"[This article provides] a summary of the various requirements and reminders about where group health plans should be in terms of compliance to date.... Requirements effective for plan years beginning on or after January 1, 2022 ... Previous requirements ... Delayed requirements."  MORE >>

"The notice requirement applies to all employers who offer prescription drug coverage, regardless of size, whether insured or self-funded or ACA grandfathered status. It also applies whether the prescription drug coverage is standalone or integrated into another plan, such as a medical plan."  MORE >>

"A provision in the enacted state budget for fiscal year 2023 amends the Massachusetts Paid Family and Medical Leave Act (PFMLA) to provide employers and employees more flexibility to use other accrued benefits to supplement paid benefits received from the state."  MORE >>

"The court concluded that the portions of the Rule applicable to air ambulance providers 'rewrite[] clear statutory terms' by 'requiring [IDR entities] to presume the correctness of the QPA and then imposing a heightened burden on the remaining statutory factors to overcome that presumption.' " [LifeNet v. HHS, No. 22-162 (E.D. Tex. Jul. 26, 2022)]  MORE >>

"[T]he share of out-of-pocket costs paid by patients with employer-sponsored health plans increased from 17.4 percent in 2013 to 19 percent in 2019, before a pandemic-related decline to 16.4 percent in 2020.... The increase in the share of expenses paid out of pocket observed between 2013 and 2019 appears to be driven by an increase in the number of workers enrolling in plans with higher deductibles."  MORE >>

"There are thousands of procedure codes with prices attached, multiplied by thousands of doctors, labs and hospitals, layered over thousands of health-plan contracts. [One consultant] said he was dealing with 700,000 unique files for insurers' in-network prices. 'It's hundreds of terabytes, reaching petabyte scale,' [he said].... The analysis of this data is overwhelming and certainly costly...  Is it too skeptical to suggest that healthcare price transparency requirements will raise overall healthcare costs?"  MORE >>