COVID-19 Telemedicine/Telehealth Services Permitted in New Jersey for Out-of-State Practitioners

March 20, 2020
Brittany A. Bonetti, Esq.  | Jill T. Ojserkis, Esq., LL.M.

New Jersey Governor Phil Murphy signed emergency legislation paving the way for New Attorney General Gurbir S. Grewal and the Division of Consumer Affair to waive numerous regulatory requirements for out-of-state practitioners to become licensed in New Jersey and offer services to New Jersey residents, including telemedicine and telehealth services. The waivers will apply during the COVID-19 public health emergency. Additionally, the Governor signed legislation under which out-of-state practitioners may provide certain telehealth and telemedicine services during the State’s COVID-19 public health emergency without obtaining a New Jersey license.

Accelerated Temporary Licensure

Under the accelerated temporary licensure process, individuals who hold current health care licenses and certifications in good standing in other jurisdictions, and have been practicing within the last five years, will be able to quickly secure New Jersey licenses by completing a one-page form, which should be sent to NJTempLicense@dca.njoag.gov. Criminal history background checks, licensing fees, and submission of proof of a sufficient amount of medical malpractice insurance (where applicable) are waived. The Division of Consumer Affairs intends to grant applications within hours of receiving the form and eligible practitioners will be deemed licensed upon submission of a completed form. The temporary licenses will be valid for 180 days, with an additional 180-day extension available upon written request. Issuance of the temporary license is not limited to COVID-19 related services. Those practicing under a temporary license must still comply with all applicable New Jersey statutes and regulations, including New Jersey telemedicine and telehealth laws and regulations.

Telemedicine/Telehealth

Without obtaining a New Jersey license, out-of-state practitioners may  provide  telemedicine and telehealth services  related  to screening for, diagnosing, or treating COVID-19. With the adoption of the emergency telemedicine/telehealth legislation, a health care practitioner who is not licensed or certified to provide health care  services  within New Jersey may provide and bill for telemedicine and telehealth services if: (1) the health care practitioner is validly licensed or  certified  to provide health care services  in  another state or territory of the or in the District of Columbia, and is in good standing in the jurisdiction that issued the license or certification; (2) the health care services provided by the health care practitioner  using  telemedicine and telehealth are within the practitioner’s authorized scope of practice in the jurisdiction that issued the license or certification; (3) unless the health care practitioner has a preexisting provider-patient relationship with the patient that is unrelated to COVID-19, the health care services provided are limited  to services related to screening for, diagnosing, or treating COVID-19; and (4) in the event that the health care practitioner determines during a telemedicine or telehealth encounter with a patient located in New Jersey that the encounter will not involve services related to screening for, diagnosing, or  treating COVID-19, and the practitioner does not have a  preexisting provider-patient relationship with the patient that is unrelated to COVID-19, the practitioner shall advise the patient that the practitioner is not authorized to provide services to the patient, recommend that the patient initiate a new telemedicine or telehealth encounter with  a health care practitioner licensed or certified to practice in New Jersey, and terminate the telemedicine or telehealth encounter. The legislation suggests that an out-of-state practitioner may provide telemedicine and telehealth services  related  to COVID-19 even if he or she has not established a traditional provider-patient relationship. The legislation does not enumerate a waiver of the provider-patient relationship for in-state practitioners rendering telemedicine or telehealth services.

The amount charged for telemedicine and telehealth services must be reasonable and consistent with the ordinary fees typically charged for that service. The practitioner cannot bill if he or she terminates a telemedicine or telehealth encounter because the encounter does not involve the provision of services related to screening, diagnosing, or treating COVID-19. Health care practitioners using telemedicine or telehealth modalities are subject to the same standard of care or practice standards as are applicable to in-person settings.

The legislation requires the Commissioner of Health and the Director of the Division of Consumer Affairs in the Department of Law and Public Safety to waive any requirement of State law or regulation as may be necessary to facilitate the provision of health care services using telemedicine and telehealth during the COVID-19 public health emergency, including any privacy requirements that would  limit the use of electronic or technological means that are not typically used in the provision of telemedicine and telehealth. The legislation does not  authorize the waiver of any State laws or regulations restricting the collection, exchange,  transmission, or use of confidential patient health information.

COVID-19 Alert for Joint Commission Accredited Hospitals

By Jill T. Ojserkis, Esq., LL.M. and Brittany A. Bonetti, Esq.

