Garrett Fenton Quoted Regarding PPACA Compliance Acceleration in LifeHealthPro

"3 ways PPACA compliance is getting real"

Garrett Fenton was quoted regarding the acceleration of Patient Protection and Affordable Care Act (PPACA) provisions following the Supreme Court's ruling in favor of the U.S. Department of Health and Human Services (HHS) in King v. Burwell. Fenton said if the Court had ruled against HHS, members of Congress might have used the need to come up with an individual health insurance market rescue plan as an opportunity to make major changes in the law. Now that the Supreme Court has given HHS permission to continue to offer access to PPACA premium tax credits through HHS-established PPACA exchange programs, "we know the exchanges are here to stay," and "that opportunity is effectively gone," he said.

Following the Court's decision, clients are increasingly asking lawyers for assistance on how family-owned employers can ask for accommodations for employers' religious practices with respect to contraceptive coverage. "We see it most frequently on the insurer side," as employers ask the insurers for help and insurers ask lawyers for advice on how to proceed, he said.

Employers also want help regarding the structure of wellness programs and whether plans have paid their Patient-Centered Outcomes Research Institute (PCORI) fees. These questions arise when the IRS or Department of Labor conducts a general review of an employer's benefit plan and ends up flagging PPACA compliance concerns. "Some are more detailed than others," Fenton said, adding it "could lead to some sort of further enforcement," but at this point he has not heard of document production letters leading to more intense enforcement activity.

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