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Federal E-News
November 2006
- SEC Postpones Action on Proxy Access Ruling Until December
- GAO Chief Criticizes New Pension Law, Calls for Focus on Income Preservation Strategies in Retirement
- NFTC Divestiture Lawsuit Clears Hurdle; President Signs New Sudan Executive Order
- NCTR, Other State, Local Groups Support Repeal of New 3% Withholding Requirement
- National Health Panel Recommends Universal Care as New Studies Show Coverage Continues to Decline, Dissatisfaction with Health Care System Increases
- As Hedge Funds Increase, Congressional Attention, Concern also Grow
- Bush "Astounded," "Floored" by Size of CEO Pay Packages; Urges Shareholders to Take "Close Look" When Pay, Performance are Not Linked
- New Reports Document Poor State of US Health IT; With Help from Congress Stalled, Governors Move to Address State-level IT Issues
- New Forms, Guidance From the IRS Available
- Part B Premiums for Higher Income Elderly to Begin in 2007; Lower Investment Income Will Not Qualify for Premium Adjustment
- Boo! Sixth Circuit Reverses Itself and Delivers Halloween Ruling that KY Disability Plan is Age Discriminatory on its Face
- NCSL Issues Report on Pensions and Retirement Plan Enactments in 2006 State Legislatures
- Everything You Wanted to Know about the New PPA – But Were Afraid to Ask
SEC Postpones Action on Proxy Access Ruling
Until December
On October 11th, the Securities and Exchange Commission (SEC) announced
that it will postpone its consideration of proposals for revisions to
Rule 14a-8 concerning shareholder proxy initiatives, originally set
for October 18th, until December 13, 2006. The SEC is considering amending
Rule 14a-8 to address issues raised by the Second Circuit’s September
decision in AFSCME v. AIG. Some believe that the delay indicates a serious
split among the five SEC Commissioners over the right direction to take
on the contentious issue of proxy access, while others think it is just
smart politics on the part of SEC Chairman Chris Cox, a former California
Congressman, to wait until after the November elections to see which
way the winds might be blowing in the new 110th Congress.
Following the September 5, 2006 ruling by the U.S. Court of Appeals
for the Second Circuit in American Federation of State, County and Municipal
Employees Pension Fund v. American International Group, the SEC staff
had been immediately directed to develop recommendations for amendments
to Rule 14a-8. In that decision, the court found that AIG did not have
the right to exclude AFSCME's shareholder proposal seeking proxy access
in order to nominate directors. (See the October
NCTR Federal E-News)
This prompt reaction by the SEC led some to believe that it was poised
to defend its current reading of the so-called "town meeting rule,"
which the 2nd Circuit's decision conceded was within the SEC’s
discretion to adopt as a new interpretation – but not without
explaining its departure from prior norms. It was thought that Chairman
Cox, having seen the furor from the business community that arose when
former SEC Chairman William Donaldson tried to promulgate a new proxy
access rule in 2003, would choose to follow what some viewed as a course
of lesser resistance.
However, according to some reports, the other four SEC Commissioners
are not unanimous in their support of such an approach. In addition,
there has been strong pressure from shareholder groups to avoid what
former SEC Commissioner Harvey Goldschmid has said would be a "tragic
mistake" if the Commission decided "to simply turn the clock
back." Finally, postponing the SEC’s consideration until
after the election may have helped reduce the chance of Congressional
meddling in the decision-making process, and also permits Chairman Cox
to make a more politically informed assessment of the best course to
follow.
The Council of Institutional Investors (CII) called the SEC's decision
to postpone action as "great news for investors." CII stated
in a press release that it believes "resolutions on proxy access
would make boards more responsive to shareowners, more thoughtful about
whom they nominate to serve as directors and more vigilant about their
oversight duties." CII said that it looks to working with the SEC
"to help craft a sensible and effective rule that safeguards the
interests of long-term shareowners without being unduly burdensome to
business." Rich Ferlauto, AFSCME's director of pension and benefit
policy, also praised the action, saying that the SEC had created an
opportunity for shareholders, regulators and issuers to "get together
to try to construct a process that might work for everybody."
Jack Ehnes, chairman of CII's Board of Directors and CEO of the California
Teachers’ Retirement System (CalSTRS), issued a joint statement
with Fred Buenrostro, head of the nation’s largest public pension
plan, the California Public Employees’ Retirement System (CalPERS),
commending Chairman Cox for his decision "to go forward with a
deliberative rulemaking process on the use of the proxy to nominate
corporate directors," and expressing their confidence that the
SEC's action "will result in a thoughtful rule permitting reasonable,
fair shareowner access."
By effectively letting the court decision stand until after the scheduled
filing deadlines for most companies with Spring annual meetings, the
SEC’s delay may mean that some proxy access proposals will appear
on ballots during the 2007 season. The nature and course of any such
proposals -- as well as the outcome of the November elections -- may,
in the end, provide the best indicator of where the SEC may go from
here.
GAO Chief Criticizes New Pension Law, Calls
for Focus on Income Preservation Strategies in Retirement
U.S. Comptroller General David Walker thinks that the new Pension Protection
Act (PPA) leaves the issues of coverage and plan design largely unanswered,
and that it "will likely not reverse" the long-term decline
in DB systems. The head of the Government Accountability Office (GAO)
recently called for more attention to such questions as how existing
retirement policies can be reformed to encourage income preservation
strategies "so that retirement income lasts an individual's entire
life (for example, benefit annuitization)."
In a speech on "Retirement Challenges in the 21st Century"
on October 10th, Mr. Walker said that the PPA was a key reform, but
that it only shrinks, but does not close, many loopholes regarding DB
plan funding. In addition, he said that the PBGC deficit "can be
expected to continue to grow."
According to the GAO chief, the new pension law fails to address the
"fundamental mismatch" between DB plan assets and liabilities.
Furthermore, the "appropriate balance of responsibility for retirement
among employers, government and workers remains unclear," Walker
cautioned. He warned policymakers to be careful when shaping reforms
to improve plan funding that they not cause plan terminations that otherwise
might not occur.
In his address before the annual conference of the International Foundation
of Employee Benefits Plans, Walker also addressed the need for reform
of Social Security and the importance of a systematic reexamination
of the nation’s health care system. Based on GAO's simulations,
balancing the budget in 2040 could require actions as large as cutting
total federal spending by 60 percent or raising federal taxes to 2 times
today's level. "Faster economic growth can help, but it cannot
solve the problem," he stressed. "We cannot simply grow our
way out of this problem," according to Walker.
Walker Powerpoint
NFTC Divestiture Lawsuit Clears Hurdle;
President Signs New Sudan Executive Order
A Federal judge recently rejected an effort to have the lawsuit by
the National Foreign Trade Council(NFTC) challenging the constitutionality
of Illinois' Sudan divestiture law dismissed. President Bush has also
signed a new Executive Order on Sudan generally toughening U.S. sanctions
but also acknowledging that such actions may be undesirable in certain
geographic areas of the ravaged country, which are provided new exemptions.
On October 26th, Judge Matthew Kennelly of the Federal District Court
for the Northern District of Illinois denied the State of Illinois’
motion to dismiss the August lawsuit filed by the NFTC and the boards
of eight Illinois police and fire pension funds challenging the Illinois
Sudan divestiture law. Under the Illinois statute, Illinois public pension
funds are required to divest completely from companies doing any business
in or with the Sudan by July 27, 2007. The NFTC lawsuit argues that
the Illinois law intrudes on the Federal government’s exclusive
power over foreign affairs; violates the clause of the U.S. Constitution
that vests Congress with the power to legislate regarding foreign commerce;
and is preempted by the Federal government’s own trade sanctions
against Sudan. (See October
NCTR Federal E-news)
Illinois had argued that neither the NFTC nor the police and fire pension
plans had legal standing to bring the suit. "Legal standing"
means that a party in a lawsuit is sufficiently affected by the subject
of the suit, and there is a case or controversy that can be resolved
by legal action. In part, Illinois had argued that the eight pension
funds were "creatures and instrumentalities of the state,"
and as such were precluded from challenging a state statute on certain
Federal constitutional grounds. In an oral statement, Judge Kennelly
is reported to have found no merit in any of the grounds which the state
had asserted to deny standing, determining that the public pension funds
are likely to suffer irreparable harm and are not municipal entities.
The State of Illinois was given fourteen days to reply to the NFTC
complaint itself, and the Judge indicated that he will rule on the motion
for a preliminary injunction and the merits of the case at the same
time. Judge Kennelly is reported to have indicated that he intends to
issue a final ruling prior to the January 27, 2007 deadline for the
next round of public pension fund divestment. Nor oral argument is scheduled.
Earlier in the month, President Bush signed new Sudan legislation into
law, and also issued a new Executive Order on Sudan that same day (October
13th), in part to take into account the new Darfur Peace and Accountability
Act. The new Order specifically forbids transactions relating to Sudan's
petroleum and petrochemical industries, sectors in which the President
noted that "the Government of Sudan has a pervasive role"
that poses a "threat to the national security and foreign policy
of the United States." However, the new Order also exempts from
the prohibitions certain areas in Sudan, including Southern Sudan, Darfur
and marginalized areas in and around Khartoum. In effect, the new Order
means that so long as activities and transactions in these areas do
not involve the Government of Sudan or the petroleum and petrochemical
industries, U.S. sanctions no longer apply to these exempt locations.
Illinois
Motion to Dismiss
New
Sudan Executive Order
NCTR, Other State, Local Groups Support
Repeal of New 3% Withholding Requirement
NCTR has joined with NASRA and five other national organizations representing
state and local governments to support legislation repealing a new withholding
requirement set to take effect in 2011. Small businesses are also strongly
opposing the requirement, but reports from Capitol Hill suggest that
it will be increasingly difficult to block the law, which is projected
to raise approximately $7 billion over the first 10 years it is in effect.
Section 511 of the Tax Increase Prevention and Reconciliation Act of
2005 (TIPRA, P.L. 109-222), enacted in March of this year, contains
a requirement that all states and many local governments, as well as
certain instrumentalities thereof, withhold three percent on all payments
to persons providing them with property or services. Political subdivisions
of states (and any instrumentalities thereof) with less than $100 million
in annual expenditures for such properties or services would be exempt.
