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 »
By D. Finn Pressly, Edward I. Leeds and Uchenna J. Osagiede on Posted in Health Plans,Healthcare Providers / Suppliers,Preventive ServicesSummary The Departments of Labor, the Treasury, and Health and Human Services have jointly issued FAQs that address the requirement to cover the full cost of certain preventive care services in view of the recent ruling in Braidwood v. Bacerra that invalidated some of those requirements. The Upshot The Bottom Line Given that the Biden Administration expects to challenge [&hellip… Continue Reading »
By D. Finn Pressly and Edward I. Leeds on Posted in CARES Act,COBRA,COVID-19,Health Plans,Healthcare Providers / SuppliersSummary The almost three-year-old COVID-19 national emergency and public health emergency declarations (Declarations) are slated to expire May 11, 2023. The Upshot The Bottom Line Plan sponsors should use the coming months to work with their advisors and administrators to ensure that their plan design, documents, and communications are appropriately reviewed and, if necessary, revised [&hellip… Continue Reading »
By D. Finn Pressly on Posted in Consolidated Appropriations Act (CAA),Health Plans,LegislationWith little time to spare before the provisions expired, Congress has extended, and President Biden is set to sign into law, an important safe harbor that allows plan sponsors to continue offering reduced-cost telehealth services without disrupting the ability to contribute to health savings accounts (HSAs). The extension is part of the $1.7 trillion Consolidated [&hellip… Continue Reading »
