"[F]or HDHPs with plan years beginning on or after January 1, 2022, this temporary relief generally does not apply to telehealth services that occurred from January 1 through March 31, 2022, and such telemedicine visits must be subject to the HDHP minimum deductible. Plan sponsors are permitted but not required to adopt this temporary relief."  MORE >>

"Previously, CMS extended this nonenforcement policy to eligible individual and small group market plans, commonly known as 'grandmothered plans,' one year at a time. This year's open-ended extension may reflect a policy shift--or simple pragmatism. Grandmothered plans are distinct under the ACA from 'grandfathered plans,' which are plans that were in existence on March 23, 2010, and have not undergone certain prohibited changes[.]"  MORE >>

"Ryan S. claimed that United created barriers to accessing substance use disorder care and wrongfully denied payment of covered benefits in violation of ERISA and the federal [MHPAEA] ... [T]he district court ... granted United's motion to dismiss on jurisdictional grounds, contending that Ryan S. lacked standing to challenge any of the six allegedly illegal practices he had identified. Ryan S. appealed. The Ninth Circuit addressed each of the practices individually and concluded that three were sufficient to grant him standing, but three were not." [Ryan S. v. UnitedHealth Group, Inc., No. 20-56310 (9th Cir. Mar. 24, 2022; unpub.)]  MORE >>

"Enforcement actions are handled by the DOL and the [CMS], ... and regulators are signaling that they plan to step up their activities. DOL investigations are triggered by employee complaints, Kirschbaum said, and those complaints can also lead to class-action lawsuits."  MORE >>

"In a report and accompanying dataset released Friday, the Oregon Health Authority showed that in 2019, commercial insurers paid Oregon hospitals double what Medicare paid for the same services.... This means employer-sponsored plans pay far more for hospital services, which costs businesses more in premiums, and costs people more in deductibles, co-pays and other out-of-pocket expenses."  MORE >>

"A majority of the public (61%) say limiting how much drug companies can increase the price of prescription drugs each year to not surpass the rate of inflation should be a 'top priority' for Congress. Slight majorities also say capping out-of-pocket costs for insulin at $35 a month (53%) and placing a limit on out-of-pocket costs for seniors (52%) are top priorities for Congress to take action on in the coming months. Majorities across partisans say many of the health care priorities asked about are important for Congress to work on in the coming months."  MORE >>

"If your company has invested in a benefits decision support tool or is considering it, it's easy to focus solely on its function for open enrollment. However, ... there are several ways it can provide significant value year-round. If you're not continuously encouraging your employees to use it, you're leaving money on the table in terms of return on investment, not to mention overlooking opportunities to reduce stress, save money, and increase employee satisfaction."  MORE >>

"Employees may bypass benefits -- especially voluntary and nontraditional benefits -- because they don't understand them and the need they fill, or the enrollment process just seems too difficult or inconvenient.... The good news is there are proven best practices you can implement to create more effective communication and easier enrollment processes."  MORE >>