Due to President Trump’s declaration of a national emergency regarding COVID-19, on March 16, 2020, The Joint Commission announced its suspension of all regular surveying. The Joint Commission advised that there may be a small number of surveys that will need to continue, such as high-risk situations. The length of the survey moratorium period is unknown. During this time The Joint Commission advised that accreditation will be extended without disruption of status. The Centers for Medicare and Medicaid Services has confirmed that Medicare payment status also will not be affected.

Hospitals should be aware of Joint Commission guidance, which indicates that if an established provider’s privileges are scheduled to expire amid a national emergency declaration, The Joint Commission will allow an automatic extension of medical staff reappointment beyond the 2-year period under the following conditions:

  • A national emergency has officially been declared
  • The organization has activated its emergency management plan
  • Extending the duration of providers’ privileges during an emergency is NOT prohibited by State Law.

According to Joint Commission guidance, the duration of the extension cannot last more than 60 days following termination of the state of emergency declaration. Organizations utilizing this privileging extension option are responsible for determining how the extension will be documented. This privileging extension guidance is not unique to the COVID-19 national emergency declaration and instead is applicable to national emergencies in general.

Now is the time for hospitals to review their current emergency operations plan. Although not new, when a hospital activates its emergency operations plan, The Joint Commission permits hospitals to grant disaster privileges to volunteer licensed independent practitioners (LIP) and volunteer practitioners who are not licensed independent practitioners, but who are required by law and regulation to hold a license, certification, or registration (non-LIP).  A disaster is deemed to exist when there is an emergency that, due to its complexity, scope or duration, threatens the organization’s capabilities and requires outside assistance to sustain patient care, safety, or security functions. In order to exercise this option medical staff bylaws must identify those individuals responsible for granting disaster privileges to volunteer LIPs. The hospital must also identify, in writing, those who are responsible for assigning disaster responsibilities to non-LIPs. Even in the midst of a disaster, the hospital must verify licensure and have a written description of its methodology for overseeing the performance of volunteer LIPs and non-LIPs. It is important to keep in mind that this flexible privileging option is only available to volunteer LIPs and non-LIPs and that hospitals must determine how to distinguish volunteers from hospital staff.

WARNING ICON ADDED TO MEDICARE/MEDICAID “NURSING HOME COMPARE” WEBSITE

by Bard L. Shober, Esq.

Searching for an appropriate nursing home for your loved one just got a little easier.  The Centers for Medicare & Medicaid Services (CMS) announced last month that they will display a warning icon for nursing homes with abuse citations on their consumer “Nursing Home Compare” web page.

Nursing homes that have received a citation for abuse will be identified with an icon of an open palm surrounded by a red circle.  Officials will update the icons monthly along with the facilities overall inspection results.

This marks an improvement over the old system that required consumers using the web page to await quarterly updates.  In addition, consumers will know instantly if the nursing home has had a recent citation for abuse.  Also available at the “Nursing Home Compare” web page will be the results of the CMS five star system that rates each nursing home on a variety of categories including staffing and quality measures.

Unfortunately, the new icon will only be present until the next inspection if the nursing home remedies the issues that caused the abuse citation; meaning the new system does not provided an historical account of abuse findings.  To date, nearly 5% of the nation’s more than 15,000 nursing homes have received the icon.

An informed consumer makes the best decisions.  This improvement at the CMS website helps us all be better consumers for our families and friends that need long-term nursing care.

 

New Jersey Medical Aid in Dying Act Update

A law that is as controversial as New Jersey’s Medical Aid in Dying for the Terminally Ill Act (“Act”) is bound to have its challengers.

The first challenge to the Act came in the form of a temporary restraining order (“TRO”) which was issued by a Superior Court Judge in Mercer County, New Jersey on August 14, 2019.  The TRO prevents physicians from ordering life-ending medication prescriptions to patients until at least Oct. 23, 2019. The Judge granted a TRO because state agencies and regulatory boards allegedly failed to provide guidance to the State’s physicians on how best to implement the provisions of the Act.

Supporters of the Act contend that the law provides sufficient clarity to allow physicians to act without regulations from New Jersey agencies. Physicians who do not want to participate in the Act may transfer care of the patient to another physician per the patient’s request. The suit alleges that the law violates the state constitution on religious, due process, and equal protection grounds.

Oregon, the pioneer of death with dignity laws, faced similar challenges when it became the first state to allow residents to receive life-ending medication from an attending physician. Oregon and several other jurisdictions have successfully defended their laws allowing residents to end their lives in a dignified manner. In Gonzales v. Oregon, 546 U.S. 243 (2006), the United States Supreme Court upheld Oregon’s Death with Dignity law in a six to three decision.

