News & Analysis as of

Health Insurance Employer Group Health Plans Medicare

Bass, Berry & Sims PLC

More Losses than Gains? OIG Declines to Approve Certain Medicare Advantage Gainsharing Arrangements in Advisory Opinion 24-08

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On September 13, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published Advisory Opinion 24-08, in which it declined to approve a proposal by a Medicare Advantage organization (MAO)...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

Pullman & Comley - Labor, Employment and...

Group Health Plans and Medicare Secondary Payer Rules: Do the Mandatory Reporting Obligations Apply to You?

The Medicare Secondary Payer provisions (MSP) apply to group health plans sponsored by employers with 20 or more employees, in both the private and public sectors. MSP’s mandatory reporting requirements are designed to...more

Groom Law Group, Chartered

CAA 2023 Includes HSA Telehealth Relief, MHPAEA, Medicare, and Medicaid Changes

Last week the Senate passed the Continuing Appropriations Act, 2023 (“CAA23”).  The House of Representatives will likely consider the measure today, and President Biden is expected to sign the bipartisan measure into law...more

Venable LLP

REMINDER: October 15 Is the Deadline for Prescription Drug Notices and the Extended Deadline for Form 5500s

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Does your company's health plan provide prescription drug coverage? If so, you have until October 15, 2022 to send a notice to individuals who are enrolled in Medicare Part A or Part B and are eligible for the company's...more

Goodwin

Federal District Court Ruling May Jeopardize Insurance Coverage of More Than 50 Recommended Procedures, Screenings, and Treatments

Goodwin on

Under the Affordable Care Act, group health plans and health insurance issuers are required to provide health insurance coverage based on recommendations made by healthcare coverage professionals. The covered categories...more

Benesch

Dialysis & Nephrology Digest - July 2022

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SCOTUS sides with OH-based medical plan in dispute with DaVita over dialysis reimbursements - In a 7-2 vote, the Supreme Court ruled in favor of the Marietta Memorial Hospital Employee Benefit Plan in a case that hinged...more

Smith Anderson

ARPA COBRA Subsidy's Impact on Employer Health Plans

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The American Rescue Plan Act of 2021 (ARPA) provides temporary COBRA continuation coverage premium assistance for certain eligible qualified beneficiaries. On April 7, 2021, the Department of Labor issued a FAQ and model...more

McDermott Will & Emery

American Rescue Plan Act of 2021: Key Healthcare Provisions

On March 10, 2021, US Congress finalized and passed the American Rescue Plan of 2021 (ARPA), the latest COVID-19 relief package that largely tracks President Joe Biden’s initial $1.9 trillion proposal. The ARPA extends...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

New COVID-19 Relief Law Includes Full COBRA Premium Subsidy

The American Rescue Plan Act of 2021 (ARPA), which became law on March 11, 2021, provides a 100 percent subsidy of premiums under the Consolidated Omnibus Budget Reconciliation Act (COBRA) beginning on April 1, 2021, through...more

Sheppard Mullin Richter & Hampton LLP

Families First Coronavirus Response Act Imposes Benefit Mandates on Insurers and Group Health Plans

In a much needed sign of bipartisanship, the Senate passed and President Trump signed last night the Families First Coronavirus Response Act. The new law is effective today and requires insurers and group health plans to...more

Brownstein Hyatt Farber Schreck

Health Plan Coverage of Coronavirus Testing and Treatment

With the news about the spread of the 2019 novel coronavirus (“COVID-19”) in the U.S. and the world rapidly evolving, group health plan sponsors need to address how the plan will provide virus-related benefits. ...more

Seyfarth Shaw LLP

Deadline is Approaching for Group Health Plan Service Agreement Updates

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Seyfarth Synopsis: Recent changes to the federal rules governing confidentiality of substance use disorder (SUD) patient records may require updates to agreements between group health plans and their third-party vendors....more

Foley & Lardner LLP

Massachusetts Governor Proposes Facility Fee Ban

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Massachusetts Governor Charlie Baker has restarted the discussion on health care cost containment in the Commonwealth with a proposed bill that contains a raft of initiatives. This is the first in a series of blog posts to...more

Patrick Malone & Associates P.C. | DC Injury...

Hospital tries to stick ER nurse with $1 million in debt for her preemie’s care

It’s the price and cost problem, stupid. That’s a fictitious but new tattoo that voters might want politicians to take up as they consider the many major problems with the American health care system, especially as yet more...more

Kilpatrick

Group Health Plan Section 111 Reporting is Back

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Self-insured plan sponsors thought they had seen the last of Group Health Plan Section 111 Reporting in 2009, but like a character in a movie …… it’s baaaccckkk. ...more

Epstein Becker & Green

The Proposed Expansion of Health Reimbursement Arrangements: Is This a Game Changer for Employers?

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On October 22, 2018, in perhaps the most significant guidance resulting from President Trump’s 2017 Executive Order 13813, “Promoting Healthcare Choice and Competition Across the United States” (“2017 Executive Order”), the...more

Patrick Malone & Associates P.C. | DC Injury...

Better Healthcare Newsletter from Patrick Malone - October 2018

For Americans and their health coverage, October and November will be a time to remember. And act. The season is upon us when it pays to learn the critical facts about your current health insurance coverage and your...more

Ballard Spahr LLP

Bipartisan Budget Act of 2018 Enacts Changes to Employee Retirement and Health Benefit Plans, and Medicare

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Following a brief shutdown of the federal government, on February 9, Congress passed and President Donald J. Trump signed into law the Bipartisan Budget Act of 2018 (Budget Act), which provides Congress until March 23 to...more

Holland & Knight LLP

Senate's Updated Draft Better Care Reconciliation Act Changes Provisions Affecting Employers

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The U.S. Senate Republicans on July 13, 2017, released an updated discussion draft of the Better Care Reconciliation Act of 2017 (BCRA), its bill to repeal and replace the Affordable Care Act (ACA). As we have outlined in a...more

Poyner Spruill LLP

Cash-Out Options - Things to Consider Before Jumping In

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With the rise in health insurance costs and changing work demographics, employers nationwide are considering innovative benefit designs that are intended to not only contain costs but also provide employees greater...more

Akin Gump Strauss Hauer & Feld LLP

The Better Care Reconciliation Act of 2017 vs. The American Health Care Act: Summary of Key Differences

On June 22, 2017, Senate Republicans released a discussion draft of their proposal to repeal and replace the Affordable Care Act (ACA), titled the “Better Care Reconciliation Act of 2017” (BCRA). Beyond the title change,...more

Jones Day

Issues for Employers as Health Care Legislation Moves to the Senate

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ABSTRACT - Although the American Health Care Act, as passed by the U.S. House of Representatives, mainly affects the individual and small group health insurance markets, it has implications for large employers. The repeal of...more

Holland & Knight LLP

Passed House AHCA Bill Contains Numerous Provisions Affecting Employers

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Holland & Knight originally issued this alert in March 2017 regarding the American Health Care Act (AHCA) as it stood on that date. This client alert provides an update on the AHCA as passed by the U.S. House of...more

Eversheds Sutherland (US) LLP

ACA Brief: Path to Repeal - Revenue Provisions in the Crosshairs

This ACA Brief is the third in a series of installments that will closely track congressional and administrative actions relating to ACA provisions that impact large employer-sponsored plans. As detailed in Sutherland’s...more

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