Lobbying Affiliate: MML&K Government Solutions
{ Banner Image }

Healthcare Law Blog

Comprehensive Healthcare law services.
It's kind of our bag.

Contact Us

250 Character(s) Remaining
Type the following characters: hotel, whisky, three, mike, niner

* Indicates a required field.

Stay Connected

RSSSubscribe to this blog via RSS
Join us on LinkedIn
Facebook

Archives

Categories

McBrayer Blogs

Related Blogs

Showing 63 posts from 2015.

Lessons Learned from Recent Data Security Breaches, Part One

March 17, 2015
Posted In Data Breach, Electronic Protected Health Information (ePHI), Health Information Technology for Economic and Clinical Health Act (HITECH Act), Health Insurance Portability and Accountability Act of 1996 (HIPAA)

The recent series of security breaches at Target, Sony, Home Depot, and Anthem Inc. serve as stark reminders that all organizations, even the ones with most secure networks, face significant cybersecurity threats and challenges that could cause substantial financial costs and reputational damage. The Anthem security breach, in particular, should sound alarms about the need to improve the security of protected health information (“PHI”) for every covered entity. This week’s posts will discuss what health care providers can learn about preventing data breaches based on the breaches at Anthem and Target. More >

CMS Rule on Medicare Overpayments? Don’t Hold Your Breath

March 12, 2015
Posted In Centers for Medicare & Medicaid Services (“CMS”), False Claims Act, Medicaid, Medicare, Patient Protection and Affordable Care Act (“ACA”)

Since the Center for Medicare & Medicaid Services proposed a rule three years ago suggesting that providers could be liable for returning Medicare overpayments going back ten years, providers have been anxiously awaiting a final ruling. Unfortunately, providers’ anticipation for a final ruling will have to continue. On February 16th, CMS announced that it would delay the final rule on reporting and returning overpayment…by another full year! More >

Kentucky’s Evolving Behavioral Health Providers

By Lisa English Hinkle on March 10, 2015
Posted In Affordable Care Act, Medicaid, Medicare, Patient Protection and Affordable Care Act (“ACA”)

Psychology TherapyOne of the most important effects of the Patient Protection and Affordable Care Act (“ACA”) is the profound change in the coverage of behavioral health services. Building on the Mental Health Parity and Addiction Equity Act of 2008, the ACA requires both Medicaid and Medicare to provide far more robust behavioral health benefits, especially in the area of substance abuse. This expansion of benefits is not without growing pains - health care providers are waking up to the new reality of a vastly expanded need for substance abuse and other mental health services as well as providers. As state Medicaid programs struggle to finance these new benefits, the need for behavioral health care providers and clinicians has become acute. This is especially true in Kentucky, where access to substance abuse care is crucial due to the epidemic of prescription drug and heroin addictions. Fortunately, however, the Cabinet for Health and Family Services has taken proactive steps to strengthen and expand behavioral health infrastructure to meet the ACA’s directives. More >

The Unhappy Intersection of Hospital Mergers and Antitrust Laws

March 5, 2015
Posted In Affordable Care Act, Hospitals

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.Modern Hospital More >

Medical Staff By-laws are Contracts? Minnesota Supreme Court Says “Yes”

March 3, 2015
Posted In Hospitals, Medical Staff By-Laws

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 >

The Importance of HPSA and MUA Designation

February 24, 2015
Posted In Affordable Care Act, Health Professional Shortage Area ("HPSA"), Medically Underserved Area ("MUA"), Rural Health Clinic

Rural communities in Kentucky are still largely underserved by health care providers. With the expanded range of Medicaid and Medicare services now available as a result of the Patient Protection and Affordable Care Act (“ACA”), rural health care infrastructure needs a shot in the arm to meet the demand. Fortunately, several programs exist to incentivize the provision of rural health care, and Kentucky providers in underserved areas should begin taking advantage of them. More >

HIPAA and “Meaningful Use” Audits: Issues to Consider and How to Prepare

By Christopher J. Shaughnessy on February 19, 2015
Posted In Audit, Electronic Health Records (“EHR"), Health Insurance Portability and Accountability Act of 1996 (HIPAA), HIPAA Risk Assessment, Meaningful use incentives

As more and more providers adopt electronic health records (“EHRs”) systems (and with new regulations concerning their required use for purposes of Medicare billing for chronic care management, their popularity can only continue to grow), a myriad of compliance issues continue to surround them. To that end, the federal government has stepped up auditing programs to ensure compliance with HIPAA/HITECH as well as making sure taxpayer money has been invested wisely through the Meaningful Use program. The bent of these audit programs is clearly along the lines that applicable covered entities and business associates should be preparing with a “when” mindset, rather than “if,” as these audits are going to happen. More >

What the Anthem Cyberattack Means for the Health Care Industry

By Anne-Tyler Morgan on February 12, 2015
Posted In Data Breach, Electronic Protected Health Information (ePHI), Health Insurance Portability and Accountability Act of 1996 (HIPAA), Patient Privacy

Unfortunately, account hacks and data breaches are nothing new. Every day, we hear reports of hackers compromising networks and their protected data. When it happens on a massive scale to a powerful player in the health insurance industry, however, all health care entities should sit up and take note. On February 4, 2015, Anthem Inc. (“Anthem”), the second largest health insurance company in America, admitted that hackers compromised the company’s network and stole the information of up to 80 million customers. This may be the largest health-related data breach in history. More >

Quality Over Quantity: The Shift from Fee-for-Service to Value-Based Payment Systems

By Anne-Tyler Morgan on February 10, 2015
Posted In Accountable Care Organizations (“ACO”), Alternative Payment Models, Fee for Service, Health Care Law, Medicare

The United States Department for Health and Human Services (“HHS”) recently announced its intention to tie thirty percent of fee-for-service Medicare payments to alternative and value-based payment models by 2016. HHS hopes to increase that amount to fifty percent by the end of 2018. Currently, up to twenty percent of payments are made through alternative models, a substantial increase in a short amount of time since almost no payments were made through alternative models as recently as 2011. Two days after HHS’ announcement, a group of key health care industry stakeholders announced the formation of the Health Care Transformation Task Force, a new industry consortium making a public commitment to transition seventy-five percent of its business between now and 2020 to value-based arrangements. These developments demonstrate the shift from fee-for-service payments based on quantity of work regardless of outcome and signals a larger trend to seek quality over quantity. With the seemingly meteoric rise of value-based care, it is important to understand the ramifications of alternative payment models within the health care industry as a whole. More >

New Rule on Medicare Reimbursement for Chronic Care Management Services

February 5, 2015
Posted In Centers for Medicare & Medicaid Services (“CMS”), Chronic Care Management, Medicare

In November 2014, the Centers for Medicare & Medicaid Services (“CMS”) issued a final regulation with changes intended to ensure Medicare’s payment system “reflect[s] changes in medical practice and the relative value of services, as well as changes in the statute.”[1] One of the beneficial changes for physicians is the new Medicare reimbursement of chronic care management (“CCM”) services, which began with the New Year on January 1, 2015. All providers should pay special attention to the essential requirements for chronic care management reimbursement and begin identifying eligible fee-for-service Medicare patients. More >

Lexington, KYLouisville, KYFrankfort, KYFrankfort, KY: MML&K Government Solutions