For inquiries, please contact our Front Desk at fd@molawoffice.com or Admin at admin@molawoffice.com. You can also reach us by phone at +1 305-548-5020, option 1.

For traffic ticket assistance, visit molinatrafficticket.com.

Why Medical Practices in Miami-Dade Need Outside General Counsel: A Practical 2025 Guide

What “Outside General Counsel” Means for a Medical Practice

Core objectives

• Speed up decisions: plain-English answers when your administrator or physician-owner needs a green light.
• Prevent problems: update policies, contracts, and training so issues don’t become investigations.
• Protect the enterprise: align your payor, vendor, and employment obligations with your insurance, privacy, and compliance posture.

12 Areas Where General Counsel Protects and Grows a Practice

1) Payor Contracts, Credentialing & Revenue Cycle

• Review and negotiate managed-care agreements, reimbursement schedules, and termination clauses.
• Build a denials/appeals playbook and set timelines with your billing vendor.
• Clarify out-of-network language, patient estimates, and dispute procedures under federal balance-billing rules.

2) Compliance Program (HIPAA, OIG Guidance, Florida privacy)

• Maintain policies and procedures (privacy, security, sanctions, minimum necessary).
• Conduct risk analyses and role-based training (front desk, MA, billing).
• Refresh Business Associate Agreements (BAAs) and vendor oversight.
• Map data flows in your EHR, portal, texting, telehealth, and marketing tools.

3) Cybersecurity & Incident Response

• Minimum controls: MFA, encryption, access logs, off-boarding procedures.
• Incident playbook: who investigates, who notifies, how quickly, and what gets documented.
• Coordinate cyber insurance endorsements with contractual promises to payors, hospitals, and landlords.

4) Telehealth & Cross-Border Care

• Confirm Florida telehealth registration requirements for out-of-state clinicians.
• Standardize patient consents, modality disclosures, and e-prescribing limits.
• Align platform BAAs and ensure secure messaging/recording settings.

5) Stark/AKS Risk Awareness & Financial Relationships

• Review referral patterns, leases, equipment-sharing, and compensation models.
• Paper medical director arrangements, productivity bonuses, and expense allocations.
• Ensure fair market value support and pre-signature review of high-risk deals.

6) Employment & Independent Contractors

• Clinician and staff agreements with confidentiality, IP, non-solicit, and clear call coverage and comp schedules.
• Update handbooks (leave, timekeeping, device use, social media, harassment).
• Ensure proper exempt/non-exempt classification and incentive/bonus documentation.
• Build a discipline/termination checklist to reduce wrongful-termination exposure.

7) Vendor & EHR Agreements

• Negotiate service levels, downtime credits, breach notice clocks, and data ownership/export formats.
• Control subprocessors touching PHI; align BAAs with your privacy/security policies.
• Add transition assistance clauses for EHR or billing vendor changes.

8) Patient-Facing Materials & Marketing

• Review consents, authorizations, financial responsibility forms, and notice of privacy practices (English/Español).
• Check website terms, privacy, cookies, and texting/email consent for recalls, reminders, and promotions.
• Tighten refunds/cancellations and subscription programs (e.g., concierge care) to avoid processor issues.

9) Clinical Policies that Affect Liability

• Standardize scope-of-practice protocols for MAs, RNs, APRNs, and PAs.
• Update informed consent and after-hours coverage procedures.
• Align documentation practices with payer and malpractice expectations.

10) Real Estate: Medical Office & Equipment Leases

• Watch for build-out, exclusivity, signage, parking, and hazardous waste provisions.
• Ensure “Additional Insured,” “Primary/Non-Contributory,” and Waiver of Subrogation demands match your policies.
• Clarify early termination and relocation rights; align with long-term strategy (new modality or growth).

11) Practice M&A, Partner Buy-Ins/Buy-Outs & Succession

• Draft operating/shareholder agreements with buy-sell triggers (death, disability, divorce, deadlock, departure).
• Create valuation methods, restrictive covenants, and governance rules that actually work in your clinic.
• Prepare a light data room so you’re due-diligence ready year-round.

12) Collections & Financial Policy

• Milestone billing, late fees, interest, and suspension/termination rights for nonpayment (as appropriate).
• Surprise-billing disclosures, good-faith estimates, and charity/hardship policies.
• Demand letters and internal A/R workflows that your team can actually follow.

What a General Counsel Engagement Looks Like (Month 1–3)

Days 1–15: Baseline & Quick Wins

• Discovery meeting with physician-owner/administrator to map top risks.
• Update BAAs, confirm HIPAA policies exist and are in force, and patch high-risk vendor terms.
• Refresh employment/contractor templates (including bilingual where helpful).
• Align insurance endorsements (GL, professional/E&O, cyber) with lease and payor demands.

Days 16–45: Institutionalize

• Load approved templates (consents, financial responsibility, BAAs, employment, vendor addenda) into your EHR/HRIS/drive.
• Publish a privacy/marketing compliance checklist for front desk and billing.
• Run a 60-minute training for staff on PHI handling, texting, and incident escalation.

Days 46–90: Measure & Optimize

• Track KPIs: claim denials overturned, days in A/R, redline rate on vendor/payor contracts, training completion, incidents closed without breach notification.
• Tabletop cyber incident and EHR outage drills; tighten response times.
• Plan the Q2/Q3 roadmap (e.g., renegotiating a hospital call-coverage agreement or adding a new service line/telehealth state).

How to Measure ROI from General Counsel

• Revenue protection: fewer denials, faster credentialing, cleaner payor audits.
• Risk reduction: zero reportable breaches, fewer HR disputes, fewer uncovered insurance gaps.
• Speed: shorter contract cycles with payors and vendors; faster answers to operational questions.
• Valuation readiness: governance, leases, IP/BAAs, and policies in a data room for lending or M&A.

Pricing & Working Style (What Practices Usually Choose)

• Reserved hours for advice, redlines, and brief negotiations.
• Two scheduled check-ins per month with your administrator.
• Document library: BAAs, employment/IC agreements, vendor addenda, payor redline playbook, patient consents.
• Quarterly report on KPIs, incidents, and recommended updates.

FAQs From Medical Practices

Conclusion: Make Legal a Clinical Advantage