Anyone who interacts with third party payors encounter acronyms on a regular basis. While acronyms are intended to facilitate efficient communication, their use often instead leads to confusion. This blog is intended to provide a brief overview of some commonly used acronyms in managed care. Please note that, although some of the acronyms are specifically applicable to Florida, most are … Continue Reading
Employers with established wellness programs that collect health information and/or require a medical exam can no longer rely on the EEOC regulations to justify that incentives provided under their wellness programs are voluntary. On December 20, the EEOC published a final rule (83 Fed. Reg. 65296) vacating the rules that allowed employers to offer those financial incentives to … Continue Reading
Over the course of the last six years in Washington, D.C., one of the primary goals of the Republican Party has been to repeal the Affordable Care Act (ACA). Since the Republican Party gained control of the House of Representatives in 2010, there have been literally dozens of votes to repeal the ACA. The Senate joined this effort when the … Continue Reading
Recently the White House Behavioral Health Parity Task Force issued guidance on the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (Parity Law). The Task Force could not have known, though, that on November 8th, the election may have changed the direction of the Task Force report and subsequent implementation. … Continue Reading
On April 8, 2016, the Internal Revenue Service (IRS) released Private Letter Ruling (PLR) 201615022, which denied tax-exempt 501(c)(3) status to a commercial accountable care organization (ACO). This ruling marks the first time the IRS published any guidance regarding commercial ACOs. The last guidance from the IRS regarding ACOs came in 2011 and was related to ACO participation in … Continue Reading
Many employers offer some type of “wellness program” to their employees as a way to improve employee health and reduce healthcare spending. Wellness programs can be called many different things, including “weight loss challenges” or “healthy employee programs”. Recently, there were new rules issued by the U.S. Equal Employment Opportunity Commission (EEOC) regarding the way these programs can be structured, … Continue Reading
Florida’s First District Court of Appeal issued its opinion in the highly watched case of Southern Baptist Hospital of Florida, Inc. v. Charles et al. The First District Court ruled that the federal Patient Safety and Quality Improvement Act of 2005 (PSQIA):
- Expressly preempts any broad discovery rights afforded under Florida’s Amendment 7 for documents meeting the definition of Patient
An Illinois circuit court judge has dismissed five of six claims in a consolidated class action against Advocate Health and Hospital Corporation arising from a data breach in July 2013. The judge’s dismissal with prejudice leaves only a negligence claim, based on a duty to reasonably safeguard information, pending against Advocate. … Continue Reading
As we look into our crystal balls, we do not expect a lot of new issues in 2015. Rather, we believe that most of the significant issues will be a continuation of issues that arose in 2014 or earlier. For example, continued implementation of the Patient Protection and Affordable Care Act (the “ACA”), which was signed into law on March … Continue Reading
Does A Tax-Exempt Healthcare Organization’s Participation in an Accountable Care Organization (ACO) Adversely Affect Its Tax-Exempt Financing? IRS Notice 2014-67 Provides Guidance.
The Patient Protection and Affordable Care Act authorizes the Department of Health and Human Services (“HHS”) to establish a Medicare Shared Savings Program (“Shared Savings Program”) to promote accountability for care of Medicare beneficiaries, to improve the … Continue Reading
On Friday, March 15, 2013, approximately 100 healthcare executives, physicians and other persons interested in learning about the future of healthcare in Florida, attended Akerman Senterfitt’s second annual Healthcare Briefing at the Westin Hotel in Fort Lauderdale.
The Briefing was co-sponsored by BB&T and McGladrey, LLP, and featured a discussion with four prominent Florida healthcare executives: Phil Dutcher, Chief Operating … Continue Reading