Contact Us
Subscribe to this blog via RSS
Join us on LinkedInCategories
- Mandatory vaccination policies
- Workplace health
- 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
- Chronic Pain Management
- HIPAA
- 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")
- Drug Screening
- Electronic Health Records (“EHR")
- Urinalysis
- Affordable Insurance Exchanges
- Fraud
- Health Care Fraud
- HIPAA Risk Assessment
- KASPER
- Mental Health Care
- Office for Civil Rights ("OCR")
- Qui Tam
- Stark Laws
- Compliance
- Department of Health and Human Services (HHS)
- Federally Qualified Health Centers (“FQHCs”)
- HPSA
- Kentucky Board of Medical Licensure
- Kentucky’s Department for Medicaid Services
- Office of Inspector General of the United States Department of Health and Human Services (OIG)
- Pharmacists
- Physician Assistants
- Rural Health Centers (“RHCs”)
- Telehealth
- 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
- Fee for Service
- Health Information Technology for Economic and Clinical Health Act (HITECH Act)
- Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Health Professional Shortage Area ("HPSA")
- Hospitals
- Medicaid
- Medical Staff By-Laws
- Medically Underserved Area ("MUA")
- Medicare
- Part D
- Patient Protection and Affordable Care Act (“ACA”)
- Rural Health Clinic
- Alternative Payment Models
- Charitable Hospitals
- HRSA
- Limited Services Clinics
- Mid-Level Practitioners
- American Telemedicine Association (“ATA”)
- Criminal Division of the Department of Justice (“DOJ”)
- Health Care Fraud Prevention and Enforcement Action Team (“HEAT”)
- Kentucky Board of Nursing
- Qualified Health Care Centers (“FQHC”)
- Telemedicine
- Hydrocodone
- Kentucky Pharmacists Association
- Webinar
- APRNs
- Chain and Organization System (“PECOS”)
- United States ex. Rel. Kane v. Continuum Health Partners
- Agreed Order
- Douglas v. Independent Living Center of Southern California
- Drug Enforcement Agency ("DEA")
- Emergency Rooms
- Enrollment
- Hinchy v. Walgreen Co.
- Jimmo v. Sebelius
- Kentucky Senate Bill 7
- Maintenance Standard
- Medicare Part D
- Minors
- Overpayments
- Re-validation
- Vitas Innovative Hospice Care
- All-Payer Claims Database ("APCD")
- Chiropractic services
- Clinical Laboratory Improvement Amendments of 1988 (“CLIA”)
- Compliance Officer
- ICD-9
- Ophthalmological services
- Physician Compare website
- Texting
- 2014 Medicare Physician Fee Schedule (“PFS”)
- 501(c)(3)
- Appeal
- Centers for Disease Control and Prevention
- Chronic Care Management
- Compounding
- CPR
- Dispenser
- Drug Quality and Security Act (“DQSA”)
- Essential Health Benefits
- Food and Drug Administratio
- HealthCare.gov
- House Bill 3204
- Kindred v. Cherolis
- 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
- Sustainable Growth Rate (“SGR”)
- 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
- Kynect
- 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"
- Advanced Practice Registered Nurses
- Arbitration
- Audit
- Call Coverage
- Daycare centers
- Decertification
- Division of Regulated Child Care
- Doe v. Guthrie Clinic
- EHR vendor
- Employer Group Health Plans
- Employer Mandate
- ERISA
- Fair Labor Standards Act (FLSA)
- False Billings
- Health Professional Shortage Areas (“HPSA”)
- Health Reform
- House Bill 104
- 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
- Patient Privacy
- 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
- Autism/ASD
- Business Associate Agreements
- Business Associates
- Genetic Information Nondiscrimination Act ("GINA")
- Group Purchasing Organizations ("GPO")
- Kentucky House Bill 159
- Kentucky House Bill 217
- Kentucky Primary Care Centers (“PCCs”)
- Managed Care Organizations (“MCOs”)
- Patient Autonomy
- Personal Health Information
- Senate Bill 39
- Senate Finance Committee Report
- State Medicaid Expansion
- Center for Disease Control
- Compliance Programs
- Critical Access Hospitals (“CAHs”)
- Essential Health Benefits (“EHBs”)
- Healthcare Information and Management Systems Society (HIMSS)
- Medicare Audit Improvement Act of 2012
- Recovery Audit Contractors (“RAC”)
- Small Business Health Options Program (“SHOP”)
- Sunshine Act
- Abuse and Waste
- Consumer Operated and Oriented Plan programs (“CO-OPS”)
- Kentucky Cabinet for Health and Family Services
- Kentucky Health Care Co-Op
- Kentucky Health Cooperative (“KYHC”)
- Occupational Safety and Health Administration (“OSHA”)
- Free Conference Committee Report
- Health Care Fraud and Abuse Control Program
- House Bill 1
- House Bill 4
- Kentucky “Pill Mill Bill”
- Pain Management Facilities
- Employee Agreement
- Health Insurance
- Healthcare Regulation
- Health Care Law
McBrayer Blogs
Showing 2 posts from February 2012.
ON THE ENFORCEMENT RADAR: MEDICAID AUDITS AND THE 2012 OIG WORK PLAN
Posted In Health Care Law, Kentucky’s Department for Medicaid Services, Medicaid, Medicare, Office of Inspector General of the United States Department of Health and Human Services (OIG)
Unlike the Department of Health and Human Services Office of Inspector General (“OIG”) which publishes a Work Plan each year, the Department of Medicaid Services (“Medicaid”) generally does not publish guidance on the areas which it plans to investigate and/or audit. In fact, Medicaid’s website states … “Medicaid does not provide guidance on how companies should bill for services, but will direct you to applicable regulations. If you receive direction from staff about how to bill, the Department will not be bound by such instruction, unless it was given by a Director or Commissioner.” Because the federal integrity programs are now moving through the process, Kentucky Medicaid providers are starting to see lots of audit activities. Unlike the OIG audits, we don’t know the precise subject matter of the Medicaid audits, but the process for appeal is outlined below in addition to the areas announced for review by the OIG. More >
The Physician Employment Trend Continues
Posted In Employee Agreement, Health Care Law
As healthcare reform continues to be implemented, the trend toward clinical integration and consolidation also continues and will be a defining characteristic of healthcare delivery in the years ahead. One critical component of clinical integration and consolidation has been health systems employing physicians to form large multi-specialty groups to serve the patient population. Physicians contemplating entering into an employment relationship with a hospital or health system must examine a number of critical issues before entering into an employment agreement. More >
