The Departments of Labor, Health and Human Services, and Treasury (collectively, the “Departments”) recently released frequently asked questions (“FAQs”) addressing the implementation of the annual limit waivers, provider nondiscrimination, and transparency reporting requirements under the Patient Protection and Affordable Care Act (“PPACA”). In the FAQs, the Departments first clarified that a change to a health plan or insurance policy year will not affect the expiration date of an annual limit waiver. For instance, if a waiver was granted for an April 1, 2013 plan or policy year, the waiver will expire on March 31, 2014, regardless of whether the plan or issuer later amends its plan or policy year. Next, the Departments announced that no regulations are forthcoming to address PPACA’s provisions related to nondiscrimination against providers or coverage for individuals participating in approved clinical trials because the Departments considered such provisions to be self-implementing. Accordingly, non-grandfathered group health plans and health insurance issuers offering group coverage (“Group Health Plans”) for plan years on or after January 1, 2014, should apply these provisions using their own good faith, reasonable interpretation of the provisions. Finally, the Departments clarified that the transparency reporting requirements applicable to non-grandfathered Group Health Plans will not apply until after one benefit year, which is a calendar year for which the Group Health Plans provide coverage for health benefits, because the plan will not have all of the data necessary to fulfill the reporting requirements.
A copy of the FAQs can be found here.