"Plan sponsors and administrators should ... consider whether they intend to allow previously mandated COVID-19 benefits to lapse after the PHE ends or to voluntarily continue them as-is or in a revised form (e.g., by imposing cost-sharing on COVID-19 testing) for some period of time, as well as whether to continue benefit plan deadline tolling."  MORE >>

"As plan sponsors are in the midst of preparing for the COVID-19 national emergency (NE) and public health emergency (PHE) to end on May 11, 2023 ... President Biden now appears likely to sign legislation that will terminate the NE sooner.... [Once signed, the measure] will start the clock for purposes of unwinding the NE-associated health plan participant relief. Importantly, the legislation does not affect the scheduled end of the PHE."  MORE >>

"[Memorandum GC 23-05] seeks to clarify the scope of the McLaren Macomb decision, including: the types of provisions that may violate the NLRA; language that may be acceptable in light of the decision; whether the decision applies retroactively to previously executed severance agreements; and the potential applicability of the decision to supervisors. The memorandum is not legally binding, but it does give employers a more informed roadmap for how the Board initially will handle unfair labor practice charges challenging severance agreements."  MORE >>

"The final judgment does not impact all of the ACA preventive service requirements. Specifically, the ACIP (immunizations/vaccines) and the HRSA (women's preventive care recommendations, including the contraceptive coverage requirements and preventive screenings for children) are not changed by this ruling.... For insured coverage, the terms of the insurance policy likely provide that such coverage will continue without cost-sharing until the policy renews; state laws may also limit changes to insured coverage mid-policy." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Mar. 30, 2023)]  MORE >>

"The practical effect of this Texas decision remains to be seen.... Generous first-dollar benefits for preventive services already were common before the ACA, and employer commitment to workforce health and wellness has only grown in recent years. It's also difficult to 'take back' a popular benefit like free preventive services." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Mar. 30, 2023)]  MORE >>

"The Justice Department [has appealed] a federal judge's decision to invalidate the [ACA] requirement for free coverage of specified preventive health services.... The move kicks off a legal process that could wind up at the Supreme Court and has financial implications for some 150 million Americans on employer-sponsored health plans." [Braidwood Management, Inc. v. Becerra, No. 20-0283 (N.D. Tex. Mar. 30, 2023; notice of appeal filed Mar. 31, 2023)]  MORE >>

"Savings from prescription drug biosimilars are expected to exceed $180 billion over the next 5 years -- a more than 4-fold increase from the last 5 years. Drug costs for biologic drugs with a biosimilar competitor are down between 18% and 50% per unit."  MORE >>

"[Milliman's] review of the COPD population ... showed that approximately 40% had severe COPD and were responsible for approximately 58% of the total cost attributed to the COPD population. Results from this figure can be used to identify the severity mix of the COPD population, which can be important information for planning."  MORE >>

"Along with Colorado and Connecticut, other states that have implemented or are considering limits on facility fees are Indiana, Minnesota, New Hampshire, Ohio, Texas, and Washington. Those measures include collecting data on what facility fees hospitals charge, prohibiting add-on fees for telehealth, and requiring site-neutral payments for certain Medicaid services. A federal bill introduced in 2022 would require off-campus hospital outpatient departments to bill as physician providers, eliminating the possibility of charging facility fees."  MORE >>