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Keeping Up With the Digital Age
There are certainly many challenges for ECPs and their professional practice staff in keeping abreast of new and changing eyecare products, equipment, and related business applications. As many of you have seen, there is an equally compelling challenge for contemporary ECPs—the need to understand and advance your business using electronic technologies.
This edition of Business Essentials has several articles that we believe will be helpful to you and your team to understand the use and application of certain new electronic technologies. These articles cover such topics as New Electronic Prescription Drug Plan, Use of Electronic Health Records, and the new employment E-Verify program.
As we bring this issue to you, the Business Essentials team would very much appreciate your thoughts, ideas and suggestions regarding additional topics or possible special feature editions in the future. A moment of your time will be helpful in continuing to deliver to our readers' timely and relevant information that is valuable to you and your business. Please
let us know if you have comments, feedback or suggestions for topics and themes we could cover in the coming months.
Hedley Lawson brings over 25 years of optical industry experience to Jobson Medical LLC. For over 10 years, he has been a contributing editor to VM, most recently as writer of the monthly column "Business Essentials." He is the Contributing Editor of VM's
E-Newsletter Business Essentials. Contact
Business Essentials with questions or comments. |
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Employer May Require Business-Like Attire at Work
Q:
The receptionist at our practice tends to occasionally wear very faddish clothing—such as torn T-shirts, bare midriffs. Can we require her not to wear this type of clothing?
A: Yes, you can have a dress code that doesn't allow certain types of apparel. Employers have the right to create and enforce dress code policies.
Most employers would agree that they want their employees to work comfortably in the workplace; however, there are many other examples of appearances that employers, including eyecare professional practices, do not like and can restrict: Visible tattoos, multiple earrings, nose rings, eyebrow rings, bare midriffs, excessively long fingernails, mini-skirts, tattered jeans, and even overly strong perfume.
It should be stressed that the employer wishes to maintain a business-like appearance in the office, and that clothing that works well outside the office (at the gym, at nightclubs, at the beach) may not be appropriate for the office where patients, customers or clients visit.
Safety concerns can also be an issue involving a dress code. Excessively long fingernails pose safety and health issues, particularly in a medical office.
On occasion, an employee might claim that a tattoo is associated with a religion, and if that is the case, the employer must attempt to make a reasonable accommodation. However, the vast majority of tattoos do not involve one's religious.
It can be very difficult to approach an employee about inappropriate clothing, but clothing that’s too revealing is not appropriate for a place of business.
One of the touchiest subjects is excessively fragrant perfume. Be tactful in your approach and explain that perfumes can cause allergic reactions to some patients and customers.
It's wise to have a dress code policy that outlines your preferences, and give guidelines to your employees. As always, we at Business Essentials advise you to consult with legal counsel in drafting or reviewing your draft of such a policy.
Electronic Background
Checks
Q:
What is E-Verify? I hear quite a bit about it, but don't know if I should use it in my practice.
A:
E-Verify is a government-run system
that allows participating employers to check the criminal histories of current employees and applicants. The program is voluntary under federal law, but some states require employers to use it.
If you have a question or issue for one of our experts, contact
Business Essentials.
—Hedley Lawson, Jr. | |
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Employer Medical Costs May Jump 20 Percent in 2 Years
Employers need to face a painful financial fact: the cost of providing health care coverage for employees is projected to rise substantially next year. According to research conducted by the
PricewaterhouseCoopers Health Research Institute, employer medical care costs will increase by 9.9 percent in 2008. The auditing firm also expects a 9.6 percent bump in medical coverage costs for businesses in 2009. 
Those increases should worry employers, who have seen the growth rate of medical coverage costs slow down in recent years. And these increases may result in employers modifying or eliminating some benefits, including vision care.
So what are some of the reasons PwC found in their survey? The boom in the health care industry has triggered the construction of replacement facilities, the expansion of private hospital rooms and the development of outpatient venues. The cost of construction is adding to the overall medical costs for employers.
Underfunding of public medical insurance programs is also adding to the bulging health care spending by employers. According to a separate report published by the Employee Benefit Research Institute, under the current law, Medicare updates to physician payment rates are projected to be negative each year from 2009 to 2016, in spite of the fact that health care costs are expected to increase.
Employers are expected to continue the trend of cost-shifting some or all of the cost of paying insurance premiums to their employees in the future, the study also found. While employers have tried to curb the cost of premiums by switching to lower-cost plans or increasing co-payments or deductibles, Michael Thompson, principal in PricewaterhouseCoopers’ global human resources services unit, said he expects those strategies to taper off. About one-third of the employers surveyed said they expected to increase cost shifting in their medical plans for 2009.
The report also said employers will try to rely more on prevention and disease management programs to keep premiums lower, rather than shift more costs onto workers. This, Business Essentials notes, is an area where eyecare practices can either develop or increase their educational campaigns by partnering more closely with employers, creating a win-win situation for all concerned.
