Five Stories That Matter in Michigan This Week – April 5, 2024

  1. New Michigan House Map Approved

A panel of three federal judges recently approved new voting districts for the Michigan House of Representatives after previously invalidating several districts within Detroit.

Why it Matters: The districts were revised because the panel previously found the Michigan redistricting commission’s redrawn districts were based predominantly on race in violation of the U.S. Constitution.

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  1. Ten Reasons Why You May Want to Consider a Family Cottage Succession Plan

The goal of cottage succession planning is to set up legal ground rules that provide the best chance to keep a cottage in the family for future generations.

Why it Matters: A cottage plan usually addresses concerns through the creative use of a limited liability company (LLC), or a trust (typically used for more favorable treatment associated with the uncapping of taxable value), to own the property. Learn more from cottage law attorney Mark Kellogg.

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  1. Snack Food Brand Sues Michigan Cannabis Companies Over Trademark Infringement

Better Made Snack Foods Inc, a Detroit based snack food company, is suing multiple Michigan cannabis companies over trademark infringement alleging that the companies knowingly and willingly sold cannabis products under the brand Better Smoke.

Why it Matters: Better Made is seeking monetary damages as well as an injunction to halt the sales of Better Smoke products.

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  1. A Health Professional’s Guide to Navigating the Disciplinary Process: What to Expect if You Are Facing a Professional Licensing Investigation or Administrative Complaint

Health professionals are committed to caring for patients with expertise, compassion, and integrity. However, in the heavily regulated healthcare field, those professionals can sometimes find themselves navigating not just the medical challenges of their patients but licensing issues of their own as well. Licensing issues can arise unexpectedly, and, when they do, they can cause tremendous stress and uncertainty.

Why it Matters: As an attorney with years of experience handling professional licensing matters for health professionals, Robert J. Andretz has witnessed firsthand how professional licensing investigations and Administrative Complaints can disrupt health professionals’ careers and their ability to provide patient care. He will explore how to navigate the disciplinary process in Michigan so that you can know what to expect if you are ever faced with a threat to your license. Learn more.

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  1. Corporate Transparency Act Update

As anticipated, the finding by a federal judge in Alabama that the Corporate Transparency Act is unconstitutional has prompted (or at least been echoed by) challenges elsewhere, including in federal courts in Maine and in Michigan. FinCEN filed its appeal notice in the Alabama suit earlier this month, meaning that a decision by the 11th Circuit Court of Appeals may be forthcoming. The suits in Maine and Michigan were brought in courts covered by the 5th and 6th Circuit Courts of Appeals, which could be the beginning of a series of events that brings the question of the CTA’s constitutionality before the United States Supreme Court as a result of a possible Circuit split.

Why it Matters: Reporting companies that were formed prior to January 1, 2024, may find it advantageous to continue collecting their beneficial owner information but postpone filing the report until some of these matters have worked through their respective processes. Entities created on or after January 1, 2024, however, will still need to file their reports within 90 days of filing their organizing documents, as their reporting obligations have not been excused. Learn more from attorney Bob Burgee.

Related Practice Groups and Professionals

Cannabis Law | Sean Gallagher
Cottage Law | Mark Kellogg
Health Care Law Robert Andretz
Business & Tax | Robert Burgee

Five Stories That Matter in Michigan This Week – March 29, 2024

  1. Cannabis Regulatory Agency Takes Disciplinary Action

The Michigan Cannabis Regulatory Agency recently released its February 2024 Disciplinary Action Report, which details administrative formal complaints and disciplinary actions taken against adult-use/medical licensees in February by the CRA. The list is extensive, and the disciplinary action imposed ranges from fines to license suspension.

Why it Matters: Michigan cannabis rules and regulation are complex, cumbersome, and, as we see from the CRA’s most recent Disciplinary Action Report, aggressively enforced by the agency. For assistance in understanding and complying with Michigan’s cannabis industry regulatory framework, please contact a member of our Cannabis Law team.

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  1. Corporate Transparency Act Update

As anticipated, the finding by a federal judge in Alabama that the Corporate Transparency Act is unconstitutional has prompted (or at least been echoed by) challenges elsewhere, including in federal courts in Maine and in Michigan. FinCEN filed its appeal notice in the Alabama suit earlier this month, meaning that a decision by the 11th Circuit Court of Appeals may be forthcoming. The suits in Maine and Michigan were brought in courts covered by the 5th and 6th Circuit Courts of Appeals, which could be the beginning of a series of events that brings the question of the CTA’s constitutionality before the United States Supreme Court as a result of a possible Circuit split.

Why it Matters: Reporting companies that were formed prior to January 1, 2024, may find it advantageous to continue collecting their beneficial owner information but postpone filing the report until some of these matters have worked through their respective processes. Entities created on or after January 1, 2024, however, will still need to file their reports within 90 days of filing their organizing documents, as their reporting obligations have not been excused. Learn more from attorney Bob Burgee.

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  1. Michigan Cannabis Exceeds $261 Million in February ‘24

Cannabis sales surpassed $242 million in February, via the monthly report from the Michigan Cannabis Regulatory Agency. Michigan adult-use sales came in at $258,857,645.20, while medical sales came in at $2,178,744.68, totaling $261,036,389.88.

Why it Matters: Marijuana sales remain strong in Michigan, particularly for recreational use. However, there still are significant concerns about profitability and market oversaturation that the industry is contending with.

