Essex Law Firm

07/29/2026

The Georgia Composite Medical Board is now running unannounced inspections of med spas and IV clinics. This is part of a new inspection division created by the Board for targeted enforcement.

The new inspection unit is finding rampant violations. Unlicensed workers providing medical services, unlawful compounding, staff practicing outside their scope, adverse events going untracked, clinics with no physician oversight, treatments administered with no individualized exam, and chiropractors offering weight loss and testosterone injections they have no authority to order in Georgia.

The Board is specifically citing clinics that lack true physician oversight and fail to conduct required medical exams prior to administering treatments.

A Few Key Takeaways:

Enforcement has changed. The Board has a huge backlog with >800 cases and is understaffed. It is seeking legislative changes. The Board told a House study committee it will seek legislation imposing new limits and registration requirements on med spas and IV facilities. Registration means a filing, a named medical director, a license you can lose and increased oversight.
Increased liability to Medical Directors. If your name is on the door as the physician, you are responsible. If you delegate, you are responsible.
Patients are now reporters. They are being tasked with asking who the supervising physician is and reporting the clinics to the Board.

The Board’s recent actions do not represent new law or policy. Rather, they correspond with the the Board’s May IV hydration position statement: (1) an APRN (or an APRN-owned entity) cannot compensate the delegating physician; (2) third-party matching companies don’t circumvent this prohibition; (3) the Board is looking at operational reality over the paperwork; (4) delegating physicians must document annual onsite observation and quarterly chart reviews in a comparable specialty; and (5) standing orders and menu-based drips are not substitutes for patient-specific H&P and individualized order.

If this applies to you, whether as a medspa owner or medical director to one, then pay attention. The "paper director" is gone. Enforcement is real. The Board is no longer turning a blind eye.

A new effort by Georgia's medical board came after an AJC investigation exposed the risks in the state’s wellness and alternative medicine industry.

07/28/2026

Every gray is a representation of my life and experiences! Between running a law firm and being a mom, I know what it means to be overburdened by administrative weight. I also know how to find it.

07/13/2026

A wonderful evening attending the Medical Association of Atlanta’s Summer Gala!

06/25/2026

06/12/2026

💡 Your vendor contract or Management Services Agreement (MSA) may be exposing your medical license to legal and regulatory scrutiny.

Let that sink in.

Many doctors are becoming entrepreneurs and starting their own practices, understandably. Healthcare has become more regulated, more burdensome, and more punitive. Doctors are continually facing so many obstacles and taking all the risks.

At the same time, private equity and opportunistic companies are increasingly entering healthcare and selling LIES. Vendors in particular are taking advantage under the guise that they can help doctors ease their administrative burdens and increase efficiency. On it's face, the arrangement seems beneficial. But what about underneath the surface - the operational reality.

We had a client who's billing vendor claimed they were only a "billing company". In reality, they were a DME supplier/distributer, biller, and operated like a shadow pharmacy. The vendor wanted 40% of the monthly collections as a management service fee and gave 60% to the doctor. Yet the doctor had no EOBs and no way to verify the monthly financials provided only in a spreadsheet. On top of that, the vendor claimed in their marketing materials that they operated under the DME Ancillary Exemption under Stark Law. We can't make this stuff up.

Let that sink in.
❌ 40% of the monthly collections for a "billing company" as the management fee.
❌No EOBs yet the company was using the doctor's NPI.
❌The vendor controlled supply, distribution, billing, and took the financial risks.
❌The doctor had no verification or oversight over the vendor.
❌The vendor claimed they operated under a legal exemption that did not apply to them.

Unfortunately, there was more that could expose this doctor.

Doctors must look beyond the language in the Management Services Agreement/MSA and marketing materials and look at the operational reality.

Is the arrangement disguised as a kickback (directly or indirectly)?
Is the management service fee a FMV?
Is the compensation fee-splitting?
Does the vendor understand the regulatory environment they operate in?
Is the information in the marketing materials accurate?
Who has operational control or control over the revenue?

The mere fact that other colleagues may be using a particular vendor will not insulate you from legal exposure nor does it make the arrangement legitimate.

So to my doctors...DISCERNMENT and DUE DILIGENCE are a 𝙨𝙝𝙞𝙚𝙡𝙙. Wear it daily before you take action. And yes, healthcare attorneys (not med mal) are your 𝙨𝙬𝙤𝙧𝙙.

05/14/2026

I need to yell this from the rooftop - please stop thinking the Medical Board is your friend. Being nice, professional, or polite can cause you to lose your license!

Most doctors think the Medical Board is there to help them. They aren't. They’re there to protect the public...sometimes from you.

I know you spent several years treating patients, but majority of you spent zero minutes learning how to survive a Medical Board investigation. Your first instinct may be to call the investigator to "clear things up" because you have "nothing to hide" or you "did nothing wrong".

This is the absolute WRONG move that can be costly. Your concerns can now turn into a public consent order or worse - suspension or revocation.

When you receive a notice, you are now the subject of an investigation. You are now the "Defendant" and need to obtain a healthcare lawyer right away. A Medical Board investigation is a legal process not a minor administrative inconvenience.

Here are some common mistakes I often see for Georgia licensed physicians:

1. Thinking you can handle it on your own. See above - you are a Defendant and need legal counsel from the start.
2. Thinking the investigator is your colleague. They are not nor are they your lawyer. They are building a file against you.
3. Failing to respond or a delayed response. The Board will deem this as an admission or sign of unprofessionalism to use against you.
4. Blindly sending records. Unorganized records often lead to more questions. Additionally, sending the entire record vs. targeted records could expand the scope of their investigation against you.
5. Treating "optional" like it doesn't matter. When the Board requests an "optional" interview, they already have questions that you need to answer. If you do not answer them, they will move forward and assume the worst. They have nothing that tells them differently.
6. Sitting for an interview without counsel. While an interview can be advantageous to provide clarity, in GA, the interviews are recorded. I often tell my clients, to think of Law & Order - statements can and will be used against you.
7. Being cheap with your legal defense. You're trying to nickel and dime spending money on a specialized healthcare attorney. You wouldn't hire a discount surgeon to perform surgery on your own heart. So why would you seek a discount lawyer for your ability to practice - your livelihood and reputation? If you think a healthcare lawyer is expensive, wait until you see the bill for losing your right to practice.

Please stop DIY-ing the defense of your medical license. You're an amateur and the odds are not in your favor.
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I am a Georgia healthcare lawyer that represents GA licensed physicians before the Georgia Composite Medical Board. This post is for educational purposes only and does not constitute legal advice.

04/24/2026

If you are a licensed physician in GA, then listen up! In 2026, you may receive a letter from the Georgia Composite Medical Board!

04/22/2026

Cigna’s auto-downcoding policy just took a major hit in Maryland, and if you’re a physician, especially in Georgia, you need to be paying attention.

Last month, the Maryland Insurance Administration (MIA) slapped Cigna with an $80k fine and a Consent Order to stop their R49 "Auto-Downcoding" policy. This policy was designed to let a computer override your clinical judgment on high-level E/M codes (99214/99215) and pay you less without ever looking at a chart.

Maryland’s message was clear. Cigna cannot unilaterally and arbitrarily lower reimbursement without a formal dispute or a record request.

Why does this matter for Georgia practices? Maryland just set the precedent. Now it's time to look at your EOBs. If they are doing it in Georgia, Georgia has laws to push back. Cigna doesn't get to bypass Georgia law.

Check out my video for a full breakdown of the consent order and how to fight back. (Link in comments)

Don't let an insurance company dictate or override your medical necessity.