Massachusetts Amends State Maternity Leave Act to Extend Leave to Males

January 15, 2015 at 9:00 am | Posted in MMLA, Regulations, State Laws | Leave a comment
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In his last week of office, Governor Patrick signed a bill into law that amends the Massachusetts Maternity Leave Act (MMLA) by expanding parental leave in Massachusetts for both female and male employees . Currently the MMLA only permits female employees with eight weeks of job-protected maternity leave for the birth or adoption of a child. Males will be able to receive eight weeks of job protected maternity leave as well. The effective date for the change is April 7, 2015.

This change will require attention by Massachusetts employers with fewer than 50 employees who are not subject to FMLA.

Although the effective date is April 7, 2015, as a practical matter, Massachusetts employers with fewer than 50 employees should appreciate that there is federal discriminatory risk under the EEOC if they do not grant maternity leave to males now. To that end, the Massachusetts Commission Against Discrimination has cautioned employers that:

The MMLA, by its terms, provides eight weeks of maternity leave to female employees only. An employer, who complies with the MMLA by providing eight weeks of maternity leave to female employees only, does not violate a male employee’s right under Chapter 151B to be free from sex discrimination. However, an employer who provides leave to female employees only, and not to male employees, may violate the federal prohibitions against sex discrimination even though the employer has acted in compliance with the MMLA.

 

Federal Government Issues New “Proposed” Guidance and Modifications on SBC Regulations

December 29, 2014 at 11:28 am | Posted in Federal Laws, Regulations | Leave a comment
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Federal Government Issues New “Proposed” Guidance and Modifications on SBC Regulations with Proposed Effective Date of September 1, 2015

    Last week DOL, Treasury and HHS (“the Departments”), issued 127 pages of proposed regulations, as well as a new set of proposed SBC templates, instructions, an updated uniform glossary, and other materials to incorporate some of the feedback “the Departments” received regarding the SBC regulations and the SBC template. “The Departments” stated that the proposals will provide guidance necessary to self insured plans and health insurers as they continue to issue SBCs, and will improve the SBC for employers, participants and beneficiaries, and individuals and dependents for use as a tool in making important decisions regarding their health coverage.

The proposed modifications clarify when and how a self insured plan or health insurer must provide an SBC, and streamline and shorten the SBC template while also adding certain additional elements that “the Departments” believe will be useful to consumers.

“The Departments” have invited public comments on the proposals until 60 days following December 30th. These proposals are not final and the proposed effective date is September 1, 2015.

 

The draft updated template, instructions, and supplementary materials are available at the following links:

http://www.cms.gov/cciio/index.html

and

http://www.dol.gov/ebsa/healthreform/regulations/summaryofbenefits.html

Supreme Court to Hear Legal Challenge Federal Subsidies and Obamacare in March

December 23, 2014 at 10:53 am | Posted in Affordable Care Act, Health Care, Regulations | Leave a comment
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Supreme Court to Hear Legal Challenge Federal Subsidies and Obamacare in March

The  Supreme Court announced that on  March 4th it will hear arguments in King v. Burwell.  The case addresses the concept of statutory construction and the issue of whether  the federal government can legally hand out healthcare subsidies in 34 states that have federal exchanges since they opted out of creating their own state based exchanges. The plaintiffs  filed their opening brief on Monday which advance the argument that the literal text of the ACA does not allow for subsidies at federal exchanges. If the subsidy arrangement is struck down, the ACA will essentially have two different sets of requirements and risks for employers and employees across the country that will turn on their state of residence. In November the Supreme Court announced that it would take up the case, surprising many court-watchers and healthcare experts, since the matter had yet to be heard on reconsideration by a full en banc panel of judges in the D.C. Circuit Court of Appeals. An earlier 3 judge panel had found the subsidies to be unauthorized under the ACA..

