cmonfils | January 8, 2012
www.myhea;thguide.com
MyHealthGuide Source: Scott Cooper, Attorney, SchmidtKramer Injury Lawyers1/6/2012, Injury BlogNetwork Blog Entry
Case: Bieber v. Nace, 2011 WL 6180719 (M.D.Pa. 12/13/2011). Court Ruling
The federal court for the Middle District of Pennsylvania in Harrisburg recently addressed an issue regarding the recovery of special damages in a MMotion in Limine (request of ruling) in the above case. The Plaintiffs filed a suit arising out of a car accident and their resultant injuries. (more…)
Category: 3rd, ERISA, Self-Funding |
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cmonfils | January 8, 2012
www.myhealthguide.com
MyHealthGuide Source: Chris Dimick, American Health Information Management Association (AHIMA), 1/4/2012, AHIMA Field Guide
CHICAGO — The healthcare industry has been inundated with change in recent years and health information management (HIM) professionals are being challenged to re-evaluate and prioritize initiatives that will have the most impact on the profession. Seven of the nation’s top initiatives will be monitored throughout the year by AHIMA’s HIM experts and are discussed in this month’s Journal of AHIMA cover story, “Field Guide: Seeing the Trees Through the Forest in 2012.” (more…)
Category: Accountable Care Organizations, Health Care Legislation, HIPAA |
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cmonfils | January 8, 2012
www.myhealthguide.com
MyHealthGuide Source: Fred Hunt, Active Past President, SPBA, 12/2012, www.SPBATPA.org
The state of TPAs and the forecast for the future is the brightest it has been for many years (not to say that it is not an extremely tight marketplace).
Background and Mood
TThis article is useful for perspective in shaping corporate strategy, but also serves as a candid analysis for outsiders such as investors, researchers and others who want to understand the TPA world today and into the future. As a result of hearing often from SPBA members, we have an unmatched repository of real-world hands-on totally-candid insight. (more…)
Category: Health Insurance, Plan Sponsor, PPACA, State Law, Stop Loss, Supreme Court, Third Party Administrators |
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cmonfils | January 8, 2012
Last time, we discussed how the demands of health care reform are getting HR and finance to work together in closer collaboration.
Now, let’s take a look at why health care reform-related decision making will require cross-functional input and discussion. Remember, the health insurance exchanges are coming on line and companies must make the so called “pay-or-play” decision in just 24 months. Is it better for the company to continue to offer its employees health insurance (play)? Or is it more advantageous to eliminated health benefits and pay the resulting penalties (pay)?
Category: Health Care Legislation |
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cmonfils | January 8, 2012
As a general rule, state insurance laws apply to employer-sponsored insured group health plans but not self-insured group health plans. The Employee Retirement Income Security Act of 1974, as amended (ERISA) generally exempts group health plans sponsored by private sector employers from state insurance laws. However, because insurers must comply with state insurance laws, a group health plan that purchases insurance to provide benefits will be indirectly subject to the state laws applicable to the insurer. Thus, if your company sponsors a group health plan that includes any kind of insurance contract or policy, you should make sure that you keep up-to-date on state law changes and their impact on your plan, and that you properly notify your participants (and, in certain cases, eligible individuals) of any changes to their plan benefits.
Category: California, Connecticut, Health Insurance, Illinois, New York, Rhode Island, Texas, Wisconsin |
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cmonfils | January 8, 2012
As CPAs gear up for tax season, they’ll find the Form 1040 series for 2011 looking much the same as that of the previous year, but only because of Congress’ 11th-hour compromise late in 2010 to keep it so. Nonetheless, a number of new features affecting individuals and businesses, such as new information reporting forms, are debuting, so return preparers should be aware of developments in the past year that will affect 2011 tax returns.
Category: Health Care Legislation, PPACA |
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cmonfils | January 8, 2012
This year’s crop of healthcare buzzwords and catchphrases includes a handful of terms that are really oxymorons. By oxymoron, of course, we mean one of the words or phrases in the expression contradicts the rest. But if you think about it, that’s the very theme of health reform today.
Category: Health Care Legislation, News |
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cmonfils | January 8, 2012
On Thursday, October 20, 2011, The Centers for Medicare & Medicaid Services (CMS) released the long-awaited final rule regarding the formation of accountable care organizations (ACOs). The new rule makes a number of changes from the proposed rule discussed in our prior alert. Generally, the changes increase the financial incentives, reduce financial risks, and mitigate some compliance burdens for ACOs.
Category: Accountable Care Organizations, CMS |
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cmonfils | January 8, 2012
Many plan sponsors have not paid much attention to the U.S. Department of Labor’s current effort to substantially broaden the definition of a plan fiduciary, agrees Lynn Dudley, Senior Vice President, Policy, at the Washington-based American Benefits Council. They do it at their peril, she suggests. “Because there are so many lawsuits based on investment menus and investment choices, this is not something to take lightly,” she says.
Category: DOL, ERISA, Fiduciary |
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cmonfils | January 8, 2012
The District Court of Montana dismissed a putative class action against insurer John Alden last Thursday citing the Policy’s 3-year statute of limitations. The plaintiff brought suit against the insurer alleging it had used a defective database that produced inaccurate calculations for reimbursement of health care charges. Plaintiff was insured under an ERISA-governed employee welfare benefit plan that included medical coverage.
Category: ERISA, Reimbursement |
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