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  1. A Health Professional’s Guide to Navigating the Disciplinary Process: What to Expect if You Are Facing a Professional Licensing Investigation or Administrative Complaint

Health professionals are committed to caring for patients with expertise, compassion, and integrity. However, in the heavily regulated healthcare field, those professionals can sometimes find themselves navigating not just the medical challenges of their patients but licensing issues of their own as well. Licensing issues can arise unexpectedly, and, when they do, they can cause tremendous stress and uncertainty.

Why it Matters: As an attorney with years of experience handling professional licensing matters for health professionals, Robert J. Andretz has witnessed firsthand how professional licensing investigations and Administrative Complaints can disrupt health professionals’ careers and their ability to provide patient care. He will explore how to navigate the disciplinary process in Michigan so that you can know what to expect if you are ever faced with a threat to your license. Learn more.

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  1. The Uniform Power of Attorney Act

The Uniform Power of Attorney Act (UPOAA or Act), 2023 PA 187, was signed into law in November 2023 and goes into effect July 1, 2024. It repeals Michigan’s current statutory law on durable powers of attorney, specifically Sections 700.5501-700.5505 of the Estates and Protected Individuals Code (EPIC). The UPOAA is not part of EPIC, instead, it is a stand-alone statute located at MCL 556.201 et. seq.

Why it Matters: The UPOAA will apply to all powers of attorney in Michigan beginning July 1, 2024, with certain exceptions. Read more from attorney Melisa M.W. Mysliwiec.

Related Practice Groups and Professionals

Cannabis Law | Sean Gallagher
Business & Tax | Robert Burgee
Health Care Law Robert Andretz
Trusts & Estates | Melisa M.W. Mysliwiec

Five Stories That Matter in Michigan This Week – February 2, 2024

  1. A Health Professional’s Guide to Navigating the Disciplinary Process: What to Expect if You Are Facing a Professional Licensing Investigation or Administrative Complaint

Health professionals are committed to caring for patients with expertise, compassion, and integrity. However, in the heavily regulated healthcare field, those professionals can sometimes find themselves navigating not just the medical challenges of their patients but licensing issues of their own as well. Licensing issues can arise unexpectedly, and, when they do, they can cause tremendous stress and uncertainty.

Why it Matters: As an attorney with years of experience handling professional licensing matters for health professionals, Robert J. Andretz has witnessed firsthand how professional licensing investigations and Administrative Complaints can disrupt health professionals’ careers and their ability to provide patient care. He will explore how to navigate the disciplinary process in Michigan so that you can know what to expect if you are ever faced with a threat to your license. Learn more.

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  1. Understanding How Trademarks, Copyrights, and Patents Protect Your Business

Trademark registration separates your business from your competition and makes you unique. It is one method of protecting your intangibles while publicly providing notice to other businesses or individuals to avoid copying or infringing on your intellectual property rights.

Why it Matters: But when do you need this? When do you get them? And what are they for? Learn more on this series about trademarks, copyrights, and patents from Fraser Trebilcock attorney Andrew Martin.

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  1. Ward Off 2024 Tax Season Flu – File Early and Electronically

Earlier this week, January 29, 2024, marked the start date for the 2024 filing season and the first date that the IRS will begin accepting and processing 2024 returns. The IRS will issue most electronically filed refunds within 21 days, however there are a variety of factors that can delay the issuance of any refund claim outside of the 21-day period, so one should not rely on receiving a refund within 21-days.

Why it Matters: It is important to file early and electronically to avoid any delays in receiving a refund, if applicable. If you have any questions, contact your Fraser Trebilcock attorney.

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  1. The DOL Issues Final Rule Creating New Standard for Classifying Workers as Employees vs. Independent Contractors

On January 9, 2024, the United States Department of Labor released its final rule on worker classification under the Fair Labor Standards Act (FLSA).

Why it Matters: This new rule, effective as of March 11, 2024, signals a return to a standard more likely to classify workers as employees than contractors. Thus, it is more likely that employers will be determined to have misclassified workers as contractors, resulting in liability. Learn more from your Fraser Trebilcock attorney.

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  1. Michigan Legal Cannabis Sales Hit New Record in 2023

Licensed cannabis dispensaries in Michigan registered a record $3.06 billion in sales in 2023. This represents a 25% increase over sales in 2022. Recreational cannabis accounted for $2.74 billion of total sales in 2023.

Why it Matters: According to an analysis by Metro Times, more than $274 million in tax revenue from cannabis sales will go to local governments, schools, and roads.

Related Practice Groups and Professionals

Professional Licensing | Robert Andretz
Intellectual Property | Andrew Martin
Business & Tax | Paul McCord
Labor, Employment & Civil Rights | David Houston
Cannabis Law | Sean Gallagher

A Health Professional’s Guide to Navigating the Disciplinary Process: What to Expect if You Are Facing a Professional Licensing Investigation or Administrative Complaint

Health professionals are committed to caring for patients with expertise, compassion, and integrity. However, in the heavily regulated healthcare field, those professionals can sometimes find themselves navigating not just the medical challenges of their patients but licensing issues of their own as well. Licensing issues can arise unexpectedly, and, when they do, they can cause tremendous stress and uncertainty.

As an attorney with years of experience handling professional licensing matters for health professionals, I have witnessed firsthand how professional licensing investigations and Administrative Complaints can disrupt health professionals’ careers and their ability to provide patient care. Let’s explore how to navigate the disciplinary process in Michigan so that you can know what to expect if you are ever faced with a threat to your license.

