"Among other changes, the proposed rule would: [1] Reapply Section 1557 to many health insurers and some third-party administrators (TPAs) ... [2] Interpret Section 1557's ban on sex discrimination to include sexual orientation, gender identity, and pregnancy-related conditions ... [3] Reinstate and expand notice requirements to enable access to language assistance services and auxiliary aids and services ... and [6] Require covered entities to post information about Section 1557 and nondiscrimination at its locations and on its website."  MORE >>

"Now in their third iteration, these regulations are full of detailed rules and explanations that may again become a lightning rod for litigation. Group health plan sponsors, insurers, TPAs, and advisors may wish to submit comments ... Meanwhile, HHS emphasizes that Section 1557 and the 2020 regulations remain in effect."  MORE >>

72 pages. "[S]ome cost-saving measures can actually increase overall healthcare costs and absenteeism, while also reducing productivity and causing other adverse consequences. This Toolkit is designed to help explain the unintended consequences of increasingly common prescription drug cost control measures and offer recommendations on how to structure prescription drug benefits to protect your employees who need access to these medications."  MORE >>

"health insurers have posted their pricing data on public websites, but the sheer size of these databases has made it difficult for consumers to access, much less understand.... So far, it's difficult for patients to see the prices under their specific plan or even different plans offered by one insurer. Employers also cannot easily use the information to compare their insurers' negotiated rates with others'."  MORE >>

"[S]ome patients are encountering issues with access to the common drug, methotrexate due to its possible use as an abortifacient. Methotrexate is commonly used to treat patients with rheumatoid arthritis ... Prescriptions for misoprostol, which can be used for gastric ulcers, as well as mifepristone, which has benefits in Cushing's syndrome, are also being spotlighted[.]"  MORE >>

"For employers, the first step may be the hardest ... Employers must determine how the Dobbs decision impacts their various constituencies (employees, customers, shareholders) and how to respond. Geography may play a role. Policy decisions by labor market competitors may play a role. And your population of employees and prospective employees may play a role because your decision could impact recruitment and employee retention. Employer decisions can also be influenced by the level of employee engagement regarding abortion coverage, the associated costs of offering additional benefits, and the potential legal risk involved."  MORE >>

"Put it in writing.... Look for tax caps.... Don't forget the Truth in Lending Act (TILA) or the Fair Debt Collection Practices Act (FDCPA).... Income-Share Agreements (ISA) are considered 'credit' under TILA.... Check state law before requiring a non-compete agreement or repayment requirement."  MORE >>

"Initially, the employer had reserved the right to amend or terminate its welfare benefit plan at any time. In 1969, however, the employer removed the earlier reservation of rights to amend or terminate the retiree life insurance ... In 1984, the employer inserted a new reservation of rights clause ... In 2015, the employer terminated the retiree life insurance coverage.... [The Fourth Circuit] ruled that while the 1984 amendment allowed the employer to modify or terminate the retiree life insurance coverage, it did so only for those plan participants hired after the amendment's adoption in 1984." [Bellon v. PPG Emp. Life & Other Benefits Plan, No. 21-1812 (4th Cir. Jul. 15, 2022)]  MORE >>

"With the COVID-19 pandemic now entering its third year, plans should have well-established processes to ensure compliance with the diagnostic testing coverage requirements. It is noteworthy that this provider set its cash price for COVID-19 diagnostic tests at more than $900. It would be helpful if the agencies would issue guidance to combat apparent profiteering by certain providers." [Saloojas, Inc. v. Aetna Health of Calif., Inc., No. 22-1703 (N.D. Cal. June 23, 2022)]  MORE >>