Lab Fee Schedule Update from Anthem

Posted June 27, 2019 Anthem sent out orange envelopes on June 1 announcing updates to their lab code fee schedule. Providers have thirty days from the date of the letter to decide if they will accept the fee schedule that was sent with this announcement, dated June 1, 2019. Note: These new fees are significantly below both Medicare and Medicaid rates. While the letter sounds like a more complete list of updated fees is forthcoming, GLMS and KMA received clarification

President’s Message: The Next Generation…of Nicotine Addicts

Posted June 17, 2019 Tobacco usage among Kentucky adults is nearly double the national average. Annual smoking related healthcare costs in Kentucky total $1.9 billion dollars, of which nearly $600 million is covered by Medicaid. That is $1,116 per Kentucky household in state and federal taxes for government spending on tobacco-related health care. Beyond the financial cost, the human costs of pulmonary disease and cancer are well documented. These “shocking” statistics are not surprising to physicians – we see the

Notice of Application for Appointment to the Kentucky Board of Medical Licensure

Posted June 6, 2019 Physicians interested in being considered for a gubernatorial appointment to the Kentucky Board of Medical Licensure (KBML) must submit an application and their curriculum vitae to the Kentucky Medical Association by July 1, 2019. Applications are being sought for the KBML four-year term beginning Aug. 1, 2019, and ending July 31, 2023. Click here to obtain an application. Return the completed application to Laura Hartz by email at hartz@kyma.org or by mail at KMA, Attn: Laura Hartz, 9300 Shelbyville Road, Suite 850, Louisville,

The 2019 General Election Field is Set

Posted June 4, 2019 On Tuesday, May 21, the Primary Election was held, and Kentuckians went to the polls to select Democrat and Republican nominees for the Commonwealth’s six constitutional offices, including the Office of Governor. The General Election, scheduled for Tuesday, November 5, will see Governor Matt Bevin and his running mate, Senator Ralph Alvarado, M.D., square off against Attorney General Andy Beshear and his choice for Lieutenant Governor, Jacqueline Coleman. The gubernatorial race will be contentious with more

Update on Telehealth Law that Takes Effect July 1, 2019

Posted June 3, 2019 The recent 2019 Kentucky Telehealth Summit, held May 23 in Bowling Green, provided clarification and updates on the telehealth law passed in 2018 and becomes effective July 1, 2019. The law requires Medicaid, managed care organizations (MCOs) and commercial health plans to cover medical services provided via telehealth to the same extent they cover medical services provided in-person. Stephanie Bates, Deputy Commissioner, Kentucky Department for Medicaid Services, confirmed the Medicaid rate for telehealth services will be

Surprise bills or Inadequate Network?

Posted May 20, 2019 Health plans hold all the cards when negotiating with providers (reimbursement) and patients (health insurance rates). Recent attempts by health plans to consolidate have made that abundantly clear, and litigation to stop these mergers has tried to prevent a bad situation from becoming worse. In response, health plans have narrowed their provider networks, offering fewer choices to patients and far less reimbursement to providers. Physicians only recourse in these blatantly unbalanced contract negotiations is to say

Key Updates for Medicaid Beneficiaries

Posted May 7, 2019 “The following is a message from the Cabinet for Health and Family Services” Due to the legal decision on March 27, 2019, the Kentucky HEALTH program did not begin on April 1, 2019, and there were no changes in coverage or benefits for any Medicaid beneficiaries. Beneficiaries and their eligible family members can continue to access Medicaid-approved healthcare services, as well as vision, dental, and non-emergency medical transportation. Check out the Kentucky HEALTH Program Update and

President’s Message: A Tragic Ending

Posted April 25, 2019 During his testimony before the Kentucky Legislature a few weeks ago, Dr. Mike Kalfas, a family medicine physician, recalled seeing a young man on a Friday afternoon who was suffering from opioid addiction and writing a prescription for buprenorphine to help block the opioid cravings of his patient. After his office closed, the insurance company denied the medication because it required prior authorization. When Dr. Kalfas returned to his office on Monday morning, he learned that

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