Departments Issue Checklist for Surprise Billing IDR Process

This update was originally published by Larry Grudzien. The Departments of IRS, DOL, and HHS (the “Departments”) recently issued a checklist of federal independent dispute resolution (IDR) and related requirements (more…)

Carrier Updates Regarding the Transparency in Coverage Rules and Machine Readable Files

The “Transparency in Coverage” final rules passed on October 28, 2020, requires health insurers and group health plans to create machine readable files (MRF) and member friendly cost estimation tools (more…)

PCORI Fees Due to IRS No Later Than August 1, 2022

Fees to fund the Patient-Centered Outcomes Research Institute (PCORI) are due to the IRS no later than August 1, 2022, from employers who sponsor certain self-insured health plans such as (more…)

Appropriations Bill Restores Telehealth Exemption for HDHPs for Remainder of 2022

Congress has passed and the President has signed government funding legislation called the Consolidated Appropriations Act, 2022 (CAA-22). The CAA-22 temporarily and prospectively extends rules regarding access to telehealth services (more…)

2022 Department of Labor Compliance Penalty Chart

According to HR Service, Inc., the U.S. Department of Labor has published its final rule to adjust for inflation the civil monetary penalties assessed or enforced by the Department, pursuant (more…)

OSHA and Legislative Updates Regarding the Vaccine-or-Test Rule

The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) recently announced that it is withdrawing its temporary vaccination and testing emergency standard, following the Supreme Court’s temporary block (more…)

Humana COVID-19 At-Home Testing Updates

Beginning January 15, 2022, Humana will cover over-the-counter COVID-19 at-home test kits for members. As announced by the U.S. Department of Health and Human Services group health plans will cover (more…)

UnitedHealthcare to Cover COVID-19 At-Home Tests, Small Business Market Segment Update

On Jannuary 10, 2022, the Departments of Labor, Treasury and Health and Human Services released guidance to support the Administration’s directive that health insurers and group health plans cover, subject (more…)

Anthem Members Will be Reimbursed for Over-the-Counter COVID-19 Tests

A recent announcement from the federal government intends to increase access to COVID-19 testing. As of January 15, 2022, members can get reimbursed by their health plan without cost share (more…)

Supreme Court Blocks Vaccine Mandate for Large Businesses, Allows it for Health Care Workers

Please note:  The Supreme Court has ruled this as a stay for how this was written. If OSHA or the Biden Administration were to re-write this mandate in a more (more…)

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