E-Prescribing: New Electronic Prescription Plan 
E-prescribing has been slow to catch on with doctors, held back by legal, privacy, and cost concerns. Only 2 percent of the 1.5 billion prescriptions submitted to pharmacies annually are done so electronically. To promote adoption of the practice,
SureScripts and
RxHub, the U.S.'s two electronic prescription networks, have announced plans to merge their information systems. The merger will bring together two different parts of the pharmaceutical industry.
SureScripts, which is owned by retail and independent pharmacies, is an electronic exchange that lets doctors view patients' medication history and sends prescriptions to pharmacies. RxHub, which is owned by three drug benefit managers, sends prescriptions to mail-order pharmacies and provides insurance coverage information. The merged network will connect doctors, pharmacies, and insurance companies.
The two companies hope it will reduce costs and medical errors and make e-prescribing easier and more efficient for doctors.
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Managing Overtime Payments and FMLA Leave
As eyecare practice owners and managers, you already know that you can get into trouble by incorrectly paying overtime, paying less than is legally required, or for other reasons. 
One notable example involves Microsoft's "permatemps." The software giant ended up owing an extra $97 million to temporary workers who, despite the company's intentions, qualified for benefits. Although Microsoft only wanted its regular employees to get these benefits, the language of its plan was so broad it included workers who were temporary workers.
Similarly, in 2001 Pearle Vision Company was ordered to give
FMLA leave to an employee who was legally ineligible under the FMLA. Like Microsoft, overly-inclusive language in Pearle's company handbook said "everyone" who'd worked for one-year was eligible for FMLA leave.
In 2006, a Louisiana employer was also found liable for accidentally telling an employee she was eligible for FMLA leave. "An employer who without intent to deceive makes a definite but erroneous representation to his employee that she is an 'eligible employee' and entitled to leave under FMLA [must treat the employee as entitled to FMLA] if the employee reasonably relies on that representation," the Court wrote.
[Minard v. ITC Deltacom (5th Cir. 2006) no. 04-30230]
So, the next time you are reviewing your practice's policies, be sure that you are giving what you want to—and what you are legally required to—but watch out for overly-broad and expansive languages or verbal promises. Unless your benefit plans carefully and explicitly define who is and who is not entitled to benefits, you might end up owing someone for something you did not originally intend for them to receive.
Take the Initiative
Today's businesses are quite aware of how important it is to keep up with the latest technologies as part of an overall effort to grow the business and retain valuable talent. Participants in a study by Robert Half Management Resources were asked, "In the next two years, which of the following initiatives is your company most likely to pursue?" Here are the findings:
| Technology upgrade
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53%
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| Business process improvement
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50%
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| New product or service line extension
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27%
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| Geographic expansion
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20%
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| Merger or acquisition
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9%
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| None
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22%
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| Don't know/no answer
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3%
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Source:
Roberthalfmr.com
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Most Doctors Shun Electronic Health Records 
The idea of electronic patient records is terrific. Doctors who use electronic health records (EHRs) overwhelmingly say they have helped improve the quality and timeliness of care. Yet fewer than one in five doctors use electronic records.
Why? Cost is the issue. Nearly half of the nation's doctors practice medicine in small offices—one to three doctors. The cost of upgrading an office's personal computers, buying new software, getting technical support to shift to electronic records can average between $15,000 to $20,000 or more. And then there is the time consuming conversion. More information on EHRs can be found in the current issue of
The New England Journal of Medicine.
IRS Issues Guidance on Wage Withholding Rules
The IRS issued
Revenue Ruling 2008-29 providing guidance with respect to income tax withholding in nine different situations involving the payment of supplemental wages. The ruling clarifies when the 35 percent mandatory flat withholding rate is required, when the optional 25 percent flat rate may be used, and when the regular wage withholding rates must be used.
President Bush Signs Military Tax Benefits Bill
President Bush signed the Heroes Earnings Assistance and Relief Tax Act of 2008
(P.L. 110-245) into law on June 17. The law makes permanent the Internal Revenue Code provision that permits active duty reservists to make penalty-free withdrawals from retirement plans (the provision expired at the end of 2007). It also allows any differential military pay to be included in the calculation of wages for retirement plan purposes and allows employers to report the differential military pay on the W-2. 
The law also modifies the
Uniformed Services Employment and Reemployment Rights Act (USERRA) for the purposes of triggering the payment of qualified plan benefits, and allows recipients of military death benefit gratuities to roll over the amounts received, tax-free, to a Roth IRA or a Coverdell education savings account.
It also permits reservists who are called to active duty for at least 180 days to withdraw any remaining balances in their health care flexible spending arrangements. The law includes changes to the income taxation of certain expatriates and extends the current mental health parity law under
ERISA, the
Internal Revenue Code, and the
Public Health Service Act through Dec. 31, 2008.
IRS Releases New Guidance on HSAS
The Internal Revenue Service (IRS) released
Notice 2008-59 on June 25 providing additional guidance on health savings accounts (HSAs). The new guidance includes more than 40 new frequently asked questions and answers that cover a variety of topics, including: who is an eligible individual; issues regarding high-deductible health plans; contributions to HSAs; distributions from HSAs; and establishing an HSA.
Notice 2008-59 provides new or expanded guidance for both employers and employees, while also restating guidance issued previously by the IRS.
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