A copy of the plaintiff’s129 page  brief can be found here:  129-page document

HHS Claims that Quality Improvements and the Affordable Care Act Saved 15,000 Lives and $4 Billion in Health Spending During 2011 and 2012

May 7, 2014 at 10:43 am | Posted in Affordable Care Act, Health and Human Services, Health Care, Medical, PPACA, Regulations | Leave a comment
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HHS announced today that new preliminary data show an overall 9% decrease in hospital acquired conditions nationally during 2011 and 2012. National reductions in adverse drug events, falls, infections, and other forms of hospital-induced harm are estimated to have prevented nearly 15,000 deaths in hospitals, avoided 560,000 patient injuries, and approximately $4 billion in health spending over the same period.

HHS claims that the Affordable Care Act is also helping reduce hospital readmissions. After holding constant at 19% from 2007 to 2011 and decreasing to 18.5% in 2012, the Medicare all-cause 30-day readmission rate has further decreased to approximately 17.5% in 2013. This translates into an 8% reduction in the rate and an estimated 150,000 fewer hospital readmissions among Medicare beneficiaries between January 2012 and December 2013.

A complete copy of the HHS announcement can be found here: http://www.hhs.gov/news/press/2014pres/05/20140507a.html

Failure to Secure PHI and Two Stolen Laptops Results in $1,975,220 in HIPAA Violation Fines

April 23, 2014 at 1:25 pm | Posted in Compliance, ePHI, Health and Human Services, HIPAA, Regulations | Leave a comment
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The HHS Office of Civil Rights (OCR) announced that is has levied $1,975,220 in HIPAA fines against Concentra Health Services and QCA Health Plan Inc. for their failure to encrypt PHI stored on two laptops that were stolen.

Both Concentra and QCA, who self reported the stolen laptops, had undergone a HIPAA risk analysis and were aware…but did nothing…to secure the PHI stored on the laptops. The Concentra laptop was stolen from an employee’s office. The QCA laptop was stolen from an employee’s car. Concentra was fined $1,725,220 and QCA was fined $250,000.

“Covered entities and business associates must understand that mobile device security is their obligation,” said Susan McAndrew, OCR’s deputy director of health information privacy. “Our message to these organizations is simple: encryption is your best defense against these incidents.”

A copy of the HHS OCR press release is here:
http://www.hhs.gov/news/press/2014pres/04/20140422b.html

HHS Announces New Round of 2014 HIPAA Compliance Audits: Are You Ready?

March 25, 2014 at 9:18 am | Posted in Compliance, Federal Laws, Health and Human Services, Health Care, HIPAA, Medical, Regulations | Leave a comment
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Last month, the HHS Office of Civil Rights (OCR) announced that there will be a more vigorous HIPAA audit effort in 2014 of HIPAA covered entities, including health plans, and their business associates. Speaking at a February 24th health care technology conference, Susan McAndrew, OCR deputy director for health information privacy said: “Hopefully in coming months you’ll see actual activity that will start up on the audit process.” OCR soon will launch a survey of 1,200 organizations as a first step toward selecting those to be audited. McAndrew also stated that the organizations to be surveyed were selected from “a large database,” and the survey seeks to verify if the entity is a suitable candidate for a HIPAA audit.

In a February 24th notice published in the Federal Register, OCR announced that it will survey “up to 1,200 HIPAA covered entities, including health plans, healthcare clearinghouses and certain healthcare providers, and business associates, to determine suitability for the OCR HIPAA audit program.” According to the notice, the survey “will gather information about respondents to enable OCR to assess the size, complexity and fitness of a respondent for an audit.” An OCR spokesperson says the survey will target approximately 800 covered entities and 400 business associates.

If you have not done so already, at a minimum, a plan sponsor should start to self assess: (1) whether it is a HIPAA covered entity; (2) whether it receives protected health information (PHI); and (3) assuming it receives PHI, has it taken timely and reasonable steps to secure the PHI in a manner consistent with HIPAA’s regulations?

Happy 40th Birthday, ERISA!

