Contact Us
Categories
- Coronavirus Aid, Relief and Economic Security Act
- Code Enforcement
- Department of Labor ("DOL")
- Employment Law
- FFCRA
- CARES Act
- Nursing Home Reform Act
- SB 150
- COVID-19
- Families First Coronavirus Response Act
- Family and Medical Leave Act (“FMLA”)
- KBML
- medication assisted therapy
- Acute Care Beds
- Clinical Support
- Coronavirus
- Emergency Medical Services
- Emergency Preparedness
- Department of Health and Human Services
- Legislative Developments
- Corporate
- United States Department of Justice ("DOJ")
- Employee Contracts
- Non-Compete Agreement
- Opioid Epidemic
- Sexual Harassment
- Health Resource and Services Administration
- Litigation
- Medical Malpractice
- House Bill 333
- Senate Bill 79
- locum tenens
- Senate Bill 4
- Physician Prescribing Authority
- HIPAA
- Chronic Pain Management
- Prescription Drugs
- "Two Midnights Rule"
- 340B Program
- Hospice
- Kentucky minimum wage
- Minimum wage
- Skilled Nursing Facilities (“SNFs”)
- Uncategorized
- EHR Systems
- ICD-10
- Primary Care Physicians ("PCPs")
- Electronic Health Records (“EHR")
- Drug Screening
- KASPER
- Mental Health Care
- Urinalysis
- Affordable Insurance Exchanges
- Fraud
- Health Care Fraud
- HIPAA Risk Assessment
- Kentucky’s Department for Medicaid Services
- Office for Civil Rights ("OCR")
- Qui Tam
- Stark Laws
- Compliance
- Department of Health and Human Services (HHS)
- HPSA
- Kentucky Board of Medical Licensure
- Office of Inspector General of the United States Department of Health and Human Services (OIG)
- Pharmacists
- Physician Assistants
- Accountable Care Organizations (“ACO”)
- Affordable Care Act
- Anti-Kickback Statute
- Centers for Medicare & Medicaid Services (“CMS”)
- Certificate of Need ("CON")
- Data Breach
- Electronic Protected Health Information (ePHI)
- False Claims Act
- Federally Qualified Health Centers (“FQHCs”)
- Fee for Service
- Health Information Technology for Economic and Clinical Health Act (HITECH Act)
- Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Hospitals
- Medicaid
- Medicare
- Part D
- Patient Protection and Affordable Care Act (“ACA”)
- Rural Health Centers (“RHCs”)
- Telehealth
- Alternative Payment Models
- Charitable Hospitals
- Health Professional Shortage Area ("HPSA")
- HRSA
- Limited Services Clinics
- Medical Staff By-Laws
- Medically Underserved Area ("MUA")
- Mid-Level Practitioners
- Rural Health Clinic
- Kentucky Board of Nursing
- American Telemedicine Association (“ATA”)
- Criminal Division of the Department of Justice (“DOJ”)
- Health Care Fraud Prevention and Enforcement Action Team (“HEAT”)
- Hydrocodone
- Kentucky Pharmacists Association
- Qualified Health Care Centers (“FQHC”)
- Telemedicine
- Webinar
- APRNs
- United States ex. Rel. Kane v. Continuum Health Partners
- Agreed Order
- Chain and Organization System (“PECOS”)
- Drug Enforcement Agency ("DEA")
- Hinchy v. Walgreen Co.
