Contact Us
Subscribe to this blog via RSS
Join us on LinkedInCategories
- 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”)
- Acute Care Beds
- Clinical Support
- Coronavirus
- Emergency Medical Services
- Emergency Preparedness
- 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
- 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")
- Stark Laws
- Compliance
- Department of Health and Human Services (HHS)
- 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)
- Physician Assistants
- Qui Tam
- Accountable Care Organizations (“ACO”)
- 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)
- HPSA
- Part D
- Pharmacists
- Rural Health Centers (“RHCs”)
- Telehealth
- Affordable Care Act
- Alternative Payment Models
- Charitable Hospitals
- Health Professional Shortage Area ("HPSA")
- Hospitals
- HRSA
- Limited Services Clinics
- Medicaid
- Medical Staff By-Laws
- Medically Underserved Area ("MUA")
- Medicare
- Mid-Level Practitioners
- Patient Protection and Affordable Care Act (“ACA”)
- 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
- United States ex. Rel. Kane v. Continuum Health Partners
- Webinar
- APRNs
- Chain and Organization System (“PECOS”)
- Jimmo v. Sebelius
- Maintenance Standard
- Overpayments
- Vitas Innovative Hospice Care
- Agreed Order
- Douglas v. Independent Living Center of Southern California
- Drug Enforcement Agency ("DEA")
- Emergency Rooms
- Enrollment
- Hinchy v. Walgreen Co.
- Kentucky Senate Bill 7
- Medicare Part D
- Minors
- Re-validation
- Texting
- All-Payer Claims Database ("APCD")
- Chiropractic services
- Clinical Laboratory Improvement Amendments of 1988 (“CLIA”)
- Compliance Officer
- Essential Health Benefits
- ICD-9
- Ophthalmological services
- Physician Compare website
- 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”)
- 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
- Patient Autonomy
- Personal Health Information
- Senate Bill 39
- Senate Finance Committee Report
- State Medicaid Expansion
- Compliance Programs
- Critical Access Hospitals (“CAHs”)
- Essential Health Benefits (“EHBs”)
- Kentucky Primary Care Centers (“PCCs”)
- Managed Care Organizations (“MCOs”)
- Medicare Audit Improvement Act of 2012
- Recovery Audit Contractors (“RAC”)
- Small Business Health Options Program (“SHOP”)
- Sunshine Act
- Abuse and Waste
- Center for Disease Control
- Consumer Operated and Oriented Plan programs (“CO-OPS”)
- Healthcare Information and Management Systems Society (HIMSS)
- 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 Care Law
- Health Insurance
- Healthcare Regulation
McBrayer Blogs
Showing 24 posts from 2020.
A Christmas Miracle! Congress Agrees on a New Coronavirus Relief Bill
After nine months of negotiations and stalemates, Congress finally reached an agreement for a $900 billion relief package on December 20, 2020. Included are many familiar provisions from the March CARES Act, with a particular emphasis on small business benefits and relief for health care providers. More >
Malnutrition Diagnosis Codes: The Compliance Danger You’re Not Taking Seriously Enough
It may seem like hair-splitting, but including the wrong diagnostic codes for malnutrition on hospital inpatient claims – using codes for severe malnutrition in place of other forms of malnutrition – is a costly mistake. The estimated overpayment as a result of these coding errors is a reported $1 billion. Because the payment error rate was so high at a colossal 31%, Medicare-Severity Diagnosis Related Group ("MS-DRG") applicable entities must take note and prepare for a marked increase in Department of Health and Human Services Office of Inspector General ("OIG") audits for these coding practices. The Centers for Medicare & Medicaid Services ("CMS") also plans to implement review practices for malnutrition coding on a sample of inpatient claims. The increased payer audits will result in severe financial damage for hospitals and other MS-DRG applicable entities if they do not mitigate coding and documentation risks. More >
Alert: Rural Health Clinics - Your COVID-19 Testing Program Report is Due NOW!
