"States rely on several approaches for MHPAEA oversight, including the collection of access and utilization data  ... Regulators also evaluate insurers' comparative analyses of how they determine behavioral health benefits as compared to medical benefits.... Supplementing the law with strong standards to ensure adequate provider networks, combined with efforts to grow the behavioral health workforce, would further expand patient access to behavioral health treatment."  MORE >>

"OCR issued a model attestation form to use when requesting reproductive health information for [specified] purposes. The attestation form is only a model and is not legally required. Similar to a HIPAA authorization, attestations for reproductive health care information can be obtained and executed electronically."  MORE >>

"More employers must provide paid sick leave.... More employees are eligible for paid sick leave.... More sick leave must be provided."  MORE >>

"The Fifth Circuit noted that the NSA expressly requires IDR arbitrators, in deciding which party's offer to choose, to consider the QPA and certain information concerning other circumstances.... The Fifth Circuit reasoned that nothing in the NSA: Directed IDR arbitrators to weigh one factor or circumstance more heavily than the others. Authorized the Departments to 'superimpose' substantive requirements onto the NSA's clear and comprehensive provisions." [Texas Med. Ass'n (TMA) v. HHS, No. 23-40217 (5th Cir. Aug. 2, 2024))]  MORE >>

"As plan sponsors prepare for the 2025 plan year, most are deciding whether to limit coverage, place utilization management restrictions, or carve them out to a different third-party administrator (TPA).... When designing prescription drug benefits, there are a variety of compliance laws that impact whether and how an employer can restrict, manage, or eliminate coverage.... [P]lan sponsors should also consider the practical implications of limiting GLP-1 coverage for a particular condition[.]"  MORE >>

"In the past three years, four federal appellate courts have held that an employer may be required to offer paid leave for an employee's military service where the leave is comparable to paid leave offered by the employer for non-military reasons."  MORE >>

"The more than $560,000 in civil monetary penalties collected since March by the [HHS] Office of Civil Rights (OCR) from three HIPAA-covered entities for failing to respond to medical record requests within 30 days as required by the [HIPAA] right of access rule shows patients, their personal representatives and health care providers, health plans, health care clearinghouses the seriousness of OCR's commitment to enforcement of the Access Rule."  MORE >>

"In the case of an audit, the DOL has analyzed diverse types of outcomes data, such as denial or reimbursement rates. But -- and this is critical -- nothing in existing law requires comparability of outcomes.... The proposed rules upend current law by making differences in outcomes a strong indicator of noncompliance or, in the case of network composition, a conclusive determination of noncompliance."  MORE >>

"[T]he 223rd open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans (also known as the ERISA Advisory Council) will be held on September 10-12, 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 is studying 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 >>

"This detailed set of Frequently Asked Questions ... addresses the workplace-related issues facing employers in the wake of hurricane-related disasters. In addition to legal obligations ... [it] also addresses the practical questions that most often arise both while preparing [for] and in the aftermath of storms. The information contained here ... may be helpful following any natural catastrophe."  MORE >>

"The hot mess known as the FTC Rule to Ban Non-Competes continues to get hotter and messier as two Federal District Courts issue conflicting opinions. This conflict between the Federal Courts will not be resolved before the Rule's [effective] date of Sept. 4, 2024. Given the uncertainty over the Rule, [this] short Q&A ... provides the latest updates on the Rule and the options companies have regarding compliance."  MORE >>

"[1] Establish a benefits philosophy.... [2] Compare coverage with your peers.... [3] Listen to and learn from employees.... [4] Calculate the true benefit costs.... [5] Balance cost with long-term benefits for employees, the business, and you.... [6] Prioritize extended or enhanced benefits.... [7] Continuously adapt your benefits."  MORE >>