News & Analysis as of

Health Insurance Employee Benefits Centers for Medicare & Medicaid Services (CMS)

Akerman LLP - HR Defense

On the Basis of Sex… Discrimination in Group Health Plans and What Employers Should Know

In just a few days’ time, recently promulgated federal final rules addressing sex-based nondiscrimination in the administration of health care benefits have created a flurry of healthcare industry activity. The angst arises...more

Hall Benefits Law

Health Care Stakeholders Support Passage of The Value in Health Care Act

Hall Benefits Law on

Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care...more

Pullman & Comley - Labor, Employment and...

Group Health Plans and Medicare Secondary Payer Rules: Do the Mandatory Reporting Obligations Apply to You?

The Medicare Secondary Payer provisions (MSP) apply to group health plans sponsored by employers with 20 or more employees, in both the private and public sectors. MSP’s mandatory reporting requirements are designed to...more

Manatt, Phelps & Phillips, LLP

Biden Administration Seeks $500M to Implement and Enforce No Surprises Act and Mental Health Parity

President Biden’s proposed 2024 budget includes substantial additional amounts for continued funding of the implementation and enforcement of the No Surprises Act (NSA) and the transparency laws passed along with the NSA,...more

Husch Blackwell LLP

New Federal Guidance on Employer-Sponsored Group Health Plans and Required Action Steps for 2023

Husch Blackwell LLP on

The Consolidated Appropriations Act, 2021 (CAA) prohibits employer-sponsored group health plans from entering into agreements that contain so-called “gag clauses.” This prohibition generally restricts group health plans from...more

Venable LLP

REMINDER: October 15 Is the Deadline for Prescription Drug Notices and the Extended Deadline for Form 5500s

Venable LLP on

Does your company's health plan provide prescription drug coverage? If so, you have until October 15, 2022 to send a notice to individuals who are enrolled in Medicare Part A or Part B and are eligible for the company's...more

Jackson Lewis P.C.

4th Quarter 2022 Quick Hits for Plan Sponsors and Administrators

Jackson Lewis P.C. on

As we enter the fourth quarter of 2022, sponsors and administrators of employee benefit plans have a lot to juggle. From open enrollment and required notices to plan document deadlines, it is a busy time of year. Yet, there...more

Butler Snow LLP

The No Surprises Act – Anticipating Unanticipated Consequences

Butler Snow LLP on

The “law of unintended consequences” describes the general sociological principle that for every action there is an unintended or unanticipated outcome. An influential examination of the concept was published in 1936 by...more

Nelson Mullins Riley & Scarborough LLP

Reminder – Medicare Part D Notices due October 15, 2021

Group health plan sponsors must provide annual Medicare Part D Notices (the “Notice” or the “Notices”) by October 15, 2021. It’s your last chance to make sure your Notices will be timely delivered and comply with the legal...more

Patrick Malone & Associates P.C. | DC Injury...

The health insurance mess: Worker costs jump anew, as kids’ coverage falls

The Covid-19 pandemic has forced many Americans to reconsider their transportation options, what with fears of infection and the slashing of public transit systems’ routes and schedules. That has made used cars, motorcycles,...more

Ballard Spahr LLP

CMS Addresses Extended Deadlines for Benefit Plans

Ballard Spahr LLP on

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

Ballard Spahr LLP

CMS Encourages Flexibility in Utilization Management and Prior Authorization Within Limits

Ballard Spahr LLP on

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

Brownstein Hyatt Farber Schreck

Health Plan Coverage of Coronavirus Testing and Treatment

With the news about the spread of the 2019 novel coronavirus (“COVID-19”) in the U.S. and the world rapidly evolving, group health plan sponsors need to address how the plan will provide virus-related benefits. ...more

Mintz - Employment Viewpoints

Association Health Plan Perspectives (Part 2): The Look-Through Rule and the Limits of State Regulatory Power

In a summary of the recently issued Association Health Plan (AHP) final regulations, the U.S. Department of Labor (DOL) rightly observed that AHPs are a species of multi-employer welfare arrangements, or MEWAs, that are...more

Sheppard Mullin Richter & Hampton LLP

CMS Proposes “Wind Down” Plan for Federal Exchanges

Despite the Trump Administration’s unsuccessful attempts to fully repeal and replace the Affordable Care Act (the “ACA”), the Administration has continued to target the ACA. In the Administration’s latest salvo, the Centers...more

Seyfarth Shaw LLP

Issue 108: HHS Moves Ahead In Face of ACA Uncertainty

Seyfarth Shaw LLP on

This is the one hundred and eighth issue in our series of alerts for employers on selected topics on health care reform. This series of Health Care Reform Management Alerts is designed to provide an in-depth analysis of...more

Ballard Spahr LLP

CMS, IRS Address Affordable Care Act Issues in Transition

Ballard Spahr LLP on

The Centers for Medicare and Medicaid Services (CMS) and the IRS have each published guidance on matters arising under the Affordable Care Act (ACA). It is too early to tell whether these measures—some of the first guidance...more

FordHarrison

President Trump Signs Executive Order on Affordable Care Act

FordHarrison on

On Friday January 20, 2017, President Trump signed an executive order titled “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal.” The Order directs the Secretary of Health and...more

Burr & Forman

2016 Health Care Year in Review

Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Pierce Atwood LLP

Recent Developments in Patient Engagement and Healthcare Cost Initiatives

Pierce Atwood LLP on

In the wake of the recent flurry of commentary on the answer to the question of “What will happen to the Affordable Care Act?” the Commonwealth Fund released a new survey addressing how high-needs patients experience health...more

Epstein Becker & Green

Health Care Reform 2017: Substance, Process, and Timeline

Epstein Becker & Green on

President-elect Donald J. Trump campaigned on a promise to “repeal and replace” the Affordable Care Act (“ACA”). For several years, the newly reelected Republican majority in Congress has likewise identified ACA repeal as a...more

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