Beneficiaries

News & Analysis as of

OIG Recommends Improvements to Skilled Nursing Facility Billing Policies Regarding Changes in Therapy

The Department of Health and Human Services Office of Inspector General (OIG) recently issued a report that calls for CMS to accelerate its efforts to implement a new method for paying for changes in skilled nursing facility...more

CMS Proposes “Comprehensive Care for Joint Replacement” Model; Would Mandate Bundled Acute/Post-Acute Medicare Payment in 75 MSAs,...

On July 14, 2015, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule to establish a Medicare Comprehensive Care for Joint Replacement (CCJR) model. Under the proposed rule, CMS would provide a...more

CMS Proposes Value-Based Purchasing Model, Other Updates to the 2016 Home Health Prospective Payment System

The U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) published its proposed update to the home health prospective payment system (HHPPS) for calendar year (CY) 2016 in the July...more

The Effect of Obergefell v. Hodges for Same-Sex Couples

issued on the second-to-last decision day of the term, and provides that same-sex couples have had a constitutional right to marry since at least the passage of the Fourteenth Amendment. This ruling may come as a surprise to...more

Trustee Duties are Not for the Faint of Heart

One of the most important and farthest-reaching decisions involved in the creation of a trust is the naming of a trustee. It may seem simple enough at the outset to choose either oneself or a family member in place of a...more

July Congressional Committee Hearings on Health Policy Issues

Congressional committees continue to hold hearings on various health policy topics, including the following: ..A Senate Finance Committee hearing today focused on “Reviewing HealthCare.gov Controls.” ..The House...more

CMS Proposes to Establish Separate Payment for End of Life Planning Services

On July 8, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that updates payment rates and related reimbursement and quality policies for physician services furnished under the Medicare...more

The ABLE Act

Although the Achieving a Better Life Experience Act (or ABLE Act) was signed into law on December 19, 2014, many states have been waiting to offer ABLE accounts authorized by the Act until the IRS published regulations. The...more

Delivery System Reform 2.0: Scaling Alternative Payment Models is the New Normal

For some health care providers, a pair of recent announcements made by the Obama Administration to implement mandatory alternative payment models (APMs) for home health value-based purchasing and bundled payments for hip and...more

GAO Recommends Congress Reduce Incentives for Prescribing 340B Drugs

The United States Government Accountability Office (GAO) recently released a report entitled “Medicare Part B Drugs: Action Needed to Reduce Financial Incentives to Prescribe 340B Drugs at Participating Hospitals” (“the...more

Beneficiary Assignment Under the MSSP Final Rule

This is the fourth post in Health Care Law Today’s series on the final rule. This post addresses how CMS assigns beneficiaries to an ACO participating in the MSSP. In the MSSP ACO Final Rule, CMS finalized new...more

IRS to Prohibit Lump-Sum Cashout Windows for Pension Plan Retirees

Yesterday, the IRS issued Notice 2015-49, which abruptly announced the IRS’s intention to prohibit lump-sum cashout windows for pension plan retirees already in pay status. In recent years, many pension plan sponsors have...more

Update Beneficiary Designations After Divorce or Annulment

The Florida Fourth District Court of Appeal held, with a few exceptions, upon entry of a final judgment of dissolution or annulment, any provision of a will that “affects” a former spouse is void under section 732.507(2),...more

Update on Estate and Gift Tax Proposals

Congressional Proposals: H.R. 1105, Death Tax Repeal Act of 2015, was passed by the House, as amended, on Apr. 16, 2015. The bill amends the Internal Revenue Code to repeal the estate and generation-skipping transfer taxes...more

Appellate Court Notes

- Supreme Court Advance Release Opinions: - SC19422 - Awdziewicz v. Meriden Certain police officers retired, entitling them to pension benefits under the City Charter as previously modified in a separate lawsuit...more

Klimt Foundation Deal with Heirs of Portrait Owner Comes to Fruition at Sotheby’s

Gustav Klimt’s Portrait of Gertrud Loew was sold at auction by Sotheby’s in London last week, for over £24 million (a figure more than £6 million in excess of the upper end of its expected sale price range). Described on the...more

Eleventh Circuit Holds No Duty to Defend Directors Serving in Mixed Capacities

On June 22, 2015, the 11th Circuit affirmed a Georgia federal court decision that there was no coverage under a director’s and officer’s (D&O) insurance policy for claims asserted by beneficiaries of a family trust against a...more

Supreme Court Approves Same-Sex Marriage: Tax and Legal Implications for Same-Sex Spouses

On June 26, 2015, the Supreme Court handed down its decision in the landmark case of Obergefell v. Hodges. The Court held that the Fourteenth Amendment to the United States Constitution requires all states to license a...more

A trust is not an agency

The trustee is not an agent of the beneficiary. The trustee's duty not to delegate the administration of the trust could well be implicated if the trustee without authority were to behave as if he were the beneficiary's...more

Estate Planning for Young Families

Proper estate planning for young families is essential, despite often being overlooked by both clients and attorneys. Many young families view their estate as being “simple” because in their minds they “don’t have much,” and...more

Till Death Do Us Part. . . or at Least Until the Divorce Becomes Final

When important changes occur in life, it is advisable to reevaluate your estate planning to ensure it continues to meet the goals and objectives you have for your estate and your beneficiaries – and going through a divorce is...more

Trustees Beware: Which Fiduciary Standard Applies to Your “Business Judgments”?

To what legal standard must a trustee adhere when he or she also participates in the control of a family or closely held business? Courts continue to grapple with this question. The high courts in both Georgia and Nebraska...more

SCOTUS Reinforces ERISA Fiduciaries' Continuing Duty To Monitor Plan Investments

Recently, in Tibble v Edison International, 575 U.S.(2015), the United States Supreme Court addressed the application of the Employment Retirement Income Security Act (ERISA) statute of limitations for violations of fiduciary...more

Fiduciary News - June 2015

Changes Coming for Pennsylvania Fiduciaries in Their Ability to Access and Manage Digital Assets and Accounts - On January 1, 2015, Delaware became the first state to enact a comprehensive law granting fiduciaries the...more

No Split Gift Election Where Spouse Was a Potential Beneficiary

A husband created a Family Trust for the benefit of his wife and their descendants. Under the trust, an independent trustee may pay to or use for the benefit of the wife, or any one or more of husband’s descendants and their...more

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