On July 1, 2021, the Office of Personnel Management, Departments of the Treasury, Health and Human Services (“HHS”), and Labor (“DOL”) (the “Departments”) released the an interim final rule (“IFR”), which is the first of a series of rules implementing the Consolidated Appropriations Act of 2021’s (“CAA”) surprise billing and transparency requirements.

The provisions of the IFR generally apply to group health plans and health insurance issuers offering group or individual health insurance coverage with respect to plan (or policy) years beginning on or after January 1, 2022. The rules apply to both grandfathered and “grandmothered” (transitional) plans. In addition, the rules are generally applicable to indemnity-only plans, though the IFR recognizes that certain provisions may not be relevant in that context. Importantly, the rules do not apply to account based plans, such as health reimbursement arrangements and flexible spending arrangements, plans exempted by statute (e.g., excepted benefits), and retiree-only plans.

In the ECFC article, “A July Surprise From the Department of Treasury, HHS and DOL!,” Groom’s Katie Bjornstad Amin and Christine Keller, explain the coverage, provisions, disclosure requirements and enforcement of the first of a series of new rules implementing the CAA surprise billing and transparency requirements.

 

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