"[CMS] is issuing this memorandum to highlight upcoming requirements regarding pharmacy price concessions effective January 1, 2024. [CMS reminds] Part D plan sponsors and/or their pharmacy benefit managers (PBMs) that CMS strongly encourages them to make necessary cash flow arrangements with network pharmacies in preparation for these upcoming changes."  MORE >>

"With a total entitlement of up to 80 hours of paid time off per 12-month period, the new Ordinance is one of the most generous paid time off laws in the country and will likely require policy changes for all Chicago employers prior to the end of the year.... The Ordinance applies to all employers with employees in Illinois."  MORE >>

"As the Ordinance's December 31, 2023 effective date approaches ... [1] [E]mployers should immediately review their existing paid leave and paid sick leave policies to ensure they meet or exceed the Ordinance's requirements, and prepare any updates as needed. [2] Employers should also ensure that their payroll or other systems are prepared to identify employees' paid time off balances, as required by the Ordinance, in addition to issuing other required notices and policies."  MORE >>

"SB 616 expands California's sick pay law in several important ways, including by increasing the amount of paid sick leave an employee is entitled to accrue from 24 hours/three days to 40 hours/five days (whichever is greater), increasing the accrual cap on paid sick leave, and extending coverage of the law to employees covered by a qualifying collective bargaining agreement."  MORE >>

"[E]mployers should be aware that they may have fiduciary duties under ERISA with respect to the use of any proceeds from the settlement fund.... Unless specific guidance is issued related to the BCBSA settlement, employers may want to use the [DOL's] MLR guidance as a reference when determining how to calculate what portion of the BCBSA settlement proceeds should be considered 'plan assets,' and how those funds can be used." [ In re: Blue Cross Blue Shield Antitrust Litigation MDL 2406, No. 22-13051 (11th Cir. settlement agreement approved Oct. 25, 2023)]  MORE >>

"Among survey respondents, 76% provide GLP-1 drug coverage for diabetes, 27% provide coverage for weight loss, and 13% are considering covering for weight loss.... Those who are covering GLP-1 drugs are relying heavily on utilization management (79%) to control costs. A less common approach (32%) is step therapy. Fourteen percent of employers have no cost control mechanism in place."  MORE >>

"The sheer volume of Amazon Prime members and the ability for them to add others to their One Medical subscription means that a very large fraction of the American population is now able to access care provided by One Medical at a discounted rate.... [It] is possible that [Amazon] could eventually disrupt the status quo by undercutting mainstream providers on price and becoming a leader in virtual healthcare delivery."  MORE >>

"Despite all of the hard work that was put into the House PBM/Transparency/Data-Sharing legislative package ... coupled with the 'wait' of over three months now ... the Transparency and Data-Sharing requirements included in the House package are less likely to become law at this point in time. That said, there is a strong likelihood that the PBM reforms make their way into the law by the end of the year or at least by the end of the second quarter of 2024."  MORE >>

"This is the age of information overload: don't assume that means everyone knows and understands what your message is about.... Are you placing an over reliance on one form of employee communication to the exclusion of all others? ... Transparency builds trust and helps eliminate the blank spaces that will be surely filled in with assumptions, rumors and misinformation."  MORE >>