{"description":"Documents matching 'security erisa xxvii public health'","count":179,"total_pages":9,"next_page_url":"https://www.federalregister.gov/api/v1/documents?conditions%5Bterm%5D=security+erisa+xxvii+public+health&format=json&page=2","results":[{"title":"Improving Transparency Into Pharmacy Benefit Manager Fee Disclosure","type":"Proposed Rule","abstract":"The Department is proposing a regulation that would require providers of pharmacy benefit management services and affiliated providers of brokerage and consulting services to disclose information about their compensation to fiduciaries of self-insured group health plans subject to the Employee Retirement Income Security Act (ERISA). These disclosures are needed so that fiduciaries can assess the reasonableness of the contracts or arrangements with these service providers, including the reasonableness of the service providers' compensation. These disclosure requirements would apply for purposes of ERISA's statutory prohibited transaction exemption for services arrangements. This proposal implements section 12 of President Trump's Executive Order 14273, Lowering Drug Prices by Once Again Putting Americans First, which instructs the Department to propose regulations to improve employer health plan transparency into the direct and indirect compensation received by pharmacy benefit managers. If finalized, this regulation would affect sponsors and other fiduciaries of self-insured group health plans and certain service providers to such plans.","document_number":"2026-01907","html_url":"https://www.federalregister.gov/documents/2026/01/30/2026-01907/improving-transparency-into-pharmacy-benefit-manager-fee-disclosure","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-01-30/pdf/2026-01907.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-01907.pdf?1769721310","publication_date":"2026-01-30","agencies":[{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"}],"excerpts":"person providing services to the self-insured group <span class=\"match\">health</span> plan is defined by <span class=\"match\">ERISA</span> to be a “party in interest” to the self-insured group <span class=\"match\">health</span> plan. \n \n <span class=\"match\">ERISA</span> section 408(b)(2) exempts certain arrangements between <span class=\"match\">ERISA</span>-covered plans (including self-insured group <span class=\"match\">health</span> plans) and service providers that otherwise would be prohibited transactions under <span class=\"match\">ERISA</span> section 406. Section 408(b)(2) provides relief from <span class=\"match\">ERISA's</span> prohibited transaction rules for service contracts or arrangements between a plan and a party in interest if the contract or \n \n arrangement"},{"title":"Excepted Fertility Benefits","type":"Proposed Rule","abstract":"This document contains proposed rules that would amend the regulations regarding excepted benefits under the Employee Retirement Income Security Act of 1974, the Internal Revenue Code, and the Public Health Service Act to establish certain fertility benefits as a new category of limited excepted benefits. Excepted benefits are generally exempt from the market requirements that were added to those laws by the Health Insurance Portability and Accountability Act, the Patient Protection and Affordable Care Act, the No Surprises Act, and certain other Federal laws specifically related to group health plans and group and individual health insurance coverage.","document_number":"2026-09479","html_url":"https://www.federalregister.gov/documents/2026/05/13/2026-09479/excepted-fertility-benefits","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-05-13/pdf/2026-09479.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-09479.pdf?1778589913","publication_date":"2026-05-13","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"title <span class=\"match\">XXVII</span> of the PHS Act relating to <span class=\"match\">health</span> coverage requirements for group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and individual markets. The term “group <span class=\"match\">health</span> plan” includes both insured and self-insured group <span class=\"match\">health</span> plans. The ACA also added section 715 to <span class=\"match\">ERISA</span> and section 9815 to the Code to incorporate the provisions of part A of title <span class=\"match\">XXVII</span> of the PHS Act into <span class=\"match\">ERISA</span> and the Code, making them applicable to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers providing <span class=\"match\">health</span> insurance coverage in connection with group <span class=\"match\">health</span> plans"},{"title":"Agency Information Collection Activities; Submission for OMB Review; Comment Request; No Surprises Act: IDR Process","type":"Notice","abstract":"The Department of Labor (DOL) is submitting this Employee Benefits Security Administration (EBSA)-sponsored information collection request (ICR) to the Office of Management and Budget (OMB) for review and approval in accordance with the Paperwork Reduction Act of 1995 (PRA). Public comments on the ICR are invited.","document_number":"2025-21113","html_url":"https://www.federalregister.gov/documents/2025/11/26/2025-21113/agency-information-collection-activities-submission-for-omb-review-comment-request-no-surprises-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-11-26/pdf/2025-21113.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-21113.pdf?1764078314","publication_date":"2025-11-26","agencies":[{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"}],"excerpts":"\n www.reginfo.gov/<span class=\"match\">public</span>/do/PRAMain. \n Find this particular information collection by selecting “Currently under 30-day Review—Open for <span class=\"match\">Public</span> Comments” or by using the search function.