CMS Cracks Down on Obamacare Subsidy Verifications

The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule, “Patient Protection and Affordable Care Act (PPACA): Exchange Program Integrity.”

This proposal, CMS says, would safeguard taxpayer dollars by ensuring that people are accurately determined eligible for premium subsidies they receive through the Exchange.  In addition, to better align federal regulations with statutory requirements and congressional intent, the rule proposes that issuers must send a separate bill and collect separate payments for the portion of the consumer’s premium attributable to certain abortion services for which public funding is prohibited.

“This administration is committed to making sure taxpayer dollars are spent appropriately,” said CMS Administrator Seema Verma.  “Maintaining a high level of program integrity on the Exchange is essential, including ensuring that premium tax credits only go to those who are eligible for them. This proposed rule represents CMS’ commitment, consistent with the law, to continuously improve and strengthen oversight over the programs we administer on behalf of the American taxpayer.”

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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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Whither the Lawsuit Against Obamacare?

U.S. District Court Judge Reed O’Connor of Ft. Worth, Texas, heard arguments two months ago over a Texas-led coalition’s contention that the Affordable Care Act (ACA, or Obamacare) is no longer constitutional now that the individual mandate has lost its “tax-like” monetary penalty.

aca-on-trial-for-its-lifeBut the judge has yet to rule, though in the past — when hearing cases against Obamacare and an Obama-era rule on gender-neutral bathrooms in schools — it took him less than two weeks to issue injunctions.

“Why hasn’t he ruled yet?” asks Tim Jost, ACA expert and professor emeritus at Washington and Lee School of Law. “I suspect that he is waiting until the election is over because the last thing Republican candidates need right now is another reminder that they are trying to get rid of preexisting-conditions protections.”

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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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EBSA Proposes Automatic 401(k) Transfers Upon Job Loss or Change

The Employee Benefits Security Administration (EBSA) is seeking public commentary on a proposal to allow for the automatic transfer of 401(k) funds into an IRA or into another company’s 401(k) when a worker loses or changes jobs.

Frequently, employees leaving their current place of employment with account balances in the company’s 401(k) plan either take a distribution of their retirement savings or move the account into an IRA. The same outcome often occurs with small retirement accounts when a company terminates its 401(k) plan.

According to the agency, an auto-portability program would improve asset allocations by consolidating small retirement savings accounts, eliminate duplicative fees for small retirement savings accounts, and reduce leakage of retirement savings from the tax-deferred retirement saving system.

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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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Three Red States Approve Medicaid Expansion

Three states that are considered mostly Republican-leaning (aka “red states”) approved the expansion of Medicaid at the ballot box Tuesday. Idaho, Nebraska and Utah all said yes, while Montana rejected permanent Medicaid expansion after embracing the program in 2015.

Utah was one of three states where voters approved Medicaid expansion on Tuesday.

Idaho voters gave the largest measure of support to their ballot measure, with 61 percent saying “yes.” Utah came in at 54 percent favorable, followed by Nebraska at 53 percent. As a result, some 325,000 additional Americans will now be covered by Medicaid, which was expanded (optionally, by state) under the Affordable Care Act (ACA).

The Montana “no” vote follows the state’s earlier expansion, which added some 129,000 citizens to the ranks of Medicaid, but funding has run out, so voters put the kibosh on the program by a vote of 55 percent to 45 percent in Tuesday’s election.

Three other states saw their governorships shift from Republican to Democrat hands, so Medicaid expansion could well occur in the future in Kansas, Maine and Wisconsin. In Maine, where voters approved expansion in 2017 but the governor rejected its implementation, incoming governor Janet Mills, a Democrat, will likely carry out the voters’ wishes.


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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First Week (3 Days) of ACA Enrollment Nets 371,676 Enrollees

In week one of Affordable Care Act (ACA) Open Enrollment for 2019, 371,676 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday.  Consequently, week one was only three days long this year – from Thursday to Saturday.

Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchanges, the State Partnership Exchanges, and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.

The final number of plan selections associated with enrollment activity during a reporting period may change due to plan modifications or cancellations. In addition, the weekly snapshot only reports new plan selections and active plan renewals and does not report the number of consumers who have paid premiums to effectuate their enrollment.


