Contact Us
Categories
- 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
- Physician Prescribing Authority
- Senate Bill 4
- 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")
- HIPAA Risk Assessment
- KASPER
- Mental Health Care
- Office for Civil Rights ("OCR")
- Urinalysis
- Accountable Care Organizations (“ACO”)
- Affordable Insurance Exchanges
- Anti-Kickback Statute
- Certificate of Need ("CON")
- Compliance
- Department of Health and Human Services (HHS)
- Federally Qualified Health Centers (“FQHCs”)
- Fee for Service
- Fraud
- Health Care Fraud
- HPSA
- 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)
- Part D
- Pharmacists
- Physician Assistants
- Qui Tam
- Rural Health Centers (“RHCs”)
- Stark Laws
- Telehealth
- Affordable Care Act
- Alternative Payment Models
- Centers for Medicare & Medicaid Services (“CMS”)
- Charitable Hospitals
- 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)
- Health Professional Shortage Area ("HPSA")
- Hospitals
- HRSA
- Kentucky Board of Nursing
- 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
- 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
- Webinar
- Agreed Order
- APRNs
- Chain and Organization System (“PECOS”)
- Drug Enforcement Agency ("DEA")
- Hinchy v. Walgreen Co.
- Jimmo v. Sebelius
- Maintenance Standard
- Overpayments
- United States ex. Rel. Kane v. Continuum Health Partners
- 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
- Douglas v. Independent Living Center of Southern California
- Emergency Rooms
- Enrollment
- Essential Health Benefits
- ICD-9
- Kentucky Senate Bill 7
- Medicare Part D
- Minors
- Ophthalmological services
- Physician Compare website
- Re-validation
- 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
- Department of Medicaid Services’ (“DMS”)
- Dispenser
- Drug Quality and Security Act (“DQSA”)
- Federation of State Medical Boards (“FSMB”)
- Food and Drug Administratio
- Form 4720
- Grace Period
- HealthCare.gov
- Home Health Prospective Payment System
- 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")
- Low-utilization payment adjustment ("LUPA")
- Medicare Shared Saving Program (MSSP)
- 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
- Nonroutine medical supplies conversion factor (“NRS”)
- Outsourcing facility
- Personal Service Entities
- Physician Payments
- Ping v. Beverly Enterprises
- Power of Attorney ("POA")
- Prescriber
- Qualified Health Plan ("QHP")
- Quality reporting
- Social Media
- Spousal coverage
- State Health Plan
- UPS
- “Superuser”
- "Plan of Correction"
- Advanced Practice Registered Nurses
- Arbitration
- Audit
- Business Associate Agreements
- Business Associates
- 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
- Group Purchasing Organizations ("GPO")
- Health Professional Shortage Areas (“HPSA”)
- Health Reform
- Hospitalists
- House Bill 104
- Intermediate Sanctions Agreement
- Kentucky Health Benefit Exchange
- Kentucky House Bill 217
- 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 Autonomy
- Patient Privacy
- Payors
- Personal Health Information
- Physician Recruitment
- Physician shortages
- Provider Self Disclosure Protocol
- Registered nurses (RN)
- Residency Programs
- Self-Disclosure Protocol
- Senate Bill 39
- State Medicaid Expansion
- Statement of Deficiency ("SOD")
- Trade Association Group Coverage
- Upcoding
- Autism/ASD
- Center for Disease Control
- Compliance Programs
- Critical Access Hospitals (“CAHs”)
- Essential Health Benefits (“EHBs”)
- Genetic Information Nondiscrimination Act ("GINA")
- Healthcare Information and Management Systems Society (HIMSS)
- Kentucky House Bill 159
- Kentucky Primary Care Centers (“PCCs”)
- Managed Care Organizations (“MCOs”)
- Medicare Audit Improvement Act of 2012
- Recovery Audit Contractors (“RAC”)
- Senate Finance Committee Report
- Small Business Health Options Program (“SHOP”)
- Sunshine Act
- Abuse and Waste
- Consumer Operated and Oriented Plan programs (“CO-OPS”)
- Free Conference Committee Report
- House Bill 1
- House Bill 4
- Kentucky Cabinet for Health and Family Services
- Kentucky Health Care Co-Op
- Kentucky Health Cooperative (“KYHC”)
- Kentucky “Pill Mill Bill”
- Occupational Safety and Health Administration (“OSHA”)
- Pain Management Facilities
- Employee Agreement
- Health Care Fraud and Abuse Control Program
- Health Insurance
- Healthcare Regulation
- Health Care Law
McBrayer Blogs
Showing 8 posts tagged Department of Health & Human Services (“HHS”).