\n \n \n \n FOR FURTHER INFORMATION CONTACT: \n \n Michael Howell by telephone at 202-693-6782, or by email at \n DOL_PRA_PUBLIC@dol.gov. \n \n \n \n \n SUPPLEMENTARY INFORMATION: \n \n The CAA added provisions applicable to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and individual markets in a new Part D of title <span class=\"match\">XXVII</span> of the <span class=\"match\">Public</span> <span class=\"match\">Health</span> Service Act (PHS Act)"},{"title":"Definition of “Employer”-Association Health Plans","type":"Rule","abstract":"This document rescinds the Department of Labor's (Department or DOL) 2018 rule entitled \"Definition of Employer Under Section 3(5) of ERISA--Association Health Plans\" (2018 AHP Rule). The 2018 AHP Rule established an alternative set of criteria from those set forth in the Department's pre-2018 AHP Rule (pre-rule) guidance for determining when a group or association of employers is acting \"indirectly in the interest of an employer\" under section 3(5) of the Employee Retirement Income Security Act of 1974 (ERISA) for purposes of establishing an association health plan (AHP) as a multiple employer group health plan. The 2018 AHP Rule was a significant departure from the Department's longstanding pre-rule guidance on the definition of \"employer\" under ERISA. This departure substantially weakened the Department's traditional criteria in a manner that would have enabled the creation of commercial AHPs functioning effectively as health insurance issuers. The Department now believes that the core provisions of the 2018 AHP Rule are, at a minimum, not consistent with the best reading of ERISA's statutory requirements governing group health plans.","document_number":"2024-08985","html_url":"https://www.federalregister.gov/documents/2024/04/30/2024-08985/definition-of-employer-association-health-plans","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-30/pdf/2024-08985.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-08985.pdf?1714398255","publication_date":"2024-04-30","agencies":[{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"}],"excerpts":"at 1061 (same); \n Hall \n v. \n Maine Mun. Emps. <span class=\"match\">Health</span> Tr., \n 93 F. Supp. 2d 73, 77 (D. Me. 2000); \n Assoc. Indus. Mgmt. Servs. \n v. \n Moda <span class=\"match\">Health</span> Plan, Inc., \n 2015 WL 4426241, at *3.\n \n \n C. Association Coverage Under the <span class=\"match\">Public</span> <span class=\"match\">Health</span> Service Act \n \n The <span class=\"match\">Public</span> <span class=\"match\">Health</span> Service Act (PHS Act) establishes <span class=\"match\">health</span> coverage requirements in Title <span class=\"match\">XXVII</span> that generally apply to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers offering group or individual <span class=\"match\">health</span> insurance coverage. The provisions of Title <span class=\"match\">XXVII</span> of the PHS Act have been amended by the Affordable"},{"title":"Agency Information Collection Activities; Request for Public Comment","type":"Notice","abstract":"The Department of Labor (the Department), in accordance with the Paperwork Reduction Act, provides the general public and Federal agencies with an opportunity to comment on proposed and continuing collections of information. This helps the Department assess the impact of its information collection requirements and minimize the public's reporting burden. It also helps the public understand the Department's information collection requirements and provide the requested data in the desired format. The Employee Benefits Security Administration (EBSA) is soliciting comments on the extension of the information collection requests (ICRs) contained in the documents described below. A copy of the ICRs may be obtained by contacting the office listed in the ADDRESSES section of this notice. ICRs also are available at reginfo.gov (https://www.reginfo.gov/public/do/PRAMain).","document_number":"2024-31607","html_url":"https://www.federalregister.gov/documents/2025/01/06/2024-31607/agency-information-collection-activities-request-for-public-comment","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-01-06/pdf/2024-31607.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-31607.pdf?1735911920","publication_date":"2025-01-06","agencies":[{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"}],"excerpts":"surprise bills arise most frequently. The CAA added provisions applicable to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and individual markets in a new part D of title <span class=\"match\">XXVII</span> of the <span class=\"match\">Public</span> <span class=\"match\">Health</span> Service Act (PHS Act) and also added new provisions to \n \n part 7 of the Employee Retirement Income <span class=\"match\">Security</span> Act (<span class=\"match\">ERISA</span>), and subchapter B of chapter 100 of the Internal Revenue Code (Code).\n \n Section 102 of the No Surprises Act added Code section 9816, <span class=\"match\">ERISA</span> section 716, and PHS Act section 2799A-1, which contain limitations on cost sharing"},{"title":"Transparency in Coverage","type":"Proposed Rule","abstract":"These proposed rules set forth proposed requirements that would amend the regulations under the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code regarding price transparency reporting requirements for non-grandfathered group health plans and health insurance issuers offering non-grandfathered group and individual health insurance coverage. Specifically, these proposed rules would improve the standardization, accuracy, and accessibility of public pricing disclosures in line with the goals of the Executive Order 14221. With respect to the in-network rate and out-of-network allowed amount machine-readable files, these proposed rules would achieve these goals by adding new contextual files and additional data elements like product type, network name, and enrollment counts; changing the reporting level for aggregation of data; removing in-network rates for unlikely provider-to-service mappings; increasing the reporting period and lowering the claims threshold for out-of-network historical data; and reducing the reporting cadence. These proposed rules would also improve the findability of all of the publicly disclosed machine- readable files required under the Transparency in Coverage rules, including the prescription drug file, by requiring a text file and footer with website URLs and contact information for the files. These proposed rules would also require pricing information that is made available through an online consumer tool and paper (upon request), to also be made available by phone, and establish that the satisfaction of such requirement also satisfies the requirements of section 114 of the No Surprises Act (including for grandfathered group health plans and health insurance issuers offering grandfathered group and individual health insurance coverage that are not otherwise subject to these proposed rules).","document_number":"2025-23693","html_url":"https://www.federalregister.gov/documents/2025/12/23/2025-23693/transparency-in-coverage","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-12-23/pdf/2025-23693.