- Jimmo v. Sebelius
- Maintenance Standard
- Overpayments
- Vitas Innovative Hospice Care
- Chiropractic services
- Clinical Laboratory Improvement Amendments of 1988 (“CLIA”)
- Douglas v. Independent Living Center of Southern California
- Emergency Rooms
- Enrollment
- Kentucky Senate Bill 7
- Medicare Part D
- Minors
- Ophthalmological services
- Physician Compare website
- Re-validation
- Texting
- 2014 Medicare Physician Fee Schedule (“PFS”)
- All-Payer Claims Database ("APCD")
- Chronic Care Management
- Compliance Officer
- CPR
- Essential Health Benefits
- ICD-9
- Sustainable Growth Rate (“SGR”)
- 501(c)(3)
- Appeal
- Centers for Disease Control and Prevention
- Compounding
- Dispenser
- Drug Quality and Security Act (“DQSA”)
- Food and Drug Administratio
- HealthCare.gov
- House Bill 3204
- Kindred v. Cherolis
- Kynect
- Long-term care communities
- Mobile medical applications ("apps")
- National Drug Code ("NDC")
- National Institutes of Health
- New England Compounding Center ("NECC")
- Outsourcing facility
- Ping v. Beverly Enterprises
- Power of Attorney ("POA")
- Prescriber
- State Health Plan
- Affinity Health Plan
- Cadillac tax
- Community health needs assessment (“CHNA”)
- Condition of Participation ("CoP")
- Denied Claims
- Department of Medicaid Services’ (“DMS”)
- Federation of State Medical Boards (“FSMB”)
- Form 4720
- Grace Period
- Home Health Prospective Payment System
- Home Medical Equipment Providers
- Hospitalists
- Individual mandate
- Inpatient Care
- Kentucky Medical Practice Act
- Licensure Requirements
- Long-Term Care Providers ("LTC")
- Low-utilization payment adjustment ("LUPA")
- Medicare Shared Saving Program (MSSP)
- Model Policy for the Appropriate Use of Social Media and Social Networking in Medical Practice (“Model Policy”)
- Nonprofit hospitals
- Nonroutine medical supplies conversion factor (“NRS”)
- Personal Service Entities
- Physician Payments
- Qualified Health Plan ("QHP")
- Quality reporting
- Social Media
- Spousal coverage
- Upcoding
- UPS
- “Superuser”
- "Plan of Correction"
- Arbitration
- Audit
- Daycare centers
- Decertification
- Division of Regulated Child Care
- EHR vendor
- Employer Group Health Plans
- Employer Mandate
- ERISA
- Fair Labor Standards Act (FLSA)
- False Billings
- Health Professional Shortage Areas (“HPSA”)
- Health Reform
- Intermediate Sanctions Agreement
- Kentucky Health Benefit Exchange
- Licensed practical nurses (LPN)
- List of Excluded Individuals and Entities
- LLC v. Sutter
- Meaningful use incentives
- Medicare Administrative Coordinators
- Medicare Benefit Policy Manual
- Network provider agreement
- Nurse practitioners (NP)
- Office of the National Coordinator for Health Information Technology (“ONC”)
- Part A
- Part B
- Payors
- Physician Recruitment
- Physician shortages
- Provider Self Disclosure Protocol
- Registered nurses (RN)
- Residency Programs
- Self-Disclosure Protocol
- Statement of Deficiency ("SOD")
- Trade Association Group Coverage
- Advanced Practice Registered Nurses
- Business Associate Agreements
- Business Associates
- Call Coverage
- Doe v. Guthrie Clinic
- Group Purchasing Organizations ("GPO")
- House Bill 104
- Kentucky House Bill 217
- Patient Autonomy
- Patient Privacy
- Personal Health Information
- Senate Bill 39
- Senate Finance Committee Report
- State Medicaid Expansion
- Autism/ASD
- Compliance Programs
- Genetic Information Nondiscrimination Act ("GINA")
- Kentucky House Bill 159
- Kentucky Primary Care Centers (“PCCs”)
- Managed Care Organizations (“MCOs”)
- Abuse and Waste
- Center for Disease Control
- Consumer Operated and Oriented Plan programs (“CO-OPS”)
- Critical Access Hospitals (“CAHs”)
- Essential Health Benefits (“EHBs”)
- Healthcare Information and Management Systems Society (HIMSS)
- Kentucky Health Cooperative (“KYHC”)
- Medicare Audit Improvement Act of 2012
- Occupational Safety and Health Administration (“OSHA”)
- Recovery Audit Contractors (“RAC”)
- Small Business Health Options Program (“SHOP”)
- Sunshine Act
- Kentucky Cabinet for Health and Family Services
- Kentucky Health Care Co-Op
- Kentucky “Pill Mill Bill”
- Employee Agreement
- Free Conference Committee Report
- Health Care Fraud and Abuse Control Program
- House Bill 1
- House Bill 4
- Pain Management Facilities
- Health Insurance
- Healthcare Regulation
- Health Care Law
McBrayer Blogs
A New Day for Healthcare in Kentucky
Starting in July, practitioners may be asked to sign for mail from the Cabinet for Health and Family Services and open this to discover a “Proposed Complaint.” Thanks to a new and sweeping effort at reform in healthcare in the Commonwealth, Kentucky healthcare providers now need to know what to expect if they receive such a Proposed Complaint.
