www.njchiropractors.com I 7 Legislative Update Chiro TECHN Legal Q&A S C H O L ARSHIP WI N N E R S Q Under the new out-of-network disclosure law, is there a specific disclosure form we must use with patients or can we use our own form? A New Jersey Governor Philip Murphy signed into law on June 1, 2018, S.485 / A.2039 targeted at “surprise bills” patients may get when they treat at an in-network hospital emergency department that has out-of-network healthcare providers such as anesthesiologists or radiologists. Though hospitals were the primary target of the law, the new law also mandates specific disclosures be made to patients by outpatient doctors such as chiropractors in writing concerning the practice’s network participation status. The law is scheduled to take effect 90 days from enactment on Sept. 1, 2018. During this 90-day period from enactment, the new law directs all state professional boards, such as the Board of Chiropractic Examiners, to implement a uniform disclosure form for all of their licensees to use. The Chiro- practic Board addressed the new law at their June 2018 public session meeting but, if history is a guide, there will not be an official uniform disclosure form completed by the Sept. 1, 2018, dead- line. Thus, providers will be required to use their own disclosure form that complies with the new law until the board’s uniform disclosure form is officially promulgated. Once the official form is promulgated, all providers must use this form and discontinue use of their own form. Q If a patient posts a negative review of my practice on social media or the internet, can I force them or the site provider to take down the negative review or comment? A In most cases, no. Everyone has a constitutional right to free speech and can post their opinion on social media and internet sites. However, there is a limitation to this fundamental right. If the patient posts factually inaccurate information as opposed to an opinion, there is a potential right for the doctor to have the inaccurate infor- mation removed through legal action. The doctor must be cautioned not to respond to a negative review or posting in a manner that would violate federal HIPPA laws: Any discussion of patient care or other private health information without the patient’s consent could violate HIPPA. It is, however, permis- sible for the doctor to encourage other patients to post positive reviews, if they so choose, which will push down the negative review or comment. Q What is the proper way to ter- minate my network participation status with an insurance carrier? A The decision to participate or not with any particular health insurance carrier is an individual deter- mination that each practice must make based upon their particular practice make-up. However, once the decision is made to terminate network partic- ipation, the doctor must review their Participating Provider Agreement (“PPA”) with that particular carrier as each of these contractual agreements have their own specific termination procedure. Many PPAs require certified mail notice to a specific address with up to 90 days prior notice. Some PPAs also contain a wind-down period of up to six months wherein the doctor is still considered in-network until that wind- down period expires. Thus, it could take up to nine months under some PPAs to fully terminate participation status. It is recommended that the doctor consult with a health care attorney to review the PPA and guide them in the required process to terminate network participa- tion status. Q Is it permissible to treat employ- ees at my office and bill their insurance carrier for the treatment? A While there is no legal prohi- bition to treating employees of your practice there are a number of issues that must be addressed. Many health care plans exclude from coverage treatment by an employer. If the employee’s health plan has such an exclusion, you cannot bill their carrier for your treatment. You should review the employee’s Summary Plan Descrip- tion of their health plan to see if such an exclusion exists. If you chose to treat the employee and not bill their carrier, you must treat the employee just as any other patient. Many doctors may give an employee a quick adjustment after a long day of work but fail to perform an exam or start a patient file. This is not permissible. A chiropractic physician is required to perform a history, exam, establish a treatment plan and obtain consent for treatment prior to treating any person. This must be documented in a patient file that complies with the New Jersey Board of Chiropractic Examiners record keeping regulation, N.J.A.C. 13:44E-2.2. Jeffrey Randolph, Esq. (the author of these two articles) is an independent person of the ANJC and his views are not authorized, sponsored, or otherwise approved by the ANJC. The information provided is for gen- eral guidance on matters of interest only and may not take into account particular facts relevant to your individual situation. The application and impact of laws and health care can vary widely based on the specific facts involved. Given the changing nature of laws, rules and regulations, there may be omissions or inaccuracies in information contained in these materials. Accordingly, the information you receive is provided with the understanding that the author and the ANJC are not herein engaged in rendering legal, accounting, tax, health care or other professional advice and services nor are they providing specific advice with regard to your practice, the treatment of any specific illness, disease, deformity or condition, or any other matter that affects trade, commerce, or legal rights of others. As such, this article should not be used as a substitute for consultation with professional accounting, tax, legal, health care, or other competent advisers. Before making any decision or taking any action, you should consult an appropriately trained professional. By Jeffrey Randolph ANJC Legal Counsel