CMS offers accelerated payments to providers affected by the Change Healthcare ransomware attack. Many of our clients have experienced cash flow disruptions due to the ransomware attack on Change Healthcare, a subsidiary of UnitedHealth Group. Change Healthcare is the largest health care billing clearinghouse in the country, processing 14 billion transactions annually. The system suffered a cyberattack on February 21, 2024, and has still not recovered operations. Because of the significant financial losses being experienced by health care providers, the Centers for Medicare and Medicaid Services (CMS) has set up an accelerated payment program for Part A and Part B providers and suppliers, called the Change Healthcare/Optum Payment Disruption (CHOPD) program. Advance payments may be up to thirty days of claims payments to eligible hospitals, physicians and other providers and suppliers. (Providers that receive Periodic Interim Payments [PIP] are not eligible.) The program will be administered by the Medicare Administrative Contractors (MACs). To be eligible for CHOPD payments, the provider/supplier must submit a certification to the MAC stating, among other things, that: The provider/supplier is not able to submit claims to receive Medicare payments due to a business relationship involving Change Healthcare The provider/supplier has been unable to obtain sufficient funding from other sources to cover the disruption in claims processing The provider/supplier is not insolvent and does not intend to cease operations. The maximum allowable amount will be 30 days of Medicare claims payments based on total claims paid to the provider/supplier between August 1, 2023, and October 31, 2023, divided by three. Payments under the CHOPD program are not loans but rather advances of Medicare payments. They will be recovered through recoupment as claims are processed and if any balance remains unpaid after 90 days, interest will accrue. Health care providers experiencing disruption in claims submission should submit the form required by the MAC covering their area. A list of MACS is available at https://www.cms.gov/mac-info . For further information, contact us .

A Primer to Navigate Your Employment Contract/Personal Service Agreement

The Corporate Transparency Act (“CTA”) became law effective January 1, 2021 when Congress overrode President Trump’s veto. The purpose of the CTA is to eliminate money laundering and other illegal criminal and terrorist activities that are often conducted through anonymous shell companies. Under the CTA, business entities will be required to report certain information to the Financial Crimes Enforcement Network (“FinCEN”) of the Department of Treasury. Said information will not be publicly available but may be distributed in a limited number of instances. Who is subject to the CTA and who is exempt? FinCEN has adopted the Beneficial Ownership Information Reporting Rule (the “Reporting Rule”) by virtue of the authority granted to it under the CTA. According to the Reporting Rule, a “reporting company” is subject to the requirement of the CTA. Generally, a reporting company falls into two categories: A domestic reporting company - an entity such as a corporation, limited liability company, partnership, or other such entity that is created by filing a formation document with a state’s Secretary of State or equivalent agency; or A foreign reporting company – an entity such as a corporation, limited liability company, partnership, or other such entity that is created by filing a formation document in a foreign country but which is qualified or registered to do business in a state by filing appropriate paperwork with a state’s Secretary of State or equivalent agency. While a company may be considered a domestic reporting company or foreign reporting company at first glance, a company may be exempted from the CTA’s requirements if the company falls under any of the twenty-three (23) exemptions set forth in the Reporting Rule. Example of exemptions include, but are not limited to, certain tax-exempt entities, inactive entities, certain large operating companies, insurance companies, banks, and credit unions. In almost all cases, a for-profit entity, such as a medical practice or a practice providing other professionally licensed services, will be considered a reporting company that is subject to the CTA reporting requirements. Not-for-profit entities will be considered exempt from the CTA reporting requirements if they meet any of the following requirements: The entity is an organization that is described in Section 501(c) of the Internal Revenue Code of 1986 (the “Code”), determined without regard to Section 508(a) of the Code, and exempt from tax under Section 501(a) of the Code; The entity is an organization that is described in Section 501(c) of the Code, and was exempt from tax under Section 501(a) of the Code, but lost its tax-exempt status less than 180 days ago; The entity is a political organization, as defined in Section 