News & Analysis as of

Final Rules Qualified Health Plans

McDermott Will & Emery

CMS Interoperability and Prior Authorization Rule Significantly Impacts Payers’ Approval and Denial Practices

McDermott Will & Emery on

On January 17, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the CMS Interoperability and Prior Authorization final rule (Final Rule) (fact sheet, CMS’ interoperability website), which aims to improve prior...more

Seyfarth Shaw LLP

Final Rules Fix Family Glitch

Seyfarth Shaw LLP on

Seyfarth Synopsis: Recently, on October 11, 2022, the Internal Revenue Service (IRS) issued final regulations which finalized changes to affordability of employer coverage for the family members of employees under Internal...more

King & Spalding

Implementation of Final Rule Excluding PBM Rebates from Discount Safe Harbor Delayed Until 2023

King & Spalding on

Pharmaceutical Care Management Association (“PCMA”) lawsuit results in delayed implementation of Final Rule while Biden Administration review is ongoing - Pursuant to a Court Order, implementation of the U.S. Dept. Health...more

Bradley Arant Boult Cummings LLP

Rule Providing Relief for Grandfathered Health Plans Finalized

The Departments of Labor (DOL) and Health and Human Services (HHS) and the Treasury have finalized a rule for grandfathered group health plans under the Affordable Care Act (ACA) without making any substantive changes from...more

McDermott Will & Emery

CMS Final Rule Aims to Advance Interoperability, Exchange of Clinical and Plan Information

McDermott Will & Emery on

The Centers for Medicare & Medicaid Services (CMS) published its highly anticipated final rule aimed at enhancing interoperability and increasing patient access to health information. CMS’s final rule will require hospitals...more

Hogan Lovells

CMS releases annual health insurance exchanges final rule

Hogan Lovells on

On 18 April 2019 the Centers for Medicare & Medicaid Services (CMS) released the Notice of Benefit and Payment Parameters final rule for 2020 (2020 Payment Notice) applicable to qualified health plans (QHPs) offered on health...more

Hogan Lovells

CMS releases annual health insurance exchanges final rule

Hogan Lovells on

On April 9, 2018, the Centers for Medicare & Medicaid Services (CMS) released the Benefit and Payment Parameters final rule for 2019 (2019 Payment Notice) applicable to qualified health plans (QHPs) offered on health...more

McDermott Will & Emery

CMS Aims to Stabilize Exchanges but Does Not Address Issuers’ Biggest Questions

McDermott Will & Emery on

CMS recently released a final rule with the goal of stabilizing Exchange markets for 2018. The agency also issued several significant guidance documents where CMS extended the deadlines for 2018 rate and Exchange qualified...more

Epstein Becker & Green

HHS Sets New Requirements to Limit Surprise Medical Bills from Out-of-Network Providers

Epstein Becker & Green on

The U.S. Department of Health and Human Services (“HHS”) recently released a final rule titled “Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017” (“Final Rule”)[1] that sets...more

Epstein Becker & Green

Doing the Cha-Cha on Exchange Rules: CMS Moves Forward on Standardized Plan Offerings but Steps Back from Instituting Minimum...

Epstein Becker & Green on

On March 8, 2016, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule titled “Patient Protection and Affordable Care Act; CMS Notice of Benefit and Payment Parameters for 2017” (“Final Rule”)[1] setting...more

Epstein Becker & Green

CMS's Final Exchange and Insurance Market Standards Impact Qualified Health Plan Filings for 2015 and Beyond

On May 16, 2014, the Centers for Medicare & Medicaid Services ("CMS") released a final rule titled "Patient Protection and Affordable Care Act; Exchange and Insurance Market Standards for 2015 and Beyond" ("Final Rule")...more

Spilman Thomas & Battle, PLLC

Affordable Care Act Standards Related to Essential Health Benefits, Minimum Value, Actuarial Value and Accreditation

On February 25, 2013, the Department of Health and Human Services (HHS) released its final rule (the Final Rule) setting forth standards for health insurance issuers under the Patient Protection and Affordable Care Act (the...more

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