Category Archives: Medical Practice Blog

When Administrative Burdens Take Over, Physicians and Patients Lose

Based on the feedback I received from my last message in the Nov. 21 Kentucky Health eNews, I think it’s safe to say the issue of administrative burden touched a nerve for many of you. I am encouraged by that fact because I believe the Association has chosen a wise platform to work toward improvement for physicians. I truly feel this may be the biggest challenge ever to face the practice of medicine. It’s obvious this issue can have disastrous

Will electronic health record systems finally be able to “talk to each other” in 2018?

21st Century Cures Act to Help Reduce Administrative Burdens Related to Electronic Health Records In 2016, Congress passed the 21st Century Cures Act. One important piece of the extensive law begins January 1, 2018: the law attempts the transition to electronic health record (EHR) data interoperability. This would essentially enable different EHR systems to talk to one another. The law prohibits the blocking of heath information and explains that not sharing information is “preventing, discouraging, or interfering with the access,

5 Questions With Sarah Spurlock, Stites & Harbison PLLC Speaker at KMA’s Physician Employment Contracting Symposium

KMA is pleased to introduce a new feature series, “5 Questions With … ” Each month, KMA staff will interview a person of interest or thought leader making an impact in the world of healthcare and ask them five important questions. Sarah Spurlock, KMA legal counsel and attorney with Stites & Harbison PLLC, answered this month’s five questions regarding KMA’s upcoming Physician Employment Contracting Symposium. The event will be held Saturday, Jan. 27 from 8:30 a.m. to 12 p.m. at the

New AMA, CMS resources aid transition to the new Medicare Card

The AMA has created a webpage to help physicians prepare for the new Medicare card. The cards will significantly impact physician practice workflows, so practices should take steps now to prepare. A downloadable flyer is available for physicians to give to their health information technology (IT) vendors to ensure they have information necessary to transition IT systems to the new Medicare card. Additionally, the CMS announced a Provider Ombudsman for the New Medicare Card to serve as a resource for the physician community. The

Modifier Madness–Focus on Modifier 25

Background – HIPAA and Standard Code Sets The Health Insurance Portability and Accountability Act (HIPAA) includes administrative simplification  requirements which define standards for certain electronic health transactions. These include claims, enrollment, eligibility, payment and coordination of benefits. These requirements apply to covered entities such as health plans, healthcare clearinghouses, physicians and other healthcare providers that conduct certain financial and administrative transactions. These standards also address the security of electronic health information systems. Under HIPAA a “code set” is any set

Modifier Madness – Put the Patient First

Impact of the Modifier 25 Policy Change 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%. This will apply to claims denoted by the use of Modifier—25 processed on or after Jan. 1, 2018. For example, when a physician treats a patient for hypertension and osteoarthritis and the patient also complains of a problematic skin

Administrative Burden: A Problem We Can’t Afford to Ignore

I’m often asked to name the biggest obstacle to the modern practice of medicine.  The answer is very simple: administrative burdens. There’s probably not a physician reading this right now who isn’t shaking his or her head in agreement. But this is something I feel that the public, and perhaps more importantly, policy makers, don’t fully understand. Administrative burdens contribute to physician burnout and patient dissatisfaction, increase the cost of care and ultimately impact overall health outcomes. There are many

Kentucky Supreme Court Decision in Negligent Credentialing Case

November 2, 2017 On the heels of the Franklin Circuit Court’s decision in the medical review panel case, the Kentucky Supreme Court issued an opinion Nov. 2 in another case involving KMA. In the case of Lake Cumberland Regional Medical Center v. Adams, plaintiffs alleged liability on the part of a hospital due to “negligent credentialing” of the physician involved in a malpractice action.  Kentucky only recently recognized “negligent credentialing” as a cause of action when the Kentucky Court of

“A Friend of Medicine,” Rep. Kim Moser Seeks to Tackle Addiction Issues; Eliminate Barriers to Physicians

Rep. Kim Moser is known as and calls herself a “friend of medicine.” However, one could say that she and medicine are more than just friends. They’re family. The Taylor Mill, Kentucky native comes from a long line of healthcare workers. This includes her family practice physician father and nurse mother, internist father-in-law and nurse mother-in-law, and her pulmonologist husband and Kentucky Medical Association (KMA) 8th District trustee, Neal Moser, M.D. Moser herself is a registered nurse who spent much

KMA Statement Regarding Medical Review Panel Law Declared Unconstitutional

October 31, 2017 On Oct. 30, Franklin Circuit Court Judge Phillip Shepherd issued an opinion declaring Kentucky’s medical review panel law unconstitutional.  The Kentucky Medical Association (KMA) filed a brief with the court supporting the constitutionality of the law, as did many other organizations that share a desire to implement meaningful tort reform in Kentucky.  While KMA certainly hoped for a different outcome at this stage of the court process, it should be stressed that opinions and appeals at more

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