On December 15, 2022, the IRS published a final rule regarding information reporting under Sections 6055 and 6056. We covered the 2021 proposed rule in the December 9, 2021, edition of Compliance Corner.

On December 12, 2022, CMS released the proposed Notice of Benefit and Payment Parameters Rule for 2024. This notice is issued annually preceding the applicable benefit year and, once final, adopts certain changes. Additionally, CMS issued Premium Adjustment Percentage and related guidance to inform the payment parameters for the 2024 benefit year.

The IRS released Notice 2022-59, which announces that the adjusted applicable dollar amount for PCOR fees for plan and policy years ending on or after October 1, 2022, and before October 1, 2023, is $3.00. This is a $0.21 increase from the $2.79 amount in effect for plan and policy years ending on or after October 1, 2021, but before October 1, 2022.

On October 11, 2022, the IRS finalized its proposed rule to fix the “family glitch” in eligibility rules for the ACA premium tax credit (PTC). The new final rule will be effective starting in the 2023 tax year.

On September 7, 2022, the US District Court for the Northern District of Texas issued a ruling in Braidwood Management Inc. v. Becerra, which challenged aspects of the Affordable Care Act’s (ACA) preventive services coverage mandate.

On October 1, 2022, the US District Court for the Northern District of Texas in <em>Texas v. EEOC</em> issued an order vacating HHS guidance concerning gender-affirming care as arbitrary, capricious and in violation of the Administrative Procedure Act.

On August 26, 2022, in Franciscan Alliance, Inc., et al v. Becerra , et al, the US Court of Appeals for the Fifth Circuit upheld a federal district court injunction against HHS that stopped the agency from interpreting and enforcing Section 1557 of the ACA in a way that would require a Catholic hospital system and other religious institutions to provide coverage for (or to perform) gender-reassignment surgeries or abortions in violation of its sincerely held religious beliefs.

On August 1, 2022, the IRS published Revenue Procedure 2022-34, which provides the 2023 premium tax credit (PTC) table and the employer contribution percentage requirements applicable for plan years beginning after December 31, 2022.

On July 28, 2022, the DOL, IRS and Department of Treasury jointly issued Part 54, FAQs About Affordable Care Act Implementation. The newly issued guidance includes 14 frequently asked questions related to coverage of preventive services, specifically women’s preventive services and contraception. As a reminder, the ACA requires non-grandfathered group health plans to provide coverage for certain preventive care services with no cost-sharing for participants. Please note that male sterilization is not considered preventive care for this purpose.

On July 25, 2022, HHS issued a proposed rule revising regulations that implement Section 1557 of the Affordable Care Act. Section 1557 prohibits healthcare providers, health plans and insurers from discriminating on the basis of race, color, national origin, sex, age and disability. The previous administration scaled back many of these protections, despite court rulings that prevented the previous administration from implementing those changes. The proposed rule will reinstate the protections.