Health Care Reform Dashboard

Health Care Reform Dashboard

Charting Developments with the
Affordable Care Act and Beyond

Health Plans

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05/15/2020

IRS Increases Carryover Limits for Health FSAs/Addresses Timing of Health Insurance

The Internal Revenue Service (“IRS”) has issued new guidance, Notice 2020-33, that increases the maximum carryover limit for health flexible spending arrangements (“health FSAs”), and clarifies the ability of health plans to reimburse premium expenses incurred prior to the beginning of the plan year. Increased Carryover Limit Health FSAs generally operate on a use-it-or-lose-it basis. [&hellip… Continue Reading »
05/01/2020

Health Insurance Exchanges: A $12B Judgment

The U.S. Supreme Court has determined that the federal government must pay over $12 billion to certain health insurers that participated in health insurance exchanges in the first three years that those exchanges were in effect. In Maine Community Health Options v. United States, the court ruled that health insurers that suffered financial losses beyond [&hellip… Continue Reading »
12/05/2019

A Little Extra: IRS Ups ACA Reporting Relief

Once again, the IRS has extended the deadline for furnishing Forms 1095-B and 1095-C to individuals. Reporting penalties will not apply to those who meet the applicable deadlines and complete the forms in good faith. The deadlines for reporting information for 2019 are: Deadline for providing Forms 1095-B and 1095-C to individuals: March 2, 2020 [&hellip… Continue Reading »
12/04/2019

Health Care & Price Transparency: The Latest

Federal executive agencies recently published two rules, one final and one proposed, aimed at publicizing the various costs associated with health care. A final rule, promulgated by the Department of Health and Human Services (HHS) via the Centers for Medicare & Medicaid Services (CMS), requires hospitals to establish, update, and publish online a list of [&hellip… Continue Reading »
10/16/2019

Proposed Regulations Provide Additional Guidance on Individual Coverage HRAs

The U.S. Department of the Treasury has issued proposed regulations addressing how individual coverage health reimbursement arrangements (ICHRAs) can comply with the Employer Shared Responsibility Payments (ESRP) requirements under the Affordable Care Act (ACA) and the nondiscrimination rules for self-funded medical plans under section 105(h) of the Internal Revenue Code. The proposed regulations follow a [&hellip… Continue Reading »
09/09/2019

HIPAA Right to Access Information Enforced

With all of the attention on Health Insurance Portability and Accountability Act (HIPAA) requirements to safeguard the privacy and security of a patient’s health information, covered entities sometimes overlook the HIPAA provisions that give patients rights to their information. This includes a patient’s right to access his or her medical and billing records from providers and [&hellip… Continue Reading »
07/26/2019

U.S. District Court Upholds Short-Term Limited Duration Insurance Rule

The U.S. District Court for the District of Columbia upheld a rule that expanded the maximum length of time for short-term, limited duration insurance (STLDI). STLDI is coverage that lasts a limited period of time and is exempt from many of the requirements that apply to plans in the individual health insurance market. Concerned that STLDI [&hellip… Continue Reading »
07/02/2019

Executive Order Aims to Enhance Transparency in Health Care Costs and Quality

On June 24, 2019, President Trump signed Executive Order 13877, Improving Price and Quality Transparency in American Healthcare to Put Patients First. This is the President’s third executive order affecting the health care industry. Executive Order 13813 issued in October 2017, set the regulatory agenda for Association Health Plans, Short-Term Limited-Duration Insurance, and Individual Coverage Health Reimbursement [&hellip… Continue Reading »
06/19/2019

Coming to Market: Final Rules for Individual Coverage HRAs

The U.S. Departments of the Treasury, Labor, and Health and Human Services have issued final regulations allowing employers to establish health reimbursement arrangements and certain other types of reimbursement plans (collectively, “individual coverage HRAs”) that integrate with individual health insurance coverage. Individual coverage HRAs (ICHRAs) present an alternative to traditional group health coverage and allow employers to [&hellip… Continue Reading »
06/05/2019