In addition, other specific exemptions are made, such as for payments
of interest; payments for real property; and intra-governmental payments.
(See June
NCTR Federal E-News)
While there is no specific discussion of where public pension plans
would fit under this new law, many believe that retirement systems could
qualify as governmental entities subject to this new requirement. If
so, the withholding requirements would appear to apply to a number of
plan activities -- such as consultant contracts, fees paid to money
managers, and payments to healthcare providers where the plan administers
health benefits – but not to benefit payments.
Senator Larry Craig (R-ID) and Congressman Wally Herger (R-CA) have
introduced legislation (S. 2821, H.R. 6242) to repeal this requirement.
In recent letters to both men, NCTR and NASRA, as well as the Council
of State Governments (CSG), Government Finance Officers Association
(GFOA), International City/County Management Association (ICMA), National
Association of Counties (NACO), and National Association of State Auditors,
Comptrollers and Treasurers (NASACT), have offered their support. As
the letters point out, the new requirement, if implemented, imposes
a massive unfunded mandate on State and local governments and will cause
significant administrative burdens. Furthermore, the letters point out
that the costs for doing business with state and local governments and
their instrumentalities will increase, and the private sector companies
will pass those costs along.
Business groups, including the Federal government’s chief advocate
for small business, have also voiced concerns, warning that the provision
will impede the cash flow of small entities and would amount to "a
tax penalty on government contractors without a clear path for reimbursement."
However, as Congress faces the increasingly stark realities of record
deficits and entitlement programs teetering on the brink of collapse,
legislation that will reduce revenues – even those yet to be collected
– will face rough going unless the lost revenues are offset by
increases (or expenditure cuts) elsewhere. Got a spare $7 billion handy?
Letter
to Senator Craig
Letter
to Congressman Herger
National Health Panel Recommends Universal
Care as New Studies Show Coverage Continues to Decline, Dissatisfaction
with Health Care System Increases
A national panel authorized by the 2003 Medicare Modernization Act to
develop an action plan for Congress and the President to consider as
they work to reform health care has issued its final report to the President,
telling him that a clear majority of Americans it surveyed "are
in favor of a national system that provides universal coverage."
The report, which the President is required to review and then forward,
along with his recommendations, to the Congress, comes at a time when
new studies document that the percentage of Americans under age 65 with
health insurance coverage has declined to its lowest point since 1994
– while record numbers of those still covered are dissatisfied
with their costs and are increasingly reporting that these costs have
resulted in decreased savings for retirement and increased difficulty
in paying for basic necessities and other bills.
On September 29th, the Citizens' Health Care Working Group issued its
final report showing what it refers to as a "remarkable consensus"
among Americans for public policy that ensures that all Americans, regardless
of their financial resources or health status, have affordable health
care coverage. "In 37 states where meetings were held, and in more
than 28,000 responses on the Internet, the message was consistently
loud and clear: Americans want health care for all, and they want it
now," the Working group stressed.
While the report called for "universal coverage," it also
acknowledged that the term means different things to different people.
"The values and preferences being expressed did not lead the Working
Group to conclude that there was only one particular model for ensuring
that all Americans have access to high quality health care," the
report noted.
However, the panel underscored that people consistently emphasized
the importance of shared responsibility and fairness. It concluded that
all Americans should have access to a set of core health care services
that includes wellness and preventive services. This defined set of
benefits should be guaranteed for all, throughout their life, in a simple
and "seamless" manner. These benefits should be portable and
independent of health status, working status, age, income or other categorical
factors that might otherwise affect health-insurance status.
The Working Group proposes a five-year transition with the immediate
first step to address serious threats to health security – very
high costs, and gaps in access to basic health care, preventive services,
and health education at the community level. The recommended target
for ensuring a core set of benefits and services for all Americans is
2012.
By law, the President has 45 days from the date of submission of the
report to him to submit his report to Congress containing additional
views and comments on the Working Group’s recommendations, as
well as recommendations for legislative and administrative action that
he thinks are appropriate. The statute then requires Congress, no more
than 45 days after receiving the President's report, to hold at least
one hearing in each Committee of the House and Senate with jurisdiction
over health care, on the Final Recommendations and the President's report.
As the Administration and the Congress attempt to address this call
for universal care, the increasing decline in healthcare coverage underscores
the urgency for a response. In a new issue brief from the Employee Benefit
Research Institute (EBRI), entitled "Sources of Health Insurance
and Characteristics of the Uninsured: Analysis of the March 2006 Current
Population Survey," an analysis of U.S. Census Bureau's March 2006
Current Population Survey shows that the percentage of the population
under age 65 with health insurance coverage declined in 2005 to a post-1994
low of 82.1 percent. Furthermore, EBRI finds that while employment-based
health benefits remain by far the most common form of health coverage,
this is also continuing to decline.
