Attorneyshelp their clients resolve legal disputes. To do so, they may research laws, draft legal documents, argue their clients’ cases in court, and engage in settlement negotiations. Ahealthcare attorneyis a lawyer who specializes their practice in resolving healthcare issues. These professionals often work long hours, and stress levels may rise when cases go to court. According to the U.S. Bureau of Labor Statistics website, the median salary for all attorneys was $115,820 as of May 2015. Let’s look at the steps it takes to become a healthcare attorney.
Step 1: Earn a B.A.
Law schools generally require that applicants possess bachelor’s degrees. However, according to the U.S. Bureau of Labor Statistics (BLS), there is no specific undergraduate field of study required to attend law school. The BLS states that many law students have bachelor’s degrees in government, history, economics, or related fields.
Aspiring healthcare attorneys might benefit from completing their undergraduate studies in healthcare administration, health studies, or healthcare management. These programs provide an education on the operations and policy aspects of the healthcare industry. This knowledge may be beneficial when studying healthcare in law school or practicing healthcare law.
Prepare to Take the LSAT
Most law schools require that applicants submit Law School Admission Test (LSAT) scores. This test plays a large role in determining an applicant’s acceptance into law school. Companies offer multi-week prep courses that provide instruction about the exam’s format as well as offering test-taking tips.
Step 2: Take the LSAT
The half-day-long LSAT tests an examinee’s analytical reasoning, reading, and critical thinking skills. Most students take this exam during their junior year of undergraduate study.
Step 3: Graduate from Law School
Juris Doctor programs are offered in both full- and part-time formats. Typically, full-time programs require three years of study. During their first year, law students complete a curriculum consisting of courses in basic law subjects like contracts, property, torts, and criminal procedure. During their second and third years, students complete elective courses, judicial internships, and clinical experiences.
Some schools allow law students to concentrate their 2nd- and 3rd-year studies on healthcare law. These concentrations may include courses in healthcare finance, food and drug law, medical malpractice, and administrative law.
Take Elective Courses in Healthcare Law
Even if a student doesn’t complete a concentration in healthcare law, completing elective courses in the field provides them with a solid foundation of the legal aspects of healthcare. Available elective courses may cover topics like comparative health law and policy, corporate issues in health care, and healthcare fraud and abuse.
Prepare for the Bar
Each state has its own bar exam, and passing this test is required to become a practicing lawyer. A lawyer who aims to practice in multiple states will likely need to pass bar exams for each state in which he or she wishes to practice. Preparing for the bar exam by completing a prep course may increase an individual’s chance of passing the exam on their first try. These prep courses are usually offered by private companies to new law school graduates.
Step 4: Take the Bar Exam
The BLS reports that every state requires lawyers to be licensed. Generally, to become licensed an individual must pass the state’s bar exam and a professional responsibility exam. The format of each state’s bar exam differs, but many include multiple days of testing in the form of both essay and multiple choice questions.
Step 5: Work as a Healthcare Attorney
Government agencies, private law firms, and legal aid societies hire lawyers to practice healthcare law. Legal aid societies usually require that candidates have at least two years of experience, while private law firms may seek attorneys with eight or more years of experience. Employment is also available with non-profit organizations, social services institutions, and healthcare companies.
Step 6: Consider Earning a Master of Laws
A licensed attorney can look to a law school to earn a Master of Laws (LL.M.) in Healthcare Law. These programs may include classes covering topics like assisted reproduction and the law, disability law, elder law, government health policy, and mental health law. Sometimes, they may require students to write a thesis prior to graduation.
Aspiring healthcare attorneys must earn a bachelor’s degree, gain certification through passing the bar exam, and gain experience working as an attorney.
Survival rates are often used by doctors as a standard way of discussing a person’s prognosis (outlook). Some people want to know the survival statistics for people in similar situations, while others may not find the numbers helpful, or might not even want to know them. If you don’t want to read about the survival statistics for mesothelioma, stop reading here.
To get survival rates, doctors have to look at people who were treated at least several years ago. Although the numbers below are among the most current we have available, improvements in treatment since then could result in a better outcome for people now being diagnosed with mesothelioma.
Survival rates are often based on previous outcomes of large numbers of people who had the disease, but they can’t predict what will happen in any person’s case. Knowing the type and the stage of a cancer is important in estimating outcome. But many other factors can affect survival, such as a person’s age and overall health, the treatment received, and how well the cancer responds to treatment. Even taking these other factors into account, survival rates are at best rough estimates. Your doctor can tell you if the numbers below apply, as he or she is familiar with your situation.
