The U.S Food and Drug Administration (FDA) has issued guidance with regard to exactly which provisions of the Affordable Care Act (ACA) governing nutrition labeling requirements are effective now, and which are not required to be followed until final regulations have been issued. The guidance explains that chain retail restaurants are required to disclose the number of calories in each standard menu item, written nutrition information must be given to customers upon request, the availability of that written information must be explained to customers on menus and menu boards, and, for self-service items and food on display, calorie information must be provided on a sign adjacent to each food item.
So far, final regulations have not been issued on either requirements established by the FDA for a menu statement putting calorie information in the context of a total daily caloric intake, or on standards for determining and disclosing the nutrient content for standard menu items that come in different flavors, varieties, or combinations, but which are listed as a single menu item.
The ACA labeling requirements generally only cover restaurants with 20 or more locations doing business under the same name. Restaurants with fewer locations would still be subject to their state or local government's nutrition labeling laws. Restaurants that are subject to the ACA's rules are effectively only answerable to the ACA's provisions, since, under ACA Sec. 4205, state and local governments cannot impose nutrition labeling requirements that are not identical to the ACA's provisions. It should be noted that restaurants with fewer than 20 locations can opt to participate in the ACA nutrition labeling program, and those restaurants would then be exempt from their state and local governments' nutrition labeling laws.
For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on health reform and other developments in employee benefits, just click here.
Monday, August 30, 2010
Friday, August 27, 2010
Find Health Coverage Options With HealthCare.gov’s New Web Tool
Consumers and small employers now have a new web tool to search for health insurance coverage options in their geographic regions. This new tool is available through HealthCare.gov, a service of the U.S. Department of Health and Human Services. The Insurance Finder “widget” allows anyone with a website or blog to embed a tool on their site and begin to search for public and private health coverage options.
The tool asks users two initial questions: “select a state” and “which best describes you.” The descriptions among which consumers may select include family/children, healthy individual, individual with medical condition, pregnant woman, person with disability, senior, young adult (under 26), and small employer/self employed.
After clicking on “next steps,” users are rerouted to a HealthCare.gov page to continue the insurance finder process. Based on the consumer’s answers, the coverage finder produces a menu of personalized potential coverage choices.
For example, a small employer that is interested in new coverage available in a specific state, will enter the applicable zip code to obtain a list of insurance carriers and health care plans available in that geographic area. With information for each plan offered each carrier may include links to services it provides, its provider network, and drug coverage under the plan. Price estimates for each option are scheduled to be posted on the site in October.
Here’s the link to the Insurance Finder widget.
And here’s comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on up-to-date resources on health reform and other developments in employee benefits.
The tool asks users two initial questions: “select a state” and “which best describes you.” The descriptions among which consumers may select include family/children, healthy individual, individual with medical condition, pregnant woman, person with disability, senior, young adult (under 26), and small employer/self employed.
After clicking on “next steps,” users are rerouted to a HealthCare.gov page to continue the insurance finder process. Based on the consumer’s answers, the coverage finder produces a menu of personalized potential coverage choices.
For example, a small employer that is interested in new coverage available in a specific state, will enter the applicable zip code to obtain a list of insurance carriers and health care plans available in that geographic area. With information for each plan offered each carrier may include links to services it provides, its provider network, and drug coverage under the plan. Price estimates for each option are scheduled to be posted on the site in October.
Here’s the link to the Insurance Finder widget.
And here’s comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on up-to-date resources on health reform and other developments in employee benefits.
Wednesday, August 25, 2010
Self-Funded Health Plans Get Claims Review Guidance
New guidance from the three major federal agencies responsible for implementing the Patient Protection Act provides that plans and insurers that are not subject to an applicable state process for external review of adverse claims determinations must implement such a process. The IRS, and the Departments of the Labor and Health and Human Services are releasing the guidance in the August 26 Federal Register. This relase also includes model notices that plans and health insurers may use to satisfy the disclosure requirements of related interim final regulations for effective claims review and appeals processes that the DOL posts on its website.
The internal and external adverse claims review and appeals requirements are intended to protect consumers’ rights to a fair hearing and determination of their health insurance claims.
In July, interim final regulations provided guidance requiring group health plans and insurers to comply with existing DOL claims procedure regulations and imposing specified additional standards for internal claims review and appeals. This new release from the DOL’s Employee Benefits Secuity Administration (EBSA), Technical Release No. 2010-01, provides an interim enforcement safe harbor for non-grandfathered (that is, plans that are not excepted from compliance with the Affordable Care Act requirements) self-insured group health plans that, because they are not subject to a state external review process, are therefore subject to the federal review process. (In the case of an insured group health plan, the insurer has primary responsibility to comply with the July 2010 interim final regulations.)
This interim enforcement safe harbor applies for plan years beginning on or after Sept. 23, 2010, until it is superseded by pending future guidance on the federal external review process. While this interim enforcement safe harbor is in effect, the DOL and the IRS specify that they will not take any enforcement action against a self-insured group health plan that complies with either the procedures outlined in Technical Release 2010-01 or voluntarily complies with its state external review processes: The procedures in Technical Release 2010-01 are based on the Uniform Health Carrier External Review Model Act developed by the National Association of Insurance Commissioners (NAIC Model Act) on July 23, 2010.
HHS says that before July 1, 2011, it will issue further guidance about which state external review laws have been determined to satisfy the minimum standards of the NAIC Model Act.
For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on up-to-date resources on health reform and other developments in employee benefits, just click here.
The internal and external adverse claims review and appeals requirements are intended to protect consumers’ rights to a fair hearing and determination of their health insurance claims.
In July, interim final regulations provided guidance requiring group health plans and insurers to comply with existing DOL claims procedure regulations and imposing specified additional standards for internal claims review and appeals. This new release from the DOL’s Employee Benefits Secuity Administration (EBSA), Technical Release No. 2010-01, provides an interim enforcement safe harbor for non-grandfathered (that is, plans that are not excepted from compliance with the Affordable Care Act requirements) self-insured group health plans that, because they are not subject to a state external review process, are therefore subject to the federal review process. (In the case of an insured group health plan, the insurer has primary responsibility to comply with the July 2010 interim final regulations.)
This interim enforcement safe harbor applies for plan years beginning on or after Sept. 23, 2010, until it is superseded by pending future guidance on the federal external review process. While this interim enforcement safe harbor is in effect, the DOL and the IRS specify that they will not take any enforcement action against a self-insured group health plan that complies with either the procedures outlined in Technical Release 2010-01 or voluntarily complies with its state external review processes: The procedures in Technical Release 2010-01 are based on the Uniform Health Carrier External Review Model Act developed by the National Association of Insurance Commissioners (NAIC Model Act) on July 23, 2010.
HHS says that before July 1, 2011, it will issue further guidance about which state external review laws have been determined to satisfy the minimum standards of the NAIC Model Act.
For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on up-to-date resources on health reform and other developments in employee benefits, just click here.
