Patient-Centered Outcomes/Comparative Effectiveness (PCORI) Fee FAQ - Updated 2021

Posted by Matt Schwartz on Tue, Jun 15, 2021 @ 09:06 AM

The Patient-Centered Outcomes Research Institute (PCORI) fee initially applied from 2012 to 2019. However, in December 2019, the Further Consolidated Appropriations Act, 2020 extended the fee to 2029.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

2021 Patient-Centered Outcomes Research Institute (PCORI) Fee

Posted by Matt Schwartz on Thu, Jun 10, 2021 @ 08:06 AM

The Patient-Centered Outcomes Research Institute (PCORI) fee deadline is around the corner. In
Notice 2020-84, the IRS adjusted the applicable dollar amount to be multiplied by the average number of covered lives for purposes of calculating the fee for policy years and plan years that end on or after October 1, 2020, and before October 1, 2021.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Executive Order on Strengthening Medicaid and the Affordable Care Act

Posted by Matt Schwartz on Thu, Apr 1, 2021 @ 11:04 AM

3/24/2021 Update: CMS has extended the new special enrollment period for marketplaces using the Heathcare.gov platform until August 15, 2021. See the updated CMS FAQs for more information.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits, COVID-19

The American Rescue Plan Act of 2021 - Part 2 - DCAPs and Exchange Health Insurance

Posted by Matt Schwartz on Tue, Mar 30, 2021 @ 09:03 AM

On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (Act). The Act is a $1.9 trillion legislative package, which contains several provisions intended to relieve employers and families from some of the economic burdens associated with COVID-19.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits, COVID-19

Compliance Recap - February 2021

Posted by Matt Schwartz on Fri, Mar 12, 2021 @ 11:03 AM

February was a relatively busy month in the employee benefits world. The Department of Labor (DOL) issued EBSA Disaster Relief Notice 2021-01 regarding the end of the COVID-19 outbreak period.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits, COVID-19

Consolidated Appropriations Act, 2021: Advance EOB, Patient/Consumer Protections and Reporting

Posted by Matt Schwartz on Mon, Feb 22, 2021 @ 09:02 AM

On December 27, 2020, former President Trump signed the Consolidated Appropriations Act, 2021 (Appropriations Act). The Appropriations Act amends Title XXVII of the Public Health Service Act (PHSA), Part 7 of Title I of the Employee Retirement Income Security Act of 1974 (ERISA), and Chapter 100 of the Internal Revenue Code of 1986 (IRC).

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Compliance Recap - January 2021

Posted by Matt Schwartz on Fri, Feb 12, 2021 @ 11:02 AM

January was a busy month in the employee benefits world. President Biden issued a memorandum putting a regulatory freeze on new rules. President Biden also issued an executive order on strengthening Medicaid and the Patient Protection and Affordable Care Act (ACA).

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Executive Order on Strengthening Medicaid and the ACA

Posted by Matt Schwartz on Wed, Feb 10, 2021 @ 10:02 AM

On January 28, 2021, President Biden signed an Executive Order on Strengthening Medicaid and the Affordable Care Act (ACA) (Executive Order). The Executive Order instructs the Department of Health and Human Services (HHS) to consider establishing a special open enrollment period (SEP) for individuals to enroll in or change their current coverage under federally facilitated health insurance marketplaces.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Option for Some to Renew Policies That Do Not Fully Meet ACA Standards

Posted by Matt Schwartz on Thu, Feb 4, 2021 @ 11:02 AM

In the fall of 2013, the Department of Health and Human Services (HHS) announced a transitional relief program that allowed state insurance departments to permit early renewal at the end of 2013 of individual and small group policies that do not meet the “market reform” requirements of the Patient Protection and Affordable Care Act (ACA) and for the policies to remain in force until their new renewal date in late 2014.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Final 2022 Benefit Payment and Parameters Rule

Posted by Matt Schwartz on Fri, Jan 29, 2021 @ 11:01 AM

The Centers for Medicare & Medicaid Services (CMS) has released a final rule along with a fact sheet and press release for benefit payment and parameters for 2022.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits