[Guidance Overview]
Final Regs Issued Implementing the Mental Health Parity and Addiction Equity Act of 2008
"[T]he final regulations include some surprises that will require issuers and plan sponsors to review plan designs that may have been compliant under the interim final regulations with fresh eyes in light of the final regulations such as benefit exclusions for certain types of mental health facilities, such as residential treatment facilities."
(Groom Law Group)
|
[Guidance Overview]
New Employee Notification Requirement for Certain Michigan Employers that Sponsor Fully Insured Health Plans
"A new Michigan law regarding abortion coverage requires certain employers to provide employees with a new notice. The new law is the Abortion Insurance Opt-Out Act ... Fully insured plans issued or renewed on or after March 13, 2014 may not provide coverage of 'elective abortions.' Rather, an optional rider must be purchased to provide coverage for these abortions. For employer-sponsored fully insured plans that include this optional rider, employers must provide employees with notice of that coverage."
(Miller Johnson)
|
2014 ADP Annual Health Benefits Report
"In 2014, the average monthly health plan premium was $870, an increase of 15% since 2010. After a spike of 6.9% between 2010 and 2011, the rate of increase has moderated in subsequent years.... When premiums were adjusted for total covered lives -- considering each insured person, rather than each employee -- costs were fairly constant among income levels, averaging $411 per month in 2014.... Employer share of contributions to health premiums declined slightly from 2010 to 2014, within a tight range of -1.0% with no dependents to -1.5% with dependents."
(ADP)
|
Five Employer Characteristics for Private Exchange Implementation
"The clearest distinction in a private exchange is the ability to offer a myriad of plans and networks as well as ancillary products.... Private exchanges can offer a unique consumer experience, initially during enrollment and then ultimately in supporting employees and their families to manage their health and healthcare needs.... Early experience is showing that consumers that are given a pool of money will tend to spend the money more prudently consistent with their needs and values."
(Healthcare Trends Institute)
|
HHS Issues New HIPAA Tool for Small Businesses
"While organizations may appropriately view the [security risk assessment (SRA)] tool as a new resource ... many have pointed out that 'security risk assessment' is not in fact the correct terminology under the HIPAA Security Rule, given that the tool is targeted to ensuring compliance with the risk analysis obligations rather than 'assessment' obligations. In addition, the SRA tool does not closely follow much of HHS's prior guidance regarding how to fulfill the security risk analysis requirements under the HIPAA Security Rule."
(Ropes & Gray LLP)
|
Medicare Reveals How Much It Pays Each Doctor -- Here's What the Data Show
"[T]he released data show that Medicare paid $12 billion for about 214 million office and outpatient visits in 2012. Most providers received relatively modest Medicare payouts ... However, about 2% of physicians and other individual providers accounted for almost one-quarter of the $77 billion total. And about one-quarter of providers participating in Medicare receive about three-quarters of the total payments."
(The Advisory Board Company)
|
Doctors React to Release of Medicare Billing Records
"Doctors reacted swiftly and indignantly to Wednesday's release of government records revealing unprecedented details about Medicare payments to physicians.... [M]any of the doctors said they were just passing through the payment to drug companies. Some said they were unfairly singled out even though they were billing for an entire practice. And still others disputed the accuracy of Medicare data."
(The Washington Post; subscription may be required)
|
Health Goal Met, White House Reviews Missteps
"In an hourlong interview they requested, the officials said one of their biggest mistakes in the disastrous health care rollout last fall was worrying about the wrong thing. They said they focused too much on their ultimately unfounded fear that not enough insurance companies would participate in the health marketplaces and that premium prices would be too high. In turn, they said, they ignored what became the real problem, a website that was virtually inaccessible in its opening days."
(The New York Times; subscription may be required)
|
Depressed Employee's Vacation Leave Request Did Not Qualify For FMLA Protection
"While the leave might have proven medically beneficial, the [Eighth Circuit] found that it did not qualify for FMLA protection because the employee would not have been incapacitated for any period of the leave.... Without [a] specific connection between the leave and either treatment or a period of illness, [the employee] was unable to prove that his request had been related to his serious health condition. [Hurley v. Kent of Naples, Inc., No. 13-10298 (Mar. 20, 2014)]"
(Ogletree Deakins)
|
The Assault on the ACA Continues in the Federal Appeals Courts
"In response to questions from Justices Samuel Alito and Antonin Scalia concerning why the government contends that [the Religious Freedom Restoration Act (RFRA)] does not cover for-profit corporations, the government countered that the operative phrase for the court to interpret is 'exercise of religion.' ... The government argued that ... the court has never granted an exemption to a for-profit corporation based on the free exercise clause.... On the same day, premium tax credits ... came under a revived attack. After winning at the district court level in federal trial courts in the District of Columbia and Virginia, the government appeared to be an underdog in the oral arguments in Halbig v. Sebelius held before the U.S. Court of Appeals for the District of Columbia Circuit."
(McDermott Will & Emery)
|
Causal Analyses in ERISA and the Affordable Care Act
"This commentary piece offers some observations on the causal analyses under ERISA section 510 and ACA section 1558. Part I discusses the relationship between a but-for analysis and a mixed-motives analysis. Part II observes that the recent U.S. Supreme Court case University of Texas Southwestern Medical Center v. Nassar may change the causal analysis for ERISA section 510 claims. Part III introduces the causal analysis applicable to ACA section 1558 claims and compares that to the traditional mixed-motives analysis."
(JURIST)
|
Comments on Provider Nondiscrimination Requirements requested by IRS, EBSA and CMS
"Section 2706 of the Public Health Service Act ... provides that a group health plan shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable state law.... [M]any group health plans have ignored this requirement, feeling that it was really an issue for their third party administrators who are responsible for maintaining the networks and handling provider issues. However, in a curious turn of events, the Agencies are now asking for public comments on this issue."
(Kilpatrick Townsend)
|
Coverage Expansion in the States: Challenge and Opportunity
"[T]he percentage of uninsured non-elderly adults declined from 17.9 percent in September 2013 to 15.2 percent in March 2014. This translates to 5.4 million people who now have health insurance who previously did not, and these figures largely don't capture the surge in enrollment that occurred at the end of March. These numbers, coupled with the reported 7.1 million enrollment in the federal insurance Marketplace, signal strongly that many Americans have gained coverage."
(Robert Wood Johnson Foundation)
|
|
Benefits in General; Executive Compensation
|
|
|
|
Press Releases
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
