On the issue of gender-affirming care, how would a Harris-Walz administration affect clients in your practice?
Bottom line: A Harris-Walz administration would likely provide health plans and health plan sponsors with...more
10/22/2024
/ Affordable Care Act ,
Donald Trump ,
Employee Benefits ,
Employer Group Health Plans ,
Employer Liability Issues ,
Employment Policies ,
Gender Equity ,
Health Insurance ,
Healthcare ,
Kamala Harris ,
LGBTQ ,
Political Campaigns ,
Political Candidates ,
Presidential Elections ,
Proposed Legislation ,
Proposed Regulation ,
Sex Discrimination ,
Telemedicine
The US Departments of the Treasury, Labor, and Health and Human Services (the Departments) recently issued much-anticipated final regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). The newly issued...more
9/18/2024
/ Benefit Plan Sponsors ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Health and Welfare Plans ,
Health Insurance ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Popular ,
U.S. Treasury
Recent lawsuits filed against the group health plans of two large US employers underscore the importance of implementing formal welfare benefit plan governance structures that include fiduciary committees comparable to the...more
If our trade and industry sources have it right, we could see final regulations implementing the Mental Health Parity and Addiction Equity Act (MHPAEA), as most recently amended by the Consolidated Appropriations Act, 2021...more
8/6/2024
/ Chevron Deference ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Government Agencies ,
Health and Welfare Plans ,
Loper Bright Enterprises v Raimondo ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
Noncompliance ,
NQTLs ,
Proposed Regulation ,
Regulatory Agenda ,
SCOTUS ,
Statutory Authority ,
U.S. House ,
U.S. Treasury
On July 1, 2024, the US Department of Labor (DOL) submitted final regulations to the Congressional Budget Office (CBO), implementing the Mental Health Parity and Addiction Equity Act (MHPAEA) as most recently amended by the...more
7/30/2024
/ Congressional Budget Office ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Health Insurance ,
Healthcare ,
Insurance Industry ,
Mental Health ,
MHPAEA ,
NQTLs ,
Proposed Regulation ,
U.S. Treasury
A question in response to last week’s post on self-funding of employer group health plans assumed that stop-loss coverage under a level-funded plan could be provided under a group captive medical captive. However, it cannot...more
In a recent article in Managed Healthcare Executive, Peter Wehrwein examines the trend of self-funding of group health benefits by smaller employers who used to depend mainly or entirely on fully insured programs....more
Section 1557 of the Affordable Care Act (ACA) prohibits discrimination on the basis of race, color, national origin, sex, age or disability, or any combination thereof, in a health program or activity, any part of which is...more
6/3/2024
/ Affordable Care Act ,
Civil Rights Act ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Federal Health Insurance Exchanges ,
Final Rules ,
Gender Identity ,
Health Care Providers ,
Non-Discrimination Rules ,
OCR ,
Public Health Insurance Marketplace ,
Section 1557
In a recent On the Subject (available here), we reported on the impact of the final rule (final rule) interpreting Section 1557 of the Affordable Care Act (ACA) on self-funded group health plans that contract with licensed...more
5/21/2024
/ Affordable Care Act ,
Benefit Plan Sponsors ,
Covered Entities ,
Employee Benefits ,
Final Rules ,
Health and Welfare Plans ,
Health Insurance ,
Medicare ,
Medicare Advantage ,
Medicare Modernization Act ,
Medicare Part D ,
Section 1557 ,
Self-Funded Health Plans
The Internal Revenue Service (IRS) recently announced (see Revenue Procedure 2024-25) cost-of-living adjustments to the applicable dollar limits for health savings accounts (HSAs), high-deductible health plans (HDHPs) and...more
5/10/2024
/ Benefit Plan Sponsors ,
Deductibles ,
Employee Benefits ,
Employer Group Health Plans ,
HDHP ,
Health Insurance ,
Health Plan Sponsors ,
Health Savings Accounts ,
HRA ,
HSA ,
IRS
On April 26, 2024, the US Department of Health and Human Services (HHS) issued a final rule (press release, fact sheet, FAQs) (final regulations) reinterpreting Section 1557 of the Affordable Care Act (ACA), which prohibits...more
5/9/2024
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Disability Discrimination ,
Final Rules ,
Gender Discrimination ,
Gender Identity ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Medicare Part B ,
New Regulations ,
Non-Discrimination Rules ,
Race Discrimination ,
Section 1557 ,
Sexual Orientation Discrimination
A recently decided US Court of Appeals for the Ninth Circuit case, Ryan S. v. UnitedHealth Group, Inc., offers some useful insights on the enforcement by private litigants of the Mental Health Parity and Addiction Equity Act...more
4/19/2024
/ Appeals ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Liability Issues ,
ERISA Litigation ,
Health and Welfare Plans ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Proposed Regulation ,
