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Philadelphia Employers Will Soon Be Required to Provide Commuter Benefits to Their Employees

Summary - On June 9, 2022, the Philadelphia City Council passed an ordinance that would require certain employers to make available to eligible employees a commuter transit benefit program. The bill is currently awaiting...more

Technical Guidance Issued on Transparency in Coverage Regulations

On April 19, 2022, the U.S. Departments of Health and Humans Services, Labor, and Treasury (collectively, the Departments) issued guidance which sets forth two separate safe harbors for group health plans and health insurance...more

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...more

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...more

The CAA's New Identification Card Requirements

Summary - To help individuals better understand the costs they will bear for medical care, the Consolidated Appropriations Act (CAA) requires health plan ID cards to include clear information about deductibles and...more

Understanding the New Continuity of Care Rule

Summary - Under a new rule introduced by the Consolidated Appropriations Act, 2021 (CAA), a health plan or insurer must offer an enrollee the opportunity to elect a transitional period of continued care with a provider...more

Prohibition Against Gag Clauses

Summary - Health plan vendors sometimes impose contractual restrictions on the disclosure of data that they consider to be confidential or proprietary. A number of new rules aim to foster transparency and require...more

U.S. Supreme Court Weighs in on ERISA Breach of Fiduciary Duty Claim in Hughes v. Northwestern University

Summary - The U.S. Supreme Court this week unanimously decided an ERISA fiduciary duty case, Hughes v. Northwestern University, which will impact dozens of similar cases currently pending against fiduciaries of section...more

Understanding the New Health Care Transparency Requirements

Summary - New rules require group health plans and insurers to disclose pricing information in three phases. This is the third briefing in Ballard Spahr’s series on the Consolidated Appropriations Act, 2021 (CAA) and...more

U.S. Department of Health and Human Services Approves Updates to the List of Preventive Items and Services to be Covered Without...

Revisions to preventive care and screening guidelines will require health plans and health insurance policies to provide 100 percent coverage for additional services for women, adolescents, children, and infants, following an...more

The U.S. Department of Labor Issues Proposed Rule Giving Plan Fiduciaries Greater Latitude to Invest in ESG Funds

On October 14, 2021, the U.S. Department of Labor (DOL) released a new proposed rule, "Prudence and Loyalty in Selecting Plan Investments and Exercising Shareholder Rights," that (again) seeks to define the extent to which a...more

DOL Proposes Another Round of ESG Investing Rules for Plan Fiduciaries

Summary - The U.S. Department of Labor (DOL) released Proposed Regulations for plan fiduciaries on the role Environmental, Social, and Governance (ESG) considerations should play in investment decisions....more

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. ...more

COBRA Subsidies Included in Latest Stimulus Proposal

Group health plan sponsors and administrators may soon need to introduce changes to their offer of continued coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). The House Education and Labor...more

HHS Issues HIPAA Guidance on Contacting Survivors of COVID-19 About Plasma Donation

The Office of Civil Rights of the U.S. Department of Health and Human Services has issued guidance clarifying how HIPAA’s Privacy Rule permits covered entities (in particular, health care providers and health plans) or their...more

IRS Guidance Provides COVID-19 Relief for Participants Taking Retirement Plan Distributions and Loans

The IRS has released Notice 2020-50, which provides guidance to employers that have amended their retirement plans to take advantage of provisions under the CARES Act that provide access to special plan distributions, known...more

DOL’s Long-Awaited Electronic Disclosure Rule for ERISA Retirement Plans is Finally Here!

On May 27, 2020, the United States Department of Labor (DOL) published its highly-anticipated Default Electronic Disclosures by Employee Pension Benefit Plans Under ERISA Final Rule (the E-Disclosure Final Rule), which...more

CMS Addresses Extended Deadlines for Benefit Plans

The Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) has followed the guidance, jointly issued by the U.S. Departments of Labor and the Treasury, that extends benefits-related deadlines...more

IRS Provides Flexibility for Employer-Sponsored Health Plans and FSAs in Response to COVID-19 Pandemic

The Internal Revenue Service (IRS) has issued new guidance, Notice 2020-29, in response to the COVID-19 pandemic, providing for temporary flexibility with respect to mid-year elections made during 2020 under Code section 125...more

HIPAA Rules and Media Coverage: HHS Issues Guidance Amidst the COVID-19 Pandemic

The Department of Health and Human Services has issued guidance confirming that the public health emergency brought on by the COVID-19 pandemic does not alter the restrictions that HIPAA’s Privacy Rule places on hospitals,...more

IRS Issues New Guidance on CARES Act Provisions Affecting Retirement Plans

The Internal Revenue Service has issued frequently asked questions (FAQs) clarifying the special distribution options and loan relief provisions applicable to eligible retirement plans and IRAs found in section 2202 of the...more

CMS Encourages Flexibility in Utilization Management and Prior Authorization Within Limits

The Centers for Medicare & Medicaid Services (CMS) issued FAQ guidance encouraging health insurers to relax their utilization management and prior authorization requirements in view of the COVID-19 pandemic while at the same...more

Federal Agencies Postpone Deadlines for Employee Benefit Plan Matters

The Internal Revenue Service has issued Notice 2020-23, which automatically postpones certain deadlines affecting employee benefit plans. Specifically, any deadline that would ordinarily fall on or after April 1, 2020,...more

CMS Releases Recommendations on Adult Elective Surgeries, Non-Essential Medical, Surgical, and Dental Procedures During COVID-19...

CMS Adult Elective Surgery and Procedures Recommendations: Limit All Non-Essential Planned Surgeries and Procedures, Including Dental, Until Further Notice. ...more

Health Care and Price Transparency: The Latest Summary

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...more

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