Headlines about "Health plan admin - misc"
Gathered from the web by the editors at BenefitsLink.com.
[Guidance Overview] ERISA Preemption of State Bars on Discretionary Clauses in Health and Life Insurance Policies (PDF)
At page 5. Excerpt: "For years, discretionary clauses have been challenged by ERISA plaintiffs and consumer groups. State insurance regulators entered the fray in 2002, and appear to be succeeding in setting aside these clauses for insured plans. Significantly, the usual ERISA preemption defense appears to be giving way to a wave of state insurance regulation preventing insured ERISA plans from giving Firestone discretion to fiduciaries of insured plans. This article examines some recent case law on the preemption issue . . . ." (Proskauer Rose LLP)
[Guidance Overview] Golden State Court Allows Gay Marriages
Excerpt: "With the 172-page ruling, including a majority opinion penned by Chief Justice Ronald M. George, California becomes the second U.S. state behind Massachusetts to allow gay marriage, according to news reports . . . . The decision was a product of a deeply divided court that narrowly approved the final holding 4 to 3." (PLANSPONSOR.com)
[Guidance Overview] Worker Misclassification Investigations Gain Momentum
Excerpt: "Undoubtedly, some industries are both more prone to misclassify workers and more vulnerable to challenge due to the nature of the work involved. Construction, transportation and even the medical profession have proven at risk on the issue." (Attorney Roy F Harmon III in the Health Plan Law blog)
[Guidance Overview] Prominent Provisions of the Genetic Nondiscrimination Act
Excerpt: "The Secretary of Labor is provided new enforcement authority. It may impose a penalty against the plan sponsor or issuer for failure to meet the requirements of ERISA §§ 701 and 702 regarding genetic information and discrimination. The permissive penalty is $100 per day for each participant or beneficiary to whom the failure applies. If the failure is discovered by the Secretary before it is corrected, however, a minimum penalty of at least $2,500 per person shall apply (or, where the violations have been more than de minimis, at least $15,000 per person shall apply)." (Deloitte)
More Tying the Knot to Get Health Insurance
Excerpt: "Some people marry for love, some for companionship and others for status or money. Now comes another reason to get hitched: health insurance. In a poll released Tuesday, 7 percent of Americans said they or someone in their household decided to marry in the past year so they could obtain health-care benefits via their spouse." (Chicago Tribune)
[Guidance Overview] Genetic Discrimination Bill Expected to Be Signed Into Law: Concern Over Some Consequences for Employers
Excerpt: "The breadth of the definition [of 'genetic information' raises numerous questions. For example, an employee seeking time off to care for a family member under the Family and Medical Leave Act must provide certification of the family member's serious health condition in order to qualify for leave. This knowledge would qualify as 'genetic information' under the statute's definition. Will employees be able to claim that subsequent disciplinary actions were founded on genetic information discrimination? Does the collection of family health history for a company-sponsored wellness program put the employer at risk for claims of a GINA violation?" (Thompson Hine)
[Guidance Overview] Prison Sentences Upheld for Unpaid Plan Contributions Under ERISA Theft Statute
Excerpt: "Over a two-year period, the corporate executives in this case (a CEO and CFO) failed to make required contributions to the company's retirement plans and failed to use employee health plan contributions to pay benefits under that plan (almost $1.4 million in contributions was involved). The executives were convicted of various federal crimes (including ERISA theft and false statements) and given ten- and seven-year prison terms." (Employee Benefits Institute of America (EBIA))
The Effect of Conflicts of Interest on the Scope of Discovery
Excerpt: "As discussed in a prior article, the federal judiciary has permitted limited discovery beyond the 'administrative record' as the inquiries may bear upon the question of a structural conflict of interest as, for example, where the administrator and the insurer are the same entity. Another level of conflict of interest may exist, namely, that of 'third parties', such as consultants, who review the record and advise the administrator." (Health Plan Law blog by Attorney Roy F. Harmon III)
Health Plan Study Shows Performance Varies Region to Region
Excerpt: "Employers hope that a health insurer managing regional plans across the country will deliver consistent services to all members. New research by J.D. Power and Associates shows that may not always be the case." (Employee Benefit News; free registration required)
[Guidance Overview] Claims Administrator's Handling of Claim Satisfies Urgent Care Regulations
Excerpt: "The facts of this sad case illustrate the tragic conflict that can arise when families trying to obtain medical care for loved ones confront the claims administration mechanisms that operate as cogs and wheels within the larger mechanical apparatus of the ERISA remedial system. One of the salient facts that undoubtedly frustrated the plaintiff was that the defendant refused to approve a drug that it had previously approved and had evidently proved efficacious. Nonetheless, in the view of the district court, ERISA offers no relief for the Plaintiff's claims." (Health Plan Law blog by Attorney Roy F. Harmon III)
[Guidance Overview] Fourth Circuit Rejects Validity of Assignments Taken in Claims Settlement
Excerpt: "In this recent opinion, the Fourth Circuit considered the issue of derivative standing in the context of an ERISA claim for benefits action. . . . The Fourth Circuit affirmed the district court, holding that the assignments presumably taken by the original PEO defendant (Sikora) in a claims for benefit case through settlement were insufficient to create ERISA standing in a subsequent claim by the PEO against third parties (Fidelity Group) allegedly responsible for the defalcation in benefit funding." (Health Plan Law blog by Attorney Roy F. Harmon III)
IRS Updates 2007-2008 Priority Guidance Plan
Excerpt: "The updated 2007-2008 Priority Guidance Plan lists regulations and other guidance still under development. It also adds new items and indicates which items have already been published. Here are some of the significant projects affecting 401(k) plans and health plans that are listed as outstanding in the updated Priority Guidance Plan . . . ." (Employee Benefits Institute of America)
Postscript to Metlife v. Glenn
Excerpt: "In my opinion, the notion of internal firewalls and protections hinted at by Justice Kennedy shows a failure to understand the practical realities of insurance company claims administration. Moreover, Justice Roberts conflates insurance company administration and employer self-funded claims administration in his comments. I doubt anything definitive will come of this case and that we will have at least one footnote (probably by Justice Roberts) that will spawn endless speculation." (Health Plan Law blog by Attorney Roy F. Harmon III)
[Guidance Overview] Eleventh Circuit Joins Tenth on Production of 'Appeal-Level' Medical Reviews
Excerpt: "In this recent decision, the Eleventh Circuit added its weight to that of the Tenth on an important aspect of the standard of 'full and fair review'. The Eleventh Circuit held that an ERISA plan administrator was not required to furnish a plan participant the report of physician who conducted independent peer review of participant's medical records during review of the initial denial of participant's benefit claim. The court accepted the plan administrator's argument that it had not relied upon the report or used the report in the course of making the benefit determination until its final decision was reached." (Health Plan Law blog by Attorney Roy F. Harmon III)
Bank of America Consolidates a Dozen Bennies Vendors, Hoping to Stabilize Costs
Excerpt: "Bank of America's overhaul of its employee benefits program may in many ways be the first of its kind among corporations with jumbo-sized work forces. But benefits experts say the banking behemoth is unlikely to be the last large employer to consolidate almost all of its health-care and related vendors onto a single platform, because scores of companies are battling to stabilize -- and streamline -- their health-care operations and expenses." (Financial Week; free registration required)
[Guidance Overview] Stop Loss Carrier Averts ERISA Preemption in Dispute Over 'Fronted' Claims Reimbursement
Excerpt: "With [a] sentence of Faulknerian length, the Fourth Circuit framed the question of possible ERISA preemption of a claims administrator against a plan sponsor. The case forms a interesting addition to the growing body of law to the effect that contractual disputes between plan sponsors and claims administrators are subject to state, not federal, law." (Health Plan Law blog by Attorney Roy F. Harmon III)
[Opinion] Tax Bill Provision Meant to Hinder Tax Evasion Could Boost HSA Administration Costs
Excerpt: "HSAs are a tax scheme in which we taxpayers subsidize the health care of individuals with incomes high enough to qualify for the tax relief. It would be inappropriate if these taxpayer-subsidized funds were used to purchase entertainment centers or expensive vacation trips. Unfortunately, the only way to ensure that these funds are used for health care is to establish an administrative process to clear each payment made out of the accounts." (Physicians for a National Health Program)
[Guidance Overview] ERISA Plan's Prior Authorization and Plan Limits Requirements Preempt State Medicaid Demands for Payment If Procedures Not Followed