527(e)(1) of the Code, that is exempt from tax under section 527(a) of the Code; or The entity is a trust described in paragraph (1) or (2) of Section 4947(a) of the Code. What is required under the CTA? Reporting companies are required to file beneficial ownership information (“BOI”) reports with FinCEN. These BOI reports shall include the following: Information about the reporting company itself; Beneficial owner information; and Company applicant information. What are beneficial owners and company applicants? A beneficial owner is any individual that: Owns or controls at least twenty-five percent (25%) of the ownership interests of a reporting company, whether directly or indirectly; or Exercises substantial control over a reporting company. Even if an individual meets the above requirements, there are five (5) exemptions including, but not limited to, if the individual is a minor or an agent acting on behalf of a beneficial owner. A reporting company will have at least one (1) beneficial owner, may have multiple beneficial owners and every beneficial owner must be included in the BOI report. A company applicant must be included in the BOI reports filed by domestic and foreign reporting companies that are created on or after January 1, 2024. Company applicants fall into two categories: Direct filers – the individual who physically or electronically filed a reporting company’s formation or registration document with the Secretary of State or similar office; and An individual who directs or controls the filing action – the individual who was primarily responsible for directing or controlling the filing of the reporting company’s formation or registration document with the Secretary of State or similar office. What specific information is required for the filing? For the reporting company itself, The full legal name; All trade names or assumed (DBA) names; The current principal place of business address in the United States, or if the principal place of business address is not in the United States, the primary location in the United States where the company conducts its business; State, tribal, or foreign jurisdiction of formation; For a foreign reporting company, the state or tribal jurisdiction of first registration; and the Employer Identification Number (EIN) or Taxpayer Identification Number (TIN) issued by the IRS and, if a foreign reporting company does not have a TIN, then a tax identification number issue by a foreign jurisdiction and the name of the foreign jurisdiction. For each beneficial owner or company applicant, The beneficial owner or company applicant’s full legal name; The beneficial owner or company applicant’s date of birth; The beneficial owner or company applicant’s current residential address; provided, however, that if the company applicant forms or registers a reporting company in the course of their business, then the company applicant’s business address; Unique identifying number from an acceptable non-expired document such as: • A U.S. passport • A State issued driver's license • An identification document issued by a state, local government or tribe • If a beneficial owner has none of the above, a foreign passport; and 5. An image of the document from which the unique identifying number came from. Notwithstanding the above, a beneficial owner or company applicant may provide their respective information directly to FinCEN and obtain a “FinCEN Identifier,” which will be a unique identify number. Reporting companies can these use these FinCEN Identifiers in lieu of providing the above-required information for beneficial owners and company applicants. This is beneficial for a few reasons: (1) filing BOI reports will be faster and more streamlined; (2) it is easier for beneficial owners and company applicants of multiple reporting companies; and (3) it prevents reporting companies access to a company applicant’s personal information. When must BOI reports be filed? Domestic and foreign reporting companies created before January 1, 2024 must file a BOI report by January 1, 2025. Domestic and foreign reporting companies created on or after January 1, 2024 must file a BOI report within thirty (30) days of receiving actual or public notice that the creation or registration of the reporting company is effective. Penalties for not filing The willful failure to file a BOI report or to report false, fraudulent or incomplete beneficial ownership information may result in criminal and civil penalties such as: Up to $500 for each day violation continues; Imprisonment for up to two (2) years; and A fine of up to $10,000 If a reporting company discovers that it reported inaccurate or incomplete information, there is a ninety (90) day safe harbor from the date of the original deadline to provide corrected information. Conclusion This is a broad overview of the CTA and Reporting Rule requirements. More detailed descriptions, exemptions, and requirements are set forth in the CTA and the Reporting Rule. For further information contact us .

