MD-DC Arrangements Share Legal Issues Nationwide

Chiropractors and medical doctors (or D.O.s) have had a long and somewhat complex relationship. Though they approach healthcare issues differently, there are many instances where they share care or even work together. Such "M.D./D.C." relationships are legally complex, but often prove to be rewarding in many respects. Properly constructing the arrangements is critical, especially since government regulators and payers tend to view such arrangements with skepticism, alleging that the true reason for the combination is for chiropractors to avoid coverage restrictions.

The core legal issues the parties need to be aware of include:

Corporate practice prohibitions. Most states prohibit (or regulate) who can own a medical practice or a chiropractic practice. So called "corporate practice restrictions" for instance often prohibit a medical doctor and a chiropractor from jointly owning a clinical practice. Additionally, many states do not permit a chiropractor employing a medical doctor and vice versa. That leaves essentially two models for consideration-a direct employment model and a management type of model.

Legal structure. Getting this right is important, especially with respect to self referral restrictions. If federal patients dollars are involved (e.g. Medicare), some very complex and powerful federal laws (e.g. Stark and the Anti Kickback Statute) come into play. And many states have their own self referral restrictions. Single legal entity? Multiple legal entity? It depends on things like the payer mix, state regulation, and the type of services provided.

In office ancillary services (IOAS) or "group practice" concerns. This is closely related to self referral regulations. Both states and the federal government regulate such conduct. For instance, under applicable federal law, "designated health services" (which include physical therapy and diagnostic imaging) must be provided in the very same office where patient care is provided. Moreover, a physician (but not a chiropractor) must be physically present in the office when the DHS services are provided to patients. Additionally, to comply with the IOAS provision, the practice has to ensure that the physicians in the practice spend, on average, 75% of their total professional time working through the combined practice. MD/DC practices which don't require an M.D. often can find adhering to state and federal requirements difficult because of applicable supervision requirements.

Fee splitting. Many practices want to simply divide up income on a percentage basis, but this raises fee splitting (and kickback) issues.

These unique combined practices have to be careful to guard against the already tainted regulatory assumptions about them. Yet, there are many things conservative professionals can do to thwart successful investigations, like-

•Rules and regulations to address common risks like "patient channeling" allegations (for which many physicians have been criminally convicted);

•A compliance audit to ensure that what they are doing or planning to do complies with applicable state and federal law; and

•An annual audit to ensure continued compliance (including in areas like coding and proper documentation).

Mixed practices like M.D./D.C. relationships are not new, but the full spectrum of regulatory compliance is essential to ensure long term viability. It simply isn't sufficient to focus on one or more aspects. Getting the entity and form of compensation right is just one part of a legally complex business arrangement; and to serve physicians well requires all facets of the arrangement to be viewed and cleared.

Article Source: http://EzineArticles.com/6330010

IBS Hypnosis for Healing

If you're suffering with symptoms of IBS, beware. There are for-profit alternatives which can help. However, looking at the decision to consider an irritable bowels syndrome treatment center may not always fall into your budget. Co-pays can be costly.

There is another option. It can cost thousands of dollars less. The treatment? Hypnosis for IBS. If you've done your homework, you know the basics of the disorder. Research has proven there is a connection between your mind and body in the development of your suffering.

But I know that's not really too much fun to consider. Instead, diarrhea, constipation, feeling of fullness or bloating and gas are usually on your mind. Only, what many sufferers are learning is hypnosis can empower them to overcome their IBS symptoms. Of course, it's not a quick fix.

Some IBS hypnosis highlights might make you think twice about your treatment options.

-Symptoms run in cycles lasting for years

-Diarrhea, constipation, spasms, gas or pain can be never-ending

-10% of primary care MD visits are IBS-relatted

-IBS is the second leading cause for employee absenteeism

-Traditional intervention is 25% effective

-Hypnosis is 80% effective and can last for years

Hypnosis accesses the long-term memory. It is here that new direction can be given which positively changes how the digestive system operates. It can be retrained to process nutrition more productively with healthy results.

IBS is a nerve-wracking ordeal affecting sufferers physically, emotionally and spiritually. They feel like prisoners in their own bodies. With hypnotherapy treatment, levels of stressful anticipation can be greatly reduced and new patterns of control and empowerment are fostered.

Article Source: http://EzineArticles.com/6048833


Hypnotherapy treatment includes a series of 4-6 office visits ranging over a few months. The hypnosis sessions are personalized to individual needs and prepared by a medical professional certified as an IBS specialist.

Many certified hypnotherapists need 4-6 sessions to help build a foundation for healing. The research is amazing with patients stating their IBS symptoms disappear. Are you looking for an IBS treatment?

It could very well exist between your ears.

Clients engaged in hypnosis learn about digestive function, healthier nutritional choices and the mind-body connection. They receive an in-depth review of how hypnosis works and how to perform self-hypnosis so they may go on to become self-practitioners, ensuring a lifetime of symptom-free living.

Article Source: http://EzineArticles.com/6048833

Skin Care MD

People in flight – Photography by Denisa Tarzaka

The following pictures aren’t made up by some Photoshop artist. These are the works of French photographer Denisa Tarzaka, who relies on professional dancers and his precise timing to produce the effect of zero gravity.








 

The Monastery of Ten Thousand Buddhas

High above a lush hillside in the New Territories town of Sha Tin, Hong Kong is the Monastery of Ten Thousand Buddhas. It is not an actual monastery as there are no resident monks - instead, it is crowed with more than 13,000 statues of Buddhas of all shapes and sizes. To reach the monastery one must first climb over 400 steps up the hillside, the path lined with life-size statues of Buddhas.
“The entire path upwards was lined with Buddha statues, statues different from any Buddha I'd seen at a previous temple,” writes blogger Andy Carvin. “In fact, each statue was probably unique. There were thin Buddhas, chubby Buddhas, bald Buddhas, hairy Buddhas, Buddhas with walking sticks, Buddhas with dogs and dragons and frogs, macho Buddhas, androgynous Buddhas.”
Once inside the monastery, you are accosted by more statues – Buddhas in the garden, Buddhas in the pavilion, Buddhas in the tower. The walls inside the temple is lined with thousands upon thousands of miniature Buddhas.

The Ten Thousand Buddhas Monastery was founded in 1951 by Yuet Kai, a monk who preached Buddhism in a local monastery. Construction of the monastery began in 1949. Despite his old age, Yuet Kai carried the buildings materials personally from the foot of the mountain together with his disciples to build the monastery. It took eight years to complete all the buildings and another ten years to finish the 12,800 Buddha statues. Today, his preserved body is presented in the main hall of the monastery in a glass case, often the main attraction of the temple.















Photos by Polina Delia