Articles, White Papers and Other Information

Fact Sheet on Proposed Exchange Integrity Regulation

Document Excerpt The Centers for Medicare & Medicaid Services (CMS) released a proposed rule on November 7, 2018 to strengthen program integrity for Exchanges with respect to subsidy payments in the individual market. The proposed rule is intended to advance the Administration’s goals of: •Strengthening CMS’ oversight over State-based Exchanges (SBEs) through monitoring,reporting, and oversight […]

Proposed Regulations on ACA Exchange Integrity

Document Excerpt SUMMARY: This proposed rule would revise standards relating to oversight of Exchanges established by states, periodic data matching frequency and authority, and the length of a consumer’s authorization for the Exchange to obtain updated tax information. This proposed rule would also propose new requirements for certain issuers related to the collection of a […]

Fact Sheet on Religious and Moral Exemption and Accommodation Regulations

Document Excerpt On November 7, 2018 the Departments of Health and Human Services, Treasury, and Labor (the Departments) announced two final rules, on display at the Federal Register, that provide conscience protections to Americans who have a religious or moral objection to health insurance that covers contraceptive methods, including certain contraceptives that many view as […]

CMS and Treasury Guidance on State Relief and Empowerment Waivers

Document Excerpt SUMMARY: This guidance relates to section 1332 of the Patient Protection and Affordable Care Act (PPACA) and its implementing regulations. Section 1332 provides the Secretary of Health and Human Services and the Secretary of the Treasury (collectively, the Secretaries) with the discretion to approve a state’s proposal to waive specific provisions of the […]

Medicare and Medicaid Drug Price Transparency Proposed Regulations

Document Excerpt This proposed rule would revise the Federal Health Insurance Programs for the Aged and Disabled by amending the Medicare Parts A, B, C and D programs, as well as the Medicaid program, to require direct-to-consumer (DTC) television advertisements of prescription drugs and biological products for which payment is available through or under Medicare […]

Executive Order on Strengthening Retirement Security

Document Excerpt •The Departments will consider changes to make it easier for businesses to join together to offer Association Retirement Plans (ARPs), also known as Multiple Employer Plans. Link https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-strengthening-retirement-security-american-workers/

Proposed Regulations Adopting Methodology for Risk Adjustment Program for the 2018 Benefit Year

Document Excerpt This rule proposes to adopt the risk adjustment methodology that HHS previously established for the 2018 benefit year. In February 2018, a district court vacated the use of statewide average premium in the HHS-operated risk adjustment methodology for the 2014 through 2018 benefit years. HHS is proposing to adopt the HHS-operated risk adjustment […]

Methodology for Permanent Risk Adjustment Program for 2017 Benefit Year

Document Excerpt This final rule adopts the risk adjustment methodology that HHS previously established for the 2017 benefit year. Section 1343 of the Patient Protection and Affordable Care Act (PPACA) established a permanent annual risk adjustment program under which payments are collected from health insurance issuers that enroll relatively low-risk populations, and payments are made […]

Railroad Stock Options are Not Compensation Subject to Railroad Retirement Plan Tax

So holds the Supreme Court in Wisconsin Central Ltd. v. U.S., No. 17-530 (S. Ct. June 21, 2018). Document Excerpt Held: Employee stock options are not taxable “compensation” under the Railroad Retirement Tax Act because they are not “money remuneration.” When Link https://www.supremecourt.gov/opinions/17pdf/17-530_6537.pdf

Trump Administration Argues Key Parts of ACA are Unconstitutional

In a filing before a district court, the DOL signals it will not defend key parts of the Affordable Care Act stating that once the Tax Cuts and Jobs Act zeros out the individual mandate penalty, the individual mandate, guaranteed issue and community ratings provisions become unconstitutional. Document Excerpt In sum, once the associated financial […]

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