We have received questions from many of our clients about how to properly respond when patients and visitors bring guns into their offices. Here are some facts you need to know in grappling with this complex issue. (This discussion deals with Illinois law; firearm regulations vary greatly from state to state.) The Firearm Concealed Carry Act was passed in 2013, and allows a licensee to carry a loaded or unloaded firearm on his/her person or in a vehicle. However, the Act specifies several prohibited areas where it is illegal for a licensee to knowingly carry a firearm. The list includes medical clinics, hospitals and laboratories. Signage must be clearly and conspicuously posted at the entrance of a facility where concealed carry is prohibited. The required sign must be at least 4 x 6 inches. The Illinois State Police has developed standardized signage, available on their website at https://www.ispfsb.com/Public/Signage.aspx. The Act specifies that when a licensee is prohibited from bringing a firearm into a prohibited area, the person is allowed to store it in their vehicle in a parking facility, provided that it is stored inside a case, not in plain view, and the vehicle is locked. This parking lot exception does not apply to federal property. When law enforcement officials are on duty, they may carry a weapon as part of their official duties, not as a personal right under the Concealed Carry Act. An officer who is off duty coming to a facility as a patient or visitor would be subject to the same restrictions as any other person. Clinics should make sure that the required sign is prominently posted at the entrance. If a patient or visitor brings a weapon onto the premises, staff can point out the sign. Of course, front line staff should not be put in danger themselves and may need the assistance of security or law enforcement if the patient or visitor does not comply. If a patient repeatedly violates the law by bringing a weapon onto the premises, it would be appropriate to terminate the patient relationship. For further information contact us .

The IRS recently announced that it has suspended processing applications for the Employee Retention Credit (ERC) until at least the end of 2023. The agency claims that it has been inundated by a flood of improper ERC claims, which are being aggressively promoted by companies offering to file claims for a percentage fee. The IRS states that for claims that were filed before September 14, 2023, the agency will continue processing them, but due to increased fraud concerns, processing time will increase from 90 to 180 days. Processing could take much longer if the claim is audited. Auditors have been trained to identify claims posing the greatest risk, and as of the end of July, 252 investigations have been referred to the IRS Criminal Investigation division. The ERC is a refundable tax credit that is available to certain businesses that continued paying employees during the COVID-19 pandemic. To be eligible, the business must have fully or partially suspended operations due to a government order limiting commerce, travel or group meetings due to the pandemic during 2020 or the first three quarters of 2021; experienced a significant decline in gross receipts during that period; or qualified as a recovery startup business for the third or fourth quarters of 2021. Any organization that improperly claimed the ERC must pay it back, possibly with penalties and interest. The IRS stated that it is seeing repeated instances of entities citing supply chain issues as a basis for an ERC claim, which is not a basis for eligibility. For businesses that have filed a claim for the ERC, the IRS urges them to review the program guidelines with a tax professional to determine whether they are eligible. If the criteria were not met, the claim can be withdrawn. The IRS plans to finalize a settlement program in fall 2023 to allow businesses to repay inappropriate ERC claims.

We frequently provide legal counsel to physicians and other healthcare practitioners when their employment has been terminated or is about to be terminated. Unless the practitioner has an employment contract with the employer which clearly sets forth the circumstances under which employment may be terminated, terminations can generally be for any reason that is not illegal (e.g. illegal discrimination based upon membership in a protected class such as race, sex, religion, etc. or because the practitioner was a “whistleblower”). A termination from employment does not have to be because the practitioner has done something medically wrong. In fact, it is rarely about that. Most of the time, terminations occur because a practitioner is a “bad fit” for the employer, a determination which is made, like it or not, unilaterally by the employer. These terminations are characterized as “termination without cause,” legally meaning “for any reason or no reason,” but they occur because there is just a “bad fit.” As an example, an employer may not like how a practitioner speaks to patients or other practitioners (or both). If that is not corrected in the eyes of the employer, the practitioner may be terminated for cause (doing something wrong), but employers often use the “without cause” termination provision instead to avoid legal hassles and to prevent ruining the practitioner’s career. If you are terminated, regardless of the reason, it is very important to seek legal consultation. You will need to take the necessary legal steps to protect your career and reputation. You will likely need to consider a settlement agreement, release of liability and issues including pay, benefits pay out, malpractice tail coverage, noncompete provisions, reference letters, medical staff privileges and more. Walking away from a job without an agreed upon and executed separation agreement is NOT recommended because you will not have a documented understanding of what to expect and you