Mesothelioma is a serious disease. By the time the symptoms appear and cancer is diagnosed, the disease is often advanced. Regardless of the extent of the cancer, mesothelioma can be very hard to treat.
5-year survival rate
When discussing cancer survival statistics, doctors often use a number called the5-year survival rate. The 5-year survival rate is the percentage of people who liveat least5 years after their cancer is diagnosed. Of course, some people live longer than 5 years.
Relative5-year survival takes the proportion of people with cancer that have survived 5 years and compares it to the survival expected in a similar group of people without the cancer. This helps adjust for deaths from causes other than the cancer. Based on data from the National Cancer Institute’s SEER program, the relative 5-year survival rate for mesothelioma is between 5% and 10%. People diagnosed at a younger age tend to survive longer.
Median survival times
The numbers in the table below are from a large international study that looked at the median survival time of patients withpleuralmesothelioma who were treated with surgery between 1995 and 2009. Median survival is the length of time it took for half the people in a certain group (like those with a certain type and stage of cancer) to die. It is kind of like an average – half the patients in the group live longer than that and half the patients don’t.
Stage
Median Survival
I
21 months
II
19 months
III
16 months
IV
12 months
As a general rule, survival times are likely to be longer for people with mesotheliomas that can be operated on than for those with cancers that have spread too far to be removed. Other prognostic factors, such as those listed in How Is Malignant Mesothelioma Staged? can also affect survival.
Attorneyshelp their clients resolve legal disputes. To do so, they may research laws, draft legal documents, argue their clients’ cases in court, and engage in settlement negotiations. Ahealthcare attorneyis a lawyer who specializes their practice in resolving healthcare issues. These professionals often work long hours, and stress levels may rise when cases go to court. According to the U.S. Bureau of Labor Statistics website, the median salary for all attorneys was $115,820 as of May 2015. Let’s look at the steps it takes to become a healthcare attorney.
Step 1: Earn a B.A.
Law schools generally require that applicants possess bachelor’s degrees. However, according to the U.S. Bureau of Labor Statistics (BLS), there is no specific undergraduate field of study required to attend law school. The BLS states that many law students have bachelor’s degrees in government, history, economics, or related fields.
Aspiring healthcare attorneys might benefit from completing their undergraduate studies in healthcare administration, health studies, or healthcare management. These programs provide an education on the operations and policy aspects of the healthcare industry. This knowledge may be beneficial when studying healthcare in law school or practicing healthcare law.
Prepare to Take the LSAT
Most law schools require that applicants submit Law School Admission Test (LSAT) scores. This test plays a large role in determining an applicant’s acceptance into law school. Companies offer multi-week prep courses that provide instruction about the exam’s format as well as offering test-taking tips.
Step 2: Take the LSAT
The half-day-long LSAT tests an examinee’s analytical reasoning, reading, and critical thinking skills. Most students take this exam during their junior year of undergraduate study.
Step 3: Graduate from Law School
Juris Doctor programs are offered in both full- and part-time formats. Typically, full-time programs require three years of study. During their first year, law students complete a curriculum consisting of courses in basic law subjects like contracts, property, torts, and criminal procedure. During their second and third years, students complete elective courses, judicial internships, and clinical experiences.
Some schools allow law students to concentrate their 2nd- and 3rd-year studies on healthcare law. These concentrations may include courses in healthcare finance, food and drug law, medical malpractice, and administrative law.
Take Elective Courses in Healthcare Law
Even if a student doesn’t complete a concentration in healthcare law, completing elective courses in the field provides them with a solid foundation of the legal aspects of healthcare. Available elective courses may cover topics like comparative health law and policy, corporate issues in health care, and healthcare fraud and abuse.
Prepare for the Bar
Each state has its own bar exam, and passing this test is required to become a practicing lawyer. A lawyer who aims to practice in multiple states will likely need to pass bar exams for each state in which he or she wishes to practice. Preparing for the bar exam by completing a prep course may increase an individual’s chance of passing the exam on their first try. These prep courses are usually offered by private companies to new law school graduates.
Step 4: Take the Bar Exam
The BLS reports that every state requires lawyers to be licensed. Generally, to become licensed an individual must pass the state’s bar exam and a professional responsibility exam. The format of each state’s bar exam differs, but many include multiple days of testing in the form of both essay and multiple choice questions.
Step 5: Work as a Healthcare Attorney
Government agencies, private law firms, and legal aid societies hire lawyers to practice healthcare law. Legal aid societies usually require that candidates have at least two years of experience, while private law firms may seek attorneys with eight or more years of experience. Employment is also available with non-profit organizations, social services institutions, and healthcare companies.
