A new and unprecedented wave of class action complaints is targeting a common feature of many employer-sponsored benefit plans: tobacco-user surcharges. These surcharges are often part of a wellness program that charges higher medical plan premiums to participants who fail
Health Care Reform Dashboard
Charting Developments with the Affordable Care Act and Beyond
DOL Updates Cybersecurity Guidance to Confirm It Applies to All Employee Benefit Plans
Summary
The U.S. Department of Labor (DOL) updated its 2021 cybersecurity guidance to clarify that it applies to all employee benefit plans. The DOL guidance confirms that plan fiduciaries, including health and welfare plan fiduciaries, have an obligation to evaluate the cybersecurity…
Health Plan Compliance Deadlines Draw Near
Regulations under Section 1557 of the Affordable Care Act and HIPAA will require health plans and health care providers to take action in the coming months to meet new requirements. Health plan sponsors and providers that have not started to…
Fifth Circuit Affirms Invalidity of No Surprises Regulations
Summary
The Fifth Circuit Court of Appeals has affirmed the invalidity of regulations governing the independent review process under the No Surprise Billing Rules.
The Upshot
- Out-of-network health care providers challenged the regulations as going beyond the statute and tilting
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Courts Invalidate ACA Regulations Following Demise of Chevron Deference
Summary
Following the U.S. Supreme Court’s decision to overturn its Chevron decision three district courts have struck down provisions in nondiscrimination regulations under the Affordable Care Act that prohibit discrimination based on gender identity. in what constitutes unlawful discrimination.
The…
2024 HIPAA Developments
Over the course of the past few months, the Office of Civil Rights (OCR) and the Office of the National Coordinator for Health Information Technology (ONC), both of which are divisions of the U.S. Department of Health and Human Services…
Final Section 1557 Rules: Highlights for Health Plan Sponsors
Summary
The U.S. Department of Health and Human Services (HHS) has issued final regulations on the nondiscrimination rules set forth in Section 1557 of the Affordable Care Act. The new rules apply to certain group health plans, as well as…
Final Rules Overturn Trump Era Health Benefit Rules
Summary
The Biden administration has issued two sets of final regulations that overturn rules adopted during the Trump administration pertaining to association health plans and short-term, limited-duration insurance (STLDI). The regulations go into effect June 17, 2024.
The Upshot
- The
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HHS Aligns Part 2 Substance Use Disorder Confidentiality Requirements with HIPAA
Summary
Newly effective regulations governing confidentiality of Substance Use Disorder (SUD) records now more closely mirror regulations implementing the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other federal law. The new measures ease the administrative burden on…
HIPAA Breach Notifications – A Question of Timing
Summary
Providing notice of a vendor’s HIPAA breach is often difficult, but it can be particularly hard when information is delayed. Sometimes an investigation takes months to complete, and the HIPAA deadline for providing notice may have passed before a…