In the wake of health care reform, health care providers face numerous challenges that require them to adopt sustainable continuous improvements that advance care for their patients, enhance health in their populations and reduce the growth of their expenditures. Accountable Care Organizations (ACOs) are one vehicle through which providers are meeting these challenges head-on. Continue reading Accountable Care Organizations: Operations and Audits
Employer-sponsored health plans have a lot of work to do over the next couple of years to ensure continued compliance with HIPAA’s electronic transaction standards. HIPAA’s administrative simplification rules require a health plan to conduct certain electronic transactions in accordance with standards, code sets, and operating rules adopted by the Department of Health and Human Services (“HHS”). The PPACA significantly expands on these standards, code sets, and operating rules. The PPACA also adds the requirements that a health plan (1) obtain a health plan identifier (“HPID”) for the health plan to use with respect to the electronic transaction standards; and (2) certify compliance with the applicable electronic transaction standards.
Thus, under the PPACA’s expansion of HIPAA’s electronic transaction standards, a health plan needs to (1) ensure that it is in compliance with all currently applicable standards and operating rules (and prepare to comply with upcoming standards and operating rules); (2) obtain a HPID by November 5, 2014 (or November 5, 2015 if it is a small health plan); and (3) prepare to certify to HHS that it is in compliance with certain electronic transaction standards by December 31, 2015 (or December 31, 2016 if it is a small health plan).
Employers are sometimes tempted to enter into agreements with each other under the terms of which they agree not to recruit or hire each other’s employees. The U.S. Department of Justice takes the position that such agreements can be per se violations of the antitrust laws.
Fraser Trebilcock’s Spring 2014 Estate Strategies newsletter contains valuable information on a variety of Trusts and Estates topics, including:
- Estate planning for digital assets, such as email and iTunes.
- Property tax relief now available for disabled veterans in Michigan.
- Information on when to consider a gun trust.
One of the requirements under the Affordable Care Act effective for plan years beginning on or after January 1, 2014 was that insured health plans in the small group market could not impose a deductible exceeding $2,000/$4,000.
However, this provision has now been repealed. Continue reading Small Group Market Annual Deductible Limit Repealed