On Tuesday, I provided some common sense tips for prescribers to use when issuing a KASPER-regulated medication. Now, let’s take a look at how the prescriber can better understand the KASPER report.[1]

The Kentucky General Assembly passed House Bill 1, also known as the “pill mill bill” in 2012. Following its enactment, the Cabinet for Health and Family Services and various licensure boards issued regulations implementing its requirements. It was soon realized that the law would need some refinement to address concerns raised by the provider community and stakeholders. In 2013, House Bill 217 amended portions of House Bill 1 to address some unintended consequences of the original legislation. One of those amendments was giving an exemption to hospitals, long-term care facilities and approved researchers from the law’s requirement to report controlled substances administered directly to patients through the state’s description drug monitoring system, KASPER. However, for those licensees not exempt from the reporting, it remains a stringent requirement that a KASPER report is filed within one day of dispensing a controlled substance. (See more on HB 217 here.)

HealthCare.gov’s technical woes are expected to be fixed by November 30^th. 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.

On Tuesday, I discussed the recent trend of hospital layoffs of staff, administrative and professional alike, in order to reduce costs despite expectations of an unprecedented number of individuals seeking health care services under the ACA.

The Affordable Care Act (“ACA”) took a big leap forward this month with the opening of the federally-facilitated and state-operated Exchanges. Here in Kentucky, 70,467 people reportedly participated in pre-screenings to determine qualifications for subsidies, discounts, or programs like Medicaid on the Health Insurance Exchange’s first enrollment day, October 1, 2013. The ACA is eventually expected to provide health coverage to as many as 30 million additional Americans. So, why are hospitals across the nation slashing jobs?

Earlier this week, we discussed the three-month grace period afforded to enrollees of qualified health plans (“QHPs”). To recap that article, the ACA requires that QHPs pay claims for the first thirty days of the grace period during which premium payment remains unpaid, but issuers may pend claims for the final sixty days of the grace period. If the balance remains unpaid, the issuer may deny any claims submitted within the final sixty days.

Providers contracting with state health insurance exchanges may find themselves shortchanged for services provided due to a little-known loophole in the Affordable Care Act (“ACA”).

Earlier this week, I discussed CMS’ final rule on the prospective payment for acute care and long-term care hospital inpatient services for fiscal year 2014. The final rule provides guidance to physicians on how to designate a patient as inpatient or outpatient and the impact of the designation on Medicare Part A or Part B coverage. This blog will discuss the two midnight rule.

In August, the Centers for Medicare and Medicaid Services (“CMS”) announced a final rule regarding the prospective payment for acute care and long-term care hospital inpatient services for fiscal year 2014. This rule becomes effective on October 1, 2013.

A recent HIPAA settlement serves as an important reminder that protected health information (PHI) may be stored on “ordinary” office equipment such as printers, photocopiers, scanners and fax machines, and not just on computer hard drives.  On August 14, 2013, the Department of Health and Human Services (HHS) announced a settlement with the not-for-profit managed care plan Affinity Health Plan, Inc. (“Affinity”) for over $1.2 million in connection with HIPAA Privacy and Security breaches stemming from PHI stored on a photocopier hard drive.