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March 15th Update

IT Hack:  We have had two nearly identical incidents in the last few weeks.  These involved a malicious link someone clicked that then compromised the user’s email account.  It sent out spurious emails to other accounts with which the index user had previously had communications, including to addresses outside Starling.

Other changes were made in “inbox rules” so the user wouldn’t be as likely to realize the hack had happened.  It is still being investigated, including by Microsoft itself.  These incidents did not involve the EHR or any protected health information.  NPS tried to implement new filtering rules to put similar things directly into Junk Email. This is apparently tricky, and has resulted in numerous messages that aren’t Junk going to the Junk folder. Unfortunately, therefore, everyone needs to scan through his/her Junk Email folder going back to 3/4/19, and at least for the short term going forward, to be sure there isn’t anything important that has been placed in Junk that you’ve not seen.  The filtering will keep the malicious link from outgoing messages.

It is also reasonable to changes one’s password. To do so, log into Windows and hit CTRL-ALT-DELETE and you will get a screen similar to this and you can pick “change password” and follow the instructions.  Remember you’ll have to update the password on your other devices like your phone later.

Consulting work:  As mentioned in the last newsletter, Hayes is here evaluating the entirety of the Revenue Cycle Department. We anticipate they will be done in another several weeks, and the results will then be made available to the partners. Additionally, the whole IT/NPS company has an upcoming evaluation anticipated to start the first week of April by a company called HCI (

Financial statements: Obviously, the current statements visible in qlikview are lacking in many respects. At present, the plan is to manually improve them and distribute the reconfigured version for the 1st quarter 2019 close so that the partners can more easily view the data. It is likely, but no promises, that for second quarter 2019 we will have completed the work to migrate to the new software that will have an intuitive statement (this is part of one of the consulting jobs mentioned above).  There may be a few departments that are asked/invited to help with a “beta version” of the new statement for this first quarter, too, to verify that it shows what the physicians want to see and is in fact intuitive.

Car allowances: The Finance committee led by Dr. Chris Russo is working on additional benefits we can pursue as partners in Starling.  We will soon be able to institute a “car allowance” which will allow us to deduct expenses for autos in a new manner (other than mileage) that should allow many partners to save more money on taxes. We are hoping to get this operational for first quarter end, and we will disseminate the necessary information as soon as available.

Retirement plan:  The 401k portion of our retirement can have pre- or post-tax contributions. Post-tax are known as “Roth” contributions.  The advantage of them is that although one pays the income taxes before putting the money in the account, it then grows tax-free and withdrawals later are not taxed, whereas regular retirement account withdrawals are considered income tax in the year they are withdrawn.  You can have a mix of both types of account.  (Deciding which you want can be complicated and involves making guesses about what tax brackets may exist after your retirement.  It is a good thing to discuss with a retirement professional if you have one and aren’t completely comfortable with the decision yourself). The Profit Sharing portion of our retirement program cannot be directly made post-tax; however, it is possible to do a “Roth conversion” once the money is in the account, which accomplishes the same thing (don’t ask me why, I don’t make the rules).  You can do this two ways.  One is to just call T Rowe Price at 1-800-922-9945 and speak to someone who can walk you through the process.  It can also  be done online:  sign into your account, go to the “Transactions” tab on the top, and there will be a choice for “in-plan Roth conversion.” Also be aware that it seems some profit sharing contributions might be called “employer non-elective” contributions, just to make it more opaque……I haven’t yet done the process but will update everyone if any other nuances become apparent after doing it.