Michael Salad is a partner in Cooper Levenson’s Business & Tax and Cyber Risk Management practice groups. He concentrates his practice on estate planning, business transactions, mergers and acquisitions, tax matters and cyber risk management. Michael holds an LL.M. in Estate Planning and Elder Law. Michael is licensed to practice law in New Jersey, Florida, Pennsylvania, New York and the District of Columbia.  Michael may be reached at (609) 572-7616 or via e-mail at msalad@cooperlevenson.com.

Shaiful Kashem is a summer associate at Cooper Levenson. He is a candidate for a J.D. at Rutgers School of Law in Camden. Shaiful may be reached at (609) 344.3161 or via e-mail at skashem@cooperlevenson.com.

 

The New Jersey Medical Aid in Dying for the Terminally Ill Act

We have witnessed a growing movement to allow terminally ill patients to end their own lives on their terms throughout the United States. New Jersey joined that movement when the Medical Aid in Dying for the Terminally Ill Act (“Act”) was signed into law by Governor Phil Murphy on April 12, 2019. The Act becomes effective on August 1, 2019, making New Jersey the eighth jurisdiction in the country to allow terminally ill patients to end their own lives with life-ending medication prescribed by their attending physicians.

The Act (codified at N.J.S.A. 26:16-1, et seq.) outlines how a terminally ill patient may request life-ending medication. A patient may request life-ending medication if the patient (a) is an adult New Jersey resident (as defined by N.J.S.A. § 26:16-11), (b) is capable and has been determined to be terminally ill and (c) has voluntarily requested to receive the medication. N.J.S.A. 26:16-4.

The first prong arises out of concern that residents of other states will travel to New Jersey to receive life-ending medication.  New Jersey residency may be satisfied if a terminally ill patient provides a copy of one of the following to their attending physician: (a) a driver’s license or non-driver identification card issued by the New Jersey Motor Vehicle Commission; (b) proof that the person is registered to vote in New Jersey; (c) a New Jersey resident gross income tax return filed for the most recent tax year; or (d) any other government record that the attending physician reasonably believes demonstrates that the individual’s current residency is the state of New Jersey. These requirements are intended to prevent non-New Jersey residents from traveling to New Jersey to request life-ending medication. Other jurisdictions that enacted similar death with dignity laws have incorporated a residency requirement in order for a terminally ill patient to receive life-ending medication in that jurisdiction.

To establish residency in New Jersey, one must establish a physical address in the state and obtain a driver’s license or non-driver identification card that reflects the New Jersey address. The requirements for both forms of identification require an applicant to provide proof of address, which include copies of utility bills, bank account statements, current mortgage or rental agreements or property tax bills from the past year. To register to vote, a resident may fill out a voter registration application form established by the county in which the voter resides but the voter must produce a New Jersey driver’s license, non-driver identification card or swear that the voter does not possess government-issued identification.

The second prong is primarily the patient’s attending physician’s responsibility. N.J.S.A. 26:16-4 requires a patient to be “capable” and “terminally ill.”  “Capable” means having the capacity to make health care decisions and to communicate those decisions to a health care provider, including communication through persons familiar with the patient’s manner of communicating if those persons are available.  N.J.S.A. 26:16-3.“Terminally ill” means that the patient is in the terminal stage of an irreversibly fatal illness, disease, or condition with a prognosis, based upon reasonable medical certainty, of a life expectancy of six months or less. N.J.S.A. 26:16-3. To be determined a “qualified terminally ill patient,” a consulting physician must also examine the patient to confirm the attending physician’s diagnosis and authenticate the patient’s capacity and voluntariness. N.J.S.A. 26:16-7. Attending physicians are required to maintain extensive records, which include documentation of a patient’s requests for medication, records concerning the patient’s diagnosis, prognosis, capacity, and voluntariness in submitting such requests, as well as records from consulting physicians and any other health care professionals involved with the patient’s request for medication. N.J.S.A. 26:16-10(d). These records are a part of the medical record of a terminally ill patient. The attending physician is also required to submit a copy of these records to the New Jersey Department of Health no later than 30 days after dispensing life-ending medication to a terminally ill patient. N.J.S.A. 26:16-13(a)(1).

