54 pages. "None of the comparative analyses EBSA or CMS have initially reviewed to date contained sufficient information upon initial receipt. EBSA has issued 80 insufficiency letters addressing over 170 NQTLs, identifying specific deficiencies in the comparative analyses and requesting additional information to remediate those deficiencies.... EBSA has issued 30 initial determination letters, finding 48 NQTLs imposed on MH/SUD benefits violated MHPAEA's parity requirements.... [This Report] also describes the lack of sufficient comparative analyses for plans and issuers and provides some examples of how the CAA's provisions have allowed the Departments to supplement existing MHPAEA enforcement programs, resulting in participants and beneficiaries gaining increased access to MH/SUD benefits."  MORE >>

"[Employers with insured or self-insured plans should] alert plan participants of the following: [1] OTC COVID-19 tests are covered without health care provider involvement. [2] The claims and reimbursement process. [3] Information about network of preferred and non-preferred pharmacies/retailers and direct-to-consumer shipping program (if applicable). [4] Any purchase and/or reimbursement limits."  MORE >>

"Does the prior guidance on retirement plan disclosures have effect? ... Which plans are 'covered plans'? ... Who is a 'covered service provider'? ... How should a covered service provider disclose compensation that is unknown when the contract is entered into? ... Is the contract or arrangement subject to the new requirements under ERISA 408(b)(2)(b)?"  MORE >>

"When considering funding options for a group of employers there is a hierarchy of questions to consider: [1] Does the group meet controlled group definition? ... [2] If group does not meet controlled group definition, they are a MEWA. If so: [a] Is there less than 25% common ownership? ... [b] What state law rules apply? [c] Does the plan have to register? [d] If the plan is self-insured, can it even function in that state? [4] Does the group meet affiliated service group rules?"  MORE >>

"Guidance in the fourth quarter addressed plan sponsor reporting for several states' individual health coverage mandates ... The focus on prescription drug costs continued ... State paid leave laws garnered much attention ... Other benefit-related issues involved Colorado's benchmark plan, Connecticut's health plan identification cards, Massachusetts' tax limits for transit benefits, ... and Washington's long-term care mandate, which is now in limbo and the subject of a federal lawsuit."  MORE >>

"This enforcement fact sheet summarizes EBSA's and CMS's investigations and public inquiries, including complaints related to MHPAEA during FY 2021. This fact sheet does not report ongoing investigations that were open but not closed during FY 2021.... During FY2021, in response to requirements imposed on plans and issuers by [the Consolidated Appropriations Act, 2021 (CAA)], EBSA and CMS significantly increased their MHPAEA enforcement activity with respect to nonquantitative treatment limitations. This fact sheet does not capture results from EBSA's increased activity as a result of the CAA because the related investigations were ongoing and not yet closed during FY 2021."  MORE >>

"The debate over drug costs may have hit a tipping point. A recent federal report found that more than 5 million Medicare beneficiaries struggle to afford their prescriptions, while Morning Consult polling consistently pegs health care costs as a top issue for voters. And PhRMA spent record sums last year to oppose some proposals, arguing that lawmakers are taking the wrong approach to curb patients' costs by targeting drug prices rather than the 'broken insurance system.' "  MORE >>

"Health insurers are covering between 61 percent and 74 percent of the costs of ivermectin ... despite guidance from the FDA that it should not be used to treat COVID-19.... [P]ayers covered between $36 to $39 per ivermectin prescription, based on claims data from 2020 and 2021. "  MORE >>

"The Mark Cuban Cost Plus Drug Company ... says it will bypass health care industry 'middlemen' and help consumers avoid high drug prices by charging manufacturers' prices plus a flat 15% markup and pharmacist fee.... The launch comes several weeks after the company established its own pharmacy benefit manager."  MORE >>

"[O]ur hope and expectation had been that the prescription drug reporting requirement would also increase transparency between PBMs and plans ... However ... this new reporting requirement will not meaningfully support increased transparency for plans, with respect to their own data. In our comments we provide suggestions for how the departments can address this issue, while also addressing a handful of technical issues."  MORE >>