In another new EBRI document, the 2006 Health Confidence Survey (HCS),
co-sponsored by Mathew Greenwald & Associates, Inc., survey results
document an increasing dissatisfaction with the American health care
system, focused primarily on rising costs, with the percentage of individuals
rating the system as poor doubling since the inception of the HCS in
1998. In addition, this survey also shows that more people are reporting
that increased health care costs have resulted in a decrease in saving
for retirement (36 percent, up from 25 percent in 2004) and other savings
(53 per-cent) and in difficulty paying for basic necessities (28 percent,
up from 18 percent) and other bills (37 percent, up from 30 percent).
Citizens'
Health Care Working Group Recommendations
EBRI
Issue Brief
2006
Health Confidence Survey
As Hedge Funds Increase, Congressional
Attention, Concern also Grow
At the same time that institutional investors are expected to dramatically
increase their investments in hedge funds over the next several years,
a new survey finds that few pension funds report being satisfied with
their current investments in this area. Congress is also increasingly
nervous over the largely unregulated hedge fund industry and the House
of Representatives has passed legislation calling for a formal study
and a report to Congress. On the Senate side of the Hill, Finance Committee
Chairman Chuck Grassley (R-IA) is concerned that "hedge funds pose
huge risks to pension-holders" and has written to all Federal agencies
with possible jurisdiction asking for a report on any information requirements
facing hedge funds, and whether more transparency is necessary. "We
need to get a handle on this situation before more hedge funds go belly
up and leave rank-and-file investors in the ditch," warns Senator
Grassley.
Today, the hedge fund industry is comprised of over 9,000 hedge funds
that manage more than $1.1 trillion in assets. In the past, these high-risk,
high-stake investments were traditionally used by wealthy investors
with the means and the investment savvy to weather the challenges that
such investments can present. However, in recent years, hedge funds
have increasingly been targeted to institutional investors, who now
account for approximately $360 billion of this total. Furthermore, according
to a new study by The Bank of New York and Casey, Quirk & Associates
LLC released on October 10, 2006, worldwide, this institutional investment
in hedge funds will triple over the next four years to more than $1
trillion.
The study, entitled "Institutional Demand for Hedge Funds 2: A
Global Perspective," estimates that by 2010, approximately 25%
of all institutional investors will be investing in hedge funds, a more
than 60% increase from today. “Retirement plans globally will
account for the vast majority of asset flows, with corporate and public
pension plans in the United States accounting for the largest percentage
increase overall,” a press release from The Bank of New York states.
The study, based on over 100 interviews with institutional investors,
investment consultants, hedge funds, fund of hedge funds and industry
experts around the world, also predicts that half of global institutional
flows will go to funds of hedge funds with the other half going to direct
investments over the next five years.
However, if, as suggested, “today's hedge fund techniques will
be tomorrow's mainstream investing," then it appears that some
pension funds may still need some convincing. For example, according
to a recent survey by Mercer Investment Consulting of over 180 large
pension plans worldwide, only 23% of them are satisfied with their investments
in funds of hedge funds. Most (48%) are neutral, while 28% are dissatisfied.
Nevertheless, a third of the pension funds surveyed globally invest
in funds of hedge funds, and a majority (54%) say they plan to increase
their allocations to hedge funds within the next two years, especially
in the U.S. and Canada. Furthermore, of the pension funds that do not
currently invest in funds of hedge funds, 19% say they are likely to
do so within the next two years. Where pension funds are not invested
in such funds, a majority (60%) give fees as their reason.
Some at the Federal level are also less than convinced that everything
is as it should be in this fast-growing sector. This situation has been
exacerbated in recent years by a number of high-profile collapses of
large hedge funds, in some instances involving criminal activity. Most
recently, the collapse of Amaranth Advisors, with billions of dollars
in losses for investors, has captured the attention of the press and
the Congress. However, there is some question as to the appropriate
response.
For example, on September 27, 2006, the House of Representatives approved
H.R. 6079, the “Hedge Fund Study Act.” This measure would
direct the President's Working Group on Financial Markets to conduct
a study of the hedge fund industry, to include, among other things,
an analysis of whether hedge fund investors are able to protect themselves
adequately from the risk associated with their investments; whether
hedge fund leverage is effectively constrained; the potential risks
hedge fund pose to financial markets or to investors; and the benefits
of the hedge fund industry to the economy and the markets.
As Congressman Barney Frank (D-MA), the likely Chairman of the House
Financial Services Committee in a Democrat-controlled Congress, put
it during debate on the measure, “At the rate at which [hedge
funds] are growing, it may be we will reach the point in which there
is more money in hedge funds than there is money.” “I simply
did not think we should adjourn for the year with some people thinking
that we have now decided that the appropriate action is nothing at all,”
Mr. Frank explained. “That may in the end be a decision, but I
do not think it is one that we have yet had a chance to look at,”
he concluded.
In the Senate, concern has also been raised with what Mr. Frank referred
to as the “increasing interface between hedge funds and pension
funds.” Noting that hedge funds are not subject to disclosure
and transparency rules that apply to other financial intermediaries,
and “are permitted to operate almost completely unfettered by
government oversight or regulation, “ Finance Committee Chairman
Chuck Grassley (R-IA) has also expressed worries that “the potential
for significant losses at our nation’s pension funds due to hedge
fund investments could put the retirement security of American workers
in jeopardy.”
