Affordable Care Act, Employer Group Health Plans, Health Care Providers

Trump on Transparency: Making America Healthy Again Through Executive Order 14221; How Plan Sponsors Can Respond

Saul Ewing LLP on 3/7/2025

One mandate under the PPACA required health care providers, non-grandfathered health insurance issuers and self-insured group health plans to provide consumers with access to information about the cost of services before they...more

What risks do employers face by excluding coverage for gender affirming care in their health plans?

Dorsey & Whitney LLP on 8/3/2023

In recent years, courts have ruled upon a growing number of cases arising from delivery of and payment for gender affirming care. At the same time, state legislatures have passed a variety of laws aimed at such services. ...more

High Deductible Health Plan First Dollar Coverages in Flux

Foley & Lardner LLP on 7/21/2023

A recent string of lawsuits, regulatory guidance, and market trends have dramatically impacted the types of services that enjoy first dollar coverage under high deductible health plan (HDHP) and health savings account (HSA)...more

Frequently Asked Questions Part 60 Under the Affordable Care Act Issued

Jackson Walker on 7/17/2023

As employers work toward annual enrollment and new service contracts for their health plans, it is key to remember one of the changes to enhance disclosure to individuals contained in the “No Surprises Act” and Transparency...more

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

McAfee & Taft on 10/28/2022

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

New and Updated Women’s Preventive Health Services Guidelines Apply in 2023

Morgan Lewis - ML Benefits on 10/27/2022

The Affordable Care Act (ACA) requires non-grandfathered group health plans (and insurers) to provide coverage for certain preventive health services for all adults, women, and children. Preventive services covered under the...more

Transparency in Coverage Requirements – Compliance Deadline Approaching

FordHarrison on 6/24/2022

Summary: For Health Plans, Machine-Readable Files, containing in-network provider charges and out-of-network allowed amounts and billed charges, must be posted on a public website by July 1, 2022....more

Departments Delay Enforcement of Transparency Disclosure Requirements

Fisher Phillips on 9/7/2021

Group health plan sponsors soon will face daunting new disclosure and transparency requirements under multiple laws including the Affordable Care Act (ACA), the No Surprises Act (the Act) and the Consolidated Appropriations...more

Departments Clarify that HIV PrEP Services Must Be Free by September 17

Snell & Wilmer on 8/19/2021

Back in June of 2019, the United States Preventive Services Task Force (“USPSTF”) released an A-rated recommendation for HIV Preexposure Prophylaxis (“PrEP”). As a result, the Affordable Care Act’s preventive care rules...more

HHS Issues Interim Final Rule Implementing Certain Provisions of the No Surprises Act

Holland & Knight LLP on 7/6/2021

The U.S. Departments of Health and Human Services (HHS), Labor and Treasury, along with the Office of Personnel Management, on July 1, 2021, issued a much-anticipated Interim Final Rule with Comment Period (IFC) –...more

Health Plan Changes in the Consolidated Appropriations Act, 2021

Jackson Walker on 1/22/2021

The protections for participants and their beneficiaries in the Patient Protection and Affordable Care Act (ACA) were expanded by the Consolidated Appropriations Act, 2021 (the “Act”). Some of the changes build on concepts in...more

Price Transparency: Federal Government Issues Final Rule for Hospitals and Proposed Rule for Group Health Plans and Health...

Foley & Lardner LLP on 12/27/2019

On November 15, 2019, the Federal Government issued two rules: one in final form and one in proposed form, both designed to increase price transparency in health care. The rules follow on the Executive Order announced by...more

Strategies for Addressing Reference-Based Plans

King & Spalding on 12/13/2019

The move by some employer plans to a “reference-based” pricing model has created a need for healthcare providers to develop a strategy to confront payment challenges that these plans create. A prevalent model of...more

Transparency in coverage rule - Potential implications for self-insured health plans

Eversheds Sutherland (US) LLP on 12/4/2019

On November 15, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (collectively, the “Agencies”) issued a proposed "Transparency in Coverage" rule that would require most...more

Employers May Need to Provide Cost Data Under Proposed ACA Rules

Ogletree, Deakins, Nash, Smoak & Stewart,... on 11/26/2019

Employer-sponsored health plans and health insurers may be required to post online - and to provide participants upon request - a range of pricing and cost-sharing information beginning in 2021. Proposed Affordable Care...more

Hospital tries to stick ER nurse with $1 million in debt for her preemie’s care

Patrick Malone & Associates P.C. | DC Injury... on 11/11/2019

It’s the price and cost problem, stupid. That’s a fictitious but new tattoo that voters might want politicians to take up as they consider the many major problems with the American health care system, especially as yet more...more

Health insurance? It’s now about the price of a new car each year.

Patrick Malone & Associates P.C. | DC Injury... on 10/4/2019

Millions of Americans may sigh at Bertha, Barney, or Betty, or whatever they’ve nicknamed the beat-up family vehicle parked out front: “Wouldn’t it be great, if only we could afford a nicer, newer model?”...more

ERISA Alert: An Update on Health and Welfare and Retirement Plans

Jackson Walker on 4/4/2019

Health and Welfare Plan Update - It is 9:00 p.m., do you know where your health plan data is? As IT systems continue to expand, and data is accessed, moved and stored in many new and different ways, the Office for Civil...more

Is the Affordable Care Act a House of Cards? If Yes, What Does the Recent Texas Court Decision Mean for the US Health Insurance...

Epstein Becker & Green on 12/19/2018

In an unexpectedly broad ruling issued December 14, 2018, the U.S. District Court for the Northern District of Texas declared the Affordable Care Act (“ACA”) as unconstitutional in its entirety. This decision, if ultimately...more

Patient Protection and Affordable Care Act (PPACA) › Employer Group Health Plans › Health Care Providers