"This notice provides guidance for calculating the qualifying payment amount for items and services furnished in 2022 for purposes of sections 9816 and 9817 of the Internal Revenue Code, sections 716 and 717 of [ERISA], and sections 2799A-1 and 2799A-2 of the Public Health Service Act (PHS Act) in the case of a group health plan or group or individual health insurance issuer that does not have sufficient information to calculate the median of the contracted rates in 2019 (including for items and services not offered in 2019). This notice was drafted in consultation with the Departments of Labor and Health and Human Services."  MORE >>

"Businesses hoping to cash in on Department of Defense (DOD) appropriations in the Consolidated Appropriations Act, 2022 ... by contracting with DOD to perform functions currently performed by DOD civilian employees [will be required] to pay employer health plan contributions for workers that will perform the contracted services at the same rate as DOD would pay for services performed by its civilian employees."  MORE >>

"Telehealth services do not need to be preventative or related to COVID-19 to qualify for the relief. This relief is optional ... The relief will not apply for the period between January 1, 2022 and March 31, 2022."  MORE >>

"The new changes ... include a further limit on when employers may request a medical note for an absence and guidance on the use of sick leave for COVID-19 reasons. They also coincide with California's enactment of a new supplemental COVID-19 paid sick leave mandate, retroactive to January 1, 2022."  MORE >>

"Typically, over time, the plan sponsor has lower costs ... [P]lan sponsors have more flexibility in terms of covered benefits.... [Self-insurance provides] better access to employee claims data to see what's driving cost[.]"  MORE >>

"[T]his year, Pfizer forecast it will receive $54 billion revenue from its COVID vaccine and treatment, a sum larger than the combined revenue for all its other products.... In addition to funding research and development and extending purchase commitments, the government spent more than $100 million for manufacturers to increase their COVID vaccine production, $1 billion for their supplies and equipment, and $3 billion for contract manufacturers to perform aspects of the production process."  MORE >>

"[F]ew companies remind separating employees about the ability to convert their group life insurance coverage into an individual policy without the need for medical underwriting. For a separating employee with a medical condition ... the ability to convert their employer provided basic life insurance coverage may be the employee's only possibility to obtain or retain needed life insurance coverage."  MORE >>

"The Biden administration is expected to appeal Judge Kernodle's decision to the Court of Appeals for the Fifth Circuit but has not asked that his decision be stayed while the case is on appeal. This means the court's decision remains in effect and arbitration will proceed without the rule's guardrails.... [T]he government asked that two of the other five pending lawsuits in Georgia and Illinois be put on hold. Both courts agreed, and those lawsuits have been paused for at least 60 days." [Texas Medical Assoc. v. HHS, No. 21-0425 (E.D. Tex. Feb. 23, 2022)]  MORE >>

"Some of the adjustments potentially affect employer-sponsored health plans: [1] HIPAA Administrative Simplification ... [2] Medicare Secondary Payer.... [3] Summary of Benefits and Coverage (SBC).... The rule is effective March 17, 2022. The adjusted civil monetary penalty amounts apply to penalties assessed on March 17, 2022, if the violation occurred on or after November 2, 2015."  MORE >>

"Common exceptions where no BAA is needed involve, generally, disclosures to a healthcare provider for treatment purposes, and disclosures from a provider to a health plan for payment purposes."  MORE >>

"This Briefing Book features key findings from two dozen reports published in 2021-2022 ... by the [HHS] Office of the Assistant Secretary for Planning and Evaluation (ASPE) ... working in collaboration with [CMS] ... The Briefing Book also includes a report by the White House Council of Economic Advisors. The Briefing Book summarizes key findings in five areas: [1] Health coverage and uninsured rates; [2] Marketplace coverage; [3] Medicaid; [4] Preventive care; [and] [5] Populations of interest."  MORE >>