Seyfarth Synopsis: On December 17, 2024, the House Ways and Means Committee and the Senate Finance Committee presented two bills – the Paperwork Burden Reduction Act (HR 3797) and the Employer Reporting Improvement Act (HR 3801) – to President Biden, which he signed into law on December 23, 2024. Both laws modify provisions under the
Class Action Lawsuit Challenges Noncoverage of Obesity Drugs
Seyfarth Synopsis: As employers consider the rising costs of coverage of semaglutide drugs like Ozempic and Wegovy in their health plans, a recent class action complaint alleging obesity-related discrimination could be a sign of things to come for more legal challenges. As the use of such drugs explodes in popularity across the country, insurers…
IRS Releases 2024 Limits for Health and Welfare and Related Plans
Seyfarth Synopsis: The IRS has announced an increase to the applicable dollar amount for determining the Patient-Centered Outcomes Research Institute (“PCORI”) Fee for 2024 as well as other health and welfare limits.
The Affordable Care Act (ACA) established the PCORI to support research on clinical effectiveness. The PCORI is funded (through the Patient-Centered Outcomes Research…
Employers May Have to Pay More in 2024 as Affordability Threshold Hits New Low for Second Year in a Row
Seyfarth Synopsis: The IRS has announced adjustments decreasing the affordability threshold for plan years beginning in 2024, which may cause employers to have to pay more for ACA compliant coverage in 2024.
The IRS recently released adjustments decreasing the affordability threshold for plan years beginning in 2024 in Revenue Procedure 2023-29.
Under the Affordable…
Preventive Care Mandate Returned to Status Quo — Temporarily
Seyfarth Synopsis: The 5th Circuit Court of Appeals has stayed enforcement of a Texas federal district court ruling that that voided the ACA requirement for health plans to cover preventive care items and services (without cost sharing) recommended by the United States Preventive Services Task Force (“USPSTF”) effective as of March 23, 2010.…
FAQs Address ACA Preventive Care Questions Post-Braidwood
Update: On June 13, 2023, the 5th Circuit issued a stay order which freezes the ruling issued by a Texas federal district court that voided the ACA requirement for health plans to cover preventive items and services (without cost-sharing) recommended by the U.S Preventive Services Task Force (USPSTF). For more information, see our blog post…
Texas District Court Nullifies Portions of Preventive Care Mandate
Update: On June 13, 2023, the 5th Circuit issued a stay order which freezes the ruling issued by a Texas federal district court that voided the ACA requirement for health plans to cover preventive items and services (without cost-sharing) recommended by the U.S Preventive Services Task Force (USPSTF). For more information, see our blog post…
Happy Holidays! Agencies Gift Plans Good Faith Relief and A Compliance Deadline Extension for Prescription Drug Reporting
Seyfarth Synopsis: Plans have been scrambling to gather data and work with providers in preparation for the December 27, 2022 deadline to report prescription drug and health care spending information. Just in time for the holidays, the Departments of Labor, Health and Human Services, and Treasury (the “Departments”) have issued FAQs related to Prescription Drug…
Permanent Extension to the ACA Reporting Deadline
Seyfarth Synopsis: Recently the U.S. Treasury Department (Treasury) and Internal Revenue Service (IRS) issued regulations (the “Final Regulations”) which finalized previously proposed relief for furnishing Forms 1095-B and 1095-C to individuals. Notably, the Final Regulations provide a permanent 30-day extension to the due date for furnishing Form 1095-C to individuals. This extension was previously granted in the 2021 final instructions for completing Forms 1094-C and 1095-C for 2021 (see our blog here) issued in December 2021.Continue Reading Permanent Extension to the ACA Reporting Deadline
IRS Releases 2023 Limits for Health and Welfare Plans
Seyfarth Synopsis: The IRS has announced an increase to the applicable dollar amount for determining the Patient-Centered Outcomes Research Institute (“PCORI”) Fee for 2023 as well as other health and welfare limits.
The Affordable Care Act (ACA) established the PCORI to support research on clinical effectiveness. The PCORI is funded in part by fees paid…