Internal Revenue Service
Three federal agencies release request for information on stop-loss coverage
Posted on April 30, 2012
On April 27, 2012, the Department of the Treasury’s Internal Revenue Service (IRS), the Department of Labor’s Employee Benefits Security Administration, and the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) issued a request for information (RFI) regarding the use of stop loss insurance by group health plans and their plan sponsors, with a focus on the prevalence and consequences of stop loss insurance at low attachment points, or the point at which excess insurance or reinsurance limits apply.
Concerns have circulated that the practice could lead to higher costs in small group health insurance exchanges. Stop-loss insurance protects self-insured companies against claims above the attachment point. Employers and plans that purchase stop-loss insurance generally are not subject to state health insurance laws regarding coverage, rating policies, and other state and federal consumer protections, and thus could prove financially risky in the exchange market. Specifically, if the practice is widespread, it could worsen the risk pool and increase premiums in the insured small group market, including the Small Business Health Options Program (SHOP) exchanges.
Continue Reading "Three federal agencies release request for information on stop-loss coverage" »
IRS releases regulations on information disclosure for Health Insurance Affordability Program eligibility requirements
Posted on April 30, 2012
Today, the Federal Register published the Internal Revenue Service’s (IRS) proposed rules on the disclosure of return information under Internal Revenue Code to carry out Affordable Care Act (ACA) eligibility requirements. The proposed regulations define certain terms and prescribe certain items of return information in addition to those items prescribed by statute that will be disclosed, upon written request, under section 6103(l)(21) of the Internal Revenue Code. The IRS will disclose to the Department of Health and Human Services (HHS) certain items of return information for any relevant taxpayer—meaning any individual listed, by name and Social Security number or adoption taxpayer identification number, on the application whose income may bear upon a determination of the eligibility of an individual for an insurance affordability program, according to the proposed rules.
IRS and the Treasury Department are requesting comments by July 30 on the proposed rules and have a public hearing scheduled at 10 a.m. Aug. 31 at the IRS Building.
CCIIO and IRS release simultaneous info bulletins on premium tax credits
Posted on April 27, 2012
Yesterday, the Center for Consumer Information and Insurance Oversight (CCIIO), a branch of the Centers for Medicare and Medicaid Services (CMS), released a bulletin outlining how government will verify access to employer-sponsored coverage. This is a necessary part of the process for determining eligibility for advance payments of the premium tax credit available to support the purchase of qualified health plans (QHPs) through Affordable Insurance Exchanges. The purpose of the bulletin is to request comment from the public on a proposed interim strategy and potential regulatory approach for verification of an applicant’s access to qualifying coverage in an employer-sponsored plan under section 1411 of the Affordable Care Act (ACA). The Department of Health and Human Services (HHS) also solicits comments on the development of a long-term verification strategy.
Also yesterday, the Internal Revenue Service (IRS)…
Continue Reading "CCIIO and IRS release simultaneous info bulletins on premium tax credits" »
IRS releases NPRM on Patient-Centered Outcomes Research Trust Fund
Posted on April 16, 2012
The Affordable Care Act (ACA) includes provisions that promote research to evaluate and compare health outcomes and the clinical effectiveness, risks, and benefits of medical treatments, services, procedures, drugs, and other strategies or items that treat, manage, diagnose, or prevent illness or injury. One provision relates to the establishment of the private, nonprofit corporation, the Patient-Centered Outcomes Research Institute. The Institute will assist, through research, patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence-based medicine through the synthesis and dissemination of comparative clinical effectiveness research findings. The Internal Revenue Service (IRS) released a notice of proposed rulemaking (NPRM) regarding fees on health insurance policies and self-insured plans for the patient-centered outcomes research trust fund. The NPRM contains proposed regulations that implement and provide guidance on the fees imposed by the Affordable Care Act (ACA) on issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to fund the Patient-Centered Outcomes Research Trust Fund. These proposed regulations affect the issuers and plan sponsors that are directed to pay those fees.
Continue Reading "IRS releases NPRM on Patient-Centered Outcomes Research Trust Fund" »
IRS and Treasury release FAQs about ACA automatic enrollment, employer shared responsibility, and waiting periods
Posted on February 10, 2012
The Internal Revenue Service answered frequently asked questions related to automatic enrollment, employer shared responsibility payments, and waiting periods under the Affordable Care Act (ACA). The notice addressed employers’ questions and invited comments on proposals that the Treasury, Labor, and Health and Human Services departments expect to include in future guidance or rulemaking under the ACA.
The notice included the following information…
Final rule released requiring insurers to use plain language in describing benefits, coverage
Posted on February 9, 2012
Today the Department of Health and Human Services, the Department of Treasury, and the Department of Labor released a final rule requiring insurers to use plain language in describing health plan benefits and coverage under the Affordable Care Act (ACA). The regulations mandate health insurers and group health plans to provide concise and comprehensible information about health plan benefits and coverage to Americans with private health coverage. The new rules will also facilitate easier plan comparison for individuals and employers. The new explanations, available on or soon after September 23, 2012, will be a critical resource for the roughly 150 million Americans with private health insurance. Specifically, these rules will ensure consumers have access to two key documents that will help them understand and evaluate their health insurance choices…
IRS releases rules on tax exempt entities under the CO-OP Program
Posted on February 6, 2012
The Internal Revenue Service (IRS) released new rules for the Consumer Operated and Oriented Plan (CO-OP) Program regarding what will be recognized as tax exempt under Section 501(c)(29) of the tax code. Proposed and temporary IRS rules denote that qualified nonprofit CO-OP health insurers will need to apply for tax-exempt recognition with IRS. IRS and the Treasury Department will recognize them as exempt effective on either their date of formation or March 23, 2010, the date that the ACA became law. To qualify for a tax exemption, the entity must have received a loan from CMS for operation. IRS’s upcoming revenue procedure requires that a copy of the CMS notice of award and the fully executed loan agreement are included in the entity’s application for exemption.
