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Showing 31 posts from 2012.

The Kentucky Health Benefit Exchange: How Obamacare is Changing the Health Insurance Marketplace

Now that the President has been re-elected and the Supreme Court has upheld most of the Accountable Care Act (“ACA”), Obamacare will not be repealed. So, what does that mean for Kentuckians?  Several things including an individual mandate to buy health insurance and a health benefit exchange where Kentuckians can buy insurance. More >


With federal and state fraud and abuse enforcement efforts on the rise, all health care providers must be vigilant in identifying areas of risk and putting in place mechanisms to ensure regulatory compliance.  This holds true not just for larger institutional providers, but individual and small physician group practices, as well.  With the proliferation of federal and state contractors tasked with performing audits of coding and  billing practices, physician practices must be prepared to demonstrate proper coding and billing practices and proper documentation to support those practices.  The best preventive medicine for the individual and small physician group practice is a carefully drafted compliance program to identify and address areas of risk and to promote a culture of compliance within the practice. More >

Reforming Medicare Audits

On October 16, 2012, the Medicare Audit Improvement Act of 2012[1] was introduced in the U.S. House of Representatives by Representative Sam Graves. The purpose of this legislation is to reform the Medicare auditing program. This legislation aims to improve the accuracy and transparency of Medicare audits of hospitals as well as increase the accountability of Recovery Audit Contractors (“RAC”).[2] More >


“Like Travelocity but for health insurance” is how Executive Director Carrie Banahan and Deputy Director Bill Nold of the Office of Kentucky Health Benefit Exchange describe the developing Kentucky Exchange.  More >

Changes to Deadlines for Stage Two – Meaningful Use in the Medicare and Medicaid EHR Incentive Programs

Under the Health Information Technology for Economic and Clinical Health (“HITECH”) Act, health care professionals and hospitals may qualify for incentive payments when they adopt and meaningfully use certified electronic health records (“EHR") under a three stage process. More >

Here Comes the Sun, Are you Prepared? – Tips for Navigating the New Sunshine Provisions

The Sunshine Act was legislated as part of the Patient Protection and Affordable Care Act (the “ACA”) to reduce the risk of inappropriate financial incentives interfering with medical judgment and patient care by enhancing the transparency of financial relationships between certain health care providers (i.e. physicians and teaching hospitals) and manufacturers of covered drugs and devices.  Because these relationships are being scrutinized now more than ever, those involved in clinical research with manufacturers of drug and device companies   may find the following these general guidelines  helpful in avoiding  risks of non-compliance and legal complications: . More >


SMS text messaging is quickly becoming the preferred method of communication for many people who find it a quick and convenient way to share information with friends, family and, increasingly, with colleagues.  This is true in the health care space as well with patients increasingly using text messaging to communicate with providers and to receive health-related reminders and updates, including for health care appointments, medication therapies and health news.  For example, anyone can text the word HEALTH to 87000 and begin receiving text messages from the Center for Disease Control regarding emergency alerts, new research and reports, as well as health information and tips. More >

Is a Cloud Vendor a Business Associate?

Before a covered entity can use cloud storage for ePHI, the covered entity must enter into a business associate agreement (BAA) with the cloud vendor.[i]  It seems that there is some uncertainty surrounding this requirement, with some cloud vendors taking the position that a BAA is unnecessary for passive storage of ePHI or that they qualify for an exception under HITECH Act as a personal health records vendor. More >


Virtual or “cloud” data storage is an increasingly popular method for storing data electronically in a safe and yet conveniently accessible manner that may also represent a cost savings over traditional onsite data storage options.  Health care providers, including hospitals, pharmacies and physicians, have been slow to avail themselves of the benefits of “cloud computing” due in part to concerns about whether the cloud offers the rigorous privacy and security safeguards required for storing electronic protected health information (ePHI) under Federal and State privacy laws, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH Act) and implementing regulations. More >

Guess Who’s Coming to Visit? Long-Term Care Facility Inspections

Compliance and preparedness are two very real, everyday concerns for long-term care facilities. Not only are these important aspects of daily operations for the safety of the employees and patients, they are paramount because any day a visitor from the Office of the Inspector General (OIG”) or Occupational Safety and Health Administration (“OSHA”) could show up for an inspection.  Is your facility prepared? More >

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