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Happy New Year January 2013
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Dear (Contact First Name),
Make a 2013 resolution to be better prepared for the Federal changes that lie ahead. Improve upon your Employee Benefit Package by contacting us at Willwerth, Caven & Associates.
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Proposed Rule Clarifies Employer Mandate Calculations
Guidance on calculating the coverage threshold of 50 or more full-time employees or full-time equivalents
On Jan. 2, 2013, the Internal Revenue Service published in the Federal Register a proposed rule, Shared Responsibility for Employers Regarding Health Coverage, with guidance on complying with the requirement that "large" employers provide affordable health care coverage to employees under the Patient Protection and Affordable Care Act (PPACA). The proposed rule has a comment period that ends on March 18, 2013.
Relatedly, on Dec. 28, 2012, the IRS posted online new questions and answers regarding the PPACA's "shared responsibility" provisions.
The proposed rule and Q&As closely track the requirements outlined in the PPACA, which states that the shared responsibility provisions (that is, the employer health care mandate) applies to employers with 50 or more full-time employees or a combination of full-time and part-time employees that is equivalent to at least 50 full-time employees.
Employers with 50 or more full-time employees (including full-time equivalents) must offer all employees working an average of 30 hours per week or more in a month health care coverage with "minimum value," beginning in 2014, or pay penalties. Read More
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5 Major Health Care Reform Changes Coming In 2013
Health care reform in the coming year will go on a kind of shakedown cruise to test the seaworthiness of America's evolving health care system as it becomes more cost-conscious and quality-focused under the Affordable Care Act.
In 2012, the health insurance law, also known as Obamacare, linked Medicare payments to the quality rather than quantity of care, started penalizing health insurers that charge too much in administrative fees and executive bonuses, and began rewarding good doctors who save Medicare money.
Ahead in 2013, the law will attempt to strengthen America's health care safety net by increasing physician pay and expanding preventive care under Medicaid; bolstering the Children's Health Insurance Program, or CHIP; and launching more streamlined Medicare billing.
State insurance exchanges to promote health plan comparison-shopping also face federal certification as they prepare for a scheduled opening in 2014. Read More
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New York City Ties Doctors' Income to Quality of Care
In a bold experiment in performance pay, complaints from patients at New York City's public hospitals and other measures of their care - like how long before they are discharged and how they fare afterward - will be reflected in doctors' paychecks under a plan being negotiated by the physicians and their hospitals. The proposal represents a broad national push away from the traditional model of rewarding doctors for the volume of services they order, a system that has been criticized for promoting unnecessary treatment. In the wake of changes laid out in the Affordable Care Act, public and private hospitals are already preparing to have their income tied partly to patient outcomes and cost containment, but the city's plan extends that financial incentive to the front line, the doctors directly responsible for treatment. It also shows how the new law could change longstanding relationships, giving more power to some of the poorest and most vulnerable patients over doctors who run their care. Read More
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