Sep 17, 2024 | Announcements, Compliance, Department of Labor, Mental Health, Mental health parity, Regulatory
On September 9, 2024, the federal Employee Benefits Security Administration (EBSA) released information and a preview of the Department of Labor’s final Mental Health Parity regulations. The Final Rules are scheduled to be published in the Federal Register within the...
Aug 30, 2024 | Compliance, Employee Retirement Income Security Act (ERISA), Legislative, News, Regulatory
50 years ago – on September 2, 1974 – ERISA was signed into law by President Gerald R. Ford. The Employee Retirement Income Security Act has had a profound impact on how health benefits are provided to most working Americans. Despite its impact, the legislation...
Jul 18, 2024 | Claims, Claims negotiation, Compliance, Subrogation
If one of your plan members is injured as the result of an accident, it’s possible that subrogation may be necessary. Subrogation is a recovery process in which medical claim costs resulting from the injury, initially covered by the employer, are reimbursed from...
Jul 8, 2024 | Affordable Care Act, Compliance, Department of Health and Human Services (HHS), Department of Labor, News, Regulatory, Supreme Court, Treasury Department
Last month, in a 6 to 3 decision, the U.S. Supreme Court overturned the “Chevron Deference” doctrine. The Chevron Deference is a principle of administrative law that has required courts to defer to how regulatory agencies interpret federal statutes (legislation...
May 28, 2024 | Affordable Care Act, Announcements, Compliance, PCORI, Regulatory
As in year’s past, no later than July 31, 2024, all self-funded employer health plan sponsors are required to file and pay their PCORI fees. You may remember that as part of the Further Consolidated Appropriations Act of 2020, Congress extended the requirement that...
May 24, 2024 | Announcements, Compliance, Consolidated Appropriations Act of 2021 (CAA), Regulatory
You might remember that the Consolidated Appropriations Act of 2021 (CAA) requires all health plans to file a pharmacy data report annually to the Centers for Medicare & Medicaid Services (CMS). Each year, the Prescription Drug Data Collection reporting (RxDC)...
