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 »
President Trump signed into law a nearly $1.4 trillion spending package that avoided a government shutdown and will fund the government through September 30, 2020. The year-end spending package, signed December 20, 2019, contains a number of retirement and health and welfare provisions that will be of interest to employers and other plans sponsors and [&hellip… Continue Reading »
In a 2-1 decision, the Fifth Circuit Court of Appeals has upheld a district court ruling that the individual mandate under the Affordable Care Act is unconstitutional. However, the Fifth Circuit has sent the case back to the district court for further consideration on the extent to which the ruling invalidates other ACA provisions. The individual mandate [&hellip… Continue Reading »
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 »
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 »
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 »
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 »
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 »
Pursuant to a directive in last month’s Executive Order 13877, the Treasury Department issued guidance yesterday that lists particular preventive care items and services that may be covered by a high deductible health plan (HDHP) even before the deductible is satisfied. Many employers offer employees the opportunity to enroll in an HDHP with a health [&hellip… Continue Reading »
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 »
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 »
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 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 »
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 »
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 »
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 »