Understanding the Disciplinary Process

In Michigan, the disciplinary process for the more than 400,000 licensed health professionals is overseen by the Department of Licensing and Regulatory Affairs (LARA) Bureau of Professional Licensing (BPL). This process is designed to uphold professional standards and protect public health while, at the same time, ensuring fair treatment for health professionals.

While each case is unique, there are some common themes in the types of actions or omissions that give rise to investigations and Administrative Complaints in the healthcare field. Being aware of these can help health professionals take steps to prevent potential issues that can lead to investigations and Administrative Complaints. Some of the most common involve allegations related to negligence, incompetence, professional misconduct, professional boundaries, lack of good moral character, controlled substances, substance use disorder, impairment, misdemeanor and/or felony criminal convictions, advertising, practice outside the scope of a license, documentation and recordkeeping, and Michigan Automated Prescription System (MAPS) reports.

The Initial Filing of a Complaint

Complaints can be filed by just about anyone: current or former patients, supervisors, subordinates, professional colleagues, and even the licensees themselves. These complaints are taken very seriously by the BPL and will be investigated. You may not even know that you are the subject of a complaint until you have been contacted by the BPL as part of its investigation.

The Investigation Phase

The BPL will conduct a thorough investigation once it has received a complaint and will assign one or more investigators (known as “Regulation Agents”) to the professional licensing investigation matter. It is frequently during the investigation phase that licensees first become aware that one or more allegations have been made against them. Unfortunately, many health professionals are unaware that they have the right to have the assistance of an attorney during the investigation phase. These unrepresented health professionals frequently make statements to the investigators without the guidance of an attorney, and I have seen instances where those statements have ultimately been used to provide the foundation for an Administrative Complaint to be filed against them.

At the conclusion of the investigation, an Investigation Report will be forwarded to the Disciplinary Subcommittee (DSC) of the board that governs that particular profession. If one or more violations of Michigan’s Public Health Code have been substantiated, an Administrative Complaint may be authorized. Thankfully, not all professional licensing investigations result in the filing of an Administrative Complaint, which is why having experienced legal representation behind you is so important during the investigation phase.

Responding to an Administrative Complaint

If the BPL issues an Administrative Complaint against you, you must respond in writing within 30 days from the date that you received the Administrative Complaint. Failure to respond in writing within 30 days will result in the Administrative Complaint being forwarded to the DSC for imposition of a sanction without any input from you.

You will be presented with 3 different options. You may (1) request a settlement, (2) request a compliance conference, or (3) request a formal administrative hearing on the merits of the Administrative Complaint.

It is important to prepare a timely and thoughtful response. This is a critical stage where legal representation is critical. A well-prepared Answer to Administrative Complaint can isolate the disputed issues and mitigate the severity of the situation.

The Compliance Conference

If you request a compliance conference, you will have the opportunity to present mitigating information and your side of the story in an informal setting, and an attorney may prepare you for the compliance conference and represent you at the compliance conference. Following the compliance conference, a proposed Consent Order and Stipulation may be prepared to resolve the Administrative Complaint, and it may be revised during the negotiation process that’s sometimes follows the compliance conference. The Administrative Complaint may also be dismissed by the BPL. However, if the Administrative Complaint is not resolved with a Consent Order and Stipulation or dismissed altogether, the matter will proceed to a formal administrative hearing on the merits of the Administrative Complaint.

The Formal Administrative Hearing on the Merits of the Administrative Complaint

If you proceed to a formal administrative hearing on the merits of the Administrative Complaint, it is essential to understand what this entails. The hearing is similar to a bench trial in court with opening statements, closing arguments, the formal testimony of witnesses under oath, and the admission of exhibits. You will have an opportunity to testify and to share your side of the story in a formal setting. The hearing will be held before an Administrative Law Judge (ALJ), but the ALJ cannot make a decision at the hearing. Instead, the ALJ will issue a Proposal for Decision (PFD). Exceptions to the PFD may be filed by the parties, and the PFD is then forwarded to the DSC for its consideration. The DSC will then issue a Final Order.

A merits hearing may be the only way to obtain the result that you need to continue practicing your chosen profession. However, proceeding to a hearing is a decision that should not be made lightly, and careful preparation in collaboration with legal counsel, including the gathering  and analysis of evidence and the preparation of any witnesses, is key.

Summary Suspension

If it has been found that you pose an immediate threat to the public health, safety, or welfare, your Administrative Complaint may be accompanied by a separate document called an Order of Summary Suspension. If you receive an Order of Summary Suspension, you must stop practicing your health profession immediately and cannot practice again until the summary suspension has been dissolved.

There is more than one way to dissolve a summary suspension. If a Petition for Dissolution of Summary Suspension is filed, an emergency hearing will be scheduled before an administrative law judge (ALJ). If the ALJ determines that there is insufficient evidence that you pose an immediate threat to the public health, safety, or welfare that requires a continuation of the summary suspension, the ALJ shall dissolve the summary suspension. A summary suspension can also be dissolved by a Consent Order and Stipulation at the end of the Administrative Complaint resolution process or by a Final Order following a formal hearing on the merits of the Administrative Complaint.

