"[1] Speak with insurers and third-party administrators to understand whether, and to what extent, the coverage provided is offered in compliance with the non-discrimination requirements, as detailed in the 2024 HHS rulemaking.... [2] Confirm that, absent a religious freedom and conscious exemption, the plan does not enforce a blanket restriction or any types of nominal restrictions prohibiting plan-level coverage of healthcare benefits related to the treatment of gender dysphoria ... [3] Understand the Section 1557 complaint process, including submission, evaluation, retaliation, and disposition."  MORE >>

"In light of a recent final rule issued by HHS, all group health plans will need to update their Notice of Privacy Practices and redistribute the updated notice by February 16, 2026 to incorporate [1] notice requirements for covered entities creating or maintaining records protected under 42 CFR part 2 (related to substance use disorder patient records) and [2] a description of the new prohibition on use or disclosure of certain protected health information related to reproductive health care."  MORE >>

"The Office of Personnel Management issued its final rule establishing the health benefits program for U.S. Postal Service employees, annuitants and beneficiaries, offering small clarifications ahead of an anticipated Jan. 1 rollout.... The final rule ... clarifies portions of the regulation concerning enrollment in Medicare Part B, which newly eligible retirees will be required to accept as their primary coverage from the plan."  MORE >>

"Effective January 1, 2025, New York employers will be required to provide paid prenatal leave to eligible employees during their pregnancies.... Key steps for employers include: [1] Updating employee handbooks and leave policies ... [2] Training managers and HR staff ... [and] [3] Ensuring payroll systems are configured to properly administer prenatal leave pay[.]"  MORE >>

"[T]his cap will apply to 'health care entities,' which include providers such as hospitals, facilities, outpatient clinics, large physician groups and clinical laboratories, payors and fully integrated delivery systems.... [T]he cost target for 2025 is non-enforceable. For years 2026 and after, however, OHCA will have the authority to take enforcement action against health care entities that exceed the boundary of the target."  MORE >>

"Last year, the General Assembly passed an amendment to the law that, among other things, delayed collection of contributions and benefit payments for a year. Jackson Lewis detailed that amendment's notable changes. During the latest legislative session, lawmakers passed SB485, making additional modifications and setting new dates for contributions and benefits under the Program."  MORE >>

24 pages. "[O]ver one-third of respondents were integrating accountable care strategies that pay for quality over service volume into their ESI.... In the context of making health benefit decisions, respondents ranked expanding preventive care, increasing access to primary care, and focusing on whole-person health as the top three tenets of accountable care.... Mental health resources are a focus for future enhancements, with greater than 20 percent of respondents intending to primarily enhance these resources in the next few years."  MORE >>

"The decision eliminates an option that was geared toward bringing primary care to residents of underserved markets.... For the strategy to succeed, ... Walmart would have had to overcome recent systemic trends.... Legacy providers are dealing with the same headwinds but generally have more margin for error."  MORE >>

"[The authors] recommend that the agencies collect and make available systematic, high-quality data on the ownership structures of health care entities, with a particular focus on improving the data available on physician practices.... [CMS] should collect systematic data on physician practice ownership as part of the Medicare enrollment process, as it does for institutional providers.... CMS should take steps to improve the quality of entity-reported data."  MORE >>

"[The] main takeaway from the [DOL's] fact sheet, budget, and the stated Enforcement Projects, as well as recent experience with DOL investigations, is that the following areas may be of particular focus during future DOL investigations: [1] Cybersecurity and participant data issues.... [2] Missing participants ... [3] Illiquid and hard-to-value assets, including private equity and alternative investment classes (such as cryptocurrency) in both defined benefit and defined contribution plans.... [4] Mental health parity and MHPAEA enforcement.... [5] Proper use of plan forfeitures.... [5] Evidence of insurability issues[.]"  MORE >>

"The court ... noted that while Section 502(a)(2) claims may be asserted by an individual, they are brought in a representative capacity on behalf of the plan and seek plan-wide relief. Thus, with his Section 502(a)(2) claim, Cedeno was not simply seeking a remedy for losses in his particular account; he was seeking a remedy on behalf of the plan that would affect the accounts of others as well and perhaps lead to non-monetary equitable relief." [Cedeno v. Sasson, No. 21-2891 (2d Cir. May 1, 2024)]  MORE >>

"Within 24 hours of the FTC voting to approve the Final Rule, several entities ... filed lawsuits against the FTC in the Federal Court seeking injunctions to postpone the Effective Date and to invalidate the Final Rule. Additional lawsuits have been filed, and are anticipated to be filed, by other interested parties."  MORE >>

"The trustees project that the reserves of the combined Social Security trust funds will be depleted in 2035 and Medicare's Hospital Insurance (HI) trust fund in 2036. For HI, that's five years later than in last year's report. For Social Security, it's one year later.... The trustees' new projections, like those of the Congressional Budget Office, show a long-run financing problem that needs to be addressed, but the programs are not 'bankrupt,' as some critics charge."  MORE >>