"HHS' final rule ensures that health care providers using certified health IT systems are able to submit prior authorizations electronically, select drugs consistent with a patient's insurance coverage, and exchange electronic prescription information with pharmacies and insurance plans."  MORE >>

"Effective January 1, 2026 ... Senate Bill 1108 [amends] Oregon's paid sick leave law by allowing employees to use their accrued sick time to donate blood through a program approved or accredited by the American Association of Blood Banks or the American Red Cross."  MORE >>

"The U.S. Court of Appeals for the Fifth Circuit ... made the following points: [1] When assignment forms are broadly drafted, they may be ambiguous as to who the assignee is, but that does not invalidate the assignments. [2] There is not a requirement that an assignment form include a standalone 'right to sue' provision when the form assigns 'all rights' or 'all insurance benefits.' [3] An ERISA plan administrator may be prevented from enforcing plan provisions ... against a claimant if the administrator refuses to provide the document containing those provisions to the claimant." [Angelina Emergency Med. Assoc. v. Blue Cross and Blue Shield of Ala., No. 24-10306 (5th Cir. Aug. 8, 2025)]  MORE >>

"Selecting the optimal benefits coverage can be a stressful and even overwhelming task for your employees. Yet, as health care costs continue rising, it's more important than ever for coverage to align with their needs.... This guide for benefits leaders covers strategic preparation, communication tactics and practical tools intended to streamline your enrollment process while ensuring employees can confidently select the appropriate coverage for their needs."  MORE >>

"Generic and biosimilar savings help offset growing brand drug expenses, make medications more accessible for patients and support the sustainability of prescription benefits. This Capsule article explores metrics to monitor the use of generics and biosimilars, examines marketplace changes impacting these metrics and reviews benefit options that support the use of these lower-cost options. How close are your generic and biosimilar metrics to optimal performance levels?"  MORE >>

"[Referenced-based pricing (RBP) is] one tool alongside direct primary care, cash-bundled payments at centers of excellence, selective contracting, transparent pass-through PBMs, and high-value physician-only networks.... Here are three recent, real-world RBP stories from three very different clients: [1] When RBP flows beautifully.... [2] When RBP is only a threat. [3] When RBP 'struggles' and still wins."  MORE >>

"Relative to [the] 2024 estimates, [Milliman projects a] hypothetical couple retiring in 2025 will need to save approximately $7,000 less if they have Original Medicare plus Medigap and Part D coverage, and $1,000 more if they have Medicare Advantage plus Part D coverage, all else being equal."  MORE >>