Florida Agency for Health Care Administration (AHCA)

Chiropractors Not Allowed to Work for Clinics Owned by Non-Chiropractors in Florida, with Limited Exceptions

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Apparently there are many chiropractic physicians and other medical business owners who are unaware of the prohibition provided in Florida law against a chiropractor providing services for a business owned by non-chiropractors. By non-chiropractor, this means anyone who does not have a current, active Florida chiropractic physician’s license.

The prohibition for chiropractors was passed into law in Florida originally in 2007. The law was amended in 2012. There had previously been similar prohibitions that applied to dentists and optometrists. To read the article I wrote on these issues, click here.

What’s the Purpose of This Law?

Found in Section 460.4167, Florida Statutes, the law states that a person (which includes a corporation or limited liability company), may not engage the services of a chiropractor as either an employee or an independent contractor to provide chiropractic services, except under a limited set of circumstances. To see the complete text of Section 460.4167, Florida Statutes, click here.

The purpose of the Florida Legislature in passing this law is set forth within the law itself. Subsection 4 of the law states:

The purpose of this section is to prevent a person other than the licensed chiropractic physician from influencing or otherwise interfering with the exercise of the chiropractic physician’s independent professional judgment. In addition to the acts specified [elsewhere in the statute], . . . a person or entity other than [the ones excepted] . . . may not employ or engage a chiropractic physician licensed under this chapter.

Exceptions to the Law.

There are, of course, exceptions stated in this law for organizations that are allowed to employ or contract with chiropractors. These include:

1. Business entities owned solely by chiropractors (licensed in Florida) and their immediate family members.

2. Business entities owned by medical, osteopathic or podiatric physicians licensed in Florida.

3. Business entities owned by hospitals.

4. A clinic that trains chiropractic students that is affiliated with an accredited chiropractic college.

5. A public or private college or university.

6. A business entity that is owned by a corporation that is tax exempt under certain Internal Revenue Service regulations (not-for-profit corporation).

7. A publicly traded corporation.

8. An insurance company licensed in Florida.

9. An HMO or prepaid health clinic (as set forth in chapter 641, Florida Statutes).

10. A clinic licensed as a Health Care Clinic under Florida Statutes, which provides chiropractic services by a licensed Florida chiropractor and also provides other health care services by medical doctors or osteopathic physicians, the medical director of which is licensed under chapter 458 (medical doctors) or chapter 459 (osteopathic physicians), Florida Statutes.

Special Exception for Clinics Licensed Under Florida’s Health Care Clinic Licensure Act.

This last exception, one for clinics licensed under Florida’s Health Care Clinic Licensure Act (Section 400.990, Florida Statutes), provides perhaps the broadest exception. A clinic that is properly licensed by the Florida Agency for Health Care Administration (AHCA), and meets the other requirements of the law, can be legally owned by non-chiropractors or non-physicians, and chiropractors may legally contract with or be employed by them. The safeguard is that the licensing requirements in Section 400.990 must be met, and physician services other than just chiropractic services must be performed at the clinic.

However, even under the exception provided by the Health Care Clinic Act, any agreement or other arrangement with the chiropractic physician whereby the other person (or an entity) provides the chiropractor with chiropractic equipment or chiropractic materials must contain a provision whereby the chiropractic physician expressly maintains complete care, custody and control of the equipment or practice.

To see the complete text of the Florida Health Care Clinic Act, click here.

Violating the Law Puts Your Professional License in Jeopardy.

If the business entity, clinic or group does not fall squarely within one of the exceptions listed above, the chiropractor may not legally be employed by or provide chiropractic services for it. The penalties for violating this law include:

1. Prosecution for a felony in the third degree.

2. Any contracts associated with the services are void.

3. Disciplinary action against health care licensees pursuant to chapter 456 or chapter 460, Florida Statutes.

4. By implication, since any contracts in violation are void, then any fees or bills for services in violation of the act are also void.

Don’t jeopardize your professional license, your reputation, your assets or your liberty by risking a violation of this act. Consult with an experienced health lawyer on any such business venture or proposal.

