Federal Health & Welfare Updates

Jan 20, 2022

CMS Updates External Review Requirements for Surprise Medical Billing

On December 30, 2022, CMS issued guidance related to the external review requirement under the No Surprises Act (NSA). The NSA requires insurers and group health plans to have an external review process for any adverse determination related to NSA compliance matters. Examples of such matters, as provided by HHS regulations, include:

Jan 20, 2022

Eighth Circuit Addresses Termination of Disability Benefits

On December 27, 2021, the Eighth Circuit Court of Appeals decided Roehr v. Sun Life Assurance Co. of Canada (“Sun Life”), a case involving Sun Life’s termination of long-term disability (“LTD”) benefits of Dr. Todd Roehr, an anesthesiologist who developed intermittent tremors in his hands and finger. Sun Life terminated Roehr’s ERISA LTD benefits as of January 27, 2017, after they paid him the benefits for nearly ten years on the grounds that Roehr had failed to provide proof of disability. Although Roehr lost his challenge with Sun Life’s internal appeal process...

Jan 6, 2022

IRS Releases Guidance on Surprise Billing 2022 Qualifying Payment Amount Determination

On December 28, 2021, the IRS issued Rev. Proc. 2022-11, which provides information necessary to implement the surprise billing prohibitions under the No Surprises Act (NSA) of the Consolidated Appropriations Act, 2021. Specifically, the guidance provides the methodology for calculating the qualifying payment amount (QPA) for 2022. (See our recent article on the NSA surprise billing prohibitions in the July 8, 2021 edition of Compliance Corner.)

Jan 6, 2022

IRS Releases 2022 Mileage Rates and Vehicle Values

The IRS recently announced the optional 2022 standard mileage rates for taxpayers to use in calculating the deductible costs of using an automobile for business, charitable, medical or moving expense (for members of the Armed Forces) purposes. Further, the notice announced the amount that must be included in the employee’s income and wages for the personal use of an employer-provided automobile.

Jan 6, 2022

DOL Announces Temporary Enforcement Policy for Service Provider Disclosures

On December 30, 2021, the DOL issued Field Assistance Bulletin No. 2021-03, which announces a temporary enforcement policy for group health plan service provider disclosures under ERISA Section 408(b)(2). The bulletin also attempts to address certain questions regarding the required disclosures and indicates the DOL does not intend to issue regulatory guidance at this time.

Jan 6, 2022

HHS Issues Instructions for Reporting Prescription Drug and Other Information to the Government

On November 23, 2021, HHS issued instructions and supporting documents to report data under a transparency provision of the Consolidated Appropriations Act, 2021 (CAA), which requires group health plans and insurers to annually report certain information regarding spending on prescription drugs and health care treatment to the government. These documents describe the data submission methods for plans and insurers for the 2020 calendar year (“reference year”).

Dec 23, 2021

IRS Releases 2022 Instructions for Forms 1099-SA and 5498-SA

The IRS recently released the 2022 Instructions for Forms 1099-SA and 5498-SA. The Form 1099-SA is used to report distributions from health saving accounts (HSAs) and other medical savings accounts. The 5498-SA reports contributions to these accounts for the applicable tax year.

Dec 23, 2021

IRS Releases Draft Employers Tax Guide to Fringe Benefits

On December 7, 2021, the IRS provided an updated draft of the 2021 IRS Publication 15-B, the Employer's Tax Guide to Fringe Benefits. This publication provides an overview of the taxation of fringe benefits and applicable exclusion, valuation, withholding and reporting rules.

First2324252628303132Last

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.

Never miss an issue.

Sign up to have it delivered straight to your inbox.

Sign up