"[CMS has] released their 2024 updates to the Gag Clause Prohibition Compliance Attestation materials, including the instructions, the user manual, and the template for completing the attestation. The changes reflect some comments and challenges with the attestation template that emerged over the last few years."  MORE >>

"Houston County made a number of failing arguments that are important lessons for employers with similar exclusions under their health plans: [1] Lange was able to get coverage elsewhere ... [2] Houston County was not Lange's employer ... [3] The Health Plan was 'just a cheap plan'." [Lange v. Houston County, Georgia., No. 22-13626 (11th Cir. May 13, 2024)]  MORE >>

"At the heart of the dispute was the guidance released by HHS in December of 2022 and then updated again in March of 2024, which suggested that information collected from unauthenticated website visitors could be considered protected health information (PHI) under HIPAA. The Guidance was challenged by hospitals and healthcare providers who argued it exceeded HHS' statutory authority under HIPAA and imposed unreasonable compliance burdens." [American Hospital Association v. Becerra, No. 23-1110 (N.D. Tex. Jun. 20, 2024)]  MORE >>

"[The court explained] that even if CEO knew where the plaintiff lived, there was no evidence that the CEO knew that the plaintiff could not also receive mail at the address that was on file. Further, ... to act on such knowledge, the CEO would have had to reach out to the employee and instruct him to change his address or to unilaterally change the address in the health insurance system without the employee's permission. It ruled that, 'Good faith does not require such measures.' " [Anaya v. Birck, No. 21-2624 (N.D. Ill. May 15, 2024)]  MORE >>

"The Department has publicly announced four settlements with group life insurance carriers relating to [evidence of insurability (EOI)].... The settlement agreements make clear the Department's view that group life insurance carriers have a fiduciary duty pursuant to ERISA to ensure that eligibility determinations for coverage requiring EOI are made at or near the time the carrier receives premiums for such coverage."  MORE >>

"Some employers view these programs as providing additional compensation to those who waive coverage. In doing so, they generally are of the view that (a) an opt-out payment costs less than covering an employee on the health plan, and (b) employees who enroll in coverage receive greater total rewards than those who waive, and the opt-out payment levels the playing field."  MORE >>

"Using exposure to price increases caused by horizontal hospital mergers as an instrument, [the authors] show that rising prices raise the cost of labor by increasing employer-sponsored health insurance premiums. A 1% increase in health care prices lowers both payroll and employment at firms outside the health sector by approximately 0.4%.... [A] 1% increase in health care prices leads to a 1 per 100,000 population (2.7%) increase in deaths from suicides and overdoses."  MORE >>

"Although only a small -- albeit growing -- share of businesses offer individual coverage health reimbursement arrangements, or ICHRAs, to their workers, insurers such as Oscar Health, Centene and Highmark are gambling they are the wave of the future as employers strive to contain healthcare spending."  MORE >>

"HR leaders should recognize that a diagnosis of ASD may require greater utilization of health benefits for treatment.... [and should] ensure that benefits packages cover essential therapies like Applied Behavior Analysis (ABA) -- a gold standard treatment for autism.... Telecommuting, flex hours, and part-time work options can give parents the free hand they need to be there for their children.... Employee Assistance Programs (EAPs) offer a lifeline for parents ... providing much-needed support and guidance when the weight of it all feels too heavy to bear."  MORE >>