The third prong is a multi-step process that requires a patient to make two oral requests and one written request to a patient’s attending physician. A patient may submit a written request to receive life-ending medication to his or her attending physician when the patient makes the initial oral request or at any time thereafter. N.J.S.A. 26:16-10(a)(3). The two oral requests must be made at least 15 days apart and the attending physician must advise the patient to consult with another health care professional to discuss other treatment options but the patient is not required to participate in the consultation. N.J.S.A. 26:16-10(c). After making the second oral request, the attending physician must afford the patient an opportunity to rescind the request for life-ending medication, which may be completed at any time and for any reason. N.J.S.A. 26:16-10(a)(2),(b).

The Act has raised issues regarding life insurance policies that are owned by terminally-ill patients. Many life insurance policies contain suicide riders that prevent a payout if the insured commits suicide within the first two years of binding an insurance policy. After the two-year period lapses, most policies pay out the death benefit, even if the cause of death is suicide. However, the Act differentiates between patients who ingest life-ending medication and those who partake in assisted suicide.

Additionally, deaths that occur within the parameters of the Act do not constitute suicide or assisted suicide. N.J.S.A. 2C:11-6. As such, suicide riders in most life insurance policies are irrelevant, as deaths under the Act are not considered suicide.  The cause of death for those who pass away in accordance with the terms of the Act will likely reference natural causes on the decedent’s death certificate.

In jurisdictions in which a person passes away in accordance with similar “death with dignity” laws, the underlying terminal illness is generally listed as the cause of death and the manner of death is denoted as “natural” per the instructions of most of the jurisdictions’ respective health departments. Furthermore, in New Jersey, the Act provides that any  provision in a contract, last will and testament, insurance policy, annuity, or other agreement, whether written or oral, made on or after August 1, 2019, that purports to restrict a person’s decision to make or rescind a request for life-ending medication will be invalidated and that premium rates for insurance policies or annuities cannot be conditioned on the same request. N.J.S.A. 26:16-14. In the states in which “death with dignity” laws are in effect, we found no challenges regarding remittance of death benefits under a life insurance policy.

The Act will likely make it easier for New Jersey residents suffering from a terminal illness to end their lives on their own terms. The Act includes safeguards and a well-defined process that allows capable, terminally ill patients who are fully informed of their decision to voluntarily terminate their lives if they feel that it is in their best interest to do so. The Act also guides health care providers and advocates who support dying patients.

Michael Salad is a partner in Cooper Levenson’s Business & Tax and Cyber Risk Management practice groups. He concentrates his practice on estate planning, business transactions, mergers and acquisitions, tax matters and cyber risk management. Michael holds an LL.M. in Estate Planning and Elder Law. Michael is licensed to practice law in New Jersey, Florida, Pennsylvania, New York and the District of Columbia. Michael may be reached at (609) 572-7616 or via e-mail at msalad@cooperlevenson.com.

Shaiful Kashem is a summer Law Clerk at Cooper Levenson. He is a candidate for a J.D. at Rutgers School of Law in Camden. Shaiful may be reached at (609) 344.3161 or via e-mail at skashem@cooperlevenson.com.

 

WHAT ARE YOUR LONG-TERM CARE OPTIONS

If you think “nursing home” as soon as you hear long-term facility, that’s not surprising. However long-term care covers a range of options.  Long-term care is provided at home, in the community, or in a variety of types of facilities.  The options for long-term care span a continuum of care, and your choices may change as a parent or loved one loses mobility or chronic conditions gradually worsen.

Long-term care decisions don’t always involve a sudden crisis, and when you can, it is important to think about long-term care before a crisis occurs.

In many cases, long-term care starts at Home with family members, friends, volunteers, and often times paid home health-care aides providing the necessary care so that your loved one can remain in his or her home.  Short-term, skilled home health care is covered by Medicare; but, if Medicare is paying, it is just a short-term solution.

In addition, most areas have community services such as adult daycare, meal programs, senior centers and transportation that can be helpful as your parent remains at home. Adult daycare for example can provide a variety of health, social, and related support services in a protective setting during the day.

Independent or Retirement Living is best suited for retirees with relatively minor needs. These self-contained communities, sometimes situated in high rise complexes,  are generally light on care but offer many planned outing and activities.  Some include wellness centers on site.  The price can vary widely.

Assisted Living Facilities offer services such as medication management and limited personal care in a supervised setting.  Like independent/retirement living options, there is a real focus on activities. Also available at many assisted living facilities are personal care, housekeeping and prepared meals, often at additional cost.  The care in Assisted living facilities spans a continuum itself, and in many facilities additional care services can be provided as the need arises.

