Today’s growing and advanced health care industry is a fast-paced environment where regulatory issues, competition, and rapidly changing consumer expectations converge. Managing risks and realizing opportunities becomes a more important focus as health care organizations decide how they will adapt and evolve their business models for long-term survival.
Ensuring today’s actions will lead to achieving long-term goals can be a major challenge for anyone. Many health care organizations are unable to address the issues at hand and consider the “big picture” because they are overwhelmed with urgent matters and patient care. Our firm’s National Health Care Practice has significant experience serving health care clients. We bring an understanding of the industry together with innovative solutions that have a positive impact on bottom line. We understand the challenges facing health care providers and facilities.
Significant regulatory concerns facing the health care industry include:
Other major issues include:
With much of the rhetoric in Washington D.C. during the past couple of weeks over funding of the border wall and the current government shut down, employers still may have reporting requirements for 2018 under the Affordable Care Act (ACA). The Act requires insurers, self-insuring employers, and those employers with 50 or more full-time equivalents (FTEs) to report certain information to the IRS and Social Security Administration using forms 1095-B, 1095-C and 1094.
Pfizer recently announced a major restructuring into three business segments. The move followed an unsuccessful attempt by the company to market its OTC, or Consumer Healthcare segment as it will be named under the new regime. The reorganization will position the company’s most promising growth area as its rebranded Innovative Medicines segment with the existing business lines from the old segment, as well as adding biosimilars and a new hospital business unit.
Revenue Procedure 2018-27 provides relief for those with family coverage under high deductible health plans (HDHP) in regards to the annual deductible contributions limit for 2018 health savings accounts (HSA) under Internal Revenue Service Code section 223. The maximum coverage was initially issued as $6,900 on May 4, 2017. On March 2, 2018 the limit was reduced to $6,850 after tax reform changed the calculation for 2018 and future years.
In a recent announcement, the IRS indicated that it will begin sending notices to employers that have failed to comply with the employer responsibilities related to the Affordable Care Act (ACA). For the 2015 calendar year, the IRS plans to issue Letter 226J informing applicable large employers of their potential liability for an employer shared responsibility payment (ESRP), if any, in late 2017.
As part of the Affordable Care Act (ACA), one of the many excise taxes imposed by this act is again quickly approaching. The Patient-Centered Outcomes Research Institute (PCORI) fee is an excise tax imposed on health insurance issuers and plan sponsors of self-insured health plans effective for plan years ending on or after Oct. 1, 2012.