It has been reported that dentists and other health care professionals have been visited/contacted by U.S. Immigration and Customs Enforcement agents seeking to carry out “immigration policies” and to remove those unlawfully...more
Question: Early in every calendar year our accounts receivable tend to build up due to patients having to pay out of pocket before annual deductibles and co-pays reach their maximums. This typically results in a corresponding...more
Question: I have had several colleagues describe their experience with dental plan audits. All of them have had to pay something back. Sometimes they say this is due to a service being deemed a “noncovered service.” Other...more
1/31/2025
/ Audits ,
Dental Practice ,
Dentists ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Insurance Claims ,
Insurance Industry ,
Insurance Litigation ,
Reimbursements ,
Risk Management
Question: I recently settled a licensing complaint with the state of Michigan during my compliance conference. In my view the complaint lacked merit. However, I did not want to go through an administrative hearing because it...more
The legal arguments advanced in these court cases mainly concern whether the FTC has the statutory authority to enact such a ban. Shortly before the September 4, 2024 effective date of FTC’s ban on covenants not to compete,...more
10/30/2024
/ Appeals ,
Arbitrary and Capricious ,
Employment Contract ,
Federal Bans ,
Federal Court Litigation ,
Federal Trade Commission (FTC) ,
Florida ,
Non-Compete Agreements ,
Restrictive Covenants ,
Statutory Authority ,
Texas ,
Unfair Competition
Question: My accountant and other are telling me there is some federal government filing that I must make by the end of the year. My personal information is being sought. Can you explain what this is all about, whether I have...more
8/30/2024
/ Beneficial Owner ,
Compliance ,
Constitutional Challenges ,
Corporate Transparency Act ,
FinCEN ,
Ownership Interest ,
Personal Information ,
Private Equity ,
Reporting Requirements ,
SBA ,
Tax Exempt Entities
Question: I am considering having one or two unpaid interns in my office at different times this summer. Are there restrictions on the type of tasks that I am legally able to have them perform? Are there other legal concerns...more
This Final Rule does not take effect until 120 days after it is published in the Federal Register. Litigation seeking to prevent the Final Rule from ever taking effect has already been commenced in the United States District...more
Daniel Schulte discusses why dentists should not incentivize patient referrals in The Journal of the Michigan Dental Association (November 2023).
Question: I would like to add a referral incentive program to attract new...more
Question: Due to a staffing shortage at my office, I have been forced to make some difficult choices. For example, I have had some patients who were seen previously only for an emergency visit. They had no regular dentist and...more
Question: Are covenants not to compete and liquidated damages provisions in employment agreements still enforceable? I have seen news reports about the Federal Trade Commission and National Labor Relations Board being...more
Question: I am under audit by a dental plan I participate with. The audit has identified a few issues in connection with how my billing employees have been submitting claims for payment. For example, the name of the treating...more
7/27/2023
/ Audits ,
Billing ,
Burden of Proof ,
Dental Practice ,
False Billing ,
Fraud ,
Health Care Providers ,
Insurance Claims ,
Misrepresentation ,
Participation Agreements ,
Reasonable Doubt
Question: Our eScribe software allows us to access a patient’s prescription history. We are able to see what medications have been prescribed by other health care providers. MAPS also allows us to do this. When requesting...more
Question: A health plan that I participate with has sent me a notice stating that it has audited some of the claims I have submitted over the past three years. The health plan believes that some of these claims were improper...more
Question: More and more I have patients refusing exams and X-rays for financial reasons. These patients only want to have their teeth cleaned. I am uncomfortable allowing this in my practice. What will happen if diseases or...more
The various antitrust laws can seem unfair, complicated, and many times irrelevant to the practice of dentistry. However, these laws do apply. The U.S. Justice Department (“DOJ”) and the Federal Trade Commission (“FTC”)...more
Question: I’m reading media accounts that the FTC is about to ban all covenants not to compete. When will this happen? Will the covenant not to compete in my employment agreement that I signed two years ago be banned? Will...more
Question: I have a patient who is very difficult to deal with. He is rude to my employees, does not always follow my treatment recommendations, complains about my fees, and is generally very unpleasant. I do not care to see...more
Question: I read an article the other day describing the use of an assignment of benefits form. The article said that having patients sign this form is beneficial. It would result in his or her dental plan paying me the...more
Most physicians and dentists are familiar with contracting to be a part of a third-party payer’s network. This usually means increased patient flow (from the patients enrolled in the payer’s plan(s)) and fee...more
The Supreme Court’s decision does not mean that businesses and individuals in Michigan may return to pre-COVID-19 behavior or ignore Executive Order standards which have an independent legal basis. Employers, businesses, and...more
10/6/2020
/ Business Closures ,
Coronavirus/COVID-19 ,
Emergency Management Plans ,
Emergency Powers ,
Executive Orders ,
Governor Whitmer ,
Infectious Diseases ,
Lack of Authority ,
Masks ,
MI Supreme Court ,
OSHA ,
State and Local Government ,
Workplace Safety