Contact a Health Care Attorney Experienced in Negotiating and Evaluating Physician and Health Professional’s Business Transactions.

At the Health Law Firm we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, chiropractors, psychologists, psychiatrists, mental health counselors, durable medical equipment suppliers (DME), medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider.

The services we provide include reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, advice on setting aside or voiding contracts, litigation of contracts (in start or federal court), business transactions, professional license defense, opinion letters, representation in investigations, fair hearing defense, representation in peer review and clinical privileges hearings, litigation of restrictive covenant (covenants not to compete), Medicare and Medicaid audits, commercial litigation, and administrative hearings.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Were you aware of this law and its exceptions? Please leave any thoughtful comments below.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.

Relocating, Selling or Closing Your Medical Practice? Be Sure to Comply with Florida Law

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Relocating, selling or retiring is never an easy decision for a physician. On top of patients’ anxiety about their doctor leaving, there are also legal hoops you will be required to jump through. It’s important to know what is expected of you as you relocate, sell or retire from a practice. The last thing any doctor on his or her way out would want is a letter from the Florida Department of Health (DOH) informing him or her that when the practice closed he or she failed to follow the proper procedures under Florida law. Even in retirement, the Florida DOH can fine a physician or health care provider. And believe me that does happen.

This blog is intended to help any physician or health care provider relocating, retiring or terminating a practice. It will explain the necessary steps that need to be taken under Rule 64B8-10.002, Florida Administrative Code.

Notifying Patients of Relocation or Termination of a Practice.

When a licensed physician terminates practice or relocates and is no longer available to patients, patients should be notified of such termination, sale or relocation. The physician is required to publically announce the event by publishing an announcement once during each week for four consecutive weeks in the newspaper of the greatest general circulation in each county in which the physician practices. So for example, if you live in the Orlando, Florida, area, you would want to publish the notice in the Orlando Sentinel. The newspaper notification must announce the date of termination, sale or relocation and an address where patients can obtain a copy of their medical records.

A copy of the notice must be mailed to the Florida Board of Medicine within a month of the date of relocation or termination of the medical practice. It would be in your best interest to obtain and keep a copy of your notice from the newspaper, just in case the board audits you or someone files a complaint.

Signs at the Office are Optional.

The physician may, but is not required to, place a sign at a location in the office to notify patients by letter of the termination, sale or relocation of the practice. The sign or notice will advise patients of their opportunity to transfer or receive their records. Again, this is optional.

Keeping Medical Records.

Under Section 458.331(1)(m), Florida Statutes, a physician must keep adequate written medical records for a period of five years from the last patient contact, so medical record storage options, which must properly conform with state and federal privacy regulations, will have to be considered. Alternatively, the sale of a practice necessitates an execution of the proper medical record transfer agreement as part of the transaction.

Also keep in mind, a physician planning to close, sell or relocate a medical practice must consider how to effectively notify employees about termination and must properly maintain employee records and other medical billing records after the practice has closed its doors.

Notifying All Appropriate Groups.

On top of informing the Florida Board of Medicine, physicians may also be required to notify other licensing authorities. This may include the Drug Enforcement Administration (DEA), Florida DOH, Center for Medicare and Medicaid Services (CMS), the Florida Agency for Health Care Administration (AHCA), and other local business licensing authorities.

These rules can be confusing and complex. To ensure you have completely complied with Florida law, consult with a health law attorney experienced in these matters.

Contact Health Law Attorneys Experienced in Business Transactions and Contracts.

At the Health Law Firm we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

The services we provide include reviewing and negotiating contracts, business transactions, professional license defense, representation in investigations, credential defense, representation in peer review and clinical privileges hearings, Medicare and Medicaid audits, commercial litigation, and administrative hearings.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Comments?

Have you gone through the process of selling, relocating or retiring? How did you comply with all the rules? Please leave any thoughtful comments below.

Source:

Rule 64B8-10.002, F.A.C., Medical Records of Physicians Relocating or Terminating Practice; Retention, Disposition, Time Limitations.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.