"This article will summarize the various techniques available to an incoming administration seeking to amend or nullify existing Federal rulemaking ... [and] apply this framework in the context of Federal rulemaking under Section 1557 of the [ACA], which operates to prohibit discrimination in healthcare. [The authors] explore how the Congressional Review Act [CRA] can be utilized as an alternative to public rulemaking and opine on how the incoming Trump Administration might utilize the CRA to nullify existing Biden-era rulemaking."  MORE >>

"Under the revised simplified determination methodology, group health plan coverage will be creditable if it meets the following standards: [1] Provides reasonable coverage for brand-name and generic prescription drugs and biological products. [2] Provides reasonable access to retail pharmacies. [3] Is designed to pay, on average, at least 72 percent of participants' prescription drug expenses (versus 60 percent under the previous methodology). The proposed guidance does not define what is considered 'reasonable.' "  MORE >>

"As the Trump administration stakes dramatically new positions on matters across the federal government, we are waiting to learn its view on the HIPAA Privacy Rule to Support Reproductive Health Care Privacy Final Rule, published in April, 2024.... At this time, no court has entered a generally applicable order preventing enforcement of the 2024 Reproductive Privacy Rule ... By its terms, the rule remains in effect and enforceable by the HHS Office of Civil Rights."  MORE >>

"CMS released a December 2024 update on the progress toward AEOB rulemaking and implementation, highlighting significant progress in consumer protection and transparency in healthcare costs. This mandate, as required under the No Surprises Act, empowers patients by requiring issuers to produce pre-treatment detailed cost information. It is anticipated these measures will help to reduce and/or eliminate unanticipated medical bills."  MORE >>

"The NPRM reflects a major overhaul of the Security Rule and, if finalized, will affect how regulated entities comply with the Security Rule by: [1] Eliminating the distinction between required and addressable implementation specifications.... [2] Requiring documentation of security practices.... [3] Prescribing timeframes for completing security activities."  MORE >>

"Perhaps most significantly, the Proposed Rule modifies the Security Rule's current structural requirements underlying a covered entity's adoption, implementation, and maintenance of reasonable and appropriate technical, physical, and administrative safeguards designed to protect the confidentiality, availability, and integrity of e-PHI. As a reminder, the Security Rule mandates the use of certain implementation specifications, respecting each standard identified for the Rule's safeguard requirements."  MORE >>

"[Rev. Rul. 2025-4] only addresses state-run programs and 'does not address the Federal tax treatment of employers' or employees' contributions to private or self-insurance family or medical leave plans or the amounts received by the employees as benefits under these plans.' ... [T]he IRS' reasoning in the Rev. Rul. may provide insights on how to tax benefits under these private plans."  MORE >>

"The 2024 reference year RxDC Reporting Instructions have been released, though there were no changes to the reporting requirements or data elements from last year.... The deadline to submit reporting for calendar year 2024 is June 1, 2025 (and continues each June 1st thereafter)."  MORE >>

"The Trump administration on [February 7] notified the Supreme Court that, in its view, a Tennessee law banning the use of puberty blockers and hormone therapy for transgender minors does not violate the Constitution's guarantee of equal protection.... [A]lthough that position is a change from the one advanced by the Biden administration when the justices heard oral argument in a challenge to the law in December, the Trump administration nonetheless urged the Supreme Court to go ahead and decide the dispute." [U.S. v. Skrmetti, No. 23-5600 (6th Cir. Sep. 28, 2023; cert. pet. granted Jun. 4, 2024, No. 23-477)]  MORE >>

"While the scope of ERISA preemption is exceptionally broad, ERISA does not apply to plans offered by governmental employers or plans sponsored by religious entities unless an election has been made under the Internal Revenue Code to have the plan treated as an ERISA plan. ERISA's reach also does not extend to 'payroll practices,' which the [DOL] has excluded."  MORE >>

"During a declared national emergency, an employer can provide what are referred to as 'qualified disaster relief payments' under Internal Revenue Code section 139. These are tax-preferred payments (e.g., the payments are excluded from gross income, wages and compensation subject to tax) employees can use for reasonable out-of-pocket expenses arising from a qualified natural disaster."  MORE >>