"California law will impose new obligations on in-state and out-of-state health care service plans (HCSPs) and disability insurers that use automated decision-making tools to analyze medical necessity in utilization reviews affecting California enrollees. Health care professionals -- not automated decision-making tools -- may deny, delay, or modify provision of health care based on medical necessity determinations. Noncompliance may result in civil and criminal penalties."  MORE >>

"Employees may now use Massachusetts Earned Sick Time to 'address the employee's own physical and mental health needs, and those of their spouse, if the employee or the employee's spouse experiences pregnancy loss or a failed assisted reproduction, adoption or surrogacy.' ... The change to the law will take effect November 21, 2024."  MORE >>

"[T]he District Court held that the guidance 'improperly creat[ed] substantive legal obligations for covered entities,' and that the 'the Proscribed Combination facially violate[d] HIPAA's unambiguous definition of IIHI.' ... OCR initially appealed the District Court's order to the Fifth Circuit; however, on August 29, 2024, OCR withdrew its appeal." [American Hospital Association v. Becerra, No. 23-1110 (N.D. Tex. Jun. 20, 2024)]  MORE >>

"This chart collection explores how health spending is expected to grow in coming years, based on National Health Expenditure (NHE) projections from federal actuaries. A related chart collection explores how U.S. health spending has changed over time using historical data, and an interactive tool allows users to explore health spending changes over time."  MORE >>

"In May, a survey ... found that 57% of employers covered GLP-1 drugs only for diabetes, while 34% also covered them for weight loss (up from 49% and 26%, respectively, in 2023). Among those offering coverage for diabetes, 19% were considering making coverage available for weight loss.... HR departments eventually may face more pressure to cover the drugs compared with most treatments ... because GLP-1s have become entrenched in mainstream conversations and social-media posts about health and wellness."  MORE >>

17 pages. "This report investigates the impact of [annual wellness visit (AWV)] utilization on Medicare Fee-For-Service (FFS) enrollees' cost of care, using data from 2016-2022.... AWV utilization has steadily increased over time, reaching 30% in 2022.... AWV utilization is associated with 19% lower risk-adjusted costs compared to non AWV utilizers, with even greater cost savings observed among dual-eligible individuals and those with chronic conditions like diabetes and cardiovascular disease."  MORE >>

"[In] following the DOL's guidance with respect to such service providers, plan sponsors and fiduciaries should: [1] request and review the service provider's information and documentation regarding cybersecurity policies, procedures, guidelines, and standards ... [2] include cybersecurity and data privacy provisions in service provider agreements ... and [3] inquire whether third-party service providers have applicable insurance policies."  MORE >>