In an October 16th letter to the heads of the Treasury Department,
Labor Department, Securities and Exchange Commission, Commodity Futures
Trading Commission, and the Pension Benefit Guaranty Corporation, Senator
Grassley noted his concerns about the lack of publicly available information
regarding hedge funds, and asked for their assistance “in identifying
the scope of this problem and appropriate ways to remedy it.”
Not everyone thinks that Government regulation is the best answer.
Former Bush Treasury Secretary John Snow is reported as saying in a
telephone interview with Bloomberg on October 31st that while hedge
funds, and how best they should be overseen, is “a fair question,''
he believes that the “far bigger risk is overreaching regulation.''
Snow believes that investors are the best regulators of hedge funds,
not the government.
The Bank
of New York Study
Mercer
Survey
Grassley
Letter
Bush "Astounded," "Floored"
by Size of CEO Pay Packages; Urges Shareholders to Take "Close
Look" When Pay, Performance are Not Linked
A new survey of corporate executive pay released in early October found
that median pay packages for CEOs continued to rise at double-digit
rates in 2005. While the rate of increase was markedly lower than that
for 2004, it was still well ahead of the rate of increase for any other
group of employees. When asked about corporate pay practices later in
the month, President Bush said in an interview that "I would hope
shareholders would take a close look at some of these compensation packages
that they pay these corporate executives who are able to make money
when the company is not doing well sometimes." According to a new
study of U.S. board directors, an increasing number agree with the President.
According to the new annual survey of CEO compensation, released by
The Corporate Library on October 4, 2006, median pay packages for chief
executives rose by 16% in 2005. "The Corporate Library's 2006 CEO
Pay Survey," which looks at 1,388 CEOs' pay packages, including
salary, bonus, perks, exercised stock options and other long-term incentive
pay, found that MidCap companies led the growth curve in 2005, posting
a 19% increase over 2004’s numbers. Founded in 1999 by Robert
A.G. Monks and Nell Minow, The Corporate Library is a leading independent
source for U.S. corporate governance and executive and director compensation
information and analysis.
The 2005 growth rate was markedly down from 2004, which showed a 30%
increase, double the rate of growth in 2003. However, as The Corporate
Library’s website points out, “This does not mean that pay
levels have fallen – at least not for the majority of CEOs. What
it does mean is that compensation is just going up more slowly than
it did last year.”
Furthermore, according to the 13th Annual CEO Compensation Survey conducted
by the Institute for Policy Studies and United for a Fair Economy, released
in August of this year, average executive compensation is still up almost
300 percent since 1990, after adjusting for inflation, and has risen
at a much faster rate than the stock market or corporate profits. Looked
at another way, the ratio of CEO pay to average worker pay was 411-to-1
in 2005, according to this joint survey -- nearly 10 times as large
as the 1980 ratio of 42-to-1. “To put the CEO-worker pay gap in
perspective,” the survey explains, “we calculated how much
average production worker pay would be worth today if it had grown at
the same rate as CEO pay. In 2005, the average worker would have made
$108,138, compared to the actual average of $28,314. Similarly, if the
federal minimum wage had grown at the same rate as CEO pay, it would
have been $22.61 in 2005, instead of $5.15.”
President Bush was asked in an October 23rd CNBC interview what he
thinks about when he hears stories on corporate CEO compensation –
“one guy pulling down a billion dollars in pay packages from the
health insurance company or hundreds of millions of dollars in pay from
an oil company executive,” as CNBC’s Maria Bartiromo described
it. In response, the President agreed that these executive compensation
packages “can get out of hand, ” but cautioned that “I
don't think government should control salaries.” However, he went
on to say that “I get astounded by the size of the pay packages,
I'm -- consider me floored when I see guys making billion dollars for
-- as a CEO of a company.”
“I mean, is anybody worth $400 million,” Bartiromo asked.
“I guess it depends who you are. But it seems like not,”
President Bush replied.
Based on a new study by the Center for Effective Organizations at the
University of Southern California's Marshall School of Business and
Heidrick & Struggles, released October 4th, an increasing number
of U.S. corporate board directors appear to essentially agree with the
President. The 10th Annual Corporate Board Effectiveness Study, which
claims to be the largest U.S. study of board directors, with a response
from 768 directors at approximately 660 of the 2,000 largest publicly-traded
companies in the U.S., found that nearly 40 percent of directors surveyed
believe that CEO pay is “'too high in most cases.” This
represents a significant increase over prior years' study results. Furthermore,
81% support increasing the link between CEO pay and performance.
Institute
for Policy Studies/United for a Fair Economy Survey
CNBC Interview Transcript
Corporate
Board Effectiveness Study
New Reports Document Poor State of US
Health IT; With Help from Congress Stalled, Governors Move to Address
State-level IT Issues
According to some studies, the widespread adoption of health information
technology (HIT) could save more than $81 billion a year in health care
costs as well as greatly improve the overall quality of patient care
in the U.S. However, a comprehensive new report finds that only one
in four U.S. doctors uses some sort of electronic health record, and
only about 10% use what experts would call a "fully operational"
system. Furthermore, the study shows that only about 10% of hospitals
use computerized physician-order entry to digitally track a patient's
course of care. Another recent study documents how the use of health
IT by U.S. primary-care physicians lags far behind that of their international
counterparts. While Congress continues to appear unable to approve health
IT legislation to address this problem, the nation’s governors
are moving to increase the efficiency and effectiveness of their HIT
initiatives.
