Читать книгу A Dentist’s Guide to the Law - American Dental Association - Страница 7

Introduction

Chapter 1: How to Use This Book

1. How Should I Use This Book?

2. Will You Give Me a Referral to a Lawyer in My Area?

3. What Does a Dentist Need to Know to Select the Right Lawyer?

Chapter 2: Know the Law

4. What Are Some Laws That Apply to Dentistry?

5. What Key Federal Laws Apply in Dentistry?

6. What Key State Laws Do I Have to Comply with?

Chapter 3: Lawsuits

7. What Are The Penalties for Violating HIPAA?

8. I’ve Been Sued. What Do I Do?

9. Should I Settle? On What Terms?

10. Must a Settlement of a Malpractice Claim Be Reported to the Data Bank?

11. Will the ADA Represent Me or File a Brief on My Behalf?

Chapter 4: The ADA Legal Division

12. What Do the ADA’s Lawyers Do for Me?

Establishing the Dental Practice

Chapter 5: Practice Formats: The Business/Legal Structure

13. What Business Structure Options Do I Have?

14. What Are the Advantages and Disadvantages of a Sole Proprietorship?

15. What Are the Pros and Cons of a General Partnership?

16. Does a Limited Partnership Have Advantages Over a General Partnership?

17. What Is There About a Corporation That Would Make Me Want to Incorporate My Practice?

18. Will It Help Me to Be a Limited Liability Company?

19. Should I Create an Operating Agreement If I Choose the LLC or PLLC Format?

Chapter 6: Dental Office Design

20. What Laws Affect Office Design?

21. What Does the Americans With Disabilities Act (AwDA) Require for Office Design?

22. Isn’t There a “Grandfather” Provision That Exempts Me From the AwDA?

23. I Rent My Office Space. Isn’t AwDA Compliance the Building Owner’s Responsibility?

24. What Are the AwDA Requirements for Existing Facilities?

25. What Are the AwDA Rules for Renovation and New Construction?

26. How Do I Get More Specific Information About the AwDA Accessibility Requirements?

27. Do I Still Have to Comply With State and Local Laws?

28. Does HIPAA Impose Requirements Related to Dental Office Design?

29. Will Other Cutting-Edge Dental Issues Affect Office Design?

30. Is Video Surveillance Permitted in the Dental Office?

31. Should I Rely on Design Professionals, and What Should Their Contracts Include?

32. Do My Exam Chairs Need to Be Accessible to Patients With Disabilities?

33. Should I Have an Automated External Defibrillator (AED) in My Dental Office? If So, Where? What Legal Concerns Are There With Respect to an AED in the Dental Office?

Chapter 7: Practice Marketing

34. What Legal Limits Are There on Advertising My Practice?

35. What Rules Apply to Dental Specialty Claims?

36. Can I Use ADA Materials or Other Existing Material in Promoting My Practice?

37. Can I Use the ADA Logo to Market My Practice? How Can I Use the ADA Logo on My Website? What Rules Apply to the ADA Membership Logo?

38. Is My Website Exempt From These Traditional Practice Marketing Rules?

39. Can I Send Information About Products or Services to Patients, or Provide Patient Lists to a Company That Wants to Send Them Information?

40. What Can I Do If a Negative Rating, Review, or Comment About My Practice Is Posted on a Blog or Website?

41. Can My Dental Practice Advertise That We Accept Medicaid?

42. Does Our Dental Practice Need to Be Aware of What Federal Laws Apply to Commercial Messages Sent Via Telephone, Email, Fax and Text?

Chapter 8: Practice Websites

43. What Are Some of the Liability Issues With Practice Websites?

44. What Protective Measures Can I Build Into the Design of My Site to Help Avoid Liability?

45. What Steps About Site Content Can I Take to Reduce My Legal Exposure?

46. Are There General Rules for Communicating Online?

47. When Do I Need Permission to Use What’s Not Mine on My Website?

48. How Can I Protect What’s Mine on My Website?

49. Should I Have Written Contracts With Professionals I Hire to Help Design My Website?

50. Does My Dental Practice Website Need to Be Accessible to People With Disabilities, Such as Someone Who Is Blind or Hard of Hearing?

