Business Associate Agreements

in HIPAA Privacy & Security

Some controversy has erupted regarding the status of business associate agreements, when the business associate refuses to enter into a business associate agreement. The preamble to the HHS July 14, 2010 proposed regulations provides that - if a covered entity and business associate have failed to enter into a business associate agreement, then the business associate may use or disclose protected health information only as necessary to perform its obligations for the covered entity (pursuant...Continue Reading

Nondiscrimination for Insured Plans

in Affordable Care Act

New PHSA Section 2716 adopts new nondiscrimination rules on insured health plans beginning with the first plan year after September 23, 2010 (or January 1, 2011 for calendar year plans). The statute provides that rules similar to the Code Section 105(h) rules for self-insured plans shall apply for this purpose. We thought that the regulations implementing this new requirement were to be released soon. However, last week we heard, unofficially, that the regulations have been delayed, meaning...Continue Reading

Mini-Med Waivers and OTC Reimbursements Explained

in Affordable Care Act

As noted previously, IRS announced the OTC reimbursement guidance for health FSAs and HRAs, and HHS announced the mini-med waiver program. Unfortunately, there is not much substance in the guidance, leaving many plan sponsors with numerous questions as they approach annual enrollment. We have posted our Legal Alert on these releases at the link below.

Reimbursing OTC Drugs and Applying for Mini-Med Waivers

Mini-Med Waiver Program Announced

in Affordable Care Act

Late on Friday, September 3rd, OCIIO posted the annual waiver process for mini-med plans. Interested plan sponsors must send their applications to OCIIO and they will be processed in 30 days. If approved, the waiver will only apply for the next plan year, meaning that annual re-applications will be necessary. The guidance can be found at the following link:

http://www.hhs.gov/ociio/regulations/patient/ociio_2010-1_20100903_508.pdf

OTC Guidance Released

in Affordable Care Act, Cafeteria Plans

The Affordable Care Act provides that the cost of an over-the-counter medicine or drug cannot be reimbursed from a health FSA or HRA unless a prescription is obtained. This new rule applies only to purchases made on or after January 1, 2011. Moments ago, the IRS released Notice 2010-59, which provides guidance regarding how this new rule will operate. A link to the guidance is appended below, and we will have additional details regarding the guidance next week.

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