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Employer Group Health Plans Employee Benefits Health Care Providers

Saul Ewing LLP

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

Saul Ewing LLP on

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

Baker Donelson

Health Plan Compliance Concerns for Year-End 2024

Baker Donelson on

As employers look toward open enrollment for their group health plans, now is a good time to review action items needed for those plans by year-end, as well as upcoming deadlines in the near future. While fully-insured health...more

Fisher Phillips

Don't Forget About ERISA in Your Health Plan’s Cybersecurity Efforts: Important Reminders for Plan Fiduciaries in the Wake of...

Fisher Phillips on

Earlier this year, a cyberattack on a leading healthcare claims processing provider had an unprecedented impact on patients and healthcare providers across the country. While group health plans were not directly targeted in...more

Hall Benefits Law

Biden’s Proposed FFY 2025 Budget Seeks Mental Health Access Expansion

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The Biden administration unveiled its FFY 2025 budget, which calls for $7.3 trillion in spending. In the proposed budget, Biden maintains his pledge to focus on expanding and transforming the nation’s mental health system. He...more

Akerman LLP - Health Law Rx

Attention, Group Health Plans: New HIPAA Privacy Rule Governing Reproductive Health Care Information Imposes Obligations,...

It is critical for employers and plan fiduciaries/administrators to stay informed of HIPAA privacy and security-related legal developments because most employer sponsored group health plans — regardless of the employer’s...more

Foley & Lardner LLP

High Deductible Health Plan First Dollar Coverages in Flux

Foley & Lardner LLP on

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

Ballard Spahr LLP

Gag-Clause Attestations Due by End of Year

Ballard Spahr LLP on

Summary - By December 31, 2023, health plans and insurers must submit an attestation of compliance with the anti-gag rules of the Consolidated Appropriations Act, 2021 (CAA). The rules apply to all agreements entered into...more

Jackson Walker

Frequently Asked Questions Part 60 Under the Affordable Care Act Issued

Jackson Walker on

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

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

McAfee & Taft

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

McAfee & Taft on

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

Morgan Lewis - ML Benefits

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

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

Fox Rothschild LLP

The Supreme Court’s Dobbs Ruling Creates a Variety of Significant Legal Issues

Fox Rothschild LLP on

The Supreme Court of the United States held in Dobbs v. Jackson Women’s Health Organization, that the Constitution does not confer a right to abortion, overruling long-standing precedent in Roe v. Wade and Planned Parenthood...more

FordHarrison

Transparency in Coverage Requirements – Compliance Deadline Approaching

FordHarrison on

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

McAfee & Taft

Big surprises in the No Surprises Act

McAfee & Taft on

In one of the biggest attempts by the federal government to combat surprise medical billing, Congress in late 2020 passed the No Surprises Act (NSA), which imposes a host of new transparency and coverage requirements for...more

Fisher Phillips

Departments Delay Enforcement of Transparency Disclosure Requirements

Fisher Phillips on

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

Clark Hill PLC

Leading in a Lonely World Podcast: Meet Jamie Pagliaro, a Leader Who has Made His “Passion” for Helping Others His Life’s Work

Clark Hill PLC on

Jamie Pagliaro is the co-founder, Executive Vice President and Chief Learning Officer of Rethink, a global health technology company that provides cloud based treatment tools, training, and clinical support, specifically for...more

Saul Ewing LLP

No Surprises Act Promises New Regime for Health Plans, Health Care Providers and Insurers

Saul Ewing LLP on

The Consolidated Appropriations Act of 2021, enacted at the end of 2020 includes the No Surprises Act (“Act”), amending the Employee Retirement Income Security Act of 1974, the Internal Revenue Code of 1986, and the Public...more

BakerHostetler

Self-Funded Employer Health Plans are Changing: What to Watch

BakerHostetler on

The healthcare industry is rapidly changing, and self-funded employer sponsored health plans have more options to consider when creating solutions for their employees. In today’s episode, Jennifer Mills and Susan Hughes...more

Brownstein Hyatt Farber Schreck

Health Plan Coverage of Coronavirus Testing and Treatment

With the news about the spread of the 2019 novel coronavirus (“COVID-19”) in the U.S. and the world rapidly evolving, group health plan sponsors need to address how the plan will provide virus-related benefits. ...more

McDermott Will & Schulte

Class Certification Denied in ERISA Health Coverage Lawsuit

A federal district court denied class certification to health plan participants who claimed the plan promised them lifetime benefits. The court found too many individualized questions about what the plan told each...more

Burr & Forman

A Taxonomy of Health Wellness Programs – Part II

Burr & Forman on

A health wellness program is broadly defined as any program of health promotion or disease prevention. My recent article entitled “Taxonomy of Health Wellness Programs – Part I” reviewed the classification of health wellness...more

Foley & Lardner LLP

Details Matter: Medical Plan Anti-Assignment Clauses Protect Employers

Foley & Lardner LLP on

Yes, details matter. This is true on many fronts, including whether the documents governing the medical plan offered to employees prohibit employees and their dependents from assigning their plan benefit rights to a health...more

Fisher Phillips

Reference-Based Pricing: Another Self-Insured Option for Employers

Fisher Phillips on

As health care costs increase, employers have been exploring new types of health coverage options, one of which is reference-based pricing (RBP). This method typically does not involve a traditional insurance carrier or...more

Fisher Phillips

A Primer On Telemedicine And The Workplace

Fisher Phillips on

Most people probably do not enjoy sitting in a doctor’s reception area with other coughing and sneezing people while waiting for an appointment, or devoting hours to getting a prescription refilled. The concept of...more

Sheppard Mullin Richter & Hampton LLP

Looking Forward/Looking Backward – Day 1 Notes from the JPMorgan Healthcare Conference

A large amount of wind, much discussion about the U.S healthcare, and the public getting soaked again – if you were thinking about Washington, DC and the new Congress, you’re 3,000 miles away from the action. This is the week...more

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