"[FAQs Part 52] provided clarity on the following: [1] Flexibility in establishing the 'direct coverage' safe harbor ... [2] No enforcement action due to supply shortages ... [3] Addressing fraud for certain purchases ... [4] Coverage requirements and self-collected samples processed by laboratories ... [5] Impact to health FSAs and account-based plans."  MORE >>

"As the IRS begins to focus more than ever before on the accuracy of forms ... it is critical for employers to thoroughly review Forms 1094-C and 1095-C for accuracy. While it may be impossible to review every single form issued to an employee and to the IRS, [this article provides tips] to accurately check the relevant ACA reporting forms."  MORE >>

"[T]he 2022 law differs from the 2021 leave because an employer cannot require an employee to exhaust their COVID supplemental sick leave when excluded from the workplace under any Cal-OSHA COVID-19 Emergency Temporary Standards. If there is a local COVID sick leave ordinance, an employer may count the leave provided under the state supplemental sick leave law toward the local ordinance."  MORE >>

"An argument can be made that the new law, at least as to self-insured plans, is [preempted by ERISA]. However, employers in Illinois may choose to comply with the new law in order to avoid the penalties ... rather than waiting until the preemption issue is definitively decided.... Employers that provide fully insured medical benefits to Illinois employees could ask their brokers and insurers if they will assist with the preparation of the required. Ultimately, however, employers are responsible for preparing and providing the notices."  MORE >>

"[T]he Eighth Circuit Court of Appeals considered whether an ERISA health plan's insurer is entitled to seek reimbursement for medical expenses it paid for an insured's injury from the insured, where the insured sought relief against the person who caused the injury. The Eighth Circuit found in favor of the health plan on its right to reimbursement[.]" [Vercellino v. Optum Insight, Inc., No. 20-3524 (8th Cir. Feb. 14, 2022)]  MORE >>

"[M]ore than half (51%) of physicians who care for patients in the workforce reported that prior authorization had interfered with a patient's job responsibilities. In fact, more than one-third (34%) of physicians reported that prior authorization led to a serious adverse event, such as hospitalization, disability, or even death, for a patient in their care.... The AMA offers employers a list of questions to ask health plans about how their prior authorization requirements may impact employees."  MORE >>

"The legislation aims to extend the waivers of the geographic and site restrictions and allow Medicare beneficiaries to access telehealth even when at home [and] allow controlled substances to be prescribed via an initial telehealth encounter under the Ryan Haight Act ... The legislation would require HHS to study the impact of the pandemic telehealth flexibilities and deliver a report to Congress no later than 18 months after the end of the public health emergency."  MORE >>

"The bipartisan act ... would establish a new commission to recommend health information privacy law revisions to Congress.... This modernization could mean not only changes for existing covered entities and business associates, but appears specifically targeted at expanding HIPAA's reach to entities, such as health technology and app providers, that have thus far generally exceeded HIPAA's reach. Health technology and app providers not currently complying with HIPAA may face significant changes."  MORE >>

"[F]inancial wellness programs are now becoming an essential workplace benefit.... An employer retirement match is an attractive employee benefit that can help an employer set themselves apart.... Some employers are adding a profit-sharing arrangement to their 401(k) plans.... [O]ther benefits include providing caregiver leave and rethinking paid time off (PTO) policies.... If your company offers an HSA, now may be a good time to remind employees of this benefit and how to enroll in the account or to increase their contributions."  MORE >>

"[T]he benefits of arbitration can only be realized if it is enforceable. [A chart] highlights the most common reasons courts have refused to enforce mandatory individual arbitration in ERISA plans and offers potential solutions for overcoming these judicial obstacles."  MORE >>