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Insights
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).
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.
Small Devices & Big Consequences: Why Medical Practices Need Encryption
On Tuesday, I shared information about the U.S. Health and Human Services (“HHS”) Office of Civil Rights’ (“OCR”) first settlement with a medical practice for alleged violations of the breach notification provisions of the Health Information Technology for Economic and Clinical Health (“HITECH”) Act. The $150,000 settlement was made with Adult & Pediatric Dermatology, P.C., (“the Practice”) after the entity reported a stolen jump drive that contained PHI of approximately 2,200 patients.
Part II: Understanding All-Payer Claims Databases
Earlier this week, we discussed the benefits of all-payer claims database (“APCD”) systems. Nine states currently have APCDs in place, but Kentucky is not one of them. These systems provide a multitude of information on the cost, use, and quality of health care in a given state, but the question remains: how do providers feel about APCDs?
Part I: Understanding All-Payer Claims Databases
Over the last decade, many states have established all-payer claims database (“APCD”) systems that collect medical, pharmaceutical, and dental eligibility and claims information. Payers, including insurance providers, third-party administrators, prescription drug plans, Medicaid, and Medicare, are responsible for depositing eligibility and claims data into a collective system. The data can then be used to generate important information about cost and quality of care. By gathering detailed information in one place, a statewide picture emerges – information on service providers, patient demographics, and other important healthcare data.
Are U.S. Providers Ready to Catch Up in Medical Coding?
After the bungled introduction of HealthCare.gov, providers are unquestionably leery of other technical health care-related requirements on the horizon. If there is a lesson to be learned in the wake of the Health Exchange debacle, it is this: it is never too early to prepare for change.
"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.
Controlling Compounding: The Drug Quality and Security Act, Part II
Earlier this week we discussed the new Drug Quality and Security Act (“DQSA”) that establishes and regulates a new class of compounding pharmacies called “outsourcing facilities.” To qualify as an “outsourcing facility”, the entity must compound sterile drugs with or without patient prescriptions and comply with the DQSA’s new rules, including registering with the FDA. An outsourcing facility is not required to be a licensed pharmacy. Registering as an outsourcing facility is completely voluntary, but entities that do not register may be prohibited from compounding drugs for office use and will be required to obtain prescriptions for individual patients.
Controlling Compounding: The Drug Quality and Security Act
In October 2012, a fatal meningitis outbreak killed 64 people in the United States and infected more than 750 in 20 states. The outbreak was traced back to contaminated vials of an injectable painkilling steroid that was compounded by the New England Compounding Center (“NECC”).
Arbitration and Interlocutory Appeals in Kentucky
Earlier this week, we wrote about the recent Kentucky Court of Appeals case Kindred Healthcare, Inc. v. Cherolis, No. 2012-CA-002074-MR (Ky. Ct. App. Oct. 11, 2013). In Cherolis, the Daviess Circuit Court denied a motion by Kindred to compel arbitration of the claims brought by Cherolis (as Executrix of her mother’s estate). Immediately following the trial court’s ruling on the motion, Kindred appealed to the Kentucky Court of Appeals.