Update: Essential Health Benefits Final Rule
Posted by Mark Dorley on March 13, 2013
On February 25th, 2013, final regulations implementing the essential health benefit (EHB) provisions of the Affordable Care Act were published in the Federal Register (78 Fed. Reg. 12834-12872). The EHB rules, which amend 45 C.F.R., apply to all non-grandfathered individual and small group health plans sold after January 1, 2014, as well as Medicaid benchmark and benchmark-equivalent health plans. The EHB rules also apply to…
Feds release ACA regulation roundup
Posted by Mark Dorley on March 1, 2013
The US Department of Health and Human Services (HHS) has released a flurry of regulations implementing various aspects the Affordable Care Act (ACA) today, including insurance market rules and rules related to the small business exchanges (SHOP). Additionally, both the Internal Revenue Service (IRS) and the Office of Personnel Management (OPM) have released ACA regulations. A list of the rules is…
Final Rule: Taxable Medical Devices
Posted by Mark Dorley on February 13, 2013
The Internal Revenue Service (IRS) and Department of Treasury released the final Medical Device Tax rule on December 11, 2012. The rule imposes a tax on the sale of any “taxable medical device” by the manufacturer, producer or importer of a device. The amount of the tax is 2.3 percent of the price of the device, with an effective date of January 1, 2013.
Healthinfolaw.org releases overview of omnibus HIPAA final rule
Posted by Mark Dorley on February 1, 2013
On January 17, 2013, the U.S. Department of Health and Human Services (HHS) issued an omnibus Final Rule, which modifies the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules, as required by the Health Information Technology for Economic and Clinical Health Act (HITECH). It also includes changes to the Privacy Rule requires by the Genetic Information Nondiscrimination Act (GINA).
The team at Health Information & the Law has written a detailed overview of the Final Rule, which highlights the key changes to the Privacy, Security, Enforcement, and Breach Notification Rules. A longer, more comprehensive analysis piece along with a comparative table of changes included in the Final Rule is forthcoming at their website, HealthInfoLaw.org.
CMS and IRS release rules on exemptions to individual mandate, penalties
Posted by Mark Dorley on January 31, 2013
The Internal Revenue Service (IRS) and the Centers for Medicare and Medicaid Services (CMS) have released 2 new proposed rules related to the individual requirement to purchase health insurance (mandate). The IRS rule clarifies the requirement that nonexempt individuals maintain minimum essential coverage or make a shared responsibility payment (penalty). The CMS rule lays out specific exemptions to minimum coverage requirement, most notably that any person otherwise eligible for Medicaid under the new ACA eligibility expansion, but who resides in a state that has chosen not to expand, will not be subject to the shared responsibility payment.
Stay tuned to HealthReformGPS for a detailed analysis of these rules in the future.
Update: Financial Assistance Policies for Nonprofit Hospitals that Seek Federal Tax-Exempt Status
Posted by Mark Dorley on July 9, 2012
On June 22, 2012, the Internal Revenue Service and Treasury Department released for public view a notice of proposed rulemaking (NPRM) regarding the obligations of nonprofit hospitals seeking federal tax-exempt status. The NPRM deals with that portion of the ACA related to the obligation of nonprofit hospitals to maintain financial assistance and emergency medical care policies, as well as certain billing and collection policies, as a condition of federal tax exemption. The NPRM comment period will be for 90 days following Federal Register publication. The agencies have identified…
Update: Health Insurance Premium Tax Credit Final Regulations
Posted by Mark Dorley on June 22, 2012
On May 18, 2012, the Department of Treasury (Treasury) issued final regulations on the health insurance premium tax credits enacted by the Patient Protection and Affordable Care Act (ACA). The final regulations, which took effect May 23, 2012, contain amendments to the Income Tax Regulations (26 CFR part 1) and address several issues noted in the proposed regulations (NPRM) issued by the Treasury on August 17, 2011. The refundable premium tax credits were created to help make the purchase of health insurance through the health insurance Exchanges more affordable for low- to middle-income individuals ineligible for Medicaid and without affordable …
Essential Benefits Update: Data Collection Standards
Posted by Mark Dorley on June 15, 2012
On June 5, 2012 the United States Department of Health and Human Services (HHS) published a proposed rule (77 FR 33133-33142) that would establish data collection standards for health insurance issuers as part of the Department’s implementation of the Affordable Care Act’s (ACA) essential health benefit provisions. Comments will be accepted until 5:00 p.m. on July 5, 2012.
Under the ACA, as of January 1, 2014 all health insurers selling policies in the individual and small group…
Update: Medical Loss Ratio Requirements
Posted by Mark Dorley on May 15, 2012
On May 11, 2012, the United States Department of Health and Human Services (HHS) issued a final rule that revises previous medical loss ratio (MLR) rules to establish consumer notification requirements with which insurers must comply when meeting applicable MLR requirements. In a previous December, 2011 final rule governing other aspects of the MLR amendments, HHS had required notification only when insurers did not …
Update: Essential Health Benefits FAQs
Posted by Mark Dorley on May 9, 2012
In February 2012, CMS issued a supplemental document entitled Frequently Asked Questions on Essential Health Benefits Bulletin. This supplement to the December 16th Bulletin provides answers to 22 questions arising from the December 16th Bulletin itself. Highlights are as follows: