"Legislation to extend the telehealth HDHP safe harbor is currently pending; however, legislative action may occur very late in 2024 or in 2025 -- or not at all.... A few pending bills would make the telehealth HDHP safe harbor permanent ... If the law is not extended, telehealth will be treated as it was prior to the CARES Act in terms of HSA eligibility (i.e., as 'disqualifying health coverage' for telehealth services beyond preventive care)."  MORE >>

"The Departments ... have published guidance in the form of FAQs on: [1] Preventive care coverage for pre-exposure prophylaxis (PrEP) medication taken to prevent human immunodeficiency virus (HIV). [2] Coding requirements for preventive services claims. [3] The scope of breast reconstruction coverage under the ACA and the Women's Health and Cancer Rights Act (WHCRA)."  MORE >>

"To ensure compliance, providers, other covered entities, and business associates need to do the following before December 23, 2024: [1] Review and modify your HIPAA policies and procedures and train employees concerning the Rule. [2] Review and consider modifying authorizations or request for information forms to ask if the person is seeking RPHI. If no RPHI is sought, then the Rule does not apply.... [3] Draft and use a compliant attestation or adopt and use the OCR model attestation when the provider or business associate receives requests for RPHI."  MORE >>

"Currently, Medicare and Medicaid cover the use of AOM's for certain conditions, like diabetes. Today's new proposal would expand access to these innovative medications for obesity ... Medicare coverage would reduce out-of-pocket costs for these prescription drugs by as much as 95 percent for some enrollees. Approximately 4 million adult Medicaid enrollees would also gain new access to these medications."  MORE >>

"Beginning on January 1, 2025, the Washington Paid Family and Medical Leave Program's total premium rate will increase to 0.92% from 0.74%.... Premiums must be collected up to the Social Security cap, which will increase to $176,100 in 2025 ... Employers with 50 or more employees will pay at least 28.48% of the total premium, which will require employees to pay 71.52% of the premium.... [T]he maximum weekly benefit will be capped at $1,542.00 per week in 2025."  MORE >>

"The employees claim that Campbell Soup failed to offer an alternate standard in its program as required by ERISA, and even if they did, they failed to communicate it to the employees.... [T]he employees argue that ERISA requires participants to receive the full 'reward' if they complete the alternative standard, which should include retroactive removal of surcharges via reimbursement or refund." [Spencer v. Campbell Soup Co., No. 24-9882 (D.N.J. complaint filed Oct. 17, 2024)]  MORE >>

"Employers should review the terms of their tobacco surcharge programs to ensure that each individual is eligible to receive the full reward upon completion of the RAS and that the RAS is adequately communicated to employees -- with all materials discussing the surcharge."  MORE >>

"OCR fulfilled its requirement under the HITECH Act to perform periodic HIPAA audits. However: OCR’s HIPAA audit implementation was too narrowly scoped to effectively assess ePHI protections and demonstrate a reduction of risks within the health care sector. Specifically: OCR’s audits consisted of assessing only 8 of 180 HIPAA Rules requirements; and only 2 of those 8 requirements were related to Security Rule administrative safeguards and none were related to physical and technical security safeguards. OCR oversight of its HIPAA audit program was not effective at improving cybersecurity protections at covered entities and business associates."  MORE >>

17 pages. "This brief examines the potential impact of Medicare's proposed reinterpretation [of Medicare coverage for anti-obesity medications (AOMs)] ... [The authors] first provide an overview of AOMs ... [then] compare existing estimates of the impact of expanding access Medicare Part D to include these treatments for obesity ... [and examine] the growth in utilization of these drugs since their launch in the U.S. overall and among Medicare and Medicaid populations.... [They] compare prices and spending for these medications in the U.S. and comparator countries [and] look at out-of-pocket costs for certain medications in the Medicare population."  MORE >>

"EBSA Disaster Relief Notice 2024-01 -- extends the time for plans to furnish ERISA-required notifications, including SPDs, SMMs, and benefit determinations ... Final Regulations -- delays/suspends participant COBRA, HIPAA special enrollment, and claims/appeal-related deadlines, as well as the deadline for the plan administrator to provide the COBRA election notice. FAQs for Participants and Beneficiaries -- help participants impacted by the hurricanes/tropical storm understand their rights under ERISA.... Insurance Standards Bulletin ... encourages non-federal governmental plans and health insurance issuers offering group or individual health insurance coverage to also extend the participant deadlines and provides non-enforcement relief."  MORE >>