Title I of Division BB of the Consolidated Appropriations Act, 2021 (the “Act”), and interim final rules issued by the Departments of Health and Human Services, Treasury and Labor (the “Departments”) in July 2021 (see our...more
10/4/2022
/ Arbitrators ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Final Rules ,
Guidance Update ,
Health Care Providers ,
Health Insurance ,
No Surprises Act (NSA) ,
Out of Network Provider ,
Transparency ,
U.S. Treasury
The Consolidated Appropriations Act, 2021 (the “Act”) adopted a series of transparency requirements that apply to employer-sponsored group health plans. These transparency rules impose a series of new and complex obligations...more
3/8/2022
/ 401k ,
Affordable Care Act ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Employee Retirement Income Security Act (ERISA) ,
Health and Welfare Plans ,
Internal Revenue Code (IRC) ,
Mental Health ,
MHPAEA ,
Public Health Service Act ,
Surprise Medical Bills ,
Third-Party ,
Transparency
Section 108, Division BB of the Consolidated Appropriations Act, 2021 requires the Departments of Labor, Health & Human Services and the Treasury (the “Departments”) to issue regulations under Section 2706(a) of the Public...more
Division BB of the Consolidated Appropriations Act, 2021 (“Act”) broadly addresses surprise medical billing and health plan transparency. This post focuses on Section 202 of Division BB (the “Provision”), which establishes...more
12/7/2021
/ Brokers ,
Consolidated Appropriations Act (CAA) ,
Consultants ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Disclosure Requirements ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Insurance Industry ,
Qualified Small Employer Health Reimbursement Plan (QSEHRAs) ,
Transparency
The Departments of Labor, Health and Human Services, and the Treasury (the “Departments”) recently issued a set of Frequently Asked Questions—FAQs About Affordable Act Implementation, Part 50, Health Insurance Portability and...more
10/13/2021
/ Affordable Care Act ,
Americans with Disabilities Act (ADA) ,
Anti-Discrimination Policies ,
Civil Rights Act ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Equal Employment Opportunity Commission (EEOC) ,
GINA ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Reasonable Accommodation ,
Title VI ,
Title VII ,
U.S. Treasury ,
Vaccinations
As we previously reported, on June 13, the Departments of Health and Human Services, Labor, and the Treasury (collectively, the “Departments”) issued a coordinated set of final regulations (“final rules”) permitting employers...more
11/11/2019
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
HRA ,
Proposed Regulation ,
Proposed Rules ,
Public Health Service Act ,
Qualified Small Employer Health Reimbursement Plan (QSEHRAs) ,
Safe Harbors ,
Shared Responsibility Rule ,
U.S. Treasury
On June 13, 2019, the Department of Health and Human Services (HHS), the Department of Labor (DOL), the Department of the Treasury (Treasury Department) and the Internal Revenue Service (IRS) (collectively, the “Departments”)...more
7/11/2019
/ Affordable Care Act ,
COBRA ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Final Rules ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
HRA ,
IRS ,
Medicare ,
Public Health Service Act ,
Qualified Small Employer Health Reimbursement Plan (QSEHRAs) ,
TRICARE ,
U.S. Treasury
Health Reimbursement Arrangements (or “HRAs”) are employer-funded, account-based group health plans, which are used to reimburse certain medical expenses incurred by eligible employees, their spouses, and their dependents....more
12/13/2018
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HRA ,
IRS ,
Proposed Regulation ,
Proposed Rules ,
Qualified Small Employer Health Reimbursement Plan (QSEHRAs)
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
8/27/2016
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health and Welfare Plans ,
Health Insurance ,
Hospitals ,
Indemnity ,
Minimum Essential Coverage ,
NAIC ,
Supplemental Insurance
On June 10, the Departments of Treasury, Labor, and Health and Human Services (The “Departments”) issued a set of proposed regulations dealing with expatriate health plans, excepted benefits, lifetime and annual limits, and...more
In Notice 2014-69, the Treasury Department and the IRS clarified that a group health plan that fails to provide substantial coverage for in-patient hospitalization and physician services will not be treated as providing...more
9/30/2015
/ Affordable Care Act ,
Amended Regulation ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Employer Liability Issues ,
Health Insurance ,
Hospitals ,
IRS ,
Minimum Essential Coverage ,
Minimum Value Plans ,
Physicians ,
Proposed Regulation ,
Tax Credits ,
U.S. Treasury
Over the last couple of months, we have followed and reported on a particular ACA compliance strategy under which an employer subject to the Affordable Care Act’s employer shared responsibility (or “pay-or-play”) rules...more
In a previous post, we described an Affordable Care Act compliance strategy—referred to commercially as a “minimum value plan” or “MVP”—that involves an offer of group health plan coverage that, while similar in most respects...more
Under the Affordable Care Act’s rules governing employer shared responsibility—which are codified in Internal Revenue Code § 4980H—where an applicable large employer makes an offer of group health plan coverage that is both...more
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) ushered in broad national standards aimed at improving the efficiency and effectiveness of the U.S. health care system. Referred to generically as...more
The Departments of the Treasury/IRS, Labor and Health and Human Services (the “Departments”) recently issued a final regulation under the 90-day waiting period limitation, which is included among the Affordable Care Act’s...more
6/30/2014
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Mandates ,
Healthcare ,
Healthcare Reform ,
Internal Revenue Code (IRC) ,
IRS ,
PHSA ,
U.S. Treasury
The last few weeks have produced a regulatory frenzy under various provisions of the Affordable Care Act affecting employers...more
The Affordable Care Act (the “Act”) generally prevents an otherwise eligible employee (or dependent) from having to wait more than 90 days before coverage becomes effective under a group health plan. The regulation of waiting...more
A handful of recent guidance items that the Departments of Labor, Health and Human Services, and Treasury have issued make some important changes related to the regulation of “excepted benefits.” These changes are driven in...more
Established as a part of the comprehensive 2006 Massachusetts health care reform law, the Massachusetts Health Insurance Connector (a/k/a the “Connector”) served as a model for the American Health Benefit Exchanges that are a...more
As we have reported in this blog, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently released final regulations containing modifications to the HIPAA Privacy, Security, Enforcement, and...more
2/18/2013
/ Business Associates ,
Cloud Computing ,
Covered Entities ,
Data Breach ,
Department of Health and Human Services (HHS) ,
Employee Retirement Income Security Act (ERISA) ,
Fundraisers ,
HIPAA Omnibus Rule ,
HITECH Act ,
Marketing ,
Notice Requirements ,
OCR ,
PHI ,
Privacy Rule ,
Risk Assessment ,
Subcontractors ,
Training
In a set of Frequently Asked Questions (FAQs) posted to the Department of Labor’s website on January 24, the Departments of Health and Human Services, Labor, and Treasury (the “Departments”) put a stop to an approach to...more
The Patient Protection and Affordable Care Act (Act) fundamentally changes the way that health insurance is regulated in the United States. These changes are part of an ambitious statutory scheme that comprehensively reforms...more
Commencing in 2014, the Patient Protection and Affordable Care Act (Act) requires that health insurance coverage provided in the individual and small group markets, including coverage offered through American Health Benefit...more