On December 27, 2020, the No Surprises Act was signed into law. That Act introduced sweeping changes to how group health plans are allowed to handle payment of non-network providers and balance billing. However, it also required the Departments of Labor, Health and Human Services, and the Treasury to create reporting rules for air ambulance claims. The Act required plans to report the following on air ambulance claims:
What is Critical Status? In 2006, Congress passed the Pension Protection Act of 2006 (PPA). The PPA created four classifications for multi-employer pension plans that relate to the plans funding status: critical (red), seriously endangered (orange), endangered (yellow), and reasonably healthy (green). The plan’s status is determined by an annual valuation of the plan’s assets and liabilities, conducted by the plan’s actuary. The PPA requires the plan’s actuary to submit...
Continue reading…The Health Insurance Portability and Accountability Act (“HIPAA”) applies not only to healthcare providers, but to health plans, including multiemployer plans. It was established and designed to protect against the unauthorized use and disclosure of personal health information (including any electronic records). In its constantly changing world, HIPAA compliance can prove to be an ominous task. While not exhaustive, this blog provides five “must do” tips for HIPAA compliance:
On December 23, 2022, the Departments of the Treasury, Labor, and Health and Human Services provided health plans a small amount of relief in terms of complying with the new Prescription Drug and Health Care Spending reporting rules. These new reporting requirements, which were included in the Consolidated Appropriations Act of 2021, require plans to annual submit several data files related to prescription drug spending and other health care...
Continue reading…Not one week into the new year and we already have a slew of retirement changes that trustees and plan professionals will have to consider. On December 29, 2022, President Biden signed the 2023 Consolidated Appropriations Act into law. The law, which authorizes $1.7 trillion for government funding, also includes what is commonly called the “SECURE 2.0 Act.” This Act is a multi-year bicameral effort to expand the changes...
Continue reading…The Internal Revenue Service (“IRS”) allows taxpayers to deduct expenses related to the use of their personal vehicles (cars, trucks, vans, etc.) for business, medical, moving, and charity purposes. In addition, the IRS also allows employers to reimburse their employees for these expenses. To calculate these amounts, taxpayers and employers may either use (a) the actual expenses incurred through the use of the vehicle or (b) the standard mileage...
Continue reading…Introduction What are required minimum distributions? A required minimum distribution (“RMD”) is the minimum amount that must be withdrawn from your retirement account each year when you reach age a certain age. These rules apply to practically all retirement plans, including defined benefit plans, IRAs, SEP IRAs, SIMPLE IRAs, 401(k) plans, 403(b) plans, 457(b) plans, and other defined contribution plans. While the rules affect almost every type of plan, they...
Continue reading…In late June, the U.S. Supreme Court issued an opinion on a case that could potentially save health insurance plans thousands of dollars. The case came from the Sixth Circuit Court of Appeals and involved a dispute between a health insurance plan and a dialysis center. In a succinct seven-page opinion the 7-2 majority upheld the Plan’s decision to treat all dialysis claims as out-of-network and rejected the dialysis...
Continue reading…During its most recent session, the U.S. Supreme Court released two opinions on cases that impact ERISA health & welfare plans. One of those cases, Dobbs v. Jackson, took center stage and remains in the national conversation today. In that case, the U.S. Supreme Court overturned Roe v. Wade and allowed States to regulate abortion. While the decision did not directly implicate ERISA health and welfare plans, many fiduciaries and...
Continue reading…In December 2020, Congress passed the No Surprises Act, which, among other things, aims to end balance billing for services provided by non-contracting providers at contracting facilities and by providers of emergency services. Providers can only receive payment for these services from the Plan. Under the No Surprises Act, if a provider that does not have a contract to provide services to Plan Participants (non-contracting provider) disagrees with an...
Continue reading…