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...
Apr 18, 2023 | Announcements, Compliance, COVID-19, News, Regulatory
You may have read that on April 10, President Biden signed House Joint Resolution 7, immediately terminating the national health emergency related to the COVID-19 pandemic under the National Emergencies Act. You also may recall that earlier this year, the Biden...
Apr 4, 2023 | Caroline Fraker, Carve-outs, Compliance, Cost Savings, Dialysis, MedBen University, Regulatory, Savings, Supreme Court
At this year’s MedBen University roundtables, Senior Vice President & CPO Caroline Fraker provided an eye-opening example of why the June 2022 United States Supreme Court decision in the matter of Marietta Memorial Hospital Employee Health Benefit Plan v....
Apr 3, 2023 | Lawsuits, News, Ohio, Pharmacy Benefits Manager (PBM), Prescription, Regulatory, State legislation
Ohio Attorney General David Yost has sued pharmacy benefit managers (PBMs) Express Scripts and Prime Therapeutics for conspiring to illegally increase prescription drug prices and force pharmacies to accept low reimbursement rates. Cigna Group and Humana were also...
Mar 17, 2023 | Compliance, HIPAA, Privacy, Regulatory
Following news that digital health companies GoodRx and BetterHelp shared sensitive user information with advertisers, the Federal Trade Commission (FTC) has requested funds for ensuring health privacy in its 2024 budget proposal. The budget request sites merger...
