Beneficiaries

News & Analysis as of

OIG Issues Advisory Opinion Regarding Pharmaceutical Manufacturers’ Program to Provide Free Limited Drugs to Beneficiaries When...

On August 12, 2015, the Department of Health and Human Services Office of Inspector General (OIG) posted Advisory Opinion No. 15-11, finding that a program to supply a limited amount of free cancer drugs to federal health...more

IRS Extends Due Date for New Basis Reporting Rules

On July 31, 2015, the laws addressing the basis of property acquired from a decedent were revised. Among other things, the new laws require an executor to provide to the IRS and to each estate beneficiary a statement...more

GAO Issues Report on Medicaid Prescription Drug Fraud Controls

In July 2015, the U.S. Government Accountability Office (GAO) issued a report concerning Medicaid pharmacy-related program integrity efforts. GAO explained that this review was pursued due to the substantial amount of funds...more

IRS Announces Delay in Consistent Basis Notice to Beneficiaries Rules

I recently wrote about the provisions of the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 that require estates to give statements to beneficiaries regarding the basis of property if an estate...more

CFPB’s Office of Older Americans Releases Virginia Guides Designed for Financial Caregivers

On August 17, the CFPB released Virginia state-specific Managing Someone Else’s Money guides, which are designed to make it easier for financial caregivers to follow the state’s unique fiduciary laws and procedures. According...more

The Surface Transportation and Veterans Health Care Choice Improvement Act of 2015: Important Changes Affecting Tax Filings for...

On July 31, 2015, President Obama signed into law the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 (the "Act"), which revised a number of different federal tax laws relevant to individuals,...more

OIG Recommends Improvements to SNF Billing for Changes in Therapy

In FYs 2011 and 2012, CMS adopted new patient assessments for skilled nursing facilities (SNFs) that were intended to capture when beneficiaries start therapy, end therapy, and decrease or increase therapy. The HHS Office of...more

HUD Proposes Rule to Clarify Equal Participation of Religious Organizations in HUD Programs

On August 5, HUD announced that it would amend its existing regulations regarding the equal participation of faith based (religious) organizations in HUD programs. The amendments are being undertaken to implement Executive...more

President Signs Hospital Outpatient Observation Status “Notice” Act

On August 6, 2015, President Obama signed into law H.R. 876, the Notice of Observation Treatment and Implication for Care Eligibility Act. The new law requires hospitals to provide written and oral notification to Medicare...more

Important Tax Compliance Provisions Included in the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015

On Friday, July 31, 2015, President Barack Obama signed HR 3236, the "Surface Transportation and Veterans Health Care Choice Improvement Act of 2015" (the "Act"). The Act modifies the extended six-year statute of limitations...more

Trusts Find Shelter from State Taxes in State Courts

In two recent cases, taxpayers have successfully challenged state taxation of trust income on the basis that the taxing states had a minimal connection to the trust. In The Kimberly Rice Kaestner 1992 Family Trust v. North...more

Recent Cases of Interest to Fiduciaries

In re Estate of House, 2014 Wash. App. LEXIS 3006 (Wash. Ct. App. 2014) - A release waiving any and all claims that the parties may have or may acquire, bars recovery for unknown claims existing at the time the release...more

Death and Bitcoin: How Digital Currencies Affect Estate Planning

It may not be at the forefront of your digital currency interests, but cryptocurrencies have unique characteristics that require careful consideration for estate planning. If you have bitcoin, for example, but your...more

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

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