Tag: IRS
IRS releases regulations on information disclosure for Health Insurance Affordability Program eligibility requirements
Posted by mmcdowell 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 by mmcdowell 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)…
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IRS releases NPRM on Patient-Centered Outcomes Research Trust Fund
Posted by mmcdowell 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.
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IRS and Treasury release FAQs about ACA automatic enrollment, employer shared responsibility, and waiting periods
Posted by mmcdowell 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 by mmcdowell 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 by mmcdowell 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.
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IRS releases Draft Schedule H, instructions for tax-exempt hospitals
Posted by Mark Dorley 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.
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House passes bill with 2-year SGR fix
Posted by Mark Dorley on December 16, 2011
Introduced by Republican leadership only days earlier, the U.S. House of Representatives has passed a legislative package, some of which is paid for by reducing funding of certain components of the Affordable Care Act (ACA). The legislation provides funding for the controversial Keystone XL pipeline, preempts certain rules issued by the Environmental Protection Agency, extends unemployment insurance, and prevents a reduction in physician payments under Medicare (the “SGR fix”), among other provisions. The legislation is paid for, at least in part, by increasing the amount of ineligible premium sharing tax-credit money that can be recoped by the IRS under the ACA, and by cutting the Public Health and Prevention trust fund by $8 billion.
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IRS issues RFC on potential safe harbor for large employers
Posted by Mark Dorley 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.
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Update: Health Insurance Premium Tax Credits
Posted by Mark Dorley on September 2, 2011
This Update is the third in a series on a group of three regulations, all of which are summarized at HealthReformGPS.org. Together the rules are designed to implement both the Medicaid eligibility expansions, the process of determining eligibility for premium tax credits and cost sharing assistance in the Exchange individual market, and standards for employers purchasing coverage in Exchanges. Collectively, the rules are designed to allow individuals and families to acquire and keep coverage and move more seamlessly among publicly-supported sources of health insurance as family income and circumstances change.
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