The IRS temporary rules did include statutory guidance for tax exemption: in addition to notifying the Treasury Department that the group is applying for exemption recognition, no private inurement of earnings to shareholders or individuals can exist, (unless it lowers premiums, improves benefits, or improves the quality of health care delivered to the organization’s members). Additionally, no attempt to influence legislation or politics can be made.
HHS issued the CO-OP final rule in December, which discussed CO-OP Program eligibility standards. For for information on CO-OPs, click here.
Continue Reading "IRS releases rules on tax exempt entities under the CO-OP Program" »
IRS releases Draft Schedule H, instructions for tax-exempt hospitals
Posted on January 6, 2012
The Internal Revenue Service (IRS) has issued a draft Schedule H and accompanying instructions for tax-exempt hospitals. As required by the Affordable Care Act (ACA), non-profit hospitals must respond to questions on financial assistance policies, billing and collection practices, emergency medical care, and individuals eligible for financial assistance, beginning with the 2011 tax filing year. The draft instructions have been revised to more clearly follow the statutory provision of Section 501(r) of the Internal Revenue Code. Several of the changes relate to billing and collections.
For more information on tax-exempt hospital requirements, click here and here.
Continue Reading "IRS releases Draft Schedule H, instructions for tax-exempt hospitals" »
IRS issues RFC on potential safe harbor for large employers
Posted on September 15, 2011
The Internal Revenue Service (IRS) has released a Request for Comment (RFC) on a potential safe harbor for large employers under the shared responsibility provisions of the Affordable Care Act (ACA). Under the ACA, employers with more than 50 employees must provide affordable health coverage to workers, or else face a penalty. This potential safe harbor would allow employers to base what constitutes affordable coverage on an employee’s wages rather than the employee’s household income, which is something more difficult for employers to know or easily determine.
Continue Reading "IRS issues RFC on potential safe harbor for large employers" »
IRS Notice and Request for Comments Regarding the Community Health Needs Assessment Requirements for Tax-Exempt Hospitals
Posted on August 23, 2011
On July 7, 2011, the Treasury Department and the Internal Revenue Service (IRS) published a Notice and Request for Comments on a proposed policy regarding the Affordable Care Act’s new requirements related to tax exempt hospitals’ community health needs assessment (CHNA) obligations. Section 9007 of the Act added new Section 501(r) to the Internal Revenue Code, which delineates a series of statutory requirements, outlined in a previous implementation brief, applicable to nonprofit hospitals that seek tax-exempt status under Section 501(c)(3). The purpose of the Treasury/IRS Notice is to both describe the agencies’ approach to implementing hospital organizations’ CHNA obligations and to invite comments regarding their proposals. The CHNA requirements are effective for taxable years beginning after March 23, 2012. However, the Notice specifies that hospitals currently engaged in conducting CHNA-related activities — including development and wide publication of a needs assessment and adoption of an implementation strategy — can rely on the policies contained in the Notice as they move forward.
Stay Connected
Most Popular Content
- Contraception Coverage under the ACA’s Preventive Services Coverage Requirements, and Employer Implementation: An Update posted on April 20, 2012
- Update: Essential Health Benefits FAQs posted on May 9, 2012
- Update: Exchanges Establishment and Eligibility Final Rule posted on April 10, 2012
- State Health Insurance Exchange Navigators posted on February 28, 2011
- Update on the Final Rule: Standards Related to Reinsurance, Risk Corridors and Risk Adjustment posted on April 4, 2012
Categories
- Congressional Action
- Disparities
- Expert Commentary
- Fraud and Abuse
- Health Care Quality and Delivery System Reform
- Health Information
- Health Insurance
- Implementation Briefs
- Judiciary
- Key Developments
- Agency Profile
- Department of Education
- Department of Health and Human Services
- Administration for Children & Families
- Administration on Aging
- Agency for Healthcare Research & Quality
- and Public Health Council
- Centers for Disease Control & Prevention
- Centers for Medicare & Medicaid Services
- Health Promotion
- Health Resources & Services Administration
- National Institutes of Health
- National Prevention
- Office of Consumer Information and Insurance Oversight
- Office of Inspector General
- Office of Minority Health
- Office of Public Health and Science
- Office of the Secretary
- Department of Justice
- Department of Labor
- Department of the Treasury
- Grants
- Legislation
- Rulemaking, Rules, and Guidance
- Legal Challenges
- Long Term Care
- Medicaid and CHIP
- Medicare
- Public Health
- Tax Policy
- Workforce and Access
Archives by Date
- May 2012
- April 2012
- March 2012
- February 2012
- January 2012
- December 2011
- November 2011
- October 2011
- September 2011
- August 2011
- July 2011
- June 2011
- May 2011
- April 2011
- March 2011
- February 2011
- January 2011
- December 2010
- November 2010
- October 2010
- September 2010
- August 2010
- July 2010
- June 2010
- May 2010
- April 2010
- March 2010
Recent Posts
- Commonwealth Fund issue brief finds health insurance improves outcomes for vulnerable populations
- CCIIO announces potential plans for risk adjustment
- HHS publishes Exchange guidance and draft blueprint
- HHS releases web-based search tool to track health care system performance
- Heritage Foundation Recommends Eliminating Premium Subsidy for High Income Beneficiaries to Shore-Up Medicare
- Update: Medical Loss Ratio Requirements
- CMS releases final rule on MLR requirements
- Report estimates impact of small business tax credit
- Health Affairs article explores power of providers to win payment increases
- Department of Labor releases FAQs on mental health parity compliance