A new report, “Health Information Technology in the United States:
The Information Base for Progress,” which was jointly funded by
the Robert Wood Johnson Foundation and the Office of the National Coordinator
for Health Information Technology, provides a benchmark for where the
U.S. healthcare system stands on the adoption of electronic health care
records. As was feared, the benchmark is very low. As John Lumpkin,
senior vice president and director of the healthcare group at the Robert
Wood Johnson Foundation said, “We have to recognize that the quality
of healthcare that we have in this country is poor. If we are going
to reduce errors, working harder is not going to work."
In addition to documenting the very low level of use of HIT, the new
report also discusses the roadblocks to health IT adoption, including
financial barriers, namely the high cost of HIT systems, and provider
uncertainty regarding the value they will derive from adoption in the
form of return on investment. For example, the study points out that
economic incentives in the health care industry “generally do
not reward good performance, reducing the motivation of self-interested
health care actors to acquire HIT and compete more effectively.”
Often, the report notes, health care compensation arrangements reward
poor performance. “Inefficient and sub-optimal care, for example,
can generate more visits, tests and procedures and thus more revenue
for providers,” the report suggests. At a minimum, this reduces
incentives for physicians and others to invest in systems to improve
performance. “Making matters worse, the purchasers of HIT -- mostly
doctors and hospitals -- would capture only a small fraction of HIT’s
potential economic benefits. It has been estimated that as much as 80
percent of the potential savings generated through HIT inure to insurers
and health care group purchasers, including the federal government,
in the form of lower premiums and enhanced worker productivity,”
the report concludes.
Another new report, this one by the Commonwealth Fund, shows how poorly
the state of HIT in the U.S. compares with other countries. The Commonwealth
Fund’s 2006 International Health Policy Survey looked at more
than 6,000 primary care physicians in Australia, Canada, Germany, the
Netherlands, New Zealand, the United Kingdom, and the United States.
It found that 98% of primary care doctors in the Netherlands use electronic
patient medical records, 92% do so in New Zealand, and 89% in the UK.
As noted, this compares with only about one fourth of U.S. practitioners.
“In an era of advanced computer systems, it’s disturbing
that the vast majority of primary care doctors in the U.S. don’t
have the tools to electronically prescribe medications, access patients’
test results, or know when patients are overdue for essential care,”
said Commonwealth Fund Senior Vice President Cathy Schoen, lead author
of the article.
The Survey also found that less than a quarter of U.S. primary care
doctors (23%) receive computerized alerts for potential harmful drug
doses or interactions. By contrast, 93% of primary care doctors in the
Netherlands, 91% in the U.K., 87% in New Zealand, 80% in Australia,
and 40% in Germany have computerized alert systems. Among the surveyed
countries, only in Canada (10%) do primary care physicians make less
use of computerized alerts than do U.S. primary care physicians. Indeed,
the survey results show that almost half (47%) of U.S. primary care
physicians have no system, computerized or manual, for alerting them
to potential drug-related hazards. “The data show that U.S. primary
care doctors find it difficult or impossible to perform tasks that doctors
in other countries find easy;” according to Schoen, and “they
also practice without basic decision supports that could improve health
outcomes and reduce costs.”
Congress has been struggling to adopt new HIT legislation, but has
run into roadblocks (see October
NCTR Federal E-News). Meanwhile, state leaders are moving on their
own to address the problem. On October 19th, the National Governors’
Association (NGA) announced the creation of the State Alliance for e-Health,
a collaborative body intended to help states increase the efficiency
and effectiveness of their HIT initiatives. Developed under a contract
with the Department of Health and Human Services (HHS) Office of the
National Coordinator for Health Information Technology, the new initiative
is intended to allow state policymakers to share best practices and
policies for health IT and serve as a consensus-based, state-level advisory
and coordinating body. Goals include identifying ways to resolve state-level
health IT issues that affect multiple states, and resolving privacy
and security issues surrounding the use and disclosure of electronic
health information, which has been a sticking point in Congressional
debate.
Health
Information Technology in the United States: The Information Base for
Progress
Commonwealth
Fund's 2006 International Health Policy Survey
New
NGA Initiative
New Forms, Guidance From the IRS Available
October was a busy month for the Internal Revenue Service (IRS), as
it released updated 2006 instructions for Forms 1099-R and 5498, as
well as updated cost of living adjustments for 2007. Finally, the IRS
published its final rule regarding the use of electronic media by employee
benefit plans for providing notices to plan participants, as well as
recording participant elections and consents.
The new 2006 instructions for Forms 1099-R and 5498 contain a number
of new changes, including transfers on page R-4, which has been revised
to include the purchase of permissive service credit. In addition, distribution
codes 1 and 2 have been revised for withdrawals by qualified reservists
and certain public safety employees, respectively, based on provisions
in the Pension Protection Act of 2006.
