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McBrayer Blogs
Showing 72 posts from 2013.
More on the Final HIPAA Omnibus Rule
To follow up our previous blog on the Final Omnibus Rule (“Rule”) regarding HIPAA and HITECH, 78 Fed.Reg. 17, Part II, 5566-5702 (Jan. 25, 2013), which modifies 45 CFR Parts 160 and 164, we will now discuss the changes to the Breach Notification Rule. The modifications will greatly reshape how Covered Entities and Business Associates view a breach. More >
HHS Issues Final HIPAA Omnibus Rule
The U.S. Department of Health and Human Services (“HHS”) recently announced its issuance of the highly-anticipated regulations or Final Omnibus Rule (“Rule”) relating to the modification of the HIPAA Privacy, Security, and Enforcement rules under the Health Information Technology for Economic and Clinical Health Act (“the HITECH Act”). 78 Fed.Reg. 17 Part II (January 25, 2013) modifying 45 CFR Parts 160, 162, 164. The Final Rule, 78 Fed.Reg. 17 Part II, 563 pages in length, makes significant changes of which all providers need to be aware. A complete examination of the sweeping changes cannot be done in one article, so we will make a general summary of the most important changes. More >
Kentucky Health Cooperative One Step Closer
The Kentucky Department of Insurance just approved Kentucky Health Cooperative’s (“KYHC”) entry into the Commonwealth of Kentucky’s HMO insurance market. With this endorsement, KYHC will now be allowed to offer health plans to hundreds of thousands of Kentuckians beginning in October 2013. Benefits are set to begin in January 2014—the deadline for when most citizens will be required to have health insurance under the laws of the Affordable Care Act (“ACA”). 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 >
Medicaid Expansion in Kentucky
The Supreme Court upheld much of President Obama’s Patient Protection and Affordable Care Act (“PPACA”) in National Federation of Independent Business et al v. Sebelius, but overturned a key element of PPACA’s Medicaid expansion provisions. Originally, PPACA required states to expand Medicaid coverage to individuals at or below 133 percent of the federal poverty level or risk forfeiting existing federal funding for the state’s Medicaid program. In National Federation, the Supreme Court held that PPACA could not withdraw existing Medicaid funding from states choosing not to expand their programs. This change presents each state with a meaningful choice to opt in or out of PPACA’s Medicaid expansion. More >
Senate Finance Committee Takes an In-Depth Look at Fraud & Abuse
Earlier this week, I discussed the HHS and DOJ Annual Report for the Health Care Fraud and Abuse Program. HHS and DOJ are not the only ones who are determined to purge the health care industry of its woes. On January 31, 2013 a group of six current and former members of the Senate Finance Committee released a comprehensive report detailing recommendations on combating waste, fraud and abuse in the Medicare and Medicaid Programs. More >
Annual Report Details Record Breaking Success in Health Care Fraud Prevention
The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), required the establishment of a national Health Care Fraud and Abuse Control Program (“HCFAC”). The HCFAC Program is a joint Department of Justice (“DOJ”) and Health and Human Services (“HHS”) coordination of federal, state and local law enforcement activities to combat fraud committed against all health plans, both public and private. More >
CMS 2014 Call Letter: A Bright Future for CMS Star Rating System
On February 15, the Centers for Medicare & Medicaid Services (CMS) issued the draft calendar year (CY) 2014 Call Letter for the Medicare Advantage (MA) and Part D programs (Call Letter). It contains information that MA organizations and Part D plan sponsors (collectively, Plan Sponsors) need to prepare their 2014 bids and operations. More >
CMS Proposes to Change Physician Requirements for RHC's and FQHC's
Since the passage of the Patient Protection and Affordable Care Act of 2010 (“PPACA”), many providers, suppliers and physicians that were enrolled in Medicare and Medicaid were mandated to create compliance programs for their healthcare facilities. Since that time, small and rural providers have been scrambling to adopt and implement programs that can adequately withstand regulatory and law enforcement scrutiny. Larger providers, such as multi-state hospitals, were already equipped with a compliance program. It is the small and rural providers, limited by staff and financial resources, which have had their hands full complying with the new regulatory requirements. More >
State Legislation, the ACA, and Autism: New Laws Bring in Waves of Change
In recent years, state legislators across the country have closely focused on a specific health problem that can affect mental capacity: autism. Autism and autism spectrum disorders (ASD’s) cause developmental disabilities and numerous social, behavioral, and physical challenges. The tragedy at Sandy Hook Elementary School renewed intense public debate about this particular diagnosis and treatment of other mental health issues. More >
