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Webcasts, Conferences

CSR Data Submission for Benefit Year 2018 and Benefit Year 2017 Restatements
May 9, 2019 WEBCAST
Centers for Medicare & Medicaid Services [CMS]

CSR Data Submission for Benefit Year 2018 and Benefit Year 2017 Restatements
May 16, 2019 WEBCAST
Centers for Medicare & Medicaid Services [CMS]

Compliance Challenges with the ADA and FMLA
June 12, 2019 in LA
Ogletree Deakins

CMS Marketplace Agent and Broker Summit
July 1, 2019 WEBCAST
Centers for Medicare & Medicaid Services [CMS]

HIPAA / HITECH Update for Health Plan Sponsors and Their Business Associates
July 9, 2019 in MI
Miller Johnson

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[Official Guidance]

Text of Treasury Department and HHS Request for Information: State Relief and Empowerment Waivers

16 pages. "This RFI is intended to solicit ideas and spur additional thinking and innovation as states consider developing section 1332 waiver plans.... The Departments seek public comments on [1] ideas that states may be able to use to develop innovative waiver programs that meet the section 1332 guardrails.... [2] waiver concepts that states could potentially use alone or in combination with other waiver concepts, state proposals, or policy changes.... [3] ideas for waiver concepts that could advance some or all of the principles outlined in the October 2018 guidance and Background section [of this document].... [4] ideas for waiver concepts that incorporate the entire range of waivable requirements allowed under section 1332. The Departments are also interested in how states might align these flexibilities under section 1332 with other flexibilities under federal law, including regulatory flexibility, section 1115 Medicaid waivers, as well as state law."
U.S. Department of the Treasury, and U.S. Department of Health and Human Services [HHS]


Separate Fact from Fiction Regarding Prescription Drugs

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[Guidance Overview]

OCR Reduces HIPAA Penalties and Clarifies Liability for Transferring ePHI to Third-Party Health Apps

"OCR guidance issued last week changed the Department's historical position that the maximum penalty for violations of an identical HIPAA provision for each of the four types of violations is $1.5 million per year. While OCR retains the $50,000 maximum per-violation penalty across all tiers, its new guidance adopts graduated annual limitations for violations of the same requirement, which lower the annual limitations for all but the most serious violations."
Data Matters, Sidley Austin LLP

[Guidance Overview]

Massachusetts Releases Private Plan PFML Exemption Application and Guidance

"[T]he Massachusetts Department of Family and Medical Leave (DFML) made available the online application for private plan exemptions under the Paid Family and Medical Leave (PFML) Law. The DFML also released new information on how to calculate the required surety bond for self-insured private plans, as well as further details regarding the application process.... In order to avoid commencing the payroll tax deductions on July 1, 2019 and remitting contributions for the July-September quarter, employers must submit the exemption application by June 30, 2019."
Seyfarth Shaw LLP

[Guidance Overview]

Massachusetts' Paid Family and Medical Leave Act Notices Are Now Available

"The notices must be provided to current employees and to self-employed independent contractors in the recipients' primary languages by May 31. The templates are available in 12 languages, in addition to English -- Arabic, Chinese, French, Haitian Creole, Italian, Khmer, Korean, Lao, Portuguese, Russian, Spanish, and Vietnamese.... Employers and covered business entities have the option to create their own notices. If they do so, the notices to employees must contain [specified information]."
Constangy, Brooks, Smith & Prophete LLP

Employers: Know the Perils of Managing Employee Leave

"As of this writing, 12 states have expanded the Family and Medical Leave Act (FMLA) to add more time off or more classes of people covered. Washington, D.C., California, Massachusetts, New Jersey, New York, Rhode Island, and Washington have laws covering paid family leave.... Five states currently require paid sick leave. A small number of states provide a limited number of hours annually for parents to attend school-related events and activities for their children."
Corporate Synergies

Taking Action and Providing States with Options to Minimize Economic Burden Created by the ACA

"Today, the Departments are taking another step to prime discussions and are issuing a request for information (RFI) asking for more ideas on innovative programs and waiver concepts that states could consider in developing a State Relief and Empowerment Waiver plan ... Ultimately, the goal here is to see states develop new waiver concepts and submit waiver applications that improve their health insurance markets. To help states with that process, CMS intends to build a library of options, through more waiver concepts, so that states have additional illustrative ways to take advantage of this new flexibility. Indeed, the four waiver concepts we released last fall were just the beginning."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

DOL Appeals Association Health Plan Ruling

"The DOL, which is appealing the federal district court decision striking down its 2018 AHP regulation, announced that it will not pursue violations stemming from employers' good faith reliance on the AHP rule's validity as long as businesses in an AHP meet their responsibilities to pay health benefit claims as promised. Nor will the DOL take action against existing AHPs for continuing to provide benefits to members who enrolled before the district court's order, through the remainder of the applicable plan year or contract term."
Society for Human Resource Management [SHRM]

The Obscure Advisory Committees at the Heart of the U.S. Drug Pricing Debate

"These relatively unknown expert committees have been involved in drug coverage decisions for decades. Their identities are kept secret due to federal regulations aimed at preventing pharmaceutical industry interference. The committees make their decisions based on a drug's clinical value, independent of cost, pharmacy benefit managers say. But their power has grown more recently with the consolidation of most of the U.S. pharmacy benefits business under OptumRx, CVS and Express Scripts. Taken together, their three advisory committees now guide drug coverage for more than 90 million Americans."

Benefits in General

DOL Provides Roadmap to Avoid Misclassification of Gig Workers

"In determining joint employment liability under wage and hour laws, companies must still look at state laws, which may be much more restrictive. The road map provided by the DOL [in Opinion Letter FLSA2019-6] only outlines the economic reality test utilized by the FLSA and not the plethora of other tests utilized under federal, state or even municipal laws."

Press Releases

Most Popular Items in the Previous Issue

Text of DOL Statement on Association Health Plans After U.S. District Court Ruling in State of New York v. DOL
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2019, 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, 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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