"The Final Rule continues to prohibit discrimination on the basis of race, color, national origin, sex, age, or disability, but there are several new twists. And while many requirements under the Final Rule became effective on July 5, 2024, various provisions have staggered effective dates."  MORE >>

"[Notice 2024-75 and Notice 2024-71] take retroactive effect and, among other things, allow over-the-counter (OTC) oral contraception and male condoms to be provided by a qualified high-deductible health plan (HDHP) prior to the deductible without sacrificing eligibility for health savings accounts (HSAs). The proposed regulations would require preventive care to include certain OTC contraception without cost sharing and without a prescription"  MORE >>

"The Court concluded that the findings of Unum's reviewing physicians, while different from what Plaintiff's providers or even the Court might opine, were not unreasonable and were supported by evidence in the record. And Unum was not obliged to accord any special deference to treating provider opinions." [Eggleston v. Unum Life Ins. Co. of Am., No. 22-23393 (S.D. Fla. Oct. 21, 2024)]  MORE >>

"Cost management company MultiPlan is facing yet another lawsuit for allegedly conspiring to underpay providers -- this time, from the largest physician association in the United States. The American Medical Association's complaint, filed Thursday in an Illinois district court, accuses MultiPlan of colluding with major health insurers to set artificially low reimbursement rates for out-of-network care, forcing providers to accept payments that often don't cover their operating costs." [American Medical Association v. MultiPlan, No. 24-10959 (N.D. Ill. complaint filed Oct. 24, 2024)]  MORE >>

"[U]nder Loper Bright, employers have greater freedom to question whether the HIPAA wellness regulations represent a reasonable interpretation of HIPAA's nondiscrimination regulations and may encourage judges to do the same.... [It] is not immediately clear that tobacco usage should be considered a health status, and we may see courts declining to defer to the agency's interpretation of health status.... [C]ourts may find that tobacco usage is a lifestyle choice -- not a health status -- and thus outside the reach of HIPAA's nondiscrimination protections."  MORE >>

"Change Health's disclosure to the [HHS] Office of Civil Rights (OCR) that it has sent approximately 100 million individual breach notifications about the February 21, 2024 ... ransomware attack ... shows the sweeping damage ransomware attacks present for health plans, their fiduciaries, business associate and other service providers, employer and other plan sponsors and their participants and beneficiaries."  MORE >>

"The employer, not the insurer, is responsible for obtaining evidence of insurability. Indeed, group insurance policies typically impose a duty on the employer to do so.... When employers fail to secure evidence of insurability and a subsequent life insurance claim is denied, the court may order the employer to pay the amount of insurance that was lost on account of that failure. This applies regardless of whether the employer acted intentionally or negligently."  MORE >>

"Why aren't we covering everyone and working to make care affordable for all? A barrier to addressing this problem is the assumption that filling current gaps in access and generosity will lead to an acceleration in health care cost growth. [The authors] investigate three streams of evidence that call this assumption into question."  MORE >>

"Affected taxpayers now have until May 1, 2025, to file various federal individual and business tax returns and make tax payments. The IRS is offering relief to ... the City and Borough of Juneau in Alaska."  MORE >>

"[The FTC has] appealed a Texas federal court's August ruling that blocked nationwide enforcement of the non-compete ban. The non-compete ban will remain blocked during the pendency of the appeal process.... There are three court challenges to the non-compete ban. The status of those challenges (including appeals) is detailed [in this article.] " [Ryan LLC v. Federal Trade Commission, No. 24-0986 (N.D. Tex. Aug. 20, 2024)]  MORE >>