Regulation

In April, the Internal Revenue Service issued proposed regulations on collecting fees from health insurance issuers and self-insured group health plan sponsors for establishing the Patient-Centered Outcomes Research Trust Fund, as required under the Patient Protection and Affordable Care Act. The fund provides funding for a new Patient-Centered Outcomes Research Institute. PPACA requires the Institute to conduct research to evaluate and compare health outcomes and the clinical effectiveness, risks, and benefits of medical treatments, services, procedures, drugs and other strategies or items that treat, manage, diagnose or prevent illness or injury.

Now that the high court has upheld all Patient Protection and Affordable Care Act provisions pertaining to employers, the focus shifts to numerous compliance obligations and possible economic implications of fully implementing the health care reform law.

While there is much anticipation of the impending Supreme Court ruling on the constitutionality of PPACA, good plan sponsors already should be preparing for how they will respond to the health care reform decision. Here are some road-maps to prepare for the possible outcomes.

As I was thinking about a topic to share my "vast" knowledge and information with my benefit peers, it occurred to me just how much I don't know. If it's not regulations and politics yanking our chain, it's the financial markets undoing what we thought we knew historically about trends; it's our employee demographics changing; it's the Pension Benefit Guaranty Corporation changing rates and the Department of Labor issuing guidance; it's the vendor and consultant landscape changing with mergers or core business focus; and it's the evolution in financial products. So here are the many things I am not:

A former human resources employee who worked for Bernard L. Madoff Investment Securities pleaded guilty to five criminal counts, including sending forms to the Department of Labor about people who were not employed by the firm, even though they were on payroll and provided benefits. He also admitted to filing false U.S. individual income tax returns. The charges carry a maximum possible prison term of 19 years.

A couple months ago, a client's management team asked whether I agreed with their existing practice of automatically excluding from consideration for employment all candidates with criminal records. I advised them that I could not bless such a blanket disqualification, and I counseled them about how to modify their practice going forward. …

Despite recent tax reform proposals, experts testified at a House committee hearing April 26 that cutting incentives for retirement plans would be detrimental to savings.

The Department of Health and Human Services announced in March that Blue Cross Blue Shield of Tennessee agreed to pay the agency $1.5 million to settle a potential HIPAA violation - the first resulting from a breach under the HITECH Act's (Health Information Technology for Economic and Clinical Health) breach notification rule, which requires covered entities to report an impermissible use or disclosure of protected health information of 500 individuals or more to HHS and the media.

Employers around the country are waking up to a serious and unexpected problem with their health care flexible spending accounts. The health reform law enacted several years ago quietly limited these popular “FSA” benefits to $2,500 per year, effective January 1, 2013. But the express terms of the law conflict with the explanation provided by Congress, and many employers are scratching their heads trying to figure out when plans must be changed to meet the…

With the Supreme Court's ruling on health care reform pending, the fate of the Affordable Care Act remains largely uncertain. In the meantime, however, the law is still in force. The Department of Labor has begun requesting, through recent audit requests on health and welfare plans, that employers prove their plans currently comply with the Act. Is your plan ready? …