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Treasury Regulation 1.411(d)-6, issued December, 1998, provides that when benefit accruals in a defined benefit plan are “significantly” reduced because of a plan amendment, or a plan amendment to a defined contribution pension plan “significantly” reduces future employer contributions, then a 15-day notice of a reduction in accrual/benefits must be issued before the amendment, or a plan termination, can become...

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Several trends are emerging in health care fraud investigations. Prudence dictates that all health care providers learn from the lessons of other providers and develop plans for responding to any government audit or investigation. MEDICARE AND MEDICAID AUDITS Be aware that current enforcement efforts often begin with what appears to be a routine audit of patient records. Furthermore, billing audits of services provided in hospitals...

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On July 8, 1999 the Office of Inspector General (the “OIG”) of the Department of Health and Human Services issued a special advisory bulletin which declared that hospital-physician gainsharing arrangements are illegal. Gainsharing arrangements involve a hospital splitting part of its revenues with physicians based on cost-savings generated by physicians. In contrast, the bulletin appears to clear the way for personal...

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“Intellectual property” is the broad term for the area of law that involves the protection of proprietary rights and includes patents, trademarks, copyrights, trade secrets, and other forms of exclusive rights in intangible property. This area of law is the primary method to protect against the theft of intangible rights and technology. The various kinds of protection are not mutually exclusive. Examples of health care...

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“Carve out” plans have become the latest rage in the design of pension and profit sharing plans targeted to meet specific funding goals of an employer. The design strategy basically limits the employer’s contribution to a select group of employees (the “carved-out” group). The group will generally include a limited number of highly compensated (HC) and nonhighly compensated employees. Such a plan must, among...

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Choosing whether to purchase long-term care insurance may be one of the most important decisions a person makes during his or her life time. Long-term care provides the help an individual needs in the unlikely event they are unable to care for themselves because of a prolonged illness or disability. Long-term care differs from traditional medical care in that, medical care serves to rehabilitate or correct certain medical problems,...

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