Robust Health Care Regulatory Agenda Will Increase Employer Requirements

The Biden administration has an ambitious health care regulatory agenda for the remainder of 2022 and 2023, and that doesn’t include all the rules that will be required to implement the Inflation Reduction Act (Medicare drug price negotiation and inflation caps).

This fall, employers can expect:

• Proposed DOL mental health parity guidance that will hopefully provide employers with examples of how to complete compliant parity analyses; and
  
  
• Final IRS family glitch rules that may increase employer reporting requirements under the ACA.

In 2023, employers can expect:

• Proposed rules regarding the advanced explanation of benefits employers will be required to provide to health plan participants prior to any services being performed;
  
  
• Proposed drug pricing transparency rules including the requirement to post on the Internet a machine-readable drug pricing file and other pharmacy supply-chain transparency provisions; and
  
  
• Proposed provider directory accuracy requirements that will require employers to monitor their provider directories for inaccuracies every 90 days and update them accordingly; and
  
  
• Improved fee disclosure for health plans regarding the fees service providers charge. 

Outlook:  Should the GOP take control of one or more chambers in Congress in 2023, the IRS family glitch rules are likely to be subject to rigorous oversight and the new committee chairmen may insist DOL provide robust parity guidance for employers.