The U.S. Departments of Labor, Health and Human Services, and the Treasury have jointly published a set of frequently asked questions that offer guidance on a number of benefits issues related to the expansion of coverage...more
The Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) has finalized rules that narrow and eliminate various nondiscrimination requirements under Section 1557 of the...more
The IRS released Notice 2020-42, which provides temporary relief during calendar year 2020 from the physical presence requirements for participant elections in retirement plans....more
On May 27, 2020, the United States Department of Labor (DOL) published its highly-anticipated Default Electronic Disclosures by Employee Pension Benefit Plans Under ERISA Final Rule (the E-Disclosure Final Rule), which...more
The Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) has followed the guidance, jointly issued by the U.S. Departments of Labor and the Treasury, that extends benefits-related deadlines...more
The Internal Revenue Service (IRS) has issued new guidance, Notice 2020-29, in response to the COVID-19 pandemic, providing for temporary flexibility with respect to mid-year elections made during 2020 under Code section 125...more
The Department of Health and Human Services has issued guidance confirming that the public health emergency brought on by the COVID-19 pandemic does not alter the restrictions that HIPAA’s Privacy Rule places on hospitals,...more
The U.S. Supreme Court has determined that the federal government must pay over $12 billion to certain health insurers that participated in health insurance exchanges in the first three years that those exchanges were in...more
5/5/2020
/ Affordable Care Act ,
Appropriations Bill ,
Court of Federal Claims ,
Damages ,
Government Payments ,
Health Insurance ,
Maine Community Health Options v. United States ,
Moda Health Plan Inc. v. United States ,
Reimbursements ,
Remand ,
Repeal ,
Reversal ,
Risk Corridors Statute ,
SCOTUS ,
Tucker Act
To reduce the risk that participants will lose benefits during the COVID-19 outbreak because they fail to meet certain procedural requirements, the U.S. Departments of Labor and the Treasury announced the extension of a...more
The Centers for Medicare & Medicaid Services (CMS) issued FAQ guidance encouraging health insurers to relax their utilization management and prior authorization requirements in view of the COVID-19 pandemic while at the same...more
The Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the “Departments”) have released frequently asked questions (FAQs) for health plans implementing coverage changes under the...more
The Coronavirus, Aid, Relief, and Economic Security Act, or CARES Act, which passed the Senate last night, is Congress’s third legislative answer to the coronavirus pandemic. The CARES Act represents a heavily negotiated...more
On March 20, 2020, the Office for Civil Rights (OCR) issued guidance in furtherance of its Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency. ...more
The Office of Civil Rights, U.S. Department of Health and Human Services, issued an update to its February bulletin, which outlined how the HIPAA privacy rules apply in a state of emergency....more
Across the United States, employers are carefully considering how the COVID-19 pandemic is affecting their business. As we await further guidance and pronouncements from federal, state, and local officials, some employers are...more
3/18/2020
/ Affordable Care Act ,
COBRA ,
Coronavirus/COVID-19 ,
Crisis Management ,
DFSA ,
Emergency Management Plans ,
Furloughs ,
Health and Safety ,
Health and Welfare Plans ,
Health Insurance ,
Infectious Diseases ,
Layoffs ,
Public Health ,
Retirement Plan ,
Unemployment Benefits
To encourage individuals to seek prompt medical attention for the coronavirus (COVID-19), a number of states have taken, or are considering, action to eliminate the costs associated with testing and treating the virus and to...more
3/16/2020
/ Clinical Laboratory Testing ,
Coronavirus/COVID-19 ,
Cost-Sharing ,
Crisis Management ,
Deductible Expenses ,
Emergency Response ,
Employee Benefits ,
HDHP ,
Health and Safety ,
Health Insurance ,
HSA ,
Infectious Diseases ,
IRS ,
New Guidance ,
Public Health ,
Relief Measures
The Internal Revenue Service (IRS) issued a notice that allows individuals to participate in a health savings account (HSA) while participating in a high deductible health plan (HDHP) that provides coverage for both the...more
3/16/2020
/ China ,
Clinical Laboratory Testing ,
Coronavirus/COVID-19 ,
Crisis Management ,
Deductibles ,
Emergency Management Plans ,
Emergency Response ,
Employee Benefits ,
Employer Group Health Plans ,
HDHP ,
Health Insurance ,
Health Savings Accounts ,
Infectious Diseases ,
IRS ,
Medical Benefits ,
Medical Examinations ,
New Guidance ,
Popular ,
Public Health
Health care providers, health plans, and others who are subject to HIPAA are sure to have questions about when they may disclose information about individuals who have contracted, or been exposed to, Coronavirus (COVID-19)....more
3/13/2020
/ China ,
Coronavirus/COVID-19 ,
Crisis Management ,
Electronic Protected Health Information (ePHI) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Facilities ,
HIPAA Privacy Rule ,
Infectious Diseases ,
Patient Privacy Rights ,
Personally Identifiable Information ,
PHI ,
Policies and Procedures ,
Public Health ,
Risk Management
Although the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) may yet announce one or two year-end settlements, it appears that 2019 will be known more for the implementation of changes in...more
1/29/2020
/ Civil Monetary Penalty ,
Data Breach ,
Data Security ,
Electronic Protected Health Information (ePHI) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Facilities ,
HIPAA Security Rule ,
OCR ,
Penalties ,
Personally Identifiable Information ,
PHI ,
Regulatory Reform ,
Regulatory Violations
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
12/23/2019
/ 401k ,
Affordable Care Act ,
Compensation & Benefits ,
Corporate Counsel ,
Employee Benefits ,
Health Insurance Tax ,
Healthcare Reform ,
Individual Retirement Account (IRA) ,
Medical Leave ,
Multiemployer Plan ,
New Legislation ,
Paid Family Leave Law ,
PCORI ,
Required Minimum Distributions ,
Retirement ,
Retirement Plan ,
Safe Harbors ,
SECURE Act ,
Tax Cuts and Jobs Act ,
Tax Planning ,
Tax Rates ,
Tax Reform ,
UBIT
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
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
12/5/2019
/ Affordable Care Act ,
Deregulation ,
Employee Benefits ,
Employer Mandates ,
Filing Deadlines ,
Form 1094 ,
Form 1095 ,
Health Insurance ,
Healthcare Reform ,
Individual Mandate ,
IRS ,
Penalties ,
Popular ,
Reporting Requirements ,
Tax Planning ,
Trump Administration
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
12/4/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Disclosure Requirements ,
Final Rules ,
Health Care Providers ,
Healthcare Reform ,
Hospitals ,
Medical Expenses ,
Medical Loss Ratio ,
MLR Rebate ,
Out of Network Provider ,
Price Transparency ,
Proposed Rules ,
Regulatory Agenda ,
Rulemaking Process ,
Surprise Medical Bills ,
Trump Administration
The U.S. Department of Health and Human Services Office of Civil Rights (OCR) imposed $2,154,000 in civil monetary penalties against Jackson Health System in Florida for failing to meet HIPAA privacy and security...more
10/28/2019
/ Civil Monetary Penalty ,
Data Breach ,
Electronic Medical Records ,
Enforcement Actions ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Breach ,
Information Technology ,
OCR ,
Personally Identifiable Information ,
PHI ,
Regulatory Violations
The U.S. Department of the Treasury has issued proposed regulations addressing how individual coverage health reimbursement arrangements (ICHRAs) can comply with the Employer Shared Responsibility Payments (ESRP) requirements...more