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Messenger Model Contracting – A Structure of the Past

Posted on May 19, 2014 by

There are many organizations around the country that use a messenger model as a managed care contracting mechanism. Under the messenger model, an intermediary is used to shuttle offers from managed care organizations to individual providers who sign on to the network. Messenger model networks should not be confused with clinically integrated systems. Clinical integration […]

Self Disclosure and Repayment: Employment of Excluded Party

Posted on May 19, 2014 by

One area it is relatively common to find compliance infractions involves the employment of individuals by a health care provider who may be listed on the list of parties who are excluded from federal health care programs. Most providers have integrated routine background checks and excluded party searches into their hiring program. Occasionally, an excluded […]

Is Life Insurance a Suitable Investment? Trustees No Longer Required to Monitor Suitability

Posted on May 19, 2014 by

Under existing Wisconsin law, the trustee of an irrevocable trust that owns life insurance contracts is required to monitor the contracts to determine whether they are suitable investments for the trust and, if necessary, to take steps to prevent the lapse of the insurance coverage. These requirements apply whether or not the trustee was involved […]

Light Duty Only for Work-Related Injuries — Pregnancy Discrimination?

Posted on May 16, 2014 by

Many employers have adopted a light duty policy that only applies for an employee that suffers an on-the-job injury. The theory is to allow light duty for work-related injuries in order to encourage an injured employee to return to regular duty. Such a policy of only giving light duty to work-related injured employees has often […]

Interactive Process is a Must

Posted on May 16, 2014 by

A recent decision from the Seventh Circuit Court of Appeals (which covers Wisconsin) again emphasized the absolute necessity that an employer engage in an interactive process with an employee claiming a disability before making any decision regarding accommodations or continued employment by the employee. In reviewing a lower court’s decision to grant summary judgment in […]

Mom’s Bucket List Request Leads to Lawsuit – Seventh Circuit Declares Daughter’s Care of Dying Mother During Trip to Vegas is FMLA Protected

Posted on May 16, 2014 by

Recently, the federal Court of Appeals for the Seventh Circuit (which covers Wisconsin), clarified that the FMLA applies when an employee requests leave so that she or he can provide physical and psychological care to a terminally ill parent while that parent is traveling away from home. In doing so, the Court disagreed with other […]

What Now? Is a Temporary Impairment Now Considered a Disability?

Posted on May 16, 2014 by

Employers have always been told that an employee that suffers a temporary impairment or injury does not qualify as a disabled employee under the Americans with Disabilities Act. For example, an employee falling out of a deer stand and breaking his leg would not be considered disabled for purposes of an accommodation requirement under the […]

Treasury Department Delays Employer Mandate for Small Employers; Lower Threshold for Avoiding Penalties

Posted on May 16, 2014 by

This afternoon the Treasury Department announced that employers with 50 or more full-time equivalent employees (FTEs), but less than 100 FTEs, will not have to comply with the employer mandate of the Affordable Care Act until 2016. The determination of whether an employer meets the small employer requirements for this purpose would be based on […]

25 Days or Less

Posted on May 16, 2014 by

The notion of 25 days or less is the new watch word for the National Labor Relations Board and the proposed rules on “quickie elections.” The NLRB has promulgated new rules that are subject to public comment which would expedite the union election process to be less than 25 days from the filing of a […]

Vote Now and be Excluded Later

Posted on May 16, 2014 by

Our recent blog talked about a proposed rule from the NLRB to establish new procedures for union elections. Known as the “quickie election” rule, it has been proposed by the NLRB for comment although there are strong indications that the rule will be adopted as proposed. One of the most significant aspects of the proposed […]