News & Analysis as of

Health Plan Sponsors

Revised Draft 2018 Medicare Marketing Guidelines Open For Comment

Last week, CMS published the Revised Draft 2018 Medicare Marketing Guidelines and requested feedback from all interested parties. The draft includes many small changes to the Marketing Guidelines, including but not...more

Health Care Reform in Transition While Congress Deliberates

by Ballard Spahr LLP on

Changes are imminent for the Affordable Care Act and a range of other laws and regulations affecting the health care industry. Ballard Spahr attorneys established a Health Care Reform Initiative in 2008 to monitor and analyze...more

CMS Releases Plan for Expanded Monitoring of Medicare Advantage and Part D Appeals and Grievances

by McDermott Will & Emery on

In Depth - The Centers for Medicare & Medicaid Services (CMS) recently announced that it will monitor—beginning in January 2017—Part C and D appeals timeliness on an industry-wide basis. Under this initiative, all...more

IRS Announces Employee Benefit Plan Limits for 2017

by McDermott Will & Emery on

The Internal Revenue Service recently announced the cost-of-living adjustments to the applicable dollar limits for various employer-sponsored retirement and welfare plans for 2017. Although some of the dollar limits currently...more

HHS Releases HIPAA Privacy and Security Audit Guidelines as it Starts its Second Round of Audits and Continues Enforcement Efforts

by Winstead PC on

During April 2016 the Department of Health and Human Services (“HHS”) posted lengthy audit guidelines for HIPAA Privacy and Security on its website (over 400 pages). As HHS starts its audits of health care providers, health...more

CMS Issues Final 2017 Medicare Advantage Capitation Rates and Medicare Advantage/Part D Payment Policies

by Reed Smith on

CMS has issued its final 2017 Medicare Advantage (MA) and Part D Rate Announcement and Call Letter, which includes a series of policy and payment changes related to these programs. CMS estimates that the final policies will...more

Congressional Health Policy Hearings - April 2016

by Reed Smith on

The Senate Special Committee on Aging recently held a hearing on the status of efforts to find a cure for Alzheimer’s disease, and the panel plans an April 27, 2016 hearing to examine prescription drug price increases....more

The ERISA Litigation Newsletter - March 2016

by Proskauer Rose LLP on

Editor’s Overview - This month we review the U.S. Supreme Court’s decision in Montanile v. Board of Trustees of National Elevator Industries Health Benefit Plan where the Supreme Court considered the scope of...more

Recent Government-Issued FAQs Cause Plan Sponsors to Clarify Preventive Care and Wellness in Health Plan Communications

by McDermott Will & Emery on

On October 23, 2015, the U.S. Departments of Labor (DOL), Health and Human Services (HHS), and Treasury issued frequently asked questions (FAQs) on the implementation of preventive care and wellness provisions of the...more

The ERISA Litigation Newsletter - October 2015

by Proskauer Rose LLP on

Editor's Overview - This month, we review the Second Circuit's ruling in New York State Psychiatric Ass'n, Inc. v. UnitedHealth Grp. wherein the Second Circuit ruled that: (i) a provider association has associational...more

HIPAA Double Take: What Health Plan Sponsors Need to Know Now

by Alston & Bird on

With the onslaught of Affordable Care Act changes, health plan sponsors have much to think about lately. Given the number of other issues affecting them, plan sponsors may feel that HIPAA privacy and security is an issue they...more

IRS Announces Employee Benefit Plan Limits for 2016

by McDermott Will & Emery on

Recently the Internal Revenue Service (IRS) and the Social Security Administration announced the cost-of-living adjustments to the applicable dollar limits on various employer-sponsored retirement and welfare plans and the...more

OIG Reports Insufficient Oversight Of HIPAA Compliance

by King & Spalding on

The HHS Office for Civil Rights (OCR) must improve its oversight and enforcement of patient information privacy and security rules by “covered entities” and their business associates under the Health Information Portability...more

Compensation and Benefits Insights – September 2015

by King & Spalding on

The Patient Protection and Affordable Care Act (“ACA”)’s 40% excise tax on high-cost employer-sponsored health coverage (commonly known as the “Cadillac tax”) is slated to take effect in 2018. The IRS has issued several...more

Recap: Health Care Investors Summit – Exploring the Impact and Opportunities from Health Care Convergence

by Foley & Lardner LLP on

The 2015 Health Care Investors Summit, co-hosted by Foley and Deloitte & Touche, LLP, was held on September 24. This program examined convergence in health care and the effects on investing, mergers and acquisitions, provider...more

Important HRA Information Buried in Notice 2015-68

by Balch & Bingham LLP on

Notice 2015-68 sets forth several items for which the Agencies intend to propose regulations. The Notice also provides that the state government agency sponsoring coverage under the Basic Health Program is required to report...more

The (Poorly Named) “Cadillac Tax” Part Two: IRS Provides Further Guidance in Notice 2015-52

by Alston & Bird on

The so-called “Cadillac Tax” (Internal Revenue Code Section 4980I) applies starting in 2018 and was intended to provide a means to address what were perceived as overly rich employer-provided health benefit plan designs, as...more

New Value-Based Insurance Design Model for Medicare Advantage Plans Is the First of Multiple Medicare Plan Innovations Anticipated...

by Epstein Becker & Green on

On September 1, 2015, the Centers for Medicare & Medicaid Services (“CMS”) announced[1] the opportunity for plan sponsors to test value-based insurance design (“VBID”) in the Medicare Advantage (“MA”) market. VBID refers to...more

September and October 2015 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

by King & Spalding on

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties. To avoid such...more

Telehealth Commercial Coverage and Parity Laws: Trends, Challenges and Opportunities

by Foley & Lardner LLP on

There will always be differences among state laws on telehealth coverage, but what is remarkable is the rapidly increasing pace at which states have been adopting coverage statutes in the last few years, with currently 29...more

The ERISA Litigation Newsletter - August 2015

by Proskauer Rose LLP on

Editor's Overview - As the summer draws to a close, this month's Newsletter previews three cases that the U.S. Supreme Court already has agreed to hear that ought to be of particular interest to ERISA plan sponsors and...more

August and September 2015 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

by King & Spalding on

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties. To avoid such...more

Proceed With Caution: Does HIPAA Apply to Your Business?

by Lane Powell PC on

Even if your business is not in the health care industry, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as updated by the Health Information Technology for Economic and Clinical Health Act (HITECH...more

The Sixth Circuit Further Defines “Advertisement” Under the Telephone Consumer Protection Act

by BakerHostetler on

Last month, in a case of first impression, the Sixth Circuit Court of Appeals issued an opinion finding that unsolicited faxes intended strictly for informational purposes were not “advertisements” and therefore not...more

July and August 2015 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

by King & Spalding on

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties. To avoid such...more

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