Possible Outcomes and Sanctions

A disciplinary action may conclude with a complete dismissal of the Administrative Complaint against you. However, if one or more violations of the Public Health Code have been substantiated, sanctions must be imposed. License sanctions can vary widely depending on the severity of the Public Health Code violation and, pursuant to MCL 333.16226, may include reprimand, fine, probation, restitution, limitation, suspension, revocation, and even permanent revocation.

The Appeal Process

If you disagree with the Final Order, you may appeal it to the Michigan Court of Appeals. The appeal process is complex and requires a strategic approach. Consider the grounds for appeal carefully and consult with an experienced attorney to evaluate the feasibility and potential benefits of an appeal.

Preventative Measures and Best Practices

When it comes to professional licensing, an ounce of prevention is always better than a pound of cure. Adhering to ethical practices, engaging in continuous professional development, and staying informed about regulatory changes can help prevent complaints. A proactive approach to professional conduct is always your best defense.

Conclusion

Facing a professional licensing investigation or an Administrative Complaint can be a very stressful experience for any health professional, but understanding the process and having an experienced attorney by your side can make a significant difference.

This guide serves as a general summary and does not constitute legal guidance. Please contact us with any specific questions.


Attorney Robert J. AndretzFraser Trebilcock Shareholder Robert J. Andretz is an experienced professional licensing attorney with years of experience successfully defending doctors, nurses, and other licensed health professionals across the state of Michigan in professional licensing matters, including professional licensing investigations and Administrative Complaint matters. You can reach him at 517.377.0854 or randretz@fraserlawfirm.com.

Pharmacists Allowed to Dispense Emergency Prescription Refills Under EO 2020-25

On March 25, 2020, amid the Coronavirus (COVID-19) outbreak, Governor Whitmer signed Executive Order 2020-25 to address the critical need to pharmacy services. This Executive Order gave pharmacists the authority to dispense up to a sixty (60) day supply of emergency prescription refills to patients. This Executive Order, which took effect immediately, only applies to non-controlled substances and can only be dispensed if, “in the pharmacist’s professional judgment, failure to refill the prescription might interrupt the patient’s ongoing care and have a significant adverse effect on the patient’s well-being.” When dispensing this medication, your pharmacist must tell you that he or she is doing so pursuant to this Executive Order.

This Executive Order also requires insurers to cover these emergency prescription refills and gives pharmacists the discretion to substitute therapeutically equivalent medications without prescriber approval if there are critical shortages. The pharmacist must inform the patient of any substitution.

Pharmacists are also allowed to dispense COVID-19 treatments according to government-related protocols established by the Center for Disease Control and Prevention, National Institute of Health, or Department of Health and Human Services under this Executive Order.


We have created a response team to the rapidly changing COVID-19 situation and the law and guidance that follows, so we will continue to post any new developments. You can view our COVID-19 Response Page and additional resources by following the link here. In the meantime, if you have any questions, please contact your Fraser Trebilcock attorney.


Fraser Trebilcock Attorney Amanda S. Wolanin specializes her practice in business and tax law, bankruptcy, family law, estate planning, litigation, and real estate law. You can reach her at (517) 377-0897, or at awolanin@fraserlawfirm.com.

Governor Whitmer Orders Halt to Many Medical and Dental Services

Governor Gretchen Whitmer today signed Executive Order 2020-17, restricting non-essential medical and dental procedures in hospitals, surgery centers, clinics and medical offices. The order is wide-ranging and specific and provides examples of actions that may not be taken, and exceptions if applicable.

Many medical and dental providers have already initiated contact with patients to defer many scheduled appointments even prior to the Governor’s order, but these steps are no longer optional.

The stated purpose of the Order is “To mitigate the spread of COVID-19, protect the public health, provide essential protections to vulnerable Michiganders, and ensure the availability of health care resources, it is reasonable and necessary to impose temporary restrictions on non-essential medical and dental procedures.”

For more information regarding the Executive Order, follow the link here.


We have created a response team to the rapidly changing COVID-19 situation, and will continue to post any new developments. You can view the page and additional resources by following the link here. In the meantime, if you have any questions, please contact your Fraser Trebilcock attorney.

NEW VIDEO: The HITECH Act and HIPAA

With the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act, it has caused a number of issues for employers. It is crucial for employers to stay in legal compliance to avoid audits, and the substantial penalties that come with HIPAA violations.

This video discusses the HITECH Act and HIPAA, and their possible effects on employers.

Our lawyers at Fraser Trebilcock also devote substantial amounts of time to advising clients of legislative and regulatory changes in the employee benefits area, and frequently write and lecture on employee benefits topics. Click HERE to sign up to receive updates and alerts on matters related to Employee Benefits Law.


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President Trump Signs Executive Order on Health Care; HHS Announces CSR Payments to be Discontinued Immediately

President Donald Trump
Photo of President Trump’s news conference, courtesy of the White House.

Yesterday, October 12, 2017, President Trump issued an Executive Order entitled “Promoting Healthcare Choice and Competition Across the United States” (the “Order”). Also on October 12, 2017, the Department of Health and Human Services released a statement that the cost-sharing reduction payments authorized by section 1401 of the Patient Protection and Affordable Care Act (“subsidies”) will be discontinued immediately (the “HHS Statement”).

Executive Order

The Order articles a “policy of the executive branch, to the extent consistent with law, to facilitate the purchase of insurance across State lines and the development and operation of a healthcare system that provides high-quality care at affordable prices for American people.” To meet this policy goal, President Trump announced that his administration will prioritize three areas of law in the new future: (1) Association Health Plans (“AHPs”); (2) Short-term, Limited-Duration Insurance (STLDI); and (3) Health Reimbursement Arrangements (“HRAs”).

