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[Guidance Overview]
New Jersey Employees to Be Entitled to Pre-Tax Transportation Fringe Benefits
"While New Jersey is the first state to pass legislation aimed at protecting this benefit for employees, some municipalities, including New York City, previously have enacted similar laws. The Act will require that transit benefit elections be permitted 'at the maximum benefit levels' allowable under federal law. For 2019, such maximum benefit is $265 per month, up from $260 per month in 2018."
Proskauer
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Lawsuit Against Generic Drug Manufacturers Alleges Conspiracy to Fix Prices for Over 100 Drugs
"[Connecticut] Attorney General William Tong led a 44-state coalition in announcing a lawsuit against Teva Pharmaceuticals and 19 of the nation's largest generic drug manufacturers alleging a broad conspiracy to artificially inflate and manipulate prices, reduce competition and unreasonably restrain trade for more than 100 different generic drugs.... The drugs at issue account for billions of dollars of sales in the United States, and the alleged schemes increased prices affecting the health insurance market, taxpayer-funded healthcare programs like Medicare and Medicaid, and individuals who must pay artificially-inflated prices for their prescriptions drugs." [Connecticut v. Teva, No. 19-710 (D. Conn. complaint filed
May 10, 2019)]
Office of Connecticut Attorney General William Tong
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Drug Price Disclosures and the First Amendment
"The rule's disclosure requirement likely does regulate speech rather than non-expressive conduct: the Supreme Court held in 1976 that 'prescription drug price advertising' is protected by the First Amendment, and more recently, said that if the government regulates 'the communication of prices rather than prices themselves,' the government is regulating speech.... [T]he Supreme Court has said that, generally, disclosure requirements compel speech and are accordingly subject to heightened scrutiny under the First Amendment." [CRS Legal Sidebar LSB10298, May 13, 2019]
Congressional Research Service [CRS]
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Benefit Trends That Matter Most to Employers and Workers (PDF)
"While 32% of employers went out to bid for health coverage in 2018 for 2019, only 12% of companies actually switched plans and two-thirds have not changed their health plan coverage in the last three years.... Mental health has caught up to diabetes as a leading focus area for employee health, with 32% of employers saying they are focusing on diabetes and 30% on mental health as top employee health and well-being concerns."
Minnesota Health Action Group
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Hospital Price Study Draws Pushback
"Recently issued RAND Corporation research ... concluded that relative hospital prices -- among those studied -- increased from 236 percent of Medicare rates in 2015 to 241 percent in 2017. The study ... raised concerns in the hospital sector, including: [1] The small sample size, which encompassed less than 5% of all covered individuals in about half of all states and only 2% of the 181 million Americans with employer-sponsored insurance; [2] The lack of regard for the deterioration in hospitals' overall Medicare margin from -9.7% in 2016 to -9.9% in 2017."
Healthcare Financial Management Association [HFMA]
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ACA Round-Up: New Uninsured Data, Resources On 1332, Briefs In Texas
"A new report from the Centers for Disease Control and Prevention (CDC) shows that the uninsured rate remained largely stable in 2018 but that the number of uninsured people continues to rise. [CMS] released yet more resources for states interested in pursuing a state innovation waiver under Section 1332 of the [ACA]. And a comparatively small group of stakeholders filed amicus briefs in support of those challenging the ACA in Texas v. United States."
Katie Keith, in Health Affairs
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Bipartisan Consensus on Surprise Medical Billing, but Finding an Effective Fix May be Difficult
"[E]ven with bipartisan recognition of the problem, crafting a federal solution is expected to be complex. In addition to determining how to balance state and federal roles in regulation of insurance practices, it will be important for legislators to understand how reimbursement rates are set in the private sector, how charges may differ from actual costs, the complicated dynamics of negotiations between payers and hospital-based physicians, and the role cost shifting continues to play in the health care system as a whole."
Reed Smith
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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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