Collaboration between physicians and treatment programs is generally considered a benefit to patient care. To that end, California law changed in October 2015 to allow licensed healthcare practitioners at residential treatment facilities to provide "incidental medical services" (IMS), which are defined as:
- (i) obtaining medical histories;
- (ii) monitoring resident health status to determine the need for emergency or urgent care;
- (iii) detoxification testing;
- (iv) providing alcoholism/drug abuse recovery/treatment services;
- (v) overseeing patient self-administered medication; and
- (vi) treating substance use disorders, including detoxification.
Residential facilities interested in providing incidental medical services must apply to the Department of Health Care Services (DHCS) before providing any such services.
Incidental medical services at residential treatment facilities must be provided by one or more physicians and surgeons licensed by the Medical Board of California or the Osteopathic Medical Board or by licensed health care practitioners acting within the scope of practice of their licensure and under the direction of a physician and surgeon. The healthcare practitioners providing IMS must be knowledgeable about addiction medicine.
Residential treatment facilities who engage healthcare practitioners to provide IMS need to have a comprehensive understanding of the law that permits IMS as well as DCHS’ recent guidelines and upcoming regulations. Mistakes in this area – such as contracting with physicians to provide broader primary care or psychiatric care to their clients at your facility – can put your license (and the physician’s license) at risk and can potentially result in violations of California’s corporate practice of medicine law (CPOM), which generally prohibits licensed health professionals from working for business entities other than professional corporations or for unlicensed people. Furthermore, mistakes in this area can result in health insurance companies denying claims for reimbursement and placing your facility on their audit lists.
Facilities also need to make sure that they have a robust and thorough credentialing process for the physicians and other healthcare practitioners that they hire to provide IMS. If a patient care problem arises with the provision of IMS, your facility could potentially face significant liability for negligent credentialing.
Some of the seminar’s highlights:
- A review of California’s CPOM law and what it means for your program or your practice
- A clear understanding of the scope of permissible IMS versus prohibited practice of medicine at residential treatment facilities
- DCHS’ guidelines and anticipated regulations for IMS
- The intersection of IMS and insurance reimbursement, and best practices to maximize reimbursement
- Best practices for IMS contracts and understanding the legal relationship between the residential treatment facility and the physician
- Best practices for credentialing practitioners of IMS
- Q&A with the presenters
Let Nelson Hardiman and AATA, your resource for addiction treatment compliance education, walk you through these issues and more.