Search for: "Ex Parte State Health Planning & Development Agency"
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2 Mar 2016, 5:00 pm
Employer and union sponsored group health plans covered by the Employee Retirement Income Security Act of 1974 (ERISA) and their insurers are not required to comply with a Vermont state law that requires health insurers and certain other parties to report payments relating to health care claims and other information relating to health care services to a state agency for compilation in an all-inclusive health care… [read post]
11 Aug 2015, 2:29 pm
FAQS About Affordable Care Act Implementation (Part XXVIII) also states that the Departments also intend to streamline reporting under multiple reporting provisions and reduce unnecessary duplication when they issue the non-QHP issuers and non-grandfathered group health plans. [read post]
20 Apr 2011, 4:54 pm
As a continuing part of this representation, Ms. [read post]
27 Apr 2016, 9:01 am
FAQ 31 supplements this previous Agency guidance by confirming that group health plans and health insurers may develop a standard exception form with instructions that an attending provider may use to prescribe a particular service or FDA-approved item based on a determination of medical necessity with respect to the individual involved and suggests the Medicare Part D Coverage Determination Request Form as an appropriate model for the… [read post]
27 Apr 2016, 9:01 am
FAQ 31 supplements this previous Agency guidance by confirming that group health plans and health insurers may develop a standard exception form with instructions that an attending provider may use to prescribe a particular service or FDA-approved item based on a determination of medical necessity with respect to the individual involved and suggests the Medicare Part D Coverage Determination Request Form as an appropriate model for the… [read post]
31 May 2016, 4:05 pm
Gobeille involved a challenge to a Vermont “all payer” law similar to laws enacted by at least 20 other states, that requires health plan payers, their administrators or both to disclose individually identifiable health claims and other claims data about Plan members to a state created all payer data base. [read post]
21 Jun 2018, 10:57 am
United States ex rel. [read post]
3 Apr 2014, 1:22 pm
This definition of expatriate health plan will not extend to all health coverage provided for employees of U.S. companies working outside the United States. [read post]
11 Jul 2015, 2:14 pm
In the face of these developments, health plans and their employer or other sponsors, health plan fiduciaries, health plan vendors acting as business associates and others dealing with health plans and their management should contact legal counsel experienced in these matters for advice and help about evaluating within the scope of attorney-client privilege the implications of the Resolution Agreement and other recent… [read post]
28 Nov 2022, 1:42 pm
Consequently, in addition to sharing any concerns or other input about the proposed changes during the comment period, health care providers, health plans, health care clearinghouses, employers, community agencies, state and local governments, patients and other caregivers and other concerned parties also should begin planning and preparing to respond to the anticipated changes in the requirements. [read post]
2 Aug 2011, 4:24 pm
Affordable Care Act To Require Health Plans Cover Contraception & Other Women’s Health Procedures Beginning In 2012 Contraception Mandate Might Not Apply To Certain Religious Employer Plans Starting with plan years beginning after July 31, 2011, most employer and union sponsored group health plans and group and individual health insurers generally must cover contraceptive and certain other preventive services for… [read post]
21 Aug 2015, 6:07 pm
As part of ACA, the Internal Revenue Code now generally requires employers sponsoring a group health plan that violates the ACA out-of-pocket limit or a long list of other federal health plan rules after 2013 to self-assess, report and pay stiff new excise tax penalties of $100 per day per violation when filing their annual tax return. [read post]
3 Aug 2015, 12:07 pm
The definition of “essential health benefits” as implemented by the Tri-Agency regulations is complicated and generally varies by state, even when the group health plan is self-insured. [read post]
29 Sep 2023, 1:56 am
Under the Affordable Care Act , states are required to complete administrative or “ex parte” Medicaid renewals by verifying an enrollee’s ongoing eligibility through existing sources, like state wage databases. [read post]
25 Jun 2015, 3:02 pm
Deadline To Self-Report, Pay Excise Tax Penalties For 2014 Health Plan Violations Rapidly Approaching In light of these developments, businesses must prepare both to meet their current and future ACA and other federal health plan compliance obligations and defend potential deficiencies in their previous compliance over the past several years. [read post]
15 Dec 2015, 9:11 am
The case is captioned as U.S. and State of Wisconsin ex rel. [read post]
21 Aug 2015, 11:24 am
As part of ACA, the Internal Revenue Code now generally requires employers sponsoring a group health plan that violates the ACA out-of-pocket limit or a long list of other federal health plan rules after 2013 to self-assess, report and pay stiff new excise tax penalties of $100 per day per violation when filing their annual tax return. [read post]
11 Mar 2020, 2:07 pm
While many employers sponsoring self-insured health plans will want their health plan to provide similar coverage as part of their risk management response to the coronavirus outbreak. [read post]
26 Nov 2012, 11:26 am
Solutions Law Press, Inc. invites employer and other group health plan sponsors, fiduciaries, administrators, insurers, brokers and consultants and others involved in the design and administration of employment-based group health plans to take part in a complimentary Health Care Executive Study Group internet briefing on new and proposed guidance interpreting audit pre-existing condition limitation, wellness and disease management and… [read post]
17 Feb 2022, 8:53 am
The state then forwards the plan to FEMA for formal review and approval. [read post]
