Employers paying wages in the state of California may breathe easier tonight due to the landmark labor law decision on the case, Brinker Restaurant Corp. v. Superior Court, which was unanimously passed yesterday, April 12, 2012, by the California Supreme Court. 

At the heart of the case lay the question of an employer’s duties when it came to providing meal breaks for their employees.  The law clearly states that employers are required to provide workers who work over 6 hours with a full, unpaid, half-hour, responsibility-free meal period.  What was unclear was whether the employer was required to police these meal periods; forcing employees to stop working entirely during their break, regardless of how practical that might be, or any possible negative impacts this might have on the employee. This kind of absolute blind enforcement raised issues for employers and employees in many industries where a forced total cessation of work related activities might threaten the success of a delicate procedure, as in the health care and construction industries, or where it might cause employees to lose tips or a sales commission.

In what many seem to consider a “common sense” decision, the Supreme Court chose to alleviate these concerns.  Now, although employers must provide their employees with the opportunity to take a break, that time is to be considered as belonging entirely to the employee.  The employee may, therefore, choose to cut their meal period short, or to skip it entirely.  It is no longer the duty of the employing company to ensure that employees drop everything and take a rest, only to ensure that it is possible for them to do so. 

The hope is that by allowing this flexibility in the timing and length of meal breaks, fewer class action law suits will be filed against employers in businesses where it is not always reasonable for employees to drop everything at a pre-set time in order to take a break.  This also releases employers from the financial concern of spending management time policing employee breaks.

 It should be noted and emphasized that employers cannot in any way compel employees into giving up their meal periods without paying them a penalty of an extra hour’s worth of wages at the coerced employee’s regular rate of pay. Giving up their meal period must be the sole decision of the employee if the employer is to be released from this lawful obligation. Furthermore, if an employee chooses to work through their break period, the employer is still responsible to pay them for all time spent working.

Other important clarifications set forth by the court, and a simple bulleted list of labor laws as they have been interpreted by this decision can be found (here)[link to http://californiaemploymentlaw.foxrothschild.com/tags/brinker-restaurant-corp-v-supe/].

The full 63 page court decision may be found (here)[link to http://www.courtinfo.ca.gov/opinions/documents/S166350.PDF].

For more information call Brett Adolph at 714.467.3434 x 231 or visit paydayonesource.com.

The “Employers and Medicare: Creating A Win-Win” online seminar  includes information which helps Employers deal with the trend where more of their employees work beyond age 65.  The seminar helps both the Employer and employee compare Medicare with group medical benefits and premiums.   

 “Employers and Medicare: Creating A Win-Win” aids Employers to understand how their group health benefits compare with Medicare benefits.   For example the educational seminar  outlines how Employers can save from $300 to over $1,000 a month when just one of their Medicare eligible employees leave the group medical plan for Medicare. 

 Employees that migrate from their group health plan to Medicare often save money.  Savings are achieved from the employee’s contribution to their group health plan premium and from the deductibles, coinsurance and copayments they must cover when using their group health plan.  Medicare Advantage plans often have smaller copayments and reduced annual maximum out of pocket costs with either a low or no monthly premium.

 According to Phil Calhoun, developer of the module and Partner of Beta Benefits, “Until this website, there was no Internet Audio Visual source for Medicare education.  Our first modules focused on helping individuals understand Medicare basics.   With this new “Employers and Medicare: Creating A Win-Win”  module, the focus is on helping Employers as most either don’t have the time to find out or are unable to find information specific to an Employer.”    

 The timing for the new module fits well with the growing number of Baby Boomers aging into Medicare. With many Boomers still working, Employers will continue to face the significant financial impact on their business due to increasing group health premiums as employees advanced ages creates more claims than younger employers and cause higher premium increases.  

 Phil Calhoun explains, “Our goal is to help business owners and their advisors benefit from this information.  To supplement the website module, we also offer onsite “Lunch and Learn”  Medicare education and counseling for the Employer and their employees.”

 Beta Benefits offers free Medicare educational seminars at several southern Californiahospitals; the seminars are open to all members of the community.  The class listing is available on www.Deals4Boomers.com or contact Beta Benefits.

 Contact Phil Calhoun 800-500-9799  ext. 226  phil@betabenefits.com

For more information call Brett Adolph, 714.467.3434.

Most, but not all, RRGs are member focused with a goal to minimize premiums for doctors and not to increase profits for shareholders/ For the standard insurance carriers, the normal profit is 20% to 30% so when you remove the profit from the premium the typical savings is 20% or more a year on a annual premiums for doctor members.

RRGs are able to look at deductible options not available through standard insurance companies. Depending on the deductible, the coverage and claim potential, a RRG is able to reduce premiums as much as 50% in some cases.

Finding the right RRG is made easier with the help of a broker that can explain how they work and what your savings would be.

