News & Analysis as of

Employee Benefits Centers for Medicare & Medicaid Services (CMS)

J.S. Held

All Is Not What It Seems, Or When Is A Dollar A Dime?

J.S. Held on

Welcome to the strange and mysterious world of medical billing. If ever there was an industry in which the charges and the payments have no correlation, the medical industry is it. Medical billing can indeed be quite...more

Venable LLP

June 1, 2025 Prescription Drug Reporting Deadline for Group Health Plans

Venable LLP on

Employer group health plans must make an annual disclosure of the plan's prescription drug and healthcare spending to the Centers for Medicare & Medicaid Services (CMS). The disclosure, called the Prescription Drug Data...more

Dickinson Wright

Federal Enforcement of Mental Health Parity: Key Updates and Challenges Ahead

Dickinson Wright on

On January 17, 2025, the U.S. Departments of Labor, Health and Human Services, and the Treasury (“the Departments”) issued their 2024 Report to Congress on the enforcement and implementation of the Mental Health Parity and...more

Maynard Nexsen

More Data for Employers and Employer-Sponsored Plans

Maynard Nexsen on

On February 25, 2025, President Donald Trump signed an executive order titled “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information” (the “Order”), which...more

Woods Rogers

Employee Benefits Likely Impacted by Executive Orders

Woods Rogers on

During the first weeks of the second Trump Administration, a number of executive orders and other actions have been implemented, with some having potential implications for employee benefits. Executive Orders can, and do,...more

Woodruff Sawyer

Reminder: RxDC Reporting Due June 1st

Woodruff Sawyer on

With the 2024 reference year RxDC reporting deadline approaching in June, plan sponsors should re-familiarize themselves with the reporting requirements. The 2024 reference year RxDC Reporting Instructions have been released,...more

Morgan Lewis - ML Benefits

Medicare Part D Creditable Coverage Online Disclosure Due March 1

Each year, employers that provide prescription drug coverage to Medicare-eligible individuals through a group health plan must complete a two-step process regarding the prescription drug coverage they offer to active...more

Venable LLP

March 1 Deadlines for Group Health Plans

Venable LLP on

March 1 brings two annual deadlines for employers that sponsor a group health plan for their employees....more

Bricker Graydon LLP

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

Bricker Graydon LLP on

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

Venable LLP

June 1 Prescription Drug Reporting Deadline for Group Health Plans

Venable LLP on

Employer group health plans must make an annual disclosure of the plan's prescription drug and healthcare spending to the Centers for Medicare & Medicaid Services (CMS). The disclosure, called the Prescription Drug Data...more

Akerman LLP - HR Defense

On the Basis of Sex… Discrimination in Group Health Plans and What Employers Should Know

In just a few days’ time, recently promulgated federal final rules addressing sex-based nondiscrimination in the administration of health care benefits have created a flurry of healthcare industry activity. The angst arises...more

McDermott Will & Schulte

CMS Issues Guidance on Usage of AI in Making Coverage Determinations

On February 6, 2024, the US Centers for Medicare & Medicaid Services (CMS) issued a letter to all Medicare Advantage (MA) organizations and Medicare-Medicaid plans. The letter covered frequently asked questions and answers...more

McDermott Will & Schulte

2024 Chart of Additional Healthcare Regulations

During this election year, McDermottPlus is actively monitoring annual regulations that federal agencies are expected to release, as well as “ad hoc” regulations that will be released at the discretion of federal agencies. ...more

Hall Benefits Law

Health Care Stakeholders Support Passage of The Value in Health Care Act

Hall Benefits Law on

Seventeen healthcare stakeholder groups have come together to support The Value in Health Care Act, a bill that a bipartisan coalition reintroduced in Congress this summer. The bill supports a shift in the medical care...more

McAfee & Taft

Employee benefit rules: The gifts that keep on giving

McAfee & Taft on

As employers look back at 2023 and ahead to 2024, there are so many compliance-related items to consider relating to their employee benefit plans.  The rules employers are supposed to be complying with keep growing and...more

Quarles & Brady LLP

2023 Year-End Employee Benefits Updates

Quarles & Brady LLP on

This newsletter provides updates employers should be aware of heading into 2024, including an outline of the updated 2024 retirement and welfare plan limits, instructions related to the “gag order” attestation requirements...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

Schwabe, Williamson & Wyatt PC

Medicare Part D Notices Due October 14‎

Employers, this is your annual reminder that the Centers for Medicare & Medicaid Services (CMS) requires sponsors of group health plans to notify eligible individuals whether the employer’s prescription drug coverage is...more

Husch Blackwell LLP

New Federal Guidance on Employer-Sponsored Group Health Plans and Required Action Steps for 2023

Husch Blackwell LLP on

The Consolidated Appropriations Act, 2021 (CAA) prohibits employer-sponsored group health plans from entering into agreements that contain so-called “gag clauses.” This prohibition generally restricts group health plans from...more

McDermott Will & Schulte

How Employers Should Prepare for the End of the Covid-19 National and Public Health Emergencies

On January 30, 2023, the Biden administration announced its intention to make final extensions of both the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) through May 11, 2023, at which point...more

McDermott Will & Schulte

CMS Announces 2023 Medicare Premiums and Deductibles

On September 27, 2022, the Centers for Medicare & Medicaid Services (CMS) released 2023 premiums, deductibles and coinsurance amounts for Medicare Parts A and B, and the Medicare Part D income-related monthly adjustment...more

Venable LLP

REMINDER: October 15 Is the Deadline for Prescription Drug Notices and the Extended Deadline for Form 5500s

Venable LLP on

Does your company's health plan provide prescription drug coverage? If so, you have until October 15, 2022 to send a notice to individuals who are enrolled in Medicare Part A or Part B and are eligible for the company's...more

Jackson Lewis P.C.

4th Quarter 2022 Quick Hits for Plan Sponsors and Administrators

Jackson Lewis P.C. on

As we enter the fourth quarter of 2022, sponsors and administrators of employee benefit plans have a lot to juggle. From open enrollment and required notices to plan document deadlines, it is a busy time of year. Yet, there...more

Butler Snow LLP

The No Surprises Act – Anticipating Unanticipated Consequences

Butler Snow LLP on

The “law of unintended consequences” describes the general sociological principle that for every action there is an unintended or unanticipated outcome. An influential examination of the concept was published in 1936 by...more

King & Spalding

District Court Enjoins Montana State Statute Which Prohibits Healthcare Providers from Denying Employment Based on a Person’s Lack...

King & Spalding on

On March 18, 2022, a group of providers successfully obtained a preliminary injunction to stop enforcement of a Montana statute that prohibits employers, including healthcare providers, from compelling their employees to...more

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