To the extent consistent with law, the Order relevantly announces that government rules and guidelines should expand the availability of and access to PPACA insurance alternatives, including AHPs, STLDI, and HRAs. To effectuate this goal, the Order relevantly indicates:

“Sec. 2. Expanded Access to Association Health Plans. Within 60 days of the date of this order, the Secretary of Labor shall consider proposing regulations or revising guidance, consistent with law, to expand access to health coverage by allowing more employers to form AHPs. To the extent permitted by law and supported by sound policy, the Secretary should consider expanding the conditions that satisfy the commonality of-interest requirements under current Department of Labor advisory opinions interpreting the definition of an “employer” under section 3(5) of the Employee Retirement Income Security Act of 1974. The Secretary of Labor should also consider ways to promote AHP formation on the basis of common geography or industry.”

“Sec. 3. Expanded Availability of Short-Term, Limited Duration Insurance. Within 60 days of the date of this order, the Secretaries of the Treasury, Labor, and Health and Human Services shall consider proposing regulations or revising guidance, consistent with law, to expand the availability of STLDI. To the extent permitted by law and supported by sound policy, the Secretaries should consider allowing such insurance to cover longer periods and be renewed by the consumer.”

“Sec. 4. Expanded Availability and Permitted Use of Health Reimbursement Arrangements. Within 120 days of the date of this order, the Secretaries of the Treasury, Labor, and Health and Human Services shall consider proposing regulations or revising guidance, to the extent permitted by law and supported by sound policy, to increase the usability of HRAs, to expand employers’ ability to offer HRAs to their employees, and to allow HRAs to be used in conjunction with nongroup coverage.”

At this point is time, no changes to the law have occurred; this Executive Order merely indicates the President’s intent to make changes to the current regulatory structure in the near future. A copy of the Order is available at: www.whitehouse.gov/the-press-office/2017/10/12/presidential-executive-order-promoting-healthcare-choice-and-competition

HHS Statement

The HHS Statement indicates that its decision to immediately discontinue subsidies is based on a legal opinion issued by the Attorney General. A copy of the HHS Statement and the Attorney General opinion letter are available at: www.hhs.gov/about/news/2017/10/12/trump-administration-takes-action-abide-law-constitution-discontinue-csr-payments.html

We will keep you apprised of future developments in this regard.


Elizabeth H. Latchana, Attorney Fraser TrebilcockElizabeth H. Latchana specializes in employee health and welfare benefits. Recognized for her outstanding legal work, in both 2018 and 2015, Beth was selected as “Lawyer of the Year” in Lansing for Employee Benefits (ERISA) Law by Best Lawyers, and in 2017 as one of the Top 30 “Women in the Law” by Michigan Lawyers Weekly. Contact her for more information on this reminder or other matters at 517.377.0826 or elatchana@fraserlawfirm.com.

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Employer-Sponsored Plans Take Note: The Legislative Process to Amend, Repeal, and Replace Aspects of the Patient Protection and Affordable Care Act has Begun

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Employer-plan sponsors need to be ready to act as changes to the landscape of the Patient Protection and Affordable Care Act (“PPACA”) as applied to employer-sponsored group health plans are looming on the horizon.

On January 20, 2017, President Trump signed Executive Order 13765 titled “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal” (the “Executive Order”).  The Executive Order indicates a clear intent to repeal the PPACA in the future and in the meantime urges federal government agencies to take legally permissible leniencies in enforcing certain aspects of the PPACA: “To the maximum extent permitted by law, . . . [executive departments and agencies] . . . shall exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.”  A copy of the Executive Order is available at: https://www.gpo.gov/fdsys/pkg/FR-2017-01-24/pdf/2017-01799.pdf

While the Executive Order serves as a general mission statement for the new administration, it does not provide an instantaneous change to the PPACA (the President cannot, by unilateral action, repeal final regulations).   Furthermore, while the Executive Order provides a clear overall goal, it does not include details regarding how this goal will be achieved.  Moreover, the Executive Order does not specifically mention any relief for employers or plan sponsors, nor does it discuss if and how any PPACA provisions regulating employers and employer-sponsored plans are expected to be impacted.  Since the release of the Executive Order, all eyes in the benefits community have been on the status of the PPACA.

In the wake of the Executive Order, in February 2017, the IRS became the first agency to follow the Executive Order’s directive to start unwinding certain provisions of the PPACA.  Specifically, the IRS released a statement indicating that individual tax returns will not be automatically rejected during processing merely because the taxpayer fails to indicate his or her health coverage status.  This IRS statement appears to have loosened the IRS’ enforcement of the individual shared responsibility mandate.  The IRS’ statement related to the individual shared responsibility mandate can be found at: https://www.irs.gov/affordable-care-act/individuals-and-families/individual-shared-responsibility-provision

It is important to note that the IRS statement did not indicate that the IRS would waive penalties for individuals who fail to maintain compliant health insurance coverage: “However, legislative provisions of the ACA are still in force until changed by Congress, and taxpayers remain required to follow the law and pay what they may owe.”   And, again, the IRS statement does not address anything about its enforcement of the employer shared responsibility mandate or other PPACA provisions regulating employer-sponsored plans.  Thus, the Executive Order and IRS statement have left the employee benefits community uncertain as to how the new administration intends to address the PPACA as it relates to employer-sponsored plans.

