Contact Us
Subscribe to this blog via RSS
Join us on LinkedInCategories
- Medical Cannabis
- SB 47
- Workplace Violence
- Assisted Living Facilities
- Department of Health and Human Services' Office of Civil Rights
- Medical Residents
- EMTALA
- FDA
- Reproductive Rights
- Roe v. Wade
- SCOTUS
- 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
- Acute Care Beds
- COVID-19
- Families First Coronavirus Response Act
- Family and Medical Leave Act (“FMLA”)
- KBML
- medication assisted therapy
- SB 150
- Clinical Support
- Coronavirus
- Emergency Medical Services
- Emergency Preparedness
- 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
- Senate Bill 4
- Physician Prescribing Authority
- Chronic Pain Management
- HIPAA
- Prescription Drugs
- "Two Midnights Rule"
- 340B Program
- Hospice
- Kentucky minimum wage
- Minimum wage
- Skilled Nursing Facilities (“SNFs”)
- Uncategorized
- Drug Screening
- EHR Systems
- Electronic Health Records (“EHR")
- ICD-10
- Mental Health Care
- Primary Care Physicians ("PCPs")
- Urinalysis
- Accountable Care Organizations (“ACO”)
- Affordable Insurance Exchanges
- Anti-Kickback Statute
- Centers for Medicare & Medicaid Services (“CMS”)
- Certificate of Need ("CON")
- Compliance
- Data Breach
- Department of Health and Human Services (HHS)
- Electronic Protected Health Information (ePHI)
- False Claims Act
- Federally Qualified Health Centers (“FQHCs”)
- Fee for Service
- Fraud
- Health Care Fraud
- Health Information Technology for Economic and Clinical Health Act (HITECH Act)
- Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- HIPAA Risk Assessment
- HPSA
- KASPER
- Kentucky Board of Medical Licensure
- Kentucky’s Department for Medicaid Services
- Office for Civil Rights ("OCR")
- 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
- American Telemedicine Association (“ATA”)
- Charitable Hospitals
- Criminal Division of the Department of Justice (“DOJ”)
- Health Care Fraud Prevention and Enforcement Action Team (“HEAT”)
- 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”)
- Qualified Health Care Centers (“FQHC”)
- Rural Health Clinic
- Telemedicine
- APRNs
- Chain and Organization System (“PECOS”)
- Hydrocodone
- Jimmo v. Sebelius
- Kentucky Pharmacists Association
- Maintenance Standard
- United States ex. Rel. Kane v. Continuum Health Partners
- Webinar
- Agreed Order
- All-Payer Claims Database ("APCD")
- Chiropractic services
- Clinical Laboratory Improvement Amendments of 1988 (“CLIA”)
- Compliance Officer
- Douglas v. Independent Living Center of Southern California
- Drug Enforcement Agency ("DEA")
- Emergency Rooms
- Enrollment
- Essential Health Benefits
- Hinchy v. Walgreen Co.
- ICD-9
- Kentucky Senate Bill 7
- Medicare Part D
- Minors
- Ophthalmological services
- Overpayments
- Physician Compare website
- Re-validation
- Texting
- Vitas Innovative Hospice Care
- "Plan of Correction"
- 2014 Medicare Physician Fee Schedule (“PFS”)
- 501(c)(3)
- Affinity Health Plan
- Appeal
- Arbitration
- Cadillac tax
- Centers for Disease Control and Prevention
- Chronic Care Management
- Community health needs assessment (“CHNA”)
- Compounding
- Condition of Participation ("CoP")
- CPR
- Daycare centers
- Denied Claims
- Department of Medicaid Services’ (“DMS”)
- Dispenser
- Division of Regulated Child Care
- Drug Quality and Security Act (“DQSA”)
- Employer Mandate
- Federation of State Medical Boards (“FSMB”)
- Food and Drug Administratio
- Form 4720
- Grace Period
- Health Professional Shortage Areas (“HPSA”)
- HealthCare.gov
- Home Health Prospective Payment System
- Home Medical Equipment Providers
- Hospitalists
- House Bill 3204
- Individual mandate
- Inpatient Care
- Intermediate Sanctions Agreement
- Kentucky Health Benefit Exchange
- Kentucky Medical Practice Act
- Kindred v. Cherolis
- Kynect
- Licensure Requirements
- LLC v. Sutter
- 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
- Network provider agreement
- New England Compounding Center ("NECC")
- Nonprofit hospitals
- Nonroutine medical supplies conversion factor (“NRS”)
- Outsourcing facility
- Payors
- Personal Service Entities
- Physician Payments
- Physician Recruitment
- Physician shortages
- Ping v. Beverly Enterprises
- Power of Attorney ("POA")
- Prescriber
- Qualified Health Plan ("QHP")
- Quality reporting
- Residency Programs
- Social Media
- Spousal coverage
- State Health Plan
- Statement of Deficiency ("SOD")
- Sustainable Growth Rate (“SGR”)
- Upcoding
- UPS
- “Superuser”
- Advanced Practice Registered Nurses
- Audit
- Autism/ASD
