Tag Archives: IRS

New IRS rulemaking impacts FCA settlement payment deductibility

Effective January 14, 2021, the Internal Revenue Service (“IRS”) implemented a final rule (the “Final Rule”) concerning the tax deductibility of settlement payments made to the government.  This rulemaking followed a legislative update to the Internal Revenue Code of 1986 (“IRC”), which was implemented as part of the 2017 federal tax overhaul and specifically included … Continue Reading

IRS Issues Additional ACA Requirements for Tax-Exempt Hospitals

On December 31, 2014, the IRS published final regulations providing guidance on the community health needs assessment and financial assistance policy requirements for charitable hospitals under the ACA. The regulations address the entities that must meet these requirements, related reporting obligations, and the consequences for failing to satisfy these ACA requirements. The regulations apply to … Continue Reading

Administration Issues Proposed Rules on ACA Summary of Benefits and Coverage, Excepted Benefits/Wraparound Coverage

On December 30, 2014, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA), and the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would revise Affordable Care Act (ACA) summary of benefits and coverage (SBC) and uniform glossary requirements for group health plans and health insurance coverage. The changes, which … Continue Reading

IRS issues ACA Branded Prescription Drug Fee Regulations

The Internal Revenue Service has published final regulations that provide guidance on the annual fee imposed by the Affordable Care Act on covered entities engaged in the business of manufacturing or importing branded prescription drugs. The regulations describe the rules related to the fee, including how it is computed and how it is paid. The … Continue Reading

Circuit Split on Availability of ACA Tax Credits in Federal Exchanges

As has been widely reported, on July 22, 2014, two circuit court panels handed down conflicting decisions on whether ACA insurance premium tax credits are available for insurance purchased on federal, rather than state, insurance Marketplaces/Exchanges. On the one hand, a three-judge panel of the U.S. Court of Appeals for the D.C. Circuit ruled 2-1 that … Continue Reading

Obama Administration Continues to Update ACA Insurance Exchange and Health Plan Regulations

The Administration has issued numerous regulations recently that make additional changes to operational policies, payment provisions, and other standards applicable to health plans and Health Insurance Exchanges (also called Marketplaces) under the Affordable Care Act (ACA). Highlights include the following:… Continue Reading

IRS Issues ACA Employer “Shared Responsibility” Guidance; Delays Compliance Deadlines for Certain Employers

This post was also written by Allison Warden Sizemore. On February 12, 2014, the Internal Revenue Service (IRS) published final regulations modifying the timeline under which certain employers will be required to make “shared responsibility” payments if they do not provide qualified health insurance for their full-time employees and dependents pursuant to the Affordable Care … Continue Reading

IRS Finalizes ACA Individual “Shared Responsibility” Payment Requirements

The Internal Revenue Service (IRS) has issued final regulations to implement the ACA requirement that every individual have basic health insurance coverage, qualify for an exemption, or make a “shared responsibility” payment when filing a federal income tax return, beginning in 2014. Individuals are exempt from the payment obligation if coverage is unaffordable, if they … Continue Reading

IRS Proposes Regulations to Implement Certain ACA Insurance Premium Tax Credit, Medical Loss Ratio Provisions

On May 3, 2013, the Internal Revenue Service (IRS) published proposed regulations implementing the ACA’s health insurance premium tax credit, as amended by subsequent legislation. These proposed regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the premium tax credit, and Exchanges that make qualified health plans available … Continue Reading

IRS Proposes Hospital Community Health Needs Assessment Regulations

On April 5, 2013, the Internal Revenue Service published proposed regulations that provide additional guidance to charitable hospital organizations on the community health needs assessment (CHNA) requirements and related excise tax and reporting obligations under the ACA. The regulations address the requirement a hospital organization conduct a CHNA at least once every three years, taking … Continue Reading

Administration Proposes ACA Insurance Waiting Period Rule

On March 21, 2013, the Internal Revenue Service, Employee Benefits Security Administration, and CMS published proposed rules providing that a group health plan (or health insurance issuer offering group health insurance coverage) may not apply any waiting period that exceeds 90 days, in conformance with the ACA. Under the proposed regulations, waiting period would be … Continue Reading

OSHA, IRS, and OPM Release ACA Regulations

Several agencies besides HHS have recently issued regulations on ACA various provisions, including the following: The Occupational Safety and Health Administration (OSHA) has published an interim final rule with comment period that protects employees against retaliation by an employer for reporting alleged violations of various insurance provisions under Title I of the Act or for … Continue Reading