Yesterday, however, the House Republicans addressed this looming issue.  On March 6, 2017, the House Ways and Means Committee and the House Energy and Commerce Committee each released proposed legislation to repeal and replace certain aspects of the PPACA, entitled the American Health Care Act (the “Proposed Legislation”).  The Proposed Legislation provides insight into how the landscape of the PPACA may be altered with respect to employer-sponsored plans.

If enacted as drafted, the Proposed Legislation, as summarized, would dismantle certain taxes imposed under the PPACA, eliminate both the individual and employer shared responsibility mandate penalties, while keeping other portions of the PPACA in place, such as prohibiting pre-existing condition exclusions from coverage and allowing dependents to continue coverage under their parents’ health plans until the age of 26.

Other provisions of the Proposed Legislation establish a patient and state stability fund to provide states financial assistance to design programs aimed at each state’s own population and needs for affordable health care, transition Medicaid to a “per capita allotment,” increase the contribution maximums for health savings accounts (HSAs), repeal the tax on over the counter drugs, repeal the limitations of contributions to health flexible spending accounts, and assist those in the low to middle-income brackets with monthly tax credits to assist with health care costs.

A summary of the Proposed Legislation impacting employers, as prepared by the Committee on Ways and Means Majority Staff, is as follows:

“SUBTITLE _ — REPEAL AND REPLACE OF HEALTH-RELATED TAX POLICY”

“SECTION_04: SMALL BUSINESS TAX CREDIT

“This section repeals Obamacare’s small business tax credit beginning in 2020. Between 2018 and 2020, under the proposal, the small business tax credit generally is not available with respect to a qualified health plan that provides coverage relating to elective abortions.”

“SECTION_06: EMPLOYER MANDATE

“Under current law, certain employers are required to provide health insurance or pay a penalty. This section would reduce the penalty to zero for failure to provide minimum essential coverage; effectively Prepared by the Committee on Ways and Means Majority Staff March 6, 2017 repealing the employer mandate. The effective date would apply for months beginning after December 31, 2015, providing retroactive relief to those impacted by the penalty in 2016.

“SECTION_07: REPEAL OF THE TAX ON EMPLOYEE HEALTH INSURANCE PREMIUMS AND HEALTH PLAN BENEFITS

“Obamacare imposed a 40 percent excise tax on high cost employer-sponsored health coverage, also known as Cadillac plans. Under current law, the tax will go into effect in 2020. This section changes the effective date of the tax. It will not apply for any taxable period beginning after December 31, 2019, and before January 1, 2025. Thus, the tax will apply only for taxable periods beginning after December 31, 2024.

“SECTION_08: REPEAL OF THE TAX ON OVER-THE-COUNTER MEDICATIONS

“Under current law, taxpayers may use several different types of tax-advantaged health savings accounts to help pay or be reimbursed for qualified medical expenses. Obamacare excluded over-the counter medications from the definition of qualified medical expenses. This section effectively repeals the Obamacare tax on over-the-counter medications. The effective date begins tax year 2018.

“SECTION_09: REPEAL OF INCREASE OF TAX ON HEALTH SAVINGS ACCOUNTS

“Distributions from an HSA or Archer MSA that are used for qualified medical expenses are excludible from gross income. Distributions that are not used for qualified medical expenses are includible in income and are generally subject to an additional tax. Obamacare increased the percentage of the tax on distributions that are not used for qualified medical expenses to 20 percent. This section lowers the rate to pre-Obamacare percentages. This change is effective for distributions after December 31, 2017.

“SECTION_10: REPEAL OF LIMITATIONS ON CONTRIBUTIONS TO FLEXIBLE SAVINGS ACCOUNTS

“Obamacare limits the amount an employer or individual may contribute to a health Flexible Spending Account (FSA) to $2,500, indexed for cost-of-living adjustments. This section repeals the limitation on health FSA contributions for taxable years beginning after December 31, 2017.”

“SECTION_12: REPEAL OF ELIMINATION OF DEDUCTION FOR EXPENSES ALLOCABLE TO MEDICARE PART D SUBSIDY

“Prior to Obamacare, as an incentive for employers to offer retiree drug coverage, employers who offered sufficient prescription drug coverage to their employees qualified for the Retiree Drug Subsidy to help cover actual spending for prescription drug costs. Obamacare eliminated the ability for employers to take a tax deduction on the value of this subsidy. This section repeals this Obamacare change and re-instates the business-expense deduction for retiree prescription drug costs without Prepared by the Committee on Ways and Means Majority Staff March 6, 2017 reduction by the amount of any federal subsidy. This section applies to taxable years beginning after December 31, 2017.”

“SECTION_14: REPEAL OF MEDICARE TAX INCREASE
“Obamacare imposed a Medicare Hospital Insurance (HI) surtax based on income at a rate equal to 0.9 percent of an employee’s wages or a self-employed individual’s self-employment income. This section repeals the additional 0.9 percent Medicare tax beginning in 2018.

“SECTION_15: REFUNDABLE TAX CREDIT FOR HEALTH INSURANCE

[***]

“The program also calls for simplified reporting of an offer of coverage on the W-2 by employers. Reconciliation rules limit the ability of Congress to repeal the current reporting, but, when the current reporting becomes redundant and replaced by the reporting mechanism called for in the bill, then the Secretary of the Treasury can stop enforcing reporting that is not needed for taxable purposes.