OIG, in a Departure, Approves Hospital Provision of Nurse Practitioner Services
Traditionally, the Office of the Inspector General for the U.S. Department of Health and Human Services (“OIG”) would take a hard stance on any arrangements that might involve some form of remuneration from a hospital to a referring physician, but the winds of change may be blowing. In Advisory Opinion 22-20, published in December of 2022, the OIG has given a green light, albeit in a limited context, to an arrangement in which a hospital may have its employee nurse practitioners perform some services traditionally performed by the patients’ primary care physicians. This is a small step in the direction of a more flexible OIG stance on the federal Anti-Kickback Statute (“AKS”), but it doesn’t completely sidestep risks. More >
SCOTUS Blocks OSHA ETS; Healthcare Mandate Moves Forward
Thursday afternoon, the United States Supreme Court ruled to block the Emergency Temporary Standard (ETS) issued by the U.S. Occupational Safety and Health Administration (OSHA) that would require private employers of 100 or more workers to mandate employee vaccination against COVID-19, or weekly testing for the virus. The Court upheld, however, a similar rule for healthcare employers contracted with the Centers for Medicare and Medicaid Services (“CMS”) as further outlined below. More >
Pandemic Pivot to Telemedicine Creates New Compliance Issues for Healthcare Providers
The shift to telemedicine in the United States predates the pandemic, but COVID-19 has accelerated its widespread use. In April of 2019, the Centers of Medicare and Medicaid Service (CMS) finalized rules to increase telehealth benefits for Medicare Advantage enrollees, effectively incentivizing health systems with high numbers of private Medicare plan recipients to invest in telehealth services. 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 >
Getting Long-Term Lost with Compliance for Long Term Care? OIG Has A Roadmap
Long Term Care (“LTC”) facilities have been a renewed area of focus for regulators in recent years, due to changes in Medicare and the potential for harm to a vulnerable population at the hands of bad actors. In April of 2019, for instance, the U.S. Department of Health & Human Services Office of Inspector General (“OIG”) put out a Data Brief with the ominous headline, “Trends in Deficiencies at Nursing Homes Show That Improvements Are Needed To Ensure the Health and Safety of Residents.” Unfortunately, this renewed focus exponentially increases the need for a push to instill compliance as a key tenet of a facility’s culture. Luckily, in 2000 and again in 2008, the OIG released a very clear roadmap for compliance that’s still reliable today. We’ll hit some of the highlights. More >
A New Opportunity: Centers for Medicare and Medicaid Services Recognizes the Full Potential of Ambulance Crews and Services
In mid-February 2019, the Centers for Medicare and Medicaid Services (“CMS”), Innovation Center and the Department for Health and Human Services (“HHS”) announced a ground-breaking payment and medical services initiative for ambulance providers called “Emergency Triage, Treat and Transport” (the “ET3”). This new model is the first step in allowing providers of Emergency Medical Services to finally “take off the gloves” to fully utilize both their medical skills and unique patient knowledge to implement a more efficient and effective care model. More >
HHS Finalizes Exception to HIPAA Privacy Rule for Firearm Background Checks
In January of 2016, the Department of Health & Human Services (“HHS”) issued a final rule modifying the HIPAA Privacy Rule.[1] This modification allows certain covered entities to disclose the identities of certain individuals to the National Instant Criminal Background Check System (“NICS”), a database maintained by the FBI. The information disclosed by the entities would pertain to an individual’s mental health, preventing those subject to a federal “mental health prohibitor” from possessing or receiving a firearm. Such a disclosure naturally creates a tension in the patient-provider relationship, however, and critics contend it could potentially discourage mentally ill individuals from seeking treatment.