Category Archives: Health Care Info

Conquering ADD In Children The Natural Way

2016-05-17_2104With the way alot of the laws have changed in the past few years, its a good idea to look into alternative ways of natural health if you dont have good health insurance. Especially if you have small children with ADD, a great alternative to this is a natural supplement the below article with give you and idea of what you can do.

Attention deficit disorder in children is becoming more common over the years. Initially, parents of children with ADD thought they were to blame for their children’s lack of ability to focus. For some reason, they assumed it had something to do with their parenting methods.

Recent research, however, has already proven this belief to be entirely false. ADD is actually caused by the lack of certain chemicals in the brain.

There are prescription medications that can be used to treat this disorder but many parents today are leaning more towards natural remedies for ADD/ADHD such as listol for children.

According to surveys, natural remedies for ADD are generally preferred due to several reasons, the most common of which is that these natural treatments are usually much safer than their artificial counterparts. In other words, they can be given to children without having to worry about possible negative side effects.

Finding remedies that can assist is easy now with the use of the internet. Although they do work differently, practically all of these natural remedies for ADD will help your child concentrate on his tasks and show better social behavior.
Other Natural Remedies For ADD In Children

Diet – If you are not yet ready to give your child any medication, whether natural or artificial, you can still help him conquer his disorder by giving him other natural remedies for ADD. For example, you can improve his diet by not serving him too much processed foods, as well as foods that have high amounts of salt and fat. Particularly sweet foods, like chocolate and candies, should be minimized as well. Instead, encourage him to eat more fresh fruits and vegetables — these will not only help eliminate ADD but will also considerably improve his overall wellbeing.

Exercise – Regular exercise is also one of the most effective natural remedies for ADD. In fact, many experts speculate that the reason why there are so many cases of ADD in children today is because children spend more time playing video-games and watching TV rather than playing outdoors and getting the exercise they need.

You can help your child beat ADD by encouraging him to participate in sports event in school, or by simply spending more time playing outdoors. Once your child gets regular exercise, he will be able to focus more on the important tasks, and also become much healthier and happier.

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PhRMA Makes Additional Drug and Patient Safety Information Available on Its Web Site

painkillers_0In an effort to better inform the public about drug and patient safety information, PhRMA has launched new web site pages.   In its press release about the new web pages, PhRMA states as follows:

  • Patient safety is our highest priority. We need a strong and effective FDA with the resources and personnel necessary to ensure the safety of the U.S. drug supply and continued access to innovative medicines.
  • Patient welfare should be at the center of any effort to enhance drug safety and ensure that benefit and risk are balanced.
  • Drug safety and effectiveness monitoring must be comprehensive and continuous. PhRMA supports efforts that seek to continually improve these activities.
  • Patients and health care providers must have accurate, timely, and useful information on which to base their decisions.

However if your looking for all natural supplements in order avoid the costly side effects, you search out other alternatives. If your having problems your thyroid, you can search for thyax reviews online to see how this supplement performs. And if its something you can use.

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New Rule Allows for Electronic Transmission of Controlled Substance Prescriptions

Controlled Substance PrescriptionsA new Drug Enforcement Agency (DEA) rule could substantially impact the way prescriptions for controlled substances can be transmitted from a physician to a pharmacy.

As physicians and pharmacies seek to cut costs and maximize efficiency, electronic record keeping and prescription filing has become more commonplace.

In response, the DEA has relaxed previous restrictions on electronically filing controlled substance prescriptions. However, recognizing the high risks posed by abusing or forging controlled substance prescriptions, the DEA has created a system of requirements which must be met before a physician is able to take advantage of the new rule.

The DEA defines controlled substances as drugs and other substances that have a potential for abuse and psychological and physical dependence; these include opioids, stimulants, depressants, hallucinogens, anabolic steroids, and drugs that are immediate precursors of these classes of substances.

Once classified as a controlled substance, drugs are then broken down into one of five categories depending on the potential for abuse and risk of dependance. Today, controlled substances account for between 11% and 12% of prescriptions written in the United States.

Under the previous rule, physicians were prohibited from electronically sending prescriptions for schedule II-V controlled substances to pharmacies. However, under the current rule, which was published March 31, 2010 in the Federal Register, physicians who meet certain requirements will be permitted to e-file those prescriptions beginning June 1, 2010.

To be eligible to e-file controlled substance prescriptions, physicians must meet two of three factors. The “two-factor authentication protocol,” which seek to guard against fraudulent prescription filings by confirming the prescribers true identity includes:

  • A password or PIN number
  • biometric data- either a fingerprint or iris scan, or
  • a “hard token”- a secured device separate from a computer that can provide a password to a physician at the time of e-filing.

