HHS Seeks Input on Health Plan IDs GOP Reform Plan Offered | Mercer US

HHS Seeks Input on Health Plan IDs GOP Reform Plan Offered

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HHS Seeks Input on Health Plan IDs GOP Reform Plan Offered
Calendar09 June 2015

The Department of Health and Human Services (HHS) is seeking public comment by July 28 on requirements for the national health plan identifiers (HPIDs) mandated by HIPAA and the ACA. Under final HPID rules issued in 2012, most health plans had to obtain identifiers from a government enumerator — which assigns unique national identifiers — by Nov. 5, 2014, with small health plans granted another year to comply. But HHS later indefinitely delayed the HPID mandate to reconsider when and how the identifiers should be used.

In a request for information (RFI), HHS is now asking employers and others to weigh in on HPID requirements before issuing new guidance. The RFI doesn’t address a somewhat-related mandate to obtain a “certification” of health plan compliance with HIPAA transaction processing, but presumably no such certifications will be required this year.

The ACA has created new reasons why employees may want to make midyear changes in the health coverage elected under their employer’s cafeteria plan. Current IRS rules generally prohibit this, except in limited situations. To that limited list of exceptions, an IRS notice adds two new situations in which a cafeteria plan sponsor may allow employees to revoke elections in the middle of the plan year. Employers with cafeteria plans need to decide before the 2016 plan year whether to permit midyear election changes in either or both of these situations.

In Congress, members of the conservative House Republican Study Committee last week re-introduced an ACA replacement plan — the American Health Care Act — that would entirely repeal the ACA and replace it with a $7,500 tax deduction ($20,500 for family) for the purchase of qualified health insurance in the employer or individual markets. The group reportedly could not agree on whether or how to extend the ACA’s federal exchange subsidies if the Supreme Court strikes them down in the King case, so the bill doesn’t include a contingency plan. However, GOP leaders of House committees with health care jurisdiction are working on a response. They’ve said they won’t release their proposal until after the decision, should the court rule in favor of King.

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