Florida Law Prohibits Control of a Dental Practice by a Nondentist

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

Florida has long been a state that does not prohibit the corporate practice of medicine, unlike many other states. However, it does prohibit the corporate practice of dentistry.  The key provision in Florida law that establishes this is Section 466.028, Florida Statutes, but the Florida Board of Dentistry has also adopted administrative rules on this topic, as well.

What this means is that any corporation (or other type of business entity) that owns or operates a dental practice, under Florida law, must be one solely owned by and controlled by dentists. In this context, the term “dentists” means those licensed to practice dentistry in the state of Florida, with an active license.  Someone licensed in another state or who has a suspended or revoked license in Florida, would not meet that requirement.

Dentists Entering into Certain Types of Contracts Needs to Be Sure They Comply with the Law.

There may be certain types of contracts and agreements that a dentist or dental practice may legally enter into, especially ones that would provide administrative services or other types of non-professional services to the dentist.  These might include, for example, payroll services, staffing services (except for professional staff such as dental technicians), billing and collections services (provided the dentist retains final authority over such matters), marketing services, equipment leases (provided the dentists retains all control over the equipment), office leases, management services, or combinations of the above.  However, since any of these types of agreements may be worded so as to violate the law, a dentist should always have such an agreement reviewed in advance by his or her own experienced health attorney.  The dentist entering into any such contract must make sure he or she complies fully with the law.

Section 466.028(2), Florida Statutes, states that the purpose of the statute is to prevent any nondentists from attempting to influence or interfere with the professional judgment of the dentist.

Acts Prohibited by Law.

Acts specifically prohibited by the law include allowing a nondentist or business entity owned by a nondentist to:

1.    Employ a dentist or dental hygienist in the operation of a dental office;

2.    Control the use of any dental equipment or material while such equipment or material is being used for the provision of any dental services;

3.    Direct, control or interfere with a dentist’s clinical judgment;  and, specifically,

4.    Allowing any nondentist or organization owned by a nondentist to exercise control over:

a.    The selection of a course of treatment for a patient, the procedures or materials to be used as part of such course of treatment, and the manner in which such course of treatment is carried out by the dentist;

b.    The patient records of a dentist;

c.    Policies and decisions relating to pricing, credit, refunds, warranties and advertising; or

d.    Decisions relating to office personnel and hours of practice.

Violating Law is a Felony.

Any of these acts can result in disciplinary action against any licensed dental professional involved. More importantly, violation of this law is also a felony which may result in criminal prosecution for any person involved.  Contracts which violate the law are null and void.

Always have any contract relating to the operation of your dental practice reviewed by an experienced board certified health lawyer before signing it.

Contact Health Law Attorneys Experienced in Representing Dentists.

The attorneys of The Health Law Firm provide legal representation to dentists in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Board of Dentistry and other types of investigations of health professionals and providers.

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

Comments?

Did you know about this Florida Law that prohibits control of a dental practice by a nondentist? 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.

Shortage of Florida Physicians Approved to Recommend “Green Leaf Relief” for Patients

George F. Indest III, Board Certified by The Florida Bar in Health Law

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

Florida may be “going green” in a big way come November 2016; and I’m not talking about recycling.  The Florida Right to Medical Marijuana Initiative, or Ballot Initiative Amendment 2, has undergone revisions, and will likely be making its second run with voters since its marginal loss in 2014.  Promoters of the Constitutional Amendment predict success; hopefully this isn’t just a pipe dream.

However, the Florida Compassionate Medical Cannabis Act of 2014, currently allows low-THC cannabis to be utilized only by qualifying patients for certain medical ailments.  A licensed physician, as outlined in Chapter 458 or 459 of Florida Statutes, is required to qualify patients for the use of medical marijuana.

For FAQ’s on low-THC cannabis issued by the Florida Department of Health (DOH), click here.

Physician Requirements for Qualifying Patients and Ordering.

For a patient to qualify to obtain and use THC, a previously approved physician must examine and currently be treating a patient for a debilitating illness.  Such illnesses include cancer or any physical medical condition or ailment that produces chronic seizures or severe and persistent muscle spasms (such as epilepsy or multiple sclerosis).  Furthermore, the physician must have tried all other options of treatment without satisfactory results.  Medical marijuana must be a last resort alternative.  Section 381.986(2), Florida Statutes (2015).

