Updated Feb. 24, 2022:

• The Basics FAQs: Q1, Q3, Q4
• Eligibility FAQs: Q5, Q7, Q8, Q9, Q11
• Reporting, Claiming and Reconciling FAQs: Q24, Q26, Q27
• Suspension of Repayment of Excess Advance Payments of the Premium Tax Credit (Excess APTC) for Tax Year 2020 FAQs: Q33, Q36

Added Feb. 24, 2022: Unemployment Compensation 2020 and 2021 FAQs: Q38 through Q45.  MORE >>

13 pages. "The 2019 benefit year HHS-RADV error rates will be averaged with the 2020 benefit year HHS-RADV error rates and applied to the 2020 plan liability risk scores and risk adjustment transfers.... As a result, combined 2019 and 2020 benefit year HHS-RADV adjustments to 2020 benefit year risk adjustment transfers will not be released until summer 2022, after 2020 benefit year HHS-RADV error rates are published. This memo contains an overview of the 2019 benefit year HHS-RADV error rate methodology, an overview of the 2019 benefit year HHS-RADV reports, and information to assist issuers in understanding their results."  MORE >>

"An employer entertaining a merger must explore these ACA matters prior to entering into any agreement. While ... there is a creditable argument that no employer can become an ALE midyear, the IRS does not have any sort of guidance explicitly addressing that scenario."  MORE >>

"EAPs are typically ... subject to COBRA because they provide access to trained counselors offering therapy, which is a medical benefit. Very limited EAPs that provide only referrals by individuals who are not trained counselors are not group health plans, but that approach is uncommon."  MORE >>

"The court held that the Rule's presumption that the QPA is the correct amount and the requirement for the arbitrator to give more weight to the QPA over other permissible factors conflicted with the 'unambiguous terms of the Act.' The court vacated that portion of the Rule.... The court also determined that the Departments improperly bypassed the notice and comment period under the Administrative Procedure Act when implementing the Rule.... This ruling is generally applicable, meaning that the portion of the Rule regarding QPA presumption and weighting is vacated throughout the country." [Texas Medical Assoc. v. HHS, No. 21-0425 (E.D. Tex. Feb. 23, 2022)]  MORE >>

"The overall IDR process is not disturbed and will still be available to resolve payment disputes between payers and out-of-network providers. But [this] ruling sets aside parts of the IDR rule -- the parts that gave guidance to IDR entities -- that were meant to help keep health care costs down. With those guardrails no longer in place, providers could be more likely to use the federal IDR process to obtain higher out-of-network payments when doing so is not warranted." [Texas Medical Assoc. v. HHS, No. 21-0425 (E.D. Tex. Feb. 23, 2022)]  MORE >>

"The U.S. Justice Department has moved to block a UnitedHealth Group subsidiary's attempted $13 billion acquisition of a medical technology company.... In its lawsuit, the Justice Department alleged that UnitedHealth's move to purchase Change Healthcare would give UnitedHealth sensitive information that it could use against rival companies in the insurance industry." [U.S. v. UnitedHealth Group Inc., No. 22-0481 (D.D.C. complaint filed Feb. 24, 2022)]  MORE >>

31 pages. "[In 2020,] OCR received 656 notifications of breaches affecting 500 or more individuals, representing an increase of 61% from the number of reports received in calendar year 2019. These reported breaches affected a total of approximately 37,641,403 individuals."  MORE >>

27 pages. "OCR received 27,182 new complaints alleging violations of the HIPAA Rules and the HITECH Act [in 2020], representing a decrease of 4% from the number of complaints received in calendar year 2019. OCR resolved 26,530 complaints. Of those, OCR resolved 19,826 (75%) before initiating an investigation."  MORE >>

"The Health Data Use and Privacy Commission Act [S 3620] seeks to close the gap between existing protections and risk to personal health information (PHI) created by new healthcare technology that extends beyond the scope of HIPAA.... [T]he Act would form a health and privacy commission to conduct research and give official recommendations to Congress on how to reform health privacy laws."  MORE >>

"The FMLA was a monumental first step.... [H]owever, the FMLA only guarantees some workers the right to unpaid leave.... [S]urveys show that about 56% of the workforce is eligible for FMLA leave ... These surveys also show important gaps in workers' knowledge about the law, with more workers thinking that they are covered by the law than are covered in practice."  MORE >>