News & Analysis as of

Consolidated Appropriations Act (CAA)

King & Spalding

Congress Considering Bipartisan Legislation to Expand Medicare GME Programs

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On December 18, 2024, a bipartisan group of four Senators on the Senate Finance Committee released draft legislation that would expand the total number of Medicare Graduate Medical Education (GME) full-time equivalent (FTE)...more

Davis Wright Tremaine LLP

COVID-19 Telehealth Flexibilities Extending and Enduring

In the wake of an end of year filled with intense negotiations and political wrangling, Congress has successfully enacted the American Relief Act, 2025 ("the Budget Bill" or "legislation"), narrowly averting a government...more

King & Spalding

FDA Issues Draft Guidance on Accelerated Approval Focused on How the Agency Will Implement New Authorities

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On December 5, 2024, the U.S. Food and Drug Administration (FDA or Agency) issued a draft guidance entitled Expedited Program for Serious Conditions—Accelerated Approval of Drugs and Biologics (Draft Accelerated Approval...more

Akin Gump Strauss Hauer & Feld LLP

A New Year, Congress and Trump Administration: 10 Health Issues to Watch in 2025

As the new year begins, change is afoot inside the Beltway as the 119th Congress gets underway and Washington prepares for President Trump’s second administration. While change is bringing uncertainty on some fronts, health...more

Jackson Lewis P.C.

Health and Welfare Plans: Recent Topics in Year-End Compliance

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As we bid farewell to 2024 and look ahead to the new year, we reflect on the many evolving compliance obligations that health and welfare plan sponsors tackle each year. Although this list is by no means exhaustive, it...more

Holland & Knight LLP

Holland & Knight Health Dose: December 17, 2024

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Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

Davis Wright Tremaine LLP

Effective Care: California Left Behind as Other States Expand Hospital at Home Programs

Hospital at Home (“HaH”) programs received renewed interest during the COVID-19 pandemic as a way to relieve hospital capacity issues and allow patients to receive effective care outside of the traditional hospital setting....more

Foley & Lardner LLP

Medicare Telehealth Flexibilities Get a Three-Month Lifeline

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After much uncertainty, Congress has extended many Medicare telehealth flexibilities through March 31, 2025, in its end-of-year appropriations bill. However, several important flexibilities, such as first-dollar coverage of...more

McDermott Will & Emery

Complying With the ‘Relevant Data’ Requirement Under the Final 2024 Mental Health Parity and Addiction Equity Act: A Proposal for...

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The Mental Health Parity and Addiction Equity Act (MHPAEA) generally requires group health plans and health insurance issuers to ensure that financial requirements (such as copays and deductibles), quantitative treatment...more

Sheppard Mullin Richter & Hampton LLP

Congress Extends Telehealth Flexibilities for Two More Years

With only two weeks remaining in the year, Congress is considering a government funding deal (the “Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025” or the “Bill”) that includes a...more

Snell & Wilmer

Deadline Approaches for Expiring Medicare Telehealth Waivers: What Providers Should Know

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During the COVID-19 pandemic, both federal and state governments enacted a host of laws and implemented flexibilities to ensure health care providers, hospitals, and health systems could move traditional brick-and-mortar care...more

Dinsmore & Shohl LLP

Is the End Near? Medicare Telehealth Flexibilities Set to Expire at the End of the Year

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The temporary telehealth flexibilities that Medicare patients and providers have become accustomed to since the COVID-19 pandemic are set to expire December 31, 2024. The Consolidated Appropriations Act of 2023 extended many...more

McDermott+

No Surprises Act Implementation Under the Trump Administration

McDermott+ on

The No Surprises Act, a law that ended the practice of “balance billing” by certain out-of-network providers, was enacted as part of the Consolidated Appropriations Act of 2021 on December 27, 2020. While the law passed...more

Akin Gump Strauss Hauer & Feld LLP

FDA Announces Draft Guidance for Industry Regarding Accelerated Approval for Drugs and Biologics

On December 5, 2024, FDA unveiled the draft guidance for industry regarding accelerated approval for drugs and biologics. This guidance provides additional information regarding the development of drugs and biologics to treat...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Don’t Overlook Year-End HDHP Changes to Telehealth Cost-Sharing

Employers providing health plan coverage through a high-deductible health plan (HDHP) may need to amend their HDHP before year-end to remove first-dollar telehealth coverage. Although prior regulatory relief permitted...more

McDermott+

Virtual Care Policy Update: What to Expect in Lame Duck

McDermott+ on

Updated November 18, 2024 – The Consolidated Appropriations Act (CAA), 2023 (Public Law 117-328), signed into law on December 29, 2022, extended certain key telehealth flexibilities instituted during the COVID-19 public...more

King & Spalding

CMS Issues CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final...

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On November 1, 2024, CMS issued a final rule with updates to the Medicare payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System for...more

Alston & Bird

Final Mental Health Parity Rules: A Plan Sponsor’s Implementation Guide

Alston & Bird on

Our Employee Benefits & Executive Compensation Group discusses what health plan sponsors need to know about the final rule on nonquantitative treatment limitations (NQTLs) and NQTL comparative analysis under the Mental Health...more

Foley & Lardner LLP

Health Policy: Expected Movements in the Lame Duck Session – November/December 2024

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Congress returned to Washington this week with just five weeks left in this year’s legislative calendar. With a Continuing Resolution (CR) that expires December 20, 2024, either a year-end spending package or a new Continuing...more

Snell & Wilmer

2024 End-of-Year Plan Sponsor “To Do” List (Part 1) Health and Welfare

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We are pleased to present our annual End of Year Plan Sponsor “To Do” Lists. This year, we present our “To Do” Lists in four separate SW Benefits Updates. This Part 1 covers year-end health and welfare plan issues. Parts 2,...more

Ballard Spahr LLP

Surprise, Surprise! No Surprise Billing Regulations Upheld

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The Fifth Circuit Court of Appeals recently upheld regulations defining the qualifying payment amount (QPA). The QPA is a key factor in determining how much individuals and health plans must pay out-of-network providers in...more

McDermott+

Virtual Care Policy Update: What to Expect in Lame Duck

McDermott+ on

The Consolidated Appropriations Act (CAA), 2023 (Public Law 117-328), signed into law on December 29, 2022, extended certain key virtual care flexibilities instituted during the COVID-19 public health emergency (PHE) through...more

Bergeson & Campbell, P.C.

Washington, D.C., Is about to Get Busy: What Will Happen during the 76-Day Sprint from Election Day to Inauguration Day

There is much that happens in Washington, D.C., and in the states in the 76 days between Election Day (November 5, 2024) and Inauguration Day (January 20, 2025). My last post identified some of the unfinished business the...more

Verrill

Final Mental Health Parity Rule Spells Compliance Changes

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The long-anticipated final rule under the Mental Health Parity and Addiction Equity Act (MHPAEA) was published on September 9, 2024. The MHPAEA prohibits group health plans that provide mental health and substance use...more

Bricker Graydon LLP

Mental Health Parity and Addiction Equity Act (MHPAEA) Final Regulations Have Been Issued

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If you are a state or local government that sponsors a “self-funded” employee group health plan instead of using an insurance provider, you had previously been allowed to “opt out” of compliance with the following four...more

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