Additional Guidance Issued on Surprise Billing Protections

By: Jessica Waltman, Principal, Forward Health Consulting The Consolidated Appropriations Act of 2021 (CAA) introduced numerous protections against surprise billing for plan participants that impact group health plans, health insurance issuers, and providers.  The federal Departments of Health and Human Services, Labor, and Treasury recently released a document discussing frequently asked questions (FAQs) about theseContinue reading Additional Guidance Issued on Surprise Billing Protections

Relief Granted: Issuers and TPAs Can Satisfy Website Posting Requirement

By: Jennifer Berman, CEO, MZQ Consulting On Friday, August 19, 2022, the Departments of Labor, Health and Human Services, and Treasury (the Departments) issued updated FAQs addressing the No Surprises Act and the Transparency in Coverage Rules.  These FAQs directly address an issue related to the Transparency in Coverage Rules (the TiC Rules) that hasContinue reading Relief Granted: Issuers and TPAs Can Satisfy Website Posting Requirement

ACA Affordability Percentage Decreased Significantly for 2023

One of the most well-known components of the Affordable Care Act (ACA) is that it requires applicable large employers (ALEs) to either offer affordable, minimum value medical benefits to their full-time employees or pay tax penalties.  The ACA defined a plan as being affordable if the lowest-cost, employee-only option costs less than 9.5% of theContinue reading ACA Affordability Percentage Decreased Significantly for 2023

Tougher Enforcement of the Contraception Mandate on the Horizon

By: Jennifer Berman, CEO, MZQ Consulting On July 28, 2022, the Departments of Labor, Health and Human Services, and Treasury (the “Departments”) issued new FAQs clarifying their interpretation of the ACA’s requirement that non-grandfathered health plans provide contraception to participants at no cost. The new FAQs were issued in response to President Biden’s recent ExecutiveContinue reading “Tougher Enforcement of the Contraception Mandate on the Horizon”

Recent Federal Efforts to Affirm Access to Reproductive Healthcare Services

In the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, there have been two notable federal efforts to establish or reaffirm access to women’s reproductive healthcare services. First, the Departments of Health and Human Services, Labor and the Treasury (collectively, the Departments) released a letter at the end of JuneContinue reading “Recent Federal Efforts to Affirm Access to Reproductive Healthcare Services”

Supreme Court Rules Employers Can Limit Benefit for Dialysis

By: Megan Diehl, Manager, Compliance Consulting, MZQ Consulting The Supreme Court has been the focus of a great deal of the national discourse over the past several weeks.  In addition to the cases making headlines, the Court also issued a 7-2 ruling in a case directly related to employer sponsored health plans, Marietta Memorial HospitalContinue reading “Supreme Court Rules Employers Can Limit Benefit for Dialysis”

Implications of Abortion Decision for Employee Benefit Plans

By Jennifer Berman, CEO, MZQ Consulting On Friday, June 24, the Supreme Court released its decision in Dobbs v. Jackson Women’s Health Organization finding that the United States Constitution does not guarantee a right to abortion access.  This decision effectively overturns its prior decisions in Roe v. Wade and Planned Parenthood v. Casey.  The decisionContinue reading “Implications of Abortion Decision for Employee Benefit Plans”

Delaware Passes Mandatory Paid Leave Law

By: Jennifer Berman, CEO, MZQ Consulting On May 10, Delaware Governor Carney signed the Healthy Delaware Families Act establishing a mandatory paid leave program, making Delaware the eleventh state to enact such a program. Contributions towards the program will begin on January 1, 2025.  Benefits will be available starting January 1, 2026. The available benefitsContinue reading “Delaware Passes Mandatory Paid Leave Law”

Revised Surprise Billing Independent Dispute Resolution Guidance

By: Jessica Waltman, Principal, Forward Health Consulting The Centers for Medicare and Medicaid Services recently opened the much-anticipated federal Independent Dispute Resolution (IDR) Portal, a component of the No Surprises Act section of the Consolidated Appropriations Act of 2021 (the Act).  The opening of the portal and newly released guidance are part of the implementationContinue reading “Revised Surprise Billing Independent Dispute Resolution Guidance”