The Affordable Care Act (ACA) requires applicable large employers (ALEs) to offer affordable, minimum value health coverage to their full-time employees or possibly pay a penalty. The evolving coronavirus crisis has raised questions on how employers should determine what a full-time employee is during periods of layoff, furlough, and COVID-19 …
The HIPAA Privacy Rule protects the privacy of patient’s health information but is balanced to ensure that appropriate use and disclosure of information remains necessary during a public health emergency. This information may be used to treat a patient, protect public health, and may be used for other critical purposes. …
CMS Issues FAQ’s on Essential Health Benefit Coverage & the Coronavirus To remove barriers and financial disincentives to COVID-19 diagnosis and treatment, the Centers for Medicare & Medicaid Services (CMS) recently issued frequently asked questions (FAQ’s) on essential health benefit (EHB) coverage. EHB is a core set of items and …
On March 18, 2020, President Trump signed the Families First Coronavirus Response Act (the Act) into law. The Act requires employers to provide paid leave for some employees related to the coronavirus (COVID-19) pandemic, among other measures. The leave provisions of the Act take effect no later than 15 days …
On February 21, 2020, the Internal Revenue Service (IRS) Office of Chief Counsel released a memorandum clarifying that there is no applicable statute of limitations on pay or play penalty assessments under the Affordable Care Act (ACA). Meaning, there is no time limit for the IRS to assess penalties for …
Since 2014, the Department of Health and Human Services (HHS) has continuously extended a transition policy for certain health plans that do not comply with the Affordable Care Act (ACA). This policy has been extended another year. Health insurance issuers have the option of renewing current polices for current enrollees …
On January 31, 2020, the Department of Health and Human Services (HHS) published its proposed Notice of Benefit and Payment Parameters for 2021. The proposed rule explains the benefit and payment parameters under the Affordable Care Act (ACA). If finalized, the provisions included in the proposed rule would apply for …
Group health plan sponsors who provide prescription drug coverage to individuals who are eligible for coverage under Medicare Part D, are required to complete an online disclosure form with the Centers for Medicare & Medicaid Services (CMS). The plan sponsor must complete the online disclosure within 60 days after the …
The Department of Health and Human Services (HHS) published a final rule increasing the civil monetary penalties for violations of laws enforced by HHS, including the Health Insurance Portability and Accountability Act’s (HIPAA) privacy and security rules. Each year, HHS is required to adjust these penalties for inflation to improve …
On January 21, 2020, the United States Supreme Court denied motions to expedite consideration of Texas v. Azar, the lawsuit which challenged the constitutionality of the Affordable Care Act’s (ACA) individual mandate. The decision to deny expediting the case follows a United States Court of Appeals for the Fifth Circuit …
Affordable Care Act (ACA) reporting deadlines are approaching soon under Section 6055 and Section 6056 for the 2019 calendar year. Reporting entities must: File returns with the Internal Revenue System (IRS) by February 28, 2020 if filing on paper (or March 31, 2020 if filing electronically); and Furnish 2019 Forms …
The Equal Employment Opportunity Commission (EEOC) has indicated plans to issue new proposed rules on permissible wellness incentives under the Americans with Disabilities Act (ADA) in early 2020. Final rules were last released in May 2016, which stated that the ADA applies to employer-sponsored wellness plans that ask for health …
Not only did the Further Consolidated Appropriations Act, signed into law on December 20th, repeal three taxes under the Affordable Care Act; the law also extends payment of PCORI fees for the next ten years (2020 through 2029). The ACA created the Patient-Centered Outcomes Research Institute (PCORI) to help patients, …
On Friday, December 20th, President Trump signed H.R. 1865 into law, the Further Consolidated Appropriations Act of 2020, which included a full repeal of three taxes originally imposed by the Affordable Care Act (ACA): Repeal of the Cadillac Tax beginning in 2020, which would have imposed a 40% excise tax …
On December 9, 2019, the IRS released final 2019 forms and instructions for reporting under Internal Revenue Code Sections 6055 and 6056. These forms and instructions require certain employers to provide information to the IRS about their health plan coverage. While similar to the 2018 versions, it is important to …
