Updated Topics

The Handbook is updated quarterly and all topics in the Handbook are reviewed annually to be sure the information provided is relevant, accurate, and current. Below are examples of some of the topics updated during 2023.

LEGISLATIVE TOPICS

COVID-19 – Information added regarding the expiration of the Public Health Emergency Declaration.
Consolidated Appropriations Act of 2021 (CAA) – Updated with additional FAQs, information on fee transparency disclosure requirements and Gag Clause Prohibition Compliance Attestation submission requirements.
No Surprises Act – Updated with changes to the IDS administrative fee and additional FAQs.
Timeline of Federal Benefits Legislation – Updated with information on the Inflation Reduction Act.
Medicare - 2023 premiums, deductible and copayments were updated.  Information on the new Medicare Part B immunosuppressive drug benefit available to certain Medicare enrollees who are 36 months post kidney transplant and no longer eligible for full Medicare coverage.
Domestic Partner/Same-Sex Married Couples – Information on the Respect for Marriage Act was added.
Affordable Care Act Overview – Updated with additional FAQs released by EBSA.
Affordable Care Act and Lifetime/Annual Limits – Updated with the 2023 and 2024 cost sharing limits for non-grandfathered plans.  
Affordable Care Act and Preventive Care – Updated with updated guidelines for coverage of preventive screening for gestational diabetes and screening for diabetes after pregnancy.
Gender Reassignment – Updated with information on potential liability issues related to exclusions of gender affirming care.
State Assessments on Health Related Claims - Updated with current assessment information by state.
Mental Health Parity Acts of 1996 and 2008 – Information on proposed rules with amendments to the 2008 MHPAEA was added.
COBRA – Information added regarding the expiration of the Public Health Emergency Declaration.
Flexible Benefits Administration - Maximum HSA contribution amounts and HDHP minimum deductible and out of pocket limits for 2023 and 2024 were updated. Information added on the impact of the CARES Act.
Privacy and Confidentiality – Information on the Notice of Proposed Rulemaking to modify the HIPAA Privacy Rule to strengthen reproductive health care privacy was added.
Health Insurance Portability and Accountability Act of 1996 – Information added regarding the expiration of the Public Health Emergency Declaration.
State Assessments on Health Related Claims – Updated assessment amounts by state were added.
Ambulance/Transportation Services – Updated with information on CMS reporting deadlines for air ambulance information submittals.
Veterans’ Eligibility Rights – Information on the Civilian Reservist Emergency Workforce Act of 2021 was added.

PROCEDURAL TOPICS

Prescription Drugs – Information on additional FDA-approved biosimilar drugs, information on the FDA approval and usage of Hemgenix and Leqembi, and retail dispensing of mifepristone was added.  
Eligibility Overview – Information added regarding the expiration of the Public Health Emergency Declaration.
Occupational, Physical and Speech Therapy – Updated with 2023 threshold amounts for use with the KX modifier.
STD - Other Disability Income Sources - Disability benefits by state were updated.
STD Benefit Taxation - The Social Security taxable wage base was updated.
Dental Plan Overview – Procedures requiring submission of X-rays or periodontal charting were updated.  
Dental Topics – Coding was updated.  Additional covered and non-covered services were added.
Reinsurance – Information on Aggregating Specific Deductibles and Individual Claim Limits was added .

MEDICAL TOPICS

Breast Biopsy Procedures - Updated with additional investigational services.
Cochlear Implants and Auditory Brainstem Implants – Updated with additional investigational procedures.
Diagnostic Imaging – Updated with information on coverage of Functional Magnetic Resonance Imaging (fMRI).
Eye Surgery - Updated with additional investigational services.
Gender Reassignment - Updated with information on potential liability issues related to exclusions of gender affirming care.
Growth Hormone – Updated with additional FDA approved drugs.  
Nutritional Therapy – Medicare coverage information was updated.
Obesity – BMI requirements for patients of Asian ancestry were added.
Obstructive Sleep Apnea – Updated with additional covered services.
Surgery Overview – Updated with information on the FH Medicare GapFill PLUS medical cost lookup tool.
Telehealth – Updated with information on the impact to coverage of telehealth services due to the CARES Act and the Consolidated Appropriations Act.
Transplant Overview – Updated with additional transplant related services that may not be covered by some plans.
Vaccines/Immunizations - Updated with current information on the CDC’s Recommended Immunizations Schedules.
Varicose Veins - Updated with additional investigational services.

OPERATIONAL TOPICS

Appeals Processing - Information added regarding the expiration of the Public Health Emergency Declaration.
Claims Cost Containment – Updated with information on the CMS Web Pricer and FH Medicare GapFill PLUS tool.  
HIPAA & ACA Standards for EDI – Updated with information on the HHS proposed rule to adopt updated version of the retail pharmacy standards for electronic transactions adopted under HIPAA.   

LISTINGS AND DIRECTORIES

Internet Sites – Links were updated.
State Dental Board Directory - Links were updated.
State Intoxication Levels – Links were updated.