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Pullman & Comley - Connecticut Health Law

New Connecticut Health Care Laws Becoming Effective January 1, 2025

Hospitals and health insurance companies will bear the brunt of several new legal requirements taking effect on January 1, 2025. These requirements stem from the 2024 legislative session of the Connecticut General Assembly...more

DLA Piper

New York issues extensive new pharmacy benefit manager regulations

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On November 27, 2024, the New York State Department of Financial Services (DFS) will be releasing new regulations governing pharmacy benefit managers (PBMs). Beginning with legislation in 2021, New York has been active in...more

Zuckerman Spaeder LLP

A Pivotal Moment in the Fight for Behavioral Health Equity: New Parity Regulations and More

Zuckerman Spaeder LLP on

The NAADAC 2024 Conference & Hill Day is an annual conference that brings together thousands of addiction counselors, educators, and other addiction-focused health care professionals from across the country. The conference...more

McDermott+

CMS Issues Guidance to States on Children’s Access to Medicaid Coverage

McDermott+ on

Last week, the Center for Medicaid and CHIP Services within the Centers for Medicare & Medicaid Services (CMS) released what it calls “historic” guidance to states on best practices for adherence to early and periodic...more

Ballard Spahr LLP

Health Plan Compliance Deadlines Draw Near

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Regulations under Section 1557 of the Affordable Care Act and HIPAA will require health plans and health care providers to take action in the coming months to meet new requirements. Health plan sponsors and providers that...more

Ballard Spahr LLP

Courts Invalidate ACA Regulations Following Demise of Chevron Deference

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Following the U.S. Supreme Court’s recent decision to overturn its landmark 1984 Chevron decision, three district courts have struck down provisions in nondiscrimination regulations under the Affordable Care Act that prohibit...more

Stotler Hayes Group, LLC

CMS Announced New Changes To Medicaid Spousal Impoverishment Rules

On May 22, 2024, the Centers for Medicare and Medicaid Services (“CMS”) announced that it would be implementing updated 2024 spousal impoverishment standards that will take effect on July 1, 2024....more

McDermott Will & Emery

HHS Final Section 1557 Nondiscrimination Regulations: Gender-Affirming Care and the Role of Carriers Under ASO Arrangements

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

McDermott Will & Emery

Ten Takeaways From Long-Awaited Section 1557 Nondiscrimination Protections

On April 26, 2024, the US Department of Health and Human Services (HHS) issued a final rule (press release, fact sheet, FAQs) reinterpreting Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the...more

Arnall Golden Gregory LLP

CMS Publishes Final Rule on Medicare Advantage Agent Broker Compensation

On April 4, 2024, the Centers for Medicare & Medicaid Services (“CMS”) published its Final Rule amending the existing Medicare Advantage (“MA”) agent broker compensation regulations. The Final Rule has significant...more

McDermott Will & Emery

[Webinar] Employee Benefits Changes in 2024: New Requirements for Part-time Employees and Independent Contractors - March 7th,...

If you employ part-time workers and/or engage independent contractors, sit up and take note: 2024 will bring significant changes to how you manage your workforce. The US Department of Labor’s revised Independent Contractor...more

McDermott Will & Emery

New Illinois Protections Against Patient Medical Debt May Also Help Reduce Hospital Bad Debt

McDermott Will & Emery on

Starting in mid-2024, Illinois hospitals will be required to take a much more active role in limiting consumers’ medical debt by screening all consenting uninsured patients for both public health insurance program coverage...more

Polsinelli

Florida Proposes New Pharmacy Benefit Manager Rules

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On September 18, 2023, the Florida Office of Insurance Regulation (“OIR”) published proposed rules to implement provisions of the Prescription Drug Reform Act (Florida Senate Bill 1550) governing Pharmacy Benefit Managers...more

Pullman & Comley - Labor, Employment and...

Group Health Plans and Medicare Secondary Payer Rules: Do the Mandatory Reporting Obligations Apply to You?

The Medicare Secondary Payer provisions (MSP) apply to group health plans sponsored by employers with 20 or more employees, in both the private and public sectors. MSP’s mandatory reporting requirements are designed to...more

Sheppard Mullin Richter & Hampton LLP

CMS Announces Changes to ACO REACH Model

On August 14, 2023, the Centers for Medicare & Medicaid Services (CMS) released guidance on changes to the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model starting in performance...more

Stoel Rives - Health Law Insider®

Washington’s Law Regulating Health Care Benefit Managers Is Broad and Complex

Washington’s law regulating “health care benefit managers” (“HCBMs”) went into effect on January 1, 2022. Although Washington’s regulatory scheme for HCBMs has some similarities with how other states regulate “third party...more

McDermott+

McDermottPlus Check-Up: May 19, 2023

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The House and Senate were both in session this week, with significant healthcare activity at the committee level. The House Ways & Means Committee met to discuss healthcare price transparency, and the Ways & Means Health...more

McAfee & Taft

How changes to the “family glitch” affect workplace health plans

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The IRS finalized new rules that change eligibility requirements for the premium tax credit (PTC) created under the Affordable Care Act. It is now easier for an employee’s family members to enroll in subsidized health...more

Stinson - Benefits Notes Blog

Agencies Issue Additional Guidance Regarding Over-the-Counter COVID-19 Test Coverage

As indicated in our January 11, 2022 blog post and alert, the Department of Labor, the Department of Health and Human Services, and the Treasury (the “Agencies”) issued FAQs Part 51 on January 10, 2022, requiring group health...more

Proskauer - Employee Benefits & Executive...

There’s More! Tri-Agencies Provide Clarifying Guidance on Group Health Plan Coverage of Over-the-Counter At-Home COVID-19 Tests

A few short weeks ago we told you in a blog post that, with only four days’ notice, the Departments of Labor, Treasury, and HHS (the Departments) required that, starting January 15, 2022, group health plans cover FDA-approved...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - January 2022

The January Monthly Minute highlights the new OTC COVID-19 test coverage mandate (eff. January 15, 2022), group health plan provider compensation disclosure rules, and updated standards for ERISA plan financial statement...more

Venable LLP

Employer Group Health Plans Must Cover Over-the-Counter COVID Tests

Venable LLP on

On Monday, the government issued frequently asked questions (FAQs) requiring employer group health plans (Plans) and health insurance issuers to cover certain over-the-counter (OTC) COVID-19 tests at no cost to the...more

Polsinelli

Group Health Plan Coverage Requirements Expanded to Include Non-Prescribed Over-the-Counter COVID-19 Testing

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Effective January 15, 2022, health plans are required to cover the cost of over-the-counter (“OTC”) COVID-19 test kits obtained without a health care provider’s prescription or clinical assessment. This new requirement was...more

Robinson+Cole Health Law Diagnosis

New COVID-19 At-Home Test Coverage Requirements Increase Need for Heightened Focus on Health Care Entity’s Billing Practices

I. Biden Administration Requirement for Insurance Companies to Cover Cost of At-Home COVID-19 Tests - On January 10, 2022, the U.S. Department of Health and Human Safety (HHS) announced that the Biden-Harris...more

Stinson LLP

Agencies Issue Guidance Requiring Coverage for Over-the-Counter COVID-19 Tests

Stinson LLP on

Beginning January 15, 2022, and through the duration of the public health emergency, insurers and group health plans must cover at-home COVID-19 diagnostic tests available over-the-counter (OTC) without imposing cost-sharing,...more

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