Excerpt: "Employer health plans that require prior authorization or impose plan limits on certain types of care need not repay State Medicaid plans when those state plans pay for Medicaid recipients' treatments that the employer plan would not have paid unless the plan participant had received prior authorization under the employer plan. But this rule applies only if the plan participant first files the claim with the employer health plan and receives the employer plan's denial of payment, according to U.S. Department of Labor Advisory Opinion 2008-03A, March 31, 2008." (Deloitte via BenefitsLink.com)
[Guidance Overview] CRS Report for Congress: Summary of the Employee Retirement Income Security Act (ERISA) (PDF)
76 pages; April 10, 2008. Excerpt: "The Employee Retirement Income Security Act of 1974 (ERISA) provides a comprehensive federal scheme for the regulation of employee pension and welfare benefit plans offered by employers. ERISA contains various provisions intended to protect the rights of plan participants and beneficiaries in employee benefit plans. These protections include requirements relating to reporting and disclosure, participation, vesting, and benefit accrual, as well as plan funding. ERISA also regulates the responsibilities of plan fiduciaries and other issues regarding plan administration. ERISA contains various standards that a plan must meet in order to receive favorable tax treatment, and also governs plan termination. This report provides background on the pension laws prior to ERISA, discusses various types of employee benefit plans governed by ERISA, provides an overview of ERISA's requirements, and includes a glossary of commonly used terms." (Congressional Research Service, U.S. Library of Congress)
The Price of Excess - Identifying Waste in Health Care Spending (PDF)
22 pages. Excerpt: "To appropriately address waste in health spending, health industry leaders, policymakers and consumers must work together on system-wide goals and incentives to address the waste that imperils the health of us all. In this paper, we view waste as costs that could have been avoided without a negative impact on quality." (PricewaterhouseCoopers; lengthy free registration is required)
More than Half of $2.2 Trillon U.S. Health Tab Called Wasteful
Excerpt: "[A new PricewaterhouseCoopers' Health Research Institute study] found the top three areas of wasted spending are defensive medicine ($210 billion annually), inefficient claims processing (up to $210 billion annually), and care spent on preventable conditions related to obesity ($200 billion annually). The study report said the $1.2 trillion in waste, defined in the research as costs that could have been avoided without hurting service quality, has to be dealt with at a macro level because targeted cost-cutting leaves inefficiencies in other parts of the health system." (PLANSPONSOR.com; free registration required)
[Guidance Overview] On the Standard of Review - A New Checklist
Excerpt: "The proper standard of review to be applied in judicial review of a plan administrator's decision varies depending on venue. Nor are the Courts all persuaded that the issues have been well decided." (Health Plan Law blog by Attorney Roy F. Harmon III)
[Opinion] Law Professor Amicus Brief Filed in Glenn ERISA Case
Excerpt: "Donald Bogan (Oklahoma) sent us a copy of an amicus brief he and a few others at the University of Oklahoma College of Law filed last week in the U.S. Supreme Court ERISA standard of review case, MetLife v. Glenn, which is set for oral agreement on April 23, 2008." (Workplace Prof Blog)
[Opinion] The Interaction of LaRue, Bruch, and MetLife v. Glenn
Excerpt: "The courts are already clogged with a myriad of litigation on countless subjects. It makes no sense to turn every benefit denial or administrative error immediately into a federal lawsuit without, at least, attempting to pursue participant rights through the administrative review process. If that process is not administered in an objective and responsible manner, then it should be reformed and its decisions will not be upheld by courts until it is." (Pension & Benefits Blog)
[Official Guidance] Proposed Dept. of Defense Regs on Relationship between TRICARE and Employer-Sponsored Group Health Plans (PDF)
3 pages. Excerpt: "This proposed rule implements Section 1097c of Title 10, United States Code. This law prohibits employers from offering incentives to TRICARE-eligible employees to not enroll, or to terminate enrollment, in an employer-offered Group Health Plan (GHP) that is or would be primary to TRICARE. Cafeteria plans that comport with section 125 of the Internal Revenue Code will be permissible so long as the plan treats all employees the same and does not illegally take TRICARE eligibility into account." (U.S. Department of Defense)
[Guidance Overview] Claim for Negligent Misrepresentation That Employee Had Health Coverage Was Not Preempted by ERISA
Excerpt: "EBIA Comment: As this court noted, generalizations as to the scope of ERISA preemption can be problematic. Some state laws affect employee benefit plans in 'too tenuous, remote or peripheral' of a manner to warrant preemption by ERISA." (Employee Benefits Institute of America)
