Health Care Reform Dashboard

Health Care Reform Dashboard

Charting Developments with the
Affordable Care Act and Beyond


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COVID-19 Coverage Without a Deductible Ends After 2024

The Internal Revenue Service (IRS) has issued new guidance, Notice 2023-37, which states that for plan years ending after December 31, 2024, HSA-compatible high-deductible health plans (HDHPs) will no longer be permitted to cover COVID-19 testing and treatment before the minimum deductible is satisfied. This guidance answers the question of how long these exceptions to the [&hellip… Continue Reading »

Spring Cleaning: Preparing for the COVID Emergency’s End

Summary 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 »

Congress Breathes New Life Into Pre-deductible Access to Telehealth Services

The recently enacted Consolidated Appropriations Act, 2022 (CAA 2022) is best known for preventing a government shutdown and providing aid to Ukraine, but its more than 2,600 pages also contain language that revives a telehealth services provision that many health plan sponsors will welcome. The provision allows participants to receive benefits under a High Deductible Health Plan [&hellip… Continue Reading »

More Guidance on Coverage of Over-the-Counter COVID-19 Test Kits

Following up on their earlier guidance the Departments of the Treasury, Labor, and Health and Human Services have issued an additional set of frequently asked questions and answers on the requirement to cover over-the-counter COVID-19 test kits. The new FAQ primarily offers further explanation of a safe harbor approach described in the earlier guidance. This safe harbor generally applies [&hellip… Continue Reading »

Provider’s Claims for COVID-19 Screening Charges Move Forward

Addressing motions to dismiss, a district court in Texas has found that a provider may proceed with its lawsuit to recover the full amount of its charges for COVID-19 diagnostic testing under the FFCRA and CARES Act from an insurer. The FFCRA and CARES Act require health plans and insurers to pay the amount published by a [&hellip… Continue Reading »

Further IRS Extensions and Waivers to Affordable Rental Housing Projects as COVID-19 Persists

Summary The IRS has extended certain deadlines relating to affordable housing projects with Low Income Housing Tax Credits (LIHTC) under Section 42 of the Internal Revenue Code of 1986, as amended (the Code) or financed with tax-exempt private activity bonds under Section 142(d) of the Code. The Upshot While COVID-19 disruptions continue, owners, operators, issuers, and state [&hellip… Continue Reading »

Employee Leave Requests: ADA Considerations During COVID-19 (Podcast)

Today’s episode features a discussion of how employers should handle leaves and requests for leave due to COVID-19 and “long COVID” under the FMLA (the Family and Medical Leave Act) and the ADA (the Americans with Disabilities Act). Participating in this discussion are Melissa Costello, Of Counsel in Ballard’s Phoenix office, Tara Humma, an Associate [&hellip… Continue Reading »

Health Plan Coverage Required for COVID-19 Testing

Summary Health plans now are required to cover the cost of over-the-counter COVID-19 test kits obtained without a health care provider’s prescription or clinical assessment. The new requirement is addressed in a set of FAQs issued January 10 by the U.S. Departments of the Treasury, Labor, and Health and Human Services. The Upshot Plans must meet the [&hellip… Continue Reading »

Upcoming Compliance Deadlines for Health and Welfare Plans

Summary Throughout 2020 and 2021, employers sponsoring health and welfare plans have needed to respond to a myriad of legislative and regulatory changes arising from the COVID-19 pandemic and new health legislation. To comply with these changes, employers may need to work with their vendors, amend their plans, and take other action. In this alert, [&hellip… Continue Reading »

IRS Issues New Guidance on COBRA Deadline Extensions

The IRS (with the concurrence of the DOL and HHS) has issued new guidance explaining how the extension of the deadline for paying COBRA premiums will be applied. The extension of deadlines for individuals to elect COBRA and pay for COBRA premiums on account of the COVID-19 pandemic remains in effect. These rules operate by [&hellip… Continue Reading »

HHS Clarifies Applicability of HIPAA Privacy Rule to COVID-19 Vaccination Status Requests

The U.S. Department of Health and Human Services (HHS) has released guidance to address how the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule applies to various entities’ requests for information related to an individual’s COVID-19 vaccination status. HHS emphasized that the Privacy Rule applies only to covered entities, including health plans and most [&hellip… Continue Reading »

