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Showing 20 posts in Health Reform.

The Walmart List: Milk, Eggs, and a Doctor Visit?

By January 2015, Walmart will be operating dozen primary care clinics across the U.S. Six of these have already opened in South Carolina and Texas. Currently, some Walmart stores include acute care clinics that are operated through leases with local hospital operators. The new primary care clinics are distinct from the existing ones in several ways. The new clinics will be fully-owned by Walmart, offer a broader range of services, and be open seven days a week with longer operating hours. Walmart is partnering with QuadMed nationally to operate the clinics, rather than with local partners. The primary care clinics will be staffed primarily by nurse practitioners and medical assistants and will be supervised by a physician. More >

You're Invited To Attend a Complimentary Webinar, "Medicaid: Getting Paid & Keeping It!"

Are you a health care provider familiar with the challenges of getting paid for services rendered? Is Medicaid making it more complicated? Join the McBrayer health care group and Kentucky Primary Care Association for a discussion about the Medicaid reimbursement process -- disputes, audits, appeals, reconciliations, payment plans, and everything in between. This 2-part series webinar will help you make sense of Medicaid and put you on the road to reimbursement. More >

Physicians: Have You Checked Your Numbers?

Posted In Health Care Law, Health Reform, Medicare, Physician Payments

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 >

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 >

FTC: Don’t Limit APRNs Crucial Role in Health Care

The Federal Trade Commission (“FTC”) recently released a policy paper suggesting that state legislators should be cautious when evaluating legislative proposals to limit the scope of practice of Advance Practice Registered Nurses (“APRNs”). The FTC is concerned that by imposing more stringent physician supervision requirements, APRNS are effectively being restricted by another type of health care professional (the physician) thereby denying consumers the benefits of greater competition. This is especially troubling in light of the significant shortage of primary care practitioners in the U.S. By allowing APRNs to practice without heavier regulatory burdens, access to health care can be increased and possibly lead to “lower costs, better care, and more innovation,” according to the FTC. More >

New Rule Brings Sweeping Changes to Physician Privacy

On January 17, the U.S. Department of Health and Human Services (HHS) announced that the Centers for Medicare & Medicaid Services (CMS) would begin granting Freedom of Information Act (FOIA) requests for Medicare reimbursement to individual physicians on a “case-by-case basis.”  The new policy, effective March 18, 2014, is a departure from CMS’ long-standing practice of withholding information on physician reimbursement under the Medicare program. More >

The Affordable Care Act & Small Business Recap

On February 4, McBrayer and Business Lexington presented a panel discussion on how small businesses can navigate the Affordable Care Act. I was honored to moderate the event and hope that attendees benefited from the panel’s real-world advice on how to traverse the new landscape of health insurance. A huge thank you to the panelists: Jon Carroll, Beverly Clemons, Betsy Johnson, Cris Miller, and Garry Ramsey. More >

"Essential Benefits" Will Lead to More Patients for Some Providers

In a 2009 speech to the American Medical Association, President Obama promised, “If you like your health-care plan, you’ll be able to keep your health-care plan, period. No one will take it away, no matter what.” This declaration came as the health care law was being written and similar statements were repeated by the President after the bill became law. More >

The Young and the Restless

HealthCare.gov’s technical woes are expected to be fixed by November 30th. But, those fixes might come too late for a certain subset of needed enrollees – the young and healthy. The purpose behind the Affordable Care Act’s individual health insurance mandate was to ensure that private insurers would get enough young, healthy people in the system who could offset the costs of covering older and sicker, Medicaid-eligible patients. More >

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