Health Insurance Dept. of Health and Human Services

News & Analysis as of

Manatt on Health Reform: Weekly Highlights - June 2015 #5

Topping the news, last week's King v. Burwell ruling preserved subsidies for the 6.7 million people receiving them through the federal marketplace. In other news, President Obama pledged renewed efforts to work with...more

Washington Healthcare Update

This Week: Leading Up to the SCOTUS King v. Burwell Decision... House Votes to Repeal the Medical Device Tax... CMS Announces It Will Bolster Transitional Reinsurance Payments... MedPAC Releases June Report to Congress....more

Agencies issue proposed regulation on summary of benefits and coverage and uniform glossary

In December of 2014, the Employee Benefits Security Administration of the Department of Labor (“DOL”), the Internal Revenue Service (“IRS”) and the Department of Health and Human Services (“HHS”) (collectively, the...more

Alert: Health Plan Update on Out-of-Pocket Limitations

The Affordable Care Act (the “ACA”) established limitations on the annual out-of-pocket costs that a health plan may impose on a participant. The U.S. Department of Health and Human Services, Department of Labor and the...more

Agencies Clarify Cost-Sharing Limits Under the Affordable Care Act

The U.S. Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the Departments) have issued a set of Frequently Asked Questions (FAQs) clarifying the limitations on cost sharing under...more

Washington Healthcare Update

This Week: House Ways & Means Committee Holds Markup; Makes Significant Legislative Changes to Health Care Bills... Senate Finance Committee Holds Markup on Medicare Appeals Process Bill... CMS Issues Final Rule on...more

Monthly Benefits Alert - May 2015

As we do every month, we have provided below a comprehensive alert that highlights the most important employee benefits legal developments during May of 2015. We hope that our “Monthly Benefits Updates” continue to be a...more

HHS Solicits Comments on Use of Health Plan Identifier in E-Health Transactions

Today HHS published a request for public comments regarding the health plan identifier (HPID), including the requirements regarding health plan enumeration, and the requirement to use the HPID in electronic health care...more

New Guidance on Cost-Sharing Limits and Provider Nondiscrimination Rules

The U.S. Departments of Labor, Health and Human Services, and the Treasury have jointly issued a new set of FAQs that clarifies the application of the rules establishing cost-sharing limits. For 2016, non-grandfathered group...more

Employer Paid Individual Health Insurance Policies Create the Potential for Significant Penalties, But Limited Relief Is Available

Despite guidance from the Internal Revenue Service (“IRS”), the Department of Labor (“DOL”) and the Department of Health and Human Services (“HHS”) indicating the prohibition of the practice under the Affordable Care Act...more

EEOC Proposes Regulatory Clarification on the Application of the ADA to Employer Wellness Program Incentives

Action Item: Employers who already have, or are considering implementing, wellness programs that involve cost-sharing reductions or other financial incentives for participants should carefully review their programs given the...more

Guidance Clarifies Preventive Care Requirements

Recent guidance issued jointly by the U.S. Departments of Labor, Health and Human Services, and the Treasury clarifies how the Affordable Care Act's requirement to provide cost-free coverage for preventive care applies to...more

Medigap Insurer's Contract with Preferred Hospital Network Approved (Yet Again)

On April 22, 2015, the Department of Health and Human Services, Office of Inspector General (OIG) issued Advisory Opinion 15-05 [PDF], approving a Medigap insurer’s proposed contract with a preferred hospital network. The...more

New Regulations Permit Employers to Offer Limited Wraparound Health Coverage as Excepted Benefit - McGuireWoods Healthcare Reform...

This is the 48th in a series of WorkCite articles concerning the Patient Protection and Affordable Care Act and its companion statute, the Health Care and Education Reconciliation Act of 2010 (referred to collectively as the...more

Blog: Colorado Pharmacy Reaches HIPAA Settlement with OCR Following Improper Records Disposal

Yesterday, the U.S. Department of Health and Human Services’ Office for Civil Rights (“OCR”) announced that Cornell Prescription Pharmacy of Denver, Colorado (“Cornell Pharmacy”) has agreed to settle potential violations of...more

HHS releases HIPAA guidance on workplace wellness programs

The Department of Health and Human Services (HHS) recently issued guidance on “HIPAA Privacy and Security and Workplace Wellness Programs.” The guidance helps employers determine whether or not the health information it may...more

Innovation Waivers: An Opportunity for States to Pursue Their Own Brand of Health Reform

Abstract - States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by...more

Healthcare Legal News Volume 5 Number 2

According to a recent study by Accenture, by 2017 approximately 18 percent of the American public will purchase insurance through exchanges versus relying on traditional employer healthcare coverage or foregoing insurance...more

New HHS Regulations “Clarify” that Health Plans Covering Families Must Have “Embedded” Individual Cost-Sharing Limits

On February 27, 2015, the Department of Health and Human Services (HHS) released its final HHS Notice of Benefit and Payment Parameters for 2016. The lengthy regulation covers a wide range of topics affecting group health...more

Health Care Update - March 2015

In This Issue: - King v. Burwell before the Supreme Court and the Potential Congressional Response - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional...more

OIG Announces Plans for Health Reform Oversight Activities

On February 24, 2015, the HHS Office of Inspector General (OIG) released its “Health Reform Oversight Plan” for FY 2015, which describes the OIG’s current and planned efforts to oversee the implementation and management of...more

Manatt on Health Reform: Weekly Highlights - February 2015 #4

Wrapping up the 2015 enrollment period, Healthcare.gov and State-based Marketplaces in seven states have announced special enrollment periods (SEPs) for people who were uninsured in 2014 and discover they owe a “shared...more

Supplemental Excepted Benefits? “It depends.”

Last week, HHS, along with the Department of Labor and the Treasury, provided long overdue guidance regarding the third category of supplemental “excepted benefits” as defined by Section 2791 of the Public Health Services...more

Health Care Update - February 2015 #2

In This Issue: - Open Enrollment Update - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other Health Care News -...more

Washington Healthcare Update

This Week: Energy and Commerce Hearing Examines ICD-10 Preparedness... HHS Announces Oncology Care Model Initiative... Pennsylvania Governor Abandons Alternative Medicaid Expansion Approach for Traditional Plan....more

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