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Showing 7 posts from April 2014.

Voluntary Surrender of DEA Registration: Proceed With Caution

All too often, the Drug Enforcement Agency (“DEA”) asks a physician to surrender his or her DEA registration when the physician enters into a prescribing-related Agreed Order with the applicable state licensing authority. A DEA registration is important because, in order to write prescriptions for controlled substances or dispense controlled substances in-office, physicians must be registered with the DEA. More >

Physicians: Have You Checked Your Numbers?

As promised, the Centers for Medicare and Medicaid Services released information about Medicare payment to physicians and certain health care professionals on April 9th. The release is in conjunction with the policy change instituted by the U.S. Department of Health and Human Services, which allows CMS to respond on a case-by-case basis to Freedom of Information Act requests for Medicare payment information related to individual physicians (see more on the topic here). More >

A New Reason to Protect Protected Health Information

Recently, an Indiana jury awarded a plaintiff $1.8 million in damages after a Walgreens pharmacist inappropriately used her position to find and share the plaintiff’s protected health information (“PHI”). [1] As health care providers know, the Health Insurance Portability and Accountability Act (“HIPAA”) provides both civil and criminal penalties for improper disclosure of medical information but it does not create a state-based private cause of action for violation of its provisions. Thus, when someone’s PHI is inappropriately shared or disclosed by a health care provider, the individual does not have personal legal recourse against the offending party. The recent Indiana case (herein “Walgreens Co.”) illustrates, however, that HIPAA still has a significant role in state court suits alleging negligence and professional liability as it relates to confidentiality.

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Should Kentucky Physicians Follow California Physicians’ Lead In Challenging Medicaid Rates?

In recent years, Kentucky physicians have dealt with the state’s prescription drug abuse problem head-on – by adding substance disorder recovery services to their practices or establishing separate addiction recovery clinics. This trend has undoubtedly played a role in the 2013 decline of Kentucky deaths from overdoses of controlled substances – the first in many years. More >

A Win for Washington: Cutting ER Visits

In the summer of 2012, Washington state emergency rooms (“ER”) began tracking patients in a statewide database. Expanding Medicaid rolls and legislative attempts to cap reimbursements for non-emergency visits to ERs left the state, hospitals, and physicians knowing they had to do something to cut costs and improve quality of care within the ER setting. The product of their collaboration was the creation of seven “best practices,” known collectively as the “ER is for Emergencies” campaign. In addition to the mandatory, statewide database, the campaign urged health care providers to: More >

New Enrollment and Re-Validation Requirements for Providers/Suppliers for Participation in Medicare and Medicaid: Watch Your Mail! Part I

Even though the Centers for Medicare and Medicaid Services (“CMS”) published final regulations to implement provisions to the Affordable Care Act (“ACA”) on February 2, 2011, it is likely that many Kentucky health care providers, including physicians, are not aware of the importance of the new requirements for revalidation of Medicare and Medicaid enrollment or the new and more burdensome requirements for initial enrollment. The requirements are aimed at strengthening provider and supplier screening procedures to reduce fraud, waste, and abuse in federal health care programs. Because CMS contractors and KY Medicaid have been slow to comply with these new requirements, it is likely that many providers have not noticed the enrollment/screening changes unless they have been asked to revalidate or have applied for new or additional provider/supplier numbers. More >

A New HIPAA Security Risk Assessment Tool For Your Compliance Arsenal

On Friday, the U.S. Department of Health and Human Services (HHS) announced a new security risk assessment (“SRA”) tool for small and medium size healthcare providers. The downloadable tool (available for free here) is a self-contained, independent application that is available for Windows and iOS platforms. The SRA works by asking a series of in-depth questions about the provider’s activities and facilities. The “yes” or “no” answer format for each question reveals whether corrective action is needed in a particular area. Additional resources in the SRA help providers understand the risks associated with the use, disclosure and storage of protected health information. The SRA offers providers the opportunity to generate, update and document assessment materials and corrective action plans through the SRA; documentation is especially important for audit purposes. More >

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