Georgia's Trusted Healthcare
& Medical Provider Attorneys

Did You Know?

Katie Beckett Attorney GeorgiaDid you know DJ Jeyaram is Georgia’s leading attorney on Katie Beckett?

He has successfully helped more than 100 families obtain Katie Beckett approvals on appeal!!!

For help with Katie Beckett denials, please contact DJ at DJ@JeyLaw.com or 678.325.3872. You can also learn more on our site by clicking here.

DJ Jeyaram Joins Frazer Center Board of Directors

DJ JeyaramCongratulations DJ Jeyaram for being selected to serve on the Frazer Center Board of Directors.

Mr. Jeyaram joins an esteemed group of community members who are committed to the inclusion of individuals with disabilities. The Frazer Center provides services for children and adults with disabilities.

Honor To Serve

“It’s an honor to serve along with so many esteemed individuals who have committed their lives to helping individuals of all levels of abilities and disabilities,” Mr. Jeyaram said. “The Frazer Center understands and appreciates the value of all individuals and that there is tremendous community benefit and value in diversity.”

The Frazer’s Center Guiding Principles 

  • We value every individual as a member of the community.
  • We strive for excellence in every aspect of our work.
  • We are committed to advocacy and research on behalf of the community we serve.
  • We are faithful stewards of all the resources entrusted to our care: human, natural, and economic.
  • We are committed to building and deepening partnerships knowing we cannot do this alone.

Local and Global Community Inclusion 

The Frazer Center is a long standing advocate and resource for helping with the inclusion of individuals of all abilities into the community. According to an annual report by the Frazer Center, “We are vision builders with a passion for the world that we hope for—one in which each person has the chance to be acknowledged for their gifts, to be valued and included despite any difference in ability, and to be productive members of society.”

Learn More

To learn more about the Frazer Center and the programs it offers for adults and children with disabilities, visit http://www.frazercenter.org/

Georgia Department of Community Health Approves $140 million Medicaid Rate Increase

Georgia MedicaidGeorgia doctors, nursing home operators and other healthcare providers will soon see an increase in Medicaid reimbursements. The Georgia Department of Community Health (DCH) approved a reimbursement rate increase earlier this month that will go into effect July 1, 2016.

The increase addresses concerns that low Medicaid reimbursement rates have made it difficult for practices with high volumes of Medicaid patients to be profitable. The rate increases will most likely have the biggest impact on providers in rural Georgia communities, which serve a high Medicaid population. For some providers, the Medicaid reimbursement rate will go up by more than 50% for some procedures.

The rate increases means $140 million in increased reimbursements for Georgia providers. The increase was funded by the General Assembly earlier this year, but the Department of Community Health did not approve the rate increase until the beginning of May. The total will be paid for in part out of the Georgia budget with about two thirds of the increase coming from the federal government.

Jeyaram & Associates is a full service healthcare law firm committed to helping doctors, nurses, hospitals, nursing homes, adult day care facilities, pharmacies, and Medicaid and healthcare providers. Contact DJ at DJ@Jeylaw.com or 678.325.3872.

How Georgia Healthcare-Related Bills Fared This Legislative Session

Georgia Legislative SessionThe Georgia 2015-2016 legislative session has officially closed. Of the various healthcare-related bills that were introduced throughout the session, here are some significant bills and how they fared this session:

