By Laura Miller Andrew The opening of the health insurance marketplace on October 1, 2013, has helped employees focus on their own health care coverage. Health care coverage has moved front and center, with the press publicizing the new marketplace exchanges, and politicians debating health care reform funding. As employers enter the “open enrollment” process for their group health plans, employees are much more engaged in learning about their health care plans and the costs associated with that coverage. The health coverage provided through employer sponsored plans is often superior to the health coverage options offered on the exchange. However, employees may pay more for… Read more
By: Kate Bongiovanni Monday, September 23, 2013 is an important HIPAA compliance deadline because the changes made under the final HIPAA “omnibus” rule (the “Omnibus Rule”) become effective on this date. Generally, the Omnibus Rule makes a number of changes to the rules regarding business associates, breach notification obligations, and HIPAA enforcement. As a result, employers sponsoring group health plans and health care providers (i.e., “covered entities” under HIPAA) should review and update their HIPAA-compliance materials. The following summarizes a few of the most significant changes under the Omnibus Rule: Required Changes to Notices of Privacy Practices (“NPPs”). The Omnibus… Read more
Posted by: Kate Bongiovanni As mentioned in our Health Care blog posts from last week, employers will now have an additional year – until 2015 – to begin complying with the mandatory reporting obligations and play or pay provisions of PPACA. Yesterday, the IRS released formal guidance regarding this transitional relief. Our Client Alert addressing this guidance can be accessed here. Despite the transitional relief, it appears that employers may still need to perform the “minimum value” analysis (i.e., the 60% test) for their group health plans for the 2014 plan year. Please stay tuned – we will keep you… Read more
As posted here yesterday and explained in our client alert, President Obama announced that the employer mandate, the “Play or Pay” requirement, has been postponed until 2015. While many employers breathed a sigh of relief, employers should not stop their preparations for PPACA. The announcement stated that the state exchanges will go forward as planned as well as other PPACA requirements. Employers will still have responsibilities under PPACA. With the postponement of the employer mandate, employers will now have time to carefully look at the design of their group health plans, and will also be able to focus on what… Read more
Today, the Obama administration delayed a key requirement under PPACA. The employer mandate, the requirement for large employers to “Play or Pay” will be postponed until 2015. This means that employers will not be required to either (1) provide health coverage that is “affordable” and meets certain minimum requirements for its employees, or (2) pay a penalty for not providing such coverage. The administration cited the need to simplify reporting requirements and give businesses more time to adapt their health plans. However, please note that the requirement to have individual health coverage has not been postponed, and the new exchanges… Read more
In a session at the AHLA annual conference updating attendees on HIPAA breach notification and OCR enforcement activity, the panelists presented an interesting statistic- while only 22% of large data breaches are caused by business associates, they impact 56% of affected individuals. The panelists stated that it is very important that covered entities have strong business associate agreements that contain specific provisions regarding notification of potential breaches to the covered entity. According to Adam Greene, JD, MPH, breach notifications may represent the biggest risk for covered entities. All covered entities should be vigilant in the negotiations with business associates.
In the opening session of the American Health Lawyers Association (AHLA) Annual Meeting, former Congressman Patrick Kennedy and General Peter Chiarelli U.S. Army (Ret.) called for equal treatment of conditions impacting the brain, including post-traumatic stress disorders, autism and addictions. As the author of the Mental Health Parity Act, Kennedy stated that there continues to be a stigma regarding the treatment of “brain based” illnesses and called for all patients to receive “check ups from the neck up” when they receive check ups from their physicians. Chiarelli echoed those comments stating that the brain is the last frontier and that… Read more
Authored by: Kate Bongiovanni On June 3, 2013, the Departments of Health and Human Services, Treasury, and Labor released final regulations implementing the changes to employer-sponsored wellness programs under the Patient Protection and Affordable Care Act (“PPACA”). The final regulations adopt the distinction between the following types of wellness programs: Participatory Wellness Programs – wellness programs that do not condition a reward on an individual satisfying a health standard (or do not provide a reward at all) (e.g., reimbursements for fitness center membership costs); and Health-Contingent Wellness Programs – wellness programs that require an individual to satisfy a standard related… Read more
Authored by Laura Miller Andrew When the Patient Protection and Affordable Care Act was passed in 2010, many employers took a “wait and see” approach to compliance. Employers received a wake-up call June 28 when the Supreme Court upheld the major elements of PPACA. Time is almost up for employers, as the “Play or Pay” requirements become effective in 2014. Following are steps employers can take now to prepare: – Determine if your company is required to “Play or Pay.” As of Jan. 1, 2014, PPACA requires “applicable large employers” to offer “minimal essential coverage” to 95 percent of their full-time employees… Read more
Authored by: Laura Miller Andrew To all interested parties, we have implemented this new blog to discuss all things health care, including health care reform, HIPAA, and compliance with health care related laws. Next week, I will be live blogging from the American Health Lawyers Association (AHLA) annual conference in San Diego on topics of interest to health care professionals. Follow our blog to be kept informed on the latest news and trends about health care. Your comments are welcome and we look forward to hearing from you.