HHS Proposes to Scale Back ACA Nondiscrimination Rules

The U.S. Department of Health and Human Services (HHS) has released proposed regulations that, if finalized, will significantly narrow the scope of the nondiscrimination requirements under Section 1557 of the Affordable Care Act (ACA). Section 1557 prohibits certain health programs from discriminating against individuals on the basis of race, color, national origin, sex, age, or disability, [&hellip… Continue Reading »
05/08/2019

OCR Announces $3 Million HIPAA Enforcement Settlement for Breach of 300,000 Patients’ PHI

On May 6, 2019, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced an agreement  with Touchstone Medical Imaging, LLC (Touchstone), settling allegations that Touchstone violated the Health Insurance Portability and Accountability Act (HIPAA) Security Rule by allowing uncontrolled public access to patients’ protected health information (PHI). Touchstone provides [&hellip… Continue Reading »
05/03/2019

HHS Decreases Maximum HIPAA Penalties

The Department of Health and Human Services has announced that it is lowering the maximum amount it will assess for most types of HIPAA violations. Although the change is couched as an exercise of discretion, HHS states that it is basing the modifications on a change in its interpretation of the penalty provisions set forth in [&hellip… Continue Reading »
04/01/2019

Association Health Plan Regulations Invalidated

The U.S. District Court for the District of Columbia has set aside the most significant portions of the U.S. Department of Labor’s (DOL) regulations on Association Health Plans (AHPs). The court’s ruling invalidates regulatory provisions that sought to broaden the groups of employers that could be treated as if they were a single employer, allowing [&hellip… Continue Reading »
12/20/2018

EEOC Withdraws Wellness Incentive Guidance

The Equal Employment Opportunity Commission (EEOC) has formally withdrawn the provisions in its regulations governing wellness programs under the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA), which set limits on the amount of incentives for participation in a wellness program. This withdrawal aligns the regulations with a court order that [&hellip… Continue Reading »
12/17/2018

District Court Rules ACA Unconstitutional

The Affordable Care Act returned to the front page this weekend when a federal district court in Texas issued an opinion striking down the entire law as unconstitutional. The case arose from a lawsuit filed by a contingent of Republican state attorneys general, one governor, and a few individuals. They asserted that Congress’s elimination of [&hellip… Continue Reading »
12/03/2018

IRS Extends ACA Reporting Deadline Again This Year

For the third consecutive year, the IRS has extended by 30 days the deadline for health plan sponsors to furnish Forms 1095-B and 1095-C to individuals. A 30-day extension would place the deadline on a Saturday, so this year’s reprieve will allow employers, health insurers, and other plan sponsors to distribute the forms on or [&hellip… Continue Reading »
11/21/2018

IRS Issues Additional Guidance on Health Reimbursement Arrangements

The IRS has followed up on its recently proposed Health Reimbursement Arrangements (HRA) regulations with guidance on some open issues. Notice 2018-88 specifically addresses the interplay between HRAs and two Internal Revenue Code requirements: the employer mandate under the Affordable Care Act (Code Section 4980H) and the nondiscrimination rules for self-funded health plans (Code Section 105(h)). Employer [&hellip… Continue Reading »
10/24/2018

New Guidance Creates a New Playing Field for HRAs

The U.S. Departments of the Treasury, Labor, and Health and Human Services have jointly issued proposed regulations that envision a broad landscape for the use of health reimbursement arrangements (HSAs) and certain other account-based plans to fund health benefits. The rules provide the last and, perhaps, the most significant set of guidance generated by an Executive [&hellip… Continue Reading »
08/03/2018

Final Regulations Expand Availability of Individual Insurance Not Meeting ACA Requirements

The U.S. Departments of the Treasury, Labor, and Health and Human Services have jointly issued final rules modifying the definition of short-term, limited-duration insurance (STLDI). STLDI provides health coverage that is intended to be transitional in nature. It is not regarded as individual health insurance or minimum essential coverage and is exempt from certain Affordable [&hellip… Continue Reading »
06/22/2018

DOL Releases Final Regulation Expanding Association Health Plans

The U.S. Department of Labor (DOL) on Tuesday released final regulations modifying the Association Health Plan (AHP) rules to expand their availability for small and large employers and to address their affordability by eliminating certain coverage requirements applicable to qualified health plans under the Affordable Care Act (ACA). The regulations aim to balance the need [&hellip… Continue Reading »
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