To be eligible to e-file controlled substance prescriptions, physicians must validate their identity with a designated agency. When applying for the proper credentials to utilize e-filing programs, physicians must supply verifiable information such as government issued identification or financial account information.

Currently, Michigan laws vaguely address the current state of e-filing prescriptions for controlled substances. MCL 333.7333(7) states that physicians may electronically transmit prescriptions as long as they do not conflict with federal law.

The law does not differentiate between controlled substance and non-controlled substance prescriptions. As a result, we may see future clarification from the Michigan legislature or the Board of Pharmacy regarding this issue.

Importantly, physicians and pharmacies that currently possess the technology to e-file prescriptions must ensure that their systems comply with the new DEA “two-factor authentication protocol” requirements for controlled substances.

Licensed physicians who cannot afford to implement the required technology or simply wish to opt out of the program are still able to produce physical prescriptions which can be presented at a pharmacy.


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Medical Residents Considered Employees, Not Students, Under Federal Tax Law

Medical Residents Considered Employees, Not Students, Under Federal Tax LawOn January 11, 2011, the United States Supreme Court, in an unanimous opinion authored by Chief Justice Roberts, upheld a Treasury Department rule that established that medical residents are full-time employees, not students, for purposes of federal income taxation and Social Security coverage.

The case considered a federal law, namely the Federal Insurance Contributions Act (FICA), which exempts students from paying Social Security taxes. In 2004, the Treasury Department issued a rule that essentially stated medical residents were not students and therefore that their wages were taxable under FICA.

Petitioner Mayo Foundation for Medical Education and Research argued that this was an improper rule, and that medical residents should be treated as students under the plain language of the statute. In announcing the decision, the Court focused on the question of whether residents were “workers who study or students who work.”

The Court held that the Department’s regulation was a permissible interpretation of an ambiguous statute, and therefore that medical residents would be treated as employees for purposes of federal taxation and Social Security coverage under FICA. Chief Justice Roberts wrote, “The department certainly did not act irrationally in concluding that these doctors… are the kind of workers that Congress intended to both contribute to and benefit from the Social Security system.”

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HHS Publishes HITCH Breach Notification Interim Final Rule

HHSOn August 24th, 2009 we finally saw the publication of interim final regulations implementing the security breach notification provisions of the Health Information Technology for Economic and Clinical Health Act (“HITECH”).

While the regulations appear to parallel the statutory provisions of HITECH, the process covered entities must follow before notifying a patient of certain breaches of their protected health information (PHI) is not as strict as initially feared.

For instance, under the new regulations, covered entities will still engage in a very subjective and fact specific risk assessment before determining when to notify a patient of a breach. The regulations also provide guidance to covered entities and their business associates (BAs) relative to their mutual obligations under the new rules.

Summarized below are some key points and issues we perceive to be relevant to covered entities and business associates under the new regulations.

The Breach Rules Only Apply To “Unsecured” PHI.

Unsecured PHI is defined as PHI that has not been secured through the use of a technology or methodology specified by HHS. According to HHS guidance released in April 2009, encryption and destruction are the only two ways to secure PHI and avoid breach notification under the Act.

Click here for a link to HHS’ April 2009 “Guidance Specifying the Technologies and Methodologies That Render Protected Health Information Unusable, Unreadable, or Indecipherable to Unauthorized Individuals for Purposes of the Breach Notification Requirements”.

Fact Specific Risk Assessment.

The Regulations define a “breach” as the acquisition, access, use, or disclosure of PHI in a manner not permitted under the Privacy Rule that “compromises the security or privacy” of the PHI.” A use or disclosure compromises privacy or security only if it creates “a significant risk harm to the individual as a result of the impermissible use or disclosure.” The regulations identify a number of factors covered entities or business associates may consider during this assessment, including:

who impermissibly used or to whom the information was impermissibly disclosed;
steps taken to mitigate an impermissible use or disclosure (i.e. lost or stolen laptop is returned and forensic analysis reveals that its information was not opened, altered, transferred or otherwise compromised);
The Type And Amount Of PHI Involved.

In the event a notification is deemed necessary based on the facts all notification to individuals and HHS and must be given without “unreasonable delay,” but no later than 60 days after discovery.”

Exceptions to Breach Rule.

There are also key exceptions relative to the breach rule in situations where there is:

an unintentional acquisition, access or use of PHI;
inadvertent disclosure; or
disclosure of PHI to person not reasonably able to retain such information.