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-23693.pdf?1766178909","publication_date":"2025-12-23","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"Section 2715A of the <span class=\"match\">Public</span> <span class=\"match\">Health</span> Service (PHS) Act, incorporated into section 715 of the Employee Retirement Income <span class=\"match\">Security</span> Act (<span class=\"match\">ERISA</span>) and section 9815 of the Internal Revenue Code (Code), which provide that non-grandfathered group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers offering non-grandfathered group or individual <span class=\"match\">health</span> insurance coverage must comply with section 1311(e)(3) of the Patient Protection and Affordable Care Act (Affordable Care Act). This section of the Affordable Care Act addresses transparency in <span class=\"match\">health</span> coverage and imposes"},{"title":"Extension of Certain Timeframes for Employee Benefit Plans, Participants, Beneficiaries, Qualified Beneficiaries, and Claimants Affected by Hurricane Helene, Tropical Storm Helene, or Hurricane Milton","type":"Rule","abstract":"This document announces the extension of certain timeframes under the Employee Retirement Income Security Act and the Internal Revenue Code for group health plans, disability and other welfare plans, pension plans, and participants, beneficiaries, qualified beneficiaries, and claimants of these plans affected by Hurricane Helene, Tropical Storm Helene, or Hurricane Milton.","document_number":"2024-26014","html_url":"https://www.federalregister.gov/documents/2024/11/08/2024-26014/extension-of-certain-timeframes-for-employee-benefit-plans-participants-beneficiaries-qualified","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-11-08/pdf/2024-26014.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-26014.pdf?1730987225","publication_date":"2024-11-08","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"}],"excerpts":"elect COBRA continuation coverage. <span class=\"match\">ERISA</span> section 606, Code section 4980B(f)(6), and 29 CFR 2590.606-3. \n C. Claims Procedure Timeframes \n Section 503 of <span class=\"match\">ERISA</span> and 29 CFR 2560.503-1, as well as section 2719 of the PHS Act, incorporated into <span class=\"match\">ERISA</span> by <span class=\"match\">ERISA</span> section 715 and 29 CFR 2590.715-2719, and into the Code by Code section 9815 and 26 CFR 54.9815-2719, require <span class=\"match\">ERISA</span>-covered employee benefit plans and non-grandfathered group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers offering non-grandfathered group or individual <span class=\"match\">health</span> insurance coverage to establish"},{"title":"Definition of “Employer”-Association Health Plans","type":"Proposed Rule","abstract":"This document proposes to rescind the Department of Labor's (Department or DOL) 2018 rule entitled \"Definition of Employer-- Association Health Plans\" (2018 AHP Rule). The 2018 AHP Rule establishes an alternative set of criteria from those set forth in the Department's pre-rule guidance for determining when a group or association of employers is acting \"indirectly in the interest of an employer\" under section 3(5) of the Employee Retirement Income Security Act of 1974 (ERISA) for purposes of establishing an association health plan (AHP) as a multiple employer group health plan. The 2018 AHP Rule's alternative criteria were set aside in large part by the U.S. District Court for the District of Columbia in New York v. United States Department of Labor. The district court found the bona fide association and working owner provisions in the rule to be an unreasonable interpretation of ERISA, inconsistent with congressional intent that ERISA applies to employee benefits arising out of employment relationships. The Department, after further review of the relevant statutory language, judicial decisions, and pre-rule guidance, and further consideration of ERISA's statutory purposes and related policy goals, now proposes to rescind in full the 2018 AHP Rule in order to resolve and mitigate any uncertainty regarding the status of the standards that were set under the 2018 AHP Rule, allow for a reexamination of the criteria for a group or association of employers to be able to sponsor an AHP, and ensure that guidance being provided to the regulated community is in alignment with ERISA's text, purposes, and policies.","document_number":"2023-27510","html_url":"https://www.federalregister.gov/documents/2023/12/20/2023-27510/definition-of-employer-association-health-plans","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-12-20/pdf/2023-27510.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-27510.pdf?1702993520","publication_date":"2023-12-20","agencies":[{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"}],"excerpts":"at 1061 (same); \n Hall \n v. \n Maine Mun. Emps. <span class=\"match\">Health</span> Tr., \n 93 F. Supp. 2d 73, 77 (D. Me. 2000); \n Assoc. Indus. Mgmt. Servs. \n v. \n Moda <span class=\"match\">Health</span> Plan, Inc., \n 2015 WL 4426241, at *3.\n \n \n C. Association Coverage Under the <span class=\"match\">Public</span> <span class=\"match\">Health</span> Service Act \n \n The <span class=\"match\">Public</span> <span class=\"match\">Health</span> Service Act (PHS Act) derives its definitions of group <span class=\"match\">health</span> plan and employer from the <span class=\"match\">ERISA</span> definitions of employee welfare benefit plan and employer.\n 5 \n \n Thus, reference to <span class=\"match\">ERISA</span> is needed when determining whether a group <span class=\"match\">health</span> plan exists for PHS Act purposes and determining"},{"title":"Request for Information Regarding the Prescription Drug Machine-Readable File Requirement in the Transparency in Coverage Final Rule","type":"Proposed Rule","abstract":"This document is a request for information (RFI) regarding the prescription drug machine-readable file disclosure requirements in the Transparency in Coverage final rules. The Departments of Labor, Health and Human Services (HHS), and the Treasury (the Departments) are issuing this RFI to gather input regarding implementation of the prescription drug machine-readable file disclosure requirements under the Transparency in Coverage final rules, including what modifications to the disclosure requirements or additional technical implementation guidance might be necessary to better ensure the accurate and timely completion of the prescription drug file.","document_number":"2025-09858","html_url":"https://www.federalregister.gov/documents/2025/06/02/2025-09858/request-for-information-regarding-the-prescription-drug-machine-readable-file-requirement-in-the","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2025-06-02/pdf/2025-09858.