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The Consolidated Appropriations Act, 2021 (more here) amended The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) to require group health plans and insurers to perform, document, and disclose comparative analyses of the design and application of non-quantitative treatment limits (NQTLs) for mental health/substance use disorder (MH/SUD) benefits in the plan.  Group health plans and insurers must make this analysis available to Departments of Treasure, Labor, and HHS beginning Feb 10, 2021.  The comparative analysis must demonstrate that the processes, strategies, evidentiary standards, and other factors used to apply NQTLs to MH/SUD benefits are comparable to, and applied no more […]

The United States Department of Health and Human Services Office for Civil Rights (OCR) issued updated guidance regarding contacting former COVID-19 positive patients about blood plasma donation, as related to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy protections.  The guidance allows healthcare providers and covered entities to use protected health information (PHI) to identify and contact former COVID-19 positive patients to provide information on donating blood plasma to treat patients with COVID-19, as long as the information is not used for marketing purposes (“marketing” as defined by HIPAA).

Changes to HIPAA Privacy Rule

The HIPAA Privacy Rule allows covered entities or their […]

On March 27, 2020, Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act to provide $2.2. trillion in federal funding in response to the COVID-19 global pandemic. These funds are available to small businesses, individuals, gig and freelance workers, retail and restaurants, hospitals and public health organizations, as well as large corporations and educational organizations.  While the majority of the relief is to individuals and businesses, a portion of these funds are directed towards expansion of health care delivery in response to the crisis. This Act follows two other pieces of legislation, The Families First Coronavirus Response Act (FFCRA) and an emergency funding bill.

The CARES Act […]

This summary is written using the House Ways and Means Committee’s summary and the Kaiser Family Foundation sources.  This bill repeals the Patient Protection and Affordable Care Act and the health care provisions of the Health Care and Education Reconciliation Act of 2010, effective January 1, 2016.  This bill has several steps to move through before it becomes law.  The two bills that compromise the AHCA were introduced into the House Energy and Commerce Committee and the Ways and Means Committee and passed both on March 9, 2017.  The bill next goes to the House Budget Committee then the Rules Committee before going for a vote on […]

The Supreme Court ruled 6-2 on March 1st that self-insured employee plans cannot be forced to disclose to the state data regarding what they pay in medical claims (Gobeille v. Liberty Mutual Insurance Co. No. 14-181, March 1, 2016). SCOTUS decided that Vermont overreached in contradiction of federal reporting requirements in trying to gather and analyze the claims data from Liberty Mutual’s self-insured employee plan. Justice Kennedy, writing for the court, said that Vermont’s reporting law was inconsistent with federal goals of a “uniform national scheme” for collecting claims data. Vermont had argued that they needed the data from all payers, including self-funded employee plans, in order to […]