Health Care Reform News and Events

WFL provides up to date information regarding The Health Care Reform Act to keep you informed of legislative changes as they occur.

January, 2012

HHS Adopts Standards for EFTs and Remittance

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires the Department of Health and Human Services (HHS) to maintain uniform standards for certain electronic health care transactions so that health information can be exchanged more efficiently. The Patient Protection and Affordable Care Act (PPACA) added electronic funds transfers (EFTs) to the list of electronic health care transactions for which HHS must maintain a uniform standard.

Employee Benefits Compliance Checklist for Small Employers

Federal law imposes numerous requirements on the group health coverage that employers decide to provide to their employees. Many federal compliance laws apply to all group health plans, regardless of the size of the sponsoring employer. However, there are some compliance exceptions for group health coverage provided by small employers. For this purpose, a small employer is one with 50 or fewer employees.

IRS Issues Additional Guidance on W-2 Reporting

The Patient Protection and Affordable Care Act (PPACA) requires employers to report the aggregate cost of employer-sponsored group health coverage on employees’ Forms W-2. The purpose of the reporting requirement is to inform employees about the cost of their health coverage. The reporting does not cause employees’ health coverage to become taxable to them. This reporting requirement was initially set to take effect beginning with the 2011 tax year. However, the IRS delayed the compliance date by making health coverage cost reporting optional for the 2011 tax year. An informative IRS Q&A on Form W-2 Reporting is also provided in this article.

Medical Loss Ratio Rules

The Patient Protection and Affordable Care Act (PPACA) established the medical loss ratio (MLR) rules to help control health care coverage costs and ensure that enrollees receive value for their premium dollars. The MLR rules became effective on Jan. 1, 2011.

December

HHS Proposes Approach for Defining Essential Health Benefits
Consumer Operate and Oriented Plan Program
HHS Announces End of Early Retiree Reinsurance Program
Final Regulations Issued on Medical Loss Ratio (MLR)

November

HHS Launches HIPAA Audit Program
Updates to Recommended Preventive Care Services
2012 Compliance Checklist
60-Day Advance Notice of Plan Changes
HIPAA Administrative Simplification: Guidance and Compliance Dates