In light of Equifax breach: How to ensure maximum security of sensitive data

Equifax, one of the biggest credit reporting agencies, reported on September 7, 2017 one of the largest data breaches in history which is now impacting half the U.S. population! Equifax reported that criminals “exploited a U.S. website application vulnerability to gain access to certain files.”

The breach includes the compromise of personal information of approximately 143 million individuals, as originally reported; however, as of Oct. 15, CNN reported that there have now been another 2.5 million people breached. The breach includes information including social-security numbers, birthdates, credit card numbers and drivers’ licenses.

Now, as to how much liability Equifax will face, nobody really knows just yet. We do know, however, that the Federal Trade Commission (FTC) and many state attorney generals have already started proceedings against Equifax. “The FTC typically does not comment on ongoing investigations,” spokesman Peter Kaplan wrote in an email to Reuters. “However, in light of the intense public interest and the potential impact of this matter, I can confirm that FTC staff are investigating the Equifax data breach.” In addition, almost 40 states have joined an investigation into Equifax’s business practices.

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Best Practices for Exclusion Sanctions Screenings

Earning an exclusion from the Department of Health and Human Services Office of Inspector General (OIG) can spell the end of a career or business in the healthcare industry. Once excluded or sanctioned, an individual or entity is prohibited from receiving payment or reimbursement from any Federal healthcare program, which includes Medicare and Medicaid. The payment prohibition affects the person, anyone who contracts or employs the excluded person, and health providers that service the said person.

If a company is found to be using federal healthcare funds to service or pay an excluded individual, it can face hefty fines and civil monetary penalties. These include $10,000 for each claimed item or service furnished to the individual, up to 3 times the amount claimed for each item or service, and the possibility of also getting excluded. In order to avoid these, it is a must for companies, especially healthcare providers, to regularly and diligently screen their employees, contractors, and subcontractors for exclusions and sanctions.

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How Often Should Employers Screen Excluded Individuals?

Screening for individuals and entities that have been excluded from participating in healthcare programs is a must for any healthcare provider. After all, contracting or employing the services of excluded entities can result in significant monetary penalties, Medicaid payment bans, and the possibility of earning exclusion for the company itself.

Given this situation, it seems like the most favorable approach for healthcare providers would be to conduct sanction screenings as often as possible. This is a fairly easy task for a smaller company, but not for one that has hundreds or thousands of employees. Going through a large number of individuals every month will require a dedicated group of people and can eat up a considerable amount of time and resources.

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Emptech Exclusion Screening Update: News from the Office of Inspector General, U.S. Dept. of Health & Human Services

Providers Terminated in One State Continue to Participate in Other States…

In May, 2016 testimony to Congress, the Department of Health and Human Services Assistant Inspector General Ann Maxwell reported on a study the OIG conducted in 2014 that revealed several shortcomings with respect to the extent to which States are utilizing risk-based screening of high-and-moderate risk providers. The outgrowth of that study is included in OIG’ s 2017 Compendium of Unimplemented Recommendations.

The study found that many States have not fully implemented fingerprint-based criminal background checks, and site visits (guidance that CMS initially issued in 2015). And very importantly, most Sates reported difficulties and sustained challenges obtaining and utilizing quality screening results from Medicare or other States as substitution for their own results. This has resulted in the enrollment and revalidation of thousands of high-to-moderate risk providers.

To solve these problems OIG’ s recommendations include stepped-up CMS support of States in their efforts to implement fingerprint based technology; to increase and improve site-visits; to ensure the quality and accessibility of substitute screening data; and to access and utilize a fully functioning central system for States to submit and access screening results from other States. Thus the OIG recommends that CMS should require each State Medicaid agency to report all terminated providers. And this points to the reality that the extreme importance of advanced, methodical, and frequent exclusion screening extends to every level of engagement with all participating individuals and entities.

On the enforcement front here’s a selection of some recent actions taken by the Office of Inspector General. The full descriptions can be found on the OIG’ s official website.

– An unlicensed New Jersey dentist agreed to a $1.1 million dollar fine and a 50-year exclusion from Federal health care program participation for assuming the identity of a licensed (later deceased) dentist and presenting Medicaid claims for services using that dentist’s identity. The allegation included that the unlicensed dentist perpetrated the fraud from late 2005 to late 2012.

– Two cases in February of this year were resolved by way of self-disclosure. In Rhode Island, Orchard View Manor agreed to pay over $61,000 dollars for allegedly employing an individual that it knew or should’ve known was excluded from Federal health care program participation. And in Ohio, OhioHealth Corp. agree to a CMP of over $231,000 dollars for allegedly employing three excluded individuals.

– In April this year Pafford Medical Services Inc. in Arkansas agreed to a CMP fine of over $390,000 dollars for employing an excluded individual.

Best practices call for minimum monthly screening of all individuals and entities that a provider does business with. Emptech provides high efficiency and ensures full compliance with the lowest overall screening cost available.


Recent Enforcement Actions from the Office of Inspector General, U.S. Dept. of Health & Human Services

On the enforcement front here’s a selection of some recent actions taken by the Office of Inspector General. The full descriptions can be found on the OIG’ s official website.

– An unlicensed New Jersey dentist agreed to a $1.1 million dollar fine and a 50-year exclusion from Federal health care program participation for assuming the identity of a licensed (later deceased) dentist and presenting Medicaid claims for services using that dentist’s identity. The allegation included that the unlicensed dentist perpetrated the fraud from late 2005 to late 2012.

– Two cases in February of this year were resolved by way of self-disclosure. In Rhode Island, Orchard View Manor agreed to pay over $61,000 dollars for allegedly employing an individual that it knew or should’ve known was excluded from Federal health care program participation. And in Ohio, OhioHealth Corp. agree to a CMP of over $231,000 dollars for allegedly employing three excluded individuals.

