Contact Us
Subscribe to this blog via RSS
Join us on LinkedInCategories
- Medical Spas
- medical billing
- No Surprises Act
- 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
- COVID-19
- SB 150
- Acute Care Beds
- Clinical Support
- Coronavirus
- Emergency Medical Services
- Emergency Preparedness
- Families First Coronavirus Response Act
- Family and Medical Leave Act (“FMLA”)
- KBML
- medication assisted therapy
- 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
- EHR Systems
- Hospice
- ICD-10
- Kentucky minimum wage
- Minimum wage
- Primary Care Physicians ("PCPs")
- Skilled Nursing Facilities (“SNFs”)
- Uncategorized
- Drug Screening
- Electronic Health Records (“EHR")
- KASPER
- Mental Health Care
- Urinalysis
- Affordable Insurance Exchanges
- Compliance
- Department of Health and Human Services (HHS)
- Fraud
- Health Care Fraud
- HIPAA Risk Assessment
- HPSA
- Kentucky Board of Medical Licensure
- Kentucky’s Department for Medicaid Services
- Office for Civil Rights ("OCR")
- Office of Inspector General of the United States Department of Health and Human Services (OIG)
- Pharmacists
- Physician Assistants
- Qui Tam
- Stark Laws
- Accountable Care Organizations (“ACO”)
- Affordable Care Act
- Alternative Payment Models
- Anti-Kickback Statute
- Centers for Medicare & Medicaid Services (“CMS”)
- Certificate of Need ("CON")
- Charitable Hospitals
- 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)
- Health Professional Shortage Area ("HPSA")
- Hospitals
- HRSA
- Limited Services Clinics
- Medicaid
- Medical Staff By-Laws
- Medically Underserved Area ("MUA")
- Medicare
- Mid-Level Practitioners
- Part D
- Patient Protection and Affordable Care Act (“ACA”)
- Rural Health Centers (“RHCs”)
- Rural Health Clinic
- Telehealth
- 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
- APRNs
- Hydrocodone
- Kentucky Pharmacists Association
- United States ex. Rel. Kane v. Continuum Health Partners
- Webinar
- Agreed Order
- Chain and Organization System (“PECOS”)
- Douglas v. Independent Living Center of Southern California
- Drug Enforcement Agency ("DEA")
- Emergency Rooms
- Enrollment
- Hinchy v. Walgreen Co.
- Jimmo v. Sebelius
- Maintenance Standard
- Overpayments
- Re-validation
- Vitas Innovative Hospice Care
- 2014 Medicare Physician Fee Schedule (“PFS”)
- All-Payer Claims Database ("APCD")
- Chiropractic services
- Chronic Care Management
- Clinical Laboratory Improvement Amendments of 1988 (“CLIA”)
- Compliance Officer
- CPR
- Essential Health Benefits
- ICD-9
- Kentucky Senate Bill 7
- Medicare Part D
- Minors
- Ophthalmological services
- Physician Compare website
- Sustainable Growth Rate (“SGR”)
- Texting
- 501(c)(3)
- Affinity Health Plan
- Appeal
- Cadillac tax
- Centers for Disease Control and Prevention
- Community health needs assessment (“CHNA”)
- Compounding
- Condition of Participation ("CoP")
- Denied Claims
- Dispenser
- Drug Quality and Security Act (“DQSA”)
- Federation of State Medical Boards (“FSMB”)
- Food and Drug Administratio
- Form 4720
- Grace Period
- HealthCare.gov
- Home Medical Equipment Providers
- House Bill 3204
- Individual mandate
- Inpatient Care
- Kentucky Medical Practice Act
- Kindred v. Cherolis
- Kynect
- Licensure Requirements
- Long-term care communities
- Long-Term Care Providers ("LTC")
- Mobile medical applications ("apps")
- Model Policy for the Appropriate Use of Social Media and Social Networking in Medical Practice (“Model Policy”)
- National Drug Code ("NDC")
- National Institutes of Health
- New England Compounding Center ("NECC")
- Nonprofit hospitals
- Outsourcing facility
- Personal Service Entities
- Physician Payments
- Ping v. Beverly Enterprises
- Power of Attorney ("POA")
- Prescriber
- Qualified Health Plan ("QHP")
- Social Media
- Spousal coverage
- State Health Plan
- UPS
- "Plan of Correction"
- Advanced Practice Registered Nurses
- Arbitration
- Audit
- Call Coverage
- Daycare centers
- Decertification
- Department of Medicaid Services’ (“DMS”)
- 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
- Group Purchasing Organizations ("GPO")
- Health Professional Shortage Areas (“HPSA”)
