"The mid-year update of the DOL Children's Health Insurance Program (CHIP) Model Notice for Employers Regarding Premium Assistance Opportunities typically marks the unofficial start to the protracted health and welfare plan annual notice season for the upcoming year. However, given the uncertainty surrounding the Medicare Part D Notice of Creditable Coverage changes taking effect in 2025, employers should consider addressing the annual notice materials with haste this year to avoid any employee anxiety."  MORE >>

"One of the most notable updates in the 2024 Final Rule applies to the use of artificial intelligence, and clinical algorithms in healthcare 'Patient Care Decision Support Tools' (PCDST).... PCDSTs often deliver services through digital platforms like health care apps, telehealth platforms, and patient portals, and can be built into a provider's electronic health record system. Under the Final Rule, health programs and activities must prevent discrimination not only in their physical practice, but also when utilizing PCDSTs."  MORE >>

"[T]he Fifth Circuit reversed the district court's nationwide injunction enjoining enforcement of the USPSTF preventive services mandate on procedural grounds. The Fifth Circuit also remanded the case to the district court to consider the constitutionality of the preventive services mandate with respect to [ACIP] recommendations on immunizations for routine use and [HRSA] recommendations on preventive care and screening for women and children."
[Braidwood Mgmt, Inc. v. Becerra, No. 23-10326 (5th Cir. Jun. 21, 2024)]  MORE >>

13 pages. "Why prices remain unknown ... What do we mean by health care price transparency? ... Where do Pharmacy Benefit Managers (PBMs) come in? ... Legislative and regulatory changes ... Risks associated with increased transparency ... Who is considered a fiduciary? ... Steps you can take to leverage increased health care pricing transparency."  MORE >>

"CFOs will need to examine stricter strategies to stay ahead and be prepared for tough contract negotiations with payers. The top three factors for rising costs are: inflationary pressures, prescription drug costs and increased utilization in behavioral healthcare."  MORE >>

"Booming sales of Novo Nordisk's Ozempic and Wegovy and Eli Lilly's Mounjaro and Zepbound have led to widespread shortages of GLP-1 treatments.... San Diego-based Viking Therapeutics is accelerating development of its own injectable GLP-1 treatment after receiving positive feedback from the [FDA].... Pill versions of the injectable GLP-1 treatments are under development.... Even if Viking's new treatment makes it to the market on its newly accelerated timeline, it still won't be available until 2029"  MORE >>

"By the time these enhanced subsidies are currently set to expire at the end of next year, they will have been an integral part of the ACA Marketplaces for 5 years, or nearly half as long as the ACA Marketplaces have existed.... Enhanced subsidies have cut premium payments by an estimated 44%. ... Without these enhanced subsidies, premiums would double or more, on average, for subsidized enrollees in 12 states using Healthcare.gov."  MORE >>

"From a regulatory perspective, this decision means federal agencies (for example, the EEOC, IRS, DOL, and HHS) will need to adhere more closely to the plain language of applicable legislation.... [A] separate case ... allows challenges to agency regulations within six years after the regulation first has an effect on a company (instead of six years after the regulation is final). This could mean that agency regulations that have been in existence for a while could be challenged by new employers that come into existence."
[Loper Bright Enterprises, Inc. v. Raimondo, Sec. of Comm., No. 22-451 (S. Ct. Jun. 28, 2024); Corner Post v. Bd. of Gov. of the Federal Reserve System, No. 22-1008 (S. Ct. Jul. 1, 2024)]  MORE >>

"The July 31, 2024 un-extended Form 5500 due date for calendar year employee benefit plans is fast approaching. Careful review of the Form 5500 with your professional advisors prior to signing under penalty of perjury and filing is advised. [This article provides] some reminders and observations relative to those reviews."  MORE >>