The Evolution of Health Care Reform: What Businesses Need to Know

It is crucial for businesses to respond to the changing regulatory landscape, as the Patient Protection and Affordable Care Act (“ACA”) continues to evolve. Some recent updates center around the implementation of various components of the legislation, while others focus on the obligations of individuals and businesses under the new system.  The only constant in this process — is that businesses can expect health care reform to continue to evolve over time. Accordingly, business leaders must understand the current regulatory environment and be ready to adapt to future changes.

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Updated COBRA Notices & Various Other Matters Addressed in Recent DOL FAQs

Employer-sponsored group health plans have more work to do in conjunction with the requirements of the Patient Protection and Affordable Care Act (“PPACA”).  On May 2, 2014, the government released updated COBRA and CHIPRA model notices, proposed COBRA regulations, and a bulletin related to certain special enrollment periods in the exchanges.  The government also issued additional frequently asked questions (“FAQs) related to a variety of topics under the PPACA.  A general summary of the newly issued guidance is set forth below.  Plan sponsors will need to take action in order to comply with this newly issued guidance.

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Accountable Care Organizations: Operations and Audits

In the wake of health care reform, health care providers face numerous challenges that require them to adopt sustainable continuous improvements that advance care for their patients, enhance health in their populations and reduce the growth of their expenditures.  Accountable Care Organizations (ACOs) are one vehicle through which providers are meeting these challenges head-on.   Continue reading Accountable Care Organizations: Operations and Audits

HIPAA – Electronic Transaction Standards – Action Required!

Employer-sponsored health plans have a lot of work to do over the next couple of years to ensure continued compliance with HIPAA’s electronic transaction standards. HIPAA’s administrative simplification rules require a health plan to conduct certain electronic transactions in accordance with standards, code sets, and operating rules adopted by the Department of Health and Human Services (“HHS”). The PPACA significantly expands on these standards, code sets, and operating rules. The PPACA also adds the requirements that a health plan (1) obtain a health plan identifier (“HPID”) for the health plan to use with respect to the electronic transaction standards; and (2) certify compliance with the applicable electronic transaction standards.

Thus, under the PPACA’s expansion of HIPAA’s electronic transaction standards, a health plan needs to (1) ensure that it is in compliance with all currently applicable standards and operating rules (and prepare to comply with upcoming standards and operating rules); (2) obtain a HPID by November 5, 2014 (or November 5, 2015 if it is a small health plan); and (3) prepare to certify to HHS that it is in compliance with certain electronic transaction standards by December 31, 2015 (or December 31, 2016 if it is a small health plan).

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Health Care Reform: Enrollment Extension for Individuals, Guidance for Small Businesses

If you haven’t already enrolled in health plans through the federal insurance marketplace, you may get a little more time to do so. The Obama administration announced late Tuesday night that it will extend the deadline for those who have begun to apply for coverage online, but haven’t finished by the March 31st deadline. Administration officials said the move is in anticipation of an expected surge of people trying to sign up in the final days before the deadline.

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Small Business Health Care Affordability Tax Credits

Under the Affordable Care Act, small employers are not required to provide health insurance to their employees.  However, many small employers plan to offer health insurance coverage anyway. An important factor in this decision has been the availability of the Small Business Health Care Affordability Tax Credits. Below are some of key components of the tax credit:

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Affordable Care Act: Presentation on Recent Changes & Deadlines

Final regulations recently announced by the Obama Administration give two levels of delay to employers who had previously been required to offer insurance coverage to their employees next year. With this second round of delays, comes a second wave of questions from employers.

This week, Attorney Michael James and Rehmann Group’s Don McAnelly addressed key Affordable Care Act regulations and deadlines in a webinar.

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Michigan to Allow Health Insurers to Reinstate Canceled Plans

If your health insurance policy was cancelled in anticipation of the start of the Affordable Care Act, you may soon be able to have it reinstated.

Today, the Michigan Department of Insurance and Financial Services (DIFS) said that after careful review, Michigan is allowing health insurers to reinstate cancelled policies.

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Another Major Delay in Obamacare: Setback for Small Business Health Exchange (SHOP)

The Washington Post reports a critical function of the federal government’s new health insurance marketplace for small businesses has been pushed back for a second time. The Centers for Medicare and Medicaid Services announced that employers will not be able to enroll in plans through the SHOP until the end of November. Under the first delay, small employers were slated to begin enrolling their employees in health insurance plans on Friday, November 1st.

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ACA Impact: Public Sector

The ACA stands poised to usher in sweeping changes for many entities. Leaders need answers on how the ACA is going to impact their operations. Multiple regulations and shifting timetables, however, make it difficult to measure – and almost impossible to predict – what those changes can mean for you.

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