By D. Finn Pressly and Edward I. Leeds on Posted in Health Plans,Healthcare Providers / Suppliers,HIPAAThe Health Insurance Portability and Accountability Act (HIPAA) regulations require updates to the Notice of Privacy Practices that health plan sponsors furnish to plan participants and health care providers furnish to patients. The updates must be made by February 16, 2026. The Upshot The regulations require changes to the Notice of Privacy Practices for information [&hellip… Continue Reading »
By D. Finn Pressly and Edward I. Leeds on Posted in Health Plans,Healthcare Providers / SuppliersThe Internal Revenue Service (IRS) has provided guidance on the changes made to the rules governing health savings accounts (HSAs) in the One Big Beautiful Bill, which was enacted this summer. The Upshot The guidance addresses: The Bottom Line The guidance generally addresses narrow points affecting the HSA changes in the legislation. Comments to the [&hellip… Continue Reading »
By D. Finn Pressly, Christian Fox and Edward I. Leeds on Posted in Health Plans,Healthcare Providers / Suppliers,ReportingEmployers now may have an opportunity to save money and time by posting a Notice of Availability with respect to the reporting required by the Affordable Care Act (ACA) and Forms 1095-B and 1095-C. The Upshot The Bottom Line Health plan sponsors can save time and money by posting a Notice of Availability with respect [&hellip… Continue Reading »
By Edward I. Leeds and D. Finn Pressly on Posted in Health Plans,Healthcare Providers / Suppliers,HIPAAA federal district court has vacated a federal regulation under HIPAA that provided special restrictions on the disclosure of reproductive health information. The Upshot The Bottom Line Employers will need to watch for relevant developments and consider how they affect their HIPAA compliance measures. They will, in any event, need to consider certain amendments to [&hellip… Continue Reading »
By D. Finn Pressly and Edward I. Leeds on Posted in Health Plans,Healthcare Providers / SuppliersA recent court filing offers a reprieve to health plan sponsors in their efforts to comply with final regulations issued last year under the Mental Health Parity and Addiction Equity Act (MHPAEA). In a motion to stay proceedings in a lawsuit challenging those regulations, the U.S. Departments of the Treasury, Labor, and Health and Human Services notified the court [&hellip… Continue Reading »
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 D. Finn Pressly and Lesley Frieder Wolf on Posted in Employee Benefits/Executive Compensation,Health Plans,HIPAAA new and unprecedented wave of class action complaints is targeting a common feature of many employer-sponsored benefit plans: tobacco-user surcharges. These surcharges are often part of a wellness program that charges higher medical plan premiums to participants who fail to certify that they do not use tobacco products. As we reported earlier this year, employers who [&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 »
