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Which Healthcare Industry Purchases Are Tax-Exempt?

For those in the healthcare industry, it’s easy to assume that all medical-related purchases are exempt from sales tax. Although there are broad sales tax exemptions that apply in the area of medical purchases, there are many medical-related purchases that are not exempt.
Dan Wagner

Examples of exempt items include: prescription drugs, many over-the-counter drugs and remedies, as well as prosthetic and orthopedic devices.  Examples of items that are not exempt include: equipment such as hospital beds and diagnostic equipment purchased by hospitals, clinics, physician’s practices and other medical establishments. Similarly, medical supplies and devices are also taxable unless issued pursuant to a prescription or order by a licensed practitioner and are intended for use on a single patient and are not intended to be reusable. An example falling into this category is surgical kits as they are issued by order of a physician and the contents are intended for one-time use on a single patient.

One exception to this rule pertains to equipment and devices purchased and utilized predominantly for research and development (R&D), which are tax-exempt in Florida. If you’re not sure whether a particular item is tax-exempt, check the Florida Department of Revenue’s list of nontaxable medical and food products (Form DR-46NT).

Another area of sales/use tax compliance for hospitals and other medical establishments arises when they operate taxable enterprises, such as a cafeteria or gift shop. The establishment is required to register for sales tax purposes and to collect and remit sales tax on food and beverage sales by the cafeteria and on merchandise sales of the gift shop – even when the establishment is a nonprofit hospital. Nonprofit hospitals can apply their sales/use tax exemption to their purchases of goods and services and to any equipment that they lease, but they are not exempt from the responsibility to charge, collect and remit sales tax on taxable food and beverage and/or merchandise sales. Also, in order for nonprofit hospitals to acquire exempt status of their purchases, they must first complete Form DR-5 to apply for a sales/use tax exemption certificate from the Florida Department of Revenue.

Keeping good accounting and tax records is imperative to documenting compliance in the event of a sales/use tax audit. The Florida sales/use tax law generally provides for a 3-year statute of limitations for these types of audits. The period can be longer under certain circumstances such as fraud, substantial underpayments, substantially incorrect return or grossly false return.

No doubt, this is a complicated area of the tax law. Staying in compliance with these laws requires in-depth knowledge of the sales/use tax law governing these types of transactions. Consulting a tax professional knowledgeable in Florida sales/use tax law is likely a worthwhile investment rather than attempting to maneuver through these complex tax laws on your own. Contact me to learn more about how these laws apply to your healthcare practice or organization.

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Dan Wagner is an associate tax principal in Kaufman, Rossin’s State and Local Tax (SALT) practice. Kaufman, Rossin & Co. is one of the top CPA firms in the country. He can be reached at dwagner@kaufmanrossin.com.

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How Will Recent Regulations Affect South Florida’s Healthcare Industry?

South Florida healthcare executives gathered this week for an exclusive power lunch with Tom Hudson, to address the question: Recent regulations are likely to affect my segment of the South Florida healthcare industry by ____________________.

Janet Altman, marketing principal of Kaufman, Rossin & Co.Participants gathered at the UM Life Sciences and Technology Park to share their thoughts with broadcaster Tom Hudson, host of the new WLRN radio program The Sunshine Economy, made possible by Kaufman, Rossin & Co.

Guests shared their views about a variety of regulatory changes, including enhanced regulation around privacy.  Aldo Leiva and Jorge Rey spoke about the impact of the new Omnibus Rule, which significantly expands the types of entities required to protect patient privacy and the non-compliance penalties under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).   Mitch Levine of Quality Technology Services suggested that outsourcing to an organization like his might protect some entities from the cost and liability of the rule.

A number of healthcare technology executives attended, including Robert Chavez from Project Lift Miami, a new, digital health-focused, startup seed accelerator at Life Science Park.  The exciting and innovative technologies showcased offered luncheon participants a peek at the future of healthcare, and a discussion about research and development tax credits intrigued several participants.

One hot topic was attorney Marshall Burack’s question of whether improved technology would increase the cost of healthcare, rather than “bend the cost curve” and decrease costs.  Some guests asked whether it will be possible to focus any of South Florida’s significant wealth on start-up businesses here in our community.  Michael Gregson, CEO of WaveFront Health Technologies opined that we should not try to be the next Silicon Valley, but develop our own unique start-up culture here.

Next week real estate executives will join us for “Kaufman, Rossin Presents: Power Lunch with Tom Hudson” as we explore how South Florida can create healthy, sustainable prosperity in the long term.

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Janet Kyle Altman is marketing principal for Kaufman, Rossin & Co., one of the top CPA firms in Florida. She serves as a board member for the Women’s Fund of Miami-Dade and as a board member and immediate past chair for Friends of WLRN. Janet can be reached at jaltman@kaufmanrossin.com.