One of the physician ordering requirements is that the doctor must “register as the orderer of low-THC cannabis for the named patient on the compassionate use registry maintained by the department [of health] and update the registry to reflect the contents of the order.”  Section 381.986(2)(c), Florida Statutes (2015).

In order to become registered in Florida, licensed physicians must successfully complete an 8-hour course, offered by either the Florida Medical Association (FMA) or the Florida Osteopathic Medical Association (FOMA).  It is necessary for the physician to satisfactorily pass an examination upon completion of the course.  Section 381.986(4), Florida Statutes (2015).

Currently, only 42 doctors varied throughout Florida in areas to include Orlando, Pensacola, Tallahassee and Jacksonville, have signed up for authorization.

Why the Lack of Physicians?

Several theories may account for the lack of physician involvement in the program in Florida.

One of the theories that may explain why physicians are hesitant to jump on board with this new-age line of treatment, is the lack of scientific research conducted in the United States to back the medical efficacy of medical marijuana.  Scientists are reluctant to answer even the most basic questions about the use of medical marijuana including the long-term risks, actual benefits and the overall effect of legalization.

Many physicians may be concerned that the use of medical marijuana is supported more by popular opinion than on actual medical research.

However, a primary reason for insignificant research may be due to the unavailability of the drug for scientific study due to its illegal status.  The federal government entirely restricts the authorization to use marijuana for medical research.  The media is replete with stories on this.  As the debate over marijuana and its legalization for medical use becomes more widespread and pertinent, the drug has concurrently become more available for research.

For more information on current medical marijuana research efforts as reported by U.S.A. Today, click here.

Who Will Dispense the Marijuana?

Another hold-up in support from physicians may be due to the fact that the Department of Health (DOH) is still in the process of selecting the five dispensing organizations throughout Florida that will be developing and dispensing the drug.

As originally proposed, this requires an arduous application process presently consisting of proposals from 24 competing companies.  A dispensing organization must have the ability to meet several requirements as set forth in the statues, including the financial ability to post a $5 million performance bond upon approval.  Section 381.986(5)(b), Florida Statutes (2015).

Many physicians are still waiting to know where the drugs will be dispensed, what the dosages will be, what forms they will be available in and how much they will cost.  These are all important factors to consider in determining whether or not medical marijuana may be beneficial to certain patients.

Penalties for Misuse.

A final reason for physician avoidance of marijuana is fear of criminal prosecution and discipline by their boards, given the lingering gray areas of the law.

To read one of our previous blogs regarding a federal judge’s challenge of the DOJ’s incorrect interpretation of federal law on medical marijuana prosecutions and a win for medical marijuana advocates across the nation, click here.

It is undisputed that the use of medical marijuana is on the rise.  Therefore, any licensed physician who is contemplating or has already signed up for the program, needs to be sure they are in strict compliance with Florida law.

A physician is committing a misdemeanor, which may result in criminal penalties, if he or she orders low-THC cannabis for a patient without possessing a reasonable belief that the patient is suffering from one of the debilitating medical conditions as described in Section 381.986(3)(a)(1) and (2), Florida Statutes.

It is one of the ongoing duties of the dispensing organizations established by the Department to “monitor physician registration and ordering of low-THC cannabis for ordering practices that could facilitate unlawful diversion or misuse of low-THC cannabis and take disciplinary action as indicated.”  Section 381.986(5)(b)(7)(c), Florida Statutes (2015).

Therefore, a physician interested in obtaining authorization to order medical marijuana for his or her patients, should contact an experienced health attorney as a safeguard to ensure he or she complies fully with the law.

Comments?

Why do you believe there is a lack of physician involvement in Florida in the medical marijuana program?  What are your thoughts on the availability of medical marijuana in Florida?

Contact Experienced Health Law Attorneys for Medical Marijuana Concerns.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting and/or licensing, while complying with Florida law. We can also represent doctors, pharmacies and pharmacists facing proceedings brought by state regulators or agencies.

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

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.

Sources:

Powers, Scott.  “Medical-pot backers unfazed only 42 doctors in program.”  Orlando Sentinel 20 August 2015: Final.  Print.

Caputo, Mark.  “Medical marijuana supporters unveil new proposal for 2016.”  Miami Herald.  8 January 2015.  Web.  27 August 2015.

