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DJ Jeyaram Quoted in Leading National Medicaid Publication

Screen shot 2016-08-26 at 2.03.18 PMDJ was quoted in the national “Part B News” publication – a leading industry information source for healthcare practice managers and physicians.

Check out DJ’s quotes below in the article: “Negotiate For Patient Record Access When Rival Practices Close:”

Negotiate For Patient Record Access When Rival Practices Close

Increase your patient census and practice revenue when a nearby practice closes by striking a deal for limited access to patient records without paying for the privilege.

In fact, in some cases, the closing practice may pay you.

One of the valuable tangible assets of a practice sale is the patient records that come with it. While the purchaser can’t under HIPAA treat these records as their own until the patients affirm via signed waivers that they want to adopt the new provider, the fact that the buyer is holding the records provides an enormous incentive for them to do so.

It isn’t necessary for the buyer to purchase the entire assets of the practice either, notes Patrick Stanley, an attorney with Comitz | Beethe in Scottsdale, Ariz. Patient records may be included in a limited asset purchase agreement. As with a complete purchase, the retiring practice would then give patients notice and direct them to the purchaser to retrieve their records or, if they choose, continue their care with the new practice. Remember that the patients would have to sign on and have the final say. Note: Laws on the disposition of medical records may vary by state.

How to take custody of records

Vasilios “Bill” Kalogredis, chairman of the health law department of Lamb McErlane in West Chester, Pa., says he has negotiated several arrangements between practices that were closing down and practices that wanted to pick up their patients.

“I see this a lot,” says Kalogredis. “A solo practitioner is retiring and he can’t sell the practice, or he’s leaving one state for another. Hospitals and other practices may not want to buy, but they’re interested in the patients.”

Propose a “custodial” arrangement if buying the practice or part of it is too rich for your blood. In that case, your practice just takes responsibility for the safe- keeping of the other practice’s records. Under such an agreement, when the retiring practice gives notice to its patients, it also would inform them that they can retrieve their records from you and that you also are available to provide continuity of care.

The custodial agreement also should address the length of time that the records will be retained, says D.J. Jeyaram, owner and health care attorney at Jeyaram & Associates in Atlanta.

Consult your legal counsel and malpractice insurance carrier before entering into an agreement to make sure you’re handling things properly from the legal and ethical perspectives, Kalogredis suggests.

Some practices may even receive a fee for accepting this responsibility. But note that while receiving a fee for the storage of medical records would be kosher, an arrangement whereby you pay a fee for the right to store the records “could be seen as remuneration for referrals under the federal anti-kickback statute or its state equivalents,” says Jeyaram.

Mind HIPAA rules

Note that in a custodial arrangement, you would be only holding the patient records — they’re not really your records unless and until the patient releases them to you. “HIPAA only allows for the exchange of protected health information (PHI) without a written release if the transfer is between current or prior health care providers for the purposes of providing treatment,” says Jeyaram.

In this circumstance, under HIPAA, you would be a business associate (BA) of the transferring practice that remains the covered entity, says Jeyaram, and you should execute a business associate agreement (BAA) (PBN 7/11/16).

The BAA, which ensures HIPAA compliance in the transfer and storage of records, should be referenced in the custody agreement, Jeyaram says.
Note that though it varies by state, responsibility for retention of medical records is usually seven years or longer; be prepared to follow through on that if you accept responsibility.

Remember: A custodial arrangement gives you a good shot at inheriting these patients, but it’s not “exclusive” — in some states and under some contracts, other providers from the closed-down practice may take their patient lists with them and reach out to these patients too. In the end, it’s always the patient’s choice (PBN 5/2/16). — Roy Edroso (redroso@decisionhealth.com)

Visit http://pbn.decisionhealth.com/ to learn more.CompressedPartBNewsNegotiatePatientRecords8.16-min.pdf”CompressedPartBNewsNegotiatePatientRecords8.16-min.pdf”

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.

New Georgia Prompt Pay Law To Take Effect in 1/2013

The new Georgia Prompt-Pay law is set to take effect in January 2013.  The law will require insurers to promptly pay physicians for treating patients who are part of self-funded employer health plans. Specifically, the new law requires insurers to pay treating physicians within 30 calendar days for paper claims submissions and within 15 working days for electronically submitted claims. If the payment is not received on time, the insurer administering the self-funded plan is required to pay 12% interest on those unpaid claims.

The insurance trade group America’s Health Insurance Plans filed a lawsuit in late August challenging the statute claiming it violates ERISA, which exempts self-funded employer plans from state regulations governing health insurance.  In 2010, then governor Sonny Purdue vetoed a similar bill citing ERISA. However, current governor Nathan Deal signed the new legislation in 2011.

Last week, the American Medical Association and the Medical Association of Georgia filed a petition in federal court in Atlanta to intervene in the case as co-defendants in order to help support the law. The lawsuit currently names state Insurance Commissioner Ralph Hudgens as defendant.

“This case has national implications for resolving the regulatory void in which health insurers are unaccountable for chronically late payments when they serve as administrators for self-insured employers,” said the AMA’s president, Dr. Jeremy Lazarus, in a statement. “Georgia has effectively closed that regulatory loophole, which helps physicians maintain a sustainable practice environment.”

“Georgia’s prompt-payment law is one of the most effective in the country,’’ Lazarus said.

Glenn Allen, a spokesman for Hudgens, said Tuesday that the commissioner “believes that doctors should be paid promptly, and he will enforce the law until a federal court tells him to do otherwise.”

Dr. Sandra Reed, president of the Medical Association of Georgia, recently released a statement saying “The fundamental fairness mandated by Georgia’s statute allows physicians to redirect their limited resources from battling to get the payments they’ve earned to caring for patients.’’

“Holding health insurers accountable for on-time payment gives medical practices greater budget certainty and helps Georgia physicians keep their doors open and pay the salaries and benefits of more than 90,000 office employees,” Reed said.