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Syracuse law firm involved in Medicaid lawsuit
SYRACUSE — The state pharmacists society and several individual pharmacies are suing the state’s Medicaid program over rules requiring beneficiaries to use mail-order pharmacies for some prescriptions. Syracuse–based Hiscock & Barclay LLP is representing the plaintiffs, including the Pharmacists Society of the State of New York, a number of named pharmacists, and Medicaid beneficiaries. Requiring […]
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SYRACUSE — The state pharmacists society and several individual pharmacies are suing the state’s Medicaid program over rules requiring beneficiaries to use mail-order pharmacies for some prescriptions.
Syracuse–based Hiscock & Barclay LLP is representing the plaintiffs, including the Pharmacists Society of the State of New York, a number of named pharmacists, and Medicaid beneficiaries. Requiring prescriptions to be filled by mail deprives patients of one-on-one counseling with pharmacists they trust, says Linda Clark, an attorney with Hiscock & Barclay.
“There’s a risk that there will not be adequate coordination in terms of drug interactions and the like,” she says. “There’s really no one there to effectively look at the whole patient profile that a pharmacist would normally look at.”
The issue arose last year when prescription drugs became part of Medicaid Managed Care, in which subsidized health plans reimburse pharmacies for prescriptions as opposed to Medicaid paying directly, Clark says.
When the plans became responsible for drug coverage, the New York Legislature specifically passed laws mandating that patients have the right to choose their pharmacies, as long as that pharmacy meets or beats the mail-order price, Clark explains. The one exception was for drugs that are extremely expensive, exotic, or difficult for a local pharmacy to handle.
The Department of Health began developing a list of those drugs, but it quickly became clear that many routine prescriptions were being added, Clark says.
“The exceptions started to swallow the rule,” she says. “They came up with a list of over 400 routine drugs for all kinds of basic chronic conditions that community pharmacies have been serving forever. It’s pretty clear that was not the intent of the exception. That’s why we ended up in court.”
Mail-order drugs can create serious issues for patients, Clark says. Some people might get some drugs from the mail while others come from the pharmacy. That can create confusion.
And some of the drugs involved are critical and time sensitive, Clark notes. One patient in the case is taking anti-rejection drugs after a liver transplant.
“If you’re not at home at the moment that UPS stops by, you don’t get your drugs,” Clark says.
UPS could just leave the drugs, but that’s not a great option when therapies can cost thousands of dollars per month.
The lawsuit, filed in State Supreme Court in Albany County, is seeking to stop the list of exceptions from moving forward. Clark notes that pharmacists recognize there are some drugs that legitimately belong on the list.
The mail-order program is temporarily on hold while the suit moves ahead, she adds. No one from the state Health Department could be reached for comment on the matter.
The issues in the suit don’t just relate to patient health, Clark says. There are hundreds of millions of dollars at stake.
The mail-order program could send up to $1 billion in taxpayer funds to mail-based pharmacies that are located outside New York state, Clark says.
“Medicaid patients lose choice and access, in-state pharmacies lose prescription volume, and New York state loses the tax revenues it needs,” Craig Burridge, executive director of the Pharmacists Society of the State of New York, said in a news release. “It’s a money-grab by the nation’s largest prescription-benefit managers who are building prescription volume on pharmacies they own and control.”
Hiscock & Barclay has 360 lawyers and support-staff members. The firm has additional offices in Albany, Buffalo, New York City, Rochester, Boston, Toronto, and Washington, D.C.
Contact Tampone at ktampone@cnybj.com
Changing Estate-Planning Rules Require Careful Consideration
Is your estate plan current? The federal estate-tax rules drastically changed in 2010, were altered again in 2011, and will change again in 2013. Following is a summary of these laws. I encourage you to review your own estate plan to see how it is affected. Our federal estate-tax exemption, which is the amount you
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Is your estate plan current? The federal estate-tax rules drastically changed in 2010, were altered again in 2011, and will change
again in 2013. Following is a summary of these laws. I encourage you to review your own estate plan to see how it is affected.
Our federal estate-tax exemption, which is the amount you can pass estate-tax-free at your death, was $3.5 million in 2009, and the maximum federal estate-tax rate was 45 percent. In 2010, the estate tax was repealed. For this one year, the step-up in basis rules (which would allow heirs to sell assets they inherit with a cost basis equal to the estate fair-market value) were replaced by carryover basis. These new rules permitted a step-up of $1.3 million plus an additional $3 million for assets passing to a surviving spouse. In lieu of these rules, an election could have been made in 2010 to elect an estate-tax exemption of $5 million and a full step-up in basis.
In 2011, the federal estate tax ex-emption was $5 million with an estate tax rate of 35 percent. For the 2012 tax year, the exemption is $5.12 million. During this entire time, there is an unlimited federal and New York State marital exclusion, and the New York State exemption is $1 million. The 2013 federal exemption is scheduled to decrease to $1 million with an estate-tax rate of 55 percent. With these wild swings in federal estate tax, it’s hard to structure your estate plan wisely. Although everyone’s circumstances are different, here are some general guidelines.
It’s important to list your assets at fair-market value, and include the death benefit of your life insurance that you own in the total. Once the fair market value approaches $1 million, tax planning is imperative.
