News & Analysis as of

Cost-Sharing Patient Protection and Affordable Care Act (PPACA) Employee Benefits

Ballard Spahr LLP

Prescription for Chaos: Copay Accumulator Programs Called Into Question

Ballard Spahr LLP on

Summary - Employers taking advantage of copay accumulator programs now face unexpected administrative complications following a recent federal court decision....more

Groom Law Group, Chartered

ACA Preventive Service Requirements Partially Vacated

On March 30, 2023, the District Court for the Northern District of Texas issued an opinion and order in Braidwood Mgmt. Inc. v. Becerra that vacates the implementation and enforcement of certain preventive service provisions...more

Jackson Walker

Guidance Reminds Health Plans to Check Up on Preventive Care Compliance

Jackson Walker on

On July 19, 2021, the Internal Revenue Service, U.S. Department of Labor, and the U.S. Department of Health and Human Services (the “Tri-Agencies”) issued new frequently asked questions (FAQs) regarding the implementation of...more

Seyfarth Shaw LLP

Sad Day for Coupon-Clippers

Seyfarth Shaw LLP on

Seyfarth Synopsis: Recently, the Trump Administration issued its proposed Notice of Benefit & Payment Parameter for 2021 regulations....more

Bricker Graydon LLP

Have you done your ACA affordability cost-share homework for the 2020 health plan year?

Bricker Graydon LLP on

Under the Affordable Care Act (ACA), applicable large employers are required to offer minimum essential coverage (that is both affordable and meets the minimum value standard) to at least 95 percent of their eligible...more

Mintz - Employment Viewpoints

Will Grandfathered Plans be Rescued?

On February 25, 2019 the Department of Labor, Department of Health and Human Services, Treasury Department and the Internal Revenue Service (the “Departments”) published a request for information (the “ROI”) on grandfathered...more

Proskauer Rose LLP

ERISA Newsletter - Fourth Quarter 2017

Proskauer Rose LLP on

Editor's Overview - For over two decades, federal law has required covered health plans and insurers to ensure that certain mental health benefits are in parity with offered medical/surgical benefits. The meaning of...more

Ballard Spahr LLP

Back in the Spotlight: The Affordable Care Act Again Takes Center Stage

Ballard Spahr LLP on

After a brief lull in activity, recent developments are likely to involve all three branches of government in addressing issues under the Affordable Care Act....more

Sheppard Mullin Richter & Hampton LLP

Trump Administration Takes Aim at ACA With AHP Executive Order

Thursday, October 12th, on the heels of the recent and repeated failures to repeal and replace the Affordable Care Act (“ACA”), President Donald Trump signed an executive order nominally aimed at increasing competition in the...more

Sheppard Mullin Richter & Hampton LLP

Trump Administration Pulls the Plug on CSR Payments

After months of veiled threats, President Trump formally announced that his Administration will cease funding Cost-Sharing Reduction (“CSR”) payments, a key component of the Affordable Care Act (“ACA”) intended to help...more

Perkins Coie

The Fate of the ACA’s Cost-Sharing Reduction Subsidies

Perkins Coie on

As deliberations over a replacement of the Affordable Care Act (ACA) continue in the U.S. House of Representatives, the fate of the ACA’s Cost-Sharing Reduction subsidies (CSRs) may be at stake. Under the ACA, Marketplace...more

Ballard Spahr LLP

HHS Finalizes Health Insurance Market Stabilization Rules

Ballard Spahr LLP on

The U.S. Department of Health and Human Services (HHS) has finalized regulations designed to help stabilize the individual and small group health insurance markets and, in particular, the health insurance exchanges...more

Holland & Knight LLP

OSHA Issues Final Rule On Complaints Under Affordable Care Act's Anti-Retaliation Provision

Holland & Knight LLP on

The Affordable Care Act (ACA) added Section 18C to the Fair Labor Standards Act (FLSA) to prohibit retaliation against employees who engage in certain activities protected by the ACA. Responsibility for receiving and...more

Franczek P.C.

Final Rule Regarding Preventive Services Under ACA

Franczek P.C. on

The Department of the Treasury, DOL, and Department of Health and Human Services (HHS) issued final rules regarding coverage of certain preventive services required to be provided under ACA without cost sharing by...more

Proskauer - Employee Benefits & Executive...

Reminder: Non-Grandfathered Plans Must Implement Embedded Out-of-Pocket Maximums

As employers and plans prepare for 2016 open enrollment, they must be sure to address in their benefit design and with their third party vendors the new embedded out-of-pocket maximum limitations on individuals that were...more

Franczek P.C.

Departments Issue FAQs on Cost-Sharing and Restated Enforcement Approach on Provider Nondiscrimination Rules under ACA

Franczek P.C. on

The Departments issued FAQs clarifying prior guidance on the ACA’s cost-sharing limitations applicable to non-grandfathered plans, and restating their enforcement approach with respect to the ACA’s provider nondiscrimination...more

Akerman LLP - Health Law Rx

Reimbursement Changes, Shift to Consumerism Discussed at Akerman Healthcare Briefing

Changing reimbursement models and a shift to consumerism were two of the hot topics discussed at Akerman LLP's recent Healthcare Briefing event titled "Financial and Corporate Implications of the Affordable Care Act: A Look...more

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