"Unless [the ARPA] expansion is extended, the upper income limit (400% of the federal poverty line (FPL)) will return for 2023 and the percentage that must be paid for Exchange coverage will increase across household income bands as reflected in this revenue procedure."  MORE >>

"Insurers and plan providers may find that the valuable data they have been expecting from hospitals is already obsolete. Inaccurate data may lead to providers being unable to set appropriate reimbursement rates or offer accurate hospital rate information for their members. This phenomenon could lead to a strain on the historically close relationship between hospitals and insurers."  MORE >>

"This article analyzes several employment law issues employers may face following the Dobbs decision.... Travel benefits for employees seeking reproductive care ... [1] Is the employer's benefit plan subject to ERISA? ... [2] What procedures does the plan cover? ... [3] Specific or 'general' travel stipends? ... [4] What about privacy concerns?"  MORE >>

"Although costs of family health insurance plans now exceed $21,000, people in the U.S. continue to receive poor outcomes from healthcare. [Employers] can insist on meaningful quality reporting from health plans and encourage them to implement provider payment and/or performance guarantees to reward higher quality care. Vendor reporting that includes race and other demographic variables can help identify the unmet needs of [plan] participants."  MORE >>

"As we inch closer to the federal legalization of cannabis, everyone is wondering, are my health plans going to start covering the cost of my medical cannabis? ... The first and biggest hurdle for cannabis coverage is that cannabis would need to be FDA approved.... If FDA approval were obtained, health plans would then focus on the cost of insurance benefits and other factors during the implementation of medical cannabis coverage."  MORE >>

"About 2,000 Kaiser Permanente Northern California mental health workers announced on Wednesday plans to start an open-ended strike on Aug. 15. The workers' union representatives cited high clinician workloads, with patients waiting weeks or even months for mental health care."  MORE >>

"The employer seemed to suggest Stanton's medical conditions weren't 'serious health conditions,' which trigger FMLA rights. The argument was a no-go.... [T]he college seemed to rely on the FMLA form being incomplete and not corrected within the seven-day window allowed by the regulations. But you need to read the entire rule: 'The employer must provide the employee with seven calendar days (unless not practicable under the circumstances despite the employee's diligent good-faith efforts) to cure any such deficiency.' " [Stanton v. Jarvis Christian College, No. 20-40581 (5th Cir., March 11, 2022)]  MORE >>

15 pages. "Many health plans apply prior authorization requirements in ways that create dangerous delays in care, contribute to clinician burnout and significantly drive up administrative costs for the health care system. Insurers often force patients to suffer through periods of ineffective treatment before permitting access to the most appropriate therapy.... Many commercial insurers leverage their market power and position to steer providers to purchase their auxiliary products that drive up administrative costs and line insurers' pockets."  MORE >>