301 pages. "This proposed rule would revise [1] standards relating to past-due premium payments; ... [2] the evidentiary standard HHS uses to assess an agent's, broker's, or web-broker's potential noncompliance ... [3] income eligibility verifications for premium tax credits and cost-sharing reductions; [4] annual eligibility redetermination; [5] the automatic reenrollment hierarchy; [6] the annual open enrollment period; special enrollment periods; [7] de minimis thresholds for the actuarial value for plans subject to essential health benefits (EHB) requirements and for income-based cost-sharing reduction plan variations and the premium adjustment percentage methodology; and [8] prohibit issuers of coverage subject to EHB requirements from providing coverage for sex-trait modification as an EHB."  MORE >>

"Among other new requirements, consumers would have to provide more information proving their eligibility for special enrollment periods and for premium subsidies when they enroll. The regulation would also shorten the annual enrollment period by a month"  MORE >>

"In the less than two months since inauguration, President Trump and his administration have issued a dizzying array of health policy and related actions ... This article briefly summarizes several of these recent actions on topics that include health care price transparency, COVID-19 vaccine mandates, the Make America Healthy Again Commission, fertility services, gender-affirming care, and funding cuts for navigators. This article also discusses the Trump administration's initial approach to several significant health policy lawsuits."  MORE >>

"If the waivers expire, commercial payors ... could continue to offer reimbursement for telehealth services beyond what Medicare fee-for-service covers.... Providers may also continue to offer non-covered telehealth services to Medicare Fee-For-Service beneficiaries on a cash-pay basis, though any provider offering this opportunity would need to comply with Medicare notice and eligibility requirements as well as state law."  MORE >>

"Since the Final Rules regarding the Comparative Analysis requirement were issued in September of 2024, many plan sponsors have asked questions regarding compliance. This briefing addresses some of the most commonly asked questions."  MORE >>

"The DOL has integrated cybersecurity queries and questions into health and welfare plan examinations.... The DOL's position may make H&W plans particularly susceptible to a cybersecurity investigation, especially those impacted by data breach incidents among their providers. H&W plan sponsors should remember that following the DOL's cybersecurity recommendations and adhering to [HIPAA] is prudent."  MORE >>

"This study looks at how often US health plans cite health technology assessments (HTAs) in their drug coverage policies.... US commercial health plans cited HTAs in support of their specialty drug coverage decisions, albeit with varying frequency and less than other types of evidence. Such assessments, when considered alongside other resources, may be of particular interest to health plan decision makers if they aim to provide specialty drug coverage that aligns with a treatment's value."  MORE >>

"[The] six-month funding patch would extend certain Medicare telehealth flexibilities that are set to expire March 31 ... Some telehealth flexibilities are excluded like a benefit for people with high-deductible health plans and telehealth as an excepted benefit for seasonal and part-time workers.... Because the funding patch doesn't include a fix for the 2.83% Medicare physician pay cut ... Congress will face pressure to pass the healthcare package that Senate Democrats reintroduced on [March 7]."  MORE >>

"The at-home testing distribution program launched in January 2022. Since then, it has been significantly expanded but also had been suspended a few times over the years. The program last returned on Sept. 26 and took orders through [March 9]. It was not immediately known if the program could return in the future."  MORE >>

"Average monthly premiums for families with employer-provided health coverage in California's private sector nearly doubled over the last 15 years, from just over $1,000 in 2008 to almost $2,000 in 2023 ... Average premiums for families with employer-provided health coverage grew as fast nationwide as they did in California from 2008 through 2023... Premiums at CalPERS, which provides insurance to more than 1.5 million of California's active and retired public employees and family members, have risen about 31% since 2022."  MORE >>

"The lawsuit ... alleges that the UnitedHealth Group subsidiary's cybersecurity standards were insufficient to prevent the attack.... CareFirst said it lost a large amount of data related to employer accounts and its Medicare Advantage business ... CareFirst BlueCross BlueShield serves 3.5 million groups and individuals in Maryland and the Washington, D.C., metropolitan area. It has a 75 percent market share in the state and also serves more than 626,000 members in the Federal Employees Health Benefits Program." [CareFirst Inc. vs. Change Healthcare Technologies, LLC, No. C-03-CV-25-000701 (Balt. Cty. Circ. Ct. complaint filed Feb. 21, 2025)]  MORE >>

"Chavez-DeRemer is known for her strong support of employee stock ownership plans (ESOPs) and her sponsorship of the PRO Act, which she later retracted. The PRO Act would have made it harder to classify workers as contractors, overturn state 'right-to-work' laws, and strengthen penalties for labor law violations."  MORE >>