Jones Health Law Podcast: Recent Episodes
JAMAAL JONES
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On April 23, the Federal Trade Commission (FTC) issued a final rule, banning new non-compete agreements with all workers. It is estimated that around thirty million workersare subject to non-compete agreements, nationwide. The Commission’s final ruling states that non-compete agreements give rise to an unfair method of competition and banning non-compete agreements will result in reduced healthcare costs, new business formation, increased innovation, and higher worker earnings.The rule applies to anyone who works for a for-profit employer, despite being paid or unpaid and independent contractors. Additionally, limited use of non-competeagreements between franchises and franchisors is permitted. The rule also does not apply to non-compete agreements entered into by a person pursuant to a bonafide sale of a business entity.
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In 2018, the Agricultural Improvement Act of 2018 was signed into law, authorizing the production of hemp and removing hemp and hemp seeds from the Drug Enforcement Agency’s (DEA) list of controlled substances. The act also allowed the U.S. Department of Agriculture (USDA) to provide guidance to implement a programthat would help establish the regulatory framework regarding the production of hemp throughout the United States.
Following the Agricultural Improvement Act of 2018, Senate Bill 1020 in Florida was signed. This bill provided a state plan for the regulation of cultivating hemp within Florida. Under the bill, hemp-derived cannabinoids are not controlled substances so long as the hemp derivatesdo not exceed a total delta-9 tetrahydro cannibal (THC) concentration of 0.3 percent on a dry weight basis. Any product with a THC concentration over 0.3 percent is considered a controlled substance.
It is important to note that the sale of topical CBD products is not required to be licensed by the FDACS and is rather regulated by the Florida Division of Business and Professional Regulation. Additionally, there may be further requirements for CBD products that contain dairy or frozen ingredients.
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In the State of Florida, the Department of Health regulates the unlicensed practices of health care professionals. Florida Statute § 456.065 states that any practice, performance, or delivery of health care services byan individual without a valid and active license to practice that profession is strictly prohibited.
Not only can practicing without a valid license accumulate hefty fines for an offender, but it can also impose criminal penalties and/or sentences. The Unlicensed Activity Unit works with law enforcement and the state attorney’s offices to prosecute any individuals practicing without a license.
The unlicensed practice of health care can have serious impositions on the administrative side and criminal side. An individual practicing without a valid license may bedelivered a cease-and-desist notice to halt their practice which can have further implications if the notice is not abided by. Furthermore, individuals practicingunlicensed may be subject to citations and criminal proceedings that include fines and imprisonment.
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When a physician provides a service, the reimbursement amount for that work is often measured through a metric referred to as work relative value units (wRVU). Although not every physician may be subject to wRVUs, such as physicians who have their own private practice, many physicians who work in large healthcare organizationsmay be required to meet a minimum amount of wRVUs.
The goal of the wRVU model is for physicians’ compensation to be directly correlated to the amount of work they perform, regardless of the patient’s insurance plan or the revenue generated during the services. Focusing on the amount of work performed has proven to be more effective than the previous method of tracking a physician’s productivity by the number of patients seen and number of services performed. Additionally, calculating reimbursement simply off the amount charged to the patient can be ineffective as well because the amount does not necessarily reflect the underlying value of the work provided. As such, the current wRVU model is the standard compensation model that many physicians and employers use in the healthcare industry.
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Record Keeping
Fla. Stat. §456.057(13) of the Florida statutes states that “records owners shall notify the appropriate board office when they are terminating practice, retiring, or relocating, and no longer available to patients, specifying who the new records owner is and where medical records can be found.”
As defined in the statute, a records owner means:
- Any health care practitioner who administers treatment, dispenses drugs, or generates a medical record after making a physical or mental examination of any person.
- A health care practitioner to whom records are transferred by a previous record’s owner.
- Any health care practitioner’s employer provided that the agreement designates the practitioner’s employer as the records owner.
Notification of Changes
In addition to notifying the appropriate board office when retiring, closing, or relocating their practice, a record’s owner must also place an advertisement in the local newspaper or notify the patients in writing of the change, pursuant to Fla. Stat. §456.057(12). The patients of the practitioner must have the opportunity to request a copy of their medical record. According to Fla. Stat. §456.057(14), when a new records owner has been appointed, the new owner is responsible for providing a copy of the complete medical record to a patient or a patient’s legal representative who has requested the record.
Outside of notifying the appropriate board office and patients, practitioners may need to notify the Centers for Medicare & Medicaid Services and the U.S. Drug Enforcement Agency to comply with the appropriate disposal of the drugs within the practice. If the practitioner holds a license from the Department of Health for their use of medical equipment, they must notify the department and keep a record of the transfer or disposal of the equipment. Other establishments that may need to be notified include the Florida Agency for Health Care Administration, the hospital where the practitioner worked if applicable, other vendors whom the practitioner may have received supplies or equipment from, and the practitioner’s medical malpractice insurance carrier.
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The United States Department of Treasury’s Financial Crimes Enforcement Network (FinCEN) is required through the Corporate Transparency Act to prevent and protect the community from fraud and illicit activities involving U.S. companies. In 2021, the Corporate Transparency Act was enacted and took effect on January 1, 2024.
Beneficial Owners of any U.S. reporting company are required to file a report.Beneficial Owner is defined by the Corporate Transparency Act as any individual who, “directly or indirectly, (1) exercises substantial control over the entity or (2) owns or controls not less than 25 percent equity in the entity.”
A complete list and compliance guide are available on the FinCEN Q&A website (https://www.fincen.gov/boi-faqs#B_2).
Beneficial Ownership Information Reports can be filed using the BOI E-Filing System at: https://boiefiling.fincen.gov/
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Per the Board of Nursing, if a specific act is questionable, a declaratory statement may be requested to provide clarity. The Board of Nursing defines a declaratory statement as a means for resolving a controversy or answering questions or doubts concerning the applicability of statutory provisions, rules, or orders over which the board, or department when there is no board. On September 26, 2022, Jessica James, a registered nurse (R.N.) from Pensacola, Floridarequested a declaratory statement on clarification for the task delegation of Botox Cosmetic. The case referenced Florida Statute § 464.003, specifically quoting, “The administration of medications and treatments as prescribed or authorized by a duly licensed practitioner authorized by the laws of this state toprescribe such medications and treatments.” Jessica James’ request went on to identify some prerequisites in her case for Botox task delegation eligibility bystating that the physician would first examine the patient and write an order detailing the specific muscles to be injected as well as the units per injection site before delegating the task to a registered nurse.
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The Americans with Disabilities Act (ADA) is a comprehensive civil rights law in the United States that prohibits discrimination based on disability in everyday activities, including medical services. The ADA applies to healthcare providers and has implications for how they must treat individuals with disabilities to ensure equal access to medical services.
Title II of the ADA applies to public hospitals, clinics, and health care services operated by state and local governments. Title III of the ADA applies to privately-owned and operated hospitals, clinics, and health care providers. Under Title III of the ADA, businesses that provide services to the public are called public accommodations. Public accommodations are private entities such as a doctor's office, a dentist's office, a psychologist's office, a clinic, a hospital, a group practice, urgent care, a general physician, a physical rehabilitation facility, or other healthcare professionals.
All public accommodations must comply with basic nondiscrimination requirements prohibiting exclusion, segregation, and unequal treatment. Furthermore, the ADA requires healthcare providers to make reasonable accommodations to ensure that individuals with disabilities have equal access to medical care and health facilities.
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Health and Safety laws are regulated by various agency officials and theses are arguably the most crucial jobs in our community. Most people do not take the time to adequately research their healthcare providers prior to receiving healthcare services or medication. However, several agencies have been established to safeguard and regulate the health and safety of the healthcare services that consumers receive. These agencies can’t replace individual due diligence but they make every attempt to prevent patient harm and to eliminate fraudulent activity in the healthcare system.