Step 6: Consider Earning a Master of Laws
A licensed attorney can look to a law school to earn a Master of Laws (LL.M.) in Healthcare Law. These programs may include classes covering topics like assisted reproduction and the law, disability law, elder law, government health policy, and mental health law. Sometimes, they may require students to write a thesis prior to graduation.
Aspiring healthcare attorneys must earn a bachelor’s degree, gain certification through passing the bar exam, and gain experience working as an attorney.
How Much of My Mortgage Payment is Tax Deductible?
How much of your monthly mortgage payment is tax deductible?
The short answer is more than you might think, but not as much as you might hope.
Depending on how your mortgage is set up,your monthly payment likely includes principal, interest, taxes, and insurance, also known by the acronym PITI.
Let’s take a look at each category to see whether there’s a deduction that can lower your taxable gross income:
Principal – No
The principal is the total amount you borrow from the lender. It’s not deductible.
The portion of your house payment that goes toward the principal is generally smaller during the first years of the mortgage term but increases as the term progresses.
Interest – Yes
During the early years of a mortgage, this often makes up a larger part of your monthly payment.
The good news is you can deduct it from your gross income, according to the Internal Revenue Service’sTax Information for Homeowners. This is one of the most beneficial deductions, as it applies to mortgages with balances of up to $1 million.
Your mortgage company should have mailed you a statement,Form 1098, that outlines how much you paid in principal and interest. You should report that information on your tax return.
Real estate taxes – Yes
Property taxes on your home and the land it sits on can be deducted.
If you bought your home during the tax year, you likely paid property taxes at closing. Your closing statement should have the amount you paid. This generally is the only part of your closing costs that is deductible.
If you didn’t buy the house during the tax year, then you likely paid property taxes to your county, city, or both. The taxing authorities should have sent you a statement of how much you paid on Form 1098 in Box 4.
Insurance – No and Yes
Your home insurance is not deductible, nor is your title insurance.
Home insurance is what protects your house and its contents from fire, wind, and other specified perils. Your mortgage company requires you to purchase coverage, but the premiums – often bundled into your monthly mortgage payment – are not deductible.
Title insurance is a policy that guarantees the title for a piece of property is valid. It is often required by your lender but is not deductible.
Private mortgage insurance, however, is deductible.
Most lenders require private mortgage insurance, or PMI, when a buyer cannot make a down payment of at least 20% of the purchase price. The coverage protects the lender in case you default on the loan. The amount you pay is deductible and should show up on your Form 1098 from your mortgage company.
The outlook for next year
The private mortgage insurance just mentioned expired when the calendar year turned to 2014. You can still use it for the 2013 tax year, but as things currently stand, it won’t be available when you file next year.
In fact, changes to – and even the elimination of – the mortgage-interest deduction are discussed nearly every year. No one expects it to go away immediately, but it’s worth keeping an eye on.
How much would the loss of other mortgage-based deductions affect your taxes?
Farmers and Small Farms Can Maximize Tax Savings from Health Insurance Costs
Under the Affordable Care Act (ACA), the individual mandate requires farmers to obtain and maintain "minimum essential coverage" (MEC) for themselves and dependents.[1] Because of the many changes associated with the ACA, many farmers and farm businesses may be paying health insurance premiums for the first time in 2014 or may have faced increased premiums to comply with the ACA mandates. Accordingly, many farmers may find it helpful to understand some useful tax rules associated with the deduction of health insurance premiums.
Self-Employed Health Insurance Deduction
Under the Tax Code, the self-employed farmer may claim a deduction for health insurance costs. Premiums deductible include premiums paid for:[2]
The farmer
The farmer's spouse
Dependents of the farmer, and
The farmer's child, stepchild, adopted child or eligible foster child who has not reached age 27 by the end of the year (even if the child was not a dependent of the farmer).
The farmer may qualify for the self-employed health insurance deduction if aninitial testis met and if the health plan isestablished under the farmer's business. Moreover, the farmer mustnot have been eligibleto participate in any subsidized health plan of an employer.
Initial Test
In order to qualify for this deduction, the farmer must meet any one of the following requirements:
The farmer must have net farm profit on Schedule F (or other self-employment profit)
The farmer used one of the optional methods (such as the farm optional method) on Schedule SE,Self-Employment Tax, to calculate net self-employment (SE) earnings
The farmer is a partner in a partnership who has net SE earnings shown in box 14 of Schedule K-1 that accompanies the farmer's partnership return
The farmer is an S corporation shareholder who owns more than 2% of the stock in the S corporation and has received a Form W-2,Wage and Tax Statementthat shows health insurance premiums paid or reimbursed by the S corporation.