Nursing Homes provide medical and personal services beyond that available at assisted living facilities, with 24-hour supervision, assistance with activities of daily living and three daily meals usually standard.  Skilled-nursing is on-site to meet medical needs.  There is a large range of services available at different nursing homes, and it is important to match your needs with your nursing home choice.

By checking at Medicare.gov, you can learn more about each option, and newer options being offered, as well as Medicare’s coverage for each. LongTermCare.gov also has information and resources that can help with the difficult decisions involved in long-term care.

Bard L. Shober, Esq. is an attorney with Cooper Levenson’s Personal Injury Practice Group in Atlantic City, N.J. He concentrates primarily on medical malpractice and personal injury matters.

Cooper Levenson Attorneys Present Hot Legal Issues in New Jersey at NJSAMSS April 11th

Cooper Levenson attorneys Jill T. Ojserkis, Esq., LL.M.  and Brittany A. Bonetti, Esq. will address Hot Legal Issues affecting New Jersey Medical Staffs at the annual New Jersey State Association of Medical Staff Services (NJSAMSS) conference at the Tropicana Atlantic City. The Cooper Levenson presentation is scheduled for 10:30 a.m. to 12 noon on Thursday, April 11, 2019.

Issues to be addressed in the session include: medicinal cannabis regulations, hospital credentialing of mid-level provider, and NPDB and NJ Clearinghouse reporting.

A partner at Cooper Levenson, Ojserkis is Chair of the Healthcare Law practice group and a member of the firm’s Tax and Cannabis Law practice groups. Although she maintains a general healthcare practice in a wide variety of transactional, tax and corporate matters, she concentrates on medical staff/physician relations, transactional matters including managed care and technology, and governance issues for hospitals and medical staffs.

Bonetti is an associate in the Cooper Levenson’s Healthcare, Cyber Law and Cannabis Law practice groups. She assists hospitals and health systems, medical staffs, individual physicians and physician groups in business and regulatory legal matters of all types, helping them navigate complicated healthcare regulations such as Stark, Fraud and Abuse, Anti-Kickback and state regulatory concerns.

The NJSAMSS’s 26th Annual Education Conference will take place April 11-12, 2019. Participants may earn CEU’s for attending. The mission of NJSAMSS is to assist medical services professionals in broadening their professional knowledge and qualifications in the fields of medical staff and credentialing services through advocacy, certification, education, information, and networking. NJSAMSS members include hospitals, health care systems, managed care organizations, physician offices, and health care entities in New Jersey and adjoining states.

 

New Jersey Cannabis Law Update

by Jill T. Ojserkis, Esq., LL.M.

Despite approval of three cannabis bills, including adult use legalization, following a four hour hearing held before the joint session of the New Jersey Senate and Assembly Budget and Appropriation Committees on November 26, 2018, it appears unlikely that marijuana legislation will be voted upon in 2018. December 17, 2018 is the latest voting day of the legislative year and work still remains on gaining consensus on key issues in the bills including the tax rate, expungements and whether the proposed Cannabis Regulatory Commission would be a full-time commission. Work also remains in ensuring the number of votes needed for passage.

During the joint hearing, the Committees considered testimony related to three bills: S2703, the “New Jersey Cannabis Regulatory and Expungement Aid Modernization Act” which legalizes recreational cannabis, creates a Cannabis Regulatory Commission and provides a social justice component in the form of expungement relief and S10/S2426, the “Compassionate Use Medical Marijuana Act”, which revises requirements to authorize and access medical cannabis; establishes requirements for institutional caregivers; revises permit requirements for alternative treatment centers; and establishes additional legal protections for patients and caregivers. S2703 specifically provides that the regulation, taxing, control and legalization of marijuana products will be handled similarly to that of alcohol in New Jersey. A controversial component of S2703 also calls for all applicants, except for those seeking conditional or microbusiness licenses, to submit a statement that it has entered into a “labor peace agreement” with bona fide labor organizations.

During his keynote presentation before the Greater Atlantic City Chamber of Commerce held in the Atlantic City Campus of Stockton University on December 11, 2018, Hugh O’Beirne, President of the New Jersey Cannabis Industry Association, stated his belief that it is better for New Jersey to wait to get it right and to get needed buy-in rather than to rush given the potentially staggering economics. O’Beirne compared the population of Colorado with approximately 5.6 million residents to the more densely populated New Jersey, with 9 million residents. He also noted that New Jersey has far more visitors than Colorado. The New Jersey Office of Legislative Services (“OLS”), using Colorado as a model, calculated the per person annual spend on legal marijuana to be approximately $194.61. Were New Jersey to experience the same per resident sales as Colorado, the OLS estimates total retail sales of recreational marijuana in New Jersey to approximately $1.75 billion yielding aggregate tax revenue of approximately $210 million annually. Not addressed by O’Beirne or the OLS was the quickly falling price of marijuana in Colorado, which will see a marked reduction in tax revenue due to taxes being based on sales price.

