinic and who is legally responsible for the entity’s compliance with all federal and state laws, the clinic falls within one of the exceptions and is exempt from the Act’s licensure requirements. However, in the untimely event that a sole physician/owner passes away, the clinic is no longer afforded exemption from the Act’s licensing requirements and is no longer in compliance with the law.

 

What are my Options?

In this instance, the family members have the following choices: (1) close the practice; (2) sell the practice; or (3) apply for a health care clinic license. If the decision is made to close the practice then you have to make sure that you wind up and dissolve the business accordingly. Alternatively, it can be tricky if the decision is made to sell the practice. Even if you hire another physician to provide treatment to the patients while you try to find a buyer for the practice you will still be violating the Act. As a result, you must not continue to provide health care services until the practice is sold to someone or an entity that qualifies for an exemption under the Act or until you receive a health care clinic license.

This is important because Florida law provides that an insurer is not required to pay for medical treatment that is not lawfully provided. The plain language of the Act makes clear that a claim for reimbursement made by a clinic that is not properly licensed or that is otherwise operating in violation of the Act, constitutes an unlawful charge that is deemed non-compensable and unenforceable.

Filing the application with the Agency for Health Care Administration for a health care clinic license it tedious and must be done carefully or you risk denial. Also, the applicant should not expect to receive the license expeditiously.

 

Penalties

Under the Act, it is considered theft for an entity that does not have a health care clinic license and does not meet the requirements for an exemption to submit a charge for reimbursement. You can be charged with committing a third-degree felony if you operate an unlicensed clinic. Each day that the person violates the act is considered a separate offense. If a physician who is working for a clinic knows or has reasonable cause that the clinic is operating without a license and fails to report the clinic then that physician will be reported to the medical board for failure to report the clinic. There will also be administrative penalties imposed upon those who practice without a license.

 

Conclusion

A clinic is required to register for a license under the Act even if they were previously exempt from licensure requirements prior to the physician’s death unless some other applicable exemption exists. A sole health care provider should create a plan for succession in the event of their death. For example, upon the physician’s death the shares of the practice can “automatically” transfer to another physician of their choosing so that there isn’t a gap in care to patients. This would require careful planning and legal considerations beforehand. Our firm is well equipped with knowledgeable and experienced health law attorneys who can assist you with planning for this difficult event.

*****************************************************

It should be noted that I am not your lawyer (unless you have presently retained my services through a retainer agreement). This post is not intended as legal advice, it is purely educational and informational, and no attorney-client relationship shall result after reading it. Please consult your own attorney for legal advice. If you do not have one and would like to retain my legal services, please contact me using the contact information listed above.

 

All information and references made to laws, rules, regulations, and advisory opinions were accurate based on the law as it existed at this time, but laws are constantly evolving. Please contact me to be sure that the law which will govern your business is current. Thank you.

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