24 pages; for use in preparing 2024 returns. "What's New: [1] Preventive care for purposes of qualifying as a high deductible health plan (HDHP) under Section 223.... [2] Expenses treated as amounts paid for medical care.... [3] Health Flexible Spending Arrangement (FSA) contribution and carryover for 2024."  MORE >>

"RR 2025-4 provides guidance to the District of Columbia and states that have mandatory paid family and medical leave programs, and for employees working in and employers operating in those states.... Among other scenarios, the guidance addresses the taxation of mandatory employee contributions when voluntarily paid by the employer on behalf of the employee, which RR 2025-4 refers to as 'employer pick-up of employee contributions.' Additionally, the IRS guidance differentiates the taxation of benefits received for family leave from those received for the employee's medical leave for their own health condition."  MORE >>

"[M]any states have passed mandatory paid leave laws allowing employees to continue to receive at least partial wages when they cannot work due to injury, illness, or disability to themselves or covered family members.... [Rev. Rul. 2025-4] addresses the tax treatment of both contributions and benefits ... Calendar year 2025 is being treated as a transition period for purposes of enforcement and administration."  MORE >>

"The DOL's Wage and Hour Division clarified that in the same way employers cannot require the substitution of accrued employer-provided paid leave benefits when employees receive compensation from disability plans and workers' compensation programs, employers may not unilaterally require employees to substitute accrued employer-provided paid leave benefits when employees receive compensation from state or local paid family or medical leave programs. The Wage and Hour Division also reiterated that the substitution provision would apply that if an employee's FMLA-qualifying leave is unpaid."  MORE >>

"While the proposed rule is an important component of HHS’ ongoing effort to enhance cybersecurity requirements, many of the proposals raise significant new questions regarding HHS’ expectations. If adopted, the sweeping changes could have a significant impact on the way covered entities and business associates conduct business, including with each other.... While OCR had the opportunity to set new ground rules for the use of artificial intelligence and machine learning (AI/ML) in the proposed rule, the agency instead chose to request additional input on their use. "  MORE >>

"On January 20, 2025, President Donald Trump revoked Executive Order 14087 ... which had promoted analyzing new healthcare payment models that would lower prescription costs for Medicare and Medicaid beneficiaries.... The potential impact ... includes: [1] uncertain out-of-pocket copayment models and [2] uncertain drug pricing policies, including rebates and reimbursements received by pharmacies."  MORE >>

"Employees taking Paid Leave Oregon are entitled to use any accrued sick leave, vacation, or other employer-provided paid time off (PTO) benefit to 'true up' the wage-replacement benefit they receive from the Oregon Employment Department so that they receive a full-wage replacement while on Paid Leave Oregon. The new rules allow the Oregon Employment Department to share an employee's potential weekly benefit amount with employers so that employers know what amount of employer-provided benefit is needed to 'true up' the benefit to a full-wage replacement."  MORE >>

"Health plans, and the companies that administer them, have excluded key behavioral treatments, such as therapies for substance use and autism, and offered inadequate networks of mental health providers, according to a 142-page report released Jan. 17 ... The report, which the agencies are required to file regularly to Congress, also detailed the results of secret shopper surveys of more than 4,300 mental health providers listed in insurance directories and found an 'alarming proportion' were 'unresponsive or unreachable.' "  MORE >>

"AI-driven tools can help identify unnecessary prescriptions, promote deprescribing, and reduce risks associated with medication overload. These interventions will not only lower costs, but also improve safety and adherence for patients.... 2025 could be a turning point for biosimilars, delivering substantial savings across the healthcare system.... GLP-1 management will require creative solutions to navigate rising demand."  MORE >>

"The decision ... sends a clear message: reference-based pricing is here to stay, and courts will continue to uphold its legality. Employers adopting these models can confidently rely on their ability to curb rising healthcare costs while maintaining compliance with federal laws. For hospitals and providers, this ruling reaffirms the need to adapt to evolving payment models or negotiate contracts proactively with health plans." [The Regents of the Univ. of Cal. v. The Chefs Warehouse Emp. Benefit Plan, No. 23-0676 (E.D. Calif. Aug. 23, 2024)]  MORE >>

"Although the plan and/or the company may also be named as parties in this agreement (as reflecting their contractual responsibilities), identifying the committee as the responsible party for specific provisions, such as those relating to plan administration, monitoring, and compliance requirements, can help align the contract with the governance structure that is in place and may help prevent the company or individuals from being treated as fiduciaries to the plan."  MORE >>

"Generative AI, with its vast capabilities, offers an exciting frontier for transforming how we communicate complex benefits information. Understanding and applying these cutting-edge tools can significantly enhance the quality and efficiency of member communications. Integrating Generative AI into communications strategies not only modernizes the approach to communications but also helps meet members’ evolving needs and expectations."  MORE >>