"The COVID-19 pandemic has intensified interest in telehealth services among health care providers and health plans. Telehealth raises numerous legal issues, and OCR's proactive approach to HIPAA guidance has provided welcome clarity to providers and plans."  MORE >>

"Illinois Governor J.B. Pritzker recently signed into law two bills addressing employee leave. The Family Bereavement Leave Act (FBLA) provides eligible employees with unpaid time off to grieve the death of a family member covered by the act, and it provides employees with time off due to certain pregnancy- or adoption-related events. A recently enacted amendment to the Employee Sick Leave Act (ESLA) sets minimum standards in a negotiated collective bargaining agreement."  MORE >>

"The proposed budget reflects a substantial and sustained commitment to ramp up enforcement efforts, with specific funding for MHPAEA audit activity, including $275 million for the [DOL] over a 10-year period and $125 million for state grants to support their MHPAEA enforcement efforts."  MORE >>

"ERISA claims administrators and courts often hold plan participants and beneficiaries strictly to time limits and other plan-imposed or regulatory requirements and cut off their rights when they fail to meet these requirements. In this decision, the Second Circuit rules that insurance companies and other claims administrators must likewise meet regulatory time limits or suffer the consequences of their failure to do so." [McQuillin v. Hartford Life and Accident Ins. Co., No. 21-1514 (2d Cir. Jun. 7, 2022)]  MORE >>

"[T]he Seventh Circuit reversed, holding that a manager's threat of discipline for taking leave would be unlawful interference with FMLA rights even if the leave were not actually denied.... The court explained that an employer will be found to unlawfully impede access when an employee suffers harm from the employer's action, and this harm can result from an actual denial of leave or discouragement of taking it." [Zicarelli v. Dart, No. 19-3435 (7th Cir. Jun. 1, 2022)]  MORE >>

"The Hi-Lex decision likely made many TPAs uneasy, so they will appreciate that this court has called the Sixth Circuit's reasoning into question. Plans and TPAs will want to keep an eye on this case. The plan has appealed to the First Circuit, which may reach a different conclusion, potentially leading to a circuit split and consideration of the issue by the U.S. Supreme Court.' [Mass. Laborers" Health and Welfare Fund v. Blue Cross Blue Shield of Mass., No. 21-10523 (D. Mass. Mar. 30, 2022)]  MORE >>

"In a 9-0 ruling, the Supreme Court said CMS didn't have the authority to lower drug reimbursement rates for 340B hospitals as it did in 2018 and 2019. CMS still may be able to reduce the reimbursement rate in future years if it follows certain procedures. Questions surround the pending determination of the remedy owed to hospitals after Wednesday's ruling." [American Hospital Association v. Becerra, No. 20-1114 (S. Ct. Jun. 15, 2022)]  MORE >>

"While the Court's decision did not address the merits of 'discriminating against' the 340B Program hospitals, the decision seems to suggest that CMS could have made such adjustments had it complied with the statutory survey requirement. This suggests that the 2020, 2021, and 2022 payment reductions, done in accordance with hospital survey data, may still hold." [American Hospital Association v. Becerra, No. 20-1114 (S. Ct. Jun. 15, 2022)]  MORE >>