Jamie works with clients of all sizes to design and implement qualified retirement plans, nonqualified deferred compensation plans and incentive compensation plans. He has substantial experience assisting clients with the ...
School administrators and health care professionals may have difficulty navigating the HIPAA privacy rules and the requirements of the Family Educational Rights and Privacy Act (“FERPA”) when dealing with the health information of students. In 2008, the U.S. Department of Education (“DOE”) and the U.S. Department of Health and ...
Movin’ On Up was the theme song for The Jeffersons,* which was a 1970s sitcom that celebrated George and Louise Jefferson’s move to a deluxe apartment in the sky. Movin’ on up just became more expensive in 2018 after the changes included in the Tax Cuts and Jobs Act of 2017 (the “TCJA”). First, the TCJA suspends the individual deduction ...
Those of us who follow HIPAA enforcement actions have become accustomed to seeing multi-million dollar settlements with HHS resulting from HIPAA privacy and security violations. Without fail, those large settlements have involved the disclosure of hundreds, or even thousands, of patient records (or in the case of health plans, participant ...
Even in the Trump era, HHS has not slowed its pursuit of monetary settlements for HIPAA violations. Recent settlements have included payments of $2,140,000 for allowing PHI to be publicly accessible on the internet; $2,200,000 for theft of unencrypted PHI stored on a pen drive, and $5,500,000 for disclosure of electronic PHI due to failure to ...
Of course a HIPAA breach is bad news for any covered entity, but when there are three breaches in a row, it’s not just bad news – it’s a pattern. In three separate breach reports filed with HHS in a three-month period, Advocate Health Care Network disclosed that: (1) four desktop computers containing PHI of about 4 million patients ...
Last October in a post called HIPAA Enforcement is About to get Serious, I explained that HHS was receiving significant pressure to increase its enforcement activities and was about to commence its “Phase 2” audit program. After a slight delay in the launch date, yesterday HHS announced that the phase 2 audits are now getting off ...
Another unencrypted laptop is stolen; another health care provider is hit by HHS with significant penalties. This time, HHS has announced that Feinstein Institute for Medical Research (“Feinstein”) has agreed to pay $3.9 million to settle its HIPAA violations. As with the recent HHS settlement involving North ...
Nothing good can happen if you share PHI with a business associate without having a business associate agreement in place. North Memorial Health Care of Minnesota (“North Memorial”) learned that lesson this week when HHS announced that it had reached a $1.55 million settlement with the hospital. The HHS investigation ...
The Affordable Care Act includes a nondeductible 40% excise tax on high-cost health plans that is scheduled to become effective in 2018. This provision has been called the Cadillac Tax, but it did not take long for everyone to realize that future premium increases would quickly result in the Cadillac Tax applying to most health plans. ...
HIPAA privacy and security breaches have been a hot item in the news this year thanks to the publicity surrounding the Anthem hacks. All of the publicity has increased public awareness regarding HIPAA breaches and has put significant pressure on the Department of Health and Human Services’ Office of Civil Rights (“OCR” ...
Like many other employers, there is a good chance you are currently focused on implementing open enrollment for next year. However, the end-of year notice season is rapidly approaching, and the Medicare Part D Creditable Coverage Notice is first on the list. You must issue this notice to all individuals enrolled or seeking to enroll in your ...
When the Pension Benefit Guaranty Corporation (PBGC) was created under ERISA in 1974, it charged every defined benefit plan a flat rate premium of $1 per plan participant. The premium was little more than a nuisance in 1974, but for 2015, the flat rate premium is $57 per participant and there is an additional variable rate premium of $24 ...
Jamie Scott
Now that the U.S. Supreme Court has held that states must permit and recognize same-sex marriages, employers that have previously provided for domestic partner benefits may want to address whether those benefits should be continued. Factors to be considered include:
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Employers that have in the past only provided same-sex ...
That is not a question I want to hear from my doctor, because my response would be something like: “Are you #$%@ing kidding me?” But lately some insurers and physicians have been asking whether colonoscopy sedation is medically necessary; raising questions about whether the patient would need to decide between skipping the ...
We previously wrote about the deadline for plan sponsors of self-insured health plans to obtain a health plan identifier (HPID). For large self-insured health plans (receipts over $5 million), the deadline to obtain the HPID was November 5, 2014. On the eve of the deadline, the Centers for Medicare and Medicaid Services ...
The deadline for large health plans (receipts over $5 million) to obtain the new health plan identifier (HPID) is November 5, 2014. For insured health plans, the insurance carrier is responsible to obtain HPID, but for self-insured plans, that responsibility falls on the plan sponsor. But, until now employers have had a difficult ...