Proposed Rules
Federal legislative and regulatory activity related to employer-sponsored group health plans shows no signs of slowing, particularly with the issuance of interpretive guidance regarding the transparency and surprise-billing...more
2/26/2024
/ Dobbs v. Jackson Women’s Health Organization ,
Employee Benefits ,
Employer Group Health Plans ,
Employer Liability Issues ,
Health Insurance ,
Healthcare ,
Insurance Industry ,
Legislative Agendas ,
Regulatory Agenda ,
SCOTUS ,
Self-Funded Health Plans
Thanks to two cases about federally mandated observers on fishing boats, judicial deference to agencies is likely to soon get weaker – and more unpredictable – with wide-ranging impacts for employee benefits. Less deference...more
2/22/2024
/ Benefit Plan Sponsors ,
Chevron Deference ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employees ,
Employer Liability Issues ,
Employment Litigation ,
Environmental Social & Governance (ESG) ,
IRS ,
Loper Bright Enterprises v Raimondo ,
Private Letter Rulings ,
Proposed Rules ,
SCOTUS
This post continues our consideration of comments submitted in response to proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). Our previous MHPAEA content is available...more
2/20/2024
/ Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Health and Welfare Plans ,
Health Insurance ,
Healthcare Reform ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
U.S. Treasury
Employers and plan sponsors are facing growing – and often conflicting – pressures related to the coverage of gender-affirming care. Join McDermott lawyers Sarah G. Raaii and Alden J. Bianchi for a webinar to review recent...more
2/16/2024
/ Affordable Care Act ,
Best Practices ,
Continuing Legal Education ,
Denial of Insurance Coverage ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health Insurance ,
Health Plan Sponsors ,
Insurance Claims ,
Insurance Industry ,
Minors ,
Standard Setting Organizations ,
State Bans ,
Transgender ,
Webinars
Comments submitted in response to the proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) reflect a broad range of perspectives. Our previous MHPAEA content is available here....more
2/2/2024
/ Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Health and Welfare Plans ,
Mental Health ,
Mental Health Initiatives ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Proposed Rules ,
Standard of Care ,
U.S. Treasury
After a brief hiatus to discuss the pleading standards adopted by the US Court of Appeals for the Tenth Circuit in E.W. v. Health Net Life Insurance Company, we return to our examination of the comments submitted in response...more
This post continues our focus on comment letters submitted in response to proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). The proposed regulations were issued earlier this year by the US...more
Employer-sponsored health insurance covers almost 159 million non-elderly US workers and their dependents, and employees and jobseekers alike view group health coverage as the single most important non-cash job-related...more
11/28/2023
/ Affordable Care Act ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employees ,
Employer Group Health Plans ,
Employer Liability Issues ,
Fiduciary Duty ,
Health Insurance ,
Insurance Industry ,
Regulatory Agenda
In our last post, we considered some of the comment letters submitted in response to proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) issued by the US Departments of Labor, Health and...more
11/14/2023
/ Biden Administration ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Health and Welfare Plans ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Proposed Regulation ,
Regulatory Agenda ,
U.S. Treasury
We continue our investigation of proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) issued by the US Departments of Labor, Health and Human Services and the Treasury (the Departments)...more
11/8/2023
/ Biden Administration ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
Insurance Industry ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Proposed Regulation
This post continues our investigation of proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) issued by the US Departments of Labor, Health and Human Services and the Treasury (the...more
This post continues our investigation of proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) issued by the US Departments of Labor, Health and Human Services and the Treasury (the...more
9/26/2023
/ Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Health and Welfare Plans ,
Health Insurance ,
Healthcare Reform ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
U.S. Treasury
This post continues our investigation of proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) issued by the US Departments of Labor, Health and Human Services and the Treasury (the...more
9/21/2023
/ Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance ,
Internal Revenue Code (IRC) ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
PHSA ,
Proposed Regulation ,
U.S. Treasury