Five New Health Care Regulations Released

March 7, 2013

pic-healthThe tsunami of Patient Protection and Affordable Care Act (PPACA) rules continues.  Five new rules were released during the last week.

The Internal Revenue Service (IRS) issued proposed rules governing the health insurance tax imposed on providers of small group health insurance.  This tax increases small-business health insurance costs $8 to $14 billion annually from 2014 to 2018 and by more thereafter.  NSBA supports repeal of this tax.

The Office of Personnel Management (OPM) released a final rule establishing the Multi-State Plan Program (MSPP) as required by the PPACA.  This plan is meant to offer insurance similar to the Federal Employees Health Benefits Program in health insurance exchanges throughout the country.

The Department of Health and Human Services (HHS) released a final and an interim final rule regarding risk adjustment, reinsurance, and risk corridors; cost-sharing; user fees for Federally-facilitated Exchanges; advance payments of the premium assistance tax credit; the Federally-facilitated Small Business Health Option Program; medical loss ratios and other matters.

HHS also issued a proposed rule that sets forth the minimum functions of a Small Employer Health Options Program (SHOP), including that the SHOP must allow employers the option to offer employees all Qualified Health Plans (QHPs) at a level of coverage chosen by the employer, and that the SHOP may allow employers to offer one or more QHPs to qualified employees by other methods.  However, for plan years beginning in 2014, a SHOP would not be required to permit qualified employers to offer their qualified employees a choice of QHPs at a single level of coverage but would have the option of doing so. For plan years beginning in 2014, Federally-facilitated SHOPs (FF-SHOPs) would not exercise this option, but would instead assist employers in choosing a single QHP to offer their qualified employees. This transitional policy is intended to provide additional time to prepare for an “employee choice model” and to increase the stability of the small group market in 2014.

The PPACA requires coverage without cost sharing of certain preventive health services, including certain contraceptive services.  A new HHS regulation creates certain religious exceptions to this requirement.

To read these rules, click on the links below.  The comments periods are open on the proposed rules and the interim final rules.

Proposed Rule: Health Insurance Tax (IRS) [13 pages]

Final Rule: Establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges (OPM) [154 pages]

Final and Interim Final Rule with Comment: HHS Benefit and Payment Parameters for 2014 (HHS) [483 and 53 pages]

Proposed Rule: Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program (HHS) [26 pages]

Proposed Rule: Coverage of Certain Preventive Services (IRS/DOL/HHS) [21 pages]