Texas Moves to Restrict Telemedicine

via Lockton Compliance Services

After four years of wrangling with telemedicine providers, the Texas Medical Board formally adopted rules that limit the use of telemedicine. Employers offering (or considering offering) telemedicine benefits to Texas employees will want to work with their telemedicine providers to determine how the new restrictions, which are effective June 1, 2015, will affect their benefits.

Prior to the recent ruling, Texas required a physician-patient relationship before a physician could diagnose or treat a condition; however, it was unclear how this relationship could be established through telemedicine.

The new rules provide that a remote physician is able to create the required physician-patient relationship with respect to a new patient or condition only if the patient is at an established medical site and is in the presence of another licensed medical professional acting on behalf of the remote physician. The rules make clear that the required relationship cannot be based solely on common telemedicine practices like “an online questionnaire or questions and answers exchanged through email, electronic text, or chat or telephonic evaluation of or consultation with a patient.”

The appointment must take place at an established medical site, which generally does not include the patient’s home. In-home visits are permissible if certain requirements are met, including real-time audio and video, and all necessary equipment is present to evaluate the patient.

Once the physician-patient relationship is established with respect to a particular condition, the remote physician may treat the patient without the patient being in the presence of another licensed practitioner. Presumably this follow-up appointment can occur at the patient’s home without the additional practitioner; however, the rules are vague on this point.

The Board did provide more flexibility for mental health. Specifically, mental health services may be provided at the patient’s house and do not require the assistance of another licensed practitioner.

While this ruling is limited to Texas, it serves as a good reminder that states have the authority to regulate the practice of medicine. Further, many states are yet to provide clear rules around the provision of telemedicine, and it is likely that those states will at least consider the approach taken by the Longhorn State.

For those interested, the American Telemedicine Association has a dearth of resources discussing how each state regulates telemedicine benefits.

Scott Behrens, J.D., Compliance Services

Not Legal Advice: Nothing in this Alert should be construed as legal advice. Lockton may not be considered your legal counsel and communications with Lockton’s Compliance Services group are not privileged under the attorney-client privilege.

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IRS Provides Welcome Changes for Fixing Common Plan Errors

via Lockton Retirement Services: The Beacon

The IRS has long understood that the complexity of plan administration for employers can lead to mistakes.  Rather than requiring employers to formally apply to the IRS for approval of the correction of these errors, the IRS created the Employee Plans Correction Resolution System (EPCRS). Under EPCRS, employers have an avenue, without the costs and burden of a formal IR

S review, for correcting numerous common operational errors that frequently occur. Last week was very busy for the IRS as they announced several pieces of guidance that amend how mistakes are corrected through ECPRS; several of the amended guidelines are very beneficial to employers.

Correcting the Missed Opportunity to Defer

As more plans adopt automatic enrollment, automatic escalation, or simply streamline the process for making a deferral election, it is common that mistakes are made, resulting in the missed opportunity for an employee to defer income into the plan…

Read the full article here – IRS Fixing Common Plan Mistakes

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Don’t Ignore Investing Expenses

via Wall Street Journal – Morgan Housel

Ask me how much my cellphone costs each month, and I can tell you down to the penny. Ask me how much I pay in investment management fees each month, and I have no idea.

There is a reason for this: I see my phone bill on my credit-card statement each month. Ditto for my power bill—I write a check to the utility company each month. I am aware of every cent because I actually sit down and pay a bill.

Investment fees—for mutual funds, for 401(k) administration, for a financial adviser—are different.

Most are deducted from your assets automatically. Mutual-fund and exchange-traded-fund fees typically are deducted from the fund’s assets monthly. Many financial advisers deduct fees from client accounts each quarter. Commissioned brokers generally are paid upon each transaction..

To read the full WSJ article CLICK HERE

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Retirement Rules: Rethinking a 4% Withdrawal Rate

via Barron’s

Figuring out how to convert a nest egg into enough income to fund a comfortable retirement without completely draining savings is perhaps the biggest issue facing retirees and financial advisors. Wade Pfau, a soft-spoken, Princeton University-trained economist, has taken on the task of trying to solve the puzzle.

