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Requirements Related to Surprise Billing: Policy Update

The US Departments of Health and Human Services, Treasury and Labor, and the Office of Personnel Management issued an Interim Final Rule with comment implementing portions of the No Surprises Act, legislation enacted in December 2020 that bars surprise billing beginning January 1, 2022. Under the law, payers and providers (including hospitals, facilities, individual practitioners and air ambulance providers) are prohibited from billing patients more than in-network cost-sharing amounts in emergency and non-emergency circumstances. This IFR establishes regulations defining the payment methodology. The regulation proposes the methodology payers must use to determine cost sharing; the information payers must share with out-of-network providers; the process for submitting and receiving consumer complaints; and the format and details of the notice and consent requirements.

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COVID-19 Laws and Regulations: A Midyear Update

As employers navigate evolving COVID-19 state and federal rules, workplaces will have to stay vigilant about changes throughout the second half of 2021. These include changes to mask mandates, the Occupational Safety and Health Administration’s Emergency Temporary Standard and the New York Health and Essential Rights (HERO) Act.

Recent US Equal Employment Opportunity Commission guidance, for example, confirmed what employment lawyers had already been counseling businesses to do, according to McDermott partner Carole A. Spink in a recent Law360 article.

“The guidance was important because it did clarify that employers can provide incentives for voluntary programs. [There] was a big open question about, ‘Am I going to get into trouble because I’m trying to incentivize people to be vaccinated?'”

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Labor and Employment Policy to Watch in 2021’s Second Half

As US Congressional Democrats continue their advocacy for a pro-worker agenda, multiple bills and rules could bring about sweeping changes to the civil rights and labor protections for millions of workers. These include:

  • The Equality Act
  • The Protecting Older Workers Against Discrimination Act
  • The Pregnant Workers Fairness Act
  • The Protecting the Right to Organize Act (PRO Act)
  • The US Department of Labor’s Overtime Rule

According to McDermott partner Ellen Bronchetti, the PRO Act, for example, would enshrine a strict ABC test into federal law that would analyze whether workers qualify as independent contractors.

“I think that because Biden has promised to strengthen worker protections and strengthen workers’ right to organize, I think employers need to keep a real close eye on this legislation or versions of the legislation or pieces that might get pulled out and put elsewhere,” Bronchetti said in an article published in Law360.

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How to Apply the IRS’s COBRA Premium Subsidy Guidance

On May 18, 2021, the Internal Revenue Service (IRS) issued much-anticipated Notice 2021-31 (the Notice) regarding the Consolidated Omnibus Budget Reconciliation Act (COBRA) premium subsidy provisions of the American Rescue Plan Act of 2021 (ARPA). Under ARPA, a 100% COBRA premium subsidy and additional COBRA enrollment rights are available to certain assistance eligible individuals (AEIs) during the period beginning on April 1, 2021, and ending on September 30, 2021.

The US Department of Labor (DOL) has previously issued model notices and a set of FAQs regarding the COBRA premium subsidy. The IRS has now issued additional FAQs in the Notice that apply to employers and plan sponsors­.

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EBSA Privacy and Cybersecurity Guidance

Andrew C. Liazos, partner at McDermott Will & Emery, recently moderated an American Bar Association panel on the new cybersecurity guidance for retirement plan sponsors issued by the Department of Labor (DOL). The panel slides included 10 takeaways for the new DOL guidance.

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As a background, the DOL’s new guidance formalized its long-held view that retirement plan fiduciaries have an obligation to ensure proper mitigation of cybersecurity risks. More specifically, the DOL expects retirement plan fiduciaries to select and monitor the cybersecurity practices of their service providers.

The DOL guidance is in three parts.

  • The first part provides plan fiduciaries with a framework for reviewing a vendor’s cybersecurity practices.
  • The second part provides a robust list of cybersecurity “best practices” for record keepers and other vendors responsible for plan-related IT systems and data. For example, the DOL recommends that all retirement plan vendors with critical participant data conduct a reliable annual third-party audit of their security controls.
  • The third part provides security tips for participants and beneficiaries who manage their retirement accounts online.



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Biden HHS Pick Is a Shot in the Arm for Mental Health Parity

The federal government has taken major steps to boost insurers’ coverage of mental health and substance abuse treatment in recent years, and with the confirmation of former California Attorney General Xavier Becerra to lead the U.S. Department of Health and Human Services, that trend will likely continue.

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DOL Issues Clarification for ERISA-Governed Group Health Plans

Two days before the one-year anniversary of the official start of the COVID-19 outbreak, the US Department of Labor (DOL) issued a last-minute notice clarifying its prior guidance that relaxed the deadlines for the Employee Retirement Income Security Act-governed group health and welfare plans (ERISA) related to the Consolidated Omnibus Budget Reconciliation Act (COBRA) and various special enrollment and claims procedures.

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AB 5 Contractor-Classification Battles Set to Heat Up in 2021

Employers grappling with independent-contractor classification had a busy 2020—and should expect a flurry of additional activity this year. Few areas in employment law are changing as rapidly. Last year, many concerned about the future of contractor-classification laws paid careful attention to California and AB 5, which went into effect on Jan. 1, 2020, and codified the California Supreme Court’s landmark decision in Dynamex Operations West Inc. v. Superior Court of Los Angeles.

In a recent article for Law360, McDermott partners Ellen Bronchetti and Ron Holland consider the impacts of the California law on the gig economy, employer classification tests and organized labor in the United States.

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