Michaela is an member of the Employee Benefits Practice Group, specializing in the design, administration, and regulatory compliance of a diverse array of employee benefit issues, including, welfare benefit plans, health care ...
Earlier this year, the Internal Revenue Service (IRS) issued a number of new notices updating and clarifying the preventive services expenses that high deductible health plans (“HDHP”) can cover without affecting a participant’s health savings account (“HSA”) eligibility. As background, there are multiple requirements that must ...
Last month, the Departments of Labor, Health and Human Services and the Treasury (Departments), issued the highly anticipated final rule under the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The original text of the MHPAEA requires group health plans to offer mental health and substance use disorder (MH/SUD) care on the ...
As the temperatures continue to rise, regulations and litigation related to employer-sponsored group health plans have followed suit. As these new rules continue to evolve, we are often asked whether a self-insured group health plan is required to cover gender-affirming medical services. Many state governments have enacted legislation on ...
Earlier this month, a Mayo Clinic employee filed a proposed class action against the clinic, arguing that the clinic’s employee health plan and its third-party administrator (TPA) Medica, underpaid for services performed by out-of-network doctors, thus passing on the costs to participants.
The lawsuit alleges that the health system and ...
For the vast majority of records maintained by public schools, the Health Insurance Portability and Accountability Act (HIPAA) is not applicable. This is because most records that contain medical information related to a student and shared with the school will be considered an “education record” under the Family Educational Rights and ...
The Internal Revenue Service (IRS) gave plan sponsors an early Christmas gift with the release of new guidance late last year addressing several key provisions contained in SECURE 2.0. A welcome portion of the notice was further guidance on the new option allowing for participants in 401(k) and 403(b) plans to elect to receive employer matching ...
Late last year, the Department of Health and Human Services (HHS) issued its first HIPAA settlement agreement involving a ransomware attack. In the press release announcing the settlement, HHS stated that they began investigating Doctors’ Management Services, a Massachusetts-based medical management company, in April 2019 after ...
Well, it was good while it lasted. On September 27th, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) issued new FAQs regarding implementation of provisions of The Transparency in Coverage Final Rules (TiC Final Rules). As noted in previous insight blogs, the TiC Final Rules require ...
By: Michaela Taylor*
If you sponsor a group health plan, make sure you set a calendar alert before the winter holidays to submit the annual gag clause prohibition compliance attestation. Under the Consolidated Appropriations Act of 2021 (CAA), group health plans and health insurance issuers are prohibited from entering into agreements with ...
By: Kristine Maher & Michaela Taylor
In a 7-2 decision, the U.S. Supreme Court issued its decision in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita, Inc. (No. 20-1641), holding that the health plan's reimbursement rates for outpatient dialysis do not violate the Medicare Secondary Payer Act (MSPA). Graydon analyzed the ...