SC Practical Solutions LLC

Specialized Healthcare Consulting Services

Ransomware & Cyberthreats

Ransomware and hacking are the primary cyber-threats in health care. Over the past five years, there has been a 256% increase in large breaches reported to OCR involving hacking and a 264% increase in ransomware. In 2023, hacking accounted for 79% of the large breaches reported to OCR. The large breaches reported in 2023 affected…

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Blue Care Network POS health plans don’t require referrals

Don’t submit referrals for members with BCN point-of-service plans. POS health plan referrals cannot be submitted via e-referral Blue Care Network POS health plans don’t require referrals. Beginning April 1, 2024, the e-referral system will reject all referrals submitted for BCN POS health plans. Blue Care Network point-of-service health care plans allow members to receive…

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The Whistleblower Protection Provision of the Sarbanes-Oxley Act

  In February 2024, the Supreme Court of the United States clarified the standard for proving causation under the whistleblower protection provision of the Sarbanes-Oxley Act. This ruling eases the burden of proof that employees must meet to achieve protection under the Act. Previously, employees were required to show that their employer acted against them with “retaliatory intent.” However,…

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Antitrust Lawsuit Against HCA Will Move Forward

A federal judge has denied HCA Healthcare’s motion to dismiss antitrust litigation brought by North Carolina cities and counties related to the for-profit’s 2019 acquisition of Mission Health. The ruling, signed Wednesday, February 21, 2024, relates to consolidated class-action complaints filed in 2022 by the city of Brevard, Buncombe County, the city of Asheville, and…

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CMS Finalizes Rule to Expand Access to Health Information and Improve the Prior Authorization Process

Final rule modernizes the health care system and reduces patient and provider burden by streamlining the prior authorization process As part of the Biden-Harris Administration’s ongoing commitment to increasing health data exchange and strengthening access to care, the Centers for Medicare & Medicaid Services (CMS) finalized the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)…

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