2022-2023 PCORI Fee Released

By: Megan Diehl, Manager, Compliance Consulting, MZQ Consulting The Patient-Centered Outcomes Research Institute (PCORI) fee established by the Affordable Care Act helps fund research to evaluate and compare health outcomes, clinical effectiveness, risks, and benefits of medical treatment and services.  The fee is currently in place through 2029.  In Notice 2022-59, the IRS announced thatContinue reading 2022-2023 PCORI Fee Released

2023 Health FSA Inflation Adjustments

By Jessica Waltman, Principal, Forward Health Consulting On October 18, 2022, the Internal Revenue Service issued Revenue Procedure 2022-38 that sets forth various 2023 tax-related limits that have been adjusted for inflation.  The table below identifies updates to the 2023 health and fringe benefit plan limits addressed in the notice. Benefit 2022 2023 Maximum AnnualContinue reading 2023 Health FSA Inflation Adjustments

Biden Administration Issues Final Rule to End the “Family Glitch”

By Jessica Waltman The Biden Administration issued a final regulation and a new IRS notice on October 11, 2022, which eliminate the Affordable Care Act’s (ACA) “family glitch” beginning on January 1, 2023.  The “glitch” refers to the fact that the ACA’s current affordability standard is based on what a single person pays for employer-sponsoredContinue reading Biden Administration Issues Final Rule to End the “Family Glitch”

Medicare Part D Coverage Notices Due Mid-October

By: Lee Spiegel, Director, Compliance, MZQ Consulting The October 14, 2022 deadline by which plan sponsors that offer prescription drug coverage to provide notices of creditable or non-creditable coverage to Medicare-eligible individuals is fast approaching.  Coverage that is deemed creditable is expected to cover, on average, at least as much as the standard Medicare PartContinue reading “Medicare Part D Coverage Notices Due Mid-October”

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”