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Enforcement Back On: Departments Rescind Enforcement Relief for Machine Readable File Requirements under Transparency in Coverage Rules

On September 27th, the Departments released FAQs about Affordable Care Act Implementation Part 61 (“FAQ 61”), announcing that the Departments are rescinding prior-issued enforcement relief for certain machine-readable file requirements under the Transparency in Coverage (the “TiC”) regulations. The final TiC regulations, published in the Federal Register on November 12, 2020, in part required group […]

| 3 min read

Tighter Margins: IRS Makes It More Difficult to Meet ACA Affordability Safe Harbors in 2024

We have reported previously on the importance of understanding the coverage and reporting rules of the Affordable Care Act.  In particular, Code Section 4980H imposes penalties on large employers for failure to offer minimum essential coverage to 95% or more of their full-time employees (and dependents) or to provide affordable, minimum value health insurance. Whether […]

| 2 min read

Another HIPAA Special Enrollment Deadline Extension – What’s a Group Health Plan to Do?

Just when you thought the confusing COVID-19 ERISA deadline extensions were behind you, the Biden-Harris Administration asks you to reconsider.  Recap – In response to the COVID-19 National Emergency, DOL and Treasury issued guidance requiring benefit plans to extend certain ERISA deadlines related to COBRA continuation coverage, HIPAA special enrollment, and benefit claims and appeals, […]

| 3 min read

COVID-19 Comes to an End(emic):  Preparing Group Health Plans for Anticipated End of COVID-19 Emergencies

The Biden Administration recently announced its plan to end both the National Emergency and Public Health Emergency for COVID-19 (together, the “COVID-19 Emergencies”) on May 11, 2023.  The end of the COVID-19 Emergencies will trigger (immediately or within specified timeframes) the end of various COVID-19 requirements and related relief for group health plans.  As further […]

| 3 min read

Proposed Rules Expand Access to Contraceptive Care as a Preventive Service

On January 30, 2023, the Departments of Health and Human Services, Treasury, and Labor (collectively “the Departments”) issued proposed rules entitled “Coverage of Certain Preventive Services under the Affordable Care Act” (the “Proposed Rules”).  The Proposed Rules reflect the Departments’ continuing efforts to ensure that women have access to contraceptive care without cost sharing through […]

| 4 min read

High Deductible Health Plan Telehealth Relief, Extended Again!

If you sponsor a high deductible health plan (“HDHP”) and have been tracking telehealth relief, your head may be spinning and rightfully so!  There have been various laws and guidance impacting HDHPs and telehealth since 2020 and most recently, new legislation extended relief for 2023 and 2024 plan years.  The relief allows, but does not […]

| 4 min read

What’s Old Is New Again: HHS Proposes to Reinstate and Expand Transgender Nondiscrimination Rules

Since it was enacted in 2010, Section 1557 of the Affordable Care Act (“Section 1557”) has prohibited discrimination in covered health programs and activities on the basis of race, color, national origin, age, disability, or sex.  As we have previously reported, the application of Section 1557 has proven controversial with several competing regulations and numerous […]

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Federal Agencies Issue Guidance After Dobbs Ruling

In response to the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization, the U.S. Department of Health and Human Services (“HHS”) Secretary Xavier Becerra directed HHS agencies to act within their power to protect the rights of patients seeking reproductive care and their providers.  Some of the significant guidance HHS agencies issued in […]

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