Florida Department of Health
The Florida Department of Health (DOH) was the first accredited public health system in the United States. Their mission is to protect and improve on the health of all people in Florida by regulating healthcare practitioners and facilities. They offer programs and services for the Florida community, but they are also responsible for the licensing and regulation of various healthcare practitioners and facilities. Various healthcare professions must be licensed and are regulated via the Florida Department of Health such as: medical doctors, acupuncturist, optometrists, and many more. Certain facilities such as piercing salons and pharmacies are also regulated by the Department of Health. Complaints can be filed against any of the practitioners or facilities, which will then be investigated by an officer for violations. The complaint is referred over to the Probably Cause Panel, which will determine whether to file an Administrative Complaint against the healthcare provider based on the weight of the evidence that is provided by the complainant and the provider who under investigation. It is not uncommon for the DOH to place an emergency restriction on a provider’s license if they pose an imminent danger to patient safety. If a violation is found, the Department of Health will determine appropriate disciplinary action to enforce the regulations, which includes, probation, suspension, or even revocation of a healthcare provider’s license.
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Once a real estate purchase reaches the closing process, there are many standard and procedural documents that must be signed and notarized. All closings require many pages of paperwork filings and signatures from all parties in a transaction. Traditionally, parties would need to sign documents and appear at a physical location at a predetermined time to have signatures verified and notarized. Many states have now adopted laws that allow for virtual signature verifications. Remote Online Notarizations (also known as RON) are the backbone of remote closings. Without Remote Online Notarizations (RON), it would not be possible to conduct a remote closing. Florida became the twenty-first state to adopt remote online notarizations. On January of 1, 2020, Governor Ron DeSantis signed House Bill 409 into law allowing for Florida to accept closings using the remote online notarization system. This came at a convenient time for Florida’s real estate market with the looming pandemic soon to be underway. This new process streamlined the closing of transactions within the State of Florida.
Some states do not accept remote online notarizations but provide other options for online notarizations. Remote-Ink Signed Notarizations, (known as RIN), are notarizations with wet-ink signatures. Parties are able to use a video conference technology such as zoom to appear before a notary and sign documents virtually. The documents are then sent to the title company for processing. In-Person E-Notarization (also known as IPEN) are notarizations where closing documents are signed electronically but not remotely. This method merely eliminates the paper involved in signing. While this method is not technically ‘remote’ it cuts waste on paper and allows an electronic signature as an alternative to a ‘wet ink signature’.
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In May 2023, Florida House Bill 264 passed, and it went into effect on July 1, 2023. The bill has two main parts: the first prohibits offshore health record storage, and the second requires additional ownership disclosures.
he first part of the bill is an update of the Florida Electronic Health Records Exchange Act. This amendment prohibits healthcare providers using certified health record technologies from storing electronic health records outside the continental United States, its territories, or Canada. This prohibition extends to patient data stored through third-party cloud services and subcontracted computing facilities, which must maintain the data in the continental United States, its territories, or Canada.
Once the ban takes effect, it will no longer be possible to use vendors that do not store patient data in the continental United States, its territories, or Canada. All healthcare providers covered by the Florida Electronic Health Records Exchange Act must comply with the law by July 1, 2023. The prohibition applies to all qualified electronic health records stored using any technology that allows information to be electronically retrieved, accessed, or transmitted.
The purpose of the prohibition is to prioritize patient privacy by ensuring that personal health data remains within jurisdictions where privacy and security measures can be enforced. Offshore storage has raised concerns due to potential security breaches and varying data protection standards across countries. By mandating storage within the continental United States, its territories, or Canada, Florida aims to mitigate the risks associated with data breaches, unauthorized access, and potential exploitation of patient information. While these new regulations offer essential benefits such as increased privacy protection and informed decision-making for patients, there are also potential challenges to consider. These include increased costs for healthcare providers, technological limitations, implementation and compliance challenges, and the potential disruption of existing partnerships.
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In many states, homeowners have the option of using what’s called a Homestead Exemption to reduce the amount of property tax owed on their home per year. The exemption is a property tax break that lowers the taxable value of a home. Property taxes are assessed by the local taxing authority and are calculated based on the assessed value of the property and location. The Homestead Exemption also serves as a provision to protect against bankruptcy and creditors in the event of a homeowner’s passing. The exemption provides surviving spouses with continued lower tax and asset rates. The allowable Homestead Exemption differs based on which State the primary residence is in and does not lower or affect the assessed value of a home. In some states, a homeowner needs to meet certain requirements (age requirements, be a disabled person or a veteran, etc) to qualify for a Homestead Exemption. In Florida, the exemption is available to all homeowners on their primary residence. The Homestead Exemption can reduce the taxable property value by as much as $50,000 a year.
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After the unfortunate death of a young, aspiring nursing student in South Florida (Ms.Stephanie Balais) Florida Representatives filed House Bill 725. It is cited as the “Stephanie Balais Act”. In the products liability case of Stephanie Balais it is noted that her untimely passing was due to a Selenium treatment shereceived in 2018. It is unclear whether the fault lie with the manufacturer and the batch of products; the individual administering the product; or the lack ofestablished procedures in the event of an emergency. Liability was never determined in this case, and the case was settled out of court. However, this case prompted the introduction of House Bill 725.
The Act defines Intravenous Hydration Therapy as “a procedure in which high concentrations of vitamins and minerals are administered directly into the person's bloodstream, allowing rapid absorption of higher doses of the vitamins and minerals than if received through food or supplements”. The purpose of the Act is to ensure the safety of patients considering IV Hydration treatments. Due to the rise in popularity and frequency of thesetreatments, it has become necessary to create safety guidelines to eliminate or at the very least minimize risks for the healthcare and wellness community. This is why any written emergency plan must at a minimum include: (1) the name and address of the hospital closest to the location where the IV Hydration Treatment is being performed; (2) reasons why an emergency transfer may be obligatory; and (3) the medical services that must be utilized in the event of a medical emergency. Additionally, if a health care provider, upon review of the completed self-screening risk assessment questionnaire determines that a patient can’t safely receive an IV Hydration Treatment the provider must decline administering the treatment to that individual.
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What Is A 1031 Exchange?
In layman’s terms, a 1031 exchange is a tax break. It allows for investors to swap investment properties without having to pay taxes at the time of exchange. It grants taxpayers the ability to grow their investment without having to pay capital gains taxes until an investment is liquidated or sold for cash. There is no limit to how frequently taxpayers are able to take part in 1031 exchanges. Taxpayers can defer these capital gains taxes and rollover the gains for years.
What Are The Pros And Cons of A 1031 Exchange?
Typically, if an investor is looking to purchase a new property soon after the sale of a property, a 1031 exchange is recommended. There are many reasons why an investor would be looking to carry out a 1031 exchange. The obvious pro is deferring capital gains taxes on the sale of a property. A 1031 exchange also allows for investors who are interested in moving to a new market to move seamlessly. There are no distance limitations for a 1031 exchange. There are also no limits to how often you can take part in a 1031 exchange. This means that an investor can sell a property anywhere in the United States and use the money from that sale to purchase another similar property anywhere else in the United States. It gives investors the opportunity to switch markets without having to pay major taxes.
There are, however, some cons to keep in mind. In order to move forward with a 1031 exchange, the capital gains earned on the sale of a property must be rolled over to a ‘like-kind’ investment. Should an investor want to use the gains for any other type of investment or purchase, they would lose the protection of the 1031 exchange and be required to pay the applicable taxes. Another con is that the structure can become complicated if there are multiple investors in a property and they are not all in agreement. It is possible to complete a 1031 exchange if not all of the investors of a property agree to rollover the gains. The remaining funds would be placed into a separate account and be liquidated. This circumstance is not common and is more complex.
