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Health & Welfare Plans Newsletter
July 2, 2021
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► 8 New Job Opportunities
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[Guidance Overview]
Florida Ends Telehealth Waivers
"While providers were aware these waivers would be time-limited, many did not expect Florida would allow them to expire so suddenly and without a 'glide path' such as a 60-day advance notice. The expiration of these waivers, particularly for providers who have been heavily relying on them, means providers need to execute and implement their plans for how to deliver services post-waiver." MORE >>
Foley & Lardner LLP
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[Guidance Overview]
Agencies Issue First Set of Regs Restricting Surprise Billing
"The [interim final rule] sets out the formula for determining provider payment rates when out-of-network care can't be balance-billed. Providers will be prohibited from balance-billing patients in many scenarios and face administrative requirements concerning notification." MORE >>
Healthcare Financial Management Association [HFMA]; free registration required
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Interim Final Regs Issued on Surprise Medical Bills
"The interim final rule will ban any surprise billing for emergency services regardless of where they are provided, including if they are air medical services. Such services must be treated via an in-network basis. Other provisions of the rule include banning out-of-network charges without advance notice, bans on out-of-network charges for ancillary care and for any out-of-network charge for cost-sharing for emergency and non-emergency services." MORE >>
FierceHealthcare
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Hospital Prices Must Now Be Transparent, But for Many Consumers, They're Still Anyone's Guess
"[S]ome hospitals bury the data deep on their websites or have not included all the categories of prices required ... It's challenging for consumers and employers to use, giving a boost to a cottage industry that analyzes the data, which in turn could be weaponized for use in negotiations among hospitals, employers and insurers. Ultimately, the unanswered question is whether price transparency will lead to overall lower prices." MORE >>
Kaiser Health News
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District Court: Health Insurer Must Comply with ACA Section 1557 Nondiscrimination Rules for Entire Portfolio
"The court reasoned that the health insurer ... had authority to design plan benefits and act as a gatekeeper to health services received by participants. The court also observed that Section 1557's reference to 'contracts of insurance' indicated that Section 1557 applies to health insurers.... Notably, the district court concludes that the health insurer must comply with Section 1557 not only regarding the particular plans at issue in the litigation -- but as to its entire portfolio. That will be no small compliance burden[.]" [Fain v. Crouch, No. 20-740 (S.D. W. Va. Jun. 28, 2021) MORE >>
Thomson Reuters Practical Law
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Employee Benefits Jobs |
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Press Releases |
SageView Advisory Group Grows in the West with Acquisition of MJM401k
SageView Advisory Group
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MissionSquare Research Institute Announces Expansion of Public Plans Database
MissionSquare Research Institute
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17.5 Million Lay Fiduciaries Responsible for More Than $26 Trillion of U.S. Investment Assets
Center for Board Certified Fiduciaries
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Webcasts and Conferences (Health & Welfare Plans) |
The Five Keys to Success in Level-Funded Employer Stop-Loss Plans
July 14, 2021 WEBCAST
Society of Actuaries
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Last Issue's Most Popular Items |
Text of Agencies' Interim Final Rule and Request for Comments: Requirements Related to Surprise Billing, Part 1 (PDF)
U.S. Office of Personnel Management [OPM]; U.S. Department of Health and Human Services [HHS]; U.S. Department of Labor [DOL]; and U.S. Treasury Department
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For Surprise Medical Bills, It's the Beginning of the End
The New York Times; subscription may be required
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Fourth Circuit Largely Rules for Plaintiffs in Class Action Challenge to Aetna/Optum Billing Practices
Kantor & Kantor
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BenefitsLink Retirement Plans Newsletter, ISSN no. 1536-9587.
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