Many of you readers are either already physicians in a freestanding ER or in an urgent care facility, or you’re considering starting up one of your own. It’s crucial to understand, though, the difference between the two, as well as the laws that are set in place that affect both types of facilities. These laws are the same as the ones in place for any medical practice, but it won’t hurt to get a little refresher!
Freestanding ERs are emergency center facilities that are not attached to a hospital. Pretty self-explanatory, right? Even though they are emergency centers, not every freestanding ER is equipped to deal with trauma and intensive care, so a patient would still need to go to a hospital for those things. Freestanding ERs, though, are usually capable of taking care of wounds with severe bleeding, broken bones, heart attacks, strokes, and other major injuries. To be able to consider themselves an ER, a Freestanding ER must be open 24 hours and have a licensed emergency physician on site at all times. Freestanding ERs are also required to treat or stabilize any patient that comes into their facility, regardless of their ability to pay.
Urgent care facilities, on the other hand, function almost like a walk in primary care clinic. They can treat stomach bugs, the flu, the common cold, strep throat, earaches, sprains, and other illnesses and injuries along the same lines. Some urgent care facilities are equipped with x-ray machines and MRIs, while others are not. Urgent care clinics have a broader reach of things they can treat as long as they are non-emergencies. They are not required to stay open for 24 hours, and often have hours similar to that of a normal doctor’s office.
With these thoughts in mind, you may want to make sure your potential UCC or ER don’t violate any of these laws below. These are some of the most commonly violated laws by UCCs and freestanding ERs.-Corporate practice of medicine- In several states you must be a medical practitioner to be able to own a service that provides healthcare. Be sure to check what the laws are in your state before setting up an urgent care clinic or freestanding ER if you or any of your partners do not have medical licenses.
-Stark Law- This law prohibits a physician from referring a Medicare or Medicaid patient to another designated health service (DHS) that they are affiliated with financially. (Exceptions apply, so be sure to do your research to make sure you are not violating this law.)
-Anti-kickback statute- This prohibits any exchange (or hint of an exchange) of anything of value in return for a referral of a patient within a federal healthcare program
-Get your facility into insurance and government payer lists the minute you break ground, if not before. The sooner the better.
It’s not uncommon for these types of services to be charged with medical malpractice. So, it’s best to put safeguards in place to try to minimize the chance of this happening. Keep clear and thorough paperwork of patient visits for your records, just in case something pops up.
Urgent care clinics, especially, are sufferers of malpractice lawsuits, largely for failure to treat or failure to diagnose. These occurrences usually stem from a patient coming to the UCC with an injury or illness the clinic cannot properly treat or diagnose with their equipment on hand. Make sure every member of your staff is well trained and capable. You wouldn’t want to get sued for malpractice because a nurse did a bad job at inserting an IV into a patient’s arm and caused a lot of bruising.
If you have any questions or concerns about this topic you should contact a healthcare lawyer with questions you have regarding specific laws, exposure, and requirements.
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