Eric Allen Kauk, Esq., LL.M., Author at Catholic Benefit Plans

EARN Retirement Bill Receives Unanimous Approval from the Senate Finance Committee

The Enhancing American Retirement Now (EARN) Act, which aims to assist U.S. taxpayers in their plight to save for retirement, received a 28-0 unanimous vote of approval from the Senate Finance Committee at the June 22 markup. The EARN Act includes more than 70 various provisions within its structure, all of which are designed to […]

Texas Republicans Are Suggesting Big Tax Changes:

The Republican Party of Texas is making a move to get rid of the prohibition on churches and charities from being involved with political campaigns. The federal tax code provision that prohibits this is section 501(c)(3), otherwise known as the Johnson Amendment. The Texas Republicans claim that the Johnson Amendment interferes with religious organizations and […]

BREAKING: The IRS to Start Pursuing Churches for Politicking:

On June 22, 2022 Congress announced that it will increase the IRS’s funds, by $600 million more than the 2022 fiscal year, to a grand total of $6 billion to aid the IRS in pursuing churches that get involved with politics. The announcement was applauded by the nation’s largest association of atheists, the Freedom From […]

EBSA Offers Focal Points for Preparing for MHPAEA Compliance Efforts

With drastic efforts pending to bolster compliance with the MHPAEA under the CAA, the EBSA has indicated that non-quantitative treatment limitations should be a primary focus. Last year, the EBSA directed the majority of their focuses on four specific NQTLs: preauthorization for inpatient services, concurrent care review for inpatient and outpatient services, out-of-network provider reimbursement […]

The CAA Amendments to the MHPAEA Are Helping People Suffering from Mental Health Issues:

In 2021, the CAA amended the MHPAEA and among the changes that were made was the requirement that health plans include an analysis of their non-quantitative treatment limitations (“NQTLs”) in their compliance reports. This is supposed to greatly help people gain access to mental health services because now it cannot be more burdensome to seek […]

GINA prohibits a group health plan from collecting genetic information for underwriting purposes. What does underwriting purposes mean?

Under GINA, the definition of underwriting purposes is broader than merely activities relating to rating and pricing a group policy. Under GINA, underwriting purposes means, with respect to a group health plan: • Rules for or determination of eligibility (including enrollment and continued eligibility) for benefits under the plan or coverage (including changes in deductibles […]

Consolidated Appropriations Act & Biden Administration Create Renewed Urgency for MHPAEA Compliance

A Bill called the Consolidated Appropriations Act (CAA) was enacted by Congress roughly a year and a half ago with the purpose of revealing how the IRS, HHS, and DOL will evaluate Health Insurance Carriers and Employer Plan Sponsors’ compliance with the MHPAEA requirements moving forward. The CAA essentially mandates that all applicable health plans […]

The Characteristics and Benefits of Internal Compliance Plans:

Internal compliance plans are not required by the Mental Health Parity and Addiction Equity Act (“MHPAEA”) but some commenters have asked for them to be required. This is because an internal compliance plan can help improve compliance by promoting the prevention, detection, and resolution of potential MHPAEA violations. These plans can differ depending on if […]

Can a health plan obtain the results of a genetic test to make a determination regarding payment of a claim for benefits under the plan?

Generally, yes. If a plan conditions payment for an item or service based on medical appropriateness and the medical appropriateness depends on the genetic makeup of the patient, then the plan is permitted to condition payment for the item or service on the outcome of a genetic test. The plan may also refuse payment in […]

Sub-Classification Exceptions To The Mental Health Parity and Addiction Equity Act:

Under the Mental Health Parity and Addiction Equity Act (“MHPAEA”) the general rule is that sub-classifications are not permitted when applying the treatment limitation and financial requirement rules, but there are a few exceptions. While separate sub-classifications for generalists and specialists are not permitted, separate classifications for outpatients are permitted for (1) office visits and […]