COVID-19 Vaccination Incentives: Restrictions that Come with Rewards

Summary A set of Frequently Asked Questions addresses several issues of vital interest to employers in assessing the connection between COVID-19 vaccinations and their health plans. The Upshot The FAQs confirm that the preventive care rules under the Affordable Care Act (ACA) require health plans to cover the full cost of vaccinations that have received an emergency [&hellip… Continue Reading »

Reminder: COBRA Subsidy to End, Notice of Termination Required

The subsidy for COBRA coverage under the American Rescue Plan Act comes to an end on September 30, 2021. There is no indication at this time that the subsidy will be extended. That means that, beginning October 1, plan and COBRA administrators may start collecting premium payments from individuals who qualified for COBRA because of [&hellip… Continue Reading »

COBRA Premium Subsidies – A Little More Guidance (and a Reminder)

The IRS issued a new notice that provides guidance on a few issues that were not fully addressed in its earlier notice on the Consolidated Omnibus Budget Reconciliation Act (COBRA) premium subsidy requirements set forth in the American Rescue Plan Act (ARPA). ARPA generally requires the cost of coverage under COBRA between April 1, 2021, and September 30, 2021, to [&hellip… Continue Reading »

Reminder: COBRA Notice Deadline is May 31

This is a reminder that a COBRA notice deadline is approaching. It applies to employers that are subject to the federal COBRA rules. The American Rescue Plan Act (ARPA) requires employers that are subject to the federal COBRA rules to provide notice to those who do not currently have COBRA continuation coverage, but who are [&hellip… Continue Reading »

IRS Issues Additional Dependent Care FSA Guidance

Following up on guidance issued in February the IRS has issued a new notice on the temporary carryover rules for dependent care flexible spending accounts. The 2021 Consolidated Appropriations Act (CAA) provides that, for plan years ending in 2020 and 2021, participants in a dependent care plan may carry over unused amounts into the next plan year. These carryover [&hellip… Continue Reading »

IRS Weighs in on ARPA COBRA Subsidy

Summary The IRS issued guidance on a wide range of questions pertaining to the subsidies that employers are required to offer to COBRA qualified beneficiaries under the American Rescue Plan Act. The Upshot The guidance follows up on prior U.S. Department of Labor guidance, is generally consistent with prior IRS guidance, and includes an extensive [&hellip… Continue Reading »

Q&A: COBRA Subsidiaries Under the American Rescue Plan

The U.S. Department of Labor issued guidance on April 7 about the new COBRA subsidy rules under the American Rescue Plan (ARP). However, the DOL left some significant questions unanswered. More guidance on the COBRA provisions in ARP are expected. But until then, we address the most common questions below in an effort to provide [&hellip… Continue Reading »

COBRA Premium Assistance

The United States Department of Labor has issued much anticipated guidance and model forms under the COBRA subsidy rules introduced by the American Rescue Plan (ARP). The FAQ guidance and forms clarify some issues that employers have raised about the COBRA subsidy provisions of the ARP, but leave a number of the most significant questions unanswered. Clarifications and confirmations [&hellip… Continue Reading »

ARP: Employee Benefits and Executive Compensation

The American Rescue Plan (ARP) will have significant and immediate impacts on employee benefit plans, employers, and other plan sponsors and plan administrators. President Biden signed the ARP stimulus bill today. We highlight the most significant employee benefits and executive compensation changes under the ARP below. COBRA Provisions Section 9501 of the ARP requires employers [&hellip… Continue Reading »

A Rolling Extension – New Guidance on Employee Benefit Deadlines

The U.S. Department of Labor issued a notice that addresses how the extension announced last year for certain employee benefit deadlines will apply now that the commencement date for the extension has passed its one-year anniversary. Last spring, the DOL and IRS issued two notices that extended various deadlines for employee benefit plans and their [&hellip… Continue Reading »

Telehealth Compliance: Don’t Be Complacent During COVID-19

The incremental adoption of telehealth services exploded at the onset of the COVID-19 public health emergency (PHE), establishing telehealth as an integral tool for patient care. In efforts to maintain access to health care services and facilitate compliance with public health guidelines designed to slow the spread of COVID-19, regulatory agencies actively encouraged the use [&hellip… Continue Reading »

IRS Issues New Flexible Spending Account Rules

The IRS issued a notice that addresses many of the questions employers have raised about flexible spending accounts (FSAs) in view of the new rules set forth in the Consolidated Appropriations Act (CAA). The CAA provides temporary relief for concerns raised by the COVID-19 pandemic by allowing: 1. temporary expansions of the opportunity to carry [&hellip… Continue Reading »