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Circuit Courts Extend Non-Discrimination Protections for Transgender Individuals

On May 13, 2024, the Eleventh Circuit Court of Appeals held that certain federal non-discrimination protections apply to transgender individuals in the group health plan (insured and self-insured) context. In particular, the...more

Latest Update to the Ongoing Challenge to the ACA’s Preventive Services Mandate

On June 21, 2024, the United States Court of Appeals for the Fifth Circuit (“Fifth Circuit”) issued its ruling in Braidwood v. Becerra. The court determined that the Affordable Care Act’s (“ACA”) requirement that group...more

Back to the Future: HHS Publishes ACA Section 1557 Nondiscrimination Final Rule Similar to 2016-Era Regulations

On May 6, 2024, the Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) and the Centers for Medicare and Medicaid Services (“CMS”) published the long-awaited Nondiscrimination in Health Programs...more

HHS Updates Regulations Implementing Section 504 of the Rehabilitation Act

On May 9, 2024, the Biden Administration continued its push to update and modernize federal nondiscrimination protections by publishing revised regulations (the “Final Rule”) that amend the Department of Health and Human...more

HHS Drops Appeal in Drug Coupon Case

On January 16, 2023, the Department of Health and Human Services (“HHS”) dropped its appeal of the U.S. District Court for the District of Columbia’s September 29, 2023 decision that vacated a portion of the 2021 Notice of...more

Court Ruling Calls Into Question Whether Plans and Issuers Can Exclude Drug Coupons Towards the MOOP

On September 29, 2023, the U.S. District Court for the District of Columbia vacated the 2021 Notice of Benefit and Payment Parameters (“2021 NBPP”) amendments to Affordable Care Act regulations. The amendments permitted (but...more

Parity or Bust: Tri-Agencies Propose Sweeping Changes to Mental Health Parity Requirements

On July 25, 2023, the Departments of Health and Human Services, Labor and Treasury (“Tri-Agencies”) issued sweeping new guidance on the Mental Health Parity and Addiction Equity Act (“MHPAEA”), including a Proposed Rule, a...more

Tri-Agencies Issue Proposed Rule on Short-Term, Limited-Duration Insurance, Excepted Benefits, and Level-Funded Plans

On July 7, the Departments of Labor, Treasury, and Health and Human Services (the “Tri-Agencies”) published a long-anticipated proposed rule (“Proposed Rule”) that...more

Three Key Strategies for Defending MHPAEA Claims: Preparing for the Lawsuit Before It Is Filed

The Paul Wellstone and Peter Domenici Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”) has increasingly been the focus of government enforcement activity and private plaintiff litigation. In its 2022 Report to...more

HHS Issues Proposed Rules Implementing the Individual Health Insurance Agent & Broker Fee Disclosure Requirements

As we discussed in our earlier summary, the Consolidated Appropriations Act, 2021, Public Law 116-260 (“CAA”), signed into law by the President on December 27, 2020, imposed new compensation disclosure requirements upon...more

Mental Health Parity Remains a Priority for Tri-Agency: MHPAEA Compliance in Response to the CAA

The Mental Health Parity and Addiction Equity Act of 2008’s (“MHPAEA”) provisions of the Consolidated Appropriations Act, 2021 (the “CAA”) became effective February 10, 2021 and added a requirement for group health plans and...more

Breaking Down the “Outbreak Period” Extensions: The Clock May Begin Ticking Soon for Important Deadlines Suspended Due to COVID-19

As the COVID-19 pandemic began to overwhelm the country last spring, the Departments of Labor (“DOL”) and Treasury (together, the “Departments”) became concerned that the disruption caused by the pandemic would create...more

Trump Administration Issues COVID-19 Vaccine and Transparency Rules

In late October, the Trump Administration, through the Departments of Health and Human Services (“HHS”), the Treasury, and Labor (“Departments”), issued two different rules — one implementing the Coronavirus Aid, Relief, and...more

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