- Business Associate Agreements
- Business Associates
- Call Coverage
- Decertification
- Doe v. Guthrie Clinic
- EHR vendor
- Employer Group Health Plans
- ERISA
- Fair Labor Standards Act (FLSA)
- False Billings
- Genetic Information Nondiscrimination Act ("GINA")
- Group Purchasing Organizations ("GPO")
- Health Reform
- House Bill 104
- Kentucky House Bill 159
- Kentucky House Bill 217
- Kentucky Primary Care Centers (“PCCs”)
- Licensed practical nurses (LPN)
- List of Excluded Individuals and Entities
- Managed Care Organizations (“MCOs”)
- 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
- Patient Autonomy
- Patient Privacy
- Personal Health Information
- Provider Self Disclosure Protocol
- Registered nurses (RN)
- Self-Disclosure Protocol
- Senate Bill 39
- Senate Finance Committee Report
- State Medicaid Expansion
- Trade Association Group Coverage
- Abuse and Waste
- Center for Disease Control
- Compliance Programs
- Consumer Operated and Oriented Plan programs (“CO-OPS”)
- Critical Access Hospitals (“CAHs”)
- Essential Health Benefits (“EHBs”)
- Healthcare Information and Management Systems Society (HIMSS)
- Kentucky Cabinet for Health and Family Services
- Kentucky Health Care Co-Op
- Kentucky Health Cooperative (“KYHC”)
- Medicare Audit Improvement Act of 2012
- Occupational Safety and Health Administration (“OSHA”)
- Recovery Audit Contractors (“RAC”)
- Small Business Health Options Program (“SHOP”)
- Sunshine Act
- Employee Agreement
- Free Conference Committee Report
- Health Care Fraud and Abuse Control Program
- Health Insurance
- Healthcare Regulation
- House Bill 1
- House Bill 4
- Kentucky “Pill Mill Bill”
- Pain Management Facilities
- Health Care Law
McBrayer Blogs
Showing 6 posts in Rural Health Centers (“RHCs”).
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 >
RHCs and FQHCs – It’s time to take a second look at Alternate Payment Methodology
In July of 2014, Kentucky Medicaid established an Alternate Payment Methodology (“APM”) for all Federally-Qualified Health Centers (“FQHCs”) and Rural Health Clinics (“RHCs”) as an alternative to the all-inclusive encounter rate per patient under the standard prospective payment system (“PPS”) of 42 U.S.C. 1369a(aa). The APM allows for qualified centers to be reimbursed at a rate of 125% of the 2014 Medicare Upper Payment Limit for RHCs in place of the PPS system ($99.75 per covered visit). There are more advantages to APM than meet the eye, however, and qualified centers currently using PPS method should at the very least reevaluate APM, as proposed changes will make APM even more attractive and potentially risk-free. More >
Five Things to Know about Transitional Care Management
Tuesday’s post discussed the basics of Transitional Care Management (“TCM”), but today’s post will focus on five things that providers should know about TCM. More >
Kentucky Rural Health Clinics and FQHC’s/Look- A-Likes with Low Rates—Don’t Overlook this Rate Increase!
Approved by CMS and effective July 1, 2014, Kentucky’s Medicaid Program may now pay certain Rural Health Clinics (“RHC”), Federally Qualified Health Care Centers (“FQHC”) and Look-a-Likes a higher rate. The Department of Medicaid Services (“Medicaid”) sought approval to pay RHCs, FQHCs and Look-A-Likes that have a low per visit PPS rate at a rate equal to 125% of the Medicare rate. This means that Kentucky RHCs, FQHCs and Look-A-Likes with low Medicaid rates, just got a raise-- that is if they claim it! While the Medicaid State Health Plan Amendment provides that an “Alternative Payment Methodology” is now available, this really means that clinics with low rates can ask to be paid at a higher rate per visit without qualifying for a change in scope of service. This increase in rate is supposed to be effective on July 1, 2014, but is based upon the Medicare Upper Payment Limit for RHCs as of September 30, 2014 and the rate as we calculate it is approximately $99.70. Essentially, this means that providers with rates below the $99.70 threshold may elect to be paid under the alternative payment methodology. 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 >
The Wrap-Around Slap-Around for Primary Care Centers
For Kentucky Primary Care Centers (“PCCs”), Rural Health Centers (“RHCs”), and Federally Qualified Health Centers (“FQHCs”), getting the run-around from Medicaid on wrap-around payments is not so unusual. Frequently, these providers complain that supplemental payments distributed by the Kentucky Department for Medicaid Services’ (“Medicaid”) are too low, too late or both. More >
