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Explanation of Benefits (EOB) Practical Law

WebA statement from a health insurer addressing the extent to which a health plan participant's or beneficiary's claim for payment for plan services will be reimbursed. An explanation of …

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Public Health Service Act (PHSA) Practical Law

WebA federal law that, in the employee benefits context, includes requirements applicable to certain health plans including—subject to an opt-out provision—nonfederal, …

Category: Health Go Health

Health Care Provider Considerations for Gender-Affirming Care

WebA Practice Note addressing the issues that health care providers should consider when providing gender-affirming health care services and gender dysphoria …

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Controlled Group Rules for Employee Benefit Plans Practical Law

WebThe controlled group rules identify whether two or more corporations and certain other groups of related trades or businesses are treated as if they were one …

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Code of Conduct for Hospitals and Hospital Systems

WebA code of conduct (also known as a code of business ethics) for a hospital, hospital system, or other institutional health care provider for use as part of its health care compliance …

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Life Sciences Regulation in the United States: Overview

WebThis Q&A provides a high-level overview of key practical issues, including life sciences clinical trials, manufacturing, marketing, abridged procedure, …

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Health Care Non-Compete State Law Chart: Overview Practical …

WebA 50-state Chart providing an overview of laws governing non-compete agreements in the health care sector. This Chart summarizes the statutory and common law requirements …

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Medical monitoring in the US: an update for life science

WebMedical monitoring claims remain a troublesome feature of litigation against life sciences companies. Claimants continue to seek to fill the gap between yesterday's …

Category: Medical Go Health

Nondiscrimination Requirements for Insured Group Health Plans

WebUnder the Affordable Care Act (ACA), insured group health plans must satisfy nondiscrimination rules under Section 105(h) of the Internal Revenue Code prohibiting …

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Association Health Plans Practical Law

WebA Practice Note addressing Department of Labor (DOL) requirements for association health plans (AHPs) under regulations finalized in June 2018. The 2018 AHP final regulations, …

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Health Plan Coverage of Surgical and Medication Abortion and …

WebA Practice Note addressing employer-sponsored health plan coverage of surgical and medication abortion and related services, including abortion-related travel benefits. …

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Certification of Health Care Provider of Serious Health

WebA California-compliant medical certification form under the California Family Rights Act (CFRA) for a health care provider to certify the serious health condition of an employee, …

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HIPAA Special Enrollment Rights Practical Law

WebA Practice Note addressing the requirement under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that group health plans make available special …

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Managed Care Contracting: Overview Practical Law

WebA Practice Note providing an overview of the managed care contracting process between a health care provider and a managed care organization (MCO), such as an insurance …

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Newborns' and Mothers' Health Protection Act (NMHPA)

WebA Practice Note addressing the Newborns' and Mothers' Health Protection Act of 1996 (NMHPA), a federal law that applies to group health plans and health insurers that offer …

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Health and Safety in the Workplace Policy (PA) Practical Law

WebA Pennsylvania-specific employee policy on health and safety in the workplace. This policy helps an employer comply with Occupational Safety and Health …

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HIPAA Special Enrollment Rights: Initial Notice Practical Law

WebA model initial notice describing group health plan special enrollment rights under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Under HIPAA, …

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Qualified Protective Order Under HIPAA (Federal) Practical Law

WebA sample qualified protective order (QPO) for use in litigation in federal district court to prevent the unauthorized disclosure of protected health information (PHI) during …

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IRS Expands on Employer Opt-Out Payment Rules Practical Law

WebThe IRS has issued proposed regulations addressing the ACA's premium tax credit (PTC), including PTC eligibility and the effect of employer opt-out payments to …

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HIPAA Hybrid Entity Policy Practical Law

WebA sample policy for an entity that elects hybrid status under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to limit its HIPAA compliance obligations by …

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Terminated Employee's Unauthorized Access to HIPAA PHI Sparks …

WebThe Department of Health and Human Services (HHS) has announced a settlement with a city and its municipal health department for potential privacy and …

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Employment and Employee Benefits in the United States: Overview

WebLaw stated as at 01 Mar 2024 • USA (National/Federal) A guide to employment and employee benefits law in the United States. This Q&A gives a high-level overview of the …

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