Last week, the U.S. Court of Appeals for the Fifth Circuit affirmed in part and vacated in part a Texas federal district court order revoking the U.S. Food and Drug Administration (FDA) approval of the drug mifepristone, which is used as part of a two-drug regimen to induce abortion. The Fifth Circuit vacated the district
Proposed MHPAEA Regulations Flowchart: Understanding the New Framework for Non-Quantitative Treatment Limitations
In late July, the Departments of Labor, Treasury, and Health and Human Services released proposed regulations implementing the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Readers of our previous blog will recall that the proposed regulations include a new three-part framework for evaluating “non-quantitative treatment limitations” (NQTLs) imposed on plan benefits. NQTLs
For HDHPs, IRS Confirms Pre-Deductible COVID-19 Testing Coverage Will End Next Year
In the most recent sign that special COVID-19 benefit plan rules are drawing to a close, last Friday, the IRS issued Notice 2023-37, which clarifies the scope of COVID-19 testing and treatment that can be provided on a pre-deductible basis under a high deductible health plan (HDHP) without impacting a participant’s ability to contribute to a health savings account (HSA). As a reminder, if an HDHP covers medical items and services before the participant satisfies the IRS minimum deductible (self-only or family), that coverage may disqualify the participant’s HSA contributions. Notice 2023-37 can be downloaded here.
Understanding Recent Litigation on Medication Abortion: A Guide for Health Plan Sponsors
Last Friday, the United States Supreme Court stayed a federal district court order that suspended the U.S. Food and Drug Administration’s approval of the drug mifepristone, which is used as part of a two-drug regimen to induce abortion. This decision means that mifepristone will remain available subject to current FDA dispensation guidelines while the appeal of the district court’s decision proceeds through the U.S. Court of Appeals for the Fifth Circuit (and potentially the Supreme Court). Although the Supreme Court’s decision returns mifepristone access to the status quo for the time being, it creates a number of questions for employers and other benefit plan sponsors with respect to abortion coverage in group health plans, which we discuss below.
Update: Big Headline, Small Impact – Legislation Ends COVID-19 National Emergency
Important Update: Based on informal comments from the U.S. Department of Labor, it appears that the tolling of benefit plan deadlines will end on July 10, 2023, as described in our earlier blog on this subject, notwithstanding the legislation that was signed on Monday ending the COVID-19 National Emergency on April 10th
It’s Over: DOL, Treasury, and HHS Confirm End of (Most) COVID-19 Rules for Health Plans
Update: On April 10, 2023, President Biden signed into law legislation ending the COVID-19 National Emergency prior to the previously announced May 11, 2023 date. See our blog on this new development here. The legislation does not impact the end of the COVID-19 Public Health Emergency.
Earlier this week, the Departments of Labor, Treasury,
Now Live: Tri-Agencies Release Guidance for Group Health Plan “No Gag Clause” Attestations
On February 23, 2023, the Departments of Labor, Treasury, and Health and Human Services (the “Departments”) issued new guidance (in the form of FAQs) implementing the No Surprises Act’s prohibition on “gag clauses” in agreements between health plans and service providers. While the attestation requirement has been effective since December 27, 2020, the Departments had
A New Normal? Omnibus Bill Extends High Deductible Health Plan Telehealth Safe Harbor
The Consolidated Appropriations Act of 2023 (“CAA 2023”), signed into law on December 29, introduced sweeping reforms to the employee benefits landscape. Not only do the CAA 2023’s “SECURE 2.0” provisions make some significant changes for retirement plans, but CAA 2023 also extends the telehealth plan safe harbor for high-deductible health plans (“HDHPs”) that
District Court Rejects Participant’s Attempt to Stop Plan From Recouping Overpayments
In Kanefsky v. Ford Motor Co. Gen. Ret. Plan, No. 22-cv-2259, 10548 U.S. Dist. 2023 WL 186800 (E.D. Mich. Jan. 13, 2023), the court granted a motion to dismiss a pension plan participant’s claim that the plan was equitably estopped from recouping overpaid plan benefits. Upon termination of his employment, the participant requested and
IRS Permanently Extends Deadlines for ACA Reports to Individuals
On December 15, 2022, the Internal Revenue Service (“IRS”) published final regulations that make permanent certain relief and changes relating to the Affordable Care Act (“ACA”) reporting requirements. Specifically, the final regulations (1) include an automatic 30-day extension for providing Forms 1095-B and 1095-C to covered individuals and employees, which would otherwise be due on