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Health Insurance Department of Health and Human Services (HHS) Insurance Industry

McDermott Will & Emery

Six Wishes for the Forthcoming Final Regulations Under MHPAEA

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On July 1, 2024, the US Department of Labor (DOL) submitted final regulations to the Congressional Budget Office (CBO), implementing the Mental Health Parity and Addiction Equity Act (MHPAEA) as most recently amended by the...more

McDermott+

Regs, Regs and More Regs: The Biden Administration Releases Spring 2024 Unified Agenda

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We are in the midst of a storm of regulations that are being released by the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS), including the Calendar Year (CY) 2025...more

Hall Benefits Law

HHS Issues Proposed Rule on Nondiscrimination in Health Programs and Activities

Hall Benefits Law on

The U.S. Department of Health and Human Services (HHS) has issued a proposed rule entitled “Nondiscrimination in Health Programs and Activities.” The proposed rule, designed to advance health equity and protect people from...more

Sheppard Mullin Richter & Hampton LLP

OIG Sparks Public Excitement about Managed Care and Alludes to Incoming Enforcement Guidance

“The American people deserve to know that the insurance companies receiving more than $700B annually in taxpayer funds are working to ensure you receive effective, high-quality care. Remember, you have rights and options to...more

ArentFox Schiff

NYS Insurance Regulators to Health Insurers: Ensure Your Networks Are Adequate

ArentFox Schiff on

On February 21, Superintendent Adrienne A. Harris of the New York State Department of Financial Services (DFS) unveiled a proposed regulation, 11 NYCRR 38. If adopted, this regulation, would establish network adequacy...more

McDermott Will & Emery

Discerning Congressional Purpose from the Proposed MHPAEA Regulations Comment Letters

McDermott Will & Emery on

We continue our investigation of proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) issued by the US Departments of Labor, Health and Human Services and the Treasury (the Departments)...more

McDermott Will & Emery

The ‘Data Evaluation Requirement’ for NQTLs Under the Newly Proposed MHPAEA Regulations

Last week’s post examined the “no more restrictive” requirement that would apply to non-quantitative treatment limitations (NQTLs) set out in recently proposed regulations under the Mental Health Parity and Addiction Equity...more

McDermott Will & Emery

Short-Term, Limited Duration Insurance: How Long is Too Long?

McDermott Will & Emery on

On July 7, 2023, the US Departments of Health and Human Services, Labor, and Treasury (collectively, the departments) released a Notice of Proposed Rulemaking (NPRM) and Fact Sheet that proposes to revise the definition of...more

Zuckerman Spaeder LLP

Whither Insurance Coverage for Preventive Health Services? District Court Decision Striking Down Affordable Care Act’s Preventive...

Zuckerman Spaeder LLP on

On May 15, 2023, the Fifth Circuit temporarily stayed a district-court ruling that struck down a key part of the Affordable Care Act (ACA). As a result of the stay, the ACA’s health insurance coverage requirements for...more

Akin Gump Strauss Hauer & Feld LLP

Updates in Co-Pay Assistance and Accumulators Litigation

Key Points - A new legal challenge to OIG on Medicare Beneficiaries’ ability to receive co-pay assistance has emerged. The Supreme Court has been asked to review HHS’s prohibition of co-pay assistance programs under the...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

Manatt, Phelps & Phillips, LLP

Federal Regulators Issue Joint Report on MHPAEA Signaling Increased Enforcement Against Plans Likely

On Tuesday, the U.S. Departments of Labor, Health & Human Services, and the Treasury (the Departments) issued their joint report to Congress on the Mental Health Parity and Addiction Equity Act (MHPAEA). The Consolidated...more

Sheppard Mullin Richter & Hampton LLP

Tri-Agencies Release Guidance on Coverage of OTC COVID-19 Tests

On January 10, 2022, the U.S. Department of Health & Human Services, Department of Labor, and the Treasury (“Tri-Agencies”) published guidance about how health plans and health insurance issuers must reimburse OTC COVID-19...more

