Keira Dines Keira Dines

TMB’s Active Practice of Medicine Rule

Consider this hypothetical: a Tennessee physician retires after 35 years in practice but keeps her license there active. After a period of inactivity, she moves to Texas to be near her children and grandchildren. She decides to get a Texas license in case she wants to practice a bit. Can she do so?

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Keira Dines Keira Dines

Establishing a Physical Therapy Department

A solo practitioner practices family medicine in a “strip-type” shopping center. A number of patients have conditions requiring physical therapy and are referred out physical therapists . The physician has found through experience that his patients often do not receive the quality of treatment he envisions, and hence do not improve as he would like. He wants to expand the scope of his practice by offering PT to his patients (many of whom are covered under Medicare), and directly supervising that therapy. To do so he would lease office space in the shopping center one door down and immediately adjacent to his existing office space and put a physical therapist there. Can he do so without violating the “Stark” anti-self- referral law.

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Keira Dines Keira Dines

Ownership of Medical Records

Two common kinds of disputes arise regarding ownership of medical records. The first is when a patient wants a copy of their records, and demands possession of the original paper (or now electronic) file.

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Keira Dines Keira Dines

New Medicare Home Health Certification/Recertificaton Rules

Many physicians have patients who receive home health services under Medicare Parts A and B. In such cases physicians must certify that the patient is “confined to [their] home,” otherwise known as being “homebound.” It used to be that a patient needn’t be bedridden, but only have “a normal inability to leave home.

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Keira Dines Keira Dines

The Brave New World of At-Will Employment

During training, Dr. Smith was taught that, when the standard of care is not being met, he should  make an issue of it, and keep doing so until the problem is resolved. Following training, he goes  to work for a Non-Profit Health Organization that is effectively controlled by a hospital. He  finds things at the hospital to be, in his opinion, quite substandard: equipment not properly  maintained and calibrated, technicians not supervised and performing procedures without  authorization, and physicians (especially “heavy admitters”) making medical errors without  accountability.

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