“SECTION_16: MAXIMUM CONTRIBUTION LIMIT TO HEALTH SAVINGS ACCOUNT INCREASED TO AMOUNT OF DEDUCTIBLE AND OUT-OF-POCKET LIMITATION

“This section increases the basic limit on aggregate Health Savings Account contributions for a year to equal the maximum on the sum of the annual deductible and out-of-pocket expenses permitted under a high deductible health plan. Thus, the basic limit will be at least $6,550 in the case of self-only coverage and $13,100 in the case of family coverage beginning in 2018.

“SECTION_17: ALLOW BOTH SPOUSES TO MAKE CATCH-UP CONTRIBUTIONS

“This section would effectively allow both spouses to make catch-up contributions to one HSA beginning in 2018.

“SECTION_18: SPECIAL RULE FOR CERTAIN MEDICAL EXPENSES INCURRED BEFORE ESTABLISHMENT OF HSA

“This section sets forth certain circumstances under which HSA withdrawals can be used to pay qualified medical expenses incurred before the HSA was established. Starting in 2018, if an HSA is established during the 60-day period beginning on the date that an individual’s coverage under a high deductible health plan begins, then the HSA is treated as having been established on the date coverage under the high deductible health plan begins for purposes of determining if an expense incurred is a qualified medical expense.”

“SUBTITLE _ — REPEAL AND REPLACE OF CERTAIN CONSUMER TAXES”

“SECTION_02: REPEAL OF HEALTH INSURANCE TAX

“Obamacare imposed an annual fee on certain health insurers. The proposal repeals the health insurance tax beginning after December 31, 2017.”

For the full summary of the Proposed Legislation, please see: https://waysandmeans.house.gov/wp-content/uploads/2017/03/03.06.17-Section-by-Section.pdf and http://energycommerce.house.gov/sites/republicans.energycommerce.house.gov/files/documents/Section-by-Section%20Summary_Final.pdf

Please note that the American Health Care Act is proposed legislation; the changes which may be made to the PPACA through final legislation are still uncertain.  The Committees for both the House Ways and Means and the House Energy and Commerce have scheduled a markup of this proposed legislation for tomorrow, Wednesday March 8th.  Unless and until any legislation is finalized, employers must stay their current course, including complying with ACA employer reporting requirements and the employer shared responsibility mandate.

We will keep you posted as the legislative process progresses.

This email serves solely as a general summary of complex proposed legislation and government initiatives.  It does not constitute legal guidance.  Please contact us with any questions related to the Proposed Legislation and what impact finalization might have on your employer-sponsored plans.

Questions? Contact us to learn more.


Elizabeth H. Latchana, Attorney Fraser TrebilcockElizabeth H. Latchana specializes in employee health and welfare benefits. Recognized for her outstanding legal work, in both 2018 and 2015, Beth was selected as “Lawyer of the Year” in Lansing for Employee Benefits (ERISA) Law by Best Lawyers, and in 2017 as one of the Top 30 “Women in the Law” by Michigan Lawyers Weekly. Contact her for more information on this reminder or other matters at 517.377.0826 or elatchana@fraserlawfirm.com.

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Employers Take Note – IRS Extends Deadline for 2016 ACA Information Reporting For Individuals!

 

FB - FinalTreeThe Internal Revenue Service (“IRS”) has extended the deadline for 2016 Information Reporting by employers (and other entities) to individuals under Internal Revenue Code sections 6055 and 6056 by just over one month.  However, the deadline for these entities to file with the Internal Revenue Service (IRS) remains the same.

IRS Notice 2016-70 extends the due dates for the following 2016 information reporting Forms from January 31, 2017 to March 2, 2017:

  • 2016 Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
  • 2016 Form 1095-B, Health Coverage

However, the due dates for filing these Forms and their Transmittals with the IRS remains unchanged.  Specifically, the due date for filing the following documents with the IRS is February 28, 2017; however, if filing electronically, the due date is March 31, 2017 (employers who are required to file 250 or more Forms must file electronically):

  • 2016 Form 1094-B, Transmittal of Health Coverage Information Returns, and the 2016 Form 1095-B, Health Coverage
  • 2016 Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, and the 2016 Form 1095-C, Employer-Provided Health Insurance Offer and Coverage

As a result of these extensions, individuals might not receive a Form 1095-B or Form 1095-C by the time they file their 2016 tax returns.  In such case, IRS Notice 2016-70 explains that individual taxpayers may instead rely on other information received from their employers or other coverage providers for purposes of filing their tax returns and do not need to wait to receive Forms 1095-B and 1095-C before filing.  Once they do receive their forms, the individuals should keep it with their tax records. You can find the full Notice here.

Please note that no further extension beyond the March 2, 2017 deadline is allowed.  Therefore, this deadline for furnishing the Forms to individuals must be met.  However, additional extensions may still be available for filing these Forms with the IRS.

Background

As provided in previous Client Alerts, information reporting requirements are applicable under two Internal Revenue Code (“Code”) sections as follows:

  • Section 6055 for insurers, self-insuring employers, and certain other providers of minimum essential coverage; and
  • Section 6056 for applicable large employers.

By way of background, the IRS requires applicable large employers and sponsors of self-insured health plans to report on the health coverage offered and/or provided to individuals beginning calendar year 2015.  Although the reporting requirements extend to other entities that provide “minimum essential coverage” (such as health insurance issuers), this Client Alert focuses on the requirements imposed on employers.

