News & Analysis as of

Employee Benefits Health Care Providers

Baker Donelson

Health Plan Compliance Concerns for Year-End 2024

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As employers look toward open enrollment for their group health plans, now is a good time to review action items needed for those plans by year-end, as well as upcoming deadlines in the near future. While fully-insured health...more

Ballard Spahr LLP

Health Plan Compliance Deadlines Draw Near

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Regulations under Section 1557 of the Affordable Care Act and HIPAA will require health plans and health care providers to take action in the coming months to meet new requirements. Health plan sponsors and providers that...more

Ballard Spahr LLP

Fifth Circuit Affirms Invalidity of No Surprises Regulations

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The Fifth Circuit Court of Appeals has affirmed the invalidity of regulations governing the independent review process under the No Surprise Billing Rules....more

Hall Benefits Law

9th Circuit Explains ERISA Preemption of State Law Claims Arising from Preservice Coverage Communications

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The U.S. Court of Appeals for the Ninth Circuit recently issued an opinion with critical implications for the healthcare industry. This court decision clarifies the expansive reach of the Employee Retirement Income Security...more

Fisher Phillips

Don't Forget About ERISA in Your Health Plan’s Cybersecurity Efforts: Important Reminders for Plan Fiduciaries in the Wake of...

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Earlier this year, a cyberattack on a leading healthcare claims processing provider had an unprecedented impact on patients and healthcare providers across the country. While group health plans were not directly targeted in...more

Hall Benefits Law

Biden’s Proposed FFY 2025 Budget Seeks Mental Health Access Expansion

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The Biden administration unveiled its FFY 2025 budget, which calls for $7.3 trillion in spending. In the proposed budget, Biden maintains his pledge to focus on expanding and transforming the nation’s mental health system. He...more

Carlton Fields

[Event] The Heartbeat of Innovation: Tampa's Medical District Initiative - June 4th, Tampa, FL

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Inspired by renowned medical districts in the nation’s greatest cities, Tampa General Hospital and USF Health Morsani College of Medicine have partnered with the Tampa Bay Economic Development Council to create a life...more

Akerman LLP - Health Law Rx

Attention, Group Health Plans: New HIPAA Privacy Rule Governing Reproductive Health Care Information Imposes Obligations,...

It is critical for employers and plan fiduciaries/administrators to stay informed of HIPAA privacy and security-related legal developments because most employer sponsored group health plans — regardless of the employer’s...more

Bricker Graydon LLP

The Health Plan Fiduciary Maze: New Lawsuit Highlights Need to Navigate Carefully in the Era of Transparency

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Earlier this month, a Mayo Clinic employee filed a proposed class action against the clinic, arguing that the clinic’s employee health plan and its third-party administrator (TPA) Medica, underpaid for services performed by...more

McDermott Will & Emery

CMS Issues Guidance on Usage of AI in Making Coverage Determinations

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On February 6, 2024, the US Centers for Medicare & Medicaid Services (CMS) issued a letter to all Medicare Advantage (MA) organizations and Medicare-Medicaid plans. The letter covered frequently asked questions and answers...more

Polsinelli

Florida Legislative Session 2024: Health Care Highlights

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The Florida Regular Legislative Session began on January 9, 2024, and ended on March 8, 2024. Below is a summary of relevant health care laws that will be effective July 1, 2024, if they are approved by Governor DeSantis....more

Seyfarth Shaw LLP

Employers Consider Post-Dobbs Playbook in Dealing with Alabama Ruling on IVF Treatments

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Seyfarth Synopsis: Last week, the Alabama Supreme Court ruled that cryogenically frozen embryos are children and are protected from destruction under state law. This is the latest in a series of post-Dobbs judicial rulings...more

Woodruff Sawyer

An Employer’s Guide to Long-Term Care Insurance

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Research shows that 70% of Americans may need long-term care at some point in their lives. Although that need is greatest for older adults, anyone at any age may suffer an accident or illness that results in the need for...more

Seyfarth Shaw LLP

Wellness Apps and Privacy

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Employers looking to enhance their suite of employee benefit programs, and focused on lessons learned during the pandemic on wellbeing, are interested in providing greater access to wellness tools. And, the vendors who...more

Hall Benefits Law

Health Care Stakeholders Support Passage of The Value in Health Care Act

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Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care...more

Dickinson Wright

Top Issues in Negotiating Physician Employment Agreements

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Originally published in Healthcare Michigan, Volume 40,  No. 12 - Successful negotiation of physician employment agreements requires a careful balance of the objectives of the prospective employer with those of the...more

McDermott Will & Emery

New MHPAEA Guidance Regarding NQTLs: Network Access and Composition

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Recently proposed regulations attempt to ensure that health plans allow access to mental health or substance use disorder (MH/SUD) benefits as easily as medical or surgical (M/S) benefits. The proposed regulations, issued by...more

Foley & Lardner LLP

High Deductible Health Plan First Dollar Coverages in Flux

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A recent string of lawsuits, regulatory guidance, and market trends have dramatically impacted the types of services that enjoy first dollar coverage under high deductible health plan (HDHP) and health savings account (HSA)...more

Ballard Spahr LLP

Gag-Clause Attestations Due by End of Year

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Summary - By December 31, 2023, health plans and insurers must submit an attestation of compliance with the anti-gag rules of the Consolidated Appropriations Act, 2021 (CAA). The rules apply to all agreements entered into...more

Woodruff Sawyer

What to Consider When Choosing a Mental Health Solution for Your Employee Benefits Program

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Untreated mental health challenges can have a direct impact on how well employees perform at work—and the number of employees affected is rising. In 2021, 48% of employees said their mental health affected their work. That...more

Jackson Walker

Frequently Asked Questions Part 60 Under the Affordable Care Act Issued

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As employers work toward annual enrollment and new service contracts for their health plans, it is key to remember one of the changes to enhance disclosure to individuals contained in the “No Surprises Act” and Transparency...more

Stoel Rives - Health Law Insider®

Washington’s Law Regulating Health Care Benefit Managers Is Broad and Complex

Washington’s law regulating “health care benefit managers” (“HCBMs”) went into effect on January 1, 2022. Although Washington’s regulatory scheme for HCBMs has some similarities with how other states regulate “third party...more

McDermott Will & Emery

Top Takeaways | Specialty Spotlight: Women’s Health and Fertility

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In this session, Brian Hall, a partner in McDermott’s Healthcare practice group, moderated a panel to discuss the opportunities for growth and investment in the women’s health and fertility space....more

Ballard Spahr LLP

Court Invalidates Certain Preventive Care Requirements

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Summary - Health plans and insurance policies may no longer be required to cover the full cost of preventive care that carries an A or B rating by the U.S. Preventive Services Task Force (USPSTF), following a recent ruling...more

Stoel Rives - Health Law Insider®

Telehealth Safe Harbor Extended

High deductible health plan (“HDHP”) sponsors take note: the Continuing Appropriations Act, 2023 (“CAA23”) temporarily extends the flexibility for HDHPs to provide pre-deductible coverage of telehealth services without...more

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