In a December 11, 2018 article, NJ.com reported that 50 towns in New Jersey (or 10% of towns statewide), had banned legal marijuana businesses from operations. S2703 states that if municipalities do not “opt out” of a specific classes or all of licenses within 180 days of enaction of the law, they will be unable to do so for 5 years. The NJ.com article also noted that notwithstanding a municipality’s opt-out, the proposed bills would still permit residents over 21 to possess and use a small amount of legal marijuana in a private residence in that municipality.

S2703 also contains a combined 12% tax rate to be paid to the State and a 2% municipal excise tax. Proponents of this tax rate believe that this lower tax will promote economic growth and that, by reducing the total cost to the consumer (the price of the marijuana product plus taxes), illegal marijuana sales will be reduced. Proponents of a higher tax rate, such as Governor Murphy, believe that tax revenue should be maximized since it is the primary motivation for legalization. The New Jersey League of Municipalities has called for a 5% municipal excise tax with each licensee being required to enter into a host benefit agreement with the municipality.

The provision of licenses to microbusinesses in S2703 is seen as a means to reduce the barriers to entry by small business. Microbusinesses may have no more than 10 employees with 100% of the ownership interests being comprised of New Jersey residents who have lived in the State for at least two years. Further, and in order to promote economic opportunities within the State, at least 51% of the owners, directors, officers or employees of the microbusiness must be residents of the municipality or neighboring municipality where the microbusiness is to be located.

It has also been reported that shortly before the hearing before the joint Committees, changes were made to S10/S2426 which had offered medicinal marijuana patients broad employment protections. While the revised S10 does not permit termination of an employee merely because s/he is registered with the medical marijuana program, there are no other significant protections. Employers may maintain a drug testing policy and a prohibition against positive test results.

As written for Capaldi Reynolds & Pelosi, Certified Public Accountants newsletter

Jill T. Ojserkis at AHLA Physicians and Hospitals Law Institute in New Orleans

“The Opioid Crisis, Litigation Risks, and Medical Staffing Privileging” was the topic at a luncheon at the American Health Lawyers Association (AHLA) Physicians and Hospitals Law Institute today, Tuesday Feb. 5, 2018, in New Orleans.  Jill T. Ojserkis, Esq., a Cooper Levenson Partner, served as a panelist along with David Blank of Quarles and Brady, Washington, D.C. and Donna Michael-Ziereis, Vice-President and General Counsel, AtlantiCare Regional Medical Center, Egg Harbor Township, N.J.

The American Health Lawyers Association’s Physicians and Hospitals Law Institute focused on legal challenges faced by physicians and their counsel, the legal challenges faced by hospitals and health systems and their counsel, and the legal issues of interest to both segments of the health care delivery system.

Blurred Lines or Bright Line Between Gaming and Medical Marijuana

Last year, when the song “Blurred Lines” blasted over the airways, no one, including the recording artists (at least they claimed) realized that lines had been blurred between the popular hit song and a song titled “Got to Give It Up” written by music sensation Marvin Gaye. However, as determined by a jury earlier this year, recording artists Robin Thicke, Pharrell Williams, and T.I. did in fact blur the lines when they produced their hit single without securing the legal rights to the song.

Interestingly, in 2014, Nevada experienced its own form of blurred lines relative to the anticipated approval and operation of medical marijuana establishments and gaming. By way of background, Nevada legalized gaming in 1931 and since that time its success has been largely attributable to the regulatory oversight of the industry, coupled with the obligation to ensure that gaming is free of criminal elements. NRS 463.0129. The policy that the Nevada gaming industry remain free from criminal elements isn’t limited to those individuals included in Nevada’s Black Book or to applicants with transgressions in their background, but instead it contemplates gaming licensees operating lawfully – meaning that they will not engage in business practices that are contrary to state and/or federal law. NRS 463.1405, NRS 463.151, 463.170 and 463.200.

Read complete article here – Blurred Lines or Bright Line between Gaming and Medical Marijuana