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Idaho Board of Medicine Disavows the Corporate Practice of Medicine Doctrine
/in Hospitals & Health Systems, Physician PracticesBy Kim Stanger, Holland & Hart LLP
For decades, the Idaho Board of Medicine took the position that, with limited exceptions, the Idaho Medical Practice Act “prohibits unlicensed corporations and entities from hiring physicians as employees to provide medical services to patients.” Memo from J. Uranga to Idaho State Bd. of Medicine dated 2/26/07. This “corporate practice of medicine doctrine” had its Idaho foundation in a 1952 Idaho Supreme Court case which held that:
[n]o unlicensed person or entity may engage in the practice of the medical profession though licensed employees; nor may a licensed physician practice as an employee of an unlicensed person or entity. Such practices are contrary to public policy.
Worlton v. Davis, 73 Idaho 217, 221 (1952). The Board of Medicine warned that violations of the doctrine may result in disciplinary action against physicians and, more recently, physician assistants. Entities that improperly employed physicians or physician assistants risked the possibility of criminal action for the unauthorized practice of medicine.
Over the years, the corporate practice of medicine doctrine has been criticized as anachronistic and inconsistent with recent legislative action. See, e.g., M. Gustavson and N. Taylor, At Death’s Door—Idaho’s Corporate Practice of Medicine Doctrine, 47 Idaho L. Rev. 480 (2011). Read more
Providers Must Post New Nondiscrimination Notices
/in Nondiscrimination, Interpreters and TranslatorsBy Kim Stanger, Holland & Hart LLP
Under the new ACA Nondiscrimination Rules, covered entities (including most healthcare providers) must post and publish new mandatory nondiscrimination statements and taglines by October 16, 2016.
1. Notice of Nondiscrimination + Taglines: Facility, Website, and Significant Publications. The new mandatory “Notice of Nondiscrimination” must inform persons that:
(45 C.F.R. § 92.8(a) and (b)(1)). HHS has published a sample Notice of Nondiscrimination, which is available here. Although HHS encourages entities to post the Notice of Nondiscrimination in languages other than English, covered entities are not required to do so. Read more
New ACA Anti-Discrimination Rules: Language Assistance for Non-English Speakers
/in Nondiscrimination, Interpreters and TranslatorsBy Kim Stanger, Holland & Hart LLP
On May 18, 2016, HHS published its final rules implementing the anti-discrimination provisions of the Affordable Care Act § 1557. This is the first of several alerts discussing aspects of the new rule: this alert focuses on those provisions requiring language assistance for persons with limited English proficiency; future alerts will cover rules related to sex discrimination and persons with disabilities. The new language assistance rules build on but extend beyond HHS’s 2003 Guidance Regarding Limited English Proficient Persons, 68 F.R. 47311 (“LEP Guidance”).
Application. The new rules apply to any entities (“covered entities”) that operate a health program or activity that receives federal financial assistance under programs operated by HHS, including but not limited to Medicaid or Medicare parts A, C and D, but excluding Medicare Part B. (45 C.F.R. § 92.2(a); 81 F.R. 31383). Among others, the rule applies to hospitals, clinics, medical practices, solo practitioners, nursing homes, or other healthcare entities that participate in federal programs other than Medicare Part B. (81 F.R. 31384-85). Covered entities are not required to comply if doing so would violate applicable federal statutory protections for religious freedom and conscience. (45 C.F.R. § 92.2(b)). Also, the regulations do not apply to employment discrimination. (45 C.F.R. § 92.101(a)(2)). Read more
New ACA Nondiscrimination Rules: Protecting Individuals Against Sex Discrimination
/in Nondiscrimination, Interpreters and TranslatorsBy Patricia Dean, Holland & Hart LLP
On May 18, 2016, HHS published its final rules implementing the anti-discrimination provisions of the Affordable Care Act § 1557. This is the third of three alerts discussing various aspects of the new rules. This alert focuses on the rules protecting individuals against discrimination based on sex. The first alert (available here) focused on the rules’ requirement for language assistance for persons with limited English proficiency. The second alert (available here) focused on the rules ensuring protections for individuals with disabilities. The final rule goes into effect on July 18, 2016.
Relationship to Other Laws. Section 1557 is the first federal civil rights law to prohibit discrimination “on the basis of sex” (including gender identity and sex stereotyping) in covered health programs and activities. In doing so, it builds on HHS Titles VII and IX, and federal case law to clarify what constitutes sex discrimination and prohibit specific discriminatory practices. It does not preempt or alter other laws, and providers must continue to comply with other state and federal laws in addition to the new ACA nondiscrimination rules. Read more
New ACA Nondiscrimination Rules: Assistance for Persons with Disabilities
/in Nondiscrimination, Interpreters and Translatorsby Teresa Locke, Holland & Hart LLP
On May 18, 2016, HHS published its final rules implementing the anti-discrimination provisions of the Affordable Care Act § 1557. This is the second of three alerts discussing various aspects of the new rules. This alert focuses on the rules ensuring protections for individuals with disabilities. The first alert – published on May 26 – focused on the rules’ requirement for language assistance for persons with limited English proficiency. The third and final alert – to be issued in the near future – will cover rules related to sex discrimination.
Relationship to Other Laws. The final rules are consistent with existing directives implementing the requirements already existing under the Americans with Disabilities Act (“ADA”) and Section 504 of the Rehabilitation Act of 1973 (“Section 504). Nothing in the new rules should be interpreted to invalidate or limit the rights, remedies, procedures, or legal standards available to disabled persons under the ADA or Section 504. Accordingly, entities must ensure compliance with existing laws in addition to the new ACA rules, including state laws that may be more restrictive than the ACA regulations. Read more