This page serves as a resource center for materials and information related to the various legislation, proposals, and documents dealing with health care reform matters to assist you in navigating through the terms of the legislation and what it means for you. For specific questions related to your particular situation, please contact a member of our Health Care team.

Document Resource Center

Table of Contents (Click on a section title to jump):

American Recovery and Reinvestment Act of 2009
Health Care Reform Legislation
Health Care Reform Summary
Telemedicine
What the Legislation Means for Employers and Employees
What the Legislation Means for Providers

All documents are in PDF format unless otherwise noted. To download the latest version of Adobe Acrobat Reader, please visit Adobe's website.

• American Recovery and Reinvestment Act of 2009
  • American Recovery and Reinvestment Act of 2009 Parts A & B
  • Website: Recovery.gov (not a PDF)
  • Agency Guidance: Office of Civil Rights: Draft Guidance on HIPAA Security Rule Risk Analysis Pursuant to HITECH Act/ARRA
  • Agency Guidance: HHS: Proposed Modifications to HIPAA Privacy Rules Pursuant to HITECH/ARRA
    
• Health Care Reform Legislation
• Act: Health Care and Education Reconciliation Act of 2010 (HCERA)
• Act: Patient Protection and Affordable Care Act (PPACA)
• Consolidated Acts: PPACA as Amended by HCERA (unofficial)
  
• Telemedicine
  • Policy: National Telemedicine Initiatives: Essential to Healthcare Reform
  • Presentation: "American Recovery and Reinvestment Act of 2009 Overview: A Win for Telemedicine"
  • Presentation: "Using the Buzz: Health Reform Action and Stimulus Implementation"
    
• What the Legislation Means for Employers and Employees
• Supreme Court Ruling on PPACA
• PPACA Survives Constitutional Scrutiny Based on Congressional Power to Tax
• General Guidance
• U. S. Chamber of Commerce Report: "Critical Employer Issues in the Patient Protection and Affordable Care Act"
• EBSA FAQs Regarding PPACA Implementation, Part I (not a PDF)
• EBSA FAQs Regarding PPACA Implementation, Part II (not a PDF)
• EBSA FAQs Regarding PPACA Implementation, Part III (not a PDF)
• EBSA FAQs Regarding PPACA Implementation, Part IV (not a PDF)
• EBSA FAQs Regarding PPACA Implementation, Part V (not a PDF)
• EBSA FAQs Regarding PPACA Implementation, Part VI (not a PDF)
• EBSA FAQs Regarding PPACA Implementation, Part VII  (not a PDF)
• EBSA FAQs Regarding PPACA Implementation Part VIII (not a PDF)
• EBSA FAQs Regarding PPACA Implementation Part IX (not a PDF)
• EBSA FAQs Regarding PPACA Implementation Part X 
• EBSA FAQs Regarding PPACA Implementation Part XI
• EBSA FAQs Regarding PPACA Implementation Part XII (not a PDF)
• EBSA FAQs Regarding PPACA Implementation Part XIII (not a PDF)
• EBSA FAQs Regarding PPACA Implementation Part XIV (not a PDF)
• EBSA FAQs Regarding PPACA Implementation Part XV (not a PDF)
  
• Health Care Reform And COBRA
• Congressional Research Service Reports: Health Care Reform (via National Conference of State Legislatures) (not a PDF)
  
• Claims and External Review Procedures
• Text of DOL Technical Release No. 2013-01: Extension of the Transition Period for the Temporary NAIC-similar State External Review Process under the PPACA
• Regulatory Guidance: IRS, DOL and HHS: Interim Final Rules Relating to Internal Claims and Appeals and External Review Processes
• Amendment to the Interim Final Rules Relating to Internal Claims and Appeals and External Review Process
• Correction to Interim Final Rules Relating to Internal Claims and Appeals and External Review Processes  
• NAIC Uniform External Health Carrier External Model Review Act
• Model Notice of Adverse Benefit Determination (not a PDF)
• Model Notice of Final Adverse Benefit Determination (not a PDF)
• Model Notice of Final External Review Decision (not a PDF)
• DOL Technical Release 2011-01: Extension of Non-Enforcement Period Relating to Certain Interim Procedures for Internal Claims and Appeals Under PPACA (not a PDF)
• DOL Technical Release 2011-02: Guidance on External Review for Group Health Plans and Health Insurance Issuers Offering Group and Individual Health Coverage, and Guidance for States on State External Review Processes (not a PDF)
• DOL Technical Release 2010-01: Interim Procedures for Federal External Review
• DOL Technical Release 2010-02: Interim Procedures for Internal Claims and Appeals under PPACA
• Culturally and Linguistically Appropriate Services (CLAS) County Data
  
