HRI regulatory center: Regulatory and legislative updates and analysis

Regulatory Spotlight: CMS bets payment changes will improve Part B drug value
Regulatory Spotlight: CMS bets payment changes will improve Part B drug value
CMS eyes payment changes to Part B drugs as a way to rein in costs.
HRI Regulatory Spotlight: States take aim at high drug prices
Regulatory Spotlight: States take aim at high drug prices
States are considering requiring drug companies to justify drug costs.
Regulatory Spotlight: Payers navigate the 3Rs as they prepare 2017 premiums
Insurers grapple with changes to the ACA's three risk programs as they prepare to submit 2017 premiums. 
Regulatory Spotlight: New Medicare payment law may deprive some doctors of risk bonuses
Regulatory Spotlight: New Medicare payment law may deprive some doctors of risk bonuses
CMS is embarking on the biggest change to how it pays doctors since 1997, and billions of dollars in risk-based payments are at stake.
Regulatory Spotlight: Data integrity problems a growing risk to global pharma companies
Regulatory Spotlight: Data integrity problems a growing risk to global pharma companies
More pharmaceutical companies than ever before are being warned by regulators data integrity problems, posing business risks to cited companies.
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February 25, 2014

Final rules on ACA's employer mandate include new transition relief

The IRS issued final regulations providing guidance on the Affordable Care Act's employer shared responsibility provisions, sometimes called the 'employer mandate' or the 'pay or play' rules. The regulations apply for periods after December 31, 2014 to applicable large employers who fail to offer coverage to their full-time employees. The regulations extend earlier transition rules and provide new ones to help employers comply with the requirements.

Highlights of the final regulations include:

  • an extended transition period for employers with between 50 and 99 full-time equivalent employees, so they won't be subject to penalties until 2016
  • a temporary rule for employers with 100 or more full-time employees, so the largest penalty will not apply for 2015 if the employer offers coverage to at least 70% of its full-time employees (rather than 95% as will be required after 2015)
  • final rules for determining full-time employee status reflect the proposed regulations, including the optional look-back measurement period and stability period, with numerous clarifications and new definitions
  • additional guidance for the monthly method of determining full-time status
  • rules for determining full-time status for special categories of employment, including a new definition of seasonal employees
  • an additional year for employers who do not now offer coverage to their employees' dependents to comply, as long as coverage is offered to the children of employees by the 2016 plan year
  • safe harbors for determining if employer-provided coverage is affordable for employees for purposes of the employer penalties
  • The Treasury Department and the IRS plan to issue final regulations soon intended to simplify and streamline the associated employer reporting requirements.

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