  • SB 145: This bill would have expanded the list of conditions that could be treated with medical marijuana from 8 to 15 including post traumatic stress disorder, HIV/AIDS and autism. Although it passed the House, it was never brought to a vote in the Senate.
  • HB 916: This bill limits the Department of Community Health’s ability to recoup Medicaid funds based on clerical errors. Having been passed by both the House and the Senate, this bill currently awaits Governor Deal’s signature. If signed into law, the bill will give providers an opportunity to fix paperwork errors without penalty.
  • HB 919: This bill would have allowed individuals to receive state tax credits for donations to rural healthcare organizations. However, the Senate never voted on the bill.
  • SB 302: This bill, which requires health insurers to maintain accurate directories of their providers, passed both houses.
  • HB 1055: This bill would have repealed and replaced Georgia Certificate of Need (CON) law. However, it did not make it very far during the 2015-2015 legislative session having failed to make it past crossover day.
  • SB 1/HB 429: This bill was introduced in the Senate but its contents were ultimately combined with HB 429 prior to passing both houses. It requires insurance coverage for treatment of autism spectrum disorders.
  • HB 684: Introduced as a result of the efforts by the Georgia Dental Hygienists’ Association this bill would have allowed dental hygienists in certain settings to perform preventative care services without a dentist present. Neither the House nor the Senate brought it to a vote therefore it did not even make it past crossover day.
  • SB 304: This bill originally addressed the disclosure of certain mental health records with respect to gun background checks. The final bill passed by the legislature focuses on more efficient testing of rape kits.

If you have any questions or need assistance with healthcare regulatory issues, Jeyaram & Associates attorneys can help. Contact DJ Jeyaram at DJ@Jeylaw.com or 678.325.3872.

Healthcare Providers: Your Business Associates Could Cost You Millions

HIPAAHealthcare providers must ensure business associates adequately safeguard private health information

The Department of Health and Human Services (HHS) recently entered into a HIPAA settlement with a Minnesota hospital for $1.5 million because the hospital failed to have a written business associate agreement with one of its contractors.

Business associates are non-covered-HIPAA entities that require access to protected health information (PHI) to perform services for covered entities, often a contractor or subcontractor. The hospital’s policies failed to ensure the business associate adequately protected consumer’s PHI.

While HIPAA applies to certain covered entities, those entities must also ensure that any business associates also adequately secure PHI. HHS found that the Minnesota hospital overlooked two important aspects of the HIPAA rules.

  1. The hospital did not have a written, compliant business associate agreement with one of its IT contractors, and
  2. The hospital failed to have an accurate and thorough risk analysis of its entire IT infrastructure.

HHS investigated after the hospital reported that a laptop was stolen from an employee of the business associate. The laptop contained password protected but unencrypted PHI for almost 10,000 individuals.

The $1.5 million settlement underscores the importance of HIPAA compliance. Healthcare providers must ensure they have compliance agreements with anyone who has access to protected health information. One example of this is when a healthcare provider contracts IT services. Without compliance agreements, companies can be responsible for hefty fines even if a business associate actually causes the PHI security breach.

If you need help creating policies or contracts to protect safeguard private healthcare information, we can help. Please contact Jonathan Anderson at Janderson@JeyLaw.com or 678.325.3872.

Bill Would Eliminate Several Certificate Of Need (CON) Requirements

Certificate of NeedGeorgia House Bill 1055 Would Eliminate “Certificate of Need” (“CON”) Requirements For Several Types Of Healthcare Facilities

Georgia House Bill 1055 would cause a substantial change in the way the state regulates healthcare providers. Georgia’s CON program is administered by the Department of Community Health (DCH). A CON is required for entities before building, acquiring or expanding healthcare services and facilities. Read the full bill here.

Roots of CON Requirements Almost 40 Years Old

Georgia first created its CON program in 1979 in response to the federal “Health Planning Resources Development Act” of 1974. The federal act was later repealed, but many states including Georgia continue to have CON requirements.

The goal of Georgia’s CON program was to “ensure access to quality health care services and to ensure that health care services and facilities are developed in an orderly and economical manner and are made available to all citizens and that only those health care services found to be in the public interest shall be provided in this state.” § 31-6-1. However, since then, the efficacy of CON programs has been questioned, and bills have been introduced seeking to change Georgia’s CON program one way or another nearly every year.

Larger Healthcare Providers Argue CONs Increase Barriers To Expanding

Larger hospitals oppose measures to weaken CON requirements which restrict potential competitors. Hospitals argue they need to use profits from surgical procedures to subsidize less profitable care they are required to provide to the uninsured. On the other hand, physicians and smaller healthcare facilities tend to advocate weakening or eliminating CON requirements because those requirements create barriers to offering services in certain healthcare areas. If House Bill 1055 passes, it would significantly reduce barriers for building multi-specialty surgery centers. Physicians contend changes like this would help lower healthcare costs.

Get Help With CON Requirements

Unless House Bill 1055 passes, Georgia’s CON program will continue to loom large for health care providers of all sizes. At Jeyaram & Associates, we have extensive experience with the CON process and related Letter of Determination and Letter of Non-Reviewability requirements and can help your practice. Contact DJ Jeyaram at DJ@Jeylaw.com  or Jonathan Anderson at Janderson@Jeylaw.com.

 

Georgians With Developmental Disabilities “Shortchanged”

Developmental DisabilityGaps Remain In Community Support Services

Six years after their 2010 settlement agreement that addressed Georgia’s treatment of people with mental illness and developmental disabilities, the State and the US Department of Justice still cannot agree on what exactly that means.

Under part of the 2010 settlement, Georgia must improve care for individuals with mental illness and developmental disabilities. This includes moving these individuals into community settings when appropriate. There are annual reports filed with the court from an independent reviewer about the progress of the settlement.  According to the most recent report, Georgia still has gaps in services and waiting lists mean community integration has not been fully realized.

U.S. Supreme Court Orders Community Integration

Georgia’s compliance with the 2010 settlement will continue to be a contentious issue. A federal judge overseeing the execution of the settlement said, “The state of Georgia always has shortchanged people with mental illness.” Georgia was the focus of the Supreme Court’s 1999 ruling in Olmstead v L.C. In that case, the Court ruled individuals with mental illness and DD have a right to receive services in the most integrated community setting appropriate for their needs.

Most Applications For Assistance Initially Rejected

Despite the disagreement over what is required under the settlement, the 2010 settlement has helped many people move back or remain in their communities. This is thanks to the increased availability of Medicaid waivers. However, some disabled individuals and their families still get discouraged during the application process, especially if the application is initially rejected.

 We Can Help 

 Jeyaram & Associates has helped dozens of families get and keep support services for individuals with developmental disabilities even after an initial rejection. For more information, contact Jonathan Anderson at  janderson@jeylaw.com.

 

Are You Compliant? HHS Issues Guidance & Likely To Continue HIPAA Compliance Scrutiny

HIPAA AuditThe Department of Health and Human Services (HHS) started the year by publishing new HIPAA guidance with respect to patient access to medical records.

While the recent HHS guidance does not add anything new to the regulations, it serves as a reminder to providers of certain provisions in the law. The guidance is intended as a tool to aid individuals in exercising their rights to access their medical records and to help providers ensure HIPAA compliance.

HHS highlighted certain provisions in the HIPAA regulations including provider obligations to respond to a request from a patient within 30 days and provide PHI in an electronic format if requested (assuming the electronic format requested can be readily produced by the provider).

The guidance also reminds providers that covered entities are not required to provide every single record about an individual even if the individual asks. Certain exceptions to a patient’s right to access include:

  • Patients do not have the right to access to information that is not used to make decisions about that individual. For example, certain quality assessment or improvement records, patient safety activity records, or business planning, development and management records that are used for business decisions do not have to be provided to an individual.
  • Individuals do not have a right to access psychotherapy notes that a mental health professional maintains separately from the individual’s medical record and that document or analyze the contents of a counseling session with the individual.
  • Providers can deny access to certain records if a licensed health care professional determines in the exercise of professional judgment that the access requested is reasonably likely to endanger the life or physical safety of the individual or another person.
  • Patients do not have a right to access certain records compiled in reasonable anticipation of, or for use in, a legal proceeding.

Additionally, providers do not have to create new information, such as explanatory materials or analyses, that does not already exist in the record.

