|
| 08.25.08 | CMS Puts “HIPAA 2” on Fast Track
Clay B. Wortham
Abstract: The Centers for Medicare and Medicaid Services proposed an "aggressive timetable" for implementing the next two phases of the HIPAA Transactions Rule requirements as follows: (a) replace the current X12 4010/40101A transaction formats with the X12 5010 transaction formats on April 1, 2010, and (b) replace the current ICD-9 code sets with ICD-10 code sets on October 1, 2011. CMS published the notices of proposed rule makings (NPRMs) on Friday, August 22, 2008, in 73 Federal Register 49741 (X12 5010 NPRM) and 73 Federal Register 49745 (ICD-10 NPRM). The X12 5010 NPRM also proposes a new standard for subrogation with State Medicaid agencies that health plans will have to accommodate by April 1, 2010 (small health plans by April 1, 2011).
|
|
| 08.19.08 | CMS Expands Medicare Advantage Encounter Data Reporting Requirements
Jack A. Rovner
Abstract: The Centers for Medicare and Medicaid Services (CMS) amended 42 C.F.R. § 422.310 of the Medicare Advantage (MA) Rule to expand its authority to collect and use encounter data for risk adjustment and other purposes. The amendment, effective October 1, 2008, gives CMS the authority to require MA organizations to submit encounter data that characterizes the context and purposes of each item and service provided to the Medicare beneficiaries enrolled in their MA plans and the functional limitations of those enrollees. CMS will use the expanded encounter data to more accurately pay MA organizations based on the health and benefits utilization of the Medicare beneficiaries enrolled in their MA plans. CMS intends to define the encounter data it will collect in future guidance. |
|
| 08.18.08 | Frustrated With FMLA?
Employment Marketplace
Jason C. Kim
Abstract: Understanding and administering the federal Family & Medical Leave Act (FMLA) continues to challenge many employers. A category of leaves – leave to care for a covered family member – has created particular problems in determining who is a “covered family member” and what constitutes “care” so as to trigger the leave requirements. Neal Gerber Eisenberg Labor & Employment Practice Group partner Jason C. Kim authored an August 2008 Employment Marketplace article.
|
|
| 08.08.08 | EEOC Issues New Compliance Guidelines on Religious Discrimination
Chad Moeller
Abstract: On July 22, 2008, the EEOC added a new section to its compliance manual addressing religious discrimination in the workplace to guide agency personnel, employers, union and other entities covered by Title VII of the Civil Rights Act of 1964. Noting that U.S. workplaces have become more religiously diverse and that religious discrimination charges have increased from 1,388 in 1992 to 2,880 in 2007, the EEOC revised its compliance manual to consolidate “into one comprehensive document” religious discrimination case law and the Commission’s views regarding religious discrimination. The EEOC’s new manual section is accompanied by a Question and Answer document and a second document called Best Practices for Eradicating Religious Discrimination.
|
|
| 08.05.08 | CMS Eliminates Medicare Advantage Midyear Benefit Enhancement
Jack A. Rovner
Abstract: CMS has eliminated midyear benefit enhancement (MYBE) to Medicare Advantage (MA) plans. The MYBE prohibition was issued on July 28, 2008 at 73 Federal Register 43628 and is effective immediately. As a result, MA plan sponsors will not be allowed to apply for MYBE for contract year 2008 or beyond. CMS makes clear that the MYBE prohibition does not apply to employer- and union-only group "800-series" waiver plans. CMS stresses that MA plan sponsors "retain the longstanding flexibility to customize benefits, including enhancing benefits and reducing premiums and cost-sharing, for all '800-series' [employer- and union-only group waiver plans] in order to be able to accommodate the various needs for employer and union group health plan sponsors throughout the year."
|
|