will have nothing to enforce. Legal skills and experience with this type of matter are necessary to navigate this situation just as having an acute illness needs to be treated by a trained healthcare practitioner. Being terminated from a job is tough emotionally and dealing with legal issues on top of that is stressful. Following are some suggestions to help you should you find yourself terminated: Do not ruminate about how you have been unfairly treated. Instead, focus on moving forward and securing your next job position. Do not think that because your last job was a poor fit that they will all be that way. Instead, look for a work culture that is a better fit for your skills and personality. Do not be tone deaf. If you have been told that you "don’t get along well with others" but you do not see your own role in this, consider executive coaching. Tuning In To Your Own Behavior: Are You Tone-Deaf? (mbhealthlaw.com) Do not expect the legal necessities to be completed overnight. Instead, let your attorney guide you and aim for a Separation Agreement that is in your best interest but keep moving on. Do not think that being terminated makes you a loser and defines you or makes you unemployable. Instead, think that in the not-too-distant future (usually about one year) you will look back on what you will later call a "character building experience." You might even say, “Why didn’t I leave sooner?” Do not be a George Costanza and burn your bridges no matter how tempting. Instead, stay professional and courteous throughout the separation process and after. You do not know when you will need to reconnect. Do not sit around reliving the angst. Instead, do something constructive—what have you been putting off that will make you feel better? Give Me a Minute to Think: The Value of a Month Off (mbhealthlaw.com) Do not be unrealistic about expectations and expect an economic windfall from your employer. Instead, recognize that often the leverage is on the side of the employer and aim to negotiate and resolve the issues that are most important to you. Last but not least, always have your employment agreement reviewed by an attorney BEFORE YOU SIGN. I Did Not Have My Contract Reviewed By An Attorney Before I Signed It. Now I Need To Pull A Rabbit Out Of My Hat! (mbhealthlaw.com) For further information contact us .

Malecki Brooks Law Group, LLC is proud to continue our communication highlighting the backgrounds and accomplishments of our clients. Name: Don Kalish, CPA, President of the board of the Path to Recovery Foundation (PATH). A 50l(c)(3) organization, PATH is committed to supporting, educating, and promoting recovery for individuals and families struggling with substance use disorders. Known for: Finance and accounting expertise. Being the father of a 29-year-old son who died of an accidental opioid-fentanyl overdose. Business Background: 48 years of financial and accounting expertise in executive positions. He recently retired as the Assistant Vice President of Finance and Controller at Rush Copley Medical Center and is currently acting in a finance and healthcare consulting role with Rush Copley and Rush University. Previous Volunteer Work: With four sons, Don was actively involved in coaching and running youth sports organizations for more than 20 years and held positions on the boards of the Naperville Little League Baseball and Naperville Youth Basketball Association. He was awarded the Distinguished Service Award for Youth & Family by the Naperville Jaycees in 2001. His life changed on May 16, 2016, when his youngest son, Randy, accidentally overdosed. New Focus: Don and his eldest son, Cliff, raised more than $23,000 in donations at the 2017 Naperville Half Marathon and 5K Run for a different recovery organization. Don joined the PATH Board in 2018. Current Role: As PATH Board President, Don leads the foundation in governance decisions and serves as administrator. “We have a great team of clinicians, coaches, and volunteers who work directly with the clients. That’s not my skill set. I provide the support they need to keep doing the great things that they do for clients. I help with structure, organization, finance, and fundraising. Running a not-for-profit is very different than operating a business—completely different rules. I go to Mindy and Malecki Brooks Law Group, LLC, for advice to keep us out of trouble.” His passion: Helping other families to not experience what his family went through with the death of a young adult. Don wants to help prevent overdosing and keep kids free from substance abuse. The PATH helps, but he knows it’s an uphill battle. Opioid relapse is at 70 percent. Colleagues: “Don is a compassionate leader who follows up on commitments and assists those who are in need of guidance. I have always admired Don for his passion for life and dry sense of humor.” Eddie Bedford Supervisor and Director of Road Services, Naperville “Don's role as board president of PATH is fundamentally what elevated PATH from being a small group of passionate individuals supporting a cause to being a structured organization. Don brought his financial and managerial expertise and provided the structure necessary to successfully run a foundation. Aside from Don's professional contribution, his passion and compassion for helping those struggling with substance use disorder is what is most admirable.” Leslie Kawar, Vice President, PATH Board Roar: “Families are ashamed of addiction,” Don said. “At PATH, they can talk with people who understand. You don’t have to go it alone. We have the resources to help. I can’t be prouder of our team and the important work they’re doing to tackle substance use disorders head on.” August 31 st is International Overdose Awareness Day (IOAD). It is a day intended to remember individuals lost to overdose, acknowledge the grief of the family and friends left behind, and renew commitment to end overdose and related harms.