Foley & Lardner LLP

Federal Government Publishes an Interim Final Rule (Part 1) Implementing the No Surprises Act

Foley & Lardner LLP on

Over the last several years, both the federal government and a number of state legislatures have sought to find a solution to the billing by out-of-network providers, referred to as “Out of Network Billing” (OON Billing) and...more

Sheppard Mullin Richter & Hampton LLP

New Guidance on Health Plans’ COVID-19 Coverage Obligations

On February 26, 2021, the Departments of Labor, Health and Human Services (HHS), and the Treasury issued Frequently Asked Questions (FAQs) on the implementation of the Families First Coronavirus Response Act (“FFCRA”), the...more

Holland & Hart - Health Law Blog

Free COVID-19 Vaccines and Diagnostic Testing

Over a year after the declaration of a nationwide public health emergency due to the Coronavirus Disease 2019 (“COVID-19”) pandemic, providers are in a position to offer patients a variety of COVID-19 medical services,...more

Faegre Drinker Biddle & Reath LLP

Considerations for Entry or Reentry Into the Individual Health Insurance Market

Many health insurers and HMOs may be considering entering or reentering the individual health insurance market, either on or off a federal or state-based health insurance marketplace. Over the last two years, the individual...more

Seyfarth Shaw LLP

Supreme Court Rules Government Must Pay $12 Billion to Health Insurers Under ACA Risk Corridor Program

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On April 27, 2020, the US Supreme Court ruled by an 8-1 decision that the federal government must pay billions of dollars to health insurers who sold consumer policies on exchanges under the Affordable Care Act’s (“ACA”)...more

Stoel Rives LLP

COVID-19 Relief Legislation Contains Testing Mandate

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In the second major piece of legislation responding to the novel coronavirus (COVID-19) pandemic, the President signed the Families First Coronavirus Response Act (“Act”) into law on March 18, 2020....more

Bass, Berry & Sims PLC

Trump Administration Proposes Transparency Rule for Group Health Plans and Insurers

Bass, Berry & Sims PLC on

On November 15, 2019, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the Departments), unveiled a proposed rule (scheduled to be published on November...more

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

Will Rx drug costs fall if U.S. puts squeeze on middlemen and curbs rebates?

The Trump Administration has put out its latest prescription to try to slash out-of-control prescription drug prices: Officials want to call medication “rebates” what they say they’ve really become — “kickbacks” — and crack...more

Schwabe, Williamson & Wyatt PC

Texas Federal District Court Opines That the Affordable Care Act Is Invalid in Its Entirety: Where Does It Go from Here?

On December 14, 2018, a federal judge in Texas, in response to a lawsuit brought by 20 Republican states, issued a judgment opining that the Affordable Care Act (“ACA”) is invalid in its entirety. That is a very sweeping...more

Sheppard Mullin Richter & Hampton LLP

The Risk Corridor is Closed: Insurers Seek Recourse in the Federal Circuit

On July 30, 2018, two insurers – Moda Health Plan, Inc. (“Moda”) and Land of Lincoln Mutual Health Insurance Company – petitioned the U.S. Court of Appeals for the Federal Circuit to reconsider the Court’s June 14, 2018...more

Holland & Knight LLP

HHS Issues Final Rule Expanding Short-term Health Plans

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On Aug. 1, 2018, the Departments of Health and Human Services (HHS), Labor and Treasury jointly issued the Short-Term, Limited-Duration Insurance Final Rule. The rule is the second of three regulations resulting from...more

Holland & Knight LLP

Health Insurers Take Hit From Appeals Court Ruling on ACA's Risk Corridor Program

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• Health insurers seeking payment under the Affordable Care Act's Risk Corridor Program were dealt a blow following a recent U.S. Court of Appeals for the Federal Circuit ruling that reversed an earlier decision against the...more

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