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Improving Billing and Collections on the Exchanges: Steps Health Plans Can Take Today
February 13, 2014 WEBCAST
(Atlantic Information Services, Inc)

Roadmap to Compliant Wellness Programs Part II: Compliance with the ACA & Anti-Discrimination Laws
February 13, 2014 WEBCAST
(ABA Joint Committee on Employee Benefits)

Social Media and HIPAA Privacy: How to Reduce Your Organization’s Risks
February 26, 2014 WEBCAST
(Atlantic Information Services, Inc)

Compliance Issues for Welfare and Qualified Plans after Windsor
February 27, 2014 WEBCAST
(ABA Joint Committee on Employee Benefits)

CMS’s Sweeping New Medicare Advantage and Part D Rule: Implications for Plans, PBMs and Pharma
March 6, 2014 WEBCAST
(Atlantic Information Services, Inc)

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[Official Guidance]

Text of IRS Proposed Regs on Minimum Essential Coverage and Other Rules on the Shared Responsibility Payment for Individuals; Notice of Hearing
27 pages. Excerpt: "The preamble to the final regulations indicates that subsequent proposed regulations will provide that coverage under certain government-sponsored programs is not government-sponsored minimum essential coverage. The preamble to the final regulations also describes rules to be included in subsequent regulations for determining, for purposes of the lack of affordable coverage exemption, the required contribution for individuals eligible to enroll in an eligible employer-sponsored plan that provides employer contributions to health reimbursement arrangements (HRAs) or wellness program incentives. These proposed regulations address these issues, consistent with the rules contemplated in the preamble to the final regulations. In addition, these proposed regulations provide or clarify rules under section 5000 addressing the definition of excepted benefits, hardship exemptions that may be claimed on a Federal income tax return, and the computation of the monthly penalty amount." [Public hearing is scheduled for May 21, 2014 at 10 a.m.] (Internal Revenue Service)  

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[Official Guidance]

Text of IRS Notice 2014-10: Transition Relief from Shared Responsibility Payment by Individuals with Certain Government-Sponsored Limited-Benefit Health Coverage
"Individuals enrolled in [certain government-sponsored limited-benefit coverage] may not know when enrolling for the 2014 coverage year that such coverage is not minimum essential coverage. Accordingly, to provide relief to individuals in this situation (or to taxpayers who are liable under Section 5000A for other individuals in this situation), and consistent with the preamble to the final regulations, the Section 5000A shared responsibility payment is not imposed with respect to an individual for months in 2014 when the individual has coverage under family planning services Medicaid, tuberculosis-related services Medicaid, pregnancy-related Medicaid, emergency medical conditions Medicaid, a Section 1115 demonstration project authorized under section 1115(a)(2) of the Social Security Act (42 U.S.C. 1315(a)(2)), coverage for medically needy individuals, space available care, or line-of-duty care." (Internal Revenue Service)  

[Guidance Overview]

Does Your Wellness Plan Need a Legal Check-Up?
"Although the FAQs provide welcome guidance, there remains confusion as to the correct categorization of certain types of programs, complicated further because walking, diet, and exercises programs that were classified under the former regulations as participatory-only, are now classified as activity-only programs. Thus, plan sponsors may be under the impression that they are offering a participatory-only program because participants choose their wellness options -- but if a participant chooses a walking program, presumably the employer now has to comply with the rules relating to activity-only programs for that participant." (Davis Wright Tremaine LLP)  

U.S. District Court Blocks Missouri Restrictions on ACA Navigators
"The court concluded that any law that frustrates the ACA's purpose by imposing additional burdens on federally designated counselors or threatening to punish them for performing their duties under the ACA is preempted.... Additional state licensure requirements obstruct and frustrate the federal government's operation of the federal exchange, and thus are unconstitutional.... [The] court concluded that 'any attempt by Missouri to regulate the conduct of those working on behalf of the' federal exchange is preempted. Missouri can establish its own exchange if it wants to, but cannot impede the operation of the federal exchange." St. Louis Effort for AIDS, et al. v. John Huff, Dir. of the Missouri Dept. of Insurance, No. 13-4246-CV-C-ODS (W.D. Mo. Jan 23, 2014)] (Timothy Jost in Health Affairs Blog)  

Moody's Downgrades Insurers on Obamacare Fears
"Moody's announced Thursday it was downgrading its outlook for health insurers from stable to negative based on uncertainty related to ObamaCare. The credit rating agency cited an unstable environment because of the healthcare law's difficult rollout, and projected that insurers would earn 2 percent less than forecast in 2014.... The Moody's report also cites the slow enrollment of young people into ObamaCare as a reason for the downgrade." (The Hill)  