Overall, a 1031 exchange is a great tool for investors. The Internal Revenue Service allows for investors to get a tax break and roll over their tax liabilities on the capital gains taxes potentially forever. It is a great way for investors to maximize their opportunities and build generational wealth.
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According to Florida Statute 466.023(1), Only dental hygienists may be delegated the task of removing calculus deposits, accretions, and stains from exposed surfaces of the teeth and from the gingival sulcus and the task of performing root planing and curettage. In addition, dental hygienists may expose dental X-ray films, apply topical preventive or prophylactic agents, and perform all tasks delegable by the dentist in accordance with s. 466.024. The board by rule shall determine whether such functions shall be performed under the direct, indirect, or general supervision of the dentist.
Section (3) of the aforementioned Florida Statute, states that dental hygienists may, without supervision, provide educational programs, faculty or staff training programs, and authorized fluoride rinse programs; apply fluorides; instruct a patient in oral hygiene care; supervise the oral hygiene care of a patient; and perform other services that do not involve diagnosis or treatment of dental conditions and that are approved by rule of the board.
Section (5) of the aforementioned Florida Statute, states that Dental hygienists may, without supervision, perform dental charting as provided in s. 466.0235.
Section (5) of the aforementioned Florida Statute, states thatA dental hygienist may administer local anesthesia as provided in ss. 466.017 and 466.024.
Florida Statute 466.017(4) states that A dentist or dental hygienist who administers or employs the use of any form of anesthesia must possess a certification in either basic cardiopulmonary resuscitation for health professionals or advanced cardiac life support approved by the American Heart Association or the American Red Cross or an equivalent agency-sponsored course with recertification every 2 years. Each dental office which uses any form of anesthesia must have immediately available and in good working order such resuscitative equipment, oxygen, and other resuscitative drugs as are specified by rule of the board in order to manage possible adverse reactions.
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Effective July 1, 2020, Advanced Practice Registered Nurses (“APRN”) will be able to register their own autonomous practice throughout Florida with the passage of House Bill 607. No longer will the APRN have to provide patient care within the framework of an established protocol with a supervising physician if they are properly registered. If the APRN is not registered then an established protocol will still be required. The term Health Care Provider has been re-defined to mean a physician, osteopathic physician, podiatric physician or an APRN registered under Florida Statute §464.0123.
A registered APRN may only establish an autonomous practice in primary care, including family medicine, general pediatrics, and general internal medicine. APRNs certified as nurse midwives may engage in the practice of midwifery in accordance with Florida Statute §464.012(4)(c). APRNs engaging in autonomous practice must provide information in writing to a new patient about his or her qualifications and the nature of the autonomous practice before or during the initial patient encounter.
A registered APRN may also (1) admit a patient to a health care facility; (2) manage the care that the patient receives at the facility: and (3) discharge the patient from the facility, unless prohibited by federal law. The ARPN may provide a signature, certification, stamp, etc., that is otherwise required by law to be provided by a physician so long as the APRN is not issuing a physician certification.
There are many other requirements that an APRN has to comply with in order to legally establish and operate their autonomous practice in Florida. As more APRNs register I’m confident that additional laws and/or rules will be created to further regulate the practice area. It is important to hire a health law attorney who has the requisite experience, knowledge and training required to help you navigate the laws.
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As of November 1, 2019, a physical therapist or chiropractor, are unable to “opt-out” out Medicare. If you look at this chart you will see that physical therapists and chiropractors are not listed as providers who are able to opt out. The Medicare Benefit Policy Manual: Chapter 15 Section 40.4 states Physical therapists in independent practice and occupational therapists in independent practice cannot opt out because they are not within the opt out law’s definition of either a “physician” or “practitioner”. A non-opt-out provider, is required to submit a claim for any item or service that is, or may be, covered by Medicare.
The only situation in which they are not required to submit claims to Medicare for covered services is where a beneficiary or the beneficiary’s legal representative refuses, of his/her own free will, to authorize the submission of a bill to Medicare.
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You’ve decided that now is the time to close your healthcare entity (i.e. Medical Practice) for any number of reasons. However, you can’t simply close the doors and just walk away. There are a few steps that you need to take in order to comply with Federal and Florida law. One of the requirements is that you “wind up” your limited liability company (“LLC”).
After you’ve dissolved the company the company continues only for the purpose of winding up. During this process the LLC is required to discharge or make provisions for the company’s debts, obligations and other liabilities, as well as, settling and closing the company’s activities and affairs, including distribution of the assets of the LLC.
You may also have to prosecute and defend certain legal actions and proceedings even after dissolution, whether civil, criminal or administrative. The company would have to settle any disputes by mediation or arbitration and transfer title to the company’s real estate and other property.
The dissolved company that has completed winding up may submit a statement of termination to the Department of Business Regulations including: (a) the name of the LLC; (b) the date of filing of its Articles of Organization; (c) the date of filing of its articles of dissolution; (d) the LLC has completed winding up its activities and affairs and has determined that it will file a statement of termination; and (e) other information as determined by the authorized representative.
Finally, the trustees may distribute property of the limited liability company discovered after dissolution, convey real estate and other property and take such other action as may be necessary on behalf of and in the name of the dissolved LLC.
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If you’re purchasing a physician practice or any other type of Florida healthcare entity you must ensure that you have structured the acquisition in such a way that you are not inheriting the liabilities of the previous owner. To do so, you must conduct a thorough due diligence process and draft the appropriate agreements.
In Florida, a purchaser is generally not liable for the debts and liabilities of the seller unless the purchaser expressly (or impliedly) agrees to assume such debts and liabilities. Successor liability has the potential to become an issue when you purchase any existing company. The purchaser has the option to limit the assumption of liabilities of the seller by structuring the acquisition in a specific way. By doing so, the purchaser won’t be responsible for paying the seller’s debts and liabilities. Typically, in a “stock” purchase you are responsible for all liabilities and debts of the company, while in an “asset” purchase you are only assuming those liabilities and debts that you specifically agree to assume.
It is critically important that you hire an experienced business law attorney who has drafted these agreements specifically for healthcare entities. This attorney must conduct a thorough due diligence process which includes a lien and title search, review of recorded business loans and determine whether there are any outstanding state sales and gross receipt taxes.
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Adult Family Care Homes are Agency for Health Care Administration (“AHCA” or Agency) licensed facilities that provide care to disabled adults and frail elders in a family-type living environment. These adults choose to live with an individual or a family in a private home. One key distinction between an Assisted Living Facility and an Adult Family Care Home (“AFCH”) is that the Provider must also live in the home, which can be owned or rented by that Provider. The home has to meet the local zoning requirements prior to obtaining the AHCA license. The intent behind the Adult Family Care Home Act is to allow for residents of AFCHs to remain as independent as possible and to avoid placement in a nursing home or other licensed facility.
AFCH means a full-time, family-type living arrangement, in a private home, under which a person who owns or rents the home provides room, board, and personal care, on a 24-hour basis, for no more than five disabled adults or frail elders who are not relatives. Personal care services includes individual assistance with or supervision of the activities or daily living and the self-determination of medication, and other similar services. A resident who requires 24-hour nursing supervision may not be retained in an AFCH unless such resident is an enrolled hospice patient and the resident’s continued residency is mutually agreeable to the resident. Certain types of family-type living arrangements are not required to be licensed as an AFCH.
Although no more than five adults may reside in the home, the licensed maximum capacity of each AFCH is based on the service needs of the residents and the capability of the provider to meet the needs of the residents. Any relative who lives in the adult family-care home and who is a disabled adult or frail elder must be included in that maximum resident count.
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What is a Rural Health Clinic?
