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[Guidance Overview]
Administration Proposes to Lower Drug Costs by Targeting Backdoor Rebates and Encouraging Direct Discounts to Patients
"The HHS proposal would expressly exclude from safe harbor protection under the Anti-Kickback Statute rebates on prescription drugs paid by manufacturers to pharmacy benefit managers (PBMs), Part D plans and Medicaid managed care organizations. It would create a new safe harbor for prescription drug discounts offered directly to patients, as well as fixed fee service arrangements between drug manufacturers and PBMs. The proposal would also provide a historic new level of transparency to a system that has been shrouded in secrecy for decades."
U.S. Department of Health and Human Services [HHS]
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HHS Proposal Could Kill PBM Rebates
"The idea is to pass savings along to patients by increasing transparency, encouraging discounts given directly to consumers rather than middlemen, and prohibiting a compensation system that incentivizes annual price hikes, according to [HHS]."
HealthLeaders Media
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[Advert.]
Managers Guide to FMLA

Feb. 7 webinar. Discuss in depth what kinds of leave employees may take and how to best manage that leave, how to track down paperwork and control intermittent leave. BenefitsLink discount.
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See Health as a Resource, Not as a Problem
"The next frontier of health investment will require shifting from a predominant focus on health as a state of illness to health as a state of high capacity and overall well-being.... Despite our long-term fixations on these externals, staggering financial expenditures, and unending calls for change in the medical industry, our current approach to health will never lead to high health and high well-being.... High health and high well-being arise when people engage in practices that optimize their physical, mental, emotional, purpose and life direction dimensions."
High Health Network
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How CBO and JCT Analyzed Coverage Effects of New Rules for Association Health Plans and Short-Term Plans (PDF)
20 pages. "To estimate the effects of the new rules for AHPs and short-term plans, CBO and JCT analyzed the incremental increase in coverage in both types of plans that will result from the rules ... The agencies followed several steps in completing their analysis, beginning with a comparison of estimated premiums for the new plans with those for the lowest-cost insurance otherwise available to individuals and small employers."
Congressional Budget Office [CBO]
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Benefits in General
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DOL Issues 2019 Adjusted Penalty Amounts
"The maximum penalty for failing to file Form 5500 (which must be filed annually for most ERISA plans) increases from $2,140 to $2,194 per day that the filing is late.... The maximum penalty for failing to provide the summary of benefits and coverage (SBC) required under the [ACA] increases from $1,128 to $1,156 per failure.... For plans with automatic contribution arrangements, penalties for failure to provide the required ERISA Section 514(e)preemption notice to participants increase from $1,693 to $1,736 per day."
Thomson Reuters / EBIA
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Most Popular Items in the Previous Issue
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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2019 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.
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