[Opinion] A Closer Look at the Procedural Aspects of Delegation of Claims Review
Excerpt: "As noted [previously], the lack of the plan administrator's involvement in the benefits denial decision was cited as the reason for applying a de novo, as opposed to an abuse of discretion, standard of review. In the case discussed there, Shelby County Healthcare Corp. v. Majestic Star Casino, LLC, Slip Copy, 2008 WL 782642 (W.D.Tenn.) (March 20, 2008), the district court concluded that this lack of involvement distinguished this case from those in which deference must be accorded to the plan administrator." (Health Plan Law blog by Attorney Roy F. Harmon III)
CEOs Have Their Own Ideas About Improving Health Insurance Coverage
Excerpt: "Company CEOs are united in their hopes that there is some way to tame health care costs and insurance premium increases. But beyond that, they have their own ideas on how health plans could be improved to benefit their employees and their companies. . . . Many businesses have found ways, often through trial and error, to address the twin goals of providing health coverage to attract and keep employees while tweaking the coverage and instituting other efforts to keep a handle on the plan's sizable price tag. It's an often frustrating process, and CEOs see plenty of ways health plans could be improved." (Dallas Business Journal via bizjournals.com; free registration required)
[Guidance Overview] ERISA Preempts State Withholding Law
Excerpt: "Employers can thank the son of a Supreme Court Justice for obtaining needed guidance on an ERISA preemption issue that has been a traditional gray area of group health plan administration." (Infinisource)
[Official Guidance] The IRS Employer's Supplemental Tax Guide for Use in 2008 - Publication 15-A (PDF)
60 pages. Excerpt: "This publication supplements Publication 15 (Circular E), Employer's Tax Guide. It contains specialized and detailed employment tax information supplementing the basic information provided in Publication 15 (Circular E)." (Internal Revenue Service)
[Opinion] What's the Size, Role & Future of TPAs' Marketplace?
Excerpt: "The estimates used in this report are intended for guidance to understand what is really going on in the marketplace...not to be used as 'gospel' or plugged into statistical formulas. Basic differences in vocabulary means every number has a built-in 1,000% potential distortion factor. For example, a family of parents and 10 children are variously described as 1, 2, 3, 4, or 12 'lives', so even simple counting of heads will be distorted." (Frederick D Hunt, Jr. via Society of Professional Benefit Administrators)
Health Insurance Company Bosses Make Bigtime Bucks - Nonprofits Defend Executives' Pay
Excerpt: "Bay State health insurance bosses are raking in multimillion-dollar pay packages - and politically wired powerbrokers get tens of thousands as part-time directors - even as the state and its taxpayers struggle to pay skyrocketing health care costs, a Herald review shows." (Boston Herald)
[Guidance Overview] Appellate Court Affirms State Insurance Department Cease & Desist Order Against TPA's ERISA Challenge
Excerpt: "An Indiana appellate court held that the Indiana Department had jurisdiction over a claims administrator's activities where the practical function was the provision of insurance. This case presents analysis of the oft-cited defense to insurance department regulation, that of ERISA preemption." (Health Plan Law blog by Attorney Roy F. Harmon III)
Cleaning Up the Company's Health Insurance Eligibility Rolls
Excerpt: "A school district in Cleveland saved $3.5 million in two steps: First, it identified ineligible dependents and removed them from the district's health care rolls. Then, the district clamped down with a new policy that required spouses to use their own employer's health care coverage." (Workforce Management; free registration required)
Aetna Announces Plans to Offer New Online Search Engine to Provide Members with Access to Medical Information
Excerpt: "Aetna officials . . . announced plans to offer a new online search engine that will allow members to access at no cost medical information, information on local physicians who can address their needs and cost information based on their medical histories and coverage levels, the San Francisco Chronicle reports . . . ." (Kaiser Family Foundation)
EBSA ERISA Enforcement Efforts - Jan - Feb 2008
Excerpt: "The U.S. Department of Labor, Employee Benefit Security Administration, reports the following enforcement results for the period January 1, 2008 - February 29, 2008 . . . ." (Health Plan Law blog by Attorney Roy F. Harmon III)
[Guidance Overview] Carrier's Neglect in Compiling Administrative Record Constitutes an Abuse of Discretion
