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No Surprises, But Much Uncertainty: The Status of CAA Billing Rules

Summary - The rules in the Consolidated Appropriations Act that aim to eliminate much of the surprise from billings by out-of-network providers in particular situations are the subject of continued controversy....more

Preventive Care Rules Remain in Place for Now

The Fifth Circuit Court of Appeals has stayed the broad application of a district court decision that would have invalidated a number of preventive care requirements under the Affordable Care Act. As a result, health plans,...more

Court Invalidates Certain Preventive Care Requirements

Summary - Health plans and insurance policies may no longer be required to cover the full cost of preventive care that carries an A or B rating by the U.S. Preventive Services Task Force (USPSTF), following a recent ruling...more

Court Issues Injunction Against Revised ACA Nondiscrimination Rules

The U.S. District Court for the Eastern District of New York blocked federal rules seeking to remove nondiscrimination protections for health care patients. The blocked rules would have removed protections against...more

SECURE Act In; Cadillac Tax Out: The Spending Act Makes Serious Changes to Benefits Rules

Below is a summary of those key provisions. I. SECURE Act The Setting Every Community Up for Retirement Enhancement Act of 2019 (the SECURE Act, H.R. 1994) is arguably the most significant and comprehensive retirement saving...more

Fifth Circuit Rules Individual Mandate Unconstitutional; Fate of Rest of ACA Remains in Doubt

In a 2-1 decision, the Fifth Circuit Court of Appeals has upheld a district court ruling that the individual mandate under the Affordable Care Act is unconstitutional. However, the Fifth Circuit has sent the case back to the...more

A Little Extra: IRS Ups ACA Reporting Relief

Once again, the IRS has extended the deadline for furnishing Forms 1095-B and 1095-C to individuals. Reporting penalties will not apply to those who meet the applicable deadlines and complete the forms in good faith....more

Health Care and Price Transparency: The Latest Summary

Federal executive agencies recently published two rules, one final and one proposed, aimed at publicizing the various costs associated with health care. A final rule, promulgated by the Department of Health and Human Services...more

U.S. District Court Upholds Short-Term Limited Duration Insurance Rule

The U.S. District Court for the District of Columbia upheld a rule that expanded the maximum length of time for short-term, limited duration insurance (STLDI).  STLDI is coverage that lasts a limited period of time and is...more

Treasury Recognizes Preventive Care for Chronic Conditions Under High Deductible Health Plans

Pursuant to a directive in last month’s Executive Order 13877, the Treasury Department issued guidance last week that lists particular preventive care items and services that may be covered by a high deductible health plan...more

Coming to Market: Final Rules Issued for Individual Coverage HRAs

The U.S. Departments of the Treasury, Labor, and Health and Human Services have issued final regulations allowing employers to establish health reimbursement arrangements and certain other types of reimbursement plans...more

HHS Proposes to Scale Back ACA Nondiscrimination Rules

The U.S. Department of Health and Human Services (HHS) has released proposed regulations that, if finalized, will significantly narrow the scope of the nondiscrimination requirements under Section 1557 of the Affordable Care...more

HIPAA Guidance and Enforcement: A New Alignment?

The Office of Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS) announced that it has entered into a settlement with a business associate that provides electronic medical records services to health...more

Association Health Plan Regulations Invalidated

The U.S. District Court for the District of Columbia has set aside the most significant portions of the U.S. Department of Labor's (DOL) regulations on Association Health Plans (AHPs)....more

EEOC Withdraws Wellness Incentive Guidance

The Equal Employment Opportunity Commission (EEOC) has formally withdrawn the provisions in its regulations governing wellness programs under the Americans with Disabilities Act (ADA) and the Genetic Information...more

District Court Rules ACA Unconstitutional

The Affordable Care Act returned to the front page this weekend when a federal district court in Texas issued an opinion striking down the entire law as unconstitutional. ...more

New Guidance Creates a New Playing Field for HRAs

The U.S. Departments of the Treasury, Labor, and Health and Human Services have jointly issued proposed regulations that envision a broad landscape for the use of health reimbursement arrangements (HRAs) and certain other...more

Final Regulations Expand Availability of Individual Insurance Not Meeting ACA Requirements

The U.S. Departments of the Treasury, Labor, and Health and Human Services have jointly issued final rules modifying the definition of short-term, limited-duration insurance (STLDI). STLDI provides health coverage that is...more

DOL Releases Final Regulation Expanding Association Health Plans

The U.S. Department of Labor (DOL) on Tuesday released final regulations modifying the Association Health Plan (AHP) rules to expand their availability for small and large employers and to address their affordability by...more

Bipartisan Budget Act of 2018 Enacts Changes to Employee Retirement and Health Benefit Plans, and Medicare

Following a brief shutdown of the federal government, on February 9, Congress passed and President Donald J. Trump signed into law the Bipartisan Budget Act of 2018 (Budget Act), which provides Congress until March 23 to...more

Budget Deal Addresses Health Benefit Issues

The Congressional agreement that reopened the federal government for three weeks quietly addressed—at least temporarily—several high-profile issues affecting public and private health benefits. ...more

DOL Proposes Expansion of Association Health Plans

Following up on the direction provided by Executive Order 13813, the U.S. Department of Labor (DOL) has issued proposed regulations that would expand the ability of small employers to band together and provide coverage under...more

IRS Extends ACA Reporting Deadline

As it did last year, the IRS has extended the deadline for furnishing Forms 1095-B and 1095-C to individuals by 30 days. This reprieve will allow employers, health insurers, and other plan sponsors to distribute the forms on...more

DOL Releases Draft Model Form for Mental Health Parity Disclosure Requests

The U.S. Department of Labor (DOL) recently released a draft model form for plan participants to request disclosures from group health plans and insurers about restrictions on mental health coverage. The form is designed to...more

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