October 9, 2012 –
Medical directors need to understand responsibilities, risks of role at Florida clinics

Practitioners who choose to serve as a medical director of a clinic in Florida must understand the significant responsibility and liability they are undertaking.

Before committing to serve as a medical director, you may wish to make sure that any contractual or employment relationship between a practitioner agreeing to serve as a medical director and a clinic include provisions that allow the practitioner to terminate the contract if they cannot affect compliance with those areas under their responsibility as set forth in the Health Care Clinic Act.

For more information about this matter, please contact Bruce Lamb, leader of Gunster’s health law practice.

Now required at all Florida clinics

The hallmark of the 2003 Health Care Clinic Act is its requirement that certain aspects of the operation of a health care facility in Florida be supervised by a licensed health care practitioner. Thus, it requires that a medical director be employed or under contract with each clinic.

According to the Act, the medical director must be licensed with a full and unencumbered license as an allopathic, osteopathic, podiatric or chiropractic physician. However, it is important to note that the medical director must be authorized under law to supervise all services provided at the clinic. Thus, a clinic providing general medical care cannot be supervised by a chiropractic or podiatric physician, due to the limitations on the scope of practice of those practitioners.

Know the risks, responsibilities

Serving as a medical director can be risky to professional licensees.

Florida Statutes impose certain clinic responsibilities on the medical director. Section 400.9935, Florida Statutes, requires that the medical director accept, in writing, legal responsibility for certain activities of the clinic.

The medical director shall:

(a) Have signs identifying the medical director or clinical director posted in a conspicuous location;
(b) Ensure that all practitioners providing health care services or supplies to patients maintain a current, active and unencumbered Florida license;
(c) Review any patient referral contracts or agreements executed by the clinic;
(d) Ensure that all health care practitioners at the clinic have active appropriate certification or licensure for the level of care being provided;
(e) Serve as the clinic records owner as required under Chapter 456, Florida Statutes;
(f) Ensure compliance with the recordkeeping, office surgery, and adverse incident reporting requirements of Florida Statutes and rules;
(g) Conduct systematic reviews of clinic billings to ensure that the billings are not fraudulent or unlawful, and upon discovery of any unlawful charge, take immediate corrective action.

Additional responsibilities are imposed on clinics providing radiology services. Chapter 400 further provides that any licensed health care provider who violates the Health Care Clinic Act is subject to discipline by that practitioner’s respective licensing board and that the Agency for Health Care Administration may fine, suspend or revoke the license of a clinic.

Background – Health Care Clinic Act

The Health Care Clinic Act was enacted by the Florida Legislature in 2003. It is intended to control practices at facilities that offer health care services but are not directly owned by health care practitioners.

The act requires all entities at which health care services are provided to individuals and reimbursement for such services are tendered to third party payors be registered as clinics. There are numerous exceptions to the clinic registration requirement.

Primarily, these exceptions are applicable if the health care entity is owned solely by health care practitioners, or if the ownership of the health care entity is directly related to another licensed facility, such as is the case for hospitals or ambulatory surgical centers. Health care entities that are exempt from taxation as charitable organizations also qualify as an exception to the clinic registration rule.

Initially, the clinic registration requirement was placed under the authority of the Department of Health, but oversight of clinic registration has since been transferred to the Agency for Health Care Administration, the same agency that licenses hospitals and ambulatory surgical centers.