Obamacare Small Health Plan Caps Scrapped

As it was originally signed into law, the Affordable Care Act (ACA) capped deductibles on health plans offered in the small group market at $2,000 for individuals and $4,000 for families.

Problem was, with the caps so "low," insurers threatened to raise rates sky high, so the Department of Health and Human Services (HHS) issued a one-year regulatory reprieve for 2014.

Now, in a yearly ritual to prevent cuts in payments to Medicare service providers, President Obama has signed the Protecting Access to Medicare Act of 2014, which also eliminates the ACA deductible caps on small group plans.

Medicare physicians (the bill is dubbed "the doc fix") will now enjoy their current rates of reimbursement for another 13 months, but the caps on small health plans are gone for good.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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CMS Releases Detailed Physician Medicare Payment Data

The Centers for Medicare and Medicaid Services (CMS) has released data on physician payments under Medicare in 2012, the first such disclosure in the history of the government-run health care system for those 65 and older.

In all, the new "data set has information for over 880,000 distinct health care providers who collectively received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program," according to a CMS press release.

"Data transparency is a key aspect of transformation of the health care delivery system,” said CMS Administrator Marilyn Tavenner. “While there’s more work ahead, this data release will help beneficiaries and consumers better understand how care is delivered through the Medicare program.”

The data can be downloaded from the CMS.gov site here.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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IRS: Individual Mandate, Penalty Still On for 2014, But You Won’t Have to Pay

An Internal Revenue Service (IRS) official, testifying before the House Ways and Means Health Subcommittee yesterday, said that the Obamacare individual mandate and penalty for not purchasing health insurance are still on for 2014, but…

“Individuals who can’t afford to pay that [the penalty] don’t have to pay it,” said Mark Iwry, the IRS representative. The penalty for not having health insurance in 2014 is $95 or 1 percent of one's income, whichever is greater.

When questioned if the IRS had the authority to delay the individual mandate, Iwry said it didn't matter since the IRS believes the mandate is simple to understand and implement, unlike the twice-delayed employer shared responsibility provision of the Affordable Care Act (ACA), whichi s both hard to understand and hard to implement.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Obama Signs Gender Equity Order for Federal Contractors

President Obama has issued an executive order aimed at creating compensation equity for men and women working for federal contractors.

In doing so, the President asked the Secretary of Labor to require federal contractors to submit data on employee compensation by race and gender — which will help employers take proactive efforts to ensure fair pay for all their employees.

“Restoring opportunity for all has to be our priority, making sure the economy rewards hard work for every single American. Because when women succeed, America succeeds,” Obama said in a speech to mark the signing of the order.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Former Obama Press Secretary Predicts End of Employer Mandate

Former Press Secretary to President Obama Robert Gibbs has pronounced the Obamacare employer mandate dead on arrival. Delayed twice already, the Employer Shared Responsibility provision of the Patient Protection and Affordable Care Act (PPACA) is already on life support. Gibbs thinks it will be put out of its misery soon.

“I don’t think the employer mandate will go into effect. It’s a small part of the law. I think it will be one of the first things to go,” he told the audience at last week's Benefits Selling Expo in Colorado Springs, Colo.

Gibbs also broke with PPACA orthodoxy by calling for a cheaper level of health policies, saying, "Health care has to add an additional layer of coverage cheaper than the plans already offered."

Gibbs, however, is still a staunch supporter of health care reform: “Status quo isn’t worth going back to,” he said. “The better path forward is the path to better care.”

Shortly after Gibbs' remarks, current Obama Press Secretary Jay Carney announced at a media gathering: "We're going to continue to implement the law."

"This requirement ensures that larger employers either offer quality, affordable coverage to their employees or help offset the cost to taxpayers of these uncovered employees getting tax credits through the health insurance marketplace," Carney said at the White House. He also noted that the individual mandate — requiring all Americans to purchase health insurance or else pay a fine — starts this year.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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OSHA Seeks Commentary on Proposed CFPA Whistleblowers Protection Rule

The Occupational Safety and Health Administration (OSHA) has issued an interim final rule establishing procedures and time frames for handling retaliation complaints under the Consumer Financial Protection Act (CFPA). OSHA invites the public to submit comments on the interim final rule.