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2025-09858.pdf?1748609111","publication_date":"2025-06-02","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"L. 111-148) was enacted on March 23, 2010, and the <span class=\"match\">Health</span> Care and Education Reconciliation Act of 2010 (Pub. L. 111-152) (collectively, PPACA) reorganized, amended, and added to the provisions of part A of title <span class=\"match\">XXVII</span> of the <span class=\"match\">Public</span> <span class=\"match\">Health</span> Service (PHS) Act relating to <span class=\"match\">health</span> coverage requirements for group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and individual markets.\n 4 \n \n \n \n \n 4 \n  The PPACA also added section 715 to the Employee Retirement Income <span class=\"match\">Security</span> Act of 1974 (<span class=\"match\">ERISA</span>) and section 9815 to the Internal Revenue Code (Code)"},{"title":"Requirements Related to the Mental Health Parity and Addiction Equity Act","type":"Rule","abstract":"This document sets forth final rules amending regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and adding new regulations implementing the nonquantitative treatment limitation (NQTL) comparative analyses requirements under MHPAEA, as amended by the Consolidated Appropriations Act, 2021 (CAA, 2021). Specifically, these final rules amend the existing NQTL standard to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from using NQTLs that place greater restrictions on access to mental health and substance use disorder benefits as compared to medical/surgical benefits. As part of these changes, these final rules require plans and issuers to collect and evaluate relevant data in a manner reasonably designed to assess the impact of NQTLs on relevant outcomes related to access to mental health and substance use disorder benefits and medical/surgical benefits and to take reasonable action, as necessary, to address material differences in access to mental health or substance use disorder benefits as compared to medical/surgical benefits. These final rules also amend existing examples and add new examples on the application of the rules for NQTLs to clarify and illustrate the requirements of MHPAEA. Additionally, these final rules set forth the content requirements for NQTL comparative analyses and specify how plans and issuers must make these comparative analyses available to the Department of the Treasury (Treasury), the Department of Labor (DOL), and the Department of Health and Human Services (HHS) (collectively, the Departments), as well as to an applicable State authority, and to participants, beneficiaries, and enrollees. Finally, HHS finalizes regulatory amendments to implement the sunset provision for self-funded non-Federal governmental plan elections to opt out of compliance with MHPAEA, as adopted in the Consolidated Appropriations Act, 2023 (CAA, 2023).","document_number":"2024-20612","html_url":"https://www.federalregister.gov/documents/2024/09/23/2024-20612/requirements-related-to-the-mental-health-parity-and-addiction-equity-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-09-23/pdf/2024-20612.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-20612.pdf?1726258517","publication_date":"2024-09-23","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":" amended, and added to the provisions of part A of title <span class=\"match\">XXVII</span> of the PHS Act relating to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and individual markets. The ACA added section 715(a)(1) to <span class=\"match\">ERISA</span> and section 9815(a)(1) to the Code to incorporate the provisions of part A of title <span class=\"match\">XXVII</span> of the PHS Act into <span class=\"match\">ERISA</span> and the Code, and to make them applicable to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers providing <span class=\"match\">health</span> insurance coverage in connection with group <span class=\"match\">health</span> plans. The PHS Act sections included by these references are"},{"title":"Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program","type":"Proposed Rule","abstract":"This proposed rule contains provisions to improve implementation of the Patient Protection and Affordable Care Act, including payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2027 user fee rates for issuers offering qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This proposed rule also includes provisions related to civil money penalties (CMPs) for noncompliant issuers and other responsible entities; standards governing agents, brokers, and web-brokers; the expansion and codification of hardship exemption eligibility; implementation of the State Exchange Improper Payment Measurement (SEIPM); provider access standards and essential community provider standards for QHP certification; QHP certification of non-network plans; a prohibition on issuers from including routine non-pediatric dental services as an Essential Health Benefit (EHB); cost-sharing flexibilities for catastrophic and individual market bronze plans; establishment of catastrophic plans with plan terms of up to 10 consecutive years; QHP issuer quality improvement strategies (QISs); revisions affecting which enrollees are included in Federal Basic Health Program (BHP) payment calculations to States; and seeks comment on potential adjustments to other Federal standards, including the Federal medical loss ratio (MLR) standard in the individual market. This proposed rule also includes amendments to implement certain provisions of the Working Families Tax Cut (WFTC) legislation.","document_number":"2026-02769","html_url":"https://www.federalregister.gov/documents/2026/02/11/2026-02769/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2027-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-02-11/pdf/2026-02769.