51. Do I Really Have to Worry About All This? Won’t My Website Be Insured?

Employment Law

Chapter 9: Introduction to Employment Law

52. What Employment Law Issues Arise in a Dental Office?

53. What Law(s) Do I Have to Comply With — Federal, State, or Local Law?

54. What Is the Risk of Non-Compliance?

55. Who in My Office Needs to Know Employment Laws?

56. Are These Employment Lawsuits I Hear About for Real?

Chapter 10: Office Manual and Policies

57. How Can I Protect My Practice?

58. Are There Special Concerns Dentists Should Have About Employment Lawsuits?

59. Is Having an Office Policy Manual or Employee Handbook a Good Idea? Will It Take Care of My Legal Needs?

60. What Office Policies Do I Need?

Chapter 11: Hiring

61. When Hiring an Associate Dentist, Do I Need a Written Contract And, If So, What Should Be in It?

62. What Is the Importance of the Exempt vs. Non-Exempt Distinction?

63. Can I Conduct a “Working Interview” With a Prospective Employee?

64. Can I Require Drug Testing of Applicants?

65. What Information Should Be Included in a Background Check for a Potential Employee? Can a Credit Check Be Run Before Hiring a New Employee?

Chapter 12: Managing the Dental Team

66. How Should I Approach Performance Appraisals?

67. How Should I Handle Employee Discipline?

68. What Should I Do If the Employee Is Engaging in Unlawful Acts, Such as Embezzlement, Theft, or Writing Prescriptions on Stolen Pads?

69. I’m Concerned About a Disturbing Change in the Behavior of an Individual Who Works in My Dental Practice. What Should I Do?

70. What if I Suspect an Employee or Co-Worker Is Abusing or Taking Drugs From the Dental Office?

71. Must a Dentist Be Present When a Hygienist Is Working?

72. What Are My Obligations as an Employer When an Employee or an Associate Dentist in My Practice Has Been Called to Active Duty by the Military?

73. What Do I Need to Document?

74. What Notices Must I Post About Employment Matters?

75. Are There Employment Law Resources That Can Help Me?

Chapter 13: Termination

76. What Issues Arise When Terminating an Employee? How Does Employment “At Will” Fit in?

77. Can I Terminate an Employee Who Has HIV? What About an Employee Who Has Hepatitis C?

78. Can I Terminate a Staff Person Who Is Continuously on Sick Leave?

79. Can I Terminate an Employee for Reporting to Authorities What He or She Perceives as a Legal Violation?

Compliance: OSHA, HIPAA, FACTA, COPPA, and the Physician Payments Sunshine Act (Open Payments)

Chapter 14: OSHA

80. I Am Just a Small Business. Does OSHA Really Apply to Me?

81. I Never Hear From OSHA, But I Do Hear From a State Agency. Why Is That?

82. Does OSHA Regulate My Relationships With My Patients?

83. What Are My Obligations Under OSHA?

84. What Is the “General Duty Clause?”

85. What Is My Duty With Respect to OSHA Standards?

86. How Do I Prepare Generally for OSHA’s Required Written Programs?

87. Do I Have to Voluntarily Let an OSHA Compliance Officer Inspect My Office?

88. What Should I Do If an OSHA Inspection of My Office Is Taking Place?

89. The Compliance Officer Wants to Interview My Employee, Should I Allow It?

90. The Compliance Officer Wants to Interview Me! Do I Agree to Be Interviewed?

91. No OSHA Compliance Officer Is Trying to Inspect My Office, but OSHA Sent Me a Letter and Expects a Response. What Do I Do?

92. OSHA Issued a Citation. What Do I Do?

93. Can I Get an Extension of the Fifteen-Day Period?

94. What Happens If I Do Nothing?

95. What Are My Options After Receiving a Citation?

96. Do I Need a Lawyer?

Chapter 15: HIPAA, State Law and PCI DSS: Patient Information

97. How Does HIPAA Affect How I Manage Patient Information?

98. Do I Have to Comply With HIPAA?

99. What Do I Have to Do in Order to Comply With HIPAA’s Privacy Rule?

100. If I Give a New Patient Our Notice of Privacy Practices and the Patient Won’t Sign the HIPAA Acknowledgement, Should I Still Provide Treatment?

101. Is Following HIPAA Enough, or Should I Follow State Law (Too)?

102. Can the Outside Cover of the Record Contain Patient Information?

103. Who Can Make Entries in the Record?

104. Are There Rules About How to Write in the Record?

105. Is It OK to Alter the Record?

106. Who Owns the Record? What Rights Do Patients Have?

107. What Permission, if Any, Must a Patient Give for Me to Transfer His or Her Records?

108. How Does HIPAA Affect Dealing With Patient Surrogates or Representatives Who Request Information in, or Copies of, the Record (Such as Non-Custodial Parents)?

