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New Rule Brings Sweeping Changes to Physician Privacy

On January 17, the U.S. Department of Health and Human Services (HHS) announced that the Centers for Medicare & Medicaid Services (CMS) would begin granting Freedom of Information Act (FOIA) requests for Medicare reimbursement to individual physicians on a “case-by-case basis.”  The new policy, effective March 18, 2014, is a departure from CMS’ long-standing practice of withholding information on physician reimbursement under the Medicare program. More >

The Affordable Care Act & Small Business Recap

On February 4, McBrayer and Business Lexington presented a panel discussion on how small businesses can navigate the Affordable Care Act. I was honored to moderate the event and hope that attendees benefited from the panel’s real-world advice on how to traverse the new landscape of health insurance. A huge thank you to the panelists: Jon Carroll, Beverly Clemons, Betsy Johnson, Cris Miller, and Garry Ramsey. More >

Small Devices & Big Consequences: Why Medical Practices Need Encryption

On Tuesday, I shared information about the U.S. Health and Human Services (“HHS”) Office of Civil Rights’ (“OCR”) first settlement with a medical practice for alleged violations of the breach notification provisions of the Health Information Technology for Economic and Clinical Health (“HITECH”) Act. The $150,000 settlement was made with Adult & Pediatric Dermatology, P.C., (“the Practice”) after the entity reported a stolen jump drive that contained PHI of approximately 2,200 patients. More >

Coming to a Medical Practice near You: HIPAA and Hi-Tech Audits

On December 26, 2013, the U.S. Health and Human Services Office of Civil Rights (“OCR”) announced  its first settlement with a covered entity for not having policies and procedures in place to address the breach notification provisions of the Health Information Technology for Economic and Clinical Health (“HITECH”) Act. Adult & Pediatric Dermatology, P.C., (“the Practice”) of Concord, Massachusetts agreed to settle potential violations with a $150,000 penalty and corrective action plan. More >

Part II: Understanding All-Payer Claims Databases

Earlier this week, we discussed the benefits of all-payer claims database (“APCD”) systems. Nine states currently have APCDs in place, but Kentucky is not one of them. These systems provide a multitude of information on the cost, use, and quality of health care in a given state, but the question remains: how do providers feel about APCDs? More >

Part I: Understanding All-Payer Claims Databases

Over the last decade, many states have established all-payer claims database (“APCD”) systems that collect medical, pharmaceutical, and dental eligibility and claims information. Payers, including insurance providers, third-party administrators, prescription drug plans, Medicaid, and Medicare, are responsible for depositing eligibility and claims data into a collective system. The data can then be used to generate important information about cost and quality of care. By gathering detailed information in one place, a statewide picture emerges – information on service providers, patient demographics, and other important healthcare data. More >

Major Money Marked for Addiction Treatment in Kentucky

The Commonwealth of Kentucky has long suffered from a prescription drug abuse and methamphetamine problem, and heroin use has also been on the rise recently. As a result, more than $32 million is being set aside to help address the growing substance abuse problem in Kentucky. The much-needed funds are a result of settlements with two pharmaceutical companies, according to Attorney General Jack Conway. More >

Part II: Are U.S. Providers Ready to Catch Up in Medical Coding?

If you are a provider and are unsure about the differences in ICD-9 and ICD-10 codes or why there is a need for implementation, I highly suggest you read Tuesday’s post. More >

Are U.S. Providers Ready to Catch Up in Medical Coding?

After the bungled introduction of HealthCare.gov, providers are unquestionably leery of other technical health care-related requirements on the horizon. If there is a lesson to be learned in the wake of the Health Exchange debacle, it is this: it is never too early to prepare for change. More >

The Sun is Not Setting on the EHR Safe Harbor

The Centers for Medicare & Medicaid Services (“CMS”) and the U.S. Department of Health & Human Services Office of the Inspector General (“OIG”) recently announced that the regulation allowing certain health care entities to donate electronic health records (with the entity subsiding up to 85% of the donor’s costs) to physicians has been extended to December 31, 2021. The regulation, which provided a safe harbor from the Stark Law and Anti-kickback statute, was set to expire on December 31, 2013. More >

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