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-02769.pdf?1770671709","publication_date":"2026-02-11","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"Regulatory Overview \n Title I of the <span class=\"match\">Health</span> Insurance Portability and Accountability Act of 1996 (HIPAA) added a new title <span class=\"match\">XXVII</span> to the PHS Act to establish various reforms to the group and individual <span class=\"match\">health</span> insurance markets. These provisions of the PHS Act were later augmented by other laws, including the Affordable Care Act. Subtitles A and C of title I of the Affordable Care Act reorganized, amended, and added to the provisions of part A of title <span class=\"match\">XXVII</span> of the PHS Act relating to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and"},{"title":"Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program","type":"Rule","abstract":"This final rule contains provisions to improve implementation of the Patient Protection and Affordable Care Act, including payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs, as well as 2027 user fee rates for issuers offering qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This final rule also includes provisions related to civil money penalties (CMPs) for noncompliant issuers and other responsible entities; standards governing agents, brokers, and web-brokers; the expansion and codification of hardship exemption eligibility; implementation of the State Exchange Improper Payment Measurement (SEIPM); provider access standards and essential community provider standards for QHP certification; QHP certification of non-network plans; a prohibition on issuers from including routine non-pediatric dental services as an Essential Health Benefit (EHB); requirements related to defrayal for the cost of any State-required benefits in addition to the EHB; cost- sharing flexibilities for catastrophic and individual market bronze plans; establishment of catastrophic plans with plan terms of up to 10 consecutive plan years; QHP issuer quality improvement strategies (QISs); and revisions affecting which enrollees are included in Federal Basic Health Program (BHP) payment calculations to States. This final rule also includes amendments to implement certain provisions of the Working Families Tax Cut (WFTC) legislation.","document_number":"2026-10050","html_url":"https://www.federalregister.gov/documents/2026/05/20/2026-10050/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2027-and","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-05-20/pdf/2026-10050.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-10050.pdf?1779135308","publication_date":"2026-05-20","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"Regulatory Overview \n Title I of the <span class=\"match\">Health</span> Insurance Portability and Accountability Act of 1996 (HIPAA) added a new title <span class=\"match\">XXVII</span> to the PHS Act to establish various reforms to the group and individual <span class=\"match\">health</span> insurance markets. These provisions of the PHS Act were later augmented by other laws, including the Affordable Care Act. Subtitles A and C of title I of the Affordable Care Act reorganized, amended, and added to the provisions of part A of title <span class=\"match\">XXVII</span> of the PHS Act relating to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and"},{"title":"Federal Independent Dispute Resolution Operations","type":"Rule","abstract":"This document sets forth these final rules related to certain provisions of the No Surprises Act regarding the Federal independent dispute resolution (IDR) process, which was established as part of the Consolidated Appropriations Act, 2021 (CAA). These rules finalize new requirements relating to the disclosure of information that group health plans and health insurance issuers offering group or individual health insurance coverage must include along with the initial payment or notice of denial of payment for certain items and services subject to the surprise billing protections in the No Surprises Act. These final rules also require plans and issuers to communicate information by using claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs), as specified in guidance, when providing any paper or electronic remittance advice (ERA) to an entity that does not have a contractual relationship with the plan or issuer. This document also finalizes amendments to certain requirements related to the open negotiation period preceding the Federal IDR process, the initiation of the Federal IDR process, the Federal IDR dispute eligibility review process, and the payment and collection of administrative fees and certified IDR entity fees. This document also finalizes the definition of bundled payment arrangements, amends requirements related to batched items and services and amends the rules for extensions of timeframes due to extenuating circumstances. Additionally, this document finalizes provisions that require plans and issuers to register in the Federal IDR portal. In accordance with Federal law, a summary of these rules may be found at https://www.regulations.gov/.","document_number":"2026-11140","html_url":"https://www.federalregister.gov/documents/2026/06/04/2026-11140/federal-independent-dispute-resolution-operations","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2026-06-04/pdf/2026-11140.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2026-11140.pdf?1780348210","publication_date":"2026-06-04","agencies":[{"raw_name":"OFFICE OF PERSONNEL MANAGEMENT","name":"Personnel Management Office","id":406,"url":"https://www.federalregister.gov/agencies/personnel-management-office","json_url":"https://www.federalregister.gov/api/v1/agencies/406","parent_id":null,"slug":"personnel-management-office"},{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"concerning employment-based <span class=\"match\">health</span> coverage laws may call the Employee Benefits <span class=\"match\">Security</span> Administration (EBSA) Toll-Free Hotline at 1-866-444-EBSA (3272) or visit the DOL's website (\n www.dol.gov/agencies/ebsa \n ). In addition, information from the Department of <span class=\"match\">Health</span> and Human Services (HHS) on private <span class=\"match\">health</span> insurance coverage and coverage provided by non-Federal governmental group <span class=\"match\">health</span> plans can be found on the Centers for Medicare &amp; Medicaid Services (CMS) website (\n http://www.cms.gov/marketplace \n ), information on <span class=\"match\">health</span> care reform can be"},{"title":"Enhancing Coverage of Preventive Services Under the Affordable Care Act","type":"Proposed Rule","abstract":"This document sets forth proposed rules that would amend the regulations regarding coverage of certain preventive services under the Public Health Service Act. Specifically, this document proposes rules that would provide that medical management techniques used by non- grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage with respect to such preventive services would not be considered reasonable unless the plan or issuer provides an easily accessible, transparent, and sufficiently expedient exceptions process that would allow an individual to receive coverage without cost sharing for the preventive service that is medically necessary with respect to the individual, as determined by the individual's attending provider, even if such service is not generally covered under the plan or coverage. These proposed rules also contain separate requirements that would apply to coverage of contraceptive items that are preventive services under the Public Health Service Act. Specifically, these proposed rules would require plans and issuers to cover certain recommended over-the-counter contraceptive items without requiring a prescription and without imposing cost-sharing requirements. In addition, the proposed rules would require plans and issuers to cover certain recommended contraceptive items that are drugs and drug-led combination products without imposing cost-sharing requirements, unless a therapeutic equivalent of the drug or drug-led combination product is covered without cost sharing. Finally, this document proposes to require a disclosure pertaining to coverage and cost-sharing requirements for over-the-counter contraceptive items in plans' and issuers' Transparency in Coverage internet-based self-service tools or, if requested by the individual, on paper. These proposed rules would not modify Federal conscience protections related to contraceptive coverage for employers, plans and issuers.","document_number":"2024-24675","html_url":"https://www.federalregister.gov/documents/2024/10/28/2024-24675/enhancing-coverage-of-preventive-services-under-the-affordable-care-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-10-28/pdf/2024-24675.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-24675.pdf?1729714518","publication_date":"2024-10-28","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"provisions of part A of title <span class=\"match\">XXVII</span> of the <span class=\"match\">Public</span> <span class=\"match\">Health</span> Service Act (PHS Act) relating to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and individual markets. The ACA added section 715(a)(1) to the Employee Retirement Income <span class=\"match\">Security</span> Act of 1974 (<span class=\"match\">ERISA</span>) \n 1 \n \n and section 9815(a)(1) to the Internal Revenue Code (Code) \n 2 \n \n to incorporate the provisions of part A of title <span class=\"match\">XXVII</span> of the PHS Act into <span class=\"match\">ERISA</span> and the Code, and to make them applicable to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers providing <span class=\"match\">health</span> insurance coverage in"},{"title":"Nondiscrimination in Health Programs and Activities","type":"Rule","abstract":"The Department of Health and Human Services (HHS or the Department) is issuing this final rule regarding section 1557 of the Affordable Care Act (ACA) (section 1557). Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. Section 1557(c) of the ACA authorizes the Secretary of the Department to promulgate regulations to implement the nondiscrimination requirements of section 1557. The Department is also revising its interpretation regarding whether Medicare Part B constitutes Federal financial assistance for purposes of civil rights enforcement. Additionally, the Department is revising provisions prohibiting discrimination on the basis of sex in regulations issued by the Centers for Medicare & Medicaid Services (CMS) governing Medicaid and the Children's Health Insurance Program (CHIP); Programs of All-Inclusive Care for the Elderly (PACE); health insurance issuers and their officials, employees, agents, and representatives; States and the Exchanges carrying out Exchange requirements; agents, brokers, or web-brokers that assist with or facilitate enrollment of qualified individuals, qualified employers, or qualified employees; issuers providing essential health benefits (EHB); and qualified health plan issuers.","document_number":"2024-08711","html_url":"https://www.federalregister.gov/documents/2024/05/06/2024-08711/nondiscrimination-in-health-programs-and-activities","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-05-06/pdf/2024-08711.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-08711.pdf?1714162519","publication_date":"2024-05-06","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"modification. \n \n <span class=\"match\">Health</span> program or activity. \n OCR proposed to adopt a definition of “<span class=\"match\">health</span> program or activity.” In paragraph (1), we proposed defining <span class=\"match\">health</span> program or activity to mean any project, enterprise, venture, or undertaking to provide or administer <span class=\"match\">health</span>-related services, <span class=\"match\">health</span> insurance coverage, or other <span class=\"match\">health</span>-related coverage; provide assistance to persons in obtaining <span class=\"match\">health</span>-related services, <span class=\"match\">health</span> insurance coverage, or other <span class=\"match\">health</span>-related coverage; provide clinical, pharmaceutical, or medical care; engage in <span class=\"match\">health</span> research; or"},{"title":"Short-Term, Limited-Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage","type":"Rule","abstract":"This document sets forth final rules that amend the definition of short-term, limited-duration insurance, which is excluded from the definition of individual health insurance coverage under the Public Health Service Act. This document also sets forth final rules that amend the regulations regarding the requirements for hospital indemnity or other fixed indemnity insurance to be considered an excepted benefit in the group and individual health insurance markets.","document_number":"2024-06551","html_url":"https://www.federalregister.gov/documents/2024/04/03/2024-06551/short-term-limited-duration-insurance-and-independent-noncoordinated-excepted-benefits-coverage","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-03/pdf/2024-06551.