Health Care Reform Legislation Guidance Issued


The Internal Revenue Service, the Department of Labor, and the Department of Health and Human Services issued another set of interim final rules for group health plans and health insurance coverage in the individual and group markets under the recent health care legislation (the “Rule”). The Rule sets forth the requirements for complying with the preexisting condition exclusions, lifetime and annual limits, rescissions, and patient protections under the legislation.

Topic include:

• Preexisting Condition Exclusions

• Lifetime and Annual Limits

• Program for “Mini-Medical”Plans

• Prohibitions on Rescissions

• Patient Protections

• Designation of primary care provider

• Designation of pediatrician as primary care provider

• Patient access to obstetrical and gynecological care

• Coverage of Emergency Services

• Conclusions

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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