Health & Welfare Plans Newsletter

November 6, 2019

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[Guidance Overview]

HHS Increases Civil Money Penalties for HIPAA Noncompliance, Effective November 5, 2019

"[HHS] has issued final regulations that ... include updated penalties for certain violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).... [A] table reflects certain of HHS's annual inflation adjustments to the civil money penalties for HHS-administered provisions, which are generally effective November 5, 2019."
Thomson Reuters Practical Law

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Class Certification Denied in ERISA Health Coverage Lawsuit

"The plaintiffs sought a class action on behalf of all participants who were promised the lifetime health benefit.... The court ... found that there were too many individualized questions for the case to be handled on a class-wide basis. The claims inherently involved questions about what the plan told which participants and when, which the Court characterized as 'scattered' questions about supposed statements without a 'uniform message.' " [Fitzwater  v. Consol Energy, Inc., Nos. 16-9849 and 17-3861 (S.D. W. Va. Oct. 15, 2019)]
McDermott Will & Emery

Employers, Employees Striking a Balance on Health Care Costs in 2019

"Employers were successful at mitigating higher underlying medical cost trends through plan design changes, network strategies, vendor negotiations and other initiatives. The analysis also shows employers are passing along a lower 2.1 percent premium increase to employees, absorbing a larger 3.5 percent increase to company costs in 2019."
Aon

Chronic Care Management Keeps Health Spending Under Control

"Providing intensive support to employees faced with serious medical issues can improve care outcomes while lowering cost. The largest employers are taking the lead in offering enhanced health advocacy and intensive case management services, as well as programs that make it easy for members to seek an expert medical opinion on a diagnosis or their treatment plan[.]"
Society for Human Resource Management [SHRM]; membership may be required to view article

Wide Local Variation in Average Costs for Select Anesthesiology, Emergency Medicine, and Radiology Services

"[T]he average commercial allowed amounts were almost always higher than Medicare fee-for-service. However, compared to the variation we observed at the state level, the variation in the ratio of the commercial and Medicare rates for the selected services across CBSAs was greater, with the top of the range being as much as 9 times higher."
Health Care Cost Institute

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Drug Spending Is Reducing Health Care Costs

"American households spend the smallest share of total consumption (0.4%) of any major developed nation on out-of-pocket fees for prescription drugs.... Spending on specialty drugs has been increasing, but overall real per-capita spending on traditional drugs actually fell from $738 in 2008 to $527 in 2018.... On average, an extra $100 in prescription drug utilization by Medicare beneficiaries saves $95 that would be spent on other medical services, while delivering better outcomes."
Manhattan Institute

California's New Transparency Law Reveals 8% Increase in Wholesale Drug Prices

"Pharmaceutical companies increased the wholesale acquisition cost (WAC) of prescription drugs by a median of 25.8% from 2017 through the first quarter of 2019, according to the first public report on drug price increases by California’s Office of Statewide Health Planning and Development. The inflation rate was 2% over the same period of time. Generic drugs and prescription drugs with WACs less than $100 experienced the largest percent increases."
AISHealth

HSA Reforms Pass Key House Panel

"Three bipartisan bills to expand and improve the flexibility of health savings accounts (HSAs) cleared the powerful House Ways and Means Committee on Oct. 23. While the outlook for House and Senate floor votes on the HSA measures is uncertain, their bipartisan approval by the Ways and Means panel could set the stage for further action in the 116th Congress."
Mercer

Benefits in General

How Top Employers Are Upping Their Benefits Package to Attract Talent

"In 2019, employers most often strengthened their total rewards by enhancing compensation (73 percent) and medical benefits (52 percent). But employers also enhanced other offerings, including voluntary and supplemental benefits (40 percent), leave policies (37 percent), well-being initiatives (32 percent), retirement benefits (31 percent), and pharmacy benefits (18 percent)."
Treasury & Risk; free registration required

Press Releases

Anna Rappaport Named 2019 EBRI Lillywhite Award Recipient
EBRI [Employee Benefit Research Institute]

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Lois Baker, J.D., President  loisbaker@benefitslink.com
David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

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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