Ballad Health Provides New Details Regarding NICU Plans in East Tennessee

Ballad Health has issued a new response to the Tennessee Department of Health regarding questions about its proposed changes for the neonatal intensive care unit (NICU) in two east Tennessee hospitals, the Johnson City Press reports. In its response, Ballad provided specific details and statistics requested by former Health Commissioner John Dreyzehner. Under the proposed plan, newborns requiring Level III NICU services will be transported to Niswonger Children’s Hospital in Johnson City instead of current Level III hospital Holston Valley Medical Center, which will be downgraded to a Level I provider.

read more »

Tenet Healthcare Seeking Attorneys in Nashville, Dallas Offices

Tenet Healthcare — one of the nation’s leading investor-owned healthcare companies — is seeking several experienced health care attorneys to join its legal team based in Nashville or Dallas. The open positions are:
Senior Counsel Tenet Physician Resources
Will be the legal counsel for the Tenet Physician Resources (TPR) team to develop and implement the physician employment process and practice operations and will advise TPR on Stark, Anti-kickback, and other regulations impacting physician employment, practice acquisitions and practice operations, as well as, be responsible for Physician Employment Agreements, Professional Services Agreements, Asset Purchase Agreements, and related space and equipment lease negotiation and drafting.
Senior Regulatory Counsel
Will be responsible for understanding the daily operations of Tenet’s acute care hospitals and their affiliates and will provide oversight in the review of compliance matters, statutory and regulatory issues, fraud and abuse considerations, government investigations, HIPAA, EMTALA, reimbursement matters and conducting internal investigations.
Senior Counsel, Hospital Operations
This is a unique “in house” professional opportunity to function as the General Counsel to a portfolio of Tenet’s acute care hospitals and provide legal advice to the company’s hospital CEOs and executive teams on a wide variety of matters related to hospital operations including the review and analysis of all contractual arrangements/agreements between hospitals and other parties for compliance for Stark, anti-kickback and other fraud and abuse laws, EMTALA, HIPPA, antitrust laws and any other applicable regulatory requirements.
Interested and qualified candidates can contact Tenet’s Director Executive Search Christina Carter at or 202-329-5244.
read more »

Tennessee's Process for Handling Disability Applications Stirs Controversy

The way Tennessee physicians earn money by reviewing disability claims is stirring controversy, The Tennessean reports. There are currently about 50 doctors statewide who review disability applications, for which they receive a flat rate payment on each claim filed. Detractors feel that this incentivizes the physicians to speed through the review process because how much they earn depends on how fast they work. The article notes one doctor in particular who earned $420,000 for reviewing the disability applications of 9,088 Tennesseans during the 2018 fiscal year, averaging 12 minutes on each case. 80 percent of the cases reviewed by this doctor were denied. Tennessee has among the highest denial rates for disability applicants, rejecting 72 percent of all claims in 2017 compared to the national average of 66 percent.

read more »

House Files Motion to Intervene in Texas ACA Case

The U.S. House of Representatives recently filed a motion in federal court requesting intervention in the Texas court case that found the Affordable Care Act (ACA) unconstitutional, CNBC reports. U.S. District Court Judge Reed O'Connor last month ruled that the law was unconstitutional after the 2017 Tax Act eliminated penalties for adults without health insurance. A lawyer for the House said in the filing that federal legal rules give “the House an unconditional right to intervene,” given the ACA was passed into law by Congress and that the Trump administration is not defending the law, maintaining that “interest in this action ... is not adequately represented by the existing parties.” O’Connor has stayed his ruling pending appeal.

read more »

New Tennessee Abortion Law Will Not Require Patients to View or Listen to Ultrasounds

