[Guidance Overview]

Employer Checklist for New Health Plan Price Transparency Rules and CAA

"[S]everal provisions [of the Consolidated Appropriations Act of 2021 and related regulations, and the Transparency in Coverage Rule] that will have a large impact on self-funded health plans are effective in January 2022, including requirements related to surprise billing. [This checklist is designed] to help employers with self-funded health plans be aware of the obligations imposed by these laws and the steps they may need to take to comply[.]"  MORE >>

Foley & Lardner LLP

[Guidance Overview]

HHS Adjusts 2021 HIPAA, ACA and MSP Monetary Penalties

"Inflation adjustments released by [HHS] apply to penalties assessed on or after Nov. 15, 2021, for violations occurring on or after Nov. 2, 2015. This most recent inflation increase is 1.182%. This article highlights the changes of interest to employers sponsoring group health plans."  MORE >>

Mercer

[Guidance Overview]

Illinois Imposes Group Health Coverage Disclosure Requirements

"The Illinois Consumer Coverage Disclosure Act, which went into effect on August 27, 2021, requires an employer to notify employees in Illinois who are eligible for its group health plan whether such plan does or does not cover each of the essential health benefits identified by the Illinois [DOL].... Because this is a disclosure requirement and not a benefits mandate, the Illinois DOL maintains that this requirement also applies to self-funded group health plans regulated by ERISA."  MORE >>

Haynes and Boone, LLP

District Court Issues Nationwide Stay of CMS Vaccination Mandate for Healthcare Workers

"[A] federal district court in Louisiana issued a preliminary injunction staying the CMS vaccine mandate nationwide (except for the 10 states subject to [the Nov. 29] injunction in Missouri).... CMS is likely to appeal. In the meantime, facilities otherwise covered by the CMS rule may suspend their efforts to implement and enforce the CMS rule." [Louisiana v. Becerra, No. 21-3970 (W.D. La. Nov. 30, 2021)]  MORE >>

Holland & Hart LLP

District Court Enjoins Federal Contractor COVID-19 Vaccine Mandate in Kentucky, Ohio, and Tennessee

"Despite the breadth of the authority delegated by Congress to the president in procurement matters under the Federal Property and Administrative Services Act (FPASA), the Judge concluded that the FPASA has never 'been used to promulgate such a wide and sweeping public health regulation as mandatory vaccination for all federal contractors and subcontractors' and cautioned that 'the President's authority is not absolute.' The Judge indicated that regarding the contractor vaccine mandate, the government cannot demonstrate a 'close enough nexus to economy and efficiency in federal procurement.' " [Commonwealth of Kentucky v. Biden, No. 21-0055 (E.D. Ky. Nov. 30, 2021)]  MORE >>

Seyfarth Shaw LLP

Health and Wellness Trends to Watch in 2022

"[V]irtual care isn't going away following a massive increase in use during the pandemic.... [Expect] employer on-site clinics to rebound in the coming years, particularly 2023 to 2024, as the post-pandemic world shakes out.... Mental health, wellbeing solutions will continue to grow ... A spotlight on health equity ... Value-based care in focus ... The next evolution in workplace wellness ... More health policy activity on the horizon."  MORE >>

FierceHealthcare

Employers Could Collectively Save Billions by Boosting Employee Mental Health Benefits

"Patients with depression have a 40% higher risk for cardiovascular disease, while 32% develop a substance abuse issue, and even worse, suicide remains the 2nd leading cause of death for young adults.... [D]epression alone costs employers $44 billion annually.... [E]mployers can make major headway in improving these numbers ... The key is to combine affordable, effective, and individualized care options and improving access/removing barriers to them."  MORE >>

The Alliance

How 'Microcare' Can Promote Employee Mental Health and the Employer's Bottom Line

"According to a 2021 Gallup poll, 48% of the American workforce is searching for a new job opportunity, and many are looking for signs that companies care about them. Research shows that various forms of Microcare create a win-win for both employees ... and employers ... There are five types of Microcare that yield big payoffs in a short amount of time: Microsteps, Microbreaks, Microchillers, Microweeks and Microcations."  MORE >>

Forbes; subscription may be required

Getzen Model of Long-Run Medical Cost Trends Update for 2022-2030+

"COVID has washed over healthcare like a tsunami. According to Medicare actuaries, trends have been turned upside down in 2021, but will reverse back in 2023 as medical costs rebound. It is more prudent to base projections on long run trends for a period after the storm, extrapolating from 2026 forward, leaving the intervening turbulence (years 2022–2025) mostly unspecified."  MORE >>

Society of Actuaries

Markets or Monopolies? Considerations for Addressing Health Care Consolidation in California

"[This report] compiles the latest research and data on California's health care systems and shows that consolidation is not limited to any one system, market segment, or geographic region in the state: Most markets across California are highly concentrated. Hospital markets, in particular, are now approaching 'monopoly levels' in many California counties. In addition, there is mounting evidence that mergers of health care companies are resulting in increased prices for health care services, with little or no improvement in quality for consumers."  MORE >>

California HealthCare Foundation

FMLA Interference: Court Finds Defendants' Motion to Dismiss to Be Premature

"[The court] refused to grant a motion to dismiss to the Norfolk School Board and individual defendants, finding that discovery was necessary to determine whether outreach to the plaintiff office manager while she was on [FMLA leave] constituted more than de minimis contact." [Smith v. School Board for the City of Norfolk, Virginia, No. 21-138 (E.D. Va. Nov. 5, 2021)]  MORE >>

Ogletree Deakins

Eighth Circuit: Ordinary Summary Judgment Procedures Apply to Review of ERISA Benefit Claims

"The Eighth Circuit ... held that ordinary summary-judgment procedures under FRCP 56 apply in ERISA benefit cases where the administrator lacked discretionary authority. Parties in an ERISA case that want the district court to exercise its factfinding function under FRCP 39(b) and 52(a)(1) to decide the case on the administrative record should request that the district court do that." [Avenoso v. Reliance Standard Life Ins. Co., No. 21-1772 (8th Cir. Nov. 30, 2021)]  MORE >>

Roberts Disability Law

► View More Jobs    ► Post a Job    ► Subscribe to Job Alerts

Employee Benefits Attorney Kimberly Steefel Joins Ballard Spahr in NYC Office

Ballard Spahr LLP

Executive Compensation and Employee Benefits Partner Meredith O’Leary Joins King & Spalding in Washington, D.C.

King & Spalding

► View More Press Releases

Investigations and Enforcement: Hot Health Plan Issues

December 8, 2021 WEBCAST

Groom Law Group

► View All Upcoming    ► View Webcast Recordings

Proposed Regs Shed Light on Upcoming Health Plan Disclosure Requirements

Fisher Phillips

In Remembrance of Theodore R. Groom

Groom Law Group

ACA Reporting for Employers with a Self-Insured Plan

Newfront