March 7, 2014 at 1:00 pm | Posted in Compliance, Department of Labor, ERISA, Federal Laws, Regulations | Leave a comment
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Protections for employee benefits moved forward 40 years ago this week with the March 4, 1974, Senate passage of the Employee Retirement Income Security Act. While it would be nearly six months until President Gerald Ford signed ERISA into law in September of that year, the bill marks congressional recognition of the sanctity of retirement, health care, and other employee benefits. ERISA also calls for the DOL to play the role of chief regulator and enforcer of the new protections. The DOL’s divisions…the Employee Benefits Security Administration…performs that important task.

ACA Exchange Enrollment Hits 4 Million

February 26, 2014 at 2:09 pm | Posted in Affordable Care Act, Compliance, Health and Human Services, Health Care, Health Insurance Exchanges, Health Insurance Marketplace, Medical, PPACA, Regulations | Leave a comment
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HHS announced Tuesday that approximately 4 million Americans have enrolled through the end of January for coverage through the Affordable Care Act Exchanges. A full enrollment report for February will be released in mid-March.

“With individuals and families enrolling in coverage every day, we continue to see strong demand nationwide from consumers who want access to quality, affordable coverage,” Centers for Medicare & Medicaid Services administrator Marilyn Tavenner wrote in a blog post Tuesday. “Our outreach efforts are in full force with community partners and local officials participating in hundreds of events each week and enrollment assistors are helping more and more people enroll in coverage,” she continued.

Only five weeks remain in the open enrollment period.

Affordable Care Act Update: Final Regulations for 90-Day Waiting Period Released

February 21, 2014 at 11:19 am | Posted in Affordable Care Act, Compliance, Creditable Coverage, Department of Labor, Employment Law, Federal Taxes, Health and Human Services, Health Care, PPACA, Regulations | Leave a comment
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On February 20th, The U.S. Departments of Labor, Treasury, and Health and Human Services published final regulations (85 pages) implementing a 90-day limit on waiting periods for health coverage. The final regulations require that no group health plan or group health insurance issuer impose a waiting period that exceeds 90 days after an employee is otherwise eligible for coverage. The rules do not require coverage be offered to any particular individual or class of individuals.

To ensure that eligibility conditions based solely on the passage of time are not used to evade the waiting period limit, the rules state that such conditions cannot exceed 90 days. Other conditions for eligibility are generally permissible, such as meeting certain sales goals, earning a certain level of commission, or successfully completing an orientation period.

Additionally, requiring employees to complete a certain number of hours before becoming eligible for coverage is generally allowed as long as the requirement is capped at 1,200 hours. The rules also address situations in which it cannot be determined that a new employee will be working full-time.

The departments are issuing a companion proposed rule that would limit the maximum duration of an otherwise permissible orientation period to one month. This proposal will be open for public comment.

A link to the final rule is here: http://www.dol.gov/opa/media/press/ebsa/20140220-redfeg1.pdf.

Employer Pays $25,000 to Settle Employee FMLA Claims Arising Out of Care for the Employee’s Niece

February 7, 2014 at 1:54 pm | Posted in Compliance, Department of Labor, Employment Law, FMLA, Human Resources, Regulations | Leave a comment
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Ohio based DNA Diagnostics Center Inc. has agreed to pay $25,000 in lost wages and liquidated damages to an employee  for unlawfully denying her FMLA leave. The company  fired the employee for exercising her rights under the FMLA to care for her seriously ill 12-year-old niece, for whom the employee was standing “in loco parentis,” or in the place of a parent. Under terms of the settlement agreement, the company must expunge the employee’s record of any disciplinary references. In June 2010, the DOL issued an Administrator Interpretation clarifying the definition of son and daughter under the FMLA includes not only a biological or adopted child, but also a foster child, a stepchild, a legal ward, or a child of a person standing in loco parentis. This definition ensures that an employee who assumes the role of caring for a child receives parental rights to family leave, regardless of the legal or biological relationship.

A copy of the DOL press release is here: http://www.dol.gov/whd/media/press/whdpressVB3.asp?pressdoc=Midwest/20140204.xml

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