Federal Health & Welfare Updates

Nov 9, 2023

Departments Propose New Rules for No Surprises Act Federal Independent Dispute Resolution Process

On October 27, 2023, the DOL, HHS, and IRS (the departments) proposed a rule imposing new requirements for group health plans, insurers and healthcare providers under the No Surprises Act (NSA) federal independent dispute resolution (IDR) process. According to the departments, the proposed rule is designed to streamline the current IDR process and address legal challenges to previously issued rules.

Oct 26, 2023

CRS Reports on Paid Family and Medical Leave in the US

On September 25, 2023, the Congressional Research Service (CRS) published a comprehensive report on Paid Family and Medical Leave (PFML), incorporating studies and statistics published by the Bureau of Labor Statistics and other research organizations. This report:

Oct 26, 2023

HHS Announces Inflation Adjustments to Civil Monetary Penalties

HHS recently announced inflation-adjusted penalty amounts related to violations of Summary of Benefits and Coverage (SBC), Medicare secondary payer (MSP), and HIPAA privacy and security rule requirements. These new penalty amounts are calculated based on a cost-of-living increase of 1.07745%. The new amounts are applied to penalties assessed on or after October 6, 2023, for violations occurring on or after...

Oct 26, 2023

Departments Issue New Guidance on No Surprises Act in Response to Texas Court Ruling

On October 6, 2023, the DOL, HHS, and IRS (the departments) issued new FAQs on the status of the No Surprises Act rules and their application to the Independent Dispute Resolution (IDR) process. The guidance follows the August 24, 2023, Texas District Court decision in Texas Medical Association vs. HHS (the TMA case), which is the latest ruling in the series of ongoing disputes between the parties regarding...

Sep 28, 2023

Fourth Circuit Focuses on Availability of Monetary Relief Under ERISA for Denied Heart Transplant

On September 12, 2023, in Rose v. PSA Airlines, Inc., the Fourth Circuit Court of Appeals (Fourth Circuit) reviewed the district court’s dismissal of ERISA claims brought by Jody Rose, the mother and administratrix of the estate of a group health plan beneficiary. Specifically, the Fourth Circuit considered whether the estate could seek monetary relief under the specific claims raised.

Sep 14, 2023

Ninth Circuit Reverses Class Action Case on Behavioral Health Claims, Again

On August 21, 2023, the Ninth Circuit vacated its prior decision and issued a new opinion in a complicated class action lawsuit against United Behavioral Health (UBH, a subsidiary of Optum, a division of UnitedHealth Group). The case, which began in 2016, was sent back to the trial court for the second time.

Sep 14, 2023

District Court Addresses COBRA Notices in Class Action Lawsuit

On August 29, 2023, in Bryant v. Walgreen Co., a federal district court dismissed most of the claims against a group health plan sponsored by Walgreens Co. (Walgreens), most notably the plaintiffs’ claim that Walgreens failed to adequately notify them of their right to continue health coverage as required by the COBRA statute.

Sep 14, 2023

DOL Extending Grace Period for EFAST2 Login Credentials

On August 28, 2023, the DOL announced a grace period for users to obtain new login credentials for its EFAST2 filing system, which is used to file Form 5500 series annual returns. Beginning January 1, 2024, users will have to log in via the new Login.gov process instead of using existing EFAST2 credentials. Login.gov allows users to securely log in to many government agency websites using a single username and password.

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PPI Benefit Solutions does not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.

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