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FLYINGUNDERTHERADAR
FEDERALANDSTATEREGULATIONS
(TOKNOWANDAVOID)
EricJ.PlinkeBuckingham,Doolittle&Burroughs,LLPAttorneys&CounselorsatLaw191WestNationwideBlvd.,Suite300Columbus,Ohio43215-8120DirectDial:(614)227-4213DirectFax:(614)227-7334STATELAWS®ULATIONSHealthprovidershavehistoricallybeenregulatedprimarilybythestates,somuchoftheregulationyouwillfacewillbeundertherulesandregulationsofthestateinwhichyoupractice.SomeexamplesforOhioareasfollows:OhioMedicalPracticesAct-ORCCh.4731Establishesstandardsandparametersforconductthroughgroundsfordiscipline.Amodelacthasbeenadoptedbymoststatessothereissimilaritybetweenthevariousstatejurisdictions.Inotherwords,Ohio’sActwillbesimilar,butnotidentical,tootherstatesmedicalpracticeacts.SubjectareasofdisciplineareattachedfortheStateMedicalBoardofOhio.FormoreinformationregardingtheStateMedicalBoardofOhio,goto:/Ifyouareplanningonacceptingapositioninanotherstate,researchthatstate’sboardandregulationsbeforehand.RulesGoverningthePracticeofMedicineinOhio–OACCh.4731Thesearetopicspecificrulesthataretheeffectoflawandviolationofthemcanleadtodisciplinaryactionasaviolationofthemedicalpracticesact.
Thecurrentrulesgovernthefollowingspecificareas:OACChapter
ChapterSubject:4731-1 Limitedpractitioners4731-2 Publicnoticeofproposedadoption,amendment,orrescissionofrules4731-4 Physicianassistants4731-5 Administrationofexaminations4731-6 Medicalandosteopathiclicensure4731-7 Noticeofmeetings4731-8 PersonalinformationsystemsOACChapter
ChapterSubject:4731-9 Recordofboardmeetings4731-10 Licenseregistrationandreinstatement4731-11 Controlledsubstances;generalprovisions4731-12 Podiatrylicensure4731-13 Conductofhearings4731-14 Pronouncementofdeath4731-15 Rulesgoverningmandatoryreporting4731-16 Rulesgoverningimpairedpractitionersandapprovaloftreatmentprograms4731-17 HIVandHepatitisBvirusexposureprecautionsOACChapter
ChapterSubject:4731-18 Surgerystandards4731-19 LicenseesinfectedwithHIVorHBV:reportingrequirementsanddutyofcare4731-20 Podiatry4731-21 Intractablepain4731-22 Emeritusstatus4731-23 Delegation4731-24 Anesthesiologistassistants4731-25 Officebasedsurgery4731-26 Sexualmisconduct4731-27 Terminationofphysician-patientrelationshipReportingLawsUndercertainsituations,physicianswillhaveadutytoreportinformationand/orincidentstogovernmentalandotheragencies.Thesedutiestypicallyarisefromstatestatutes.Forexample,inOhio,therearedutiestoreportotherphysicians,felonies,elderabuse,childabuse,andcertaininjuriesstemmingfromgunshots,stabwounds,andactsofviolence.Somedutiesalsoarisefromcasedecision,suchasMorganv.FairfieldCounseling,whichcreatedadutytoreportinoutpatientmentalhealthpatientsthreatstoharmothers.TestimonialPrivilegePriortoHIPAA,thesestatelawlimitationsontheabilityofaphysiciantotestifywereoneofthemajorlegalauthoritiesforthephysician-patientprivilege.ThissectionisstillthelawandsurvivesunderHIPAAandlimitstestimonyonthesubjectofphysician-patientcommunications.EthicalCodesandOpinionsThesearemadeapplicablethroughtheMedicalPracticesActandaremandatoryprovisionsundertheAct.WhetheryouareanM.D.,D.O.,andD.P.M.,yournationalassociationhasacodeofethicswithwhichyoushouldbefamiliar.Checkthemoutonline.StateAgencyPositionStatementsShortofStatutesandRules,anAgencymayalsopublishapositionstatementorpolicy.Whilethelegaleffectoftheseissubjecttodebate,thepositionstatementitselfisagoodguideforvariouspracticeissuesanditisarecommendedpracticetobeawareofthem.SeeattachedsummaryofStateMedicalBoardofOhiopositionpapers.FEDERALREGULATIONSANDSTATUTESAnti-kickbackStatute/StarkLawTheselawsregulatereferralsbyphysicianandthemonetarybenefitsassociatedwithsuchreferrals.PenaltiesarecivilundertheStarkLawandcriminalundertheAnti-kickbackStatute.Tolearnmoregoto::///and/HIPAAThePrivacyRegulationsarewellknownandincludearelativelycomprehensivesetofrulesgoverningtheuseanddisclosureofprotectedhealthinformationbycoveredentities(whichincludeshealthcareproviders).Penaltiesarebothcivilandcriminal.HIPAAisgovernedandenforcedbytheUSDept.ofHealthandHumanServices,OfficeofCivilRights.Tolearnmoregoto:/Whilenothistoricallyacommonsourceofhealthcareproviderregulation,thefederalgovernmenthastakenamuchmoreactiveroleasasourceofregulationwhichyouneedtobeawareof.NPDB/HIPDBTheNPDBdefiensitselfbestatitsownwebsitewhereitstates:TheNPDBisprimarilyanalertorflaggingsystemintendedtofacilitateacomprehensivereviewofhealthcarepractitioners'professionalcredentials.TheinformationcontainedintheNPDBisintendedtodirectdiscreteinquiryinto,andscrutinyof,specificareasofapractitioner'slicensure,professionalsocietymemberships,medicalmalpracticepaymenthistory,andrecordofclinicalprivileges.TheinformationcontainedintheNPDBshouldbeconsideredtogetherwithotherrelevantdatainevaluatingapractitioner'scredentials;itisintendedtoaugment,notreplace,traditionalformsofcredentialsreview.Tolearnmoregoto:/Medicare/MedicaidExclusionExclusionfromthefederalpayorscanbedevastatingonaphysician’scareer.Chemicaldependencycasesthatarehandledsatisfactorilyonthestatelevelcanberedefinedonthefederalleveltoessentiallyendacareerasitunleashesachainofeventswhichpreventorvastlylimityouremployability.Tolearnmoregoto::///DEATheDEAhasbecomethemostrecentfederalagencytotakeonamoreactivero
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