"Where there is clear and convincing evidence that the amount was distributed because of a mistake of fact due to reasonable cause, employees can work with the HSA custodian to return the mistaken distribution by the following April 15. The correction process of returning the funds to the HSA allows employees to avoid taxation and the 20% additional tax that would otherwise apply for a non-medical distribution."   MORE >>

"Under the new guidance, therapeutic equivalency is determined by the FDA's Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book). The therapeutic equivalence approach does not apply to forms of contraception not listed in the Orange Book. ... [P]lans and issuers must still maintain a compliant exceptions process. Plans and issuers are not required to adopt the therapeutic equivalency approach and can continue to comply by adhering to prior guidance."   MORE >>

10 pages.  Charts with descriptions of Form 1095-C codes for Lines 14 and 16, along with flowcharts to analyze offers of coverage.   MORE >>

"The Advance Notice proposes annual updates to MA payment growth rates and changes to the MA and Part D payment methodologies to improve payment accuracy.... The CY 2025 Advance Notice includes the continued phase-in of the updated MA risk adjustment model and updates to the calculation of growth rates related to medical education costs, and other technical improvements. " [Also available: Fact Sheet and FAQs discussing provisions of the CY 2025 Advance Notice; Draft CY 2025 Part D Redesign Program Instructions ; and Fact Sheet discussing the provisions of the Draft CY 2025 Part D Redesign Program.]   MORE >>

January 31, 2024. Video of hearing, with links to Chair Rodgers  Opening Statement  and Chair Guthrie  Opening Statement  and testimony by [1]  Chapin White, Ph.D. , Director of Health Analysis, Congressional Budget Office; [2]  Sophia Tripoli, MPH , Families USA; [3]  Mr. Kevin Lyons , New Jersey State Policemen"s Benevolent Association, Inc.; [4]  Benedic Ippolito, Ph.D., M.S. , American Enterprise Institute; and [5]  Katie Martin, MPA , Health Care Cost Institute.   MORE >>

"In 2022, U.S. prices across all drugs (brands and generics) were nearly 2.78 times as high as prices in the comparison countries. U.S. prices for brand drugs were at least 3.22 times as high as prices in the comparison countries, even after adjustments for estimated U.S. rebates. Most new drugs were available first in the U.S. before being launched in other countries. The U.S. spends a higher and growing share of total drug spending on new drugs compared to other countries."   MORE >>

"[On] January 22, the House Committee on Education and the Workforce issued an RFI on 'ways to build upon and strengthen ERISA' in the lead-up to the law's 50th anniversary in September. The Committee noted that employer-sponsored health insurance, as the core of the American healthcare system, has been heavily impacted by rising health costs, leading to higher premiums, reductions in benefits, and less coverage held by small businesses.... [T]he Committee seeks feedback on several issues to explore ways of increasing affordability of coverage and quality of care.... Responses to its RFI must be submitted by March 15, 2024."   MORE >>

10 pages. "Congress should address the administrative complexity of these important benefits across existing state laws, recognize the advantages that private benefit sources offer, and provide a pathway for uniform, national paid family and medical leave standards. ERIC therefore recommends that Congress explore [1] a federal safe harbor providing relief from the state patchwork for employers that offer premium paid family and medical leave benefits, and [2] a federal effort to harmonize national paid leave standards and incentivize much-needed reforms by existing state programs."   MORE >>