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-06551.pdf?1711629917","publication_date":"2024-04-03","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"part A of title <span class=\"match\">XXVII</span> of the PHS Act relating to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and individual markets. The ACA added section 9815 of the Code and section 715 of <span class=\"match\">ERISA</span> to incorporate the provisions of part A of title <span class=\"match\">XXVII</span> of the PHS Act, as amended or added by the ACA, into the Code and <span class=\"match\">ERISA</span>, making them applicable to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers providing <span class=\"match\">health</span> insurance coverage in connection with group <span class=\"match\">health</span> plans. The provisions of the PHS Act incorporated into the Code and <span class=\"match\">ERISA</span>, as amended or"},{"title":"Request for Information; Coverage of Over-the-Counter Preventive Services","type":"Proposed Rule","abstract":"This document is a request for information (RFI) regarding the application of the preventive services requirements under section 2713 of the Public Health Service Act (PHS Act) to over-the-counter (OTC) preventive items and services available without a prescription by a health care provider. The Department of the Treasury, the Department of Labor, and the Department of Health and Human Services (the Departments) are issuing this RFI to gather input from the public regarding the potential benefits and costs of requiring non- grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage to cover OTC preventive items and services without cost sharing and without a prescription by a health care provider; seek comment on any potential challenges associated with providing such coverage; understand whether and how providing such coverage would benefit consumers; and assess any potential burden that plans and issuers would face if required to provide such coverage.","document_number":"2023-21969","html_url":"https://www.federalregister.gov/documents/2023/10/04/2023-21969/request-for-information-coverage-of-over-the-counter-preventive-services","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-10-04/pdf/2023-21969.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-21969.pdf?1696337231","publication_date":"2023-10-04","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"of part A of title <span class=\"match\">XXVII</span> of the PHS Act relating to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and individual markets. The ACA added section 715(a)(1) to the Employee Retirement Income <span class=\"match\">Security</span> Act of 1974 (<span class=\"match\">ERISA</span>) and section 9815(a)(1) to the Internal Revenue Code (Code) to incorporate the provisions of part A of title <span class=\"match\">XXVII</span> of the PHS Act into <span class=\"match\">ERISA</span> and the Code, and to make them applicable to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers providing <span class=\"match\">health</span> insurance coverage in connection with group <span class=\"match\">health</span> plans. \n \n The sections"},{"title":"Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2025; Updating Section 1332 Waiver Public Notice Procedures; Medicaid; Consumer Operated and Oriented Plan (CO-OP) Program; and Basic Health Program","type":"Rule","abstract":"This final rule includes payment parameters and provisions related to the HHS-operated risk adjustment program, as well as 2025 user fee rates for issuers offering qualified health plans (QHPs) through federally facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs). This final rule also includes requirements related to the auto re-enrollment hierarchy; essential health benefits; failure to file Federal income taxes to reconcile advance payments of the premium tax credit (APTC); non- standardized plan option limits in the FFEs and SBE-FPs and a related exceptions process; standardized plan options in the FFEs and SBE-FPs; special enrollment periods (SEPs); direct enrollment (DE) entities supporting Exchange applications and enrollments; the Insurance Affordability Program enrollment eligibility verification process; requirements for agents, brokers, web-brokers, and DE entities assisting Exchange consumers; network adequacy; public notice procedures for section 1332 waivers; prescription drug benefits; updates to the Consumer Operated and Oriented Plan (CO-OP) Program; and State flexibility on the effective date of coverage in the Basic Health Program (BHP).","document_number":"2024-07274","html_url":"https://www.federalregister.gov/documents/2024/04/15/2024-07274/patient-protection-and-affordable-care-act-hhs-notice-of-benefit-and-payment-parameters-for-2025","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2024-04-15/pdf/2024-07274.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2024-07274.pdf?1712351231","publication_date":"2024-04-15","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"},{"raw_name":"Office of the Secretary"}],"excerpts":"and Regulatory Overview \n Title I of the <span class=\"match\">Health</span> Insurance Portability and Accountability Act of 1996 (HIPAA) added a new title <span class=\"match\">XXVII</span> to the <span class=\"match\">Public</span> <span class=\"match\">Health</span> Service (PHS) Act to establish various reforms to the group and individual <span class=\"match\">health</span> insurance markets. \n These provisions of the PHS Act were later augmented by other laws, including the ACA. Subtitles A and C of title I of the ACA reorganized, amended, and added to the provisions of part A of title <span class=\"match\">XXVII</span> of the PHS Act relating to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and individual"},{"title":"Requirements Related to the Mental Health Parity and Addiction Equity Act","type":"Proposed Rule","abstract":"This document proposes amendments to regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and proposes new regulations implementing the nonquantitative treatment limitation (NQTL) comparative analyses requirements under MHPAEA, as amended by the Consolidated Appropriations Act, 2021 (CAA, 2021). Specifically, these proposed rules would amend the existing NQTL standard to prevent plans and issuers from using NQTLs to place greater limits on access to mental health and substance use disorder benefits as compared to medical/ surgical benefits. As part of these changes, these proposed rules would require plans and issuers to collect and evaluate relevant data in a manner reasonably designed to assess the impact of NQTLs on access to mental health and substance use disorder benefits and medical/surgical benefits, and would set forth a special rule with regard to network composition. These proposed rules would also amend existing examples and add new examples on the application of the rules for NQTLs to clarify and illustrate the protections of MHPAEA. Additionally, these proposed rules would set forth the content requirements for NQTL comparative analyses and specify how plans and issuers must make these comparative analyses available to the Department of the Treasury (Treasury), the Department of Labor (DOL), and the Department of Health and Human Services (HHS) (collectively, the Departments), as well as to an applicable State authority, and participants, beneficiaries, and enrollees. The Departments also solicit comments on whether there are ways to improve the coverage of mental health and substance use disorder benefits through other provisions of Federal law. Finally, HHS proposes regulatory amendments to implement the sunset provision for self-funded, non-Federal governmental plan elections to opt out of compliance with MHPAEA, as adopted in the Consolidated Appropriations Act, 2023 (CAA, 2023).","document_number":"2023-15945","html_url":"https://www.federalregister.gov/documents/2023/08/03/2023-15945/requirements-related-to-the-mental-health-parity-and-addiction-equity-act","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-08-03/pdf/2023-15945.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-15945.pdf?1690807523","publication_date":"2023-08-03","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"apply directly to group <span class=\"match\">health</span> plans or <span class=\"match\">health</span> insurance coverage offered by an issuer in connection with a group <span class=\"match\">health</span> plan, and would apply to individual <span class=\"match\">health</span> insurance coverage by cross-reference through 45 CFR 147.160, which currently provides that the requirements of 45 CFR 146.136 apply to <span class=\"match\">health</span> insurance coverage offered by a <span class=\"match\">health</span> insurance issuer in the individual market in the same manner and to the same extent as to <span class=\"match\">health</span> insurance coverage offered by a <span class=\"match\">health</span> insurance issuer in connection with a group <span class=\"match\">health</span> plan in the large group"},{"title":"Short-Term, Limited-Duration Insurance; Independent, Noncoordinated Excepted Benefits Coverage; Level-Funded Plan Arrangements; and Tax Treatment of Certain Accident and Health Insurance","type":"Proposed Rule","abstract":"This document sets forth proposed rules that would amend the definition of short-term, limited-duration insurance, which is excluded from the definition of individual health insurance coverage under the Public Health Service Act. This document also sets forth proposed amendments to the requirements for hospital indemnity or other fixed indemnity insurance to be considered an excepted benefit in the group and individual health insurance markets. This document further sets forth proposed amendments to clarify the tax treatment of certain benefit payments in fixed amounts received under employer-provided accident and health plans. Finally, this document solicits comments regarding coverage only for a specified disease or illness that qualifies as excepted benefits, and comments regarding level-funded plan arrangements.","document_number":"2023-14238","html_url":"https://www.federalregister.gov/documents/2023/07/12/2023-14238/short-term-limited-duration-insurance-independent-noncoordinated-excepted-benefits-coverage","pdf_url":"https://www.govinfo.gov/content/pkg/FR-2023-07-12/pdf/2023-14238.pdf","public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2023-14238.pdf?1688733916","publication_date":"2023-07-12","agencies":[{"raw_name":"DEPARTMENT OF THE TREASURY","name":"Treasury Department","id":497,"url":"https://www.federalregister.gov/agencies/treasury-department","json_url":"https://www.federalregister.gov/api/v1/agencies/497","parent_id":null,"slug":"treasury-department"},{"raw_name":"Internal Revenue Service","name":"Internal Revenue Service","id":254,"url":"https://www.federalregister.gov/agencies/internal-revenue-service","json_url":"https://www.federalregister.gov/api/v1/agencies/254","parent_id":497,"slug":"internal-revenue-service"},{"raw_name":"DEPARTMENT OF LABOR","name":"Labor Department","id":271,"url":"https://www.federalregister.gov/agencies/labor-department","json_url":"https://www.federalregister.gov/api/v1/agencies/271","parent_id":null,"slug":"labor-department"},{"raw_name":"Employee Benefits Security Administration","name":"Employee Benefits Security Administration","id":131,"url":"https://www.federalregister.gov/agencies/employee-benefits-security-administration","json_url":"https://www.federalregister.gov/api/v1/agencies/131","parent_id":271,"slug":"employee-benefits-security-administration"},{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"}],"excerpts":"Part A of title <span class=\"match\">XXVII</span> of the PHS Act relating to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers in the group and individual markets. The ACA added section 9815 of the Code and section 715 of <span class=\"match\">ERISA</span> to incorporate the provisions of Part A of title <span class=\"match\">XXVII</span> of the PHS Act, as amended or added by the ACA, into the Code and <span class=\"match\">ERISA</span>, making them applicable to group <span class=\"match\">health</span> plans and <span class=\"match\">health</span> insurance issuers providing <span class=\"match\">health</span> insurance coverage in connection with group <span class=\"match\">health</span> plans. The provisions of the PHS Act incorporated into the Code and <span class=\"match\">ERISA</span>, as amended or"}]}