Health Care Law Blog
Many questions surround the creation and implementation of accountable care organizations ("ACOs"). Included in these questions were concerns about the tax implications of an exempt non-profit organization in joining an ACO. In 2011, the Internal Revenue Service ("IRS") was active in providing guidance on that issue. Specifically, the IRS addressed issues related to inurement or impermissible private benefit that arise from a tax-exempt organization's participation with an ACO. It also considered the unrelated business income tax implications for the receipt of shared savings by an exempt organization.
The U.S. Court of Appeals for the Sixth Circuit has ruled that Medicare is not limited to the portion of a settlement or verdict designated for medical losses when seeking reimbursement under the Medicare Secondary Payer Act, 42 USC § 1395(b)(2) ("MSP"). Hadden v United States (Lawyers Weekly No. 01-76843). This ultimately could lead to a chilling effect on settlements.
A recent case highlights why a plan sponsor must use caution when agreeing to provide COBRA coverage that extends beyond the maximum COBRA coverage period. The court in Bekaert Corporation v. Standard Security Life Insurance Company of New York, 2011 WL 3568028 (N.D. Ohio) recently held that an employer who offered extended COBRA coverage pursuant to a separation agreement with a particular employee was not entitled to stop-loss coverage. In Bekaert,a retiree received extended COBRA continuation health coverage pursuant to a separation agreement with the employer. The retiree's medical claims were paid under the employer's self-funded health plan and then were submitted for reimbursement under the employer's stop-loss policy as excess loss claims. The stop-loss carrier denied the claims, stating the retiree was not a covered person under the stop-loss policy.
On November 29, 2011, the State Bar of Michigan's Health Care Law Section presented a webinar entitled "Making Sense of 'Meaningful Use' Incentives for Electronic Health Record Adoption," which was attended by a number of Foster Swift health care attorneys. This program gave a wonderful overview of the procedural requirements in obtaining incentive payments for the use of electronic health records ("EHR").