109. What If the Patient’s Spouse, or an Adult Patient’s Parent, Is Responsible for Paying the Patient’s Bill? What Information Can I Disclose to the Person Responsible for Payment?

110. Someone Has Subpoenaed a Patient’s Record. What Should I Do?

111. Should I Release Original Records or Is It Better to Make Copies?

112. Can I Charge Patients for Copying Their Records?

113. How Long Must I Retain Patient Records?

114. Are There Legal Issues in Making the Transition to a Paperless Office?

115. What Are the Legal Concerns in Selecting an EHR Vendor? In Entering Into a Contract With Your Chosen EHR Vendor?

116. Can I Get in Trouble if My Business Associate Violates HIPAA?

117. A School Has Contacted Us to Ask About a Doctor’s Note That Appears to Be From Our Dental Practice. Our Dental Practice Did Not Provide That Doctor’s Note. Does HIPAA Prohibit Us From Responding to the School Without the Patient’s Authorization?

118. If a Patient’s Employer or School Calls Our Dental Practice Directly and Asks Us for Information About the Patient, Can We Provide It, or Do We Need the Patient’s Authorization?

119. We Will Have Some Dental Interns in Our Office. Is There a Form the Interns Will Need to Sign for HIPAA? Do We Need to Get the Patient to Sign a Consent Form to Allow the Interns to Observe or Assist the Doctor?

120. If a Patient Brings a Friend Along to a Dental Appointment, Do I Need the Patient to Sign an Authorization Form Before Disclosing Information in Front of the Friend?

121. What Effect Did the 2013 Omnibus Final Rule Have on HIPAA Compliance?

122. What Happens to the Patient Records of a Deceased Practitioner?

123. Can My Dental Practice Apply for Incentive Payments From the Federal Government if We Buy a New Electronic Dental Record System or Upgrade our Existing One?

124. Before I Hire Someone, I’d Like to Make Sure That He or She Has Not Been Excluded From Participation in Federal Health Care Programs. Can I Look Them Up? Can I Also Periodically Check on the Status of My Current Staff?

125. I Keep Hearing About Data Breaches Involving Credit Card Numbers and Social Security Numbers. My Dental Practice Collects This Kind of Information. What Are Some of the Laws That I Should Be Aware of?

126. Will My Liability Insurance Cover the Financial Loss Caused by a Data Breach?

127. My Office Is Considering Whether to Accept Credit Card Payments and Was Told by a Card Payment Processor That Our Office Would Need to Be “PCI Compliant.” Is This Really True?

128. How Do I Respond to an Investigatory Letter From the U.S. Department of Health and Human Services Office for Civil Rights, the Federal Agency that Administers HIPAA?

129. A Law Enforcement Official Has Asked My Dental Practice for Information About One of Our Patients. What Should We Do?

Chapter 16: FACTA: Red Flags And Disposal Rules

130. What Is FACTA and How Will It Affect My Practice?

131. What Is the Red Flags Rule?

132. What Does the Disposal Rule Require?

133. Does the Disposal Rule Apply to All Dentists?

134. When Does the Disposal Rule Take Effect?

Chapter 17: COPPA

135. My Dental Practice Wants to Create a “Kids’ Corner” on Our Practice Website. Someone Mentioned “COPPA Requirements.” What Is COPPA and Does it Apply to Dental Practices?

136. How Do I Know Whether My Website is Directed at Children Under 13? Does COPPA Provide a Test or Definition?

Chapter 18: The Physician Payments Sunshine Act (Open Payments)

137. How Can I Find Out About the Physician Payment Sunshine Act and “Open Payments,” the New Federal Government Website That Has Information About Industry Relationships With Doctors and Teaching Hospitals?

138. Do I Have Any Choices About Information About Me That Might Appear on the Open Payments Website?

139. What Can I Do to Help Make Sure That Information About Me is Accurate on “Open Payments”?

140. A Dental Manufacturer’s Representative Provided Lunch for My Staff and Me. The Lunch Was Great, but Why is the Rep Asking for My NPI Number and Other Information?

