"Form 1095-A is used to report certain information to the IRS about individuals who enroll in a qualified health plan through the Health Insurance Marketplace. Form 1095-A is also furnished to individuals to allow them to take the premium tax credit, to reconcile the credit on their returns with advance payments of the premium tax credit, and to file an accurate tax return." [Also see: 2022 IRS Form 1095-A]  MORE >>

"[FAQs Part 55] clarified employers are not required to post a link to the data files on their organization's website if there is a written agreement in place that ensures that the carrier or administrator will make the relevant files publicly available in compliance with the requirements.... There is currently no specific guidance on what constitutes a valid written agreement between the employer and their carrier or TPA. Employers may be able to meet this requirement in a variety of ways."  MORE >>

"[CMS] recently posted a number of FAQs that should ease the prescription drug data collection (RxDC) reporting burden for employers sponsoring complex group health plans.... Regulators confirmed that they will accept multiple data files of the same type from the same group health plan ... if there are 'extenuating circumstances' preventing vendors from working together. CMS wants to use the plan-specific files to connect a particular group health plan with the multiple data files submitted by its vendors, and provides sample P2 files for a variety of situations."  MORE >>

"Beginning January 1, 2023, employees throughout California will be able to use sick leave or take leave under the California Family Rights Act (CFRA) to care for a 'designated person' ... defined as any individual related by blood or whose association with the employee is equivalent to a family relationship. An employee can designate this person at the time they request leave."  MORE >>

"The previous version of SPSL was passed in February 2022 and required employers with 26 or more employees to provide additional paid leave for certain COVID-19-related reasons. This law was scheduled to expire on September 30, 2022.... While SPSL will now be available through the end of the year, AB 152 does not provide an additional bank of time to those employees who may have already exhausted their allotted SPSL for the year."  MORE >>

"Despite the Supreme Court's decision in June and CMS's subsequent acknowledgement that the CY2022 cuts would need to be repaid, the agency was still reimbursing Affected Covered Entities at the reduced ASP -- 22.5% rate for 340B drugs billed." [American Hospital Assoc. v. Becerra, No. 18-2084 (D.D.C. Sep. 28, 2022)]  MORE >>

"[T]he American health care system has joined with commercial partners to define a medical condition -- in this case, sleep apnea -- in a way that allows both parties to generate revenue from a multitude of pricey diagnostic studies, equipment sales, and questionable treatments.... Like so much of U.S. health care, sleep medicine turns out to be a thriving industry."  MORE >>

"All too often, plan sponsors assume they have little opportunity to control or reduce their healthcare spend. They accept the status quo and do not challenge brokers who are receiving financial incentives to keep them in poorly managed arrangements with specific insurers. Dave Chase's book, Relocalizing Health ... outlines a 5-step process called LOCAL that a plan sponsor can implement to better manage the health of their workforce and their healthcare spend[.]"  MORE >>