Sep 4, 2023 | Compliance, Plan changes, Regulatory
Q: Are plan sponsors required to provide members advanced notice when making midyear changes to the plans? A: Yes! Under the Affordable Care Act (ACA), there are two notification requirements that apply to changes made midyear. These notifications are in addition to...
Jul 25, 2023 | Caroline Fraker, Claims data, Compliance, Consolidated Appropriations Act of 2021 (CAA), No Surprises Act (NSA), Regulatory
MedCity News reports on the latest in a series of lawsuits by large self-funded employers against national carrier administrators. These cases place a spotlight on health plan administrators that do not provide employers access to their medical claims data, in...
Jul 24, 2023 | Compliance, Department of Labor, Mental Health, News, Regulatory
On July 10, 2023, the United States Office of Management and Budget (OMB) received the Department of Labor’s newly proposed Mental Health Parity regulations. This latest installment in health plan Mental Health Parity compliance is expected to be released in the near...
May 16, 2023 | Alternative Reimbursement Strategies, Announcements, Case Studies, Client Report, Client Services, Client Surveys, Communication, Compliance, Cost Plus Pricing, Cost Savings, Direct-to-Employer Contracting, Drug costs, Forensic claims review, HealthJoy, Inflation, Kurt Harden, MedBen Rx, MedBen WellLiving, Member engagement, Mobile App, Online Services, Own Use, Pharmacy, Pharmacy Benefits Manager (PBM), Plan Design, Plan Language, Prescription, Reference-Based Pricing, Regulatory, Rx Costs, Savings, Self-funding, Specialty Drugs, Supreme Court, Wellness
The 2023 MedBen Client Report is now available to download from MedBen.com! In his opening note, MedBen President Kurt Harden states: “This Client Report is designed to demonstrate ways that clients can generate greater value from their health plan. With health...
May 15, 2023 | Affordable Care Act, Announcements, Compliance, PCORI, Regulatory
It is once again time to start thinking about warmer weather, cook-outs, and – yes – paying your PCORI fee. As in years past, all self-funded employer health plan sponsors are required to file and pay their PCORI fees no later than July 31, 2023. As part of...
May 11, 2023 | Centers for Medicare & Medicaid Services (CMS), Compliance, Consolidated Appropriations Act of 2021 (CAA), Pharmacy, Prescription, Regulatory
You might remember that the Consolidated Appropriations Act of 2021 (CAA) requires all health plans to file a pharmacy data report annually to the Centers for Medicare & Medicaid Services (CMS). Beginning this year, and each year thereafter, that reporting must be...
