Insights

FMLA requires a covered employer to maintain an employee’s coverage under its group health plan on the same basis as would have been provided if the employee had been continuously employed during the entire FMLA leave period. However, an employer may terminate an employee’s coverage during FMLA if the employee’s premiums are paid late, provided certain rules are strictly followed. Under these rules, when an employee agrees to pay their share of group health plan premiums during FMLA leave (a.k.

On October 21, 2024, the DOL, HHS, and IRS (the departments) issued proposed rules that would, among other items, expand ACA preventive service coverage requirements to include over-the-counter (OTC) contraceptive items.  Following the US Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, President Biden issued several executive orders to protect and expand access to reproductive healthcare services. Executive Order 14101, issued on June 23, 2023, specifically asked th

On October 21, 2024, the DOL updated its FAQs for the ACA and the Women’s Health and Cancer Rights Act (WHCRA) by adding FAQ Part 68. These new FAQs concern issues relating to preventive services, including coverage of Pre-Exposure Prophylaxis (PrEP) and insurance coding practices, as well as coverage for a specific breast reconstruction technique.  As background, the ACA requires non-grandfathered group health plans and issuers to cover certain in-network preventive services with zero cos

On October 30, 2024, the Fifth Circuit Court of Appeals (Fifth Circuit) reversed a district court’s decision to vacate certain regulations promulgated by three federal agencies: the DOL, HHS, and IRS (the agencies). The regulations established priorities for independent arbitrators appointed to resolve disputes between healthcare providers and payors through an Independent Dispute Resolution (IDR) process established under the No Surprises Act (NSA). In particular, the regulations establishing

Recent regulatory changes have heightened interest in carbon capture, utilization and storage projects and their associated tax credits, drawing attention from firms looking to deploy capital into green assets.

Being the victim of a data breach can be overwhelming, but taking the right steps can help secure your information and reduce the impact.

On October 8, 2024, CMS released the proposed Notice of Benefit and Payment Parameters Rule for 2026. 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 2026 benefit year. While the proposed rule primarily impacts the individual market and the Exchange, CMS’s Premium Adjustment Percentage and related guidance addresses ce

On October 17, 2024, the IRS published two notices (Notice 2024-71 and Notice 2024-75) to expand and clarify the list of preventive care benefits that are permitted under an HDHP without a deductible or with a deductible below the applicable minimum deductible for the HDHP. As background, an HDHP is generally not permitted to provide benefits for any year until the minimum deductible for that year is satisfied. However, Code section 223(c)(2)(C) provides a safe harbor to provide preventive care

On October 1, 2024, in M.S., et al v. Premera Blue Cross, et al, the United States Court of Appeals for the Tenth Circuit (the Tenth Circuit) vacated a lower court’s MHPAEA violation judgment because the plaintiffs lacked standing to bring a MHPAEA claim against the defendants in federal court. Additionally, the Tenth Circuit found that the defendants violated ERISA’s document disclosure requirements and upheld the imposition of penalties and attorneys’ fees and costs. As background, in order t