Author Archives: Sally McMahon

Medicaid MCOs’ Payment Denials and Findings of Alleged Overpayments

By Lisa English Hinkle Posted In Managed Care Organizations (“MCOs”), Medicaid With reported revenues in the billions of dollars and net profits not far behind, insurance companies providing a Medicaid Managed Care product are making huge profits on Kentucky’s Medicaid business.  Across the country, lawsuits are being filed that go so far as to allege that

Norton Healthcare to invest $78 million to expand services at Norton Children’s Hospital

Norton Children’s Hospital is expanding to improve critical care services for children and grow its family-centered approach to treating the region’s sickest kids.   Norton Healthcare announced plans to invest $78.3 million to create the Jennifer Lawrence Foundation Cardiac Intensive Care Unit (CICU) and renovate the “Just for Kids” Critical Care Center and two of

Kentucky enacts medical review panel law regarding malpractice claims

  By: Robin McGuffin and Dustyn Jones   On March 16, 2017, Governor Matt Bevin signed into law a bill that requires medical malpractice plaintiffs to obtain an opinion from a panel of healthcare providers regarding the merits of their claims before filing suit in court. The law is an attempt to eliminate frivolous lawsuits and lower

Senate Bill 18: Kentucky’s legal liability climate impacts access to care

  Most people traveling into the Commonwealth take the “Welcome to Kentucky” sign for granted. But physicians should pay close attention because crossing the border can mean a big difference in terms of legal liability. Kentuckians want access to quality care from highly skilled medical professionals, and rightly so. Unfortunately, our current legal liability system

Compounding pharmacies: Data analytics bull’s eye is on you.

By Shawn Stevison The Office of Inspector General (OIG) recently completed an analysis regarding payments for DME infusion drugs, as well as an issuance in June 2016 of the “High Part D Spending on Opioids and Substantial Growth in Compounded Drugs Raise Concerns.” If you are not familiar with those two reports from HHS OIG,

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