After years of discussing possible reform in the healthcare sphere, the Kentucky legislature recently passed Senate Bill 4. This new law has a wide reach as it encompasses all manner of healthcare providers, from individual physicians to health facilities and systems. Although the legislation was modeled after a similar measure in Indiana, the Kentucky version is different in ways that lead to some uncertainty as to how it may affect practitioners. This legislation now requires peer review of medical malpractice complaints by medical review panels before any such medical malpractice case could go to court. The panels must render an opinion within nine months after the proposed complaint has been filed or the plaintiff is free to bring the action in court. A complaint may bypass the panel and go directly to court only in the event that all parties agree to the same. As a practical matter, this means that all healthcare providers in receipt of a Proposed Complaint should notify their insurance carrier as soon as possible to ensure that coverage is timely triggered.
Creation of the Panel
Panels consist of an attorney panel chairperson and three healthcare providers. Each party can select one of the panel healthcare providers, and the two selected providers then select the third member. The law allows for selection of those persons in the same or similar specialty as the provider under review. All healthcare providers licensed in Kentucky to practice in his or her profession are eligible for selection to this panel, and can only be excused for “good cause” if chosen. Most believe that sufficient good cause shown will be similar to the good cause for excuse from serving on a jury. If a member of the panel fails to comply with the duties required, he or she may be sanctioned by the court. Healthcare providers in Kentucky need to be aware of their duty to serve on medical review panels if selected through this process.
Panel Process and Effect of the Panel Opinion
Once the panel is set, the parties may submit the evidence identified under the statute. The panel then is responsible for reviewing the submitted evidence and rendering an opinion as to whether the evidence supports the conclusion that a practitioner acted within the appropriate standard of care and whether this failure, if any, was a substantial factor in a negative outcome for the patient. Two members of the panel must agree on the conclusion. If the plaintiff decides to file suit after the panel renders the opinion, the opinion may be used as an expert opinion in the ensuing litigation. Notably, the panel members may be called as witnesses to testify on their review of the case.
Response to the Law
Supporters of this new law believe that the panel process will enable earlier resolution of frivolous claims and assist in reducing litigation costs that effectively drive up costs of malpractice insurance, as well as attract more quality healthcare providers to practice in Kentucky. There have been various criticisms of the law, including whether the provisions may affect a plaintiff’s access to the court system and therefore fail to pass constitutional muster. Another criticism contemplates whether this law merely adds another administrative burden to the process. The new law also requires further participation and effort from the healthcare and legal communities and will put additional demands on those already focused on caring for their patients and practice. As medical review panels go into effect, only time will tell if the goals of this law will be met in practice.
Kathryn A. Eckert is an associate attorney practicing in the Lexington office of McBrayer law. Ms. Eckert is a graduate of University of Kentucky and the University of Kentucky College of Law. Her practice areas are focused on healthcare professional licensure defense, malpractice and professional liability defense, medical malpractice, insurance defense, legal malpractice defense, product liability litigation and professional liability defense. You may reach Ms. Eckert at keckert@mcbrayerfirm.com or (859) 231-8780, ext. 1186.
Services may be performed by others.
This article does not constitute legal advice.