Category: Compliance
Massachusetts Health Care Reform & Reporting Requirements
—
by
The Massachusetts Health Care Reform Act (Act) was enacted in April 2006 to provide nearly universal health care coverage forMassachusetts residents. To carry out this objective, the Act created an individual mandate and employer coverage andreporting requirements, among other things. The Act precedes the federal healthcare reform law—the Affordable Care Act(ACA)— that was enacted in…
Gag Clause Attestation Deadline
—
by
As the year comes to an end, a crucial compliance deadline looms for employers with health plans. Under the Consolidated Appropriations Act (CAA), health plans and insurance issuers must submit a Gag Clause Compliance Attestation by December 31, 2024. Since its enactment in 2020, this regulation prohibits health plans from including gag clauses—provisions that limit…
Final Rule Expands Mental Health Parity Requirements
—
by
The Department of Health and Human Services (HHS) has issued a final rule that significantly expands the Mental Health Parity and Addiction Act (MHPAEA) requirements under the Affordable Care Act (ACA). This rule aims to ensure that health plans provide equal coverage for mental health and substance use disorder (MH/SUD) benefits as they do for…
Health Plans Must Update HIPAA Policies for New Reproductive Health Care Rights
—
by
Beginning Dec. 23, 2024, covered entities and their business associates must comply with stricter HIPAA privacy protections for reproductive health care. These new protections prohibit regulated entities from using or disclosing protected health information (PHI) related to lawful reproductive health care: In addition, regulated entities must obtain a valid attestation when a request is made…
The Pay or Play Percentage Increase for 2025
—
by
The Affordable Care Act (ACA) requires large employers to offer affordable health insurance coverage to their full-time employees or face a penalty known as the “Pay or Play” tax. This tax is based on the employer’s average monthly wage (AMW) and the number of full-time employees. The affordability rate for employer-sponsored health coverage will increase from 8.39% to…