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ACP offers a number of resources to help members make sense of the MOC requirements and earn points.
Understanding MOC Requirements
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Internal Medicine Meeting 2019
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Access helpful forms developed by a variety of sources for patient charts, logs, information sheets, office signs, and use by practice administration.
ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
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1. How long must I keep medical records?
According to Florida law, a physician is responsible for
maintaining records for at least five years (64B8-10.002). Because
malpractice lawsuits can be brought up to seven years after the
date of an incident (eight years for some minors), physicians are
encouraged to maintain records for the full seven years.
2. Another physician and I provide cross coverage. How
should I bill when I provide a service for the other physician's
A physician must always use his or her own Medicare number when
billing for services, even if the service is provided under a
coverage arrangement for another physician.
3. A group of independent physicians sent a
representative to an HMO to negotiate a new contract. Can the
members of this non-integrated group then refuse the offered
Federal antitrust law prohibits non-integrated physicians from
negotiating as a group, but does allow them to send a "messenger"
to the HMO to ask for contract terms. Under this type of
negotiation, however, the group members must then make individual
decisions on whether to accept the new contract without discussing
it among themselves. Any concerted action, such as a boycott of the
HMO, is deemed anti-competitive activity and subjects each of the
physicians to potential civil penalties under federal anti-trust
4. May I date a patient?
Florida Statute 458.331(1)(j) forbids "Exercising influence
within a patient- physician relationship for purposes of engaging a
patient in sexual activity. A patient shall be presumed to be
incapable of giving free, full, and informed consent to sexual
activity with his or her physician." First offense penalties for
sexual misconduct range from a one year suspension and reprimand
and $5,000 to permanent revocation of one's license and a fine of
$10,000 (F.A.C. 64B8- 8.001(2)(j)).
For these reasons, physicians are urged to exercise considerable
caution before embarking upon a physical relationship with a
patient. You may also wish to note that physicians have been found
to be in violation of this statute even when the other party was a
former patient if it can be shown that the physician used the
former physician-patient relationship in order to advance the
relationship. On the other hand, the presumption made above can be
rebutted if the other party makes an unbiased decision to embark
upon the relationship, especially if the professional relationship
5. What may I charge an HMO for emergency services if I
am not a network provider?
Florida law (641.513) requires payment to non-contracted
emergency service providers of the lesser of:
6. Must I be present when my office performs clinical
laboratory testing or other designated health
As you know, Medicare law requires that designated health
services, such as clinical laboratory services, be performed under
the "direct supervision" of a physician (42 U.S.C.1395nn(b)(2)).
Moreover, the Florida Patient Self-Referral Act (F.S. 456.053)
requires that designated health services be performed only for the
group's own patients and "under the direct supervision of such
referring health care provider or group practice" (F.S.
456.053(3)(o)3.f). The Florida clarifies that "direct supervision"
means supervision by a physician who is present in the office suite
and immediately available to provide assistance and direction
throughout the time services are being performed." (F.S.
While recent revisions do allow the physician to be absent for
short or unexpected periods, a physician member of your practice
should be present in the same office suite when clinical laboratory
services are being performed.
7. Can an insurance company force a provider to accept
its HMO product when a provider agreement for all HMO products was
Absolutely not; the all-products legislation specifically
forbids such tactics.
8. If we receive an HMO reimbursement check and cash it,
does it signify acceptance of that HMO fee schedule (or
F.S. 641.3155 states that you may not balance bill a patient for
any service that you should know is a service for which the HMO
provides reimbursement. On the other hand, if you know in good
faith that your service is not one ordinarily paid for by the HMO,
whether it be because you do not participate or it is not a covered
service, you may bill the patient your standard fee. However, if
you accept any payment from the HMO, you are agreeing that it is an
HMO-covered service, and you may not balance bill the patient.
9. Can we endorse over an HMO check to the patient's
family without incurring an acceptance of their fee
For the reasons stated above, even endorsing over the check
infers that it is a covered service for which you may not balance
bill the patient. Therefore, unless you are willing to accept this
fee as payment in full, you should not sign it over to the
10. May I balance bill a patient for HMO services if i
know the claim will be denied because I am not on the
According to F.S. 641.3154, you may bill a patient for
non-emergency services that are not covered by an HMO. Therefore,
if you in good faith know that an HMO will not cover a visit
because of the lack of pre-authorization or because you are a
non-participating provider, you may bill the patient directly.
11. What are the requirements regarding the option of
posting a bond in lieu of obtaining professional liability
The requirements for financial responsibility are found in F.S.
458.320. Assuming that the physician has staff privileges, the
physician must either maintain PLI of at least $250,000 per
claim/$750,000 annual aggregate, or complying with one of the
following two alternatives:
-1 Establishing and maintaining an escrow account consisting of
cash or assets eligible for deposit of at least $250,000 per
claim/$750,000 annual aggregate; or -2 Obtaining and maintaining an
unexpired, irrevocable letter of credit in the above amounts.
It should be noted that the above amounts are reduced to
$100,000 and $300,000, respectively, if the physician does not
maintain staff privileges.