Independent Professional Judgement Policy
To provide guidance to the Board of Directors of QuickMD, LLC (the “Company”) relating to the preservation of the independent professional judgment of medical providers working for QuickMD Medical Group and, if applicable, other medical practices contracting with the Company (“Medical Practice”), and preventing inappropriate interference from lay entities or persons associated with the Company.
In states maintaining restrictions on the corporate practice of medicine, the Company enters into management services agreements to provide administrative and operational (non-clinical) services to each applicable Medical Practice. The relationship between the Company and a Medical Practice should never interfere with the medical providers’ medical judgment or otherwise result in the Company controlling a Medical Practice. The Company recognizes this line may not be brightly drawn in some states and that its administrative services must be carefully operationalized to preserve the medical providers’ independence consistent with state laws.
To protect the fiduciary role of medical providers in making medical judgments and to ensure operations consistent with state laws, the following principles are adopted by the Company:
- The Company shall not engage in services or behaviors that constitute the unauthorized lay control over a Medical Practice and the health decisions over which a provider must retain control.
- Any management services agreement between the Company and the affiliated Medical Practices should limit the Company’s decision-making authority to non-clinical areas.
- The Company should recommend the implementation at the Medical Practice level of a Medical Group Policies Committee and as part of its management services provide the Medical Practice(s) with a sample Medical Group Policies Committee Policy, attached hereto, as a starting point for the Medical Practice to develop such a committee and policy.
- The following health care decisions are to be made by licensed medical providers only, and not made by the Company:
- Determining the nature or scope of services to be provided by the Medical Practice.
- Determining what diagnostic tests are appropriate for a particular condition.
- Determining the need for referrals to or consultation with another medical provider or specialist.
- Determining the need for, quantity, type, and appropriateness of any prescriptions a medical provider deems medically appropriate for a patient.
- Approving of the selection, maintenance, registration, and/or inspection of medical equipment, medical supplies, or drugs for the Medical Practice.
- Responsibility for the overall care of the patient, including the nature and character of all professional medical services rendered to the patient.
- Conducting any activity that constitutes the practice of medicine.
- Audits of patient records and of professional services to assure quality professional care.
- Assigning and scheduling physicians and other health care professionals to treat patients.
- Developing, implementing, and overseeing the clinical patient intake protocol to ensure clinical best practices.
- Training clinicians to facilitate safe and effective clinical consultations.
- The following business or administrative decisions and activities are ultimately made by licensed physicians only, and not by the Company, although the Company may assist on such matters at the direction of licensed physicians and such ultimate decisions may be made by licensed physicians in consultation with the Company:
- Selecting, hiring/firing (as it relates to competency or proficiency), supervising or disciplining of physicians, allied health staff, and medical assistants, and verification of current licensing credentials and any other educational credentials required by law or pertinent agency rule (for example, re-certifications, continuing professional education, cardiopulmonary resuscitation, etc.).
- Setting the Medical Practice’s schedule of charges and fees, which schedule must be available to patients on request, and any modification or waiver thereof.
- Determining how income will be allocated or distributed by the Medical Practice.
- Determining the coding and billing procedures for the Medical Practice.
- Serving as the named party to whom the Medical Practice’s bills and charges are directly made payable.
- Assuming ownership of any patient medical records.
- Payment of all professional, medical, and administrative staffing necessary for the operation of the Medical Practice.
- Setting the parameters under which the Medical Practice will enter into contractual relationships with third-party payers.
- Reviewing and executing contracts between the Medical Practice and third-party payers for the delivery of health care services.
- Reviewing and executing contracts between the Medical Practice and vendors.
- Adopting policies for recordkeeping as to patient medical records, billing records, and such other records as may be required by law or rule including Controlled Dangerous Substance inventories, as applicable.
- Adopting medical policies at the place where medical services shall be rendered.
- Determining necessary security, including drug storage, prescription pad control, and confidentiality of patient records.
- Responsibility for the professional propriety of billing and of advertising or other representations including disclosure of financial interest in health care services offered to the public.
- Supervising the selection of the clinical and/or medical equipment, supplies, and/or drugs for use by the Medical Practice.
While a physician may consult with the Company in making the decisions described above, the physician must retain the ultimate responsibility for, or approval of, those decisions.