Retiree Health VEBAs: A New Twist on an Old Paradigm: Implications for Retirees, Unions and Employers

This issue brief provides an overview of stand-alone Voluntary Employees\u27 Beneficiary Association trusts, through which employers have been able to rid themselves of future obligations to pay retiree health benefits in exchange for making a significant payment to designed to approximate the projected cost of these benefits. The paper include three case studies, including the VEBAs at the Big Three automakers

Changing Risks Confronting Pension Participants

The past decade has seen a shift from traditional employer-sponsored defined benefit pensions toward individual account defined contribution plans. This has profound implications for participants’ retirement security, as it involves a reallocation of risks and rewards from the plan sponsor to the employee. While much has been written about the transfer of investment risk and the potential consequences of bad investment choices, less attention has been focused on other potential hazards to retirement security. These include the effect of job changes and other employment factors on contribution patterns, the chance of outliving one’s accumulated assets, and the tension between encouraging participants to save for retirement while allowing access to those assets for a variety of other pressing financial needs. This chapter examines these challenges to participant retirement income security and identifies several legal and policy changes that might enable participants to cope better with such changes

A National Retirement Income Policy: Problems and Policy Options

This Article examines the need for a national retirement income policy, identifies the major components of such a policy, and briefly discusses some of the policy options for private pension plans. This Article is an overview of several critical policy areas. It is not an exhaustive policy analysis, nor does it provide a definitive series of options for achievement of a particular policy. Its focus will be on the private pension system, rather than on federally provided benefits such as social security or Medicare, or employer-provided pensions for state, local, or federal employees. The issues discussed are a starting point for the type of national debate that must accompany the development of short- and long-term retirement security goals

A Crosswalk Between the Final HIPAA Privacy Rule and Existing Federal Substance Abuse Confidentiality Requirements

This Issue Brief provides an overview of and crosswalk between the Privacy Rule and the federal Confidentiality of Alcohol and Drug Abuse Patient Records statute, 42 U.S.C. § 290dd-2, and its implementing regulations at 42 C.F.R. Part 2 ( 42 C.F.R. Part 2 ). The crosswalk is intended to highlight the differences between the requirements of the Privacy Rule and 42 C.F.R. Part 2. In addition, this Issue Brief addresses the Privacy Rule\u27s applicability to special populations and psychotherapy services provided by substance abuse paraprofessionals

Behavioral Health Benefits for Public Employees: Effect of Mental Health Parity Legislation

Recently, the Center for Health Services Research and Policy through a grant from the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services, examined contracts providing for mental health benefits for state employees in eight states to assess whether legislative attempts to require parity between physical and mental illnesses resulted in noticeable differences in behavioral health benefits for state employees. We concluded that, except in states that have mandated full parity for some or all types of mental illnesses, behavioral health benefits for state employees have not changed significantly as a result of the state parity laws, since they still remain subject to traditional restrictions, such as higher cost-sharing and greater limitations on outpatient visits and inpatient treatment days, than those imposed on physical illnesses. Thus the considerable state activity surrounding mental health parity may have little effect on state employees\u27 access to mental health services, since although state laws required parity in dollar limitations, they generally permitted the continuation of other plan design features that are more restrictive for mental health coverage. However, many of the contracts we examined were multi-year contract and may not have fully reflected recent state activity. Moreover, if Congress renews the Mental Health Parity Act when it expires in September, 2001, and expands the scope of the Act to cover some of these other plan design features, states with more limited parity laws are likely to follow. In that case, perhaps state employees with mental illnesses may see significant change in the future

An Assessment of Legal Issues Raised in High Performing Health Plan Quality and Efficiency Tiering Arrangements: Can the Patient Be Saved?

A legal analysis released by The George Washington University School of Public Health and Health Services and the Robert Wood Johnson Foundation affirms the legality under federal and state law of physician ranking systems used by health plan provider networks. This analysis examines seven types of possible legal allegations against physicians tiering, concluding how the approach is undertaken plays a significant role in determining legal backlash

Does HIPAA preemption pose a legal barrier to health information transparency and interoperability?

This paper summarizes the results of a review of nearly 500 judicial opinions decided as of fall 2006, involving access to protected health information (PHI) and privacy of medical information under the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). This review was undertaken to determine whether HIPAA, which permits application of state privacy laws that are more stringent than the federal privacy standard, acts as a legal barrier to the creation of interoperable health information systems that permit transparency of health information. The availability of transparent and complete information regarding health system performance has been recognized as essential to improving the quality of care and reducing health care disparities