Mintz Levin Examines Reference Pricing Models

In "Rethinking ACA Compliance Strategies Involving Reference Pricing Models and “MVP” Arrangements," Alden Bianchi of Mintz Levin indicates:

"Under the Affordable Care Act’s rules governing employer shared responsibility...where an applicable large employer makes an offer of group health plan coverage that is both “affordable” and provides “minimum value” to substantially all of its full-time employees, the employer is not liable for assessable payments under Code § 4980H. In an effort to drive down the cost of complying with these rules, certain applicable large employers...have sought less expensive ways to offer coverage that is both “affordable” and provides “minimum value”...which included the reference pricing models and “MVP arrangements” that some employers were considering. Two recent developments, one in the form of a set of FAQs issued by the Departments of Health and Human Services, Labor and Treasury/IRS, and the other a mere (though troubling) rumor, may cause employers to reconsider both these approaches."

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