The Tennessee law enacted this year regarding ultrasounds prior to abortions will not mandate that the patient view or listen to the ultrasound, but instead requires the physician to include a new disposition in the report indicating whether a heartbeat was detected and to provide the woman an opportunity to learn the results if requested, NPR reports. The bill began as a ban on abortions after the detection of a heartbeat, however, was amended because of the U.S. Supreme Court's recent decision to strike down abortion restrictions in Texas out of concern that the court would find Tennessee’s restrictions similarly unconstitutional. Bill sponsor Rep. Micah VanHuss (R-Jonesborough) told his colleagues that he still thought it would lead to fewer abortions, but Rep. John Ray Clemmons (D-Nashville) questioned whether the new rules disregard the anguish of a woman considering abortion.

read more »

AG Slatery Defends Participation in ACA Lawsuit

Tennessee Attorney General Herbert Slatery is defending his participation in the lawsuit that led to a federal judge to rule the Affordable Care Act (ACA) as unconstitutional, saying “the Commerce Clause of our Constitution that, according to the court, prevents Congress from compelling Tennesseans to buy insurance, especially if they can't afford it or don't want it,” The Chattanooga Times Free Press reports. U.S. District Court Judge Reed O'Connor last December ruled in favor of the 19 Republican state attorneys general, who argued that the law was unconstitutional after the 2017 Tax Act eliminated penalties for adults without health insurance. The U.S. Supreme Court had previously upheld the mandate, saying it was constitutional because it fell under Congress's taxing power. State Democrats have blasted the ruling, warning of consequences for the 1.7 million Tennesseans with pre-existing health conditions and the quarter of a million people in the state who obtain their insurance coverage through the ACA.

read more »

Rural Clinics Grapple with Frozen TennCare Payments

An estimated 20 rural health clinics that opened in the last 15 months are facing financial distress due to promised TennCare payments being temporarily frozen until the state establishes new payment rules, The Tennessean reports. Many of these clinics are the only health provider in the area due to several rural hospital closures. While national and state health care organizations have expressed the necessity of ending the moratorium, a TennCare spokeswoman defended the freeze due to the complicated nature of creating required rules for billing procedures for all of the state’s 150 rural clinics.  The moratorium has been extended twice; the current freeze is scheduled to end in April but could be extended again.  

read more »

Lauderdale Hospital Struggling with Financial Hardships

Employees at Lauderdale Community Hospital in Ripley did not receive a paycheck for two weeks, WREG reports. The hospital is operated by Kansas City-based EmpowerHMS, which also missed payroll for several of its hospitals in Oklahoma as well. The employees were eventually paid on Friday; however, the hospital is still facing financial hardships, owing the city of Ripley $186,709.00 in back taxes and Lauderdale County $164,985.50 in back taxes. Hospital CEO Michael Layfield said that the facility is facing the same financial woes as many other rural hospitals and that the organization is “struggling because of volumes dropping and decreases in reimbursement."

read more »

State Democrats Ask AG Slatery to Remove Tennessee from ACA Lawsuit

Tennessee Democrats rebuked a federal judge's ruling that the ACA is unconstitutional and are asking Tennessee Attorney General Herbert Slatery to remove Tennessee from the lawsuit, The Chattanooga Times Free Press reports. U.S. District Court Judge Reed O'Connor on Friday ruled that because a 2017 congressional tax bill eliminated penalties for those without health insurance, the ACA is unconstitutional. The lawmakers are calling on Senator Lamar Alexander, who is chairman of the Senate Health Committee, to protect Tennesseans — of which 1.26 million have preexisting health conditions — should the ruling be upheld on appeal. Alexander previously supported a "repeal and replace" plan, saying, "I don't think Tennesseans would be comfortable canceling insurance for 22 million Americans and trusting Congress to find a replacement in two years.”

read more »

Department of Health Requests More Information on Ballad NICU Consolidation

The Tennessee Department of Health has requested additional information regarding Ballad Health's plans to consolidate NICU services in the tri-cities area, WJHL reports. Currently, two area hospitals — Holston Valley Medical Center (HVMC) in Kingsport and Johnson City Medical Center — have Level III NICUs, however, Ballad’s plan would reduce HVMC to a Level I nursery. Some of the information requested by the department includes how the hospitals will handle high-risk pregnancies in a non-NICU facility, financial analysis for the project and estimated timeline for completion.

read more »