• Deduction Limitations on Certain Health Insurance Providers
• Proposed Rule on the $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers
  
• Dependent Coverage
• Regulatory Guidance: IRS, DOL, and HHS: Interim Final Rules Relating to Dependent Coverage of Children to Age 26
• Regulatory Guidance: IRS Notice 2010-38: Tax Treatment of Health Care Benefits Provided with respect to Children Under Age 27
• Agency Guidance: DOL FAQs on Dependent Coverage (not a PDF)
• DOL Fact Sheet
• Model Notice of Opportunity to Enroll in Connection with Extension of Dependent Coverage to Age 26
• Revised Model CHIP Notice
  
• Discriminatory Fully Insured Plans
• IRS Notice 2010-63: Request for Comments on Requirements Prohibiting Discrimination in Favor of Highly Compensated Individuals in Insured Group Health Plans
• IRS Notice 2011-1: Delay of PPACA Nondiscrimination Provisions Applicable to Insured Group Health Plans
  
• Early Retiree Reinsurance Program
• Fact Sheet: Early Retiree Reinsurance Program
• Regulatory Guidance: HHS Interim Final Rule: Early Retiree Reinsurance Program
• Application for Early Retiree Reinsurance Program
• Application Instructions
• HHS: Notice of a New System of Records
• Application Dos and Don'ts
• HHS Powerpoint
• Early Retiree Reinsurance Program (ERRP) Website
•  See Other Important Health Care Resources below
• ERRP Notice to Plan Participants
• ERRP Claims Ineligible for Reimbursement
  
• Essential Health Benefits
• HHS Fact Sheet on Final Essential Health Benefits Standards (not a PDF)
  
• HHS Final Rules on Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation
• HHS Proposed Rules on Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation
• HHS Rules on Essential Health Benefits
• FAQs on Essential Health Benefits Bulletin – February 17, 2012
• Essential Health Benefits Bulletin Center for Consumer Information and Insurance Oversight (December 16, 2011) 
• Actuarial Value Calculator
• Actuarial Value Calculator Methodology
• Minimum Value Calculator
• Minimum Value Calculator Methodology
• Health Insurance Marketplace Guidance
• Role of Agents, Brokers, and Web-brokers in Health Insurance Marketplaces
  
• Health Insurance Providers Fee
• Proposed Rules on Health Insurance Providers Fee
  
• Grandfathered Plans
• Report: Grandfathered Health Plans Under PPACA
• IRS, DOL, HHS: Interim Final Regulations Regarding Grandfathered Plans
• IRS, DOL, HHS: Amendment to Interim Final Regulations Regarding Grandfathered Plans
• HHS Fact Sheet: Amendment to Interim Final Regulations Regarding Grandfathered Plans (not a PDF)
• HHS Fact Sheet: Grandfathered Plans (not a PDF)
  
• HHS Press Release: Grandfathered Plans (not a PDF)
• Table: HHS Table of Provisions Applicable and Inapplicable to Grandfathered Plans
• HHS Model Language for Grandfathered Health Plan Disclosure under Section 1251 of PPACA
  