Note: Further information on the optional methods of calculating SE earnings, such as the nonfarm method, farm method and the use of both methods for farmers who have both farming and nonfarming income may be found in IRS Publication 334, Tax Guide for Small Businesses.
Health Plan Established Under the Farmer's Business
In addition, the health insurance plan must beestablished(or considered to be established)under the business. The business under with the health insurance plan is established may be a farm or nonfarm business. This test may be met under the following rules.
For the self-employed farmer, the health insurance policy can be in the name of the farm business (or a nonfarm business of the farmer) or in the farmer's name.
For farmers who are partners, the health insurance plan may be in the name of either the partnership or the farmer. The premiums may be paid by either the partnership or the farmer, but if the policy is in the farmer's name and the farmer pays the premiums personally, the partnership must reimburse the farmer. In addition, regardless whether the partnership or the farmer pays the premiums, the farmer must report the premium amounts as a guaranteed payment. These premium amounts must appear on Schedule K-1 and will be included in the farmer's gross income for tax purposes. Otherwise, the health insurance plan will not be considered to be established under the farmer's business.[3]
For a farmer who owns more than 2% of the stock in an S corporation, the health insurance policy may be in the name of either the S corporation or the farmer. Either the farmer or the S corporation may pay the premiums. If the policy is in the farmer's name and the farmer pays the premiums, the S corporation must reimburse the farmer for the premiums that the farmer paid. Regardless whether the farmer or the S corporation paid the premiums, the premium amounts must be included as wages on the farmer's Form W-2. Otherwise, the health insurance plan will not be considered to be established under the farmer's business.[4]
For the farmer with an S corporation, the health insurance premiums that are included in wages are subject to income tax withholding, but are not subject to social security or Medicare taxes. However, premiums treated as partnership guaranteed payments are subject to income tax, social security and Medicare taxes.
Farmer Must Not Have Been Eligible for Employer Coverage
In addition, the farmer does not qualify for the self-employed health insurance deduction for any month during the year that the farmer was eligible to participate under an employer's subsidized health plan. This includes such a plan offered by an employer of the farmer, the farmer's spouse or a dependent of the farmer in which the farmer was eligible to participate.[5]
Additional Rules on Calculating the Deduction
It is important to clearly document and identify that the health plan is "established under the business". For farmers with multiple farm businesses, documenting which business under which the health plan is established is important because the amount of the deduction for health insurance premiums is limited by the amount of SE income earned from that business.[6] The farmer cannot add the net profits of all businesses to arrive at an increased limit for the deduction of health premiums. However, if the farmer has more than one plan, each established under its respective farm or nonfarm business, the farmer may deduct the insurance premiums of each plan up to the net earnings of the farm or nonfarm business under which each plan is established.[7] Generally, the amount of SE income is the net income from the farm or nonfarm business under which the plan is established minus the deductible part of any SE tax the farmer has paid in connection with that business.
Relationship Between the Deduction and the Premium Assistance Credit Under the ACA
Farmers that obtain coverage through the Marketplace exchange may qualify for the Premium Assistance Credit (PAC) if the farmer's household income is between 100% and 400% of the federal poverty guideline.
Note. The federal poverty guideline income amount varies depending upon the number of persons in the farmer's household. For a review of the federal poverty guideline amounts for 2014 and details on the PAC, seethe September 12, 2014 farmdoc daily article.
Generally, farmers who receive a PAC will need to reduce the amount of health premiums deductible by the amount of PAC for which they are eligible.[8] This rule prevents the farmer obtaining a deduction and a credit for the same cost of coverage. An adjustment is necessary because the SE health insurance deduction reduces the farmer's income, potentially qualifying the farmer for a larger PAC. A larger PAC, however, will reduce the amount of health premium deductible. This "circular" mathematical relationship between deductible premiums and the PAC amount the farmer may qualify for will require a special mathematical adjustment to arrive at the correct amount of deductible premiums for farmers obtaining a PAC from Marketplace-obtained coverage.