A Rural Health Care Clinic (RHC) is a clinic designed to provide quality care to patients in rural areas. They are Medicare certified programs that must be established in areas designated as rural shortage areas. An RHC is not permitted to care for patients of mental diseases or rehabilitation services. At least fifty percent of the time the clinic is open there must be a nurse practitioner, midwife, or physician assistant to provide care to patients. These medical professionals are under direction of a physician. RHCs are required to staff personnel, but there are no requirements to maintain a Board of Directors. Two types of Rural Health Clinics exist: (1) an Independent Rural Health Clinic which is a freestanding clinic not associated with a hospital or any type of Health Care Agency; and (2) a Provider Based Rural Health Clinic which is the subordinate of a hospital, home health agency or nursing facility. Also, Rural Health Clinics do not receive federal funding for start-up or expansion.
What is an FQHC?
A Federally Qualified Health Center are primary care outpatient centers that serve underserved communities. FQHCs qualify for reimbursements from the Health Resources and Services Administration (HRSA), Medicaid, and Medicare. An FQHC can receive government grants, donations, and private sectors in addition to the Medicaid reimbursements. To be considered a Federally Qualified Health Center a clinic must meet certain requirements including: (1) serving an underserved area; (2) provide care on a ‘sliding fee scale’ which is based on ability to pay; (3) complete required annual reports; (4) provide holistic and social services; (5) and not be approved as a rural health clinic.
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In Florida, doctors are required to report all criminal activities committed after they receive their medical license even though it is not in relation to employment and occurs after regular working hours. Any report or complaint filed towards a medical professional will be investigated by the Florida Department of Health. Being placed under arrest can trigger disciplinary action from the state licensing boards. Medical disciplinary actions require a much lower burden of proof than federal cases. It is possible to be penalized, face Medicare/Medicaid exclusion, and potentially have your license revoked based on the severity of the crime and investigation. It is entirely possible that a physician can face the loss of their medical license even if an investigation does not result in criminal prosecution and a conviction at a trial.
According to the Florida Board of medicine, all criminal activities after receiving your medical license must be timely reported. The Board provides various options for reporting including email, online service portal, or via regular mail. If a complaint is issued via sending an email or letter, the correspondence must include the date of the offense, the activity that happened, and the county and state of jurisdiction. The complaint cannot reach processing without the proper information.
The Florida Department of Health’s Medical Quality Assurance (MQA) launched a user-friendly online portal. The portal was developed in collaboration with the Agency for Health Care Administration (AHCA) to allow for easy reporting of any complaints again medical providers from fraud to unlicensed activity and violations. The portal offers education on the different federal agencies for complaints as well.
See below for email, website and address:
MQAOnlineService@FLHealth.Gov
www.mqa-vo.doh.state.fl.us./datamart/voservicesportal
Florida Department of Health
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By definition, a death certificate is an official government issued document that declares the known data of a deceased person at their time of death. A death certificate is a legal record of death. This can include but is not limited to, the identifying statistics of the decedent along with the specific information of the death in question such as the time of death, exact location of death, and cause of death.
According to the Florida Statutes (FS § 382.008), the death certificate is to be signed within 72 hours by the appropriate party. The typical certifier of the death certificate is the medical practitioner in charge of the decedent’s care for the illness or disorder which resulted in the death of the decedent. The death certificate may also be signed by the medical physician that was attending to the decedent at the time of death or immediately after death. In the instance of a natural death, it is expected that the medical practitioner that was caring for the decedent (withing the previous 3 months) will sign the death certificate. At times there will be no specific illness or conditional circumstances which resulted in the death of the decedent. The signing medical practitioner or medical examiner will declare the cause of death to the best of his or her knowledge and belief. It is common to use terminology such as “probable” and “likely” for a decedent whose cause of death is not certain. It is up to the medical practitioner to use their best medical opinion at the time of signing the death certificate.
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The Office of Inspector General’s (“OIG”) list of Excluded Individuals and Entities (“LEIE”) provides information to the healthcare industry, patients and the public regarding individuals and entities currently excluded from participation on in Medicare, Medicaid and all other Federal healthcare programs.OIG imposes exclusions under the authority of sections 1128 and 1156 of the Social Security Act. On May 8, 2013, the OIG released a Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs, which states that no federal healthcare program payment may be made for items or services furnished by (1) an excluded person or (2) at the medical direction or on the prescription of an excluded person.When an individual or entity gets a “Notice of Intent to Exclude” (“NOI”), it does not necessarily mean that they will be excluded. OIG will carefully consider all material provided by the person who received the NOI before making a decision. All exclusions implemented by OIG may be appealed to an HHS Administrative Law Judge (“ALJ”), and any adverse decision may be appealed to the HHS Department Appeals Board (“DAB”). Judicial review in Federal court is only available after a final decision by the DAB.Reinstatement of an excluded individual or entity is not automatic once the specified period of exclusion ends. In order to participate in Medicare, Medicaid, and all Federal healthcare programs once the term of exclusion ends, the individual or entity must apply for reinstatement and receive written notice from OIG that reinstatement has been granted.Web: www.JonesHealthLaw.com Phone: (305)877-5054 Instagram: @JonesHealthLaw Facebook: @JonesHealthLaw Youtube: @JonesHealthLaw--- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
What is a Non-Compete Agreement or Provision? A Non-Compete provision may prohibit current and former employees from simultaneously or subsequently being employed by another entity or operating their own business within a certain geographic radius for a defined period of time (i.e. 2 years) if the employee will provide similar services in a competing field of work. This provision is typically presented to employees upon an employment offer as a part of an employment agreement. A Non-Compete Agreement is a standalone agreement between an employer and employee that has one or more Non-Compete provisions or restrictive covenants. An agreement can also be entered into after employment has begun but should be provided at least 14 days prior to taking affect. Employers require employees to sign a Non-Compete to limit competition, conflicts, and improve quality of work. Original Ban on Non-Compete Agreements On January 11, 2021, the District of Columbia signed D.C. Act 23-563, which banned Non-Compete provisions in employment contracts protecting employees from being required to sign a non-complete agreement as a condition of their employment. This act prohibits employers from presenting Non-Compete agreements and opens the door for employees to “moonlight”, seek additional employment, or pursue other professional endeavors since they would no longer be restricted to a single employer. The Purpose of the Clarification Amendments D.C.’s ban was one of the broadest bans on Non-Compete provisions. Employees were free to simultaneously work two jobs with no wage threshold. Only medical professionals were prohibited from simultaneously working for two employers. The original Act was immediately subject to criticism and has had various delays to its applicability date due to its controversy and vague (if any) limitations in most areas. Web: www.JonesHealthLaw.com Phone: (202)505-4796 Instagram: @JonesHealthLaw Facebook: @JonesHealthLaw Youtube: @JonesHealthLaw
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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.
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.
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Biomedical waste is the inevitable outcome in most health care offices. Professionals in the health care field need to keep up to date information on the regulations for handling any type of biomedical or hazardous/chemical waste that is a result of services provided. While the most obvious concerns are those of public safety and possible health risks, if not stored or disposed of properly, this waste can also result in thousands of dollars in fines. There are many types of health care waste to consider: biohazard, chemical, pathological, chemotherapy waste, etc. The waste produced by each office will determine the proper treatment and disposal. The Department of Health along with the state’s environmental and health departments regulate the storage, containment, treatment, and disposal of biomedical waste.
According to the State of Florida’s Bureau of Community Environmental Health, Biomedical waste is defined as any solid or liquid waste that may present a threat of infection to humans. The term includes, but is not limited to, nonliquid human tissue and body parts; laboratory and veterinary waste that contains human-disease-causing agents; discarded disposable sharps; human blood and human blood products and body fluids; and other materials that in the opinion of the Department of Health represent a significant risk of infection to persons outside the generating facility. The term does not include human remains that are disposed of by persons licensed under Chapter 497.