Excerpt: "By relying on upon written evidence alone, the carrier in Granite v. Guardian Life abused in discretion in determining that a cancer patient had never been 'actively at work' as required by the life insurance policy. The procedural irregularities in the carrier's adjudication of this claim drew sharp criticism by the district court. The case provides a good backdrop for discussion of the concerns voiced by those critical of the deference afforded plan administrators operating under a conflict of interest." (Health Plan Law blog by Attorney Roy F. Harmon III)
UNC Health Care Requiring Patients to Pay Costs Up Front
Excerpt: "UNC Health Care on Saturday began asking patients at its affiliated hospitals and physician clinics to pay up front for their share medical care costs, the Raleigh News & Observer reports. Under the new policy, patients will contribute up front copayments for physician visits, as well as for tests such as MRI scans." (Kaiser Family Foundation)
[Guidance Overview] Alaska Supreme Court - An Opinion on ERISA Preemption
Excerpt: "The Supreme Court held: 1) ERISA § 514 does not pre-empt a common law claim for negligent misrepresentation by non-participants. 2) Emotional distress damages were justified, even in the absence of physical injury . . . . 3) The allocation of 75 % fault to the Fund and 25 % fault to the employer was justified. The Court seemed to approve Judge Suddock's analogy of the employer to a 'lay consumer' and the Trust to an insurance company." (Alaska Employment Law)
Employers Most Satisfied When Enrollment Systems, Related Resources Are Integrated
Excerpt: "Employers are using their benefits enrollment systems to encourage employees to adopt healthier behaviors, a new survey by Watson Wyatt Worldwide has found. The survey of 117 U.S. companies conducted in December 2007, at the end of the annual enrollment process, found that more than half (53%) have incorporated health risk assessments into their enrollment systems or will incorporate these programs by 2009 . . . ." (Wolters Kluwer Financial Services)
[Official Guidance] Text of Proposed Labor Regs: 7-Day Safe Harbor for Participant Contributions for Plans Having Fewer Than 100 Participants (PDF)
Excerpt: "[T]he Department believes that adoption of a '7-business day' safe harbor rule would present little, if any, additional risk to plan participants and beneficiaries. In this regard, the Department believes that most employers with small plans that are taking longer than 7 business days to deposit participant contributions will expedite the depositing of those contributions to take advantage of the safe harbor. The Department also believes that where participant contributions are being made by employers with small plans within a period shorter than 7 business days, few employers with small plans will incur the costs attendant to modifying their payroll system in order to hold such contributions for a few additional days." (Employee Benefits Security Administration, U.S. Department of Labor)
[Guidance Overview] Employee Benefits Update, February 2008 (PDF)
7 pages. The newsletter covers select compliance deadlines, retirement plan developments, and health and welfare plan developments. (Reinhart Boerner Van Deuren s.c.)
Health Insurers Work to Address Issues Involving Retroactively Canceled Policies
Excerpt: "The health insurance industry has begun efforts to 'defuse a growing furor over retroactive policy cancellations that have saddled some patients with big medical bills and sparked lawsuits,' the Wall Street Journal reports. According to the Journal, health insurers 'say they have the right to rescind policies when policyholders don't disclose pre-existing medical conditions' or 'when they misrepresent information on their policy application,' but 'some policy rescissions can seem arbitrary and unfair.'" (Kaiser Family Foundation)
More Employers Link Health Risk Appraisals to Open Enrollment
Excerpt: "Employers are redefining open enrollment by using the process to encourage workers to sign up for health risk appraisals and disease management programs. They see the benefits enrollment period as the perfect time to educate workers on how healthier lifestyle decisions affect health care costs." (Employee Benefit News; free registration required)
[Guidance Overview] DOL Addresses Fiduciary Responsibility to Collect Delinquent Plan Contributions (PDF)
2 pages. Excerpt: "In Field Assistance Bulletin 2008-01 (February 1, 2008), the DOL articulated for its Office of Enforcement a theory of fiduciary responsibility under ERISA for collection of delinquent contributions to retirement and welfare plans." (Sutherland Asbill & Brennan LLP)
Health Plans Put Onus on Insured
Excerpt: "Of the estimated 54 million Americans who are covered by their employers’ health plans, about three of four are in plans that give them the option of going out of network. And while most people covered under such plans probably understand that out-of-network services will cost them more, they may be startled to find out just how much more they may end up spending." (New York Times (free registration required))
[Opinion] A Rip-Off By Health Insurers?
