Health Insurance Dept. of Health and Human Services

News & Analysis as of

Colleges/Universities Granted Extended Relief for Premium Reductions in Connection with Student Health Insurance

The Departments of Labor, Health and Human Services and the Treasury (collectively, the “Departments”) on Friday extended enforcement relief, via publication of FAQs About Affordable Care Act Implementation Part 33 (“FAQs”),...more

January 1st is Quickly Approaching – Have you Reviewed your Health Plan for Section 1557 Compliance?

Earlier this year the U.S. Department of Health and Human Services (“HHS”) finalized regulations that implement Section 1557 of the Affordable Care Act (“Section 1557”). You can read our prior discussions of these regulations...more

Section 1557 of the Affordable Care Act: Implications for Health Care Providers and Health Insurers

Section 1557 of the Affordable Care Act (the “ACA”) prohibits discrimination on the basis of race, color, national origin, sex (including gender identity), age, or disability under any health program or activity that receives...more

Student Health Insurance Plans and the ACA: Agencies Provide Enforcement Relief that Allows Colleges and Universities to Continue...

Late last week, the Departments of Labor (“DOL”), Health and Human Services (“HHS”) and the Treasury (collectively, the “Agencies”) issued a very welcome FAQ that will allow higher education institutions to continue...more

Temporary Relief for Certain Student Health Plans Extended Indefinitely

In recently issued guidance, the U.S. Departments of Treasury, Labor, and Health and Human Services indicated that they will indefinitely extend relief to colleges and universities that subsidize the cost of individual...more

Employer Obligations Under New Nondiscrimination Rules: ACA Section 1557 and Requirements for Federal Contractors

Two new regulations require some employers to make health plan design and administrative changes. While not all employers are subject to these requirements, those who are will need to review their plans and be aware of other...more

Continuing Assaults on Surprise Out-of-Network Bills

California struck the most recent blow against surprise out-of-network medical bills. Surprise bills are different from the bills you get when you knowingly choose an out-of-network provider. Those are painful, but they...more

Manatt on Health Reform: Weekly Highlights - October 2016

Vermont moves closer to launching the country’s first all-payer ACO; CMS approves Arizona’s 1115 waiver extension but rejects the State’s proposed work requirement and premiums for those earning below the FPL; and CMS issues...more

Hot Topics in Employer Health Benefits

As we start looking forward to 2017, and as many employers head into annual enrollment periods this fall, employers need to be aware of recent changes in the law that have a significant impact on health benefit plans. This...more

A Deeper Dive: Employers Receiving Federal Funding May Be Subject to ACA’s Nondiscrimination Rule and Need to Cover Transgender...

In recent months, we have written a fair amount about providing transgender benefits in light of the nondiscrimination provisions of the Affordable Care Act. Our blogs of March 30, 2016 and June 22, 2016 highlight the key...more

The Risk Corridors End Game

Since the first cases were filed earlier this year, we have been following nationwide litigation seeking full risk corridors payments to qualified health plans (QHPs) providing coverage on the Affordable Care Act (ACA)...more

Hospital and Fixed Indemnity Policies; Excepted Benefits; Supplemental Coverage under Recently Proposed Treasury Regulations; and...

We reported in a recent post on proposed regulations dealing with, among other things, the treatment of hospital indemnity or other fixed indemnity insurance products in the group market. This post takes a closer look at the...more

We Received an Exchange Subsidy Notice…Now What?

The Affordable Care Act exchanges/marketplaces are required to notify employers of any employees who have been determined eligible for advance payments of the premium tax credit or cost-sharing reductions (i.e., subsidy) and...more

HHS Final Rule Extends Anti-Discrimination Protection to Transgender Patients

This past May, the Department of Health and Human Services (HHS) issued a final rule implementing Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin,...more

Employers Beware – Marketplace Notices Under the Affordable Care Act May be Coming to You

As we have previously explained, certain employers with 50 or more full-time employees (or equivalents) will incur a penalty from the IRS if they fail to offer health insurance coverage to their full-time employees and their...more

Manatt on Health Reform: Weekly Highlights - August 2016

Oregon’s hospitals see improved financial performance following the ACA; CMS denies Indiana’s request for an additional lockout period in the Medicaid expansion program; and a new Manatt Health report details Medicaid funding...more

Anti-Discrimination, Language Access Rules Compliance Deadline Fast Approaching for Health Insurers

Health insurers and HMOs have a limited time to review the new federal meaningful access rules and amend plan documents accordingly. However, many payors still have not revised their plans to include the required language,...more

Health Update - July 2016

The Vulnerability of Healthcare Information - According to a report the Brookings Institute issued in May 2016, 23% of all data breaches occur in the healthcare industry. Nearly 90% of healthcare organizations had some...more

Addressing the Opioid Crisis

Following the July 13 U.S. Senate's passage of Comprehensive Addiction and Recovery Act (CARA), providers, families and communities should evaluate the act's impacts. The reform, S. 524, is viewed as a comprehensive approach...more

DC Circuit strikes down HHS regulation regarding fixed indemnity plans

On July 1, 2016, in the case of Central United Life Insurance Company v. Burwell (No. 15-5310), the US Court of Appeals for the District of Columbia Circuit ruled that the US Department of Health and Human Services (HHS)...more

More Clarity on Expatriate Health Plans and the ACA

Expatriate health plans have been surprisingly difficult to reconcile with the Affordable Care Act (ACA). Proposed regulations set to take effect in 2017 provide some useful guidance to U.S. employers that sponsor expatriate...more

Injunction Enjoining Enforcement of HHS Attestation Rule Affirmed

The Court of Appeals for the District of Columbia affirmed the District Court’s decision in Central United Life v. Burwell on July 1, 2016. This decision is very significant for those assessing the future strength of, and...more

Major Changes To Nondiscrimination Requirements Under ACA Effective Soon: Are Covered Entities Ready?

The HHS Office of Civil Rights (“OCR”) published a final rule May 18, 2016, broadening the nondiscrimination requirements applicable to all health programs and activities receiving federal financial assistance from HHS, those...more

Manatt on Health Reform: Weekly Highlights - June 2016 #5

Kentucky proposes premium assistance and high deductible health plans to cover expansion enrollees under an 1115 waiver; New York Legislature expresses unanimous support for a reimbursement increase for safety-net hospitals;...more

HHS Issues Final Rule On Nondiscrimination In Health Programs And Activities

On May 18, 2016, the United States Department of Health and Human Services ("HHS") Office for Civil Rights ("OCR") issued a Final Rule implementing Section 1557 of the Affordable Care Act ("ACA"), which prohibits...more

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