"On February 18, 2022, President Biden again formally extended the COVID-19 National Emergency ... [Certain deadlines] continue to be tolled for one year (or, if earlier, 60 days from the end of the National Emergency).... For Participants: [1] COBRA qualifying event and disability extension notices ... [2] COBRA election ... [3] COBRA premium payments ... [4] HIPAA special enrollment period ... [5] Benefit claims and appeals ... [6] External review ... [7] Perfecting a request for external review ... For Plan Administrators: COBRA Election Notice."  MORE >>

"In a footnote to its opinion, the court acknowledged the plan's assertion that the price of the testing was too high and noted that its ruling did not foreclose a counterclaim challenging the propriety of the pricing." [Diagnostic Affiliates of N.E. Hou, LLC v. United Healthcare Servs., No. 21-0131 (S.D. Tex. Jan. 18, 2022)]  MORE >>

"This case highlights the importance of understanding the broad array of privacy laws -- apart from HIPAA -- that may limit the ability of health plans and their business associates to use and disclose PHI. A use or disclosure of PHI that is permitted by HIPAA may still run afoul of other laws." [Fiorarancio v. Wellcare Health Plans, Inc., No. 21-14614 (D.N.J. Jan. 11, 2022)]  MORE >>

39 pages. "Despite partisan gridlock on numerous healthcare issues in Congress, bipartisan support could bring measures to expand telehealth access, broaden access to behavioral health services and further expand transparency ... At the state level ... [e]mployers can expect new or enhanced paid leave benefits, continued focus on mental health parity, and efforts to expand access to telehealth.... Federal agencies are expected to adjust COVID-19 requirements for employers and group health plans as the pandemic wanes. Implementation and enforcement efforts will concentrate on transparency, surprise billing and mental health parity.... A wide variety of litigation has implications for employer-sponsored health plans."  MORE >>

62 pages, Feb. 2022. "Of the 1,000 total hospitals reviewed ... Only 14.3% were complying with the transparency rule. Only 37.9% of the hospitals posted a sufficient amount of negotiated rates, but over half were not compliant in other criteria of the rule, such as rates by each insurer and named plan. Only 0.5% of hospitals owned by the three largest hospital systems in the country -- HCA Healthcare, CommonSpirit Health, and Ascension -- were in compliance."  MORE >>

"CBO used a general-equilibrium, overlapping-generations model to analyze the economic and distributional implications of five illustrative single-payer health care systems. The working paper builds on previous CBO studies about single-payer health care systems."  MORE >>

"[The court] concluded that Bristol had standing to raise the ERISA claims alleged in the Complaint, even though it was neither a plan participant nor a medical provider with an assignment from a participant -- but instead purchased the right to raise the claims in question from the bankrupt medical provider's assets." [Bristol SL Holdings, Inc. v. Cigna Health and Life Ins. Co., No. 20-56122 (9th Cir. Jan. 14, 2022)]  MORE >>

"A significant and worrying number of workers are forced to make hard choices and sacrifices with regard to their health care. Concerns over health care costs are driving employees' need for greater access to mental and behavioral health services.... [E]mployees are willing to give up benefit plan features that were once considered untouchable if they can expect significantly lower costs in return.... Fortunately, each point is actionable."  MORE >>