For married couples, equalizing your estates may result in the lowest estate tax. Putting disclaimer or credit-shelter trusts, which maximize the use of both spouse’s exemptions, in your wills could double the amount passing free of estate tax for a married couple. If you have a formula clause, you should review it. Depending on the estate-tax exemption amount in the year of your death, it could potentially disinherit the spouse if the tax-exempt amount is left to children and the balance to your spouse.
Making gifts of real estate or closely held business interests may be wise, and valuation discounts as well as low interest rates work in your favor. Gifting appreciating assets during your lifetime and placing life insurance into an irrevocable life-insurance trust could leverage your exemption even more. Reviewing beneficiary designations and coordinating them with your overall estate plan is of prime importance, since many people pass more assets by beneficiary than by their wills. Flexibility is key, with the fluctuating exemptions, basis rules, and estate-tax rates.
Durable powers of attorney, health-care proxies, and living wills are lifetime documents that everyone should have in place. A durable power of attorney states who would make your financial decisions, and a health-care proxy designates who would make your medical decisions, if you were unable to do so. HIPAA language should be included in your documents so that the privacy laws allow your agent access to your personal information. A living will states that you do not want to be kept alive by artificial means if you are in an irreversible coma with no chance of recovery, and if that mirrors your wishes, you should sign a living will.
Are you confused yet? Congress may adopt new legislation for 2013. Uncertainty makes it difficult to plan, but waiting to see what happens next may not be the best course of action. The earlier you implement flexible tax and estate planning to respond to these changes the better. This article just scratches the surface. There are many rules not shown here that you would need to consider.
Grace Ghezzi is vice president with Benefit Consulting Group (or BCG), specializing in fee-only financial planning. Contact her at (315) 413-4460 or via email at gghezzi@bcgcny.com
American Society of Women Accountants report offers ideas to boost diversity
The American Society of Women Accountants (ASWA) has issued a new report making several recommendations for how companies can increase hiring of women and minorities in the accounting and finance professions, especially in high-level positions. In the report, entitled “2012 ASWA Special Report on Solutions to Increase Diversity in the Accounting and Finance Fields,” ASWA
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The American Society of Women Accountants (ASWA) has issued a new report making several recommendations for how companies can increase hiring of women and minorities in the accounting and finance professions, especially in high-level positions.
In the report, entitled “2012 ASWA Special Report on Solutions to Increase Diversity in the Accounting and Finance Fields,” ASWA examines what both employers and employees can do in order to increase diversity numbers at all levels of the accounting and finance profession, with a special emphasis on the top rungs of the career ladder.
“ASWA is troubled by the lack of diversity at the top of the profession,” ASWA National President Cheryl Heitz said in a news release. “It is important for any employee to feel valued at their place of work. We see minorities and women drop out of the profession when the organization’s policies and culture conflict with minority and women’s needs and expectations.”
The report explores the importance of introducing minorities and women to the accounting and finance fields at a young age. Then, in order to encourage retention and advancement, organizations need to implement structural mechanisms that foster a welcoming company culture where motivated and skilled minority and women professionals wish to stay, ASWA says.
The organization adds that it is equally important for minority and women employees to focus on personal career advancement. The report cites programs in the accounting and finance fields and highlights successful diversity initiatives in other industries that have made significant strides towards the diversity goals ASWA has set.
Highlights of the 2012 ASWA Special Report on Solutions to Increase Diversity in the Accounting and Finance Fields include:
– Bring exposure to the industry by educating students about accounting and finance
– Businesses can implement structural mechanisms and programs that foster growth opportunities and promotions
– Companies can create an inclusive culture by educating employees about the benefits of retaining a diverse staff and the
unique challenges diverse employees face
– Diverse individuals should take certain steps to focus on personal career advancement
ASWA issued the special report in conjunction with its 2012 ASWA Annual Conference for Accounting and Financial Women — “Connect. Advance. Lead,” held in San Diego, Calif. Oct. 22-24.
The full ASWA special report is available at http://bit.ly/ASWAResearch.
HealtheConnections’ HIE moves past 1 million CNY patient records
SYRACUSE — Central New York’s health information exchange (HIE) now covers patient records for more than 1 million people in its 11-county region, its overseeing
OCC adds new partner to higher ed center
SYRACUSE — Onondaga Community College (OCC) has added a new school to its list of colleges that offer degree programs on its campus. The Northeastern
New bill would encourage high-tech growth
SYRACUSE — New legislation pushed by Sen. Kirsten Gillibrand aims to encourage the growth of high-tech jobs across the country. Gillibrand announced the America Innovates
ConMed profit, sales rise in Q3
UTICA — Sales and profit rose in the third quarter at ConMed Corp. (NASDAQ: CNMD), surpassing analysts’ estimates. The Utica–based medical-device manufacturer reported net income
SBA names top Central New York lenders in 2012 fiscal year
SYRACUSE — M&T Bank, NBT Bank, Adirondack Bank, and Solvay Bank topped lists of the most active lenders in the U.S. Small Business Administration’s (SBA)
Profit falls at Pathfinder Bancorp
OSWEGO — Net income available to common shareholders at Pathfinder Bancorp (NASDAQ: PBHC), the holding company for Pathfinder Bank, was $670,000 in the third quarter,
State tax revenue off by 0.2 percent from last year
Tax revenue dropped slightly in the first half of New York’s fiscal year, Comptroller Thomas DiNapoli said today. The state collected $31.6 billion in taxes
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