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Kaufman, Rossin-Sponsored WLRN Radio Show Takes on Healthcare Industry

The second episode of The Sunshine Economy aired this morning on WLRN Public Radio, sponsored by Kaufman, Rossin & Co., and titled “Diagnosis: Healthcare.”
Janet Altman, marketing principal of Kaufman, Rossin & Co.
Host Tom Hudson highlighted the changes in the South Florida’s healthcare market, including the industry’s decreasing employment, the impact of the Patient Protection and Affordable Care Act (ACA) and the wide price differences among hospitals for the same procedures.

Guests included the CEOs of two hospital groups, Brian Keeley of Baptist Health and Steve Sonenreich of Mount Sinai Medical Center, and the conversation with them focused on transparency in hospital pricing.  In a news-making moment, Mr. Sonenreich committed to post the prices that Mount Sinai charges, and challenged others to provide pricing and qualitative data for the public to compare.

In addition, Florida Blue CEO Pat Geraghty participated in a discussion about the Florida insurance market and the future reforms under Obamacare, and Maurice Ferre, CEO of MAKO Surgical, discussed trends in advanced health care product manufacturing.

The Sunshine Economy series broadcasts Mondays at 9 a.m., with a second chance to listen at 7 p.m., or online.  Next week the program tackles the local real estate industry, including perspectives on commercial and residential markets, a tour of a high-profile construction site and an interview with Bank United CEO John Kanas about real estate lending.

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Janet Kyle Altman is marketing principal for Kaufman, Rossin & Co., one of the top CPA firms in Florida. She serves as a board member for the Women’s Fund of Miami-Dade and as a board member and immediate past chair for Friends of WLRN. Janet can be reached at jaltman@kaufmanrossin.com.

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HIPAA Omnibus Rule – Are You in Compliance with New Breach Notification Requirements?

Jorge Rey - IT security - Kaufman, Rossin - MiamiOn January 17,2013, the U.S. Department of Health and Human Services (HHS) issued the Omnibus Rule, which significantly expands the types of entities required to protect patient privacy and the non-compliance penalties under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

The Omnibus Rule becomes effective on March 26, 2013, and HIPAA covered entities and business associates must comply with its requirements by September 23, 2013. The new rule affects the HIPAA Privacy, Security, Enforcement and Breach Notification Rules mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act.

HIPAA violation investigations are on the rise by the HHS. Last year, the HHS settled with five covered entities for amounts ranging from $50,000 to $1.7 million.

  • The Hospice of Northern Idaho agreed to pay $50,000 after an unencrypted laptop containing health records was stolen.
  • Massachusetts Eye and Ear Infirmary and Massachusetts Eye and Ear Associates, Inc. agreed to pay $1.5 million to settle potential violations of HIPAA after an unencrypted laptop was stolen.
  • Alaska Department of Health and Human Services agreed to pay $1.7 million after a USB hard drive possibly containing health records was stolen from an employee’s vehicle.
  • Phoenix Cardiac Surgery settled for $100,000 after the investigation concluded that the practice was posting clinical and surgical appointments for their patients on an Internet-based calendar that was publicly accessible.
  • Blue Cross Blue Shield of Tennessee agreed to pay $1.5 million after they reported that 57 unencrypted computer hard drives had been stolen from a leased facility.

The HIPAA Privacy and Security Rules have so far focused on health care providers, hospitals, health plans and other entities that process health insurance claims. The Omnibus Rule expands many of the requirements to business associates of these entities, such as vendors and subcontractors who have access to protected health information. Some of the largest breaches that have been reported to HHS have involved business associates.

Other changes include:

  • Clarification of when breaches of unsecured health information must be reported to HHS under the HITECH Act’s Breach Notification Rule
  • Penalties are increased for noncompliance based on the level of negligence with a maximum penalty of $1.5 million per violation
  • New limits on how information is used and disclosed for marketing and fundraising purposes
  • Prohibits the sale of an individual’s health information without their permission
  • More individual rights for patients regarding medical records, sharing proof of immunizations and authorizing use of health information for research

Covered entities and their business associates need to be in compliance with the Omnibus Rule by September 23, 2013.  Business associates must identify an information security officer who can implement the compliance program, have a consulting firm implement the program or take a hybrid approach.

Contact me to learn more about how you can comply with the HIPAA Omnibus Rule and safeguard protected health information. Our information security and compliance team can provide risk assessments, security training and guidance on HIPAA and HITECH.

Download our healthcare data breaches white paper.

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Jorge Rey, CISA, CISM, CGEIT is an associate principal and the director of information security & compliance for Kaufman, Rossin & Co. Kaufman, Rossin is one of the top CPA firms in Florida. Jorge can be reached at jrey@kaufmanrossin.com.