While the extra health care dollars distributed by HHS for coronavirus testing were well received by rural health clinics and other providers, those funds come with important reporting requirements that take effect immediately. The Department of Health and Human Services’ funding initiative of $225 million for rural health clinics’ coronavirus testing efforts, known as the Rural Testing Relief Fund or Rural Health Clinic (“RHC”) COVID-19 Testing Program, is no exception to such requirements. These reporting requirements as well as the others for state and federal health care dollars related to the pandemic should be carefully followed as the HHS Inspector General and the Department of Justice are already investigating to ferret out misuse, fraud, waste, and abuse of these funds. More >
WARNING: DOL Moves the Goalposts on FFCRA for Healthcare Providers
When the Families First Coronavirus Response Act (“FFCRA”) was passed, healthcare providers breathed a sigh of relief to see that an exception had been carved out for them regarding the mandatory leave provisions of the law. This exclusion permitted entities with less than 500 employees to exclude “health care providers” from mandatory leave provisions. The first rules to interpret this provision defined “health care providers” in such a manner that all employees of a healthcare provider that itself met the definition would also meet the exclusion. This interpretation is no more. More >
A Potpourri of COVID-19 Takeaways for Healthcare Providers
While the COVID-19 virus surges and possibly re-surges in states all around us, Kentucky’s cautious management of this crisis has created opportunities for healthcare providers to ease back into business and shift into recovery. Whether Kentucky can continue to contain the virus is uncertain, but as healthcare providers retool and spend the federal dollars infused by the CARES ACT, here are the areas to watch. More >
Reimbursement Relief for Healthcare Providers Treating the Uninsured
Reimbursement relief is on the way for healthcare providers who have conducted COVID-19 testing or provided treatment for COVID-19 individuals who are uninsured. The COVID-19 Uninsured Program Portal allows for providers to submit claims for reimbursement beginning May 6, 2020 for COVID -19 services on or after February 4, 2020. These reimbursements will be made at Medicare rates. More >
FCC is awarding funds for the COVID-19 Telehealth Program
The Coronavirus Aid, Relief, and Economic Security (CARES) Act that was passed into law in March 2020 set aside $200 million in funds for the Federal Communications Commission (FCC) to establish the COVID-19 Telehealth Program. The program’s intent is to keep physicians and patients safe while continuing care remotely. The support provided through telehealth is intended for treatment of both coronavirus and other ongoing health conditions during the pandemic. More >
DOJ’s Nursing Home Initiative Targets Providers – Compliance Will Be Critical!
A new initiative announced by the Department of Justice (DOJ) on March 3, 2020, is aimed at investigating “grossly substandard care” in nursing homes. The National Nursing Home Initiative will initially be targeting the nation’s most problematic facilities and will use both civil and criminal enforcement actions where these facilities are putting the health and safety of residents in danger. The initiative serves as one focus in the DOJ’s larger efforts in protecting the elderly and is coordinated by the Elder Justice Initiative. More >
CMS Suspends the Advance Payment Program and Reevaluates Accelerated Payments
On April 26, 2020, the Centers for Medicaid & Medicare Services (CMS), announced that the Advance Payment Program for Part B suppliers was ending immediately and that the amounts being paid under the Accelerated Payment Program will be reevaluated. Going forward, new applications for the Advanced Payment program will not be accepted. There are interesting implications and questions for providers who received funds under this program going forward as CMS has not issued any guidance concerning how this will be handled. More >
Kentucky Sets Detailed Timeline for Phased Reopening of Healthcare Providers
The Kentucky Department for Public Health (KDPH) has released a four-stage plan for reopening Kentucky’s health care services in the wake of the COVID-19 pandemic with the first phase beginning on April 27, 2020, and the fourth and final stage being implemented on May 27, 2020. The intention is to gradually loosen restrictions on services while providing requirements that must be met in order to mitigate against the COVID-19 pandemic. More >