CFPA, enacted July 21, 2010, protects employees against retaliation by entities that offer or provide consumer financial products or services, such as residential mortgages, mortgage loan modification and foreclosure relief services, private education loans, payday loans, consumer credit and debt relief services.

This interim final rule establishes procedures, burdens of proof, remedies and statutes of limitations similar to other whistleblower protection statutes that OSHA administers.

Individuals may submit comments electronically at http://www.regulations.gov, the Federal eRulemaking Portal, via mail or facsimile. See the Federal Register notice for details. Comments must be submitted by June 2, 2014.

OSHA has also developed a new fact sheet, Filing Whistleblower Complaints under the Consumer Financial Protection Act*. The fact sheet explains who is covered under the act, protected activity, types of retaliation and the process of filing a complaint.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Medicaid Enrollments Reach 3 Million on Marketplaces

The Department of Health and Human Services (HHS) on Friday announced that 3 million poor Americans had signed up for Medicaid during the first enrollment period of the Affordable Care Act (ACA), which ended March 31. HHS did not say how many of the 3 million were former recipients just resigning up.

The current data includes people who qualify for Medicaid programs that have existed for decades.

"The increase in Medicaid enrollments across the country is encouraging," HHS Secretary Kathleen Sebelius said in a government blog posting.

The ACA offered expanded Medicaid funding to states that chose to participate, but only about half the states (26, to be exact) actually accepted the offer once the Supreme Court ruled the feds couldn't force them to expand the program.

Medicaid has traditionally been funded largely by the federal government but administered by the states.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Final Deadline for Obamacare Sign-Ups Finally Finalized

The Centers for Medicare and Medicaid Services (CMS) on Wednesday announced that those who started their health insurance sign-ups on HealthCare.gov but had difficulties could still enroll — but they must do so by Tax Day, April 15, or face a non-compliance tax penalty at the end of the year.

"For those in line on the 31st [of March], we encourage consumers to finish the process as soon as possible. They must complete their enrollment by no later than the 15th [of April] for coverage this year," said Aaron Albright, CMS spokesperson.

Several state-operated Marketplaces have already announced similar grace-period deadlines.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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Employer Violates ADA with Pre-Offer Drug Test

In a recent court case, an employer was found in violation of the Americans with Disabilities Act (ADA) for requiring applicants to take drug tests before making a job offer.  

The EEOC successfully argued that the pre-offer drug tests violated the ADA because the tests constituted a “medical examination” that gathered medical information about the applicants, even if the tests were intended only to detect evidence of illegal drug use.  

The outcome of this case serves to remind employers that all pre-employment drug tests should be conducted post-offer.  It also serves as an example of how a formal interviewing and hiring policy can help to avoid this type of litigation altogether.  

The Department of Labor estimates that it costs employers up to 30 percent of an employee’s salary to replace a wrong hire. Additionally, violating anti-discrimination laws during the new hire process can result in significant penalties. According to the EEOC, discrimination charges and monetary remedies for victims of discrimination (including job applicants) have reached an all-time high over the past three years.

To help employers ensure that their hiring practices are effective and legally compliant, Personnel Concepts has introduced a comprehensive Interviewing and Hiring Program for Small Businesses.  This exclusive solution includes a guidebook featuring recommendations from three attorneys, two sets of documentation forms to avoid common legal issues relating to interview questions, and best practices in recruiting employees. 


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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HealthCare.gov Site Goes Down on Last Day of Sign-Ups

On the last official day to sign up for health insurance on the Affordable Care Act (ACA) marketplaces, the main federal site — HealthCare.gov — went down for four hours, directing visitors to a virtual waiting room or just alerting them that the site was offline for "maintenance."

Normally, maintenance on the site is done by 5 a.m. EDT, but today a "software bug," according to a Health and Human Services (HHS) statement, kept it inoperable for an extended period. HHS denied the site had been hacked or that it crashed because of a heavy load.

HealthCare.gov averaged 1.5 million visits a day last week, but that number jumped to 2 million over the weekend.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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