Keywords: medical marijuana lawyer, marijuana attorney, low-THC cannabis, medical cannabis, complaint against physician, Florida law, health attorney, doctor defense attorney Department of Health, Compassionate Medical Cannabis Act, disciplinary action for prescribing, medical marijuana regulations, prescribing controlled substances, physicians recommending marijuana, health regulation lawyer, medical license defense attorney, The Health Law Firm, health law attorney, DEA defense lawyer, medical marijuana ordering physician, compassionate-use in Florida, physician certifications for medical marijuana, cannabis for treatment of debilitating medical condition

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

Florida HB 0653 Signed Into Law; Effective 2/1/2012

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

The Florida Legislature unanimously passed HB 653 which relaxes some of the draconian exclusions enacted under SB 1986, which went into effect on July 1, 2009. SB 1986, which added provisions to Chapter 456, Florida Statutes, among others, prevented numerous healthcare providers from obtaining or renewing licenses based on prior criminal convictions, which could have occurred decades earlier.

HB 653 has been passed unanimously by the Florida Legislature and has been signed by the Governor to be effective July 1, 2012. It has been signed into law as Chapter 2012-64, Florida Laws and amends Section 456.0635(5), Florida Statutes (2012).

Under HB 653, the professional boards within the Department of Health (such as the Board of Medicine, Board of Nursing, Board of Psychology, Board of Massage Therapy, etc.) now will, if signed by the Governor, only prohibit the renewal or granting of a health professional’s license, certificate or registration, if the individual:

1. Has been convicted of, or entered a plea of guilty or no contest to, regardless of adjudication, a felony under Chapters 409 (Medicaid offenses), 817 (theft or fraud) or 893 (drug offenses), Florida Statutes, or similar laws in other jurisdictions, unless the individual successfully completed a drug court program for the felony and provides proof that the plea was withdrawn or the charges were dismissed, or unless the sentence and any related period of probation for such conviction or plea ended:

– For first and second degree felonies, more than fifteen (15) years before the date of application;

– For third degree felonies, more than ten (10) years before the date of application, except for third degree felonies under Section 893.13(6)(a), Florida Statutes; and

– For third degree felonies under Section 893.13(6)(a), Florida Statutes, more than five (5) years before the date of application.

2. Has been convicted of, or entered a plea of guilty or no contest to, regardless of adjudication, a felony under 21 U.S.C. Sections 801-970 or 42 U.S.C. Sections 1395-1396 (federal Medicare & Medicaid offenses), unless the sentence and any subsequent period of probation for such convictions or plea ended more than fifteen (15) years before the date of application; or

3. Is listed on the OIG’s list of excluded individuals and entities.

This new legislation has the effect of reducing the period of time a health professional may be prohibited from holding a license because of a conviction for one of the enumerated felonies. Under the current law, there is a fifteen (15) year prohibition for all enumerated offenses. The new legislation, if signed, will reduce the period to as little as five (5) years for drug offenses.

However, it also broadens the reach of the current Florida law by including, for the first time, convictions under “similar laws in other jurisdictions.” This may now “catch” many to whom the Florida law did not previously apply.

HB 653 also allows individuals previously denied renewals under SB 1986 who at are now eligible for renewal to obtain a license without retaking and passing their examinations.

The latter requirement above, number 3, may present a “catch 22” for many health professionals. Usually, if a licensed health professional is convicted of a felony, loses his/her license or is denied renewal of a health professional’s license, this is reported to the National Practitioner Data Bank (NPDB). The NPDB now includes reports previously made to the Healthcare Integrity and Protection Data Bank (HIPDB). If this occurs, in most cases the Office of Inspector General (OIG) commences action to exclude the professional from the Medicare Program. This automatically places the health provider’s name on the OIG’s List of Excluded Individuals and Entities (LEIE). Therefore, most licensed health professionals, even if they are no longer prohibited from holding a license under numbers 1 and 2 above, may still be prohibited because of requirement number 3 above.

Doubtless, this lacuna (gap) in this legislation will require additional corrective legislation in the future.

To view a summary of HB 653, click here.

To view the Bill Analysis of HB 653 from the Health and Human Services Quality Subcommittee, click here.

To view the Bill Analysis of HB 653 from the Health Care Appropriations Subcommittee, click here.

To view the Bill Analysis of HB 653 from the Health and Human Services Committee, click here.

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.

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