9 pages. Patient-Centered Outcomes Research (PCORI) Fee to be reported on page 3.  MORE >>

"With the CMS release of the final CY 2025 Part D redesign program instructions, plan sponsors now have the necessary guidance to review the actuarial value of their prescription drug coverage versus the standard Part D coverage. This analysis will be particularly important for plan sponsors with [HDHPs] that passed 2024 Part D creditable coverage testing with low margins.... Fixes could include adjusting the deductible to or around the minimum HDHP deductible amounts, lowering the out-of-pocket maximum or reducing member coinsurance for prescription drugs."  MORE >>

"The final rule does contain more specific guidance and stronger safeguards than HHS originally proposed for entities seeking to invoke federal conscience and religious protections. This Sidebar begins by discussing the unique textual features of Section 1557 that have given rise to some of these legal questions, before turning to the 2024 rule and concluding with considerations for Congress." [LSB11169 May 28, 2024]  MORE >>

32 pages. "With regard to Medicaid and CHIP, the CAA 2024 includes numerous provisions related to mental health and substance use disorder.... With regard to Medicare, the CAA 2024 extends funding for quality measure endorsement, input, and selection for Medicare quality programs and for outreach and assistance to low-income beneficiaries. " [R48075 May 24, 2024]  MORE >>

"Under the proposed rules, United Health Group's internal process utilizing the algorithm would be subject to a three-part test, including ... [1] The no more restrictive requirement ... [2] The design and application requirement ... [3] The data evaluation requirement." [Ryan S. v. UnitedHealth Group, Inc., No. 22-55761 (9th Cir. Apr. 11, 2024)]  MORE >>

"[The court] found that the Plan language was unambiguous allowing for the offset of Social Security benefits 'resulting from the same Total Disability,' which required a causal relationship to the disability at issue. It found that Reliance's interpretation that the benefits were offsetable simply because the timing of the award of earned income benefits coincided with Plaintiff's disability was unconvincing." [Aisenberg v. Reliance Standard Ins. Co., No. 22: 0125 (E.D. Va. May 14, 2024)]  MORE >>

"[T]he rise in SUDs among the workforce is causing employers to take on more expenses related to the conditions. However, upstream interventions could be vital to creating a healthier workforce and reducing costs."  MORE >>