78 pages. "This memorandum provides interested parties with the revised Medicare Part D Drug Inflation Rebate guidance for 2022, 2023, and 2024. This memorandum includes ... [1] A summary of changes and clarifications to the initial memorandum, the Medicare Part D Drug Inflation Rebates Paid by Manufacturers: Initial Memorandum, released on February 9, 2023 ... [2] A summary of the public comments received in response to the initial memorandum, and [CMS'] responses ... [3] Revised guidance that establishes final policies for the Medicare Part D Drug Inflation Rebate Program[.]" [Also available: Fact Sheet and CMS Letter to Plans and PBMs ]   MORE >>

"[1] Prepare for ACA reporting.... [2] The first year of annual attestation of compliance with the CAA-21's gag clause prohibition is due December 31st, 2023 ... [3] Beginning in 2024 ... plans and insures must expand the internet-based price comparison tool to include all covered items, services and drugs.... [4] Plan document updates ... [5] Nondiscrimination testing ... [6] Life insurance imputed income."   MORE >>

"[T]he Ordinance will no longer cover any individual who performs at least two hours of work in the City of Chicago in a two-week period. Instead, the Ordinance will apply to individuals who work 80 hours within the City of Chicago in a 120-day period.... [T]he Ordinance will be accompanied by a one-year “cure period” during which time workers do not have a private right of action to sue employers under the Ordinance. "   MORE >>

"The delay to July 1, 2024 impacts the following provisions of the Ordinance: [1] Paid sick leave accrual and carryover ... [2] Paid leave accrual ... [3] Collective bargaining agreements in effect ... [4] Medium employer partial payout extended ... The December 13th amending ordinance also modified the Ordinance as follows: [1] Definition of a covered employee ... [2] Written policy in primary language ... [3] Recordkeeping for non-covered employees ... [4] Prerequisites for paid leave private right of action."   MORE >>

"Humana is the latest insurer to be sued over its use of artificial intelligence in claims processing, with a lawsuit alleging the payer used AI model nH Predict to improperly deny care ... [P]laintiffs argued the payer prematurely cut payments for MA beneficiaries' rehabilitation care. According to the suit, Humana based the cuts on the AI model's 'rigid and unrealistic predictions for recovery' -- not doctors' recommendations -- despite knowing the model's estimations were often 'highly inaccurate.' " [Barrows v. Humana, Inc., No. 23-0654 (W.D. Ky. complaint filed Dec. 12, 2023)]   MORE >>

"One study found that 60% of lower back MRIs were inappropriate; MRIs can cost $2,500 more than recommended alternatives like physical therapy. Evidence-based guidelines suggest ultrasounds should be the first line of testing in diagnosing certain areas of abdominal pain before ordering other types of imaging. The national average cost of an ultrasound is $400, compared to $900 for a CT scan."   MORE >>

"During the period 2020-22, both the COVID-19 pandemic and the unprecedented government response to the public health emergency dramatically affected health care expenditure trends. After increasing by 10.6 percent in 2020, total expenditures grew at a slower rate of 3.2 percent in 2021 as reductions in COVID-19 supplemental funding and public health expenditures partly offset strong growth in the use of health care goods and services. In comparison, the prepandemic average annual growth rate for overall health spending was 4.4 percent during 2016-19. "   MORE >>

"U.S. health care spending grew 4.1% to reach $4.5 trillion in 2022, faster than the increase of 3.2% in 2021, but much slower than the rate of 10.6% in 2020.... Spending for hospital care services increased 2.2% in 2022 to reach $1.4 trillion; however, this was a slower growth rate compared to 4.5% that was experienced in 2021.... Spending on physician and clinical services increased 2.7% to $8,84.9 billion in 2022, slower than the increase of 5.3% in 2021.... Retail prescription drug spending increased 8.4% to $405.9 billion in 2022, a faster rate than in 2021 when spending increased by 6.8%."   MORE >>

"The Consolidated Appropriations Act, 2021, includes a provision for GAO to review the federal independent dispute resolution process. This report describes [1] the number and types of disputes submitted between April 2022 and June 2023, and the status of their resolution; [2] selected stakeholders' experiences with the process, and agency actions to address challenges; and [3] how federal agencies oversee the process." [GAO-24-106335]   MORE >>

"The Inflation Reduction Act (IRA) includes provisions to increase accessibility and affordability of prescription drugs for the 65 million Medicare beneficiaries, reduce the rate of growth in Medicare drug spending, and improve the financial sustainability of the Medicare program. These IRA provisions include a rebate on certain Part B and D drug prices if prices rise faster than inflation. This fact sheet focuses on ... the Medicare Part B inflation rebate, and its impact on the drugs that meet the law's criteria in calendar year 2023."   MORE >>

"[T]he pre-FMLA protected leave policies ... increased mothers' time investments in children and the likelihood of the households having childcare expenses.... [T]he policies exacerbated the motherhood penalty in labor market outcomes and ... affected fertility choices, increasing the likelihood of having a first child and decreasing the likelihood of having subsequent children."   MORE >>

"The standard mileage rate for transportation or travel expenses is 67 cents per mile for all miles of business use.... The standard mileage rate is 14 cents per mile for use of an automobile in rendering gratuitous services to a charitable organization under Section 170.... The standard mileage rate is 21 cents per mile for use of an automobile: [1] for medical care described in Section 213; or [2] as part of a move for which the expenses are deductible under Section 217(g)."   MORE >>

10 pages. "[T]wo student loan management program options are gaining significant attention as they allow employer contributions in different ways: Student loan direct payment program and student loan retirement matching program. [This article describes] these programs in detail to help employers determine the best approach for the organization's objectives and employee demographics."   MORE >>