Rev. June 2024. "What's New: Sections 4375 and 4376 patient-centered outcomes research fee increase. The fee for policy and plan years ending on or after October 1, 2023, but before October 1, 2024, is increased to the applicable rate of $3.22 multiplied by the average number of lives covered under the policy or plan. The fee for policy and plan years ending on or after October 1, 2022, but before October 1, 2023, remains at the applicable rate of $3.00, multiplied by the average number of lives covered under the policy or plan."  MORE >>

"[The updated FAQs] make clear that: [1] Covered entities affected by the Change Healthcare breach may delegate to Change Healthcare the tasks of providing the required HIPAA breach notifications on their behalf. [3] Only one entity -- which could be the covered entity itself or Change Healthcare -- needs to complete breach notifications to affected individuals, HHS, and where applicable the media. [3] If covered entities work with Change Healthcare to perform the required breach notifications in a manner consistent with the HITECH Act and HIPAA Breach Notification Rule, they would not have additional HIPAA breach notification obligations."  MORE >>

"The [Telehealth Modernization Act of 2024 (HR 7623)] largely seeks to continue Medicare's hospital-at-home program through 2029, which provides resources for at-home care for patients who need acute-level care. The Bill would also eliminate the geographic originating site restrictions on telehealth visits through 2026. Absent these changes, the programs will expire at the end of 2024."  MORE >>

"[E]mployers are not required to offer creditable prescription drug benefits, and there is no penalty for employers who do not. The impact is only to Medicare eligible employees or their eligible dependents who are not offered creditable coverage and who do not enroll in Medicare Part D when they are initially eligible for benefits."  MORE >>

"[A] federal lawmaker warned weight loss drugs have the potential to bankrupt the healthcare system, and new research from Blue Cross Blue Shield found nearly six in 10 patients taking the drugs don't reach a meaningful health benefit.... Weight loss medications such as Ozempic and Wegozy can cost upward of $10,000 a year. In 2022, Medicare spent $5.7 billion on the medications, up from $57 million in 2018 ... If half of Americans with obesity took weight loss drugs, it would cost $411 billion annually[.]"  MORE >>

"[The Council is] writing to request that Treasury and the IRS publish official guidance on which employer plan sponsors may rely affirming that the 100% excise tax under Internal Revenue Code Section 4976 does not apply to an employer's reallocation or repurposing of welfare benefit fund assets to provide other health and welfare benefits to employees and their beneficiaries. [The Council also recommends], at least in the interim, that Treasury and the IRS begin again to issue private letter rulings (PLRs) on the same and related issues, as needed."  MORE >>

"Rates of potentially preventable hospital admissions and readmissions ... are now widely used as measures of ambulatory care and hospital quality.  ... [The authors] trace the metamorphosis of the use of [ambulatory care sensitive condition (ACSC)-related] admissions from an access measure to use as a quality indicator of both ambulatory and inpatient care. We also question the validity of using ACSC admission rates as quality measures, especially to judge the performance of individual providers."  MORE >>

"[T]he 222nd open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans (also known as the ERISA Advisory Council) will be held on July 8-10, 2024.... The meeting will take place at the [DOL offices in Washington, DC] ... [and] will also be accessible via teleconference ... The purpose of the open meeting is for Advisory Council members to hear testimony from invited witnesses and to receive an update from [EBSA]. The Advisory Council will study the following topics: [1] Making Welfare Plan Claims and Appeals Procedures More Accessible to Participants, and [2] Lifetime Income and Qualified Defined Investment Alternatives (QDIAs)."  MORE >>

"The new law narrows several exemptions and exceptions to the statute.... First, the 'goodwill or ownership' exemption is now limited only to where 'the person signing the covenant purchases, sells, acquires, or disposes of an interest representing one percent or more of the business.' Second, the 'nonsolicitation agreement' exemption has been significantly narrowed."  MORE >>

"The FTC posits that all non-competes [1] are a method of competition as opposed to a condition of the marketplace, [2] are facially unfair because they are restrictive and exclusionary, and [3] tend to negatively affect competition in labor, product, and service markets. Thus, the FTC adopted a rule to ban non-competes entered into on or after the rule's effective date." [Ryan LLC v. FTC, No. 24-0986 (N.D. Tex. consolidated brief in response to motion for stay and preliminary injunction, filed May 29, 2024)]   MORE >>