The most comprehensive resource available for human resources professionals providing HR news, white papers, custom research answers, webinars and OnDemand programs on the hottest HR topics,...
April 20 — The Obama administration addressed a smattering of issues in the 31st edition of frequently-asked-questions and answers related to Affordable Care Act implementation, including coverage rescissions, preventive services and cost-sharing limitations.
On coverage rescissions, the guidance said a plan can't retroactively cancel the benefits of a worker who has resigned his or her position if no fraud has taken place.
The FAQs, released April 20, tackled two issues related to preventive services.
The guidance said that if a health plan or issuer “utilizes reasonable medical management techniques within a specified method of contraception,” it may develop and use a standard exception form and instructions as part of steps used to ensure it is providing an “easily accessible, transparent, and sufficiently expedient exceptions process that is not unduly burdensome on the individual or a provider.”
Additionally, the guidance stated that a plan or issuer can't impose cost sharing on medications used to prepare for a colonoscopy.
The guidance also said that plans and issuers must disclose how they calculate payments for out-of-network services.
As for cost-sharing limitations, the administration said that a non-grandfathered large group market or self-insured group health plan must count an individual's out-of-pocket expenses for providers who don't accept reference prices toward a maximum out-of-pocket limit.
To contact the reporter on this story: Kristen Ricaurte Knebel in Washington at email@example.com
To contact the editor responsible for this story: Jo-el J. Meyer at firstname.lastname@example.org
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to email@example.com.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to firstname.lastname@example.org.
Put me on standing order
Notify me when new releases are available (no standing order will be created)