The Perils of Self-Directed IRAs

Individual retirement accounts were created in 1974 as tax-sheltered retirement savings for employees whose employer did not offer an employer-provided retirement vehicle. Since then, they have been used primarily as rollover vehicles, such that amounts accumulated under employer-provided retirement plans can be rolled over into an individual retirement account. This Article examines the perils involved with a rollover IRA owner decides to invest his IRA assets in non-traditional assets

Precision Medicine: Viable Pathways to Address Existing Research Gaps

Precision Medicine (PM) seeks to customize medical treatments for patients based on measurable and identifiable characteristics. Unlike personalized medicine, this effort is not intended to result in tailored care for each patient. Instead, this effort seeks to improve overall care within the medical domain by shifting the focus from one-size-fits-all care to optimized care for specified subgroups. In order for the benefits of PM to be expeditiously realized, the diverse skills sets of the scientific community must be brought to bear on the problem. This research effort explores the intersection of quality engineering (QE) and healthcare to outline how existing methodologies within the QE field could support existing PM research goals. Specifically this work examines how to determine the value of patient characteristics for use in disease prediction models with select machine learning algorithms, proposes a method to incorporate patient risk into treatment decisions through the development of performance functions, and investigates the potential impact of incorrect assumptions on estimation methods used in optimization models

Coverage in Transition: Considerations When Expanding Employer-Provided Health Coverage to LGBTI Employees and Beneficiaries, 24 Cardozo J. Equal Rts. & Soc. Just. 3 (2017)

The rights of transgender individuals has been in the headlines during 2017 - ranging from President Trump\u27s tweet to announce a ban on transgender individuals from serving in the military due to the tremendous medical costs to a nationwide injunction imposed by a federal district court on the HHS regulations that prohibit health-care discrimination against transgender individuals under the Affordable Care Act (ACA). There are three important reasons why transgender rights are in the news. First, the Human Rights Campaign Foundation, designed to promote the lives of lesbian, gay, bisexual, and transgender (LGBT) people, scores employers in its Corporate Equality Index (CEI) based on their commitment to equal treatment for LGBT employees. To achieve a 100% score in its 2017 CEI, an employer must provide equal health coverage for transgender individuals without exclusion for medically necessary care. This includes medical benefits and services related to transgender transition (e.g., medically necessary services related to sex reassignment). Second, the Seventh Circuit in the summer 2017 decision of Hively v. Ivy Tech Community College held that Title VII\u27s prohibition on sex discrimination in the employment context extends to sexual orientation and gender identity. Third, HHS\u27 regulations prohibiting health-care discrimination against transgender individuals became effective January 1, 2017. As a result of litigation, the portion of those regulations that prohibit discrimination on the basis of gender identity are now subject to a nationwide ban. The Department of Justice\u27s motion requesting a remand and stay of the litigation so that HHS could reconsider its opinion was granted by the federal district court, but the injunction remains in effect. This article discusses the issues facing employers who are considering expansion of their group health plans to include transition-related medical benefits for transgender employees and their beneficiaries for the treatment of gender dysphoria. Issues include federal and state discrimination laws, federal income tax treatment, Title VII prohibitions on sex discrimination in the employment context, and ACA\u27s prohibition against sex discrimination in the health care context. In the backdrop, the Supreme Court has granted cert in the Gloucester County School Bd. v. G.G. case, which will review Title IX\u27s prohibition of sex discrimination in the education context as a school board\u27s policy required students to use the restroom consistent with their birth sex, rather than their gender identity. As the ACA incorporates Title IX\u27s prohibition of sex discrimination into the health care context, the Supreme Court\u27s decision could have far reaching impact

\u3ci\u3eProtective Plan Provisions for Employer-Sponsored Employee Benefit Plans\u3c/i\u3e

Federal case law has provided plan sponsors of the Employee Retirement Income Security Act of 1974 (ERISA) covered plans with the ability to insert plan provisions that are more favorable to the plan sponsor rather than the plan participant or beneficiary (so-called “protective plan provisions”). This Article first examines what is the “plan document” for purposes of ERISA and what protective plan provisions should be considered for insertion into the plan document and its related “instruments.