Proposed Rules Would Require Hospitals to Publish Retail Prices for Health Care Services

On Monday, July 29, 2019, the Centers for Medicare and Medicaid (CMS) proposed rules that would require all Medicare-participating hospitals to post their negotiated prices for standard health care services. The Outpatient Prospective Payment System (OPPS) & Ambulatory Surgical Center (ASC) proposed rule is intended to increase pricing transparency and help consumers understand the charges…

New Executive Order Addresses Healthcare Issues

On June 24, 2019, President Trump issued an Executive Order (“EO”) directing the relevant federal agencies to issue regulations or other guidance to make available more meaningful information related to the price and quality of healthcare. This summary highlights aspects of the EO that may be relevant to employer-sponsored group health plans and their covered…

Court Strikes Down Association Health Plan Rules

On March 28th, 2019, a Federal District Court in the District of Columbia struck down significant portions of the Department of Labor’s (DOL’s) Association Health Plan (AHP) Final Rule. Specifically, the Court found the DOL “failed to reasonably interpret” ERISA when issuing these rules by: expanding the definition of “employers” to include disparate groups of…

ACA Legal Challenges Continue

Apr 2019 – This article is intended to provide you with an update on current legal challenges to invalidate the ACA. There is no immediate impact to employer-sponsored health plans or other requirements under the ACA.   In 2018, a Texas Court ruled in favor of 20 Republican state attorneys general (“AGs”) to invalidate the…

Court Strikes Down Association Health Plan Rules

On March 28th, 2019, a Federal District Court in the District of Columbia struck down significant portions of the Department of Labor’s (DOL’s) Association Health Plan (AHP) Final Rule. Specifically, the Court found the DOL “failed to reasonably interpret” ERISA when issuing these rules by: expanding the definition of “employers” to include disparate groups of…

House Passes Legislation to Improve HSAs

The House of Representatives passed two pieces of legislation that, among other things, purport to improve and “modernize” health savings accounts (“HSAs”).     While the bills call for significant changes to the current rules affecting HSAs, the specific details are very different.   Summary of Proposed Changes   H.R. 6199 would: Exclude a direct…

New Jersey Out-of-Network Bill

On June 1, 2018, New Jersey Gov. Murphy passed the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the “OON Act”). In general, the OON Act applies to emergency services and other care provided by out- of-network physicians in in-network settings (i.e. hospital-based physicians). It takes effect on September 1, 2018.   The Act…