On October 18th, the IRS announced cost-of-living adjustments applicable
to dollar limitations for pension plans and other items for tax year
2007, many of which have changed due to reaching the statutory thresholds
that trigger adjustment upward. For example, the limit on the annual
benefit under a defined benefit plan under Section 415(b)(1)(A) is increased
from $175,000 to $180,000; the cap on deferrals under Section 457(e)(15)
is increased from $15,000 to $15,500. Others, however, remain the same,
such as the dollar limitations under Section 414(v)(2)(B)(i) and (B)(ii)
on catch-up contributions.
Finally, on October 20th, the IRS published its final rule concerning
the use of electronic media by employee benefit plans for providing
notices to plan participants, as well as recording participant elections
and consents. The final standards, which apply to retirement plans --
401(a), 403(a), 403(b), and 457 -- as well as to accident and health
plans, medical savings accounts, health savings accounts, and IRAs,
are codified in Treas. Reg. 1.401(a)-21, are effective October 20, 2006,
and apply to electronic notices, elections, and consents on or after
January 1, 2007.
1099-R Instructions
2007
COLA Increases
Electronic Notices,
Consents Final Rule
Part B Premiums for Higher Income
Elderly to Begin in 2007; Lower Investment Income Will Not Qualify for
Premium Adjustment
The Centers for Medicare & Medicaid Services (CMS) recently announced
revised numbers for the higher Part B premiums for high-income Medicare-eligible
individuals that will take effect for the first time in 2007. In addition,
the Social Security Administration (SSA) has decided that decreases
in work income, but not investment returns, will qualify for possible
relief from the new, higher rates.
The Medicare Part B standard monthly premium is intended to cover 25%
of Part B program costs, with Medicare subsidizing the rest. However,
when Congress adopted the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (the Medicare Modernization Act or MMA), it
established a Medicare Part B premium “subsidy reduction”
which takes effect in January of next year. It is estimated that about
5% of beneficiaries will be affected, and by paying an increased share
of costs, they will decrease Medicare costs by an estimated $7.7 billion
over the next five years.
Here’s how it will work: beneficiaries with incomes above a certain
threshold will pay a greater share of program costs – beginning
with 35% of costs and increasing in 15% increments to as much as 80%
for the wealthiest when the program is fully phased in. The premium
will vary depending upon enrollees’ modified adjusted gross income
(AGI) and income tax filing status, and these income amounts will be
indexed annually for inflation.
The premium increase will be determined based on income two years prior
to the year for which the increase takes effect. For example, 2005 modified
adjusted gross income would be used to determine a beneficiary’s
2007 Part B premium. Thus, for 2007, individuals whose AGI in 2005 exceeded
$80,000 and couples with a 2005 AGI of at least $160,000 will be affected;
for those with AGIs of up to $100,00 and $200,000 respectively in 2005,
their monthly premium will be $105.80, instead of $93.50, in 2007. Individuals
with a 2005 AGI over $200,000, and couples with an 2005 AGI over $400,000
will pay $161.40 monthly, the highest premium for 2007.
Confused? It gets even more complicated: premiums in 2007 for the more
affluent represent one-third of their new percentage share of costs.
In 2008, it will rise to two-thirds of their new share, and only by
2009 will they be paying their new, increased percentage of costs in
full.
What happens if AGI decreases? Will Part B premiums also be reduced?
The answer is a definite and unequivocal “maybe.” If the
income losses are due to a “major life-changing event” such
as spousal death, changes in marital status, partial or full work stoppages
or reduction or loss of pension income, then a reduction will be considered.
However, according to new rules published by the Social Security Administration
(SSA) on October 27th, if the income loss is due to decreases in dividend
income and loss of income from financial securities, then the answer
is “no.” According to SSA, such decreases “are not
'events' but rather fluctuations in the financial markets and should
not be considered as part of the list of events with a potentially permanent
effect on income."
So the next time the market tanks, please try to think of it as just
a fluctuation and not a major life-changing event. You may not feel
any better about it, but SSA thanks you for doing your part to keep
government spending under control.
New
SSA Rule on Medicare Part B Income-Related Monthly Adjustments
Boo! Sixth Circuit Reverses Itself
and Delivers Halloween Ruling that KY Disability Plan is Age Discriminatory
on its Face
On October 31st, the U.S. Court of Appeals for the Sixth Circuit ruled
that the Equal Employment Opportunity Commission (EEOC) had established
a prima facie violation of the Age Discrimination in Employment Act
(ADEA). The decision permits the EEOC to proceed with its suit alleging
that Kentucky's disability retirement plan for state and county employees
discriminates against workers on the basis of their age. The case has
been going on for a decade, with lower courts ruling in favor of Kentucky.
At issue is a disability program that was available to employees with
at least five years of service but was not available to those who qualified
for regular retirement benefits when they became disabled. The decision
opens the way for the EEOC to continue to ignore that disability benefits
are part of a comprehensive retirement program in the public sector.
The case began with an age discrimination charge filed with the EEOC
by a deputy sheriff who applied for disability retirement in 1995 at
age 61, with 17 years service as a public employee. He was denied because
he had become eligible for regular retirement benefits at age 55. Since
employees who qualified for disability retirement benefits were credited
with additional years for purposes of calculating the disability retirement
benefits – the number of years until the employee would have reached
normal retirement age, not to exceed 20 years of service – the
deputy claimed that he was being denied additional benefits because
of his age.