• HSAs, HRAs, FSAs
• Congressional Research Service Report: HSAs: Overview of Rules for 2010
• IRS Notice 2010-59: Guidance regarding Definition of Over-the-Counter Drugs
• IRS Revenue Ruling 2010-23: Previous Ruling Allowing Reimbursement of OTC Drugs Ruled Obsolete
• IRS Q&As on OTC Medications (not a PDF)
• IRS Notice 2011-5: Rules for the Use of Health FSAs, HSAs or HRAs Debit Cards
• IRS Notice 2012-40: Guidance on FSA $2,500 limit on salary reduction contributions for plan years beginning before 2013 and comments requested on potential modification of use-or-lose rule
  
• Lifetime and Annual Limits
  
• IRS, DOL, HHS: Proposed and Final Regulations Regarding Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections
• Model Notice on Lifetime Limits and Enrollment Opportunity  
• HHS Insurance Standards Bulletin: Process for Obtaining Waivers of the Annual Limits Requirements under PHS Act Section 2711
• HHS Guidance on Sale of Mini-Med Plans (December 9, 2010)
• HHS Guidance on HRA Exemption From Annual Limits: Supplemental Guidance
• Technical Instructions for the Waiver Extension and Waiver Application Process
• Medical Loss Ratios
• FAQs About Medical Loss Ratio (MLR) Insurance Rebate
• Technical Release No. 2011-04 Guidance on Rebates for Group Health Plans Paid Pursuant to the Medical Loss Ratio Requirements of the Public Health Service Act
• Final Regulations Regarding Medical Loss Ratio Requirements Under PPACA; Final Rule
  
• Medicare Tax
• Correction to Proposed Rules Relating to Additional Medicare Tax
• Proposed Rules Relating to Additional Medicare Tax
  
• Multiple Employer Welfare Arrangements (MEWAs)
  
• EBSA Proposed Rules Ex Parte Cease and Desist and Summary Seizure Orders
• EBSA Proposed Rules Filings Required of Multiple Employer Welfare Arrangements and Certain Other Related Entities
• EBSA Proposed Revision of Annual Information Return/Reports
• EBSA Notice of Proposed Revision of the Form M-1
• EBSA Proposed Revision to Form M-1 (not a PDF)
• Fact Sheet on MEWA PPACA Proposed Regulations (not a PDF)
• Final Regulations on Filings Required of Multiple Employer Welfare Arrangements and Certain Other Related Entities
• Final Rules on Ex Parte Cease and Desist Summary Seizure Orders
• Fact Sheet: Final Regulations Related to Multiple Employer Welfare Arrangements Under PPACA (not a PDF)
  
• Patient-Centered Outcomes Research Fee
  
• Final Regulation on Fees Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes Research Trust Fund
• Notice of Proposed Rulemaking: Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes Research Trust Fund
• IRS Notice 2011-35 Request for Comments on Funding of Patient-Centered Outcomes Research Trust Fund
• Patient Protections
  
• IRS, DOL, HHS: Proposed and Final Regulations Regarding Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections
• Model Notice on Patient Protections
• Patient's Bill of Rights (not a PDF)
• Fact Sheet on new Patient Bill of Rights
• Pre-Existing Condition Exclusions
  
• IRS, DOL, HHS: Proposed and Final Regulations Regarding Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections
• Interim Final Rule: HHS: Pre-Existing Condition Insurance Plan Program ("High Risk Pool")
• Pre-Existing Condition Insurance Plan Website
•    See Other Important Health Care Resources below
• Pre-Existing Condition Insurance Program Map Plan (PCIP)
  
• Preventive Health Services
  
• Notice of Proposed Rulemaking Regarding Coverage of Certain Preventative Services Under PPACA 
• HHS Fact Sheet on Women's Preventative Services Coverage and Religious Organizations
• Updated Guidance on Temporary Enforcement Safe Harbor
  
• Advanced Notice of Proposed Rulemaking 
• Final Regulations Regarding Exemption
• Guidance Regarding Temporary Enforcement Safe Harbor
• Amendment to the Interim Final Rules
• IRS, DOL and HHS: Interim Final Rules Relating to Coverage of Preventive Services
• HHS Fact Sheet on Preventive Services
• HHS List of Recommended Preventive Services
• Women's Preventive Services: Required Health Plan Coverage Guidelines (not a PDF)
• Request for Information on Value-Based Insurance Design in Connection with Preventive Care Benefits
  