The Uninsured Rate Is Dropping, But Don't Thank Obamacare Yet
"[T]he small decrease in the uninsured rate is difficult to attribute directly to Obamacare right now.... [T]he uninsured rate has been trending downward this entire year, likely a product of a declining unemployment rate and greater access to employer-sponsored insurance. At the same time, the Gallup poll does have some evidence that employment isn't the entire story. They show that the biggest declines in the uninsured rate are among those who are unemployed." (Sarah Kliff in The Washington Post; subscription may be required)  

Early Evidence Indicates CO-OP Premium Rates Are Competitive
"The next significant tests will be to see how many CO-OPs were able to enroll enough people and to see if the CO-OPs' premium rates were realistic enough for them to become sustainable. Evidence will also accumulate about which plans are competing well against their commercial counterparts -- for example, by offering integrated care delivery or specialized services. Those CO-OPs that do succeed may offer lessons for other health systems and insurers striving to provide higher-quality care at lower cost." (Robert Wood Johnson Foundation)  

Could Exchanges Encourage More Value-Based Pricing?
"Until prices correlate with services rendered, there's no telling when the needle will be moved on substantive cost containment.... Leah Binder, president and CEO of the Leapfrog Group... believes the time is right for value-based purchasing to finally take hold, calling the movement 'a market-driven phenomenon' that's inevitable. But it's not being driven by the ACA. 'It's coming from another major sea change that employers are responsible for,' she explains, 'and that is the advent of high-deductible health plans.'" (Employee Benefit News)  

Provider Consolidation Leads to Less Competition and Higher Costs
"Research demonstrates that when hospitals consolidate, either merging with other hospitals or buying up physician practices, health care costs go up. Provider consolidation gives hospitals greater negotiating strength and limits competition, resulting in higher prices for services, higher costs for patients, and no improvement in the quality of care delivered." (America's Health Insurance Plans [AHIP])  

CBO Cost Estimate for H.R. 2810, 'SGR Repeal and Medicare Beneficiary Access Act of 2013'
"H.R. 2810 would replace the Sustainable Growth Rate (SGR) formula, which determines the annual updates to payment rates for physician services in Medicare, with new systems for establishing those payment rates. CBO estimates that enacting H.R. 2810 would increase direct spending by about $121 billion over the 2014-2023 period. (The legislation would not affect federal revenues.)" (Congressional Budget Office)  

[Opinion]

The So-Called 3.8% Medicare Surtax: Unfit for Survival
"Section 1411 of the IRC, often erroneously called a Medicare surtax, is in actuality not that at all, and is rather in every respect a completely separate, full-blown, second income tax imposed on individual taxpayers, on trusts and estates, and indirectly on passive owners of interests in S corporations, LLCs and partnerships, on recipients of interests in qualified pension and other qualified plans and charitable remainder trusts inter alia -- an extraordinarily wide swath of taxpayers.... Even more problematic than the misleadingly false labeling of the tax is the establishment, as part of the Affordable Care Act, of a complicated, unbelievably difficult second income tax for the sole purpose of providing the government funds required to administer the health reform law, as long into the future as that legislation remains on the books." (Alvin D. Lurie via BenefitsLink.com)  

[Opinion]

Changing the ACA Definition of Full-Time Employee Would Put More Workers at Risk and Increase Federal Spending
"[E]mployers seeking to avoid penalties are more likely to marginally reduce the hours of workers whose schedules lie just above the threshold.... If the threshold were moved to 40 hours, even a modest reduction in work hours-half an hour per week-would allow employers to escape most of the mandate penalties without offering coverage. The number of workers potentially affected is much lower at thresholds below 40 hours." (The Commonwealth Fund)  

ERISA/Employee Benefits Legal Compliance Checklist
"[This] ERISA and employee benefits legal compliance checklist [will] help you assess your benefits program and structure.... Even one poorly answered question could be very problematic, with significant cost and liability implications. Make sure that 2014 starts with your benefits in full legal compliance." [Includes retirement and health & welfare plans.] (Wagner Law Group)  

Another Benefits Grab Bag of Guidance and Reminders for Health and Retirement Plans
Topics include: Preventive care expansion for non-grandfathered or non-exempt plans; Cost sharing limitations; Expatriate health plans; Wellness programs; Early Retiree Reinsurance Program update; Retirement plan delayed disclosure deadline reminder; Certain FBAR filings for plans with foreign accounts delayed again; and, Operating your plan to be prepared for governmental audits and other challenges. (Winstead P.C.)  

National Health Council Launches New Resources to Help Patients Compare Out-of-Pocket Marketplace Health Insurance Costs
National Health Council

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