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According to the Florida Department of Elder Affairs, an Assisted Living Facility (“ALF”) is a residential care facility that provides housing, meals, personal care and supportive services to older persons and disabled adults who are unable to live independently. ALFs are intended to be a less costly alternative to more restrictive institutional settings for individuals who do not require 24-hour nursing supervision. Florida ALFs can range in size from a single resident to hundreds and may contain individual apartments or suites that a resident shares with others. An ALF is a “Community residential home”, which is a dwelling licensed to service residents who are clients of the Department of Elderly Affairs (“EA”), the Agency for Persons with Disabilities (“APD”), the Department of Juvenile Justice (“DJJ”), or the Department of Children and Families (“DCF”) or licensed by the Agency for Health Care Administration (“AHCA” or “Agency”) which provides a living environment for 7 to 14 unrelated residents who operate as the functional equivalent of a family, including such supervision and care by supportive staff as may be necessary to meet the physical, emotional and social needs of the residents. Examples of residents include: frail elders; a person who has a handicap; a person who has a developmental disability; a non-dangerous person who has a mental illness; a child who is found to be dependent; or a child in need of certain services. There are many requirements to opening and operating a Florida licensed Assisted Living Facility. This podcast does not attempt to highlight all of the legal requirements and should only be considered an educational overview. There are many legal considerations and requirements that were not addressed in this podcast. It is in your best interest to contact an experienced health care attorney if you are considering opening or purchasing an ALF so that they can help you navigate the process. Web: www.JonesHealthLaw.com Phone: (305)877-5054 Instagram: @JonesHealthLaw Facebook: @JonesHealthLaw Youtube: @JonesHealthLaw
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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 is tedious and must be done carefully or you risk denial. Also, the applicant should not expect to receive the license expeditiously.
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Just as is the case with Advanced Practice Registered Nurses, the Florida Legislature has recognized that Physician Assistants (PA) are capable of performing certain health care activities that they were previously prohibited from performing. The changes are largely administrative and does not significantly increase the independent clinical services that they may provide to a patient. On June 29, 2021, the governor approved House Bill 431, which expands the scope of practice for Physician Assistants. The provisions set forth in the House Bill 431 took effect on July 1, 2021.
Notably, the law does not permit PA to sign for medical marijuana certification, workers compensation medical examinations required to determine maximum medical improvement, and impairment ratings. Florida PA are bound by the requirements contained in Florida Statute §§458.347 and 459.022.
One of the more noteworthy changes to the law is that it deletes the requirement that a physician assistant must inform his or her patients that they have the right to see a physician before the physician assistant prescribes or dispenses a prescription (amendment to Fla. Stat. §458.347(4)(e)(1)) and Fla. Admin. Code R. 64B8-30.012. Also, physician assistants are now authorized to procure drugs and medical devices and revising the requirements for a certain formulary (amendment to Fla. Stat. §458.347(4)(f)(1) and Fla. Admin. Code R. 64B8-30.008).
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Florida allows for conversion of a business from another state. The terms ‘conversion’ and ‘domestication’ can be used interchangeably depending on the state you are in but there are a few differences that should be noted. The most notable difference is that conversion allows for a change in entity type. Florida allows for LLCs to change the applicable governing law and convert into a Florida corporation (an S Corp). The company is then treated as though it was originally formed in Florida. This might provide tax benefits for the business owner. Domestication of a company merely allows for the company to relocate. In Florida, the term ‘domestication’ refers to the move of a company formed internationally into the state and is a more complex procedure.
Alternatively, business owners can register as foreign LLC’s, dissolve the company and form a new company, or go through a merger in their new state if conversion is not allowed. However, these methods can be more costly and don’t have the added benefits previously mentioned.
It is recommended that an attorney assist with the process to ensure the forms are submitted accurately. At Jones Health law, we have experienced attorneys that can provide legal support during the conversion process.
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A group home by definition is a residence that offers full time care for those who are unable to care for themselves. Group homes offer assistance for those who are unable to care for themselves due to age or medical disability and can’t be cared for by family members.
Group homes are usually smaller than other care facilities with more centralized care and fewer residents (usually 6 beds or under). Typically, 24-hour care and supervision is provided by at least one caregiver around the clock. Group Homes are not typically responsible for the personal care of residents such as bathing or using facilities. While health insurance does not typically cover the cost of a group home, long term care insurance might.
Applicants will need to provide their licensing department with a business plan and operations manual along with the prospective location and community plan, geographical plan, zoning requirements, etc. Applicants may be eligible to receive Community Development Grant Block Funding to set up their home. Local community offices provide information on funding and assistance for group homes.
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Developments of new drugs and medical technology have enabled physicians to perform treatments and procedures in the comfort of medical offices that were once only able to be performed in hospital settings. To confirm whether obtaining an Office Surgery License is required for your office to perform these surgeries you must carefully examine the rules on office surgeries because they have changed recently.
The registering Surgeon should submit an Office Surgery Registration form with an original signature. The office must also provide proof of completion of necessary training (i.e. certificates/diplomas) by all physicians. If any physicians that will also be performing Level 2 or Level 3 surgeries are hired to the office after the approval, the Department must be notified immediately to update records.
For each level, there are specific outlines for medication, equipment, and registration requirements which can be found by visiting: http://www.doh.state.fl.us/mqa/medical/osr_home.html.
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Whether an aromatherapy product is a cosmetic or a drug under the law is determined by the product’s intended use. The Federal Food, Drug and Cosmetic Act defines “cosmetics” by their intended use, as “articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance.” Florida Statute §499.003(12) adopted the FDA’s definition of “cosmetic” verbatim, but further stated that the definition does not include soap. The law doesn’t require cosmetics to have FDA approval before they go on the market. But FDA can take action against a cosmetic on the market if they have reliable information showing that it is unsafe when consumers use it according to directions on the label, or in the customary or expected way, or if it is not labeled properly.
The FDA Act defines “drugs”, in part, by their intended use, as “articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease” and “articles (other than food) intended to affect the structure or any function of the body of man or other animals. For example, claims that a product will relieve colic, ease pain, relax muscles, treat depression or anxiety, or help you sleep are drug claims.
Intended use may be established by claims stated on the product labeling, what consumers expect it to do, in advertising on the internet, or in other promotional materials. Ultimately, the FDA makes decisions on a case-by-case basis. Certain claims may cause a product to be considered a drug, even if the product is marketed as if it were a cosmetic. It may also be established that a product is a drug based upon the ingredients that have a well-known therapeutic use.
Essential oil fragrances marketed for promoting attractiveness is a cosmetic. However, a fragrance marketed with certain “aromatherapy” claims, such as assertions that the scent will help the consumer sleep or quit smoking, meets the definition of a drug because of its intended use. Under Florida Statute §499.005(5) it is a crime to disseminate false or misleading advertisement of a drug, device or cosmetic, which is punishable as a misdemeanor of the second degree. It is also a violation of the Florida Drug and Cosmetic Act to disseminate any false advertisement of any drug, device or cosmetic, which includes misleading advertisements according to Florida Statute §499.0054(1)(a). These advertisements include those on a website or social media account. Keep in mind that a cosmetic product must be labeled according to cosmetic labeling regulations.
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In this episode we are discussing the ear, nose, and throat with Otorhinolaryngologist, Daniel Branovan, M.D.! As the Director and Chair of the New York Ear, Nose & Throat Institute, Dr. Branovan is an Ear, Nose and Throat doctor who has served Brooklyn for 14 years, and who utilizes the most modern technology and equipment to get patients on the road to better health more quickly. He is widely known as a top provider of minimally-invasive sinus surgery. Recently, Dr. Branovan has opened a second medical office in Hallandale Beach, Florida.
