"The proposed amendment to ESSTA would allow employees who allege a violation of their rights to commence a civil action in court. Such an action could seek compensatory damages, injunctive and declaratory relief, attorneys' fees and costs, as well as other relief the court deems appropriate."   MORE >>

"Once a health plan or other Covered Entity receives a request protected health information from the individual or his personal representative, the Right of Access Rule requires the Covered Entity to provide access to all requested protected health information within any 'designated record set' within 30 days unless the requested information falls within one of two exceptions to the Rule."   MORE >>

"A decision from the United States Court of Appeals for the Tenth Circuit, which found that several provisions of an Oklahoma law regulating pharmacy benefit managers (PBMs) were preempted by federal law, will remain in place for now after a panel denied Oklahoma's motion to stay the mandate ... [A] stay would have allowed Oklahoma to enforce the challenged provisions while it pursues review by the Supreme Court of the United States[.]" [ PCMA v. Mulready , No. 22-6074 (10th Cir. Aug. 15, 2023; pet. for en banc hearing denied Dec. 12, 2023; motion to stay denied Jan. 2, 2024)]   MORE >>

"Michigan's top insurance regulator [ reminded health plans ] that they cannot deny coverage for clinically proven cancer treatments, after a deceased patient's insurer refused to pay for life-saving gene therapy treatment."   MORE >>

"Walgreens has agreed to pay $360 million to healthcare insurer Humana to settle a lawsuit claiming that the retail pharmacy giant for years overcharged for prescription drug reimbursements.... Humana had claimed Walgreens filed 'millions of falsely-inflated' prescription drug prices for more than a decade."   MORE >>

"As the call for clearer prescription drug pricing has grown, there could be significant shifts in the prescription drug landscape in the coming years ... Concerns have arisen around manufacturers potentially raising costs for non-Medicare plans to recoup lost revenue from IRA price negotiations. ... [T]here are several situations that could result in increased or decreased costs for plan sponsors in addition to potential price shifting."   MORE >>

"Recent data from the Health Care Cost Institute (HCCI) show that price growth accounted for more than half the change in per person health care spending from 2017 to 2021. Nearly half of people in the US get health insurance through work, either through their own employer or as a dependent.... [This article answers] ten questions about the role of employers in lowering health care spending."   MORE >>

"Federal regulations require health insurers to promptly hand over records to patients facing claim denials within 30 days, however, Anthem, Aetna and UnitedHealth blew past the 30-day deadline in a recent ProPublica investigation."   MORE >>

"When shopping for an EAP, it's important to consider employee knowledge gaps that might be impacting your utilization rate.... It's important to understand the breadth of programs available, and to be able to compare those options head-to-head with your current benefits plan.... When calculating your EAP's ROI, remember that employees tend to engage with these programs in waves."   MORE >>

"While the Council appreciates the departments' goal of increasing access to prescription drug coverage and in mitigating the extent of out-of- pocket costs, we are concerned that if the NBPP 2025 EHB prescription drug rule is extended to large group insured and self-funded group health plans, such plans may be forced to eliminate certain prescription drugs from their formularies due to increased plan costs, including because there is no requirement that these plans cover EHBs."   MORE >>

339 pages. "[A]fter considering the views expressed by commenters, the Department is finalizing its [ October 2022 proposal ] with some modifications.... [T]his final rule returns to a totality-of-the-circumstances analysis of the economic reality test in which the factors do not have a predetermined weight and are considered in view of the economic reality of the whole activity."   MORE >>

"The Supreme Court will hear oral arguments on two cases challenging the deference given to federal agencies' interpretations of statutes they are charged with enforcing. If Chevron is overruled or pared back, federal agencies enforcing labor and employment laws will likely face more challenges to their rules and other interpretive guidance. Overruling Chevron may cause agencies to issue fewer new regulations, take more modest positions in the regulations they do issue, or both."   MORE >>

"A s many as half of today's five-year-olds can expect to live to the age of 100 ... This article looks at the implications this change will have on employment, from changing attitudes toward career paths and career development to the physical and cultural environment of the workplace. Considerations include adapting to changing needs in the areas of employee health and well-being, benefits and financial planning."   MORE >>