More healthcare-related regulatory news for plan sponsors, including links to detailed information.
HHS issues final rule providing notice of benefit payment parameters for 2015
The U.S. Department of Health and Human Services (HHS) issued a final rule providing Notice of Benefit and Payment Parameters for 2015 that, among other things, makes it easier for health insurers to get risk adjustment payments, in part because of administration policies that affect the populations of people who will enroll in the Patient Protection and Affordable Care Act (ACA) marketplace plans.
The HHS said it is considering proposing that states could recommend modifications to an ACA provision giving employees a choice of plan options in the Small Business Health Options Program (SHOP) marketplaces. But the HHS final rule has standards for employee choice in the federally facilitated SHOP marketplace.
For more information on the final rule, click here.
DOL issues report on evaluation of tools and metrics to support employer selection of health plans
The U.S. Department of Labor (DOL) has issued a report entitled “Evaluation of tools and metrics to support employer selection of health plans.” The research for the report was conducted in RAND Health and sponsored by the DOL. It is based on a review of the trade and scientific literature and health insurers’ websites; an analysis of product and service offerings from a random sample of 70 health insurance companies; an expert panel meeting with 15 individuals representing a variety of perspectives, including academia, consumer advocacy groups, measures developers, and employer coalitions; and case study interviews with nine employers and business coalitions.
The report describes a conceptual framework of health plan features, evaluates the current availability of quality measures and decision tools to employers, and describes how employers make decisions when choosing a health plan.
To read the entire report, click here.
CMS issues memorandum on coverage of same-sex spouses
The Centers for Medicare and Medicaid Services (CMS) has issued a memorandum on coverage of same-sex spouses. CMS is issuing this guidance to clarify the current regulations’ prohibition against discrimination based on sexual orientation. This guidance operates to clarify these terms as CMS has used them in 45 CFR 147.104(e). This clarification is consistent with the policy of ensuring that all individuals have access to health coverage.
To read the entire memorandum, click here.
The House passes bills exempting certain individuals from ACA coverage requirements
The U.S. House of Representative agreed to the following bills on March 11:
• H.R.1814 (the “Equitable Access to Care and Health Act”), which would provide an additional religious exemption from the ACA’s individual health coverage mandate for individuals who file a sworn statement with their tax returns that their “sincerely held religious beliefs” would cause them to object to medical healthcare that would be covered by the law’s minimum essential coverage requirement (but medical healthcare would not include treatment or examinations required by law or third parties, such as a prospective employer)
• H.R.3474 (the “Hire More Heroes Act”), which would allow employers to exclude employees with health coverage under TRICARE or the Veterans Administration from being taken into account under the ACA’s employer mandate (thereby providing an incentive for employers to hire veterans, because the veterans already are covered by the federal veterans health programs)
• H.R.3979 (the “Protecting Volunteer Firefighters and Emergency Responders Act”), which would exclude volunteer firefighters and emergency responders from being taken into account under the ACA’s shared responsibility requirements (and thus, employers need not offer them health insurance)
H.R.1814 was approved by voice vote, H.R.3474 by 406-1, and H.R.3979 by 410-0.