Category Archives: Advocacy

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

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

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

KMA Files Motion to Intervene in Lawsuit Challenging Medical Review Panels

The Kentucky Medical Association has filed a motion to intervene in the lawsuit filed in Franklin Circuit Court challenging the constitutionality of Senate Bill 4, which established Medical Review Panels to evaluate medical malpractice claims before they can proceed in court. KMA was among several health care stakeholders that supported the legislation and worked with legislators to ensure it would pass constitutional muster. “We believe that not only is the new law constitutionally sound, but that it will also improve

The Economic Side: New Law Ensures Coverage of Tobacco Screening and Cessation

A new law passed in the final days of the 2017 legislative session will ensure patients who want to quit smoking will have access to treatments their physicians prescribe. In the past, KMA members reported widespread barriers related to tobacco screening and cessation treatments. The problems persisted even after the Affordable Care Act was implemented; tobacco cessation coverage continued to vary by insurer with no consistency, burdensome prior authorizations and gaps in coverage. One of the most common complaints was

Senate Bill 4 Passes in House Committee

The House Health and Family Services Committee passed Senate Bill (SB) 4 on Tuesday, Feb. 28, which would establish Medical Review Panels in Kentucky. Medical Review Panels consist of three medical experts who are selected to review malpractice claims in a timely, independent fashion before those claims can proceed to court. Panels then provide opinions, which are admissible in court, on whether the standard of care was breached and, if so, whether the breach caused injury to the patient. 

MIPS and MACRA — The Time is Now!

Starting in 2017, physicians must make an important decision each year—one that will affect Medicare reimbursements. The new Medicare Quality Payment Program, which includes the Merit Based Incentive Payment System (MIPS), has an implementation date of Jan. 1, 2019, but physicians must take action starting in 2017 to avoid payment reductions or have a chance to receive payment incentives in 2019 of up to 4 percent. “Due to the advocacy efforts of the American Medical Association, the Kentucky Medical Association

Tort Reform on the Agenda–Legislative Changes Bring New Opportunity for Health Care-Related Issues

A new look to the Kentucky House of Representatives offers new opportunities for legislation important to physicians in the 2017 session of the Kentucky General Assembly, which convenes Tuesday, Jan. 3, and continues for 30 legislative days. Republicans gained control of the House for the first time in nearly 100 years; they now have a 64-36 supermajority advantage to match the supermajority Republicans have held in the Senate for many years. Early indications suggest the Republicans will attempt to capitalize

Kentucky Physicians Visit Congressional Delegation During AMA National Advocacy Conference

Physicians attending the AMA National Advocacy Conference in Washington, D.C., last month had a lot on their minds. The 14-member Kentucky delegation was no exception. But while the hundreds of physicians and medical students who attended the conference were there to lobby, they also wanted to express appreciation to their Congressional delegation for repealing the Sustainable Growth Rate (SGR) formula, according to AMA President Steve Stack, MD, of Lexington. SGR, repealed in 2015, was the method used by the Centers

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