Federal Health & Welfare Updates

Aug 14, 2024

Fifth Circuit Affirms District Court Judgment Vacating Surprise Billing Rule Provisions

On August 2, 2024, the Fifth Circuit Court of Appeals (Fifth Circuit) affirmed the district court’s decision to vacate regulations promulgated by three federal agencies: the DOL, HHS, and IRS (the agencies). The regulations established priorities for independent arbitrators appointed to resolve disputes between healthcare providers and payors through an Independent Dispute Resolution (IDR) process established under the No Surprises Act (NSA).

Jul 31, 2024

District Court Rules NSA Does Not Create a Cause of Action to Enforce Arbitration Awards

On May 30, 2024, the federal district court in the Northern District of Texas issued an order granting Health Care Service Corporation's (HCSC) motion to dismiss the claims of plaintiffs Guardian Flight LLC and Med-Trans Corporation against HCSC. Plaintiffs are air ambulance providers who provided services out-of-network and went through the Independent Dispute Resolution (IDR) process with the defendant to settle a payment dispute. 

Jul 31, 2024

Eleventh Circuit Affirms FMLA Does Not Provide Pre-Birth Leave for Fathers

Recently, in Tanner v. Stryker Corp. of Michigan, the US Court of Appeals for the Eleventh Circuit (Eleventh Circuit) affirmed a lower court’s ruling that a non-birthing parent does not have a right to protection under the FMLA prior to the birth of a child. As background, the plaintiff was expecting a child with his former girlfriend who lived out of state. The plaintiff requested leave under FMLA to travel and await the birth of the child. 

Jul 17, 2024

HHS Gender Identity Rules Subject to Nationwide Injunction

On July 3, 2024, the US District Court for the Southern District of Mississippi issued a stay on the effective date of parts of the final rule issued by HHS on May 6, 2024 (the May 2024 Rule), that applies the ACA Section 1557 nondiscrimination provisions to discrimination on the basis of gender identity. The May 2024 Rule was scheduled to take effect on July 5, 2024. On May 30, 2024, the states of Tennessee and Mississippi joined with...

Jul 17, 2024

HHS Releases New Resources on HIPAA Reproductive Healthcare Privacy Final Rule

On June 27, 2024, HHS updated its “HIPAA and Reproductive Health” web page with resources to help covered entities, including group health plans, and business associates comply with the 2024 final HIPAA Privacy Rule to Support Reproductive Health Care Privacy (the 2024 Final Rule). On April 26, 2024, HHS published the 2024 Final Rule, which modifies the existing HIPAA Privacy Rule. 

Jul 17, 2024

HHS Announces Settlement for Potential HIPAA Violations

On July 1, 2024, the OCR announced that it settled an investigation into Heritage Valley Health System (HVHS), a healthcare provider, following a ransomware attack that resulted in a breach of PHI. OCR alleged that HVHS failed to take necessary steps required by HIPAA to reduce the risk of a ransomware attack. OCR began an investigation into HVHS on October 31, 2017, after media reports of the provider experiencing a data breach. 

Jul 2, 2024

Fifth Circuit Reverses Injunction in ACA Preventive Care Challenge and Sends It Back to the District Court

On June 21, 2024, the Fifth Circuit Court of Appeals (Fifth Circuit) reversed the nationwide injunction imposed by a Texas federal district court that prohibited the federal government from enforcing the ACA’s preventive care mandate. However, the Fifth Circuit remanded the case back to the district court for further proceedings, so the fate of the mandate remains unresolved. 

Jul 2, 2024

IRS Issues FAQs on Educational Assistance Programs

On June 17, 2024, the IRS issued FAQs related to educational assistance programs under Section 127 of the IRC. Educational assistance programs are sponsored by employers and provide up to $5,250 in tax-free benefits to employees for certain qualified educational expenses. These expenses include items such as tuition, fees, books, supplies, equipment, etc. Principal or interest payments on qualified education loans made by the employer are also...

Jul 2, 2024

Texas Judge Vacates OCR Website Tracking Technology Guidance

On June 20, 2024, the US District Court for the Northern District of Texas ruled that guidance issued by the HHS Office for Civil Rights (OCR) on the use of third-party online tracking technologies by HIPAA-regulated entities, which include covered entities (such as healthcare providers) and business associates, was unlawful and that OCR overstepped its authority when it issued the guidance. The district court invalidated OCR’s guidance that...

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PPI Benefit Solutions does not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.

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