Medical Expenses as an Itemized Deduction
Out of pocket medical costs for the farmer can alternatively be treated as an itemized deduction. The expenses that qualify for itemized deduction include health insurance premiums paid for health insurance. Qualified medical expenses, including health insurance premiums, claimed as an itemized deduction has three disadvantages for the farmer:
The farmer must itemize (instead of claiming the standard deduction) in order to benefit from this method of claiming health insurance premiums
The overall amount deductible is limited to the amount in excess of 10% of AGI (or 7.5% of AGI if the farmer or farmer's spouse is age 65 or older before the end of the tax year)[9]
Farmers that itemize deductions in higher-income years may face a limit on the amount of overall itemized deductions because of the phaseout rule for itemized deductions
The itemized deduction phaseout income threshold for 2014 is $254,200 for farmers with single filing status, $305,050 for married farmers filing jointly and $152,525 for married farmers filing separately.[10] While the medical expenses claimed are not directly subjected to the itemized phaseout calculation,[11] many other itemized deductions the farmer may claim may be subject to this phaseout, thereby reducing the overall benefit from itemizing.
Given these limitations associated with itemized deductions, the self-employed farmer should claim their health insurance costs under the rules for the self-employed health insurance deduction if possible. Proper planning may provide farmers with the ability to qualify under the rules for that deduction if the farmer does not already qualify. This can mean a substantial increase in the amount of health insurance premiums deductible over the amount deductible as an itemized deduction.
Farmers that qualify for the self-employment health insurance deduction may use that method to claim 100% their health insurance premiums (subject to the business income limitations mentioned) and claim all other qualifying medical expenses as itemized deductions if the farmer chooses to itemize in the year.
Small Farm Businesses Offering Coverage
If the farmer owns a business that provides health coverage to employees, the farm business may qualify for the Small Business Health Care Tax Credit. To qualify for this credit, the farmer's business must:
Employ less than 25 employees that constitute "full-time equivalents" (special counting rules exist to determine the number of employees under this rule)[12]
The average annual wages of the full-time equivalent employees (FTEs) is not greater than $50,800 for 2014 ($50,000 for 2010 through 2013)
The farm employer must be required to make a non-elective contribution for each employee enrolled in the health plan in an amount of not less than 50% of the cost of the coverage applied uniformly across employees.
If the farm employer has more than 10 FTEs or pays more than the average annual threshold level of compensation, the farm employer may still qualify for a reduced credit. Note that the special counting rules for FTEs will take into account full-time and part-time employees (so a farm business with over 25 employees may still qualify for the credit once the special counting rules are applied, especially if there are part-time employees).
Generally, in order for the farm employer to qualify for this credit, the insurance and payment arrangement must meet certain guidelines.[13] For 2014 onward, this credit may be claimed by the farm employer fortwo consecutive tax years, even for farm employers that previously qualified for and claimed this credit prior to 2014.
While the maximum credit was 35% of premiums paid by the farm employer in tax years prior to 2014, for 2014 onward the maximum credit has been increased to 50% of premiums paid. Accordingly, this credit can provide a substantial recovery in health insurance costs to a farm employer who offers coverage to employees (including the farmer).
Note that for 2014 and subsequent years, however, only health insurance coverage obtained through the Small Business Health Options Program (SHOP) exchange will qualify for this credit.
In addition, if the farm business cannot make use of the credit in a year because there is not tax liability against which the credit may be claimed, the credit is subject to a 20 year carryforward period (providing an added advantage in a later year with taxable income and tax liability). If after 20 years the credit expires without being claimed by the farm business, the farm business may claim it as a deduction in the year following the expiration year.[14] Because the farm business receives a tax credit for premiums paid, the farmer must generally reduce the amount of any health insurance premium deduction it claims by the amount of the credit obtained.
Note. While the Small Business Health Care Tax Credit may provide a significant recovery of premiums paid by the small farm business on behalf of employees in the form of tax savings, the rules are unfortunately quite complex. The small farm business may need to engage in some proactive planning to ensure it qualifies for this credit. More information on this tax credit may be found atwww.healthcare.gov/will-i-qualify-for-small-business-health-care-tax-credits/This website includes a helpful estimator for the farm business to use in determining whether it will qualify and the potential amount of the credit.
Conclusion
Farmers and small farm businesses may be facing increased health insurance costs to comply with the Affordable Care Act. Maximizing the tax savings from the health insurance premiums paid has become increasingly important for farmers and small farm businesses in the wake of the ACA. Some of the tax rules in this area are complex. The farmer should consult with their tax advisor on the best way to reduce health care costs through tax savings and proactive planning may be required for the farmer or small farm business to qualify for the best options.
References
Lovell, M. "Small Farms and the ACA."farmdoc daily(4):176, Department of Agricultural and Consumer Economics, University of Illinois at Urbana-Champaign, September 12, 2014.
