January 29, 2019

Tax Reform: Are Your Parking Expenses Deductible?

A recent notice from the Internal Revenue Service has provided additional guidance regarding changes that the Tax Cuts and Jobs Act (TCJA) made to the tax treatment of parking fringe benefits. Previously, employers could generally deduct expenses related to “qualified transportation fringe benefits” that they provided to employees, including parking. The new law disallowed this deduction.

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Topics: Tax Reform

January 23, 2019

Forks in the Road to BPCI-A Participation

“We want to pay for outcomes, not process ... We need results, American patients need change, and when we need mandatory models to deliver it, mandatory models are going to see a comeback.”

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Topics: BPCI-A

January 10, 2019

Here’s What to Expect in Year 3 of MIPS

As we move into the third performance year of the Quality Payment Program (QPP), CMS is starting to take the training wheels off the Merit-based Incentive Payment System (MIPS). The threshold to avoid a penalty in 2019 doubled to 30 points, and the exceptional performance threshold increased to 75 points (up from 70 points in 2018).

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Topics: MIPS and MACRA

December 21, 2018

Physicians: There’s Still Time for 2018 Year-End Tax Planning

Almost exactly one year ago, Tax Cuts and Jobs Act (TCJA) brought about the most significant tax reform in 30 years. It was a good news, bad news situation. The TCJA included a juicy 20 percent deduction on qualified business income for owners of pass-through entities. Sadly, the provision specifically excluded healthcare professionals and other “specified trades or businesses.” Continue reading >

Topics: Tax Planning

November 15, 2018

Physician Alignment and Data Are Key to BPCI-A Success

Bundled Payments for Care Improvement-Advanced (BPCI-A) is one of the latest evolutions of value payment methodologies to come from the Centers for Medicare and Medicaid Services (CMS). The roots of BPCI-A are in the original bundled payment demonstration project, the Acute Care Episodes (ACE) program of 2009, which shares an underlying theme that a single, bundled payment for all providers for a defined episode of care will promote efficiency of care, coordination of care and improvement in the quality of care. CMS would like to see higher quality performance paired with lower expenditures in these identified patient populations.

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Topics: BPCI-A

November 08, 2018

Tax Reform: Want to Grab Lunch?

Before passage of the Tax Cuts and Jobs Acts (TCJA), both meals and entertainment for clients and business associates were 50 percent deductible for tax purposes as long as business was discussed before, during or after the meal. Expenses for entertainment, amusement and recreation are no longer deductible starting in 2018. However, the wording in the TCJA was unclear on whether meals are now included in the overall definition of “entertainment.”

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Topics: Tax Reform

October 11, 2018

Tax Reform: Time To Change Entity Structure? Maybe Not

Since the passing of the Tax Cuts and Jobs Act (“TCJA”) in December, many healthcare providers started to wonder if there might be a tax advantage to changing their choice of entity. With the new 21 percent corporate flat tax, would C Corporations be a better option? Or would the benefit of the 20 percent pass-through deduction be more beneficial?

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Topics: Tax Reform

October 03, 2018

Price Transparency: Go Deeper Than Compliance with New CMS Rule

Chalk one up for advocates of consumerism. CMS is encouraging price transparency with its FY2019 Inpatient Prospective Payment System (IPPS) rule released in August.

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Topics: IPPS, Price Transparency, Hospital Chargemaster

September 13, 2018

Tax Reform: Do You Want the Good News About Depreciation First?

The Tax Cuts and Jobs Act (TCJA) made several significant changes to depreciation rules when it became law in December 2017. In the “good news” department, two provisions in the law provided increased opportunities for businesses—including physician practices, hospitals and other medical practices that own or lease buildings—to expense the cost of depreciable assets sooner. On the “not-so-good news” side of things, several types of building improvements will now be depreciated over longer periods when their costs exceed the limits for immediate expensing. In addition to the longer recovery period, the new law and related guidance have created some uncertainty over what improvements may qualify for the same-year recovery provisions.

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Topics: TCJA, Tax Reform

August 15, 2018

TAX REFORM: IRS Limits Tax Strategies for Pass-Through Healthcare Entities

On August 8th, the IRS released proposed regulations addressing the Section 199A deduction, commonly known as the 20 percent pass-through deduction. The guidance clarified several aspects of Section 199A that are of particular interest to healthcare providers, including the definition of “specified service trades or businesses” (SSTBs) and restrictions on splitting up existing businesses. At first glance, it appears that these new rules will limit the ability of healthcare professionals to qualify for the deduction. (For a broader look at the general impact of the proposed regulations, see the HORNE article, “Tax Reform: Guidance For Pass-Throughs Is Here.”)

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Topics: Tax Reform, Section 199A

July 24, 2018

BPCI Advanced Model – Deadline Fast Approaching

The final phase of CMS’ voluntary Bundled Payments for Care Improvement Advanced (BPCI-A) application process is finally here. Whether your hospital or physician practice intends to participate in the model beginning October 1 (or in a future year) or you are a healthcare attorney advising an organization that intends to participate, CMS’ recent announcements regarding the model are noteworthy.

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Topics: BPCI-A, Bundled Care

July 19, 2018

Getting it Right: Traits of Effective Physician Compensation Models

As value-based payment models gain traction, healthcare organizations are feeling pressure to control costs and improve the quality of patient care, all at a time when the supply of physicians is falling short of demand.

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Topics: Physician Compensation, Value-Based Care

July 12, 2018

How Will You Win the War for Physician Talent?

Competition for physicians is already heated. It’s about to get scorching. Demand is on a trajectory to drastically outpace supply, with a projected shortage of up to 120,000 physicians by 2030, according to the Association of American Medical Colleges.

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Topics: Physician Compensation