Parkview Health Systems, Inc. recently reached an agreement with HHS to pay $800,000 for potential HIPAA privacy violations. Parkview had left 71 cardboard boxes of medical records unattended on the driveway of a retiring physician. As we wrote last month, improper disposal of PHI represents approximately 5% of all reported ...
HIPAA requires that any breach of unsecured PHI in violation of the privacy rule must be reported to the affected individuals and to HHS. When the breach affects 500 or more individuals, the notice to HHS must be made within 60 days following the breach. HHS maintains a list of reported breaches affecting 500 or more individuals ...
Where is one place you should never find private medical records? Dylan was right - the answer is blowing in the wind. But that is exactly what a man found while driving down a Kansas City street. When the man traced the flying records back to their source, he found a crew dumping the records into an open dumpster at Research Hospital ...
The Urban Institute is generally viewed as a center-left policy research institute that has been supportive of the Affordable Care Act. That is why it is so surprising that it just published a brief suggesting the elimination of the employer mandate, along with its substantial penalties for failing to offer employees affordable ...
New York and Presbyterian Hospital (“Presbyterian”) and Columbia University (“Columbia”) are affiliated as the New York Presbyterian Hospital/Columbia University Medical Center. According to a recent report published by the HHS Office of Civil Rights (“OCR”), Presbyterian and Columbia are separate covered ...
Under the Affordable Care Act, every employer must accurately identify its full-time employees to determine if it is subject to the employer mandate penalties and to calculate the amount of those penalties. Generally, a full-time employee is an individual that averages at least 30 hours of service per week. There are situations where ...
HHS recently updated the Federal Poverty Limit (FPL) for 2014. Before the Affordable Care Act, when HHS would announce the annual update to the Federal Poverty Level (FPL), most employers could emulate Alfred E. Neuman with a “What, me worry?” kind of attitude. That is no longer the case. Employers need to follow the FPL ...
Prior to 2014, flexible spending accounts (FSAs) have been exempt from many group health plan rules, such as COBRA and HIPAA portability, by qualifying as an “excepted benefit” under applicable guidance. Because most FSAs qualify as an excepted benefit, the actual requirements for the exemption have received little ...
During the last presidential campaign, President Obama famously touted the role of government in helping private businesses by saying “If you’ve got a business-you didn’t build that.” Now the federal government has had 3 years to set up the Affordable Care Act insurance exchanges and has spent an estimated $500 million
One of the fundamental building blocks of Health Care Reform under the Affordable Care Act was that states would be provided Federal funds to expand Medicaid to cover more people and to provide better benefits. But in NFIB v. Sebelius, the U.S. Supreme Court granted states greater flexibility to opt out of the Medicaid expansion.
The ...
The debt limit deal passed by the House and Senate yesterday included a small concession to Republicans under Health Care Reform. Subsidies available to purchase insurance on an exchange are available to individuals with household income between 100% and 400% of the Federal Poverty Level. As originally envisioned, the ...
Jamie D. Scott
Since the grand opening of the Affordable Care Act exchanges last week, it has been difficult to avoid reading about all of the crashes, glitches and overall dysfunction of the online enrollment process. While the Obama administration has blamed the problems on high demand, other experts have suggested that the real culprit is ...
HHS has issued a report summarizing the health plan choices and premiums available under the 36 federally facilitated exchanges and 11 of the state-run exchanges. The report is not a complete listing of premiums, but instead focuses on the plans with the lowest premiums in each state and shows the estimated premiums before and ...
Jamie Scott
There seems to have been a recent rash of thefts involving electronically stored health information, including names and social security numbers. Most stolen health information is taken by stealing the flash drive, laptop or desktop on which the information is stored. It is difficult to tell in these cases whether the target of ...
The Kaiser Family Foundation has produced a cartoon called The YouToons Get Ready for Obamacare. YouToons are little people with big heads that represent average Americans and that have a remarkable resemblance to Wii characters. The cartoon is about 7 minutes long and provides a surprising amount of information in an ...
On August 1, 2013, a Treasury Department press release announced the launch of a website providing health care reform information to small business owners. To get started on the website, you input the state of business operations, the number of its full-time employees (including full-time equivalents), and whether health insurance ...
One challenge to keeping health information private as required under HIPAA is in knowing all of the places where it is stored in paper form or electronically. HHS just announced a resolution agreement with Affinity Health Plan (a not-for-profit managed care plan serving the New York metropolitan area) after it was discovered that ...
Health Care Reform places caps on out-of-pocket maximums on all non-grandfathered plans beginning in 2014. For 2014, the maximums are $6,350 for individual coverage and $12,700 for other coverage classes. Even though for most plans the out-of-pocket maximum has included deductibles and co-insurance payments, the maximum ...