Issue 2 - February 2004

Ask the Attorney
Follow these 10 steps for multi-disciplinary practices
By Deborah Green, Esq.

I believe that the future of chiropractic — at least for me — lies in aligning myself with other specialties. If I wanted to expand my practice to become multi-disciplinary, what would I need to do?

If a multi-disciplined practice that includes a medical doctor is in line with your healthcare philosophies, I suggest you follow these 10 tips — under the guidance of an attorney who specializes in healthcare issues.

1. Understand your state’s laws. Does your state permits a chiropractor to own a medical practice alone or in tandem with a medical doctor?

2. Don’t interfere with medical decisions. Regardless of how the multi-discipline practice is structured, certain rules apply. Under no circumstances are you permitted to exercise control over medical issues.

Owning or managing a multi-discipline practice does not magically increase your scope of practice to include medicine. As a licensed chiropractor, you are only permitted to make decisions concerning chiropractic care.

3. Fill in the paperwork. Have the papers notarized if required. Fill in all the blanks, if any. Failure to do to this may result in severe consequences.

4. Use your attorney and accountant. Make sure you get a new Employer Identification Number (EIN) for your company. If you have formed a corporation instead of an LLC, check with your lawyer before you talk with an accountant to determine whether the corporation should be an “S” or “C” corporation.

5. Charge fair market-value prices. If you operate a management company, the prices you charge the medical practice should be referenced in the management agreement, should be at fair market value (not a percentage) and the agreement should be valid for at least a year.

6. Document loans to the medical practice. If you loan money to the new practice in the form of cash, equipment, transfer of patients or the like, have evidence of that loan in the form of a note or security agreement and file that evidence with the state to secure the loan.

7. Secure loans to the practice. Secure your loan with collateral. Collateral assures that you will be repaid for the money or items of value that you loaned to the practice to help facilitate its start-up.

8. Protect your personal liability. Your personal liability is limited only when you comply with the requirements of corporate law. The benefits of corporate operation flow from the legal recognition of the corporation as an entity separate from its individual shareholders, directors and officers.

9. Keep corporate and personal affairs separate. Never mix corporate and personal funds, assets or accounts. Do not use corporate funds or assets for personal or other purposes.

Avoid any indication that you are dealing in a personal capacity. The corporate name should be used on the telephone, advertisements, letterheads, cards and signs. When you sign documents, make it clear that you are acting on behalf of the corporation.

10. Create a compliance program. This type of program acts as a template for the practice and gives both the professional and non-professional staff access to the appropriate rules for conducting a multi-discipline practice.

A compliance program should:

• Describe the procedure for performing an in-house audit of coding and billing;

• Deal with HIPAA issues;

• Prevent inadvertent fraud and abuse; and

• Deal with other issues pertinent to the way you envision the practice operating.

Ms. Green is a practicing attorney in New York and Florida. She can be reached at 954-971-7778, FAX 954-971-3787; or by e-mail at healthattorney@aol.com.

LEGAL DISCLAIMER: This column is provided for educational purposes only. The accuracy or timeliness of the information presented herein is not warranted. The information presented is not intended to be advice as to a specific fact pattern with which you may be presented. Accordingly, please note that the information contained herein is not being presented as legal advice with respect to any matter and that no attorney-client relationship is established.