Category Archives: Medical Practice Blog

KMA Update on Medical Review Panels Case

Published: March 7, 2018 In 2017, the Kentucky General Assembly passed legislation that was signed by Governor Bevin establishing “medical review panels” in Kentucky. This legislation represents the first meaningful tort reform passed by the General Assembly in a generation. Unfortunately, the law was challenged in Franklin Circuit Court, where Judge Phil Shepard found the law to be unconstitutional. The Bevin administration appealed the ruling directly to the Kentucky Supreme Court, which accepted the case on a somewhat expedited basis. 

Beyond the White Coat Gallery to Display KMA Member Talents Outside of Medicine

As a physician, you know that your job is more than just a profession. It’s a mission. But it’s also one that can easily become the center of your identity and has the potential to lead to burnout. KMA’s 2018 Annual Meeting will feature physician and author Shawn C. Jones, M.D., FACS, whose book, Finding Heart in Art: A Surgeon’s Renaissance Approach To Healing Modern Medical Burnout, uses Renaissance paintings as a framework to explain how medical professionals can manage

Anthem Agrees to Fully Rescind Proposed Modifier 25 Cuts

Published Feb. 23, 2018 This afternoon, Anthem notified the American Medical Association (AMA) that it plans to fully rescind its policy to reduce payments for E&M services reported with CPT modifier 25. The announcement follows months of pushback on the policy from organized medicine, led by the AMA, which met with Anthem about the changes.  Kentucky Medical Association (KMA) and Greater Louisville Medical Society (GLMS) leadership also met with local Anthem officials in December to strongly oppose the policy and

President’s Message: Letting Doctors Be Doctors

Published Feb. 19, 2018 It’s no secret that the landscape of healthcare, and particularly the practice of medicine, has changed. While many improvements have been made in the treatment of disease and injury, the business of caring for patients is now unfortunately influenced greatly by outside parties, particularly policymakers and insurance companies. I don’t think anyone would be surprised to hear that their interests extend somewhat outside of providing quality care for patients. Meanwhile, the mission of a physician hasn’t

Anthem – Update Modifier 25

Published Jan. 31, 2018 KMA helps reduce initial reimbursement cut from 50 to 25 percent In October, Anthem announced that evaluation and management (E/M) services, historically eligible for separate reimbursement when reported by the same provider on the same day as a minor surgery, would be reduced by 50%. After discussions between Anthem and medical associations at the national, state and local levels, including KMA, Anthem has announced that the reduction will now be 25%, effective with dates of service

5 Questions with Sen. Ralph Alvarado, M.D.

Jan. 30, 2018 With the 2018 Kentucky General Assembly off and running, KMA spoke to Sen. Ralph Alvarado, a physician and advocate for the medical community, about the session and his thoughts on several KMA priority bills. What inspired you to run for political office? As I began my career in private practice, I began to appreciate how much defensive medicine impacted the treatment of my patients.  Medical tort reform began to gain steam in Kentucky and I reached out

Kentucky’s 1115 Waiver Approved; Governor Bevin Announces Kentucky HEALTH Program

On Jan. 19, 2018, Governor Matt Bevin and the Kentucky Department for Medicaid Services announced that Kentucky won approval from the Centers for Medicare and Medicaid Services (CMS) for its Section 1115 Medicaid Waiver Application. The resulting program, Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) is part of an overall initiative to “transform the Kentucky Medicaid program to empower individuals to improve their health and gain employer sponsored coverage or other commercial health insurance coverage, while simultaneously

Administrative Burdens Cost Both Dollars and Health

Like most of you, I entered into the field of medicine motivated by the desire to help others. Treating and caring for the sick is more than just a profession, it’s a mission and a great responsibility only bestowed to a handful of the population. Which is why it’s such a shame that so much of our time as physicians is spent on paperwork and in front of computers. The administrative burdens we face are actually making patients sicker and

Patients shouldn’t have to pay for Anthem’s poor business decisions

By Patrick T. Padgett Executive Vice-President, Kentucky Medical Association Op-ed appeared in January 5, 2018 Lexington Herald-Leader Even though physicians, hospitals, nurses and other medical providers give care to people every day, they have very little control over how that care is delivered. That control, unfortunately, rests with health insurers. Their policies dictate not only what is covered, but how care is delivered, and they say a great deal about what insurers really value. Policymakers are sometimes forced to step

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