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District Court Judge Stops HHS Regulations Regarding Contraception Mandate

When Congressional drafters wrote the Affordable Care Act 10 years ago, they included a provision requiring group health plans to provide preventive care without cost sharing. Much of that coverage requirement was set forth in the Act itself with some specificity. It included immunizations, screenings, and other “evidence-based items or services” recommended by the United States Preventive Services Tax Force. The Act also provided for special rules for preventive care “with respect to women;” however, those rules were not specified in the Act and were to be determined by a government agency. After the law safely passed, the Health Resources and Services Administration, acting on the findings of the Institute of Medicine, decided that preventive care with respect to women must include coverage for contraceptive services without cost sharing. In the decade since that provision became law, plan sponsors have been dealing with nearly constant administrative and judicial pinball regarding this contentious topic. More ›

Recently Issued Final Regulations Provide Clarification on Employee Wellness Programs

On May 29, 2013, the U.S. Department of Health and Human Services (HHS), U.S. Department of the Treasury (Treasury), and U.S. Department of Labor issued the final rule governing employee wellness programs under the Affordable Care Act (ACA). This rule is intended to provide comprehensive guidance as to the general requirements for wellness programs by restructuring the regulations proposed by the departments in November 2012. These regulations replace the wellness program provisions of paragraph (f) of the 2006 Health Insurance Portability and Accountability Act (HIPAA) nondiscrimination and wellness provisions jointly published by HHS and the Treasury and implement Section 2705 of the Public Health Service Act (PHS). As amended by the ACA, the PHS’ nondiscrimination and wellness provisions largely reflect the 2006 regulations and extend the HIPAA nondiscrimination protections to the individual market. The rule applies to group health insurance coverage for plan years starting on or after January 1, 2014. More ›

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