Practical HR Tips, News & Advice. Updated Daily.
A health insurer agreed to pay $1.5 million and adopt a detailed corrective action plan to resolve HIPAA security allegations stemming from a 2009 data breach. This is the first HIPAA enforcement action to result from the breach reports now required by the HITECH Act. Like many data breaches that have been making the news […]
Many, perhaps most, employers provide some coverage to employees’ dependents under the benefit plans they offer. But an employer needs to be careful when it does so. Many factors can complicate this coverage. Following are examples that highlight complicated situations that can arise for an employer that covers employees’ dependents and how an employer should address […]
Imaging you run a health plan and you’re responsible for preventing overpayments for ineligible beneficiaries. Dependent audits sound like a good idea, but when and how do you do them? Do you think it is better to do a proactive dependent audit to catch improper free riders before they incur big charges or would you […]
Approximately 105 million Americans now have health coverage without lifetime limits on benefits — including 95 million individuals with employer-sponsored health coverage — due to health care reform requirements, according to a new report by the U.S. Department of Health and Human Services (HHS). The Affordable Care Act prohibits health plans renewing on or after […]
Health reform has been strongly urging plans to cover the essential health benefits (EHB) package, and that means there will have to be coverage in 10 categories of health benefits. The Centers for Medicare and Medicaid Services (CMS) gave examples of what to expect under the state-based approach to defining EHB by giving examples and […]
The failure to administer COBRA continuation coverage notices correctly can cost employers and plan administrators money, time and aggravation, says COBRA expert Paul M. Hamburger, Esq. of Proskauer Rose LLP. He provides four tips they can use to help avoid COBRA notice missteps: (1) prepare clear, accurate and complete COBRA notices; (2) be sure to […]
The administration doesn’t mind taking the occasional detour on its route to health reform implementation, it seems, perhaps because until the Supreme Court decides on the constitutionality of its “individual mandate” (oral arguments will be March 27), the fate of the law’s employer provisions has to be considered uncertain. Backpedaling also may be occurring with […]
Citing concerns from health care providers, federal regulators are delaying the compliance deadline for HIPAA’s ICD-10 code set rules, which had been scheduled for Oct. 1, 2013, the agency announced Feb. 16. “We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead,” said […]
If the individual mandate under health care reform is struck down, it will render the employer mandate meaningless, the American Benefits Council (ABC) argues in an amicus brief to the U.S. Supreme Court. ABC does not argue about the constitutionality of the individual mandate; instead it says that it is non-severable from the law’s insurance […]
Here’s one positive pattern in COBRA coverage lawsuits: Even if a plan administrator violated the COBRA law, if it acts reasonably under the circumstances, courts are inclined to mitigate the amount of any penalties. But even though the law is more than 25 years old, case law shows there’s still a learning curve about its […]