Business Associates.

Under the new regulations, BAs must comply with the privacy and security regulations, just like covered entities. BAs must have policies and procedures documenting compliance with the privacy rule’s use and disclosure provisions and the security rule’s administrative, physical and technical safeguards requirements.

An interesting issue is raised relative to when BAs acting as “agents” of a covered entity versus BAs acting as “independent contractors” and the breach notification time frames requirements under both scenarios. If a business associate is acting as an agent of a covered entity then the business associate’s discovery of the breach will be imputed to the covered entity. Accordingly, the covered entity will have to provide notifications to the patient and HHS based on the time the business associate discovers the breach, not from the time the business associate notifies the covered entity. Conversely, if the business associate is an independent contractor of the covered entity (i.e., not an agent), then the covered entity must provide notification based on the time the business associate notifies the covered entity of the breach.

Among Other Issues, BA Agreements May Need To Be Amended To:

clearly address the agent versus independent contractor status of the BA; and
the timing of BA notification to a covered entity following a breach.

Grace Period, Enforcement And Penalties.

Finally, the regulations account for a grace period allowance before HHS expects to begin enforcement. The regulations took effect on September 23, 2009, but HHS has delayed seeking sanctions until February 22, 2010.

The caveat to this allowance period, however, is that the regulations significantly broaden the enforcement and penalties associated with a violation. Under the new system, HHS will employ a tiered penalty system based on the mental state of the offender.

Additionally, HHS has also delegated some of the enforcement mechanisms to state Attorney General offices. Effective February 18, 2009, the Michigan Attorney General can bring actions under HIPAA independently of HHS. Finally, the regulations allow for penalties to be shared with those harmed by the disclosure (though, we have not seen regulations or guidance from HHS on the definition of the “harm” necessary to share in penalties).…

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Health Care Employers feel the Pain of H1N1 Vaccination Policies

H1N1 Vaccination PoliciesMany Hospitals and other employers in the health care industry are discussing the benefit of H1N1 vaccinations for their employees. Some are even considering mandating that employees receive the vaccination. After all, if your employees are “at will,” then you can impose new conditions of employment on them at any time.

On many levels, mandating the vaccine for health care workers makes sense. After all, OSHA mandates that employers provide their employees with a safe place to work. Doesn’t a mandatory vaccination ensure a safer place for employees to work? A healthy workforce also means less absenteeism. And, the idea of mandatory vaccinations isn’t totally foreign to health care: think TB vaccinations. I also compare a mandated vaccination to drug testing: somewhat invasive, but for the common good.

On the other hand, mandatory vaccinations raise many legal issues. For instance, if your workforce is unionized, then this would require negotiations with the union before implementation, as it affects the terms and conditions of employment. If you are non-unionized and have many employees opposed to the mandatory vaccination, a mandate may be what pushes employees to organize. Another consideration is that some have asserted that the vaccination is untested and potentially dangerous. If an employee is vaccinated over his/her objection, that may create liability for the employer if the employee experiences an injury or serious side effects from the vaccine.

While there are many good reasons to mandate the H1N1 vaccine, an employer who moves in this direction is definitely treading onto unsettled legal grounds.…

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FTC Red Flag Rules – Regulation From A New Direction

healthcare law infoIt never ceases to amaze me the number of varying directions from which hospitals and health care providers get regulated!

The most recent federal agency to jump on the health care regulation bandwagon appears to be the Federal Trade Commission (FTC). On November 9, 2007, the FTC, in conjunction with federal bank regulators, issued a set of regulations intended to combat identity theft. These regulations are commonly referred to as the “Red Flag Rules.” The Red Flag Rules require financial institutions and other “creditors” to implement a program designed to detect, prevent and mitigate identity theft in connection with the creation and maintenance of “covered accounts.”

Many hospitals and health care providers began to pay attention to these regulations a few months ago when word started to “eek out” that the Red Flag Rules might apply to hospitals and other health care providers. While the application of these rules to any specific transaction will depend upon the specifics of the transaction at issue, what does seem pretty clear at this point is that if you are affiliated with a health care provider that periodically allows patients to pay for their medical services through a series of payments, over time, that health care provider is likely a “creditor” and needs to comply with the Red Flag Rules. Health care providers should, with very limited exception, expect to comply with the Red Flag Rules as of November 1, 2008.

