Health Care Reform Dashboard

Charting Developments with the Affordable Care Act and Beyond

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Kurt R. Anderson

Latest from Health Care Reform Dashboard

Health Care Reform Dashboard

OCR Announces Eight Settlements within Last Month to Resolve Alleged HIPAA Violations

By Paige A. Haughton & Edward I. Leeds

October 2, 2020

Following a very quiet start in HIPAA settlement activity in 2020, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has recently announced eight settlements with covered entities and business associates. The most recent of these announcements involves the second-largest HIPAA settlement amount in OCR’s history, amounting to $6.85 million. This settlement with Premera Blue Cross (PBC) pertains to an incident that occurred in May 2014 when hackers installed…

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Court Issues Injunction Against Revised ACA Nondiscrimination Rules

By Brian M. Pinheiro, Edward I. Leeds & Paige A. Haughton

August 20, 2020

The U.S. District Court for the Eastern District of New York issued an order on Monday (August 17, 2020) that prevented federal rules removing nondiscrimination protections from taking effect. The rules would have removed protections against discrimination based on gender identity and sex stereotyping from the nondiscrimination provision within the Patient Protection and Affordable Care Act (ACA). The rules at issue relate to an ACA provision that prohibits discrimination, in part, on the basis of…

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Short-Term Limited Duration Insurance Rule Upheld

By Edward I. Leeds & Jessica M. DuBois

July 21, 2020

The U.S. Court of Appeals for the District of Columbia Circuit upheld the final regulations issued by the Trump administration that increased the availability of short term, limited duration insurance (STLDI). The regulations extended the period for which STLDI may be offered to 12 months, allowing it to be renewed twice for a total duration of up to three years. It is unclear at this time whether the decision will receive further review by the…

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U.S. Supreme Court Upholds Exemption to ACA’s Contraceptive Mandate

By Edward I. Leeds & Paige A. Haughton

July 10, 2020

In Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, the Supreme Court this week upheld regulations issued by the U.S. Departments of Treasury, Labor, and Health and Human Services (the Departments) that exempted employers with sincerely held religious beliefs and employers with moral objections from the requirement to provide contraceptive coverage under their group health plans. This contraceptive mandate derives from a provision within the Patient Protection and Affordable Care…

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CMS Scales Back ACA Nondiscrimination Rules

By Edward I. Leeds & Brian M. Pinheiro

July 7, 2020

The Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) has finalized rules that narrow and eliminate various nondiscrimination requirements under Section 1557 of the Affordable Care Act (Act). Section 1557 prohibits certain health care providers, health benefit plans, and health insurers from discriminating against individuals on account of race, color, national origin, sex, age, and disability. The final rules make no significant changes to the rules…

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IRS Increases Carryover Limits for Health FSAs/Addresses Timing of Health Insurance

By Edward I. Leeds, G'nece Jones & Brian M. Pinheiro

May 15, 2020

The Internal Revenue Service (“IRS”) has issued new guidance, Notice 2020-33, that increases the maximum carryover limit for health flexible spending arrangements (“health FSAs”), and clarifies the ability of health plans to reimburse premium expenses incurred prior to the beginning of the plan year. Increased Carryover Limit Health FSAs generally operate on a use-it-or-lose-it basis. Contributions for a year may be used to reimburse expenses incurred in that year. Any amounts remaining are forfeited.…

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Health Insurance Exchanges: A $12B Judgment

By Edward I. Leeds & Ada B. Okafor

May 1, 2020

The U.S. Supreme Court has determined that the federal government must pay over $12 billion to certain health insurers that participated in health insurance exchanges in the first three years that those exchanges were in effect. In Maine Community Health Options v. United States, the court ruled that health insurers that suffered financial losses beyond the corridors established under the Affordable Care Act’s Risk Corridors Program are entitled to recover for those losses. The…

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Disclosing Information about the Novel Coronavirus under HIPAA

By Edward I. Leeds

March 13, 2020

Health care providers, health plans, and others who are subject to HIPAA are sure to have questions about when they may disclose information about individuals who have contracted, or been exposed to, Coronavirus (COVID-19). To address these questions, the Office of Civil Rights, U.S. Department of Health and Human Services, issued a bulletin, reminding us that the privacy rules of HIPAA continue to apply in an emergency while identifying when the rules allow for…

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SECURE Act In; Cadillac Tax Out: The Spending Act Makes Serious Changes to Benefits Rules

By Jean C. Hemphill, Edward I. Leeds, Brian M. Pinheiro, Diane A. Thompson, Joshua T. Natzel & Ada B. Okafor

December 23, 2019

President Trump signed into law a nearly $1.4 trillion spending package that avoided a government shutdown and will fund the government through September 30, 2020. The year-end spending package, signed December 20, 2019, contains a number of retirement and health and welfare provisions that will be of interest to employers and other plans sponsors and plan service providers. Below is a summary of those key provisions. I. SECURE Act The Setting Every Community Up…

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Fifth Circuit Rules Individual Mandate Unconstitutional; Fate of Rest of ACA Remains in Doubt

By Edward I. Leeds

December 19, 2019

In a 2-1 decision, the Fifth Circuit Court of Appeals has upheld a district court ruling that the individual mandate under the Affordable Care Act is unconstitutional. However, the Fifth Circuit has sent the case back to the district court for further consideration on the extent to which the ruling invalidates other ACA provisions. The individual mandate requires individuals to obtain minimum essential health coverage or pay an assessment under the Internal Revenue Code.…

Health Care Reform Dashboard

Charting Developments with the Affordable Care Act and Beyond

Blog Authors

OCR Announces Eight Settlements within Last Month to Resolve Alleged HIPAA Violations

Court Issues Injunction Against Revised ACA Nondiscrimination Rules

Short-Term Limited Duration Insurance Rule Upheld

U.S. Supreme Court Upholds Exemption to ACA’s Contraceptive Mandate

CMS Scales Back ACA Nondiscrimination Rules

IRS Increases Carryover Limits for Health FSAs/Addresses Timing of Health Insurance

Health Insurance Exchanges: A $12B Judgment

Disclosing Information about the Novel Coronavirus under HIPAA

SECURE Act In; Cadillac Tax Out: The Spending Act Makes Serious Changes to Benefits Rules

Fifth Circuit Rules Individual Mandate Unconstitutional; Fate of Rest of ACA Remains in Doubt

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