The DOL Employee Benefits Security Administration has updated its COBRA web page with a fact sheet and FAQs on maintaining health coverage after the COBRA premium reduction ends.

Click here to view the fact sheet.

Click here to view the FAQs.

The Departments of Treasury, Labor and Health and Human Services have issued guidance addressing the internal claims and appeals and external review processes. The requirements set forth in these interim final regulations apply only to non-grandfathered group health plans and are effective the first plan year beginning after Sept. 23, 2010 for calendar year plans starting Jan. 1, 2011. PPACA requires all non-grandfathered group health plans to implement an external review process in addition to the internal claims appeal process already mandated under ERISA.

The interim final rule provides guidance on the new, mandatory external review process required under PPACA and makes changes to the existing standards for internal claims and appeals.

Internal Claims and Appeals Processes

Under PPACA, group plans and insurers offering group coverage must implement internal claims and appeals processes that comply with the claims and appeals procedures requirements under Section 503 of the Employee Retirement Income Security Act (ERISA), if they are not already subject to those requirements (e.g., church and governmental plans). In addition, the interim final rule creates six new requirements for group health plans and insurers, including the definition of a denial to include a rescission of coverage and that urgent care claims must be decided and the claimant must be notified within 24 hours after the plan or insurer receives the claim.

External Review Process

For the external review standards, the guidance provides a basis for determining when plans and issuers must comply with an applicable State external review process and when they must comply with the Federal external review process.

Click here to view the interim final rules.

The IRS has addressed many aspects of tax treatment for qualified transportation benefits provided by employers. The information letter focuses on the use of smartcards, transit passes and qualified parking, in addition to the tax treatment of such passes and parking that employers provide by crediting employee’s smartcards.

By definition:

A “transit pass” is any pass, token, farecard, voucher, or similar item (including an item exchangeable for fare media) that entitles a person to transportation on mass transit facilities [Code § 132(f)(5)(A)].

“Qualified parking,” is parking that is located on or near the employer’s business premises or on or near a location from which the employee commutes to work via mass transit or commuter highway vehicle [Code § 132(f)(5)(C)].

Click here to read more.

HHS has temporarily pulled a final breach notification rule until further consideration. The Interim Final Rule for Breach Notification for Unsecured Protected Health Information issued pursuant to the HITECH Act was published in the Federal Register Aug. 24, 2009 and became effective Sept. 23, 2009. After the 60-day public comment period, HHS is withdrawing the rule and intends to publish a final rule in the Federal Register in the coming months, according to a notice issued by HHS.

"This is a complex issue and the Administration is committed to ensuring that individuals’ health information is secured to the extent possible to avoid unauthorized uses and disclosures, and that individuals are appropriately notified when incidents do occur,” according to the notice.

HHS has issued interim final regulations on the high risk pool program (Pre-existing Condition Insurance Plan (PCIP)). This program provides affordable health insurance coverage to uninsured individuals with preexisting conditions until 2014 when the exchanges established under health care reform are available. The regulations were published in the Federal Register and address administration, eligibility, enrollment, benefits, oversight and funding.

Click here to read the interim final rules.

The Patients’ Freedom to Choose Act was introduced in the House of Representatives today by Rep. Erik Paulsen (R-MN) and a companion bill was introduced in the Senate by Senator Kay Bailey Hutchison (R-TX). The bills (H.R. 5923/S. 3673) would repeal the $2,500 cap on FSAs and the restrictions placed on the use of FSA and HSA dollars for reimbursement of over-the-counter drugs included in the health reform law.

The IRS released guidance explaining why the standard mileage rate for medical expenses is lower than the rate for business expense deductions. For 2010, the standard mileage rate for medical expenses is 16.5 cents per mile, while the rate for business expenses is 50 cents per mile.  The mileage rates differ because automobile expenses that are deductible medical expenses under Code Section 213 are not the same as those that are deductible business expenses under Code Section 162.

Congress approved legislation earlier today that will restore unemployment benefits to people who have been out of work for six months or more, after a seven-week interruption that caused 2.5 million people to lose unemployment benefits. There was, however, no measure to extend the subsidy for COBRA benefits.

The Centers for Medicare and Medicaid Services (CMS) have modified the definition of an HRA for reporting purposes. CMS has removed the distinction between a free-standing HRA and an embedded HRA meaning all HRAs are reportable if they meet the $1,000.00 value threshold.

The Medicare Secondary Payer Mandatory Reporting User Guide for group health plans has been updated to address the required reporting of "linked" HRA coverage and other changes, such as the obligation of responsible reporting entities to provide information to CMS when group health plans are or have been primary to Medicare.

Click here to view.