Legal Alerts

HIPAA Privacy Rules Amended to Require Protection of Reproductive Health Care Information

By Stacy Barrow - May 14, 2024

On April 26, 2024, the Office of Civil Rights (OCR) at the U.S. Department of Health & Human Services (“HHS”) issued a Final Rule amending the HIPAA Privacy Rule to protect the ability of individuals to receive reproductive health care when the care is provided lawfully under the circumstances without risk of an individual’s identity [Read More]

IRS Releases 2025 HSA Contribution Limits and HDHP Deductible and Out-of-Pocket Limits

By Stacy Barrow - May 9, 2024

  In Rev. Proc. 2024-25, the IRS released the inflation-adjusted amounts for 2025 relevant to Health Savings Accounts (HSAs) and high deductible health plans (HDHPs). The table below summarizes those adjustments and other applicable limits. 2025 2024 Change Annual HSA Contribution Limit (employer and employee) Self-only: $4,300 Family: $8,550 Self-only: $4,150 Family: $8,300 Self-only: +$150 [Read More]

Agencies Release Final Regulations on Fixed Indemnity Insurance, Refrain from Addressing Level Funded Plans

By Stacy Barrow - April 8, 2024

On March 29, 2024, the IRS, DOL and HHS (collectively, “the Agencies”) released final regulations implementing new notice requirements for group hospital or other fixed indemnity plans that begin on or after January 1, 2025.  As discussed in more detail below, these final regulations differ from the proposed regulations released by the Agencies on July [Read More]

Reminder: RxDC Reporting Due June 1st

By Stacy Barrow - March 26, 2024

With the 2023 reference year RxDC reporting deadline approaching soon, plan sponsors should familiarize themselves with recent updates to the RxDC Reporting Instructions. As a reminder, the Consolidated Appropriations Act, 2021 includes a provision that requires group health plans and health insurance issuers (collectively “plans and issuers”) to report certain specified data related to prescription [Read More]

A Cautionary Tale: Self-Funded Plan Administrators Must Meaningfully and Effectively Communicate With Plan Participants and Their Providers on Appeal

By Stacy Barrow - January 9, 2024

Sponsors of self-funded ERISA plans have fiduciary obligations to plan participants, which includes the obligation to provide a full and fair review of claims and effectively and meaningfully communicate or engage with plan participants regarding claims denials. One district court recently clarified that this obligation may include the need for the plan administrator, which is [Read More]

The Crucial Role of Comparative Analyses Under the Mental Health Parity Proposed Rule and Technical Guidance

By Stacy Barrow - December 4, 2023

On July 25, 2023, the agencies released an extensive proposed rule related to the Mental Health Parity and Addiction Equity Act (the “Proposed Rule”) as well as a Technical Release requesting comments on certain proposed data requirements for nonquantitative treatment limitations (“NQTLs”) and the potential for an enforcement safe harbor if certain data requirements are [Read More]

IRS Adjusts Health Flexible Spending Account and Other Benefit Limits for 2024

By Stacy Barrow - November 13, 2023

On November 9, 2023, the Internal Revenue Service (IRS) released Revenue Procedure 2023-34, which increases the health flexible spending account (FSA) salary reduction contribution limit to $3,200 for plan years beginning in 2024, an increase of $150 from 2023.  Thus, for health FSAs with a carryover feature, the maximum carryover amount is $640 (20% of [Read More]

Agencies Issue Additional FAQs Regarding the Transparency in Coverage Final Rules

By Stacy Barrow - October 12, 2023

On September 27, 2023, the DOL, IRS, and HHS released FAQs About Affordable Care Act Implementation Part 61 (“FAQ Part 61”) which addresses lingering questions about enforcement of the Transparency in Coverage Final Rules (TiC Final Rules), specifically the provisions of the TiC final rules requiring plans and carriers to post machine-readable files for in-network [Read More]

Tenth Circuit Court of Appeals Hands Down a Big Win for ERISA Preemption

By Stacy Barrow - August 31, 2023

After several failed attempts by pharmacy benefit managers (“PBM”) to challenge state laws regulating PBMs, the 10th Circuit Court of Appeals (in Pharmaceutical Care Management Association v. Mulready) handed down a big win for PBMs and, by extension, self-funded ERISA plans, when it held that provisions under an Oklahoma insurance law that established strict network [Read More]