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 »
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 »
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 »
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 »
The Equal Employment Opportunity Commission (EEOC) has formally withdrawn the provisions in its regulations governing wellness programs under the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act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 »
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 »
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 »
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 »
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 »
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 »
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 »
The 21st Century Cures Act set the stage for additional guidance to be issued under the Mental Health Parity and Addiction Equity Act (MHPAEA) and increased enforcement of its requirements. In a recent set of proposed frequently asked questions and answers, the Departments of Labor, Health and Human Services, and the Treasury provided examples of [&hellip… Continue Reading »
The IRS has announced that it will restore the family deduction limit for Health Savings Account (HSA) contributions to $6,900 for 2018. The IRS had previously set this limit last spring, but earlier this year announced that changes made by the Tax Cuts and Jobs Act would lower the limit to $6,850. Although only a [&hellip… Continue Reading »
Following a brief shutdown of the federal government, on February 9, Congress passed and President Donald J. Trump signed into law the Bipartisan Budget Act of 2018 (Budget Act), which provides Congress until March 23 to enact appropriation and certain other funding measures and establishes a general agreement on spending that will last into 2019. [&hellip… Continue Reading »
The Congressional agreement that reopened the federal government for three weeks quietly addressed—at least temporarily—several high-profile issues affecting public and private health benefits. Most significantly, the new appropriations act: Delays the effective date of the so-called Cadillac Tax by two years to 2022. This Affordable Care Act (ACA) provision imposes a 40 percent tax on [&hellip… Continue Reading »
Following up on the direction provided by Executive Order 13813, the U.S. Department of Labor (DOL) has issued proposed regulations that would expand the ability of small employers to band together and provide coverage under a single Association Health Plan (AHP). Under the new rules: AHPs may be formed by employers that are engaged in [&hellip… Continue Reading »
As it did last year, the IRS has extended the deadline for furnishing Forms 1095-B and 1095-C to individuals by 30 days. This reprieve will allow employers, health insurers, and other plan sponsors to distribute the forms on or before March 2, 2018, rather than January 31, 2018. The IRS also extends the good-faith transition [&hellip… Continue Reading »
The IRS has announced its intent to begin enforcing the employer-shared responsibility provisions (otherwise known as the employer mandate or pay-or-play provisions) of the Affordable Care Act for the 2015 calendar year. The IRS also published a template letter that it will mail to any applicable large employer (ALE) if it determines the ALE owes [&hellip… Continue Reading »
After a brief lull in activity, recent developments are likely to involve all three branches of government in addressing issues under the Affordable Care Act. The Legislature: It is often said that Congress rarely takes action until a crisis needs to be addressed. With the demise of this summer’s repeal and replace effort, initiatives to [&hellip… Continue Reading »
A federal judge ruled on Tuesday that the Equal Employment Opportunity Commission (EEOC) must revisit regulations governing employee wellness programs because the agency did not provide adequate supporting information for the rules. In AARP v. EEOC, U.S. District Judge John Bates agreed with AARP—a lobbying group for older Americans—that the EEOC had failed to justify [&hellip… Continue Reading »
The momentary lull in congressional activity on health care provides an opportune time for an update on the efforts to repeal and replace the Affordable Care Act (ACA). Following the House of Representatives’ approval of the American Health Care Act on May 4, 2017, the Senate Republican leadership introduced its own version, the Better Care [&hellip… Continue Reading »
The House Ways and Means and Energy and Commerce Committees have released, in two parts, budget reconciliation legislation, the first steps of Congress’ proposal to “repeal and replace” the Affordable Care Act. Reconciliation legislation is limited to budget-related provisions and restricts legislators’ ability to address fully all of the repeal and replacement provisions that we [&hellip… Continue Reading »
The U.S. Court of Appeals for the Third Circuit has vacated a district court’s dismissal of a data breach class action filed against Horizon Healthcare Services Inc., in the wake of the 2013 theft of two computer laptops containing unencrypted personal information of Horizon Healthcare plan members. The decision potentially expands the circumstances under which [&hellip… Continue Reading »
Changes are imminent for the Affordable Care Act and a range of other laws and regulations affecting the health care industry. Ballard Spahr attorneys established a Health Care Reform Initiative in 2008 to monitor and analyze health care reform developments. This Health Care Reform Dashboard was a product of that initiative. We intend to continue following [&hellip… Continue Reading »
