Friday, March 18, 2011

Friday wrap up

The President signed into law today a new continuing resolution funding the federal government until April 8, 2011.

The Labor Department today issued a technical release (2011-01) extending the grace periods from enforcement of several new Affordable Care Act requirements on group health plans, including FEHB plans -- most significantly the requirements for a 24 hour time frame (instead of the long standing 72 hour time frame) for making urgent care claims decisions, providing notices in a culturally and linguistically appropriate manner, and disclosing diagnosis codes and treatment codes and their corresponding meanings on explanations of benefits (thereby unnecessarily creating privacy issues).

These requirements created by a July 23, 2010, regulation, apply only to grandfathered plans in the private sector but OPM has decided to apply the claims and internal appeal requirements of that regulation to all FEHB plans. The Affordable Care Act regulators explained that the extended grace period is intended to give them time to publish new regulations necessary or appropriate to implement the internal claims and appeals provisions of PHS Act section 2719(a).

The FEHBlog has discussed the Golinski v. OPM case pending in federal district court in San Francisco. Ms. Golinski is suing for FEHB coverage of her same sex spouse. On Wednesday, the court dismissed Ms.Golinski’s complaint against OPM but allowed the plaintiff an opportunity to amend her complaint to raise the claim that that Section 3 of the Defense of Marriage Act is unconstitutional. A copy of the opinion is available here.

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