Dr. Branovan studied medicine at Stanford University and completed his residency at The New York Eye and Ear Infirmary in Otolaryngology. Dr. Branovan also earned a Master’s degree at Harvard University. His awards and recognitions include “Best Physicians in America,” New York Magazine’s “Best Minimally Invasive Surgeons,” and Castle Connolly’s “Best Physicians in the New York Metro Area.”
He is certified by the American board of Otolaryngology, and belongs to professional associations like the American College of Surgeons. He is fluent in English and Russian.
During our discussion, Dr. Branovan discussed a range of topics including: (1) His training and the pros & cons of being an ENT doctor; (2) a description of a typical day in the office; (2) why we feel pressure in our ears when travelling via airplane; (3) whether certain demographics are predisposed to certain health conditions that an ENT doctor treats; (4) why we shouldn't put Q-tips in our ears and alternatives to cleaning out ear wax; (5) minimally invasive surgery due to advancements in tools and technology ; (5) myths and misconceptions about ENT procedures; (6) how weather, environment, and lifestyle have an impact on your ENT health; and more.
We touch on a wide range of topics in this podcast that I know you don't want to miss. Don't forget to listen and share with anyone that you think would be interested in listening as well.
Dr. Daniel Branovan can be reached at:
Instagram: @doctorbranovan
Address: 1000 E. Hallandale Beach Blvd., #1-102, Hallandale Beach, Florida 33009
Phone: 754-400-5959
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Under Florida law, no person other than a Florida licensed dentist, nor any entity other than a professional corporation or limited liability company composed of dentists may:
- Employ a dentist or dental hygienist in the operation of a dental office.
- Control the use of any dental equipment or material while such equipment or material is being used for the provision of dental services, whether those services are provided by a dentist, a dental hygienist, or a dental assistant.
- Direct, control, or interfere with a dentist’s clinical judgment.
As per statute, a non-dentist must not directly employ a dentist (i.e. W-2 employee) but they may work with the dentist as a 1099 independent contractor. The non-dentist cannot pay a dentist a salary or commission. The dentist may create their own wholly owned professional corporation while the non-dentist may provide their services through an LLC or other taxable organization. No employment contract may exist between the dentist and the operator but an independent contractor agreement may be necessary. Any dentist who is employed by a non-dentist may face disciplinary action.
The non-dentist who is providing the office space and equipment cannot control the use of dental equipment while such equipment or material is being used for the provision of dental services (emphasis added). This means that while the dentist is operating dental equipment the non-dentist cannot barge in and place restrictions on how the equipment or material is being used once a patient is being treated. For example, if a dentist is treating a patient and that treatment was expected to last 30 minutes but is now at the 45-minute mark the non-dentist cannot physically manipulate any dental equipment or tell the dentist that she has to finish within the next 5 minutes because another dentist needs to use it. However, a lease agreement can place general restrictions on the operation and use of the equipment that is being leased to the dentist.
Most importantly, a non-dentist cannot interfere with a dentist’s clinical judgment by instructing them on a course of treatment to provide to a patient. All clinical decisions must be left to the discretion of the dentist. The purpose of this law is to prevent non-dentists from influencing or interfering with the exercise of a dentist’s independent professional judgment.
The relationship between the non-dentist and dentist will be a network of lease, rental, marketing, practice management and administrative agreements. Any dental equipment lease agreement between a non-dentist and dentist must contain a provision stating that the dentist expressly maintains complete care, custody, and control of the equipment or practice.
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The administration of intravenous (“IV”) therapy is defined as the therapeutic infusion and/or injection of substances (i.e. supplements, vitamins and minerals) through the venous peripheral system, consisting of activity which includes observing, initiating, monitoring, discontinuing, maintaining, regulating, adjusting, documenting, planning, interviewing and evaluating. It involves the administration of medication through a needle or catheter. It is believed by some that delivering medication directly into the bloodstream can help to quickly manage a patient’s pain or symptoms. In addition to treating illnesses, IV therapy proponents claim that it may also increase athletic performance, reduce jet lag, build immunity or help with dehydration by using vitamins and minerals. According to several practitioners, IV therapy should be customized for each patient’s needs to maximize results.
Most Florida licensed medical doctors, osteopathic doctors, dentists, registered nurses, medical assistants, and licensed practical nurses may provide iv therapy to patients if they possess the appropriate certifications and training. Several of these practitioners must complete a required 30-hour IV certification course. Regardless of who you hire to provide IV therapy they should have several years of experience with administering IVs.
The overwhelming majority of mobile IV therapy patients will be self-pay. Medicare, Medicaid and commercial payors typically won’t cover the costs for these treatments. However, I have seen reports where commercial payors may utilize specific per diem codes to pay certain infusion providers for services, supplies and equipment. Medicare has limited coverage for home infused drugs under the Part B and Part D benefit when it is medically justified.
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Recently, the Board of Nursing voted to approve the following revised language for adoption by rule as the definition of “primary care practice”: “Includes physical and mental health promotion, assessment, evaluation, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses, inclusive of behavioral and mental health conditions”. This definition would be read in conjunction with Section 464.0123(3), Florida Statutes. The Board also voted to accept the recommendation, also for adoption by rule, from the Council on APRN Autonomous Practice for “standards of practice” as: “Advanced practice registered nurses who are registered pursuant to Section 464.0123, F.S., shall engage in autonomous practice only in a manner that meets the General Standard of Practice. The General Standard of Practice shall be that standard of practice, care, skill, and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similarly situated health care providers.” Web: www.JonesHealthLaw.com Phone: (305)877-5054 Instagram: @JonesHealthLaw Facebook: @JonesHealthLaw Youtube: #JonesHealthLaw
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Whether you are still in nursing school, just graduated from nursing school or seeking new employment as a nurse you will likely need take a drug test as part of the pre-employment process. Also, it is not uncommon for nurses and other healthcare providers to submit to random drug testing even after they are employed. Some nurses are taking illicit drugs and it should come as no surprise if they fail their drug test. However, there are individuals who are shocked to find out that they have failed a drug test because they are not knowingly taking any illicit drugs. Some nurses may have false positives on drug tests for various reasons not related to drug abuse. One common way that nurses fail drug tests is when they take prescription drugs that may contain prohibited drugs as part of the formula. For example, some drugs may contain a very small percentage of methamphetamine. Nurses who take prescription drugs without a prescription or any legitimate medical reason for using the drug can also subject your license to discipline.
If you have a legitimate problem with drugs or alcohol the Board of Nursing might require you to attend rehabilitation center or treatment facility. If you fail your drug test many hospitals require the nurse to self-report to the Intervention Project for Nurses (“IPN”). If you choose not to self-report they will likely report you. You should speak with a health law attorney to determine whether self-reporting to the IPN is the right decision for you. You should review your hospital’s policies and procedures manual to determine how the hospital handles these types of matters internally. The manual should also inform you of whether IPN reporting is mandatory or voluntary.
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Keiana Chisholm is a 12-year software architecture consultant for her firm, “Chisholm Perennial Solutions.” Her firm consults on software architecture and engineering with a focus on healthcare systems. She received a bachelor’s degree in health services administration from Florida International University in Miami, FL and a Master of Science in Health Informatics from Northeastern University in Boston, MA. Keiana also owns and operates “The STEM Kidz” a STEM toy focused e-commerce site. She founded the charitable initiative the “Chisholm Perennial International Foundation” in 2018, which promotes STEM advocacy in early education.