– And in April this year Pafford Medical Services Inc. in Arkansas agreed to a CMP fine of over $390,000 dollars for employing an excluded individual.

Best practices call for minimum monthly screening of all individuals and entities that a provider does business with. Emptech’s fully integrated platform helps ensure full compliance with the highest automated efficiency, the lowest overall screening cost available, backed by state-of-the-art data security and our locally-based subject matter experts.


FORM I-9 MADE EASY

Finding the answers to Form I-9 questions can be challenging, and the information can be confusing, unless you know where to look. There are more than 15 pages of instructions and a 69-page handbook that provides details on how to properly complete the Form I-9. In addition, there is an entire body of case law related to Form I-9 compliance.

Form I9 Made Easy

It’s important for employers and employees to be as detailed as possible when completing Form I-9, as fines for mistakes can be as high as $2,156 for a first offense, and an employer subject to a Form I-9 audit can be fined up to hundreds of thousands of dollars.

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Frequently Asked Questions About Form I-9

To ensure compliance with government regulations, and to avoid first-offense fines as high as $2,156, it’s of utmost importance to properly complete and process all Form I-9 and corresponding documentation. Otherwise known as the Employment Eligibility Verification Form, Form I-9 can be used to verify the identity and employment eligibility of anyone hired by U.S. employers, whether that person is a United States citizen or a non-citizen.

Although completion of the Form I-9 is designed to be straightforward, there are quite a number of details that employees and employers must be vigilant about to ensure thorough compliance with all federal requirements. Attention to detail also ascertains that the document is not rendered incomplete, or deemed fraudulent, due to errors that could be easily avoided.

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Puerto Rico law significantly increases unemployment insurance wage base

As part of a larger labor reform law to attract businesses to the territory, Puerto Rico Governor Ricardo Rossello Nevares approved legislation that increases the unemployment insurance (UI) wage base from $7,000 to $10,500.

The law also increases the weekly unemployment benefit for laid off workers from a range of $7 to $133 to a range of $60 to $240.

Both changes are effective immediately. (Law No. 4, Law of Transformation and Labor Flexibility, January 26, 2017.)

For 2016, Puerto Rico’s unemployment insurance tax rates ranged from 2.4% to 5.4%, with the rate for new employers at 3.3%.

The territory’s jobless rate is more than 11%, one of the highest of all US jurisdictions and significantly more than the US average of near 5%.


A closer look at the Taxable Wage Base and how it works

Definition:
A taxable wage base is the maximum annual wage on which a taxpayer must pay taxes.

How it works:
Let’s assume that Mary earns $150,000 a year as COO at the XYZ Organization, and the US government sets the taxable wage base for Social Security at $100,000 this year, which means that Mary will only pay Social Security taxes on the first $100,000 of her income.

Hypothetically, let’s say that Mary’s take-home pay is $9,000/pay period. After she has earned her $100,000 for the year the employer will stop withholding Social Security taxes. After Mary’s taxable wage base has been reached, her take-home pay might go up to approximately $9,250.

A closer look at SUI and Unemployment Compensation

Studies show that employers’ unemployment costs are rising higher and higher each year. Companies continue to fend off these ever increasing costs; however, many companies still wind up paying more then the minimum un-insurance premiums each year because they don’t have a thorough understanding of the laws.

Each state normally determines the amount of an organization’s un-insurance payment, based on the laws established in each organization’s state, along with a comparison of benefits against taxes an organization would typically pay in a given period of time.

So much of this is in the hands of the State’s interpretation, as there is nothing official about the process, which is why States are getting away with overcharging premiums unless there is a knowledgeable and watchful eye overseeing the process. Currently the law in place deems that it is not mandated for States to report any overcharging due to oversights unless the mistake is greater than 18 percent.

To learn more about how Emptech can help your organization reduce it’s employer unemployment taxes substantially, please call on us at 1-800-518-3874 or visit our website at www.empetch.com. You can also email us at info@emptech.com.


New Mexico 2017 SUI wage base to increase, tax rate notices to be issued in November

The New Mexico Department of Workforce Solutions announced that the 2017 state unemployment insurance (SUI) taxable wage base will increase to $24,300, up from $24,100 for 2016.

tax

According to the Department, revised state unemployment insurance (SUI) tax rates for the third and fourth quarters 2016, the result of legislation enacted earlier this year, will be issued in November 2016. Employers affected by the change will have their accounts credited for any overpaid amount for the third quarter, the amount of which may be applied against future SUI taxes or requested as a refund.

SUI tax rates for calendar year 2017 will also be issued in November.

Legislation changed the SUI rate computation
As we previously reported, HB 283 will reduce many experience-rated employers’ SUI tax rates for third and fourth quarter 2016 and beyond by adding an “experience history factor” to the rate calculation formula.

Effective for calendar year 2017, an additional “reserve factor” will be added to the computation of SUI tax rates that will reduce many employers’ tax rates. The “reserve factor” will be multiplied by an “experience history factor,” computed as all of the employer’s previous contributions, minus all of the employer’s benefit charges, to equal the reserve balance, divided by the average of the last three fiscal years of taxable payroll, and then applied to a schedule.

The bill requires that experience-rated employers’ SUI tax rates for 2016 be recomputed using the new formula for the third and fourth quarters 2016 (effective July 1 through December 31, 2016).

Note that this is not a retroactive change to the beginning of the calendar year. New employer tax rates will not change, and the minimum SUI tax rate will remain at 0.33% and the maximum rate (before adding the excess claims premium) at 5.4%

For an in-depth look at understanding SUI, please see our blog post and our social media posts.