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McBrayer Blogs
THE KENTUCKY HEALTH BENEFIT EXCHANGE: LITTLE GNOME FACTS
“Like Travelocity but for health insurance” is how Executive Director Carrie Banahan and Deputy Director Bill Nold of the Office of Kentucky Health Benefit Exchange describe the developing Kentucky Exchange. More >
Changes to Deadlines for Stage Two – Meaningful Use in the Medicare and Medicaid EHR Incentive Programs
Under the Health Information Technology for Economic and Clinical Health (“HITECH”) Act, health care professionals and hospitals may qualify for incentive payments when they adopt and meaningfully use certified electronic health records (“EHR") under a three stage process. More >
Here Comes the Sun, Are you Prepared? – Tips for Navigating the New Sunshine Provisions
The Sunshine Act was legislated as part of the Patient Protection and Affordable Care Act (the “ACA”) to reduce the risk of inappropriate financial incentives interfering with medical judgment and patient care by enhancing the transparency of financial relationships between certain health care providers (i.e. physicians and teaching hospitals) and manufacturers of covered drugs and devices. Because these relationships are being scrutinized now more than ever, those involved in clinical research with manufacturers of drug and device companies may find the following these general guidelines helpful in avoiding risks of non-compliance and legal complications: . More >
THE “WILD WILD WEST” OF SMS
SMS text messaging is quickly becoming the preferred method of communication for many people who find it a quick and convenient way to share information with friends, family and, increasingly, with colleagues. This is true in the health care space as well with patients increasingly using text messaging to communicate with providers and to receive health-related reminders and updates, including for health care appointments, medication therapies and health news. For example, anyone can text the word HEALTH to 87000 and begin receiving text messages from the Center for Disease Control regarding emergency alerts, new research and reports, as well as health information and tips. More >
Is a Cloud Vendor a Business Associate?
Before a covered entity can use cloud storage for ePHI, the covered entity must enter into a business associate agreement (BAA) with the cloud vendor.[i] It seems that there is some uncertainty surrounding this requirement, with some cloud vendors taking the position that a BAA is unnecessary for passive storage of ePHI or that they qualify for an exception under HITECH Act as a personal health records vendor. More >
IS HIPAA IN THE CLOUDS?
Virtual or “cloud” data storage is an increasingly popular method for storing data electronically in a safe and yet conveniently accessible manner that may also represent a cost savings over traditional onsite data storage options. Health care providers, including hospitals, pharmacies and physicians, have been slow to avail themselves of the benefits of “cloud computing” due in part to concerns about whether the cloud offers the rigorous privacy and security safeguards required for storing electronic protected health information (ePHI) under Federal and State privacy laws, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH Act) and implementing regulations. More >
Guess Who’s Coming to Visit? Long-Term Care Facility Inspections
Compliance and preparedness are two very real, everyday concerns for long-term care facilities. Not only are these important aspects of daily operations for the safety of the employees and patients, they are paramount because any day a visitor from the Office of the Inspector General (OIG”) or Occupational Safety and Health Administration (“OSHA”) could show up for an inspection. Is your facility prepared? More >
Compliance Plan – A Provider’s Defense
The Office of the Inspector General (“OIG”) has always encouraged Medicare and Medicaid providers to implement a compliance program. For 14 years, as a matter of fact, OIG has provided compliance guidance in 11 healthcare sectors (including: hospitals, nursing facilities, home healthcare, hospice and third-party billers). With the passing of the Patient Protection and Affordable Care Act (“PPACA”), compliance plans and programs are now mandatory for any provider enrolled in a Federal health care program, including Medicare. More >
Kentucky Health Cooperative Insurance, Available in 2014
The Supreme Court Decision of June 28, 2012 upholding the Patient Protection and Affordable Care Act (“PPACA”) in National Federation of Independent Business, et al., v. Sebelius , Secretary of Health and Human Services, et al., reignited the creation and implementation of Consumer Operated and Oriented Plan programs (“CO-OPS”). CO-OPs are aimed at offering small businesses and individuals more affordable health insurance options, especially in states where there are a few insurance carriers capitalizing the market with plans that are not economically targeted at the smaller insurance market. More >
Fraud, Waste and Abuse Controls Under The Affordable Care Act
The Affordable Care Act (“ACA”) strives to improve our health care system in three main areas; by expanding consumer protections, strengthening Medicare and reducing health care costs. One key way the government hopes to achieve these goals is through tougher fraud and waste controls. Given the focus on prevention, penalty and recovery, compliance plans are of the utmost importance for all health care providers. First we examine all of the elements incorporated in the ACA that pertain to fraud, abuse and waste before we can begin to develop a compliance plan for our facilities. The new law contains a host of tools aimed at enforcing fraud and waste prevention. Let’s review: More >
