Okay. First one is from Casey. “She’s wondering if we’ll be covering legalities like obtaining malpractice insurance, HIPAA, etc. She’s wondering as a PA if she needs to see a patient face to face or she can strictly do all her work virtually. She can’t seem to find much in her Michigan state laws about that. As far as malpractice insurance, any recommendations? Am I going to need some form of cyber protection for HIPAA. If I’m only licensed in the state of Michigan, I’m assuming I cannot consult with patients anywhere other than Michigan unless I obtain licensure in other states. Thinking I probably just need a lawyer.”
Chris: Yes. It gets very complicated, and there’s a lot of gray area here. We’ve consulted I think probably four or five health care attorneys now on these questions, so let’s start with the easier questions first.
Malpractice insurance. Let me see, I mean, there are a number of different options. It is probably best just to contact your state organization and ask for a recommendation because there are different options in different parts of the country. I use Admiral, but I’m kind of special. They’re insuring me also for teaching this program and the health coaching program, and I wouldn’t probably use them except for that they’re doing that as well as my malpractice insurance. I think our NP and other physicians are using Thorson. I can check to see who our PA is using. It kind of depends if you’re going to be in practice for yourself or if you’re going work with somebody else. All of our NPs and PAs are on our own policies. They have their individual insurance, and then there’s a full clinic policy as well. Malpractice, again, best to reach out to your state or licensing board and ask or maybe other people you went to school with and get some recommendations for Michigan.
As far as in-person versus virtual, this is one of those gray areas. I can tell you where we’ve settled based on all of these conversations we’ve had with attorneys. I mean, that is that we require an in-person visit for the first time, so patients from outside of the area either drive in or fly in and have their— it’s actually not the first time it’s during the case review. As you know from this course, we have a case review model where we do a 30-minute initial consult to start, and then after they’ve done all the labs, they come into the clinic for the case review, so that’s an in-person visit. Then we can do all of the follow-ups via phone and video, but we’re currently requiring an in-person visit once a year. That’s a Medicare requirement. There’s no explicit requirement for non-Medicare practices. Those who aren’t working outside of the insurance system. We felt it was conservative to kind of try to match the Medicare requirement. It not might be overly conservative. I know of a lot of other clinics that are not doing that, but that’s how we do it. We will be talking a little bit more about HIPAA, and when you talk to an insurer insurance provider about malpractice, you can also talk to them about them about HIPAA. That’s usually part of the deal there. Hopefully that helps, and yes, it is generally wise to consult with an attorney in your state when you’re setting up your practice because the regulations can really vary state by state. Anything that I tell you that applies to us in California may not necessarily apply to you, and, of course, it also varies based on your license type.