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Health Insurance Employer Group Health Plans 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

Hall Benefits Law

HHS Updates HIPAA Privacy Rule to Protect Reproductive Healthcare Privacy: What Group Health Plans Need to Know

Hall Benefits Law on

The U.S. Department of Health and Human Services (HHS) has issued a final rule that modifies the Standards for Privacy of Individually Identifiable Health Information (“the Privacy Rule”) under the Health Insurance...more

Kilpatrick

Changes to the HIPAA Privacy Rules – A Primer for Self-Insured Group Health Plans

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The Office for Civil Rights (“OCR”) of the US Department of Health and Human Services recently released a final rule (“Final Rule”) to update the HIPAA Privacy Rules for reproductive health care information. The Final Rule...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

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

Manatt, Phelps & Phillips, LLP

Examining the Financial Structure and Performance of Rhode Island’s Acute Hospitals and Health Systems

This study summarizes research conducted on behalf of the Rhode Island Foundation and partner organizations in early 2024....more

Stevens & Lee

Gag Clause Prohibitions in ERISA, the Internal Revenue Code and the Public Health Service Act

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If you work for or represent group health plans or issuers of group health plans, it is important that you take a look at the contracts they have with health care providers before the end of 2023. The Internal Revenue Code...more

Dorsey & Whitney LLP

What risks do employers face by excluding coverage for gender affirming care in their health plans?

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In recent years, courts have ruled upon a growing number of cases arising from delivery of and payment for gender affirming care. At the same time, state legislatures have passed a variety of laws aimed at such services. ...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

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

McAfee & Taft

How changes to the “family glitch” affect workplace health plans

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The IRS finalized new rules that change eligibility requirements for the premium tax credit (PTC) created under the Affordable Care Act. It is now easier for an employee’s family members to enroll in subsidized health...more

Morgan Lewis - ML Benefits

New and Updated Women’s Preventive Health Services Guidelines Apply in 2023

The Affordable Care Act (ACA) requires non-grandfathered group health plans (and insurers) to provide coverage for certain preventive health services for all adults, women, and children. Preventive services covered under the...more

Mintz - Employment Viewpoints

HHS, Treasury and Labor Issue More Guidance on the No Surprises Act

Title I of Division BB of the Consolidated Appropriations Act, 2021 (the “Act”), and interim final rules issued by the Departments of Health and Human Services, Treasury and Labor (the “Departments”) in July 2021 (see our...more

FordHarrison

Transparency in Coverage Requirements – Compliance Deadline Approaching

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Summary: For Health Plans, Machine-Readable Files, containing in-network provider charges and out-of-network allowed amounts and billed charges, must be posted on a public website by July 1, 2022....more

Jackson Lewis P.C.

Court Strikes Down a Portion of the No Surprises Act Interim Regulations

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While health plans, insurers, and providers are busy understanding and implementing the new requirements under the No Surprises Act, a U.S. District Court recently vacated an essential portion of the interim regulations...more

Verrill

Surprise Medical Bills: Texas District Court Vacates Portion of Independent Dispute Resolution (IDR) Process in Agency Rule

Verrill on

The U.S. District Court for the Eastern District of Texas recently vacated a portion of the Requirements Related to Surprise Billing, Part II, Interim Final Rule (the “Rule”) regarding the independent dispute resolution (IDR)...more

Manatt, Phelps & Phillips, LLP

The Manatt State Cost Containment Update - February 2022: Health Data Corner

The Health Data Corner compiles the latest state health care data capacity innovations and policy developments, and showcases select, novel data use cases emerging from states....more

McAfee & Taft

Big surprises in the No Surprises Act

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In one of the biggest attempts by the federal government to combat surprise medical billing, Congress in late 2020 passed the No Surprises Act (NSA), which imposes a host of new transparency and coverage requirements for...more

Robinson+Cole Health Law Diagnosis

New COVID-19 At-Home Test Coverage Requirements Increase Need for Heightened Focus on Health Care Entity’s Billing Practices

I. Biden Administration Requirement for Insurance Companies to Cover Cost of At-Home COVID-19 Tests - On January 10, 2022, the U.S. Department of Health and Human Safety (HHS) announced that the Biden-Harris...more

Locke Lord LLP

Don't Get Caught Off Guard – New Rules Established by the No Surprises Act

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In December 2020, Congress adopted the Consolidated Appropriations Act, 2021 (the “CCA”), which includes a special rule — the “No Surprises Act” — that is designed to protect consumers from surprise medical bills for...more

Fisher Phillips

Departments Delay Enforcement of Transparency Disclosure Requirements

Fisher Phillips on

Group health plan sponsors soon will face daunting new disclosure and transparency requirements under multiple laws including the Affordable Care Act (ACA), the No Surprises Act (the Act) and the Consolidated Appropriations...more

Snell & Wilmer

Not All Surprises Are Good – Phase I of the Surprise Billing Rules

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On July 1, 2021, the Office of Personnel Management, Department of the Treasury, Department of Health and Human Services (“HHS”), and Department of Labor (collectively the “Departments”) issued the interim final rule...more

Dorsey & Whitney LLP

HHS Gives Guidance to Providers on the No Surprises Act in Interim Final Rule

Dorsey & Whitney LLP on

On July 1, 2021, the Department of Health and Human Services (HHS), along with other federal agencies, released an interim final rule implementing certain provisions of the No Surprises Act. The No Surprises Act aims to...more

Holland & Knight LLP

HHS Issues Interim Final Rule Implementing Certain Provisions of the No Surprises Act

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The U.S. Departments of Health and Human Services (HHS), Labor and Treasury, along with the Office of Personnel Management, on July 1, 2021, issued a much-anticipated Interim Final Rule with Comment Period (IFC) –...more

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