Contact Us
Subscribe to this blog via RSS
Join us on LinkedInCategories
- 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
- HIPAA
- Chronic Pain Management
- 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
- KASPER
- Mental Health Care
- Affordable Insurance Exchanges
- Fraud
- Health Care Fraud
- HIPAA Risk Assessment
- Office for Civil Rights ("OCR")
- Stark Laws
- Kentucky’s Department for Medicaid Services
- Qui Tam
- Compliance
- Department of Health and Human Services (HHS)
- Kentucky Board of Medical Licensure
- Office of Inspector General of the United States Department of Health and Human Services (OIG)
- Physician Assistants
- HPSA
- Pharmacists
- Accountable Care Organizations (“ACO”)
- Certificate of Need ("CON")
- Federally Qualified Health Centers (“FQHCs”)
- Fee for Service
- Part D
- Rural Health Centers (“RHCs”)
- Telehealth
- Anti-Kickback Statute
- Centers for Medicare & Medicaid Services (“CMS”)
- Data Breach
- Electronic Protected Health Information (ePHI)
- False Claims Act
- Health Information Technology for Economic and Clinical Health Act (HITECH Act)
- Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Medicaid
- Medicare
- Patient Protection and Affordable Care Act (“ACA”)
- Affordable Care Act
- Health Professional Shortage Area ("HPSA")
- Hospitals
- Medical Staff By-Laws
- Medically Underserved Area ("MUA")
- Rural Health Clinic
- Alternative Payment Models
- Charitable Hospitals
- HRSA
- Limited Services Clinics
- Mid-Level Practitioners
- 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”)
- Qualified Health Care Centers (“FQHC”)
- Telemedicine
- Hydrocodone
- APRNs
- United States ex. Rel. Kane v. Continuum Health Partners
- Webinar
- 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")
- Hinchy v. Walgreen Co.
- Emergency Rooms
- Enrollment
- Kentucky Senate Bill 7
- Medicare Part D
- Minors
- Re-validation
- Texting
- Chiropractic services
- Clinical Laboratory Improvement Amendments of 1988 (“CLIA”)
- Ophthalmological services
- Physician Compare website
- All-Payer Claims Database ("APCD")
- Compliance Officer
- Essential Health Benefits
- ICD-9
- 2014 Medicare Physician Fee Schedule (“PFS”)
- 501(c)(3)
- Appeal
- Chronic Care Management
- Compounding
- CPR
- Drug Quality and Security Act (“DQSA”)
- House Bill 3204
- Kindred v. Cherolis
- Long-term care communities
- New England Compounding Center ("NECC")
- Outsourcing facility
- Ping v. Beverly Enterprises
- Power of Attorney ("POA")
- Sustainable Growth Rate (“SGR”)
- Centers for Disease Control and Prevention
- Dispenser
- Food and Drug Administratio
- HealthCare.gov
- Kynect
- Mobile medical applications ("apps")
- NADSA Conference
- National Drug Code ("NDC")
- National Institutes of Health
- Prescriber
- State Health Plan
- Affinity Health Plan
- Cadillac tax
- Community health needs assessment (“CHNA”)
- Denied Claims
- Federation of State Medical Boards (“FSMB”)
- Form 4720
- Grace Period
- Individual mandate
- Kentucky Medical Practice Act
- Model Policy for the Appropriate Use of Social Media and Social Networking in Medical Practice (“Model Policy”)
- Nonprofit hospitals
- Physician Payments
- Qualified Health Plan ("QHP")
- Social Media
- Spousal coverage
- UPS
- Arbitration
- Condition of Participation ("CoP")
- Department of Medicaid Services’ (“DMS”)
- Home Health Prospective Payment System
- Home Medical Equipment Providers
- Hospitalists
- Inpatient Care
- Licensure Requirements
- LLC v. Sutter
- Long-Term Care Providers ("LTC")
- Low-utilization payment adjustment ("LUPA")
- Medicare Shared Saving Program (MSSP)
- Network provider agreement
- Nonroutine medical supplies conversion factor (“NRS”)
- Payors
- Personal Service Entities
- Quality reporting
- Upcoding
- “Superuser”
- "Plan of Correction"
- Daycare centers
- Decertification
- Division of Regulated Child Care
- EHR vendor
- Employer Mandate
- Fair Labor Standards Act (FLSA)
- False Billings
- Health Professional Shortage Areas (“HPSA”)
- Intermediate Sanctions Agreement
- Kentucky Health Benefit Exchange
- Licensed practical nurses (LPN)
- List of Excluded Individuals and Entities
- Meaningful use incentives
- Medicare Administrative Coordinators
- Medicare Benefit Policy Manual
- Nurse practitioners (NP)
- Office of the National Coordinator for Health Information Technology (“ONC”)
- Part A
- Part B
- Physician Recruitment
- Physician shortages
- Registered nurses (RN)
- Residency Programs
- Self-Disclosure Protocol
- Statement of Deficiency ("SOD")
- Advanced Practice Registered Nurses
- Audit
- Call Coverage
- Doe v. Guthrie Clinic
- Employer Group Health Plans
- ERISA
- Group Purchasing Organizations ("GPO")
- Health Reform
- House Bill 104
- Patient Privacy
- Provider Self Disclosure Protocol
- Trade Association Group Coverage
- Business Associate Agreements
- Business Associates
- Kentucky House Bill 217
- Patient Autonomy
- Personal Health Information
- Senate Bill 39
- Senate Finance Committee Report
- State Medicaid Expansion
- Autism/ASD
- Genetic Information Nondiscrimination Act ("GINA")
- Kentucky House Bill 159
- Kentucky Primary Care Centers (“PCCs”)
- Managed Care Organizations (“MCOs”)
- Compliance Programs
- Center for Disease Control
- 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”)
- Kentucky Pharmacists Association
- Kentucky “Pill Mill Bill”
- Free Conference Committee Report
- Health Care Fraud and Abuse Control Program
- House Bill 1
- House Bill 4
- Pain Management Facilities
- Employee Agreement
- Health Insurance
- Healthcare Regulation
- Health Care Law
McBrayer Blogs
Showing 10 posts in Hospitals.