Employers who are deemed applicable large employers, as well as employers of any size who offer self-funded health coverage, must carefully review and study these instructions, which set forth numerous details, definitions and indicator codes which must be used to complete the requisite forms.  The instructions address the “when, where and how” to file, extensions and waivers that may be available, how to file corrected returns, and potential relief from penalties imposed for incorrect or incomplete filing.

The IRS utilizes information from these returns to determine which individuals were offered minimum essential coverage, whether individuals were eligible for premium tax credits in the Marketplace, as well as to determine penalties to be imposed on employers under Pay or Play (Code section 4890H; Shared Responsibility for Employers Regarding Health Coverage, 26 CFR Parts 1, 54, and 301, 79 Fed. Reg. 8543 (Feb. 12, 2014)).   Due to the impact of proper reporting, a clear understanding of these forms and instructions is essential.

Code section 6056 applies to applicable large employers (generally employers with at least 50 full-time employees, including full-time equivalent employees).  Information with respect to each full-time employee (whether or not offered coverage) must be reported on Form 1095-C.  Transmittal Form 1094-C must accompany the Forms 1095-C; all the Forms 1095-C together with the Transmittal Form 1094-C constitute the Code section 6056 information return that is required to be filed with the IRS.  For applicable large employers who self-insure, there is a separate box to complete which incorporates the information required under Code section 6055.

Code section 6055 applies to employers of any size who self-insure.  Non-applicable large employers with self-funded plans must report their information on Form 1095-B, as well as on transmittal Form 1094-B.  All of the Forms 1095-B together with the Transmittal Form 1094-B constitute the Code section 6055 information return that is required to be filed with the IRS.  Again, if the employer who self-insures is also an applicable large employer, the employer will instead use Forms 1095-C and 1094-C, which include a section for self-insured plans.

Employers subject to these requirements must report in early 2017 for the entire 2016 calendar year.

Additionally, employers must provide informational statements to the individuals for whom they are reporting.  Form 1095-C or Form 1095-B (as applicable) may be used as this informational statement.

The links to the Final Forms and Instructions are below:

2016 Forms for Applicable Large Employers (Code Section 6056)

2016 Instructions for Forms 1094-C and 1095-C: click here.

Form 1095-C, Employer Provided Health Insurance Offer and Coverage: click here.

Form 1094-C, Transmittal of Employer Provided Health Insurance Offer and Coverage Information Returns: click here.

Additionally, the IRS has posted numerous Questions and Answers regarding Code section 6056 on its website, here.

2016 Forms for Employers who Self-Fund (Code Section 6055)

2016 Instructions for Forms 1094-B and 1095-B

Form 1095-B, Health Coverage

Form 1094-B, Transmittal of Health Coverage Information Returns

The IRS’ Questions and Answers regarding Code section 6055 can be found here.

Change in Forms for 2016

The changes to the 2016 forms are reflected in the above Instructions but are relatively minor in scope.  The most noteworthy changes are to Form 1094-C with the removal of the Line 22 box for “Qualifying Offer Method Transition Relief” as it was only applicable for 2015; as well as two new Line 14 codes (1J and 1K) added to Form 1095-C which are available to reflect conditional offers of coverage to an employee’s spouse. As explained in the instructions, a conditional offer of coverage to a spouse is “an offer of coverage that is subject to one or more reasonable, objective conditions (for example, an offer to cover an employee’s spouse only if the spouse is not eligible for coverage under Medicare or a group health plan sponsored by another employer).”  See 2016 Instructions for Forms 1094-C and 1095-C.

Penalties Imposed

Both sets of Instructions (for Forms 1094/1095-B and Forms 1094/1095-C) set forth the following penalty information for failure to comply with the information reporting requirements for 2016:

The penalty for failure to file a correct information return is $260 for each return for which the failure occurs, with the total penalty for a calendar year not to exceed $3,193,000.

The penalty for failure to provide a correct payee statement is $260 for each statement for which the failure occurs, with the total penalty for a calendar year not to exceed $3,193,000.

Special rules apply that increase the per-statement and total penalties if there is intentional disregard of the requirement to file the returns and furnish the required statements.

However, the IRS has continued the good faith transition relief from penalties for 2016.   Indeed, IRS Notice 2017-70 states:

Specifically, this notice extends transition relief from penalties under sections 6721 and 6722 to reporting entities that can show that they have made good-faith efforts to comply with the information-reporting requirements under sections 6055 and 6056 for 2016 (both for furnishing to individuals and for filing with the Service) for incorrect or incomplete information reported on the return or statement. This relief applies to missing and inaccurate taxpayer identification numbers and dates of birth, as well as other information required on the return or statement. No relief is provided in the case of reporting entities that do not make a good-faith effort to comply with the regulations or that fail to file an information return or furnish a statement by the due dates (as extended under the rules described above).

Thus, it is imperative to timely distribute and file the forms; otherwise penalties may ensue.

This correspondence is intended to provide general information only, does not constitute legal advice, and cannot be used or substituted for legal or tax advice.

 

Questions? Contact us to learn more.


Elizabeth H. Latchana specializes in employee health and welfare benefits. Recognized for her outstanding legal work, she was selected as the 2015 “Lawyer of the Year” in Lansing for Employee Benefits (ERISA) Law by Best Lawyers. Contact her for more information on this reminder or other matters at 517.377.0826 or elatchana@fraserlawfirm.com.
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