HIPAA - Forgotten But Not Gone

With so much emphasis being placed on Affordable Care Act (ACA) compliance these days, some folks have gradually (and frighteningly) forgotten about the ACA's "older brother" - the Health Insurance Portability and Accountability Act (HIPAA).  Several ACA provisions supersede or expand upon HIPAA provisions that went into effect on and after January 1, 1997 (e.g., preexisting condition limitations, guaranteed issue/renewability, certificates of creditable coverage, etc.).  However, the ACA did virtually nothing to change the privacy and security aspects of HIPAA, which are not only still in effect, but carry stiff fines and penalties for non-compliance.

HIPAA created a new acronym - PHI - which stands for protected health information.  And among the many requirements created by HIPAA, perhaps none are more important than those addressing the request, disclosure and use of PHI by "covered entities" and "business associates".  HIPAA privacy rules also create rights for individuals to access, review, and amend their PHI.  Readers are likely familiar with the seemingly constant flow of HIPAA disclosure notices.  I want to provide a considerable amount of caution in this week's post, relative to HIPAA and PHI:

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ACA Transition Relief - Employer Mandate

In February of this year (2014), I provided an overview of the IRS' final regulations pertaining to the Affordable Care Act's (ACA) employer mandate.
Since this is such a confusing provision of the ACA, to say nothing of the fact that there have been not one, but two separate delays of this provision, I decided to recap some of the more pertinent aspects of the final regulations and associated transitional relief.

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Prescription Drugs - Health Care's Low Hanging Fruit

There is an often overused metaphor equating things easily obtained with "low hanging fruit".  And in the world of health care and consumer driven health care (CDH), there is perhaps NO lower hanging fruit to be had than prescription drugs.  I would further submit that few if any other product category in our entire economy has the sheer number of FREE...DISCOUNTED...REDUCED...SAMPLE offers connected to it, by a variety of constituencies including - manufacturers, distributors, insurers and employers - than do prescription drugs.  But do the very people these offers of "low hanging fruit" are directed toward understand the "what", "why", or even "where" associated with them?

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Employers Reimbursing Employees for Individual Coverage

Recently, the IRS issued guidance which places harsh penalties on employers that deploy the strategy of "dumping" employees into the Individual health insurance marketplace.  The guidance followed the White House's objection to the idea of allowing employers the ability to provide employees with a lump sum of money with which to buy individual insurance on the exchange/marketplace.  This builds on guidance released last year from the Department of Labor (DOL) which was more broad in scope.  A previous blog post addressed the DOL guidance, which effectively "killed" the ability to use tax preferred funds from HRAs and FSAs to fund Individual health insurance premiums, regardless of the source of such coverage.
The recent ruling and associated guidance is short and sweet.  Here's the scoop...

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COBRA, ACA, and Special Enrollment Rights

With the seemingly endless flow of guidance, updates, notices, and delays swirling about relative to the Affordable Care Act (ACA),  a rather important piece of guidance may have been overlooked.  Issued jointly by the Department of Labor (DOL) and Health and Human Services (HHS) earlier this month (May 2, 2014), this guidance provides an opportunity for individuals enrolled in COBRA coverage the option to dis-enroll in their COBRA coverage, and enroll in potentially lower cost individual health insurance coverage, FOR A LIMITED TIME.  (Click - http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/SEP-and-hardship-FAQ-5-1-2014.pdf )
This week's post addresses this guidance and provides additional information related to the transection of COBRA and the ACA.

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HSA Updates and Advanced Guidance

The Internal Revenue Service (IRS) has announced the Health Savings Account (HSA) maximum contribution amounts, and qualified high deductible health plan (QHDHP) deductible and out of pocket limits for 2015.  Since I have provided basic guidance on "all things HSA" in a previous post (see - http://sstevenshealthcare.blogspot.com/2013/10/health-savings-accounts-hsas.html ), I thought I would provide some advanced HSA guidance in this week's blog, along with the recently announced 2015 IRS maximums.

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CDHPs Affect on Health Care Spending

Ordinarily, I try to couple a picture with the content of my post, creating a theme of sorts.  This week, my selected picture IS the essence of the blog post.  The picture is a chart provided by the Centers for Medicare and Medicaid Services (CMS) showing the slowing of health care spending from 2002 to 2013, by nearly 90%.  A previous blog post addressed this topic (click - http://sstevenshealthcare.blogspot.com/2014/01/whats-causing-health-care-spending-to.html)
One of the factors contributing to the slow down in health care spending cited in this post (titled appropriately - What's Causing Health Care Spending to Slow?) is the growth in popularity and implementation of so called high deductible health plans with accompanying tax preferred spending accounts.  Better known as Consumer Driven Health Plans, or CDHPs, these plans affect both the demand and supply of health care, and as time, data, and logic has now proven, THESE PLANS REDUCE HEALTH CARE COSTS WITHOUT COMPROMISING CARE!

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