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Department of Health and Human Services (HHS) Insurance Industry

Array

This Week in eDiscovery: The Cost of Securing Sensitive Data, Responding to Discovery Issues

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Every week, the Array team reviews the latest news and analysis about the evolving field of eDiscovery to bring you the topics and trends you need to know. This week’s post covers the period of August 19-25. Here’s what’s...more

ArentFox Schiff

No More Surprise Medical Bills: Fifth Circuit Affirms Vacatur of Arbitration Provisions of Surprise Billing Rules (TMA II)

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On August 2, health care providers scored yet another significant victory when the US Court of Appeals for the Fifth Circuit affirmed the vacatur of various federal regulations regarding the arbitration procedures used to...more

McDermott Will & Emery

Six Wishes for the Forthcoming Final Regulations Under MHPAEA

McDermott Will & Emery on

On July 1, 2024, the US Department of Labor (DOL) submitted final regulations to the Congressional Budget Office (CBO), implementing the Mental Health Parity and Addiction Equity Act (MHPAEA) as most recently amended by the...more

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, Issue 3, July 2024

Welcome to our third issue of The Health Record - our healthcare law insights e-newsletter! We are winding down the summer with our talented group of law students and they have continued to research and write, shadow...more

McDermott+

Regs, Regs and More Regs: The Biden Administration Releases Spring 2024 Unified Agenda

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We are in the midst of a storm of regulations that are being released by the Centers for Medicare & Medicaid Services (CMS) and the US Department of Health and Human Services (HHS), including the Calendar Year (CY) 2025...more

Hall Benefits Law

HHS Issues Proposed Rule on Nondiscrimination in Health Programs and Activities

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The U.S. Department of Health and Human Services (HHS) has issued a proposed rule entitled “Nondiscrimination in Health Programs and Activities.” The proposed rule, designed to advance health equity and protect people from...more

Sheppard Mullin Richter & Hampton LLP

OIG Sparks Public Excitement about Managed Care and Alludes to Incoming Enforcement Guidance

“The American people deserve to know that the insurance companies receiving more than $700B annually in taxpayer funds are working to ensure you receive effective, high-quality care. Remember, you have rights and options to...more

ArentFox Schiff

NYS Insurance Regulators to Health Insurers: Ensure Your Networks Are Adequate

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On February 21, Superintendent Adrienne A. Harris of the New York State Department of Financial Services (DFS) unveiled a proposed regulation, 11 NYCRR 38. If adopted, this regulation, would establish network adequacy...more

McDermott Will & Emery

Discerning Congressional Purpose from the Proposed MHPAEA Regulations Comment Letters

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We continue our investigation of proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) issued by the US Departments of Labor, Health and Human Services and the Treasury (the Departments)...more

McDermott Will & Emery

The ‘Data Evaluation Requirement’ for NQTLs Under the Newly Proposed MHPAEA Regulations

Last week’s post examined the “no more restrictive” requirement that would apply to non-quantitative treatment limitations (NQTLs) set out in recently proposed regulations under the Mental Health Parity and Addiction Equity...more

Foley & Lardner LLP

HRSA Uninsured Program Covid-19 Services: OIG Audit Finds HRSA Paid for Claims that did not Comply with Federal Requirements

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On July 13, 2023 the Office of Audit Services of the Department of Health & Human Services Office of Inspector General (OIG) released the long-awaited audit (A-02-21-01013) of the Health Resources and Services Administration...more

McDermott Will & Emery

Short-Term, Limited Duration Insurance: How Long is Too Long?

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On July 7, 2023, the US Departments of Health and Human Services, Labor, and Treasury (collectively, the departments) released a Notice of Proposed Rulemaking (NPRM) and Fact Sheet that proposes to revise the definition of...more

Zuckerman Spaeder LLP

Whither Insurance Coverage for Preventive Health Services? District Court Decision Striking Down Affordable Care Act’s Preventive...