141. What Is Teledentistry and What Are Some of the Regulatory and Legal Concerns?

Business Considerations

Chapter 19: Contracts

142. Should I Sign This Contract?

143. How Do the Legal Considerations Fit in?

144. Do I (Still) Have to Do What the Contract Says?

Chapter 20: Common Dental Agreements

145. What Are Some of the Issues Involved in a Buy-Sell Agreement?

146. How Should I Evaluate a Contract With an Insurance Plan?

147. Do I Need Employment Agreements With My Staff?

148. How Can I Get the Most Mileage Out of an Associate Agreement?

149. Should the Associate Be an Independent Contractor or Employee?

150. Are Restrictive Covenants Enforceable?

151. What Should My Office Lease Contain?

152. How Can I Be Sure That My Dental Laboratory Uses the Exact Materials Prescribed to Manufacture a Prosthesis?

153. What Can I Do If I Have Been Charged for a Product or Service That I Received but Didn’t Order?

154. Can I Sell Merchandise From My Dental Office, Such as Vitamins and Minerals or Electric Toothbrushes?

Chapter 21: Antitrust

155. What Are the Antitrust Laws and What Do They Mean to Me as a Dentist?

156. Can I Consult With Other Dentists When Setting My Fees?

157. Is There Anything the ADA Can Do to Stop Insurance Carriers From Taking Actions or Engaging in Practices That Create Difficulties for Dentists?

158. Do the Antitrust Laws Prevent Me From Promoting Direct Reimbursement?

159. Can Our Association Establish a Code of Ethics That Restricts Advertising or Prohibits Unacceptable Practices?

160. Can Dentists Refuse to Deal With Health Care Practitioners Who Engage in Unethical Conduct or Who Engage in the Practice of Dentistry Without a License?

161. Do the Antitrust Laws Prevent Insurance Companies From Setting Low Reimbursement Rates? From Imposing Burdensome Contractual Provisions?

162. Is There Anything That a Group of Dentists Can Do to Address Threats to Our Practice?

Chapter 22: Tax Issues

163. Is It OK for Me to Stay on Cash Basis Accounting or Must I Use Accrual Basis Accounting?

164. Can I Claim the Americans With Disabilities Act Tax Credit for Purchases of Intraoral Cameras, Panorex Machines, New Chairs, Etc.?

165. What Are My Requirements Regarding Payroll Taxes?

Chapter 23: Insuring Your Practice

166. What Type of Professional Liability Insurance Should I Have?

167. What About Liability Other Than Malpractice?

168. Can I Insure Against Damage to My Practice?

169. What Insurance Helps Protect My Income?

170. What Other Insurance Issues Are Important?

Payment, Collection, and Reimbursement

Chapter 24: Payment and Collections

171. Which NPI Do I Use to Submit a Claim? I Have a Type 1 NPI for Myself and a Type NPI for My Corporation/Group/Partnership.

172. A Patient Refused to Pay for What His Insurance Refused to Cover. What Can I Do?

173. How Can I Better Position My Practice to Minimize the Need to Send Non-paying Patients to Collection and Improve My Practice’s Chance of Prevailing in Collection Matters?

174. A Patient Is Refusing to Give Our Dental Office His or Her Social Security Number (SSN). Can I Refuse to Treat the Patient? Why Would a Patient Be Reluctant to Provide This Information? Can Collecting Social Security Numbers Pose a Legal Risk for a Dental Practice?

175. Who Pays When Parents Are Divorced?

176. Can I Check My Patient’s Credit History Before Agreeing to Provide Care?

177. What Are the Payment Card Industry Data Security Standards (PCI DSS)?

178. If the Patient Doesn’t Accept My Work or Refuses to Come Back to Let Me Finish It, and I’ve Already Collected Insurance for It, Do I Have a Problem?

179. Are There Legal Problems Giving Discounts to Family, Staff, or Colleagues?

180. Can I Extend Dental Coverage Through My Office to Patients Who Do Not Have It by Establishing My Practice’s Own In-Office Dental Plan?

181. Are There Legal Problems in Offering and Awarding Social Coupons to New or Existing Patients?

182. If a Patient Is Behind on Payments, Can I Withhold Records or Stop Treatment?

183. Am I Required to Continue Treatment If the Patient Is in Bankruptcy?

184. Can I Charge Interest on Overdue Amounts? What About Collection Costs?

185. When Should I Use a Collection Agency?

186. Are There Limits to What Can Be Done in Collections?

187. How Does Small Claims Court Work? Is It Worth It?

188. What Should I Do If the Patient Wants a Refund, or a Nominal Sum for Malpractice?

Chapter 25: Insurers and Other Commercial Payers

189. The Plan’s Explanation of Benefits Makes It Seem Like I’m Overcharging. Is That Legal?

190. I Submitted a Claim to an Insurance Company Six Months Ago, and I Still Haven’t Received My Reimbursement. What Can I Do?

