When it comes to health care, Florida is one of the most heavily regulated states in the country. In addition to federal law, Florida health care law is fraught with nuanced regulations that apply to:
- Primary health care providers
- Medicare Part B providers
- Diagnostic imaging centers
- Ambulatory surgical centers
- Durable medical equipment providers
- Other professionals
Ultimately, there are three main federal laws about which medical professionals and organizations need to be aware:
- The Stark Law
- The federal anti-kickback statute
- The federal false claims statute
Within all of these, one must be extremely familiar with Medicare billing regulations, provider enrollment and the use of ancillary providers including nurse practitioners and physicians assistants and ‘incident to’ billing. All too often these present serious costly mistakes.
On the local level, health care providers must pay attention to the Florida Patient Self-Referral Act and the Florida Patient Brokering Act.
Ultimately, it is extremely important for clients undertaking these transactions to fully understand their exposure and obligations. Many physician groups go into situations with management agreements, investing in or contracting to be medical directors for diagnostic imaging, home health, nursing homes, assisted living facilities, co-management agreements with hospitals and surgical centers. If you or your organization is faced with any of these issues, it is critically important to understand your legal obligations and to mitigate all potential risk and costs.