"For plan years that end on or after October 1, 2024 and before October 1, 2025, the fee is $3.47 per covered life. Issuers of specific health insurance policies and plan sponsors of applicable self-insured health plans are required to pay the PCORI fee.... PCORI fees may also apply to health reimbursement arrangements (HRAs) and health flexible spending accounts (health FSAs) that are considered self-insured health plans[.]"  MORE >>

"Employers will be required to begin offering New York employees 20 hours of paid leave during a 52-week period to attend to prenatal medical needs, which is in addition to existing sick/safe leave already required in New York.... The guidance asserts that, unlike New York's sick/safe leave law, paid prenatal leave is not accrued, and the full 20 hours of leave will be available immediately to all employees, regardless of their length of employment, beginning on January 1, 2025."  MORE >>

"As of 1/1/25, all private-sector employers in New York, regardless of their size, must provide eligible employees 20 hours of paid prenatal leave. Paid prenatal leave may be used only by employees directly receiving prenatal healthcare services."  MORE >>

"The state's informal guidance now provides employers with answers to some of the questions they have grappled with over the last six months while working to implement this new benefit prior to the end of the year."  MORE >>

"Maine's program, which will provide up to 12 weeks of paid leave per year, covers all eligible employees of private and public employers ... in the state regardless of employer size. Employers and employees will split a 1% payroll tax to fund the paid family and medical leave program starting January 1, 2025."  MORE >>

"This case underscores the importance of group health plan fiduciary's responsibilities for overseeing their third-party administrators. It is not only a good idea to request claims data from third-party administrators, but also to conduct claims audits and analyze the data provided to ensure the plan is being administered according to its terms and in compliance with law." [Owens & Minor, Inc. v. Anthem Health Plans of Virginia, Inc., No. 24-0820 (E.D. Va. complaint filed Nov. 18, 2024)]  MORE >>

"Health care providers, health plans, and applicable business associate vendors have until December 23, 2024, to be in compliance with most aspects of the updated HIPAA Privacy Rule. HIPAA-regulated entities should use the coming weeks to ensure that workforce members are trained on the new HIPAA requirements and any resulting process changes related to the provision of protected health information."  MORE >>

"Although the contract term between the parties was set to end in April 2019, the contractor stopped providing services in August 2018. In February 2019, the provider discovered that the contractor had accessed its electronic record system on three occasions between September 2018 and February 2019 (that is, during the time before the end of the original contract term but after the contractor had stopped providing consulting services). The contractor allegedly used the PHI to create medical claims for services that were not actually provided, leading to roughly 6,500 false Medicare claims."  MORE >>

"The [Congressional Review Act] allows Trump to speed up the repeal process by bypassing committee hearings and avoiding the Senate filibuster, so a simple majority vote is all that's required.... It's a tempting mechanism for Trump to employ in healthcare. Out of the 10 most expensive Biden rules likely to fall within the lookback window, five were finalized by the Department of Health and Human Services (HHS)."  MORE >>

"[1] Continued bipartisan agreement on pension reform.... [2] Don't give up on 401(k) Plans ... [3] More and faster SECURE Act guidance ... [4] Subject ERISA litigation to reasonable pleading rules.... [5] A final decision whether ERISA fiduciary breach claims may be subject to mandatory arbitration ... [6] Loper Bright will have limited impact.... [7] Congress will not cut back employee plan tax benefits to raise revenue ... [8] The best of the [ACA] will be preserved."  MORE >>