"Every group health plan sponsor needs to have a comparative analysis of how their plan develops and applies non-quantitative treatment limitations.... NQTL analyses are NOT a one-time proposition.... [C]ommon failures include not identifying the MHPAEA benefit classifications and/or the specific M/S and MH/SUD benefits affected by the NQTL, failing to identify and/or define factors, and not demonstrating compliance of an NQTL as applied.... [The] Biden Administration is expressly asking for the statutory authority to directly pursue parity violations by entities that provide administrative services to ERISA group health plans, including health insurance issuers when they are providing administrative services to self-funded plans."  MORE >>

"[FAQs Part 52] gives plans and insurers more flexibility in how they satisfy the safe harbor that permits capping reimbursements at $12 per test if they provide 'adequate access' to tests through both a pharmacy network and a direct-to-consumer shipping program.... When providing coverage through a direct-to-consumer shipping program, the plan or insurer must cover reasonable shipping costs."  MORE >>

"[T]he Departments acknowledge that small plans covering individuals in a limited geography may be able qualify for this $12 limit without providing a direct-to-consumer shipping option. In other words, these small plans could only offer in-person distribution.... The new FAQs also clarify that tests requiring a reading in a lab are not covered by these rules.... OTC COVID-19 tests must be self-administered and self-read.  MORE >>

"The Regulations largely mirror the proposed rules that were issued in December 2020 ... [T]he NYSDOL notably did not respond to questions from commenters related to collective bargaining agreements, leaving open questions about what constitutes 'comparable benefits' sufficient to comply with the Sick Leave Law."  MORE >>

"As federal agencies decide how telemedicine should or should not become an accepted mode of reimbursable treatment, several independent health insurers see the frontline impact and bottom-line efficiencies of telemedicine and are moving ahead with plans of their own."  MORE >>

"In addition to withdrawing board regulations, Idaho's Division of Occupational and Professional Licenses has made it even easier for out-of-state providers to render telehealth in Idaho during the COVID-19 emergency."  MORE >>

"Cuban's company is pledging to sell a growing range of generic drugs online at cost plus 15 percent, plus a $3 fee for pharmacists, plus $5 shipping.... If drugs were still purchased predominantly by individuals paying out of pocket, those price differences would be enough to win substantial market share. Yet, over 90 percent of Americans now have health-insurance coverage that pays for prescription drugs.... The market for Cuban's drug company is therefore likely to be limited to the uninsured and those with skimpy insurance coverage."  MORE >>