In a recent decision, Texas Medical Association v. U.S. Department of Health and Human Services (“HHS”), a U.S. district court in Texas vacated portions of the regulations implementing the federal independent dispute resolution (“IDR”) process under the No Surprises Act (“NSA”).

As a reminder, insurance carriers are required to satisfy certain medical loss ratio (“MLR”) thresholds. This generally means that for every dollar of premium a […]

Medicare Part D Notification Requirements Employers that provide prescription drug benefits are required to notify Medicare-eligible individuals annually as to whether the employer-provided benefit is creditable or non-creditable so that these individuals can decide whether or not to delay Part D enrollment. Also, the employer must annually notify CMS as to whether or not the employer plan is creditable.

The IRS recently announced in Revenue Procedure 2023-29 that the Affordable Care Act (“ACA”) affordability indexed amount under the Employer Shared Responsibility Payment (“ESRP”) requirements […]

The Departments of Labor (“DOL”), Health and Human Services (“HHS”), and the Treasury (collectively, “the Departments”) recently published mental health parity enforcement guidance, including new […]