• Reporting
  
• IRS Notice 2012-9 Interim Guidance on Informational Reporting to Employees of the Cost of Their Group Health Insurance Coverage
• IRS Notice 2010-69: Interim Relief with Respect to Form W-2 Reporting
• IRS 2012 Form W-2
• IRS Notice 2011-28: Interim Guidance on Informational Reporting to Employees of the Cost of Their Group Health Insurance Coverage
• IRS Guidance on Form W-2 Reporting of Employer-Sponsored Health Coverage
  
• Rescissions
  
• IRS, DOL, HHS: Proposed and Final Regulations Regarding Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections
• Retaliation Complaints Under PPACA
• DOL Interim Final Regulations Procedures for Handling of Retaliation Complaints Under PPACA
• OSHA Fact Sheet: Filing Whistleblower Complaints Under the PPACA
  
• Automatic Enrollment and Waiting Periods
  
• Proposed Rules on Ninety-Day Waiting Period Limitation and Technical Amendments to Certain Health Coverage Requirements Under PPACA
• IRS Notice 2012-59/DOL Technical Release No. 2012-2 Regarding 90-Day Waiting Period Limitation Under Public Health Service Act § 2708
• IRS Notice 2012-17/DOL Technical Release No. 2012-01 FAQ Regarding Automatic Enrollment, Employer Shared Responsibility, and Waiting Periods
• Employer Pay or Play Penalties
  
• Congressional Research Service Report: Potential Employer Penalties Under PPACA
  
• IRS Correction to Public Hearing, Proposed Rules on Shared Responsibility for Employer Health Coverage
• Proposed Regulations on Shared Responsibility for Employers Regarding Health Coverage
• FAQ on Employer Shared Responsibility Provisions Under PPACA 
• IRS Notice 2012-58: Determining Full-Time Employees for Purposes of Shared Responsibility for Employers Regarding Health Coverage (§4980 H)
• IRS Notice 2012-17/DOL Technical Release No. 2012-01 FAQ Regarding Automatic Enrollment, Employer Shared Responsibility, and Waiting Periods
• IRS Notice 2011-73: Request for Comments on Health Coverage Affordability Safe Harbor for Employers (Section 4980H)
• IRS Notice 2011-36: Request for Comments on Shared Responsibility Provisions for Employers Regarding Health Coverage
• Proposed Rules on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding Health Insurance Premium Tax Credit
• IRS Notice 2012-31 Minimum Value of an Employer-Sponsored Health Plan
• Congressional Research Service Report: Summary of Potential Employer Penalties
• IRS Notice 2012-33 Request for Comments on Reporting by Applicable Large Employers on Health Insurance Coverage
• IRS Notice 2012-32 IRS Request for Comments on Reporting of Health Insurance Coverage
• Other Related Guidance
• Final Regulations on Health Insurance Premium Tax Credit - Guidance to individuals related to employees who may enroll in eligible employer-sponsored coverage and who wish to enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the premium tax credit. (February 1, 2013)
  
• Final Regulations on Health Insurance Premium Tax Credit - Guidance to individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the premium tax credit, and to Exchanges that make qualified health plans available to individuals and employers. (May 23, 2012)
• Correction to Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage
• Proposed Regulations on Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage
• Proposed Regulations on Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions; Miscellaneous Minimum Essential Coverage Provisions
• Small Business Health Option Programs (SHOP)
• Proposed Rules on Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program 
• Small Employer Tax Credits
  
• Form 8941 and Instructions for Small Businesses and Tax-Exempt Organizations Tax Credit
• Agency Guidance: IRS FAQs on Small Business Health Care Tax Credit (not a PDF)
• Regulatory Guidance: IRS Notice 2010-82: Tax Credit for Employee Health Insurance Expenses for Small Employers  
  
• Regulatory Guidance: IRS Notice 2010-44: Tax Credit for Employee Health Insurance Expenses of Small Employers
• Regulatory Guidance: IRS Rev. Rul. 2010-13: Determining Average Premium in Connection with the Small Employer Health Insurance Credit
• IRS Small Business Health Care Tax Credit for Small Employers (not a PDF)
• Congressional Research Service Report: Summary of Small Employer Tax Credits Under PPACA
• IRS Small Business Health Care Tax Credit Podcast 
  
• Stop Loss Insurance
• Request for Information Regarding Stop Loss Insurance
• Responses to DOL Request for Information on Stop Loss Insurance
  
• Summary of Benefits and Uniform Glossary
  
• Final Regulations
• Guidance for Compliance
• Templates, Instructions, and Other Materials
• Template (authorized year of applicability) (Word format)
• Sample Completed SBC (authorized for second year of applicability) (Word format)
• Summary of Benefits and Coverage (SBC) Template (Word format)
• Revised Summary of Benefits and Coverage (SBC) Template
• Sample Completed SBC (Word format)
• Revised Sample Completed SBC
• Instructions for Completing the SBC (Group Health Plan Coverage)
• Why This Matters—Language for "Yes" Answers
• Why This Matters—Language for "No" Answers
• HHS Information for Simulating Coverage Examples
• Uniform Glossary of Coverage and Medical Terms
• HHS Coverage Example Calculator and Related Information
• Proposed Regulations
• Templates, Instructions, and Related Materials—Subregulatory Guidance
• HHS Fact Sheet (not a PDF)
  
• Tax Impacts
• Report: Joint Committee on Taxation Explanation of Revenue Provisions in the PPACA and Reconciliation Act
• Transitional Reinsurance Program Fees
• HHS Notice of Benefit and Payment Parameters for 2014
• Amendments to the HHS Notice of Benefit and Payment Parameters for 2014
  
• Wellness Plans
• Incentives for Nondiscriminatory Wellness Programs in Group Health Plans: Proposed Rule
  
• DOL Fact Sheet on Wellness Programs (not a PDF)
• HHS Proposed Regulations on Health Insurance Market Rules
  
• Congressional Research Service Report: Wellness Programs: Selected Legal Issues
• General Guidance
• PPACA Self-Compliance Checklist
  
• What the Legislation Means for Providers
• April 2010 Health Care E*Bulletin: Summary of Health Care Reform Changes

Related Jones Walker Publications

• July 2012 Employee Benefits, ERISA & Executive Compensation E*Bulletin: Patient Protection and Affordable Care Act Passes Constitutional Muster; IRS Issues Guidance on W-2 Reporting Requirement
• November 2010 Employee Benefits, ERISA & Executive Compensation E*Bulletin: Affordable Care Act: New Grandfathered Health Plan Guidance
  
• April 2010 Employee Benefits, ERISA & Executive Compensation E*Bulletin: Health Care Reform is Now Law: Will the Light Come on When Your Employees Open the Fridge?
  
• April 2010 Health Care E*Bulletin: Summary of Health Care Reform Changes
  
• April 2010 Employee Benefits, ERISA & Executive Compensation E*Bulletin: COBRA Subsidy Extended Again . . . and Again
  
• March 2010 Employee Benefits, ERISA & Executive Compensation E*Bulletin: COBRA Subsidy Extended Again
  
• January 2010 Employee Benefits, ERISA & Executive Compensation E*Bulletin: COBRA Subsidy Extended; Department of Labor Issues Revised Model Notices
  
• March 2009 Employee Benefits, ERISA & Executive Compensation E*Bulletin: DOL Issues Model Notices for "Second Chance" COBRA Election and Subsidy
  
• February 2009 Employee Benefits, ERISA & Executive Compensation E*Bulletin: Stimulus Law Makes Major Changes to COBRA

Other Important Health Care Resources

• Relevant Websites:
• Website: U.S. Department of Health and Human Services
• Website: Centers for Medicare and Medicaid
• Website: IRS PPACA Site
• Website: DOL PPACA Site 
• Website: Early Retire Reinsurance Program
• Website: Pre-Existing Condition Insurance Plan Website

Events

• "Pleading the Fifth Amendment in Civil Litigation"
• "Federal Tax Crimes"