Keiana is an established New York based software architect and founder of IT software firm Chisholm Perennial Solutions. Her passion for developing meaningful technology is only eclipsed by her drive to instill that same passion in future generations. She believes social, education, and economic empowerment all grow from a strong scientific education. This philosophy is reflected in her personal motto to “innovate, inspire and be of service to others.” Keiana puts this motto into action though her e-commerce venture “The STEM Kidz” which provides the educational toys and tools for today’s youth to develop into tomorrow’s world leaders. A business leader herself, Keiana has partnered with Amazon to act as a mentor for Amazon’s Black Business Accelerator program. Through her guidance and mentorship, she helps build sustainable equity and growth for Black entrepreneurs in their own online business ventures.
Keiana plans to continue building her career as a leader in technology whose focus on empowerment and education will lift those around her and their communities. The charity she founded in 2018, the “Chisholm Perennial International Foundation,” was developed with STEM advocacy at the heart of its mission. The foundation serves to advance STEM curriculum in a hands-on capacity by helping foster innovation in underserved communities. The foundation’s reach stretches from Brooklyn to Africa, where she travels every year to speak to both students and educators about the importance of STEM focus in every school’s curriculum.
Contact:
Chisholm Perennial Solutions
Email: KeianaChisholm@cpsolutionsgroup.org
Instagram: @cpsgroup1
Web: www.cpsolutionsgroup.org
The Stem Kidz
Instagram: @tehstemkidz
Web: www.thestemkidz.com
Chisholm Perennial Solutions International Foundation
Instagram: cpsinternationalfoundation
Web: www.cpsolutionsfoundation.org
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If you are listening to this podcast it means that you have probably received a letter from the Agency for Healthcare Administration (“AHCA”) stating that they have uncovered criminal offenses that disqualify you from working for a health care provider. AHCA may have uncovered this offense a result of background screening submitted as part of the employment process for a health care provider and/or participation as a Medicaid provider. This applies to clinical staff as well as facility owners, administrators and chief financial officers and those seeking enrollment as a provider in the Florida Medicaid program. Fear not, because you may be eligible to file an Exemption from Disqualification if you meet certain criteria.
Our firm can assist you with demonstrating to AHCA by clear and convincing evidence that an exemption from disqualification should be granted. The application will only be reviewed once all relevant supporting documents are received by AHCA. Filling out the application can be a bit tricky, so you should definitely hire a health law attorney that has experience with doing so in order to prevent delays in processing your application.
Once you’ve submitted your application it takes approximately 30 days for AHCA to render its decision to you. Exemptions granted by one agency will be considered by other agencies, but it is not binding on subsequent agencies. It is possible for AHCA and DOH to deny your application even though you feel you meet the criteria for an exemption. In those instances, our firm will represent you before AHCA and DOH Boards if you chose to contest the Agency decision. You have 21 days from the date you sign for the certified letter to request an appeal. The administrative law judge will only decide whether the agency’s intended action is an abuse of discretion.
Web: www.JonesHealthLaw.com
Phone: (305)877-5054
Instagram: @JonesHealthLaw
Facebook: @JonesHealthLaw
Youtube: #JonesHealthLaw
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
If you are a nurse (i.e. LPN, RN, APRN, etc) and have decided to participate in the Intervention Project for Nurses (“IPN”) you will first have to undergo an evaluation, which will include an interview with an IPN approved doctor and a toxicology test. After this evaluation has been completed, IPN may suggest no monitoring or require that you enter into a monitoring contract.
Typically, you have roughly two weeks to sign the monitoring contract. Prior to signing the contract, you should thoroughly review the IPN Participant Manual so that you understand the requirements for participation. The last thing you want is to comply with the monitoring contract only to have your contract extended or have your case referred to the Board of Nursing because you failed to adhere to the Participant Manual’s requirements.
You will also receive a contract packet, which will include: (1) Progress Evaluation for Therapy Form; (2) Work Performance Evaluation Form; (3) Notice of Address/Employer Change; (4) IPN Medication Management Evaluation Form and (5) Medication Report. Depending on your situation you many not be required to complete all of these forms.
Contract lengths typically vary from 2 – 5 years and you are required to keep your contact information updated throughout the term of the contract. IPN will review your participation after one year of active monitoring. If you comply with the terms of the contract they will grant you early completion and suspend your contract. For example, if you are have a 2 year contract term and you pass all of your toxicology testing and other requirements under the contract IPN may suspend the second year of your contract so that you can return to practice without any further obligations under the contract.
During the contract period you will be required to undergo random toxicology testing. This is an abstinence contract which means that you are prohibited from using mood altering, controlled or addictive substances including alcohol or alcohol-based products or THC/cannabis products (i.e. CBD, Hemp, etc.). This is true even if you are not participating in the IPN program for any of these specific products.
Web: www.JonesHealthLaw.com
Phone: (305)877-5054
Instagram: @JonesHealthLaw
Facebook: @JonesHealthLaw
Youtube: #JonesHealthLaw
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
Sedation Dentistry is a mild to moderate level of sedation used to assist dental patients with attaining a temporary insensitivity to pain while remaining conscious. Typically, this is used for lengthier procedures and is also found to be very beneficial for patients that suffer from anxiety about having dental work done. It is also offered to minimize the amount of pain felt during a procedure. For lengthier or more painful procedures such as root canals, it is always recommended.
The Florida Board of Dentistry allows dentists to administer a small dose of oral sedation without having advanced training or permitting. A single dose of a medicine is allowed up to the maximum dosage per patient weight. Dentists are also allowed to supplement with nitrous oxide. This is considered “minimal sedation”. Formal advanced training in sedation is required to administer “moderate sedation”. This is done through an internship or an approved course. Dental professionals must complete 60 hours of didactic instruction on a minimum of 20 patients, and an inspection of the office must be performed including a demonstration of an emergency drill before any permit is issued with the Board of Dentistry. To administer “deep sedation” or general anesthesia, a dentist must complete a residency in General Anesthesia an receive a permit from the Board of Dentistry. Pediatric sedation requires a completely separate permit and training requirements.
Web: www.JonesHealthLaw.com
Phone: (305)877-5054
Instagram: @JonesHealthLaw
Facebook: @JonesHealthLaw
Youtube: #JonesHealthLaw
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
In this episode we are discussing Psychiatry with Aminata Cisse, M.D.! Dr. Cisse is a board-certified psychiatrist, specializing in mental health disorders. Her blog "Am Taar Wellness" offers an integrated approach of holistic healing and traditional psychiatric care, specifically tailored to the needs of women of the African Diaspora. During our discussion, Dr. Cisse discussed a range of topics including: (1) the distinction between a Psychiatrist and Psychologist; (2) challenges of being a black psychiatrist and for those seeking treatment; (3) a typical day in the office and finding balance; (4) the media's impact on our perception of psychiatry; (5) myths about psychiatry and pros/cons of being a psychiatrist; (5) the impact of social media on our mental health; (6) COVID-19 vaccine's impact on our short-term and long-term mental health; and (7) is telepsychiatry less effective than in-person consultations, and more.
We touch on a wide range of topics in this podcast that I know you don't want to miss. Don't forget to listen and share with anyone that you think would be interested in listening as well.
Dr. Aminata Cisse can be reached at:
Instagram: @dr.amicisse
Email: amtaarwellness@gmail.com
Web: www.AmTaarWellness.com
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
In this episode we are discussing Ophthalmology with Sergio Morello, Jr., M.D.! Dr. Morello has been practicing Ophthalmology for over 30 years in both his native Brazil as well as the United States. Dr. Morello recently partnered with a colleague to open South Florida Eye Health with locations in Sunrise and Aventura, Florida. During our discussion, Dr. Morello discussed a range of topics including: (1) Growing up in Brazil with a family of physicians and then moving to the United States to practice Medicine; (2) distinctions between Ophthalmologists and Optometrists; (3) a typical day in the office and the types of surgeries that he performs, such as Lasik and PRK; (4) frequency with which we should see an Ophthalmologist, how to monitor one's eye health, and how lifestyle choices can affect your vision; (5) common eye diseases and how diabetes can lead to vision loss; (5) the evolution and technological advancements in ophthalmology; (6) COVID-19 vaccine's impact on our vision; (7) balancing work and his personal life, and more.
