By D. Finn Pressly and Edward I. Leeds on Posted in Health Plans,Healthcare Providers / Suppliers,NondiscriminationSection 1557 of the Affordable Care Act mandates nondiscrimination in health care programs managed or funded by the Department of Health and Human Services (HHS), with upcoming deadlines for compliance set for May and July 2025. However, uncertainties remain regarding enforcement and future regulatory guidance, especially concerning provisions related to transgender discrimination and foreign language [&hellip… Continue Reading »
By Edward I. Leeds, Gregory P. Szewczyk, Eric K. Temmel and Mudasar Khan on Posted in HIPAA,HIPAA and Data Security,UncategorizedThe U.S. Department of Health and Human Services (HHS) has proposed changes to its Health Insurance Portability and Accountability Act (HIPAA) Security Rule designed to enhance the cybersecurity of health care providers, health plans, and related entities. The Upshot The Bottom Line Public comments on the proposed rule are due on or before March 7, [&hellip… Continue Reading »
By Edward I. Leeds and D. Finn Pressly on Posted in Health Plans,Healthcare Providers / SuppliersSummary The Biden administration has issued two sets of final regulations that overturn rules adopted during the Trump administration pertaining to association health plans and short-term, limited-duration insurance (STLDI). The regulations go into effect June 17, 2024. The Upshot The Bottom Line The new rules come as no surprise, but employers considering entering into an association health [&hellip… Continue Reading »
By Edward I. Leeds and D. Finn Pressly on Posted in Health Plans,Healthcare Providers / Suppliers,HIPAASummary Providing notice of a vendor’s HIPAA breach is often difficult, but it can be particularly hard when information is delayed. Sometimes an investigation takes months to complete, and the HIPAA deadline for providing notice may have passed before a health plan or health care provider even knows who was affected by the breach and [&hellip… Continue Reading »
By D. Finn Pressly and Edward I. Leeds on Posted in Health Plans,Healthcare Providers / SuppliersSummary The United States Department of Health and Human Services (HHS) has filed court pleadings stating that it does not intend to initiate enforcement actions against plans that maintain copay accumulator programs. The Upshot The Bottom Line The non-enforcement policy provides welcome—albeit temporary—relief for employers weighing their options following the court’s decision. In court papers [&hellip… Continue Reading »
By D. Finn Pressly and Edward I. Leeds on Posted in Health Plans,Healthcare Providers / SuppliersSummary Employers taking advantage of copay accumulator programs now face unexpected administrative complications following a recent federal court decision. The Upshot The Bottom Line Plan sponsors should consult with their advisers to determine how this recent federal court decision affects their employee prescription drug benefit design. Some employers may not even know that their benefit [&hellip… Continue Reading »
By D. Finn Pressly and Edward I. Leeds on Posted in Consolidated Appropriations Act (CAA),Health Plans,Healthcare Providers / SuppliersSummary The Departments of Labor, Health and Human Services, and the Treasury have issued guidance that coordinates application of the No Surprise Billing rules under the Consolidated Appropriations Act, 2021, with the cost-sharing limits under the Affordable Care Act and the requirement to provide access to cost information through an internet-based self-service tool under the [&hellip… Continue Reading »