The McDermott+ Check-Up features updates on healthcare legislative and regulatory activities that could impact health insurers, group health plan sponsors, healthcare providers and others in the health benefits industry. This post covers a recent Federal Trade Commission report on anticompetitive behaviors by pharmacy benefit managers as well as recent Senate hearings on medical debt and healthcare transparency.
Group health plan sponsors, third-party administrators and other health plan service providers must navigate a shifting legal landscape as they determine how to offer gender-affirming benefits, including whether − and to what extent − group health plans must cover gender-affirming medical or surgical treatments, especially regarding minors. In this On the Subject, we discuss recent legal developments impacting gender-affirming care and approaches to group health plan coverage.
Joanna Kerpen authored an article on final HIPAA rules for privacy enforcement and audit programs, particularly those with additional requirements aimed at group health plan sponsors. This report focuses on the final regulations issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), in January 2013, HIPAA enforcement and audit programs, HIPAA-related additional requirements of group health plan sponsors, and the actions that must be taken by group health plan sponsors to ensure compliance with the final regulations and requirements and to prepare for potential audits and enforcement actions.
“The final HIPAA regulations made many changes to the existing HIPAA privacy and security rules that are applicable to covered entities,” Ms. Kerpen wrote, and she urged plan sponsors to conduct a comprehensive review of their compliance plans to prepare for audits or enforcement action.
Read the full article here.
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