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Interim Final Rules Regarding Whistleblower Complaints under PPACA

The Occupational Safety and Health Administration (?Ç£OSHA?Ç¥) recently issued interim final regulations governing the employee protection (i.e., ?Ç£whistleblower?Ç¥) provisions of PPACA. PPACA amended the Fair Labor Standards Act to provide protection to an employee against retaliation by an employer for engaging in certain protected activities, including (1) receiving a premium tax credit or cost-sharing subsidy for health insurance coverage that the employee obtained through a healthcare exchange; (2) providing information to the employer or the government related to a violation, or an act reasonably believed to be a violation, of the requirements of PPACA (such as the prohibition on lifetime dollar limits on coverage or preventive care coverage requirements); (3) testifying in, or assisting with, a proceeding concerning such a violation; or (4) objecting to, or refusing to participate in, an activity that may be in violation of PPACA. The interim final regulations, which were effective on February 27, 2013,… Continue Reading

HHS Issues Final Rules Regarding Guaranteed Health Insurance Availability, Guaranteed Renewability, Fair Health Insurance Premiums, and Catastrophic Plans

The U.S. Department of Health and Human Services (?Ç£HHS?Ç¥) recently released final rules under the Patient Protection and Affordable Care Act (?Ç£PPACA?Ç¥) that guarantee the availability and renewability of health insurance coverage in both the individual and group markets. Beginning in 2014, health insurance issuers must offer to and accept any individual or employer who applies for coverage. In addition, issuers cannot deny coverage to small employers for failing to satisfy minimum participation or contribution requirements, and they must renew any existing health insurance coverage at the option of the plan sponsor or individual, subject to a few exceptions, including fraud and nonpayment of premiums. The final rules also restrict the premiums that issuers may charge in the individual and small group markets by only permitting premium variances based on age, geographic area, tobacco use, and family size. Issuers in the large group market may be similarly restricted if the… Continue Reading

March 2013