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- Part 2
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McBrayer Blogs
Showing 59 posts in Health Care Law.
An Unlikely Consequence, cont.
On Tuesday, I discussed the recent trend of hospital layoffs of staff, administrative and professional alike, in order to reduce costs despite expectations of an unprecedented number of individuals seeking health care services under the ACA. More >
An Unlikely Consequence
The Affordable Care Act (“ACA”) took a big leap forward this month with the opening of the federally-facilitated and state-operated Exchanges. Here in Kentucky, 70,467 people reportedly participated in pre-screenings to determine qualifications for subsidies, discounts, or programs like Medicaid on the Health Insurance Exchange’s first enrollment day, October 1, 2013. The ACA is eventually expected to provide health coverage to as many as 30 million additional Americans. So, why are hospitals across the nation slashing jobs? More >
The ACA Loophole Of Which Providers Should Be Aware, Part II
Earlier this week, we discussed the three-month grace period afforded to enrollees of qualified health plans (“QHPs”). To recap that article, the ACA requires that QHPs pay claims for the first thirty days of the grace period during which premium payment remains unpaid, but issuers may pend claims for the final sixty days of the grace period. If the balance remains unpaid, the issuer may deny any claims submitted within the final sixty days. More >
Clarifying the “Two-Midnight Rule” and Part A Payments, cont.
Earlier this week, I discussed CMS’ final rule on the prospective payment for acute care and long-term care hospital inpatient services for fiscal year 2014. The final rule provides guidance to physicians on how to designate a patient as inpatient or outpatient and the impact of the designation on Medicare Part A or Part B coverage. This blog will discuss the two midnight rule. More >
PHI May Be In More Places Than You Think
A recent HIPAA settlement serves as an important reminder that protected health information (PHI) may be stored on “ordinary” office equipment such as printers, photocopiers, scanners and fax machines, and not just on computer hard drives. On August 14, 2013, the Department of Health and Human Services (HHS) announced a settlement with the not-for-profit managed care plan Affinity Health Plan, Inc. (“Affinity”) for over $1.2 million in connection with HIPAA Privacy and Security breaches stemming from PHI stored on a photocopier hard drive. More >
Licensure Requirements for Home Medical Equipment Providers, Personal Service Agencies
It is no surprise that, given the current health care climate, providers who were unregulated just a few years ago are now subject to certification and licensure requirements. More >
The Pioneer Program Report Card
In 2012, thirty-two organizations were selected to participate as “Pioneers” in a pilot Accountable Care Organization (“ACO”) program created through the Affordable Care Act (“ACA”). The program’s goals were to revolutionize the health system and reduce medical costs by basing physician and hospital pay on quality rather than quantity. More >
Categorizing Nurses under the Fair Labor Standards Act
There has been a surge of nursing lawsuits in recent years, with nurses arguing they have been denied overtime pay, meal breaks, and fair wages as guaranteed to them by the Fair Labor Standards Act (“FLSA”). The FLSA makes a distinction between exempt and non-exempt employees, with the latter receiving overtime and wage protection. More >
Plan for the Worst, Hope for the Best: Why You Must Have a HIPAA Risk Assessment
“The single biggest and most common compliance weakness is the lack of a timely and thorough risk analysis.” More >
Tools for the Trade: Understanding HIPAA
As a result of the intricate details and requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), it comes as no surprise that HIPAA Privacy and Security Rules can cause challenges and confusion for even the most sophisticated providers. With this in mind, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) has recently provided tools meant to educate both consumers and providers on HIPAA. More >