Following several years investigation and negotiations, the EEOC agreed,
and filed suit in August of 1999 in U.S. District Court alleging a violation
of the ADEA by the Jefferson County Sheriff’s Office, the Kentucky
Retirement Systems (KRS), and the Commonwealth of Kentucky. Eventually,
the District Court granted summary judgment to KRS in 2003, finding
that the EEOC failed to show a prima facie case because it did not present
evidence of discriminatory intent. On appeal to the U.S Court of Appeals
for the Sixth Circuit, the District Court’s grant of summary judgment
in favor of KRS was affirmed in September of 2005 by a three-judge panel.
However, the EEOC requested a rehearing, and the full court later granted
en banc review and has now vacated the panel's decision.
In its recent ruling, the majority found that “there is absolutely
no dispute" that an employee who becomes disabled after reaching
normal retirement age "is adversely treated because of his or her
age when compared to a disabled coworker who is similarly situated in
all relevant aspects other than age." Furthermore, the majority
noted that KRS did not dispute that the plan "pays lower disability-retirement
benefits to an older worker who, apart from age, is similarly situated
to a younger worker in all relevant respects." The Court found
that “[o]nce a plaintiff has established that a policy is facially
discriminatory in that it classifies or disadvantages an employee 'because
of' the employee’s protected status, additional proof of discriminatory
intent is not needed, as it is directly evidenced by the facially discriminatory
nature of the policy itself," rejecting the KRS argument that the
employer's age classification, to violate ADEA, had to be motivated
by animus or stereotype against older workers.
The dissent argued that KRS “does not provide younger workers
with a specific benefit unavailable to older workers." Rather,
the plan "simply provides that a worker who is disabled before
reaching eligibility for normal retirement benefits has a way of receiving
a retirement benefit equal to (or closer to) what he would have received
had he not become disabled before reaching the normal retirement age
or 20 years of service." While the majority opinion “argues
that because older employees with, e.g., 10 years of service and final
pay of $50,000 receive fewer benefits than younger employees with the
same years of service and final pay, the KRS plan is facially discriminatory,”
the dissent points out that “the majority misses the point that
a 53-year-old employee who becomes disabled is not similarly situated
to a 33-year-old employee who becomes disabled, even if they have the
same service years and final pay at the time of disability. All else
being equal, the non-disabled 33-year-old of course has more years to
work and live than does a non-disabled 55-year-old.” According
to the dissenters, “the number of years of additional work credit
lost is a factor related to, but not determined by, age."
The ruling permits the EEOC to finally proceed with its case against
Kentucky in District Court. After more than 10 years’ expense
at both the Federal and State levels, the EEOC will get to pursue its
position that where a benefit plan ties the amount of benefits provided
to the number of years it will be before an employee reaches normal
retirement age, it is explicitly age-based and provides facial discrimination
that does not require additional proof of intent.
Therefore, if your plan has a disability program that provides additional
service for employees who become disabled before normal retirement age,
and denies similar benefits for those eligible for normal retirement,
you may want to read the Kentucky ruling very closely. Trick or treat!
6th
Circuit Decision on KRS Disability Program
NCSL Issues Report on Pensions and
Retirement Plan Enactments in 2006 State Legislatures
In October, the National Conference of State Legislatures (NCSL) issued
its annual report summarizing selected pensions and retirement legislation
that state legislatures enacted in 2006. According to Ron Snell, NCSL’s
Director of State Services, "the long-term security of defined
benefits was the issue of broadest concern to state legislatures in
2006 as it was in 2005.” Legislated benefit increases were “few
and modest,” while a substantial number of states enacted increases
in contribution levels.
The NSCL report is organized according to the topics that legislatures
addressed in 2006, from benefit changes to vesting. Long-term security
of defined benefits was a major focus -- reflected in action to reduce
future benefits for new employees and place caps on future cost-of-living
adjustments; increase employer and employee contribution levels; modify
provisions for service purchase to ensure that the purchaser bear the
cost; and provide for very limited benefit enhancements.
However, the report states that “the most dramatic development
of 2006” was the vote by West Virginia members of the defined
contribution Teachers' Retirement Plan voted to merge it with the newly-reopened
defined benefit teachers' plan.
NCSL 2006
Report on Pensions and Retirement Legislation
Everything You Wanted to Know about
the New PPA – But Were Afraid to Ask
During the NCTR Annual Convention in Austin, Texas, in October, Mary
Beth Braitman with Ice Miller LLP provided attendees with a summary
of certain provisions of the Pension Protection Act of 2006 affecting
governmental plans.
Ice Miller’s summary of items of interest from the 907 page PPA
is arranged in Internal Revenue Code section order. Where ERISA amendments
could be of interest, they have been included, followed by ADEA provisions.
At the end, non-code amendments are discussed. Each PPA section title
is provided, after which a summary of the law and the effective date
of the provision are noted.
Ice
Miller Summary of PPA Provisions Affecting Governmental Plans
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