- Health Reform
- Home Health Prospective Payment System
- Hospitalists
- House Bill 104
- Intermediate Sanctions Agreement
- Kentucky Health Benefit Exchange
- Licensed practical nurses (LPN)
- List of Excluded Individuals and Entities
- LLC v. Sutter
- Low-utilization payment adjustment ("LUPA")
- Meaningful use incentives
- Medicare Administrative Coordinators
- Medicare Benefit Policy Manual
- Medicare Shared Saving Program (MSSP)
- Network provider agreement
- Nonroutine medical supplies conversion factor (“NRS”)
- 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
- Quality reporting
- Registered nurses (RN)
- Residency Programs
- Self-Disclosure Protocol
- Statement of Deficiency ("SOD")
- Trade Association Group Coverage
- Upcoding
- “Superuser”
- Autism/ASD
- Business Associate Agreements
- Business Associates
- Genetic Information Nondiscrimination Act ("GINA")
- 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
- Abuse and Waste
- Center for Disease Control
- Compliance Programs
- Consumer Operated and Oriented Plan programs (“CO-OPS”)
- Critical Access Hospitals (“CAHs”)
- Essential Health Benefits (“EHBs”)
- Healthcare Information and Management Systems Society (HIMSS)
- Kentucky Cabinet for Health and Family Services
- Kentucky Health Care Co-Op
- 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
- Employee Agreement
- Free Conference Committee Report
- Health Care Fraud and Abuse Control Program
- House Bill 1
- House Bill 4
- Kentucky “Pill Mill Bill”
- Pain Management Facilities
- Health Care Law
- Health Insurance
- Healthcare Regulation
McBrayer Blogs
Showing 2 posts from April 2012.
HOSPITAL PAYMENT FOR PERFORMANCE: DRIVEN BY PHYSICIAN’S QUALITY
As the fate of the Affordable Care Act is being determined by a divisive Supreme Court, the health care industry is being led or possibly dragged by the Department of Health and Human Services (“HHS”) and the Center for Medicare and Medicaid Services (“CMS”) into new payment systems that focus on quality of care, outcomes and individual provider performance rather than the traditional fee for service payment model. Even if the Supreme Court finds the Affordable Care Act to be unconstitutional, the change from a payment system focused upon individual services to payment focused upon the quality of the care and patient outcomes are being woven into the fabric of the Medicare reimbursement system. While change in the system is assured, whether the new models will actually bring about better and more efficient care or just reduce available reimbursement is unknown. Despite the unknown effect of paying for performance based upon quality, CMS is marching on with new programs and payment penalties. Physicians, whether employed by a hospital or in a private practice, should be aware of how quality is beginning to drive hospital reimbursement as well as the importance of the physician’s role in determining the quality of care provided by hospitals. By 2017, 6% of all DRG payments will be subject to quality measures through new CMS payment programs for hospital readmissions, value based purchasing and hospital acquired conditions. With these new programs determining a significant amount of payment, physicians must understand the programs and direct their services accordingly. Likewise, hospitals must develop ways to compensate physicians for providing high quality care in a manner that allows hospitals to earn performance payments. More >
PROPOSED PAIN CLINIC LEGISLATION WILL REQUIRE SIGNIFICANT CHANGES TO PROVIDER OPERATIONS AND INCREASE LEGAL SCRUTINY OF PRESCRIBING PRACTICES
The Kentucky General Assembly is currently considering sweeping legislation to combat prescription drug abuse through increased regulation of pain clinics and greater scrutiny of prescribing practices by various agencies of state government. House Bill 4 and the Free Conference Committee Report proposing to modify House Bill 4, if enacted and signed by Governor Beshear, will place significant limits on ownership of pain clinics and also impose a host of requirements governing the operation of pain clinics in the Commonwealth of Kentucky. More >