We touch on a wide range of topics in this podcast that I know you don't want to miss. Don't forget to listen and share with anyone that you think would be interested in listening as well.
Dr. Sergio Morello can be reached at:
Phone: 954-859-2020
Web: www.SouthFloridaEyeHealth.com
Address: 7800 W Oakland Park Blvd, Building B, Unit 205, Sunrise, FL 33351
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
In this episode we are discussing acupuncture with Olivia Gold, A.P., Dipl.O.M.! Ms. Gold a NCCAOM Board Certified Acupuncture Physician and Diplomate of Oriental Medicine and runs her own practice called Gold Point Acupuncture. During our discussion, Ms. Gold discussed a range of topics including: (1) Her training and what it's like studying Chinese medicine, the pros & cons of being an acupuncturist, and what a typical day is like in the office for her; (2) she defines acupuncture and the other types of Chinese medicine; (3) myths about acupuncture and how she educates clients on the difference between western and eastern medicine; (4) the types of conditions that acupuncture can treat and its benefits; (5) the cost of acupuncture and length of time it takes to experience results; (5) patient demographics in acupuncture; (6) how acupuncture is treated differently from state to state; and more.
We touch on a wide range of topics in this podcast that I know you don't want to miss. Don't forget to listen and share with anyone that you think would be interested in listening as well.
Ms. Olivia Gold can be reached at:
Phone: 904-613-9455
Web: www.GoldPointAcupuncture.com
Instagram: @GoldPointACU
Address: 3107 Sawgrass Village Circle, Ponte Vedra Beach, Florida 32082
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
In this episode we are discussing oral health with Pediatric Dentist, Marvin Abarca, D.D.S.! Dr. Abarca is a Board-Certified Florida licensed dentist and after several years of practicing recently opened his own dental clinic called Little Champions Pediatric Dentistry. During our discussion, Dr. Abarca discussed a range of topics including: (1) His training and finishing top of his class at an HBCU, the pros & cons of being a dentist, and what a typical day is like in the office for him; (2) differences between general and pediatric dentistry; (3) how to maintain oral health in kids and teenagers; (4) poor diet and lack of exercise and the effect it has on oral health; (5) affordability of dental care and the evolution of dentistry; (5) myths and misconceptions about pediatric dentistry; (6) substance abuse's impact on oral health; and more.
We touch on a wide range of topics in this podcast that I know you don't want to miss. Don't forget to listen and share with anyone that you think would be interested in listening as well.
Dr. Marvin Abarca can be reached at:
Phone: 305-285-8341
Web: www.LittleChampionsDental.com
Instagram: @LittleChampionsDental
Address: 1330 Coral Way, Suite 406, Miami, FL 33145
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
In this episode we are discussing COVID-19 and prescription medication with pharmacist, Maria Frangos! Ms. Frangos is a licensed pharmacist in the New York City area and works in a private retail pharmacy. During our discussion, Ms. Frangos discussed a range of topics including: (1) Her training, practicing as a woman, the pros & cons of being a pharmacist, and what a typical day is like in the office for her; (2) the evolution of the pharmacy industry; (3) substance abuse and diversion of prescription medication; (4) the long term effects of prescription drug abuse; (5) different types of prescription drugs across various demographics; (5) practicing during the COVID-19 pandemic; (6) her opinion of pharmaceutical sales reps; and (7) the costs of prescription medication.
We touch on a wide range of topics in this podcast that I know you don't want to miss, such as the COVID-19 Vaccine, testing for COVID-19, prescription medication abuse and more. Don't forget to listen and share with anyone that you think would be interested in listening as well.
Maria Frangos can be reached at:
Email: frangosmaria@gmail.com
Instagram: @mfrxangos
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
In this episode we get down and dirty with Podiatry! Dr. Jemaar Graham is a Florida licensed podiatrist who treats individuals as well as athletes who suffer from foot injuries and conditions. During our discussion, Dr. Graham discussed a range of topics including: (1) His training, practicing while black, the pros & cons of being a doctor, and what a typical day is like in the office for him; (2) Foot Fetishes and plastic surgery for feet"; (3) myths about podiatry; (4) the most common types of conditions and recovery after serious foot injuries; (5) What type of sneakers should you wear to play basketball and why women should stop wearing high heals; (5) what causes varicose veins and planter fasciitis and how to treat them; (6) the role that diet plays in foot conditions (i.e. diabetes); (7) should I be weary of nail salons and how to prevent toe fungus; (8) practicing during the COVID-19 pandemic; and (9) the evolution of podiatry.
We touch on a wide range of topics in this podcast that I know you don't want to miss especially if you've been having lingering foot problems, such as bunions, athletes foot, or toe fungus. Don't forget to listen and share with anyone that you think would be interested in listening as well.
Dr. Graham can be reached at:
Instagram: @graham.dpm
Phone: 941-919-3666
Web: 360-Orthopedics.com
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
“Health Law” is broad and interdisciplinary term used to describe an area of legal practice by which certain local, state and federal laws, rules, regulations and other jurisprudence regulate individuals, the health industry, and the delivery and financing of healthcare services. Many national and state boards and associations have created rules and regulations in order to protect rights of the public and those practicing or working in the healthcare industry. While these rules and regulations are not legally binding under the color of the law, many courts view these rules favorably and they hold great weight in courtroom proceedings.
Many of those practicing within the healthcare industry may not be aware of the laws that govern their practice area. The healthcare industry is highly regulated and the laws governing the industry are complex and interconnected in many instances. It usually takes the assistance of an expert in Health Law to assist you to ensure that you are acting within the confines of the applicable Health Law or any other law that may impact your relationship or transaction. It is important to be proactive rather than reactive to avoid any investigations by governmental agencies, licensing boards, or associations.
Web: www.JonesHealthLaw.com
Phone: (305)877-5054
Instagram: @JonesHealthLaw
Facebook: @JonesHealthLaw
Youtube: #JonesHealthLaw
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
In this episode we do a deep dive into the fertility treatment process with Dr. Jessica Bauer, a Florida Licensed reproductive endocrinologist a/k/a "fertility doctor". During our discussion Dr. Bauer discussed a myriad of topics including: (1) Her training, women in medical school, the pros & cons of being a doctor, and what a typical day is like for her in the office; (2) the different types of fertility treatments that are available to women today; (3) demographics of women who suffer from fertility issues and the type of activities that could cause fertility issues; (4) mental health considerations, the stigma of the industry and risks associated with in vitro fertilization; (5) "designer babies" and having septuplets; (6) the highs and lows of her career so far and advice to women who are thinking of becoming a doctor, as well as, women who are struggling to get pregnant.
This episode is packed with useful information that you don't want to miss especially if you or someone you know has been struggling to get pregnant or are thinking about storing your eggs for use at a later date. Don't forget to listen and share with anyone that you think would be interested in listening as well.
Dr. Jessica Bauer can be reached at:
Instagram: @Jessicabauer_fertilitydoc
Phone: 866-483-6366
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
In this episode we discuss Health Insurance with licensed Health Insurance Agent, Oxana "Oxanacare" Parfenova. She discusses the (1) challenges of being a Health Insurance Agent; (2) how and why she got into the industry; (3) Distinguishes between Obamacare a/k/a Affordable Care Act and commercial plans; (4) common health insurance acronyms, phrases and words that are important for any subscriber to understand; (5) current and future industry trends; and (6) most importantly who is eligible for health coverage and how, when and where can they obtain that coverage...and at what cost?
Oxana can be reached at:
Instagram: @Oxanacare
Phone: 786-352-5879
Email: OxanaP87@gmail.com
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app