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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DOL Proposal Allows More Flexibility in Drug Testing

The Department of Labor (DOL) has issued a Notice of Proposed Rulemaking (NPRM) that loosens the standards for drug testing for unemployment compensation (UC).

dol-proposes-UC-drug-policyIn 2017, Congress passed, and the President signed, a resolution of disapproval revoking a 2016 rule that imposed a one-size-fits-all approach on states with regard to identifying occupations for regular drug testing.

The Middle Class Tax Relief and Job Creation Act of 2012 amended the Social Security Act to allow states to conduct drug testing for UC applicants for whom suitable work is available only in an occupation that regularly conducts drug testing. The state may then choose to offer or deny UC benefits to an applicant who tests positive for drug use under these circumstances.

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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 Increases 401(k), IRA and Other Retirement Limits for 2019

The Internal Revenue Service (IRS) has released Notice 2018-83, which details cost-of-living adjustments for retirement contributions in 2019. Section 415 of the Internal Revenue Code requires annual adjustments on benefits and contributions under qualified retirement plans.

IRS-announces-cola-adjustmentsEmployees participating in 401(k), 403(b), most 457 plans and the federal government’s Thrift Savings Plan will be able to contribute $19,000 annually, up from the current $18,500 limitation. The catch-up contribution limit for employees 50 or older remains unchanged at $6,000.

The IRA contribution limit, unchanged since 2013, will be increased to $6,000, up $500.

Other more unusual plans will also see adjustments:

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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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Employees to Walk Out at Google to Protest Sexual Harassment, Favoritism

Stay on guard at your worksite: Watch our video on Workplace Harassment Investigations.

At 11 a.m. today local time, hundreds Google employees worldwide will stage a walkout over revelations in a New York Times article detailing hush-hush, non-transparent treatment of executives accused of sexual harassment — taking specific aim at the company’s binding arbitration agreement that prevents employees from suing over harassment, discrimination and even racism.

Reportedly, the company paid out $90 million to Android developer Andy Rubin after it found credible sexual harassment claims against him. Rubin denies both the claims and the extent of the payout.

“While Google has championed the language of diversity and inclusion, substantive actions to address systemic racism, increase equity, and stop sexual harassment have been few and far between,” an employee statement reads. “ENOUGH. Reassuring PR won’t cut it: we need transparency, accountability, and structural change.”

The group is demanding employee representation on the Board of Directors.

Google CEO Sundar Pichai says he supports the walkout but claims, in a memo to employees, that the company has terminated 48 employees, including 15 senior executives, over the past two years for sexual harassment without doling out exit packages. The protest group claims there are “thousands” of more incidents that go unreported and unpunished.

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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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Obamacare Open Enrollment Begins Tomorrow

The window for signing up for health insurance plans effective Jan. 1, 2019, closes at the end of Obamacare open enrollment on Dec. 15 of this year, following the opening of the federal exchange — HealthCare.gov — tomorrow.

aca-premiums-to-drop-for-2019

ACA Open Enrollment begins Nov. 1

While this opening is of somewhat limited interest to applicable large employers (ALEs) — those companies with 100-plus workers who must provide health insurance for their employers under the Affordable Care Act (ACA) — there is one scenario to be on guard for.

If even one employee working for an ALE cannot afford his or her company health insurance premium and goes on the federal exchange to get subsidized health care, then that ALE is subject to an assessment from the IRS.

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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 Redesigns Its State Plans Webpage

The Occupational Safety and Health Administration (OSHA) has redesigned its State Plans webpage, where visitors can click on their state’s mapped location and see if its safety programs are state or federally run, with a pop-up box offering contact information and a brief overview of which workers are covered.

OSHA-state-plans-webpageSome 22 states have jurisdiction over private industry and state and local government entities. Six other states have jurisdiction only over government agencies.

Under the page’s “Monitoring of State Plans” resources, the agency provides links to Federal Annual Monitoring Evaluation Reports, the State Plan Policy Procedures Manual and contact information for OSHA’s federal Office of State Programs.


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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