Health Plan Compliance Deadlines Draw Near

Regulations under Section 1557 of the Affordable Care Act and HIPAA will require health plans and health care providers to take action in the coming months to meet new requirements. Health plan sponsors and providers that have not started to prepare for these new requirements should begin to take measures now.

Section 1557. Final regulations under the nondiscrimination rules in Section 1557 introduce (in many respects, reintroduce) a number of administrative rules. Two of these rules require compliance by November 2, 2024. By that date, health care providers and health plans that are subject to Section 1557 (and where the provider or plan sponsor has at least 15 employees) must designate an individual to coordinate compliance with the nondiscrimination rules. By that same date, these providers and plans (regardless of size) must take measures to provide an applicable notice of nondiscrimination. In view of the timing, some health plan sponsors may choose to include this notice with their annual enrollment materials.

HIPAA. HIPAA regulations issued earlier this year provide additional protection for reproductive health care information. These regulations restrict the use and disclosure of protected health information for purposes of investigating or imposing liability on any person for the mere act of seeking, obtaining, providing, or facilitating reproductive health care. A health plan or health care provider must obtain a signed attestation that meets specified requirements before permitting the use or disclosure of protected health information that potentially includes information on reproductive health care for purposes of health care oversight, judicial or administrative proceedings, law enforcement, or the duties of a coroner or medical examiner. These requirements take effect December 23, 2024.

Lawyers at Ballard Spahr are prepared to help you comply with both sets of requirements. Please contact us if you would like our assistance.

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