Pfau, 37, spent the first decade of his career teaching economics to bureaucrats from emerging markets at the National Graduate Institute of Policy Studies in Tokyo. But he has long had an interest in retirement, going back to his doctoral thesis, which focused on President George W. Bush’s Social Security reform proposal. Pfau came into the limelight in 2010 with a paper that poked holes in the 4% rule long used in financial planning to help retirees spend a nest egg judiciously. After data showed that the rule, which posits the withdrawal of 4% of a portfolio in the first year of retirement, with annual adjustments for inflation thereafter, had worked in only two of 20 developed countries — the U.S. and Canada — Pfau dug deeper. He found that the rule wouldn’t work in a number of circumstances, including retiring during a market downturn and in a period of historically low interest rates.

Barron’s: The 4% rule was first introduced in 1994 by financial advisor Bill Bengen, and quickly became conventional wisdom. What’s wrong with it?

Wade Pfau: Where to begin.…It’s not always appropriate. The rule suggests that if retirees withdraw 4% of their portfolio in their first year of retirement, and adjust that initial amount for inflation in subsequent years, they’ll have a low risk of depleting their portfolio in 30 years. In 1994, a 30-year retirement was a conservative assumption — retiring at 65 or even 55 and living another 30 years was well beyond average life spans. But today, there is a 50% chance that one member of a higher-income, 65-year-old couple will live until 95…

To read the full article CLICK HERE

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Tips for Tapping Roth IRAs

via Wall Street Journal

The wait is over. Five years ago, the number of Roth IRAs boomed after the Internal Revenue Service eased rules for creating Roths with money held in traditional IRAs. This year, droves of investors who did conversions in 2010 have reached the end of the five-year waiting period and so can qualify to tap their Roths without penalty or taxes—as long as they follow IRS rules.

It’s important to have a strategy, financial advisers say, especially when an investor has more than one type of retirement account—say, a 401(k) or a traditional individual retirement account in addition to a Roth. For example, delaying Roth withdrawals could help smooth the tax impact of distributions people must start taking from traditional IRAs after age 70½. Also, a Roth left untouched for years could become a significant legacy for heirs…

To read this WSJ Article CLICK HERE

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Can Companies Solve Workers’ Money Problems?

via Wall Street Journal

Companies are expanding their wellness programs to focus on workers’ wallets in addition to their waistlines. Meredith Corp., Staples Inc. and PepsiCo Inc., among others, have begun offering programs aimed at improving employees’ financial security.

Modeled after physical-wellness programs that invite employees to lose weight or undergo health screenings, financial-wellness programs include finance classes, counseling sessions and even videogames designed to help staffers pay down debt, stick to a budget and invest for their retirement.

Bosses say the programs also boost productivity, citing research findings that suggest workers under financial strain can be distracted and absent from work. Employees, though, may wonder why their employers don’t just pay them more…

To read the full WSJ article CLICK HERE

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Fidelity’s New Chief Confronts Market Shift

via Wall Street Journal

Abigail Johnson, who took over as CEO of Fidelity Investments in October, faces a wave of customers moving into passively managed funds. Shown here in 2012, Ms. Johnson rarely makes public appearances.

BOSTON—Abigail Johnson was so eager for change at mutual-fund giant Fidelity Investments that she once tried to oust her own father as CEO, according to executives at the time. A decade later, Ms. Johnson is finally in charge, and she appears no less willing to shake things up.

Ms. Johnson, 53 years old, is quietly reshaping the company that Edward “Ned” Johnson III, 84, built into a money-management behemoth that oversees the retirement plans of millions of Americans. Since she took over as CEO in October, she has cut costs and overhauled units that are losing money, replaced heads of underperforming divisions and pushed the company into businesses her father long resisted.

But some current and former Fidelity executives and analysts question whether Ms. Johnson has the vision to drive the company forward, or will be a big enough catalyst for change…

To read the full WSJ Article CLICK HERE

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