The Illinois Department of Financial and Professional Regulation (IDFPR) recently announced that due to “technological system challenges,” it is extending the expiration date for physician licenses from July 31, 2023, to August 31, 2023. This extension does not apply to all physicians. Physicians who are licensed through the Interstate Medical Licensure Compact are not affected by the technology issues, and so the July 31, 2023, deadline remains in place for those physicians. Also, we've been informed that IDFPR is not extending the deadline to complete continuing medical education requirements; those should have been met by July 31, 2023.

You may have seen or heard the term “PLLC” used in connection with your profession and wondered what it is and whether you should have one. This article provides basic information about PLLCs and whether one may be right for you. “PLLC” stands for “professional limited liability company” and provides the same liability protections as a limited liability company, or LLC. However, under the Illinois Professional Limited Liability Company Act, a PLLC is intended to be used in lieu of an LLC when the owners (members) are using the company to provide professional services that are required to be licensed under Illinois law, such as medical services. Accordingly, there are restrictions as to who can own a PLLC in general and who can own a PLLC together. Only people who are licensed to provide a professional service may own a PLLC. For example, an unlicensed person cannot own a PLLC that operates as a medical practice, even if they hire licensed physicians as employees. Additionally, an unlicensed person cannot own a PLLC with a licensed person if that PLLC is providing professional services. So, for example, a husband MD and a wife who runs the medical practice cannot own the PLLC together. Only the husband MD may own the PLLC. Going a step further, Illinois law also restricts which professional licensed persons may own a PLLC together. A PLLC can be owned by multiple people if those people are all licensed under the same Illinois law or if they are all licensed under related professions. These related professions fall under the following categories: Engineering/architecture Physician/podiatrist/dentist/optometrist Psychologist/social worker/marriage-family therapy/sex offender evaluations Acupuncture/massage/naprapathy/OT/PT/ST To further illustrate this, a physician can own a PLLC with a podiatrist but a physician cannot own a PLLC with a registered nurse. After determining that a PLLC is an appropriate legal entity, the next step is to file Articles of Organization with the Illinois Secretary of State. These Articles vary slightly from the traditional LLC Articles in that they require some specific information. First, instead of the company name ending in “LLC”, the company name must end in “PLLC” or an approved designation thereof. Second, the Articles of Organization must contain a specific purpose clause. This clause provides details about the type of professional services to be rendered and under what law those professional services are governed. Third, the Articles of Organization require the PLLC to list a principal place of business address. In LLCs, people often use their home address or a virtual office address as the principal place of business address. However, in a PLLC, that is not acceptable. Instead, in Illinois, the Articles of Organization must list the address where the professional services are actually rendered. In Illinois, once the Articles of Organization have been filed with the Illinois Secretary of State, the PLLC must also be registered with the Illinois Department of Financial and Professional Regulation (“IDFPR”). It is not enough to have an individual license; the PLLC itself must also be licensed. IDFPR requires a copy of the filed Articles of Organization to verify the name matches, the specific purpose clause is included, and the principal place of business addresses matches the registration. In addition, IDFPR requires every owner of the PLLC to provide their respective individual license number in order to tie the individual to the PLLC. Now, what if you currently have an LLC but it really should be a PLLC? The Articles of Organization must be amended to include the new “PLLC” ending and to include the specific purpose clause if one has not yet been adopted. Once the amendment is filed, the name change must be updated with IDFPR, the IRS, all other state and federal government agencies for which the LLC/PLLC deals with, insurance companies, credentialing companies, etc. Please reach out to our office if you have any questions, wish to form a PLLC, or wish to convert your existing LLC to a PLLC. For further information contact us .