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On May 15, 2023, the Fifth Circuit temporarily stayed a district-court ruling that struck down a key part of the Affordable Care Act (ACA). As a result of the stay, the ACA’s health insurance coverage requirements for...more

Skadden, Arps, Slate, Meagher & Flom LLP

Privacy & Cybersecurity Update - April 2023

In this month’s Privacy & Cybersecurity Update, we look at Washington state’s passage of the first-ever state-level health data privacy law and the finalized California Consumer Privacy Act regulations. We also examine a...more

Rumberger | Kirk

The Multiple Issues Surrounding Medicare and Past Damages

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What amount of past medical expenses can a plaintiff present to the jury when he or she is a Medicare recipient? The short answer: only the amount of past medical expenses the plaintiff is obligated to pay, not the gross...more

Bass, Berry & Sims PLC

OIG Approves Free Drug Program for Ultra-Rare Condition in Advisory Opinion 23-02

Bass, Berry & Sims PLC on

On February 23, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued Advisory Opinion 23-02, approving a pharmaceutical company’s program to provide a free 14-day supply of an...more

Verrill

A Last-Minute Gift – Prescription Drug Reporting Grace Period and Good Faith Relief

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In a move akin to last-minute gift-giving, the Departments of Labor, Health and Human Services, and the Treasury (the “Departments”) released FAQ 56 on December 23, 2022, which provides relief regarding the Prescription Drug...more

Foley & Lardner LLP

CMS Extends Delayed Enforcement of the Good Faith Estimate

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On Friday, December 2, 2022, the Centers for Medicare & Medicaid Services (CMS) issued an FAQ regarding the Good Faith Estimate (GFE) and Convening Provider/Facility requirements in the Federal No Surprises Act. The issued...more

Akin Gump Strauss Hauer & Feld LLP

Updates in Co-Pay Assistance and Accumulators Litigation

Key Points - A new legal challenge to OIG on Medicare Beneficiaries’ ability to receive co-pay assistance has emerged. The Supreme Court has been asked to review HHS’s prohibition of co-pay assistance programs under the...more

Goodwin

Federal District Court Ruling May Jeopardize Insurance Coverage of More Than 50 Recommended Procedures, Screenings, and Treatments

Goodwin on

Under the Affordable Care Act, group health plans and health insurance issuers are required to provide health insurance coverage based on recommendations made by healthcare coverage professionals. The covered categories...more

Faegre Drinker Biddle & Reath LLP

Federal District Court Invalidates Some Surprise Billing Rules: What It Means for the No Surprises Act

On February 23, 2022, the United States District Court for the Eastern District of Texas invalidated portions of Part II of the interim final rule (“IFR”) issued by the U.S. Departments of Health and Human Services, Labor,...more

Manatt, Phelps & Phillips, LLP

Federal Regulators Issue Joint Report on MHPAEA Signaling Increased Enforcement Against Plans Likely

On Tuesday, the U.S. Departments of Labor, Health & Human Services, and the Treasury (the Departments) issued their joint report to Congress on the Mental Health Parity and Addiction Equity Act (MHPAEA). The Consolidated...more

Bradley Arant Boult Cummings LLP

The COVID-19 Home Game: Biden Administration Requires Insurance to Cover At-Home Tests

In light of the difficulty of test scheduling and concerns about costs to consumers, the Biden administration this week announced that the Department of Health and Human Services will require private health insurance and...more

Sheppard Mullin Richter & Hampton LLP

Tri-Agencies Release Guidance on Coverage of OTC COVID-19 Tests

On January 10, 2022, the U.S. Department of Health & Human Services, Department of Labor, and the Treasury (“Tri-Agencies”) published guidance about how health plans and health insurance issuers must reimburse OTC COVID-19...more

Mintz - Employment Viewpoints

Broker and Consultant Disclosures to Group Health Plans under Division BB of the Consolidated Appropriations Act, 2021

Division BB of the Consolidated Appropriations Act, 2021 (“Act”) broadly addresses surprise medical billing and health plan transparency. This post focuses on Section 202 of Division BB (the “Provision”), which establishes...more

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