In the world of healthcare compliance, staying up to date with federal regulations and guidelines is crucial to avoid costly penalties. One such regulation that affects healthcare providers and group health plans is the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015, commonly known as the “Inflation Adjustment Act.” This act directs federal agencies to adjust civil monetary penalties to account for inflation. In a recent development, the Department of Health and Human Services (HHS) issued final rules on October 6, 2023, updating the civil monetary penalties for inflation.

Understanding the Updated Penalties

The adjusted penalties are applicable to penalties assessed on or after October 6, 2023. It’s important to note that these penalties apply to violations occurring on or after November 2, 2015, which is when the Inflation Adjustment Act was enacted.

To gain a comprehensive understanding of the updated penalties for group health plans and healthcare entities, it is recommended to refer to the official PDF document available on the website where this information originated. The document provides detailed information on the revised penalty amounts and the specific regulations impacted.

Employer Action: Ensuring Compliance

Healthcare entities, including health care plans, health care clearinghouses, and health care providers, must remain vigilant and ensure proper application and compliance with the Health Insurance Portability and Accountability Act (HIPAA)’s Privacy and Security Rules. Failure to adhere to these rules can result in substantial penalties, and the updated figures highlight the importance of this compliance.

Furthermore, employers should be cautious when offering incentives that might discourage Medicare/Medicaid-eligible employees from enrolling in the employer’s health plan. These incentives could lead to non-compliance and, subsequently, penalties under the updated regulations. Lastly, employers should be aware of the Summary of Benefits and Coverage (SBC) disclosure requirement and ensure that employees receive SBCs in a timely fashion, especially in connection with open enrollment. Accurate and timely provision of SBCs is essential for maintaining compliance with federal regulations.

We’re committed to providing exceptional support, so please don’t hesitate to reach out to our dedicated Total Benefit Solutions health insurance specialists at (215)-355-2121. We’re here to answer any questions or address any concerns you may have.