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Product ID: 409160EAU
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Interaction of Health Care Reform With Other Laws

OnDemand Webinar (82 minutes)

Increase your confidence as you address the complex interaction of ACA and other federal and state laws.Human resource professionals, plan sponsors, benefits consultants, health care issuers, and plan administrators face an ever-changing legal landscape as they attempt to answer questions, engage in ACA-compliant plan designs, and minimize litigation risk. Changes in Congress and changes in administrations often result in wholesale change, while Supreme Court decisions sometimes bend toward uniform administration of employer health care plans and other times tolerate state and local variations that complicate the national administration of such plans. Added to that quicksand, the challenges of the COVID-19 pandemic have resulted in additional uncertainty. This topic is intended to increase your confidence as you attempt to address the complex interaction of ACA - now over a decade old - and other federal and state laws and to translate the issues at play before Congress, the executive, and the courts into compliant health care plan design and administration.


Diane M. Soubly, Butzel Long


Federal Health Care Reform and Interaction With Other Federal Statutes

• Interaction With ERISA

- Incorporation of ACA Mandates and Enforceability Through ERISA Section 510

- Associated Health Plans (ACA Definition of Employer)

• ACA Section 1557 and Direct Reference to Other Federal Discrimination Laws

• Drug-Pricing Rule Tied to Medicare Reimbursement Pricing

• ACA Whistle-Blower Provision and Federal Labor Standards Act

• Federal Labor Law - Section 301 of the Labor Management Relations Act

• HIPAA and HITECH Final Rules (Group Health Plans and Business Associate Agreements)

• Tribal Members Can Avail Themselves of Private Health Insurance, Veterans Benefits, Medicare and Medicaid, Tricare and Still Enroll in ACA Marketplace Plans

Federal Health Care Reform and Federal Constitutional Issues

• Constitutional Sources of Authority for ACA

• Standing to Challenge ACA Individual Mandate After Zero Penalty

• Contraceptive Mandate and Exemptions for Religious or Moral Convictions

Federal Health Care Reform and Interaction With Other State or Local Law

• Medicaid Expansion: Commandeering State Agencies? Work Requirements?

• Minimum Essential Coverage

- State Benchmark Plans

- Federal Floor: ACA Mandates for Non-Grandfathered Plans

• Claims Procedures Issues - Non-Grandfathered Plans; Simple Cost Regulations Appeal Procedures

• Interaction With ERISA Preemption Principles

- State Insurance Laws

- Equal Benefits Ordinances

- State PBM Laws

- Any Willing Provider Laws

- All Payer Data Laws

- State and Local Anti-Discrimination Statutes and the Federal Law Savings Clause

Federal Health Care Reform and the Pandemic

• Extended Enrollment Period for COVID-19: Potential Extended Open Enrollment Period for 2022

• Telehealth Visits

• Vaccine Mandates and Employer Costs for Testing for Nonvaccinated Employees

• Private University Plans Subject to ERISA: Vaccine Mandates

• Public Sector Employers: Jacobson v. Massachusetts Versus Mandates With Religious and Health Exceptions