The government’s emphasis on HIPAA is expected to continue with pending audits of covered entities and business associates likely to take place this quarter. Now is the time for healthcare providers to review their policies to ensure that they are complying with the HIPAA regulations.

If you would like to review the HHS guidance it is available at http://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html.

If you need help ensuring HIPAA compliance, please contact Danielle Hildebrand at dhildebrand@jeylaw.com or 678.325.3872.

 

 

Consider Creating A “Care Committee” For Your Special Needs Child

Special Needs TrustWhen setting up a special needs trust, we ask parents to designate someone to serve as their child’s trustee. The trustee’s job is to ensure the child receives the best possible care – without necessarily being the primary care giver.

The trustee oversees things like the child’s finances, overall health, housing, benefits and education. However, finding someone who is extremely knowledgeable in all of these areas and knows all of the members of your family and how they interact with one another – can be a challenge. As a result, we often recommend creating a Care Committee.

However, before we get to care committees, let’s do a quick refresher on special needs trusts. Special needs trusts are legal instruments specifically designed to hold property for a person with disabilities.

Every special needs trust has a trustee – the person responsible for managing the trust’s assets for the benefit of the person with the disability. A special needs trust gives the trustee very broad authority to use the trust funds in whatever way she thinks will best help the trust beneficiary given the beneficiary’s current and future needs and other resources.

Because the trustee of a special needs trust has these discretionary powers and cannot typically be forced to make distributions to the beneficiary, the funds in the trust do not harm the beneficiary’s ability to qualify for government benefits like Medicaid or Supplemental Security Income (SSI).

This brings us back to Care Committees. Since the trustee of the special needs trust cannot always be expected to know everything about the beneficiary’s care and needs, parents may decide to name several knowledgeable people to serve as a formal advisory committee.

The Committee can include any number of people, but it is typically composed of a small group that parents select because they understand the beneficiary’s needs. Committees are often made up of caregivers, doctors, social workers, family members, lawyers and other advocates. The Committee members are supposed to advise the trustee about the best way to utilize the trust assets, even though the trustee usually retains the ultimate authority over the disposition of the trust.

However, in some cases the trust will mandate that the trustee must follow the committee’s advice unless it is clearly against the beneficiary’s best interests.

The Care Committee also facilitates a conversation between the trustee and the beneficiary. Since this relationship can sometimes be difficult, especially if the trust beneficiary is fully competent and resents the trustee’s control over the assets, the Care Committee can advocate for the beneficiary’s needs without antagonizing the trustee.

The Committee can also take some of the pressure off of the trustee, because she will have help making difficult decisions that a lone trustee may agonize over.

Not all parents feel the need to create a Care Committee for a special needs trust, but if you are interested in establishing one, we can help you design the right committee for your family. Contact DJ Jeyaram at DJ@Jeylaw.com or 678-325.3872.

Congratulations To Jeyaram & Associates For Being Featured In The Business News Daily

Reprinted with permission from the Business News Daily
Special Needs Trusts

 

Owner DJ Jeyaram Esq. shared the story behind Jeyaram & Associates, a family-focused law firm that specializes in special needs trusts, wills, estate planning and healthcare legal services.

My son Kai, pictured in this photo, was born with a rare genetic condition called Williams Syndrome. He brings us an amazing amount of joy despite all of his challenges.

Soon after my son was born, we realized that we needed a plan to protect him in case anything happened to me or my wife, so we began offering special needs trusts, which help protect children’s current and future government benefits.

I started my business in 2007 after working at a large law firm. I realized that most special needs families could not afford my big firm rates and I was forced to refer these families to small firm attorneys that did not necessarily have the proper training to set up a special needs estate plan. Three months later, I hung out my shingle and have successfully been in business for more than 8 years. It’s been one of the best decisions I ever made.

One of the biggest challenges we face is limiting the number of pro bono cases we take every year. Because we have a special needs child and are ingrained in the special needs community, we meet a lot of families that need legal help but don’t have the necessary resources. We want to help everyone because we always think ‘That could be us.’