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McBrayer Blogs
Showing 59 posts in Health Care Law.
The Doctor Is Out, But The PA Will See You Now
On March 25, 2013, Governor Steve Beshear signed House Bill 104, a bill that will change how Physician Assistants (“PAs”) practice in the Commonwealth. Under former law, a PA had to be directly supervised in by a doctor in the first eighteen months of their medical practice. Kentucky had the longest supervision requirement of any state in the U.S. More >
An Analysis of Urinalysis—Considerations for Health Providers
Urinalysis, also referred to as urine drug screening, is an important procedure that health providers use for several reasons: to monitor patients’ medication compliance, detect drug abuse, or identify the presence of disease. There are numerous implications that accompany a urinalysis examination though, and health providers are sometimes left wondering if they should hand over the cup to patients. 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 >
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 >
IS HIPAA IN THE CLOUDS?
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 >
Compliance Plan – A Provider’s Defense
The Office of the Inspector General (“OIG”) has always encouraged Medicare and Medicaid providers to implement a compliance program. For 14 years, as a matter of fact, OIG has provided compliance guidance in 11 healthcare sectors (including: hospitals, nursing facilities, home healthcare, hospice and third-party billers). With the passing of the Patient Protection and Affordable Care Act (“PPACA”), compliance plans and programs are now mandatory for any provider enrolled in a Federal health care program, including Medicare. More >
Accountable Care Organizations Program Models
The Supreme Court’s decision upholding the Affordable Care Act supports The Centers for Medicare and Medicaid Services (CMS) different programs for the development of Accountable Care Organizations (ACOs). In Kentucky, we are beginning to see these organizations emerge in different models. More >
THE PERILS OF PRESCRIBING CONTROLLED SUBSTANCES
As the Kentucky Board of Medical Licensure’s (“KBML”) implementing regulations for House Bill 1 are now effective on an emergency basis for the next six months, physicians, nurse practitioners, and other licensed prescribers have specific statutory and regulatory requirements establishing when and how they may prescribe controlled substances. These rules must be followed or physicians and others may face serious consequences that include criminal misdemeanor offenses, loss of prescribing privileges, and disciplinary actions against professional licenses. All practitioners must pay careful attention to these rules because even minor violations may create problems. Because the KBML’s regulations are more comprehensive than the requirements of House Bill 1, a great deal of confusion exists concerning what physicians and practitioners are required to do and when. Recognizing that compliance with its emergency regulations may mean major changes in the way physicians practice medicine, the KBML has announced that it expects full compliance by October 1, which creates a welcome grace period. While the ambiguities and details will be worked out over the course of the next six months, physicians should take heed and incorporate these things into their practices. More >
Federal Medicaid Opt-Out Effect on Hospitals
The mandatory expansion of Medicaid was an important element of the Affordable Care Act as providing health care benefits to uninsured was intended to achieve equity. The expansion of Medicaid rolls was also intended to reduce the cost of providing care for the uninsured and the need for disproportionate share hospital funding, which is an adjustment to account for the needs of hospitals serving a large number of low-income patients. With the ability to opt out of the Affordable Care Act’s expansion of Medicaid eligibility (read more: The Federal Medicaid Apple: Poison or the Cure?), the opt-out states may create financial problems for hospitals that depend on disproportionate share payments to cover part of their costs for providing non-reimbursed services to the indigent and uninsured. The Affordable Care Act’s decrease in disproportionate share payments to hospitals is not changed by the Supreme Court’s ruling. More >
