"This Carrier Letter includes instructions for all Federal Employees Health Benefits (FEHB) Carriers that offer High Deductible Health Plans (HDHPs) or Consumer Driven Health Plans (CDHPs) and currently have enrolled Postal Service employees, Postal Service annuitants and their eligible family members.... This letter concerns treatment of FEHB plan Health Reimbursement Arrangement (HRA) or similar reimbursement credits that may be offered under such FEHB plans.... Health Savings Accounts (HSAs) are excluded from the requirements discussed in this letter."  MORE >>

"This Carrier Letter announces the 2026 Clinical Quality, Customer Service, and Resource Use (QCR) Measure Set that will be scored as part of the 2026 Plan Performance Assessment (PPA). Attachment 1 is a chart displaying the complete QCR Measure Set."  MORE >>

"Expenses for OTC items (other than medicines or drugs) may qualify as medical care only if they are 'primarily for' the prevention or alleviation of a physical or mental defect or illness. Expenses that merely benefit general health, on the other hand, are considered personal expenses and will not qualify as medical care expenses.... Employers that sponsor health FSAs or HRAs may design their plans to define the medical care expenses that are eligible for reimbursement more narrowly than what is permitted under Code Section 213(d) and the CARES Act."  MORE >>

"The FMLA permits one of four methods to define the 12-month period (leave year) ... The FMLA and state leave laws vary on intermittent bonding leave.... States rarely invoke married couple limitations.... The rule can also be circumvented.... Use of the key employee rule is rarely advisable, as the test for economic injury is hard to meet, and timely determinations and notices are cumbersome."  MORE >>

"In July 2024, three federal district court judges blocked enforcement of several Section 1557 nondiscrimination provisions, which prohibit discrimination within certain health programs and activities for those who have protected health status, including race, color, national origin, sex, disability, and age. These cases lead the way for what is likely to be an onslaught of litigation redefining the regulatory landscape now that Loper Bright has removed the 1984 Chevron doctrine."  MORE >>

"56% of hospitals providing at least one shoppable service which requires public price reporting did not report any prices. Of hospitals reporting prices, most hospitals (66%) report prices for only a portion of the services they provide. In addition, 12% of hospitals reported prices for services they do not provide. Only 6% of hospitals had complete concordance with price reporting and services they actually provide. Current compliance enforcement and penalties do not appear adequate to achieve the goals of the Hospital Price Transparency Rule."  MORE >>

"Since Medicare doesn’t disclose the net price it pays for drugs, it’s hard to ascertain the exact savings that were gained through negotiations.... [F]or all their opposition, many [drug company] executives told shareholders and analysts the final price offers won’t materially impact their companies’ respective bottom lines."  MORE >>

"[CMS] has reported that the reduction in spending associated with the new negotiated prices amounts to $6 billion evaluated at 2023 volumes of prescriptions. [This] analysis examines the differences in the prices that were realized through negotiation by Part D plans and those obtained through the IRA's negotiation program for the 10 drugs selected for those negotiations."  MORE >>

"The distribution of parental leave uptake and childcare activities continues to conform to traditional gender roles.... [G]iving each parent a non-transferable endowment of parental leave or only paying for the length of time equally taken by each parent would both dramatically increase men's share whereas decreasing childcare costs has almost no effect."  MORE >>