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The Spencer’s Benefits Reports is a summary of the week's news items posted in the WHAT'S NEW pages of Spencer’s Benefits Reports Online. For questions regarding this email service, contact Customer Service at (800)449-9525.
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The Centers for Medicare and Medicaid Services (CMS) has published guidance for group health plans to comply with Medicare secondary payer (MSP) mandatory reporting requirements. The new guidance, along with preliminary instructions and the required information that must be submitted, is available at http://www.cms.hhs.gov/MandatoryInsRep/…
In a recent report to Congress, the Government Accountability Office (GAO) concluded that the Pension Benefit Guaranty Corporation’s investment policies may carry more risk than acknowledged by the PBGC…
Joining four other circuit courts, the Ninth Circuit U.S. Court of Appeals has ruled that cash balance plans are not inherently age-discriminatory in violation of ERISA. The case is Hurlic, et al. v. Southern California Gas Company, et al. (No. 06-55599)…
In Rev. Proc. 2008-48, the Internal Revenue Service describes the circumstances under which a child of parents who are divorced, separated, or living apart is treated as the dependent of both parents when the custodial parent has not released the claim to the exemption for the child under IRC Sec. 152(e)(2). The guidance affects health and accident plans under IRC Secs. 105(b) and 106(a), fringe benefits under Sec. 132(h)(2)(B), medical care under Sec. 213(d)(5), Archer medical savings accounts under IRC Sec. 220(d)(2), and health savings accounts under IRC Sec. 223(d)(2)…
In the August 19 Federal Register, the Centers for Medicare and Medicaid Services (CMS issued final regulations that detail annual changes to the Medicare fiscal year 2009 hospital inpatient prospective payment system (PPS) rates and updates to the long term care prospective payment system. The CMS describes the changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes generally are applicable to discharges occurring on or after Oct. 1, 2008…
An insurance company did not abuse its discretion when it excluded certain commissions in calculating the amount of a beneficiary’s long term disability benefits. This was the decision of the Fifth Circuit U.S. Court of Appeals in Dunn v. GE Group Life Assurance Company, et al. (No. 07-10739)…
Following are several recent questions that were submitted by subscribers and the answers from Spencer editors…
A “dramatic” redistribution of patients by age since 1970 is illustrated in the 2006 National Hospital Discharge Survey, published in July by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention…
Ruling in two consolidated cases, the Fifth Circuit U.S. Court of Appeals has found that ERISA preempted Texas’ “any willing provider” (AWP) law and that, as a result, health care plans were not required to reimburse an out-of-network drug therapy firm for services provided to plan participants. The cases are Quality Infusion Care, Inc. v. Humana Health Plan of Texas, Inc. (No. 07-20703) and Quality Infusion Care, Inc. v. Humana HMO Insurance (No. 07-20887)…
For single-employer pension plans terminating in September 2008, and for multiemployer plans involved in a mass withdrawal, the interest rate established by the Pension Benefit Guaranty Corporation for calculating immediate annuities is 6.24%, up from the 6.05% rate that applied in August…
Most adults in the U.S. agree that the U.S. health care system needs either “fundamental change or complete rebuilding,” according to a recent report from the Commonwealth Fund’s Commission on a High Performance Health System. The study report, Public Views on U.S. Health System Organization: A Call for New Directions, presents results of a Harris Interactive survey of 1,004 adults…
The Railroad Retirement Board has issued final regulations that amend the agency’s existing rules concerning partition of annuities pursuant to a court decree or court-approved property settlement. The final rules, which appeared in the August 13 Federal Register, were issued in order to incorporate provisions of the Pension Protection Act of 2006 (PPA)…
The Medicare physician group practice (PGP) demonstration improved the quality of care delivered by all participating physician groups to patients with congestive heart failure, coronary artery disease, and diabetes mellitus during the demonstration’s second performance year, the Centers for Medicare and Medicaid Services (CMS) reported on August 14. The improved performance earned the ten participating groups $16.7 million in incentive payments for the period from April 1, 2006, through March 31, 2007. The PGP demonstration rewards health care providers for coordinating the overall health care needs of Medicare patients assigned to the groups and for improving health outcomes…
In Rev. Proc. 2008-50, the Internal Revenue Service updates its Employee Plans Compliance Resolution System (EPCRS), which is the agency’s comprehensive system of voluntary correction programs for sponsors of qualified retirement plans. The revenue procedure supersedes Rev. Proc. 2006-27, C.B. 2006-1, 945…
In its fourth annual analysis and forecast of health savings accounts (HSAs), Information Strategies, Inc. (ISI), predicts that the number of HSA-covered lives and accounts will double from January 2008 to January 2009…
Emergency department visits following a recent hospitalization might indicate poor inpatient care or poor follow-up planning, according to a report from the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention…
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