"You may terminate a qualified beneficiary's COBRA coverage for submission of fraudulent claims if three requirements are met: [1] your health plan must permit you to terminate active employees' coverage for the same reason; [2] the plan must allow you to terminate COBRA coverage for cause; and [3] the plan's COBRA notices and communications must disclose the plan's right to terminate coverage for cause."  MORE >>

"Effective February 21, 2025, the Earned Sick Time Act (ESTA) applies to all employees in Michigan and covers employees not eligible for sick leave under the Paid Medical Leave Act (PMLA). The ESTA contains anti-retaliation and anti-interference provisions, and allows employees to bring a civil action against their employer for violation of the ESTA. Employers not previously covered by the PMLA should implement a sick leave policy in accordance with the ESTA, and employers who currently follow the PMLA should review their policies and revise them to comply with the ESTA."  MORE >>

"The IDR regulations remain in flux more than ever in the wake of the U.S. Supreme Court's Loper Bright decision nullifying the long-standing Chevron doctrine and emphasizing that courts must apply their own judgment in reviewing agency actions rather than deferring to agency interpretations of statutory requirements.' [Texas Med. Ass"n (TMA) v. HHS, No. 23-40217 (5th Cir. Aug. 2, 2024)]  MORE >>

"As of mid-2024, eight states have committed to a process to slow spending growth by establishing statewide targets for health care spending growth.... [In 2022,] Rhode Island was the only state to meet its spending growth target of 3.2 percent; it had the lowest rate of spending growth at 1.6 percent. Oregon's 2022 spending grew 3.6 percent, only slightly exceeding its 3.4 percent target. Connecticut also slightly exceeded its 3.2 percent target with spending growth at 3.4 percent. Meanwhile, Delaware and Massachusetts significantly exceeded their targets with 2022 spending growth of 6.3 percent and 5.8 percent, respectively."  MORE >>

"ICHRA enrollees may now account for a noticeable fraction of the 24.3 million Americans who had individual or family major medical coverage March 31, 2024.... [One] sign that some of the new individual enrollment could be ICHRA enrollment is that individual enrollment increased by 3.2 million during a year when the labor market was strong but reported enrollment in employer-sponsored group health plans fell by 1.5 million"  MORE >>

"While the overall significance of these investments to the health care sector is disputed, they have attracted regulatory, legislative, and academic interest, particularly in the midst of ongoing conversations about health care quality and costs.... This Legal Sidebar explores recent regulatory and enforcement activities involving private equity investments in health care under federal antitrust law and the False Claims Act, including efforts to hold private equity firms and funds directly liable alongside portfolio companies." [LSB11215 Aug. 8, 2024]  MORE >>

"The Senate version would appropriate $13.8 billion in total for the DOL, just shy of the $13.9 billion that Acting Secretary of Labor Julie Su requested in April. The Employee Benefits Security Administration (EBSA) would receive $206.1 million of that total, an increase from its 2024 budget of $191.1 million. Su had requested $205.7 million. The House version would provide $10.5 billion to the DOL and $181.1 million to EBSA."  MORE >>

"Employers should remain mindful that the notice requirement does not apply to the Rule's enumerated exceptions. That is, employers do not need to deliver notice to workers [1] who are considered highly compensated senior executives (as defined in the Rule) with existing noncompetes or [2] entered into a noncompete pursuant to the bona-fide sale of a business. Employers likewise do not need to deliver notice to a worker in a situation where causes of action related to an existing noncompete accrued before the final rule."  MORE >>