191. An Insurance Company Is Withholding Payment for Part of the Claims I Submitted to Them Recently. They Say They’re “Offsetting” an Amount They Overpaid Me Previously. Can They Do This?

192. Dental Benefit Plan XYZ Claims I’m a Participating Provider in Their Plan, and That I Have to Treat All of Their Enrollees Who Come to My Office, and Accept Their Fees as Full Reimbursement. How Can This Be? I Never Signed a Contract With Plan XYZ.

193. Can an Insurance Plan Force Me to Allow It to Audit Out-of-Network Charts, or Does HIPAA Prevent This?

The Patient

Chapter 26: The Dentist-Patient Relationship

194. What Rights Does a Patient Have to Privacy and Confidentiality?

195. What Should I Do to Protect Patient Information?

196. My Patient Is in a Lawsuit. Do I Have to Testify? Doesn’t the Dentist-Patient Privilege Help Me Avoid This?

197. What If I See Signs of Abuse or Neglect Upon Examination?

Chapter 27: Diagnosis and Treatment

198. Are There Specific Legal Concerns to Watch for When Taking a Health History?

199. How Often Should Patients Be Asked to Update Their Health History Forms?

200. Are There Legal Issues Regarding Treatment Planning?

201. Who Must Give Informed Consent?

202. So How Do I Go About Getting Informed Consent?

203. Should I Use an Informed Consent Form?

204. What If the Patient Refuses to Consent?

205. Can I Proceed With Treatment Even If the Patient Will Not Consent to Recommended Diagnostic Procedures?

206. Can I Provide Care That the Patient Wants But I Do Not Think Is Indicated?

207. Did I Commit Malpractice? What is the Standard of Care?

208. I’m a Volunteer Dentist, Donating Dental Services. Do the Same Rules Apply?

Chapter 28: Referrals

209. Are There Legal Issues to Consider When I Make a Referral?

210. How Does the Law Regulating Self-Referral (Stark Law) Affect My Dental Practice?

211. When Might the Stark Law Apply?

212. How Could the Federal Anti-Kickback Statute Affect My Practice?

Chapter 29: Thorny Patient Treatment Issues

213. Do I Have to Hire Sign Language Interpreters for Hearing Impaired Patients?

214. Who Pays for the Interpreter? I’d Lose Money If I Have to Pay.

215. Must I Provide Foreign Language Interpreters?

216. Do I Have to Allow Service Animals (Such as Seeing Eye Dogs) in the Operatory?

217. Do I Have to Allow Motorized Wheelchairs in My Dental Practice? What About Segways?

218. Are There Laws Prohibiting Discrimination Against Patients Who Are Part of a Protected Class?

219. Must I Treat Patients With HIV, HCV, or Other Infectious Diseases?

220. Can I Ask a Patient If He or She Has Any Infectious Diseases — HIV in Particular?

221. What Are the Rules About Managing an Obese Patient?

222. How Do I Handle a Drug-Seeking Patient — One I Suspect May Be Calling Around for Prescriptions?

223. How Can I Learn More About My Responsibilities in Regard to Infection Control?

224. Is It True That I Can Apologize to a Patient for an Unexpected Outcome and That My Apology Can’t Be Used Against Me in Court If the Patient Sues?

225. What Should I Do If a Patient Leaves My Practice in the Middle of Treatment Against My Advice?

226. What Are My Obligations Concerning a Colleague Who I Believe to Be Impaired or to Lack Essential Clinical Skills?

Chapter 30: Terminating the Relationship

227. I’m Closing My Practice. What Must I Tell My Patients? How and When Do I Tell Them?

228. How Do I Handle a Threatening or Abusive Patient? How Do I Dismiss an Unruly Patient From My Practice?

Appendices

1. Checklist of Questions to Ask When Forming a Group Practice

2. Buy-Sell Agreements (Background)

3. Sample Employee Associateship Agreement

4. Sample Independent Contractor Associateship Agreement

5. New Employee Checklist

6. Termination Checklist

7. Sample Website Development Agreement

8. HIPAA Business Associate Checklist

9. Selecting an EHR Program for Your Dental Practice

10. Service Animals in the Dental Office

11. Sample HIPAA Business Associate Agreement

12. What Did the U.S. Supreme Court Decide in North Carolina State Board v. FTC (2015)?

Index