General Category > General Questions
who should be credentialed
desheba:
Thanks Richard and Billergirlnyc.....this answered my question! sorry for all the confusion....we are in florida so, I will research further about the state requirements. I appreciate all of your help! :)
RichardP:
You are welcome. Thanks for being tenacious. Please humor me and read through the quoted info below - to see where I was coming from with my questions. If your setup was in California, it would be illegal. I'm guessing it is probably also illegal in Florida - but that is for your folks to find out on their own. I'm just raising the red flag. And note that this issue must be resolved before we can begin to move toward the issue of credentialing. Good luck.
For the benefit of any passers-by, here is the California Code prohibiting ownership of medical clinics by non-physicians. This was the issue that attracted my attention in the initial post, and is why I wanted to know who hired the doctor in question. This is definately a state issue. But it is also a Federal issue if Medicare patients are involved. I can't imagine that any state would deviate too far from what is quoted below - but only the appropriate health-care attorney would know for sure (or someone who actually reads the business code of the particular state ;)).
From here:
http://www.mbc.ca.gov/licensee/corporate_practice.html
The following is to provide guidance to physicians on the prohibition against the corporate practice of medicine.
Note: This area of law can be complicated, therefore physicians are encouraged to discuss their medical practices and business enterprises with appropriately knowledgeable legal experts. The Medical Board of California continues to receive complaints and inquiries about the law, and some repeating issues are presented here. ...
In addition, the following "business" or "management" decisions and activities, resulting in control over the physician's practice of medicine, should be made by a licensed California physician and not by an unlicensed person or entity:
* Ownership is an indicator of control of a patient's medical records, including determining the contents thereof, and should be retained by a California-licensed physician.
* Selection, hiring/firing (as it relates to clinical competency or proficiency) of physicians, allied health staff and medical assistants.
* Setting the parameters under which the physician will enter into contractual relationships with third-party payers.
* Decisions regarding coding and billing procedures for patient care services.
* Approving of the selection of medical equipment and medical supplies for the medical practice.
The types of decisions and activities described above cannot be delegated to an unlicensed person, including (for example) management service organizations. While a physician may consult with unlicensed persons in making the "business" or "management" decisions described above, the physician must retain the ultimate responsibility for, or approval of, those decisions.
The following types of medical practice ownership and operating structures also are prohibited:
* Non-physicians owning or operating a business that offers patient evaluation, diagnosis, care and/or treatment.
* Physician(s) operating a medical practice as a limited liability company, a limited liability partnership, or a general corporation.
* Management service organizations arranging for, advertising, or providing medical services rather than only providing administrative staff and services for a physician's medical practice (non-physician exercising controls over a physician's medical practice, even where physicians own and operate the business).
* A physician acting as "medical director" when the physician does not own the practice. For example, a business offering spa treatments that include medical procedures such as Botox injections, laser hair removal, and medical microdermabrasion, that contracts with or hires a physician as its "medical director."
In the examples above, non-physicians would be engaged in the unlicensed practice of medicine, and the physician may be aiding and abetting the unlicensed practice of medicine.
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