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
On April 29, 2024, the Department of Labor (“DOL”) released a final regulation (the “Final Rule”) that rescinded the Trump Administration rule that expanded the availability of association health plans (“AHPs”) (“Trump DOL...more
On March 28, 2024, the Departments of Labor, Treasury, and Health and Human Services (the “Tri-Agencies”) issued final regulations on short-term, limited-duration insurance (“STLDI”), hospital and other fixed indemnity...more
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
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
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
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
CMS published the Calendar Year (“CY”) 2024 Medicare Advantage (“MA”) Capitation Rates and Part C and Part D Payment Policies (“Rate Announcement“) on March 31 and, five days later, issued the MA and Part D final rule for...more
On March 9, 2023, President Biden released his budget for Fiscal Year 2024. Similar to proposals in its last budget, the Administration’s new budget proposes a number of major tax increases, including the following:...more
4/4/2023
/ Biden Administration ,
Compensation & Benefits ,
Employee Benefits ,
Federal Budget ,
Future Tax Treatment ,
Health Insurance ,
Infrastructure ,
Retirement ,
Retirement Plan ,
Tax Liability ,
Tax Reform
On March 30, 2023, the District Court for the Northern District of Texas issued an opinion and order in Braidwood Mgmt. Inc. v. Becerra that vacates the implementation and enforcement of certain preventive service provisions...more
4/3/2023
/ Affordable Care Act ,
Constitutional Challenges ,
Cost-Sharing ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare ,
Non-Grandfathered Health Plans ,
Preventive Health Care ,
Religious Freedom Restoration Act (RFRA) ,
Vacated
Last week the Senate passed the Continuing Appropriations Act, 2023 (“CAA23”). The House of Representatives will likely consider the measure today, and President Biden is expected to sign the bipartisan measure into law...more
12/26/2022
/ Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
Health Savings Accounts ,
Healthcare ,
Healthcare Reform ,
HSA ,
Medicaid ,
Medicare ,
Medicare Secondary Payer Act ,
Mental Health Parity Rule ,
Pending Legislation ,
Regulatory Agenda ,
Telehealth
On Tuesday, December 13, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“New Proposed Rule”) to improve the prior authorization process and advance interoperability for Medicare Advantage...more
12/22/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Comment Period ,
Federally Facilitated Exchanges ,
Health Insurance ,
Healthcare ,
Managed Care Contracts ,
Medicaid ,
Medicare ,
Medicare Advantage Organizations (MAOs) ,
Prior Authorization ,
Proposed Rules ,
Qualified Health Plans
On September 7, 2022, the District Court for the Northern District of Texas ruled a key component of the Patient Protection and Affordable Care Act’s (“ACA”) preventive services mandate unconstitutional. Braidwood Mgmt. Inc....more
As a reminder, on Friday July 1, 2022, with respect to plan or policy years beginning on or after January 1, 2022 through July 1, 2022, group health plans (self-funded and insured) and health insurance issuers are required to...more
On February 18, 2022, President Biden again formally extended the COVID-19 National Emergency, which was set to expire on March 1, 2022. As explained in detail in our previous alerts, this most recent extension means that...more
On December 2, 2021, President Biden announced new actions to combat COVID-19, given the emergence of the new Omicron variant. As part of his nine-point plan, the President included a directive that “the more than 150...more
Illinois recently enacted the Consumer Coverage Disclosure Act (the “CCDA”), which requires that Illinois employers provide a disclosure to employees regarding how the employer’s group health plan compares with the essential...more
On December 2, 2021, President Biden announced new actions to combat COVID-19, given the emergence of the new Omicron variant. As part of his nine-point plan, the President included a directive that “the more than 150...more
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
On September 15, the House Ways and Means and Energy and Commerce Committees advanced components of the Democrats’ $3.5 trillion budget reconciliation package (“Budget Legislation” or “the Legislation”). The Legislation...more
On July 1, 2021, the Office of Personnel Management, Department of the Treasury, Department of Health and Human Services (“HHS”), and Department of Labor (“DOL”) (collectively, the “Departments”), released the interim final...more
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
This webinar will include a discussion on the various provisions of the new surprise billing law, how it interacts with current law, expected guidance from the Biden Administration, and implications for health insurance...more
1/6/2021
/ Biden Administration ,
Health Care Providers ,
Health Insurance ,
Health Plan Sponsors ,
Healthcare Reform ,
Hospitals ,
New Legislation ,
Out of Network Provider ,
Physicians ,
Surprise Medical Bills ,
Webinars
In the recently-decided Rutledge v. Pharmaceutical Care Management Association (“PCMA”), the Supreme Court found 8–0 (Justice Barrett did not take part) that ERISA did not preempt an Arkansas state law that established...more
1/5/2021
/ Corporate Counsel ,
Drug Pricing ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance ,
Pharmaceutical Industry ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Preemption ,
Prescription Drug Coverage ,
Prescription Drugs ,
Rutledge v Pharmaceutical Care Management Association ,
SCOTUS
The dust has settled and the 2020 election has concluded with former Vice President Biden poised to become president. At the same time, Democratic control of the House of Representatives has narrowed to the smallest margin...more