Compliance with the Red Flag Rules is, in many ways, tied to your HIPAA compliance program and the policies and procedures health care providers already have in place. Similar to the HIPAA Security and Privacy Regulations, the Red Flag Rules deal with access to information in patient medical records and billing account records and the extent to which those records may be accessed and used to commit identity fraud.

To begin your compliance efforts, look to identify points of access or entry into patient records or accounts that might lend itself to identify theft. Form a committee or task force made up of representatives from: HIM, HIPAA privacy and security, patient accounts, patient registration, pharmacy and the emergency department. Ask this group to brainstorm the points of access to relevant patient information and to analyze specific examples and experiences with patient identity theft to begin to develop a sense of where your identify theft risk lies.

Next, look at your existing privacy and security policies developed as part of your HIPAA compliance efforts and then evaluate what changes or additions need to be made to those policies in order to minimize your identity theft risk. In addition, you may need to revise policies or add new policies that will alert you to identity theft when it occurs and guide your response to patient identity theft.

Other things you will need to do over time as you build your Red Flag Rules compliance program will include demonstrating Board approval and oversight of your program and amending your existing business associate agreements so that your business associates are contractually obligated to be your partners in this effort.

In addition to resources being developed by the American Health Lawyers Association, the AHA and other organizations, your compliance counsel should be available to assist with the development of a Red Flag Rules compliance program.…

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Where HIPAA and FERPA Meet: Student Health Records and Disclosure Requirements

Family Educational Rights and Privacy ActThe Departments of Education and Health and Human Services have issued joint guidance on how the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) apply to student health records. The guidance also addresses certain disclosures that are allowed without consent or authorization under both laws, especially those related to health and safety emergency situations.

FERPA is a federal law that generally prohibits an institution from disclosing the education records or personally identifiable information from education records, without a parent or eligible student’s written consent. An eligible student is one who is over 18 years of age or who attends a post-secondary institution at any age. FERPA applies to institutions that receive funds pursuant to any program administered by the U.S. Department of Education, including medical and other professional schools. Please note that if an institution receives funds in this manner, FERPA applies to the recipient as a whole, including all its components, such as a department within a university.

“Education records” are broadly defined to include records that are directly related to a student and that are maintained by an educational institution or by a party acting for the institution. At the elementary and secondary levels, this can include student health records. In post-secondary institutions, medical and psychological treatment records of eligible students are excluded from the definition of “education records” if they are made, maintained, and used only in connection with treatment of the student and disclosed only to individuals providing the treatment. If the disclose is for purposes other than treatment, the records are then subject to FERPA’s requirements and can only be disclosed with the student’s written consent or under one of several enumerated exceptions to written consent.

HIPAA requires covered entities (health plans, health care clearinghouses and health care providers) to implement appropriate safeguards to protect the privacy of patients’ identifiable health information and to set limits and conditions on the uses and disclosures that may be made of such information without patient authorization. HIPAA also gives patients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections.

Whether FERPA or HIPAA apply to a particular set of records first depends on the record holder’s status as a FERPA or HIPAA covered entity. In some situations, an entity may be both. For example, when a school provides health care to students in the normal course of business, such as through its health clinic, it is both a “health provider” under HIPAA and subject to FERPA’s requirement. The analysis then hinges on whether the records meet FERPA’s “education” or “treatment” records definitions. If the records are education or treatment records under FERPA, HIPAA does not apply because HIPAA specifically excludes these records from coverage. For example, if a school is a HIPAA covered entity, and the only health records maintained by the school are education or treatment records under FERPA, the school does not have to comply with the HIPAA Privacy or Security Rules because these records are specifically excluded from coverage.

Other examples of arrangements where either HIPAA or FERPA apply:

  • If a person such as a school nurse acts on behalf of a school subject to FERPA, and maintains student health records, these records are education records under FERPA, just as if the school maintained them directly, even if the health care is provided to students off-site. HIPAA would not apply to these records.
  • FERPA applies to most post-secondary institutions. Student records at post-secondary campus health clinics are either education records or treatment records under FERPA, even if the school is a HIPAA covered entity. If the student health clinic is open to the public or school staff or both, the protected health information of the clinic’s non-student patients is still subject to HIPAA Privacy and Security Rules.
  • Patient records maintained by a hospital affiliated with a university that is subject to FERPA are not typically education records or treatment records under FERPA because university hospitals generally do not provide health care services to students on behalf of the educational institution. If the hospital runs the student health clinic, clinic records of students would be subject to FERPA as education records or treatment records and not HIPAA.

There is a never-ending array of possible situations that may arise when considering the interplay between FERPA and HIPAA. Consult legal counsel when presented with a request for disclosure of student health information to avoid inappropriate disclosures or denials for information.


