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Showing 9 posts in Healthcare Regulation.

Compliance Programs for Nursing Facility Providers

Posted In Health Care Law, Healthcare Regulation

Nursing facilities are now required to develop and implement effective compliance and ethics programs under newly-created Section 483.85 of the Affordable Care Act (“ACA”) §6102. These programs must be in effect by November 28, 2017. These regulatory requirements are highly complex, especially the requirement of annual review and revision of the programs.   More >

Reclassification of Hydrocodone Takes Effect This Week

The U.S. Drug Enforcement Administration (“DEA”) published a Final Rule on August 22, 2014, which elevates hydrocodone-combination products (“HCPs”) to a Schedule II category of drugs under the Controlled Substances Act. That rule becomes effective this week – on October 6, 2014. While some hydrocodone products are already listed as Schedule II, some combination products (such as Vicodin, Norco, and Tussionex) were previously listed on the less-restrictive Schedule III. In determining whether rescheduling was necessary, the DEA considered multiple factors including the potential for abuse, likelihood of dependence, and the threat to public health posed by the drug. More >

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

Posted In Audit, Denied Claims, Health Care Law, Health Reform, Healthcare Regulation, Medicaid, Webinar

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 >

New Law Affecting APRNs Takes Effect Today

Posted In APRNs, Health Care Law, Healthcare Regulation, Kentucky Senate Bill 7

Today, Senate Bill 7, signed by Governor Beshear on February 26, 2014, becomes effective. The new law allows for an Advanced Practice Registered Nurse (“APRN”) to request to discontinue a Collaborative Agreement for Prescribing Authority for Non-Scheduled drugs (“CAPA-NS”) after having a CAPA-NS in place for four years. Specifically, the new law states: More >

Changes Halted on Medicare Prescription Drug Program

After receiving bipartisan opposition and heavy concern from patient groups and insurers, the Centers for Medicare and Medicaid Services (“CMS”) has declared that it will not be moving forward with draft regulations released in January which proposed several changes to the Medicare Part D program. More >

Hot Topics in Healthcare

Posted In Health Care Law, Health Reform, Healthcare Regulation

On June 26, 2013, McBrayer attorney Lisa English Hinkle presented "Hot Topics in Healthcare" at the Fayette County Bar Association's  Bench & Bar Conference. If you were unable to attend, but would like to know what's hot in the healthcare industry, you can access a PDF copy of the seminar presentation here.  More >

Final Rule for Physician Payments Sunshine Act Recently Released

The long-awaited final regulations for the Physician Payments Sunshine Act (“Sunshine Act” or “Act”) were finally released on February 1, 2013. I previously discussed the Sunshine Act (see Here Comes the Sun, Are you Prepared?,10/18/2012), but with the final rule now implemented, providers should take a second look at it and reconsider its implications. More >

House Bill 1 Revisited: Kentucky General Assembly Amends the Pill Mill Bill

In a 2012 Special Session, the Kentucky General Assembly passed House Bill 1, also known as the “pill mill bill,” to reign in the overprescribing of prescription drugs and the diversion of prescription drugs.  Following the enactment of House Bill 1 and it being signed into law by Governor Beshear, the Cabinet and various licensure boards issued regulations implementing House Bill 1’s requirements.  After emergency regulations were promulgated, Governor Beshear’s office held a series of stakeholder meetings to address the concerns of health care providers and other stakeholders to address some of the compliance and logistical issues that were being raised by stakeholders.  Both Governor Beshear’s office, as well as various licensure boards, recognized that House Bill 1 and the implementing regulations would require amendment and refinement to address concerns raised by the provider community and other stakeholders.  During the 2013 Regular Session of the General Assembly, some of these concerns were addressed in House Bill 217 which amended portions of House Bill 1 to address some of the compliance and other issues raised by health care providers and other stakeholders. More >

The Doctor’s Doctor: Professional Courtesy in an Age of Healthcare Regulation

For over 200 years, professional courtesy has been a hallmark of physician practice, a symbol of collegiality among doctors.  Historians describe its 18th century beginnings as physicians providing charity care for the families of their deceased colleagues—an early form of health insurance for doctors’ widows and children.  Over the years, the concept of collegial care also became the preferred alternative to physicians treating themselves or their own family members.  In fact, the American Medical Association’s (“AMA”) first code of medical ethics created an obligation among doctors to reciprocate medical care and to extend the courtesy to physician family members as well. Today, the AMA recognizes professional courtesy as a “long-standing tradition” but not an ethical requirement.[1]  The federal government’s commentary about “the provision of free or discounted health care items or services to a physician or his or her immediate family members or office staff,” however, is far more cautious than nostalgic. [2]   The Department of Health and Human Services Office of Inspector General’s advice that physicians “consult with an attorney” before extending professional courtesy warns that certain arrangements for free or discounted medical care run afoul of fraud and abuse laws.[3] More >

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