37, 88 OMAHA!, Hut, Hut….Go!
By Thomas Ferkovic, R.Ph., MSManaging Director
Medic Management Group LLC
Peyton Manning made the 'OMAHA!' trigger word famous to let his lineman and team know that something was changing. Wouldn’t it be great if before every patient exam the doctor could calI a set of signals to get everyone lined up right? If every morning were exactly the same and patients came to the office in a neat and orderly fashion running a medical practice would be easy and you would not need to choreograph the patient flow dance. Unfortunately, patients do not present with the same symptoms, problem list, medications or fit neatly into the schedule slots. The reality is patients come in all sizes, shapes, variety, and sometimes they present with emergencies. The practice has many exam rooms, ancillary services, employees of various skill sets. Some days staff are on vacation, sick or tied up with other duties. Practices have many variables working in them hourly. How do you organize a busy, complex practice for maximum efficiency? Sometimes we need to look to other organizations for ideas on how daily duties are organized. Read article
Do We Really Need Health Care, After All?
By Craig B. GarnerFounder, Garner Health Law Corporation
More than seven years ago, U.S. Supreme Court Chief Justice Roberts saved the Affordable Care Act (the “ACA”) by upholding the constitutionality of the individual mandate through Congress’s authority to “lay and collect Taxes.” Rejecting the Commerce Clause and the Necessary and Proper Clause as a means to sustain the individual mandate, the Court acknowledged that Congress’s taxing authority can exceed its power to regulate commerce, but the power to tax affords Congress less control over individual behavior than its power to regulate commerce. At the time Chief Justice Roberts concluded Congress can only require “an individual to pay money into the Federal Treasury, no more.” As it turns out, Congress was unable to require an individual to pay the cost of the individual mandate, leaving the Internal Revenue Service to focus its collection efforts on the interception of refunds. Read article
Payor-Provider Partnerships are the Cornerstone of Improving Health Plan Quality Scores
By Carla D'Angelo
, Vice President, COPE Health Solutions
By Evan King
, Principal and Chief Operating Officer, COPE Health Solutions
Payors of all stripes are increasingly holding health plans accountable for moving the health care system from the horse and buggy era to a “transportation network” for entire populations. The Centers for Medicare and Medicaid (CMS), state government and employers have heightened expectations for health plans to do more to achieve specific and complex quality outcomes. Read article
$2.175M HIPAA settlement highlights breach reporting
By Richard S. Cooper, Esq.Member, McDonald Hopkins
The U.S. Department of Health and Human Services Office for Civil Rights (OCR) announced its settlement with Sentara Hospitals for failing to properly report a breach and for allowing its parent corporation to create, receive, maintain or transmit protected health information (PHI) of Sentara affiliated hospitals without entering into a business associate agreement (BAA). Read article