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New Michigan Law Related to Billing Sexual Assault Survivors for Costs of Forensic Exam

Billing Sexual Assault Survivors for Costs of Forensic ExamHealth care providers may no longer seek payment directly from sexual assault survivors for any portion of the costs of a sexual assault medical forensic examination, including any insurance deductible, co-pay, denial of claim or other out-of-pocket expenses, if the survivors do not have insurance, or if they refuse to have the claim submitted to their insurance carrier. Instead, effective December 29, 2008, health care providers are eligible to seek reimbursement for these costs directly from the state Crime Victims Services Commission (formerly the Crime Victims Compensation Board).

Prior to seeking reimbursement from the Crime Victims Services Commission, health care providers must advise the patient, either orally or in writing, that a claim will not be submitted to their insurance carrier without their express written consent and that they may decline to consent if they believe that submitting the claim would substantially interfere with their personal privacy or safety. If the patient declines to have the claim submitted to his or her insurance carrier or if the patient is uninsured, the provider may then seek reimbursement from the Crime Victims Services Commission. The provider may not bill the patient directly.

If the patient consents to have the claim submitted to his or her insurance carrier, the health care provider must submit the claim to the patient’s insurance carrier, including Medicare or Medicaid. If reimbursement cannot be obtained from the patient’s insurance carrier, the health care provider may then submit the claim for reimbursement to the Crime Victims Services Commission. If reimbursed by the patient’s insurance carrier for any portion of the claim, the health care provider may not also seek reimbursement from the Crime Victims Services Commission or the patient for the balance of the claim.

In order to be eligible for reimbursement, the examination must include all of the following: collection of a medical history, a general medical examination, a detailed oral, anal, or genital examination, and administration of a sexual assault evidence kit and related medical procedures and laboratory and pharmacological services.

The Crime Victims Services Commission will not pay more than $600 for the cost of performing a sexual assault medical forensic examination. This includes payments up to $400 for the use of an emergency room, clinic, or examination room and the sexual assault medical forensic examination, up to $125 for laboratory services, and up to $75 for dispensing pharmaceutical items related to the sexual assault.…

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OCR Contemplates Electronic Medical Record Networks

health law careIn case you missed it, on December 15, 2008, the Office of Civil Rights published information that suggests it is thinking about how HIPAA applies to the electronic exchange of health information in a networked environment. If you want to review the materials for yourself, they are located here.

In summary, so long as the primary purpose for and function of an electronic network is treatment oriented, HIPAA should not be a barrier to the development of an effective network. OCR’s focus in its comments was on setting up electronic exchange networks so as to create a level of trust between patients and the covered entities participating in these networks. OCR recommends that patients be advised, either in the Notice of Privacy Practices or in some other document, that their health information will be used and disclosed for treatment purposes through an electronic network.

Some of the other points made by OCR in this guidance includes the following:

While covered entities are not required to agree to allow patients to restrict otherwise permissible uses and disclosures of their information, a covered entity must have policies in place to deal with the issue and if a covered entity does agree to allow certain restrictions, the covered entity must abide by that agreement, except in an emergency situation;
OCR acknowledges that HIPAA does not require a covered entity to allow patients to “opt-in” or “opt-out” of an electronic network but suggests that the ability to afford patients that kind of choice will help build trust between patients and providers who use electronic networks;
Minimum necessary concepts apply to the electronic networks and the access of health information for payment and health care operations purposes through such networks;
Regardless of the scope or purpose of an electronic health information exchange network, any disclosures of health information by a covered entity through the network must comply with the Privacy Rule and, in addition must also be in compliance with any more stringent State law requirements;
Even in an electronic exchange environment, the HIPAA Privacy Rule requirements that patients consent to the disclosure of psychotherapy notes still applies;
Covered entities who set up electronic health information exchange networks must implement appropriate administrative, technical and physical safeguards to protect the privacy of the protected health information; and
Covered entities that participate in an electronic network need to be aware that whatever information they import into their electronic records via a network become a part of their legal medical record. However, network participation alone does not make all of the information about a patient that is accessible through the network a part of their legal medical record.

Overall, given the clients that I have worked with who are setting up, trying to set up, or thinking about setting up these kinds of electronic exchange networks, the OCR guidance is not overly enlightening but still helpful in that it confirms that there is a right way and a wrong way to set up such a network and that if you have the right goal — facilitating better access to information for treatment purposes — you should be able to get where you are trying to go.…

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