Excerpt: "Have health insurers been systematically cheating patients and doctors of fair reimbursement for medical services? That is the disturbing possibility raised by an investigation of the industry’s arcane procedures for calculating “reasonable and customary” rates." (New York Times (free registration required))
IRS Provides Safe Harbor for Supplemental Group Health Insurance
Excerpt: "[In Notice 2008-23, the] IRS has provided a safe harbor for supplemental group health insurance to be considered excepted from the general group health plan requirements found in Chapter 100 of the Internal Revenue Code. The IRS expects to incorporate the standards of this safe harbor as requirements in future proposed regulations." (CCH Tax News Headlines)
State E-Health Activities in 2007: Findings from a State Survey
Excerpt: "States see e-health initiatives as high-priority; however, they and their private sector partners face significant challenges that accompany such initiatives, including the issues of cost and time required for implementation and for realizing a return on investment. Nevertheless, as reflected in the wide range of e-health activities across the states, a consensus has emerged that these policies and initiatives are significant and well worth the effort." (The Commonwealth Fund)
Insurers Say They Wont Pay for Preventable Medical Errors
Excerpt: "Employers could begin to see cost savings and improvements in the quality of health care in the next year as more private insurers plan to follow the federal government’s lead in refusing to pay hospitals for medical errors. In recent months, Blue Cross and Blue Shield, Aetna and WellPoint have said they will look for ways to stop paying for certain preventable errors called 'never events' or 'serious reportable events' " (Workforce.com)
Health Care Reform Must Include Information Technology Support, Group Says
Excerpt: "The U.S. Congress needs to pass health-care IT legislation before private companies develop multiple systems that don't talk to each other, two advocacy groups say." (Washington Post; free registration required)
Gaps in Data Slow Retiree Prescription Subsidies
Excerpt: "Because of administrative snafus, some employers that have applied for the Medicare Retiree Drug Subsidy are now scrambling to meet a March 31 deadline for final reconciliation. If they are unable to confirm eligibility of all of their plan members, they will not be paid for them . . . ." (Workforce.com)
PHCS Provider Reimbursement Controversy Affects ERISA Self-Funded Health Plans
Excerpt: "The investigation by New York Attorney General Andrew Cuomo into the protocols used by managed care companies to calculate reasonable and customary charges will likely have an effect on self-funded health plans and benefit administrators as well. The controversy promises to be technical, political and litigious." (Health Plan Law blog by Attorney Roy F. Harmon III)
[Opinion] Benefits in 2020: Big Challenges Ahead
Excerpt: "Dallas Salisbury. The CEO of the Employee Benefit Research Institute, a well-regarded, nonpartisan think tank in Washington, D.C., paints a bleak picture of the future of employee benefits over the next 15 years." (CFO.com)
[Official Guidance] Text of 'Monthly Benefits News & Developments' by Milliman for February 2008 (PDF)
Only 2 pages, but 'what's there is cherce,' as Spencer Tracy might say. (Milliman)
[Guidance Overview] Letter Stating That Participant Wished to Appeal Benefit Denial Should Have Been Treated as an Appeal
Excerpt: "Three weeks before the deadline, the participant's attorney sent the insurer a letter stating, among other things, that the participant 'wishes to appeal' the decision and requesting certain documents and information. The insurer replied with a letter that gave the participant an additional 40 days to submit a 'complete appeal.'" (Employee Benefits Institute of America)
New York State Attorney General Accuses Health Insurers of Fraud
Excerpt: " New York Attorney General Andrew Cuomo is suing United Health, one the nation's largest health insurers, and demanding information from more than a dozen others. He accuses the industry of manipulating data so it can charge patients an unfairly high portion of the bill for out-of-network doctors." (National Public Radio)
[Guidance Overview] Eleventh Circuit Reverses Lower Court And Holds Subrogation Appropriate Against Funds in Conservator's Account
Excerpt: "This case is important because the Eleventh Circuit clarified that Knudson and Sereboff allow a health plan to establish entitlement to a fund, even where a third party (i.e., someone other than the plan participant) holds the fund, so long as 'the settlement proceeds are still intact and, therefore, constitute an identifiable res that can be restored to its rightful recipient.'" (Clear Direction blog)
Text of GAO Report: HHS Pursues Efforts to Advance Nationwide Health Information Technology But Has No 'National Strategy'
17 pages. Excerpt: "Even though HHS is undertaking . . . various activities, it has not yet developed a national strategy that defines plans, milestones, and performance measures for reaching the President's goal of interoperable electronic health records by 2014. In 2006, the National Coordinator for Health Information Technology agreed with GAO's recommendation that HHS define such a strategy; however, the department has not yet done so." (United States Government Accountability Office)
Text of DOL EBSA Field Assistance Bulletin 2008-02: Guidance on Final Wellness Program Rules
Excerpt: "[Issue:] What types of health promotion or disease prevention programs offered by a group health plan must comply with the Department's final wellness program regulations and how does a plan determine whether such a program is in compliance with the regulations? . . . . Use the following questions to help determine whether the plan offers a program of health promotion or disease prevention that is required to comply with the Department's final wellness program regulations and, if so, whether the program is in compliance with the regulations." (Employee Benefits Security Administration, U.S. Department of Labor)
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