Kentucky Supreme Court Addresses Negligent Credentialing
2017 has been a banner year for developments in healthcare litigation in Kentucky. While the focus has largely been on medical review panels, another issue of importance has been that of negligent credentialing claims brought against hospitals. Nationwide, states have been split on whether this cause of action is recognized. Lost in the recent rulings regarding medical review panels was the Kentucky Supreme Court’s quiet release of its opinion on November 2, 2017 striking down negligent credentialing as a separate and new cause of action against hospitals. This opinion provides clarity for hospitals facing claims of negligence related to physicians with staff privileges at their facilities and also provides guidance for counsel to properly defend cases with credentialing allegations. More >
The Unhappy Intersection of Hospital Mergers and Antitrust Laws
The rapidly-evolving field of health care has been moving lately towards a single-minded goal – coordination of patient care in the name of efficiency and efficacy. Hospital systems are more and more often merging with other medical practices to better achieve the standards and goals of the Patient Protection and Affordable Care Act (“ACA”). The Ninth Circuit Court of Appeals, however, recently provided a stark reminder that the ACA isn’t the only law hospitals need to consider compliance with in these mergers.
More >
Medical Staff By-laws are Contracts? Minnesota Supreme Court Says “Yes”
That sound you just heard was the simultaneous gasp of hospital boards of directors throughout the state of Minnesota. In Medical Staff of Avera Marshall Regional Medical Center v. Avera Marshall, Minnesota’s highest court made two holdings that strengthened the autonomy of physicians and may shed light as to how courts may interpret medical staff by-laws in the future. More >
Telehealth/Telemedicine: An Opportunity for Physicians and Providers to Add a New Line of Service
The cost effectiveness of providing health care via telemedicine or telehealth promises to be an effective tool to increase coverage and reimbursement of healthcare provided remotely or through telehealth. Towers Watson, a national consulting company, recently published a 2014 study that suggests that telemedicine could save $6 billion annually for the health care industry. "Achieving this savings requires a shift in patient and physician mindsets, health plan willingness to integrate and reimburse such services, and regulatory support in all states," according to Dr. Allan Khoury, a senior consultant at Towers Watson.[1] Recent studies have assigned significant cost savings generated by telehealth use that include cost savings of $537 million per year for emergency departments using telehealth to reduce transfers and spending reductions of 7.7% to 13.3% per person per quarter in the cost of care for chronically ill Medicare beneficiaries using a health buddy via telehealth. [2] As the cost effectiveness of providing services via telehealth and telemedicine is proven, Medicare, most state Medicaid programs and commercial insurers are increasing coverage as well as reimbursement for telehealth services. State law requirements for providing telehealth and coverage differ greatly. Consequently, physicians and health care providers should be aware of the complexity of providing telehealth and its requirements, but should also incorporate telehealth services into their practices as a new way of providing services and a new line of business. More >
The ACA’s Effect on Nonprofit Hospitals
By considering the promotion of health a charitable endeavor, the IRS has long granted nonprofit hospitals tax-exempt status under 501(c)(3), the charitable organization exemption. To maintain their status, nonprofit hospitals have always been required to meet specific requirements, such as having an independent board of trustees or offering preventive health outreach programs in their communities. 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 >
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 >
Clarifying the “Two-Midnight Rule” and Part A Payments
In August, the Centers for Medicare and Medicaid Services (“CMS”) announced a final rule regarding the prospective payment for acute care and long-term care hospital inpatient services for fiscal year 2014. This rule becomes effective on October 1, 2013. More >
Beyond Making the Rounds: Hospitalists & Quality of Care under the ACA, cont.
On Tuesday, I discussed how hospitalists play a vital role in meeting the ACA's quality of care standards for the inpatient setting. Now, let's take a look at how PCPs must also work to meet these same standards. More >
Beyond Making the Rounds: Hospitalists & Quality of Care under the ACA
By now, everyone knows the Affordable Care Act’s (“ACA”) motto is “increase quality, decrease costs.” As providers transition from the fee for service payment model to new payment systems that are tied to quality, one subset of providers will play a pivotal role in bringing health care into a new era: hospitalists. More >