CMS, IRS Proposed ACA “Shared Responsibility” Payment/Exemptions Rules

On February 1, 2013, CMS and the Internal Revenue Service (IRS) published two proposed regulations to address the requirement to maintain minimum essential coverage under the Affordable Care Act (ACA). By way of background, the ACA requires every individual to have basic health insurance coverage (known as minimum essential coverage), qualify for an exemption, or … Continue Reading

IRS Proposes ACA Employer “Shared Responsibility” Requirements for Employee Health Coverage

This post was also written by Allison Warden Sizemore. On January 2, 2013, the Internal Revenue Service (IRS) published a notice of proposed rulemaking and notice of public hearing regarding implementation of an ACA “shared responsibility” provision that requires certain large employers (generally 50 full-time employees and full-time equivalents) to offer minimum essential health coverage … Continue Reading

IRS Issues Regulations to Implement ACA Medical Device Tax

This post was also written by Ruth N. Holzman and Angelo Ciavarella. On December 7, 2012, the IRS published final regulations that provide guidance on the 2.3% excise tax imposed on any sale occurring after December 31, 2012, of any “taxable medical device” by the manufacturer, producer or importer of such device (such tax enacted as part … Continue Reading

IRS Issues Notice on ACA Branded Prescription Drug Fee Parameters for 2013

The IRS has issued Notice 2012-74, which provides guidance on the ACA branded prescription drug (BPD) fee for the 2013 fee year. Specifically, the guidance addresses: (1) the submission of Form 8947, “Report of Branded Prescription Drug Information,” (2) the time and manner for notifying covered entities of their preliminary fee calculation, (3) the time … Continue Reading

IRS Regulations Implement Insurer Fee to Fund PCORI Trust Fund

On December 6, 2012, the IRS published final regulations implementing fees on issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to fund the Patient-Centered Outcomes Research Trust Fund. The Trust Fund supports the Patient-Centered Outcomes Research Institute (PCORI), which was established by the ACA to assist patients, clinicians, purchasers, … Continue Reading

IRS Schedules Hearing on Proposed Rules for Charitable Hospitals (Dec. 5)

On December 5, 2012, the IRS is holding a public hearing on its June 26, 2012 proposed regulations that provide guidance regarding ACA requirements for charitable hospital organizations relating to financial assistance and emergency medical care policies, charges for certain care provided to individuals eligible for financial assistance, and billing and collections. This hearing was … Continue Reading

Congressional Health Policy Hearings

A number of recent Congressional hearings have focused on health policy issues, including the following: A House Small Business Healthcare Subcommittee hearing on “Medicare’s Durable Medical Equipment Competitive Bidding Program: How Are Small Suppliers Faring?” Senate Aging Committee hearings on “Implementing the Physician Payments Sunshine Act” and “Eliminating Waste and Fraud in Medicare: An Examination … Continue Reading

Congressional Hearings

The Senate Health, Education, Labor and Pensions Committee held a field hearing in Connecticut on “Lyme Disease: A Comprehensive Approach to an Evolving Threat.”  On September 11, 2012, the House Ways and Means Oversight Subcommittee is holding a hearing on the Internal Revenue Service’s implementation of various ACA tax provisions. Also on September 11, the … Continue Reading

IRS Schedules Nov. 9, 2012 Hearing on ACA Branded Prescription Drug Fee

The Internal Revenue Service (IRS) is holding a November 9, 2012 public hearing on the ACA’s branded prescription drug fee.  The subject of the hearing will be the agency’s August 18, 2011 notice of proposed rulemaking that cross-referenced temporary regulations also issued on August 18.  The IRS must receive outlines of topics to be discussed at the … Continue Reading

Congressional Health Policy Hearings

Recent Congressional hearings have focused on the following health policy issues, among others: A House Ways and Means Health Subcommittee hearing entitled “Physician Organization Efforts to Promote High Quality Care and Implications for Medicare Physician Payment Reform”; A Senate Commerce, Science and Transportation Committee hearing on short-supply, “gray market” prescription drugs; and A House Oversight … Continue Reading

IRS Notice on ACA Insurance Plans Fees to Fund Patient-Centered Outcomes Research Trust Fund

On April 17, 2012, the Internal Revenue Service (IRS) published proposed regulations that implement and provide guidance on an ACA provision imposing fees on issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to fund the Patient-Centered Outcomes Research Trust Fund. The Trust Fund supports the Patient-Centered Outcomes Research Institute … Continue Reading
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