To learn more contact Phil Calhoun at 1.800.500.9799 x 226.

Life saving device? Or something much more complex? Time will tell.

I heard a very interesting radio piece about “distracted doctoring” on NPR the other day. My first thought was “are they trying to draft what is an obvious concern in motor vehicle operation and apply it to doctors?”

What I thought sounded true was when a proponent of mobile devices in healthcare said basically, and I paraphrase, “Doctors have always operated in a distracting environment and nobody said get rid of nurses” or words to that effect.

Another thought I had was “How many Doctor sites are ‘mobile device friendly?’. Things are changing so fast my guess is that not many are yet.

Electronic Medical Records pretty much guarantee that this is a reality that all Doctors and other medical professionals will have to confront in the very near future.

The complete article can be found here “Hospitals Guard Against Smartphones Distracting Doctors”

Internal controls have always played a strong role in preventing fraud.  Now more than ever it’s important to establish procedures in your practice that will mitigate your risk of loss. 

ELLS CPAs has been engaged on numerous occasions to investigate the circumstances and damages resulting from employee fraud or embezzlement.  These cases have cost the medical practices anywhere from several thousand to over a million dollars.   Many of these frauds were perpetrated by the physician’s most trusted employee.

Don’t wait until you are a victim to take action.  We have developed a two page “Risk Assessment Checklist” that will enable us to determine many of the weaknesses you have in your practice. Once these risks are assessed we can recommend and help you incorporate procedures and/or safeguards into your practice to lessen your risk of fraud and embezzlement.  

Please contact ELLS CPAs  for the checklist, call 714.569.1000.

By Gregory N. Lewis

The credits can be reduced when a state has an outstanding advance or loan for two consecutive years, thereby allowing the Federal government to recover their monies directly from employers.

As a result of outstanding loans, tax reduction of .3% will be applied to wages paid in 2011 for 21 states, inculding California.

For more information please call Brett Adolph, 714.467.3434 x 231

For more information call Brett Adolph, Payday Payroll at 714.467.3434

Physicians and their staff have long expressed frustration with the time they spend interacting with health plans. Until recently, however, little information existed about the magnitude of these interactions. In What Does It Cost Physician Practices To Interact With Health Insurance Plans? (2009) L.P. Casalino et al conducted a national survey with physicians and practice administrators. The findings are shocking.

Revenue Deterioration

When time is converted to dollars, the authors estimate that the national cost to practices just from interactions with health plans is at least $23 billion to $31 billion each year. Furthermore, physicians reported spending three hours weekly interacting with plans while nursing and clerical staff spent materially more time.

Casalino et al estimate that medical practices spent an average of $68,274 per physician per year interacting with health plans.  The median value was $51,043. Shockingly, primary care practices spent $64,859 annually per physician. This is roughly one third of the income plus benefits of the average primary care physician!

Today, health plans proclaim that they have reduced the administrative burden they place on physicians. However, Casilino’s paper strongly suggests the contrary. Physicians continue to be dissatisfied with this burden. For example, (1) the average physician reports spending nearly three weeks per year on these interactions; (2) the nursing staff spends twenty three weeks per physician per year; and (3) clerical staff spends forty four weeks. Ironically with the emergence of electronic health records which were designed to improve administrative obstacles in the spirit of increased efficiency, the average physician is dedicating only two hours per week to providing quality data to health plans or to reviewing quality data for the practice.

Billing and administrative costs are no less onerous than time spent with insurance companies on the phone. California spends $167 billion on health care each year. Administrative costs account for approximately twenty-five percent of this sum or slightly over $42 billion per annum. While little was known about billing and insurance-related (“BIR”) costs until recently, James G. Kahn, et al. estimate in their paper, The Cost of Health Insurance Administration in California: Estimates for Insurers, Physicians, and Hospitals (2005), that physician offices spend a staggering 27 percent and 14 percent of revenue on administrative and BIR functions, respectively. Simply, this is grossly inefficient.

Billing and Insurance Functions Graph

As practices attempt to improve reporting coupled with an emphasis on measuring outcomes, the administrative costs, unfortunately, will only increase. While the thirst for more statistics will increase providers’ knowledge and ostensibly improve the ability to measure a wide variety of data points, the reality is that administrative burdens are increasing – not decreasing.

These findings are a grave concern for our health care system. The estimated $31 billion cost to physician practices for time spent with health plans is more than twice the GDP of Jamaica while the $23 billion that California spends on billing and insurance-related costs is roughly twice the GDP of Iceland. As legislative change – such as the migration of ICD-10 – continues to add complexity to our system, it is imperative that physicians take a more proactive approach to their revenue and cost structures.

For more information call Ken Alston at 949.250.0011 ext 233 or visit our website www.medvisioninc.com

ELLS CPAs & Business Advisors can help you safegaurd your practice by placing financial controls in your practice. For more information call ELLS at 714.569.1000.