"Although the Final Rule requires a covered entity to collect an attestation from requesters of PHI potentially related to reproductive health care, HHS makes clear that group health plans and business associates cannot rely on the attestation and must make an independent determination on the use or disclosure of PHI.... The attestation will be limited to the specific use or disclosure, so each use or disclosure request will require its own attestation."   MORE >>

"A mid-year election change will typically be effective as of the first of the month following the election change request to avoid the Section 125 cafeteria plan issues associated with paying for retroactive coverage. The primary exceptions are for new hires (elections may be retroactive to the date of hire) and newly born/adopted children (medical coverage must be retroactive to the date of the birth/adoption)."   MORE >>

"Unique substantive requirements, regular amendments to the Ordinance, Rules and administrative guidance, and proactive enforcement have been hallmarks of the mandate since it went into effect in April 2014."   MORE >>

"In light of the relatively low pleading standard the Ninth Circuit has set, group health plans and their sponsors, administrators and fiduciaries should pay careful attention to the internal processes they utilize in determining coverage for MH/SUD benefits as compared to M/S benefits. The Ninth Circuit's ruling may significantly impact the health care industry, especially with proposed MHPAEA regulations anticipated to be finalized this year." [ Ryan S. v. UnitedHealth Group, Inc. , No. 22-55761 (9th Cir. Apr. 11, 2024)]   MORE >>

"The standard established in Ryan S. makes it difficult to challenge a Parity Act claim at the pleading stage, which will open up Parity Act lawsuits to discovery. The Ninth Circuit's opinion also makes it easier to bring a putative class action based on a Parity Act violation[.]" [ Ryan S. v. UnitedHealth Group, Inc. , No. 22-55761 (9th Cir. Apr. 11, 2024)]   MORE >>

"Covered entities and business associates should carefully review [OCR's] FAQ webpage , in conjunction with all UHG/Change statements, and consider taking the following steps: [1] Contact Change/UHG about notifications and compromised data.... [2] Prepare to evaluate whether patients are impacted.... [3] Review BAAs with Change.... [4] Conduct a dark web investigation.... [5] Continue to monitor relevant sites for updates."   MORE >>

"Transplant insurance policies are a way for employers to mitigate both the severity and frequency of catastrophic health claims stemming from transplant procedures. These policies are often called transplant carve-outs, because the financial risk posed by transplant procedures is being 'carved out' from the regular plan and covered with a supplementary insurance policy. Transplant carve-outs promotes predictability rather than variability of cost in terms of budgeting, thus helping to stabilize a group's stop loss rates."   MORE >>

"This year's benefits enrollment season gives employers opportunities to enhance the employee experience and to maximize the ROI of their programs by leveraging technology.... Start by listening to your employees.... Integrate wellbeing resources.... Simplify your employee experience."   MORE >>

"Walmart, citing "lack of profitability," announced plans to close all 51 of its health centers in five states, while the retailer will continue to operate its 4,600 pharmacies and more than 3,000 Vision centers."   MORE >>

"In combination with the Inflation Reduction Act's introduction of Medicare drug price negotiations, the Biden administration's reform of Medicare Advantage ads introduced precedent for monitoring direct-to-consumer advertising (DTCA). Yet, there is still room for reform, regulation, and improvement.... DTCA explicitly increases consumption of pharmaceutical products and, perhaps more insidiously, implicitly influences Americans' perception of drug efficacy.... Patient and consumer protection is desperately needed."   MORE >>

"[1] Determine which of your workers have agreed to non-compete clauses. This may include former workers, and may include 'Senior Executives.' [2] Consider whether your existing agreements will be enforceable under applicable state laws that are not preempted by the FTC rule.... [3] [S]tart thinking about the logistics of notifying your workers about unenforceable non-competes. [4] If your business relies on trade secrets or other confidential information ... consider taking additional steps to protect your most valuable information from being misappropriated by departing workers ... [5] Develop a system to keep track of any restrictive covenants you use moving forward."   MORE >>

"The Chamber alleges in its complaint that 'the economy as a whole will suffer' because dominant firms snatch the best employees from startups and small businesses. The Chamber argues that the FTC's Rule is an assertion of power that is contrary to centuries of state and federal law and relies on 'novel claims of authority.' " [Chamber of Commerce of the U.S.A. v. Federal Trade Commission, No. 24-00148 (E.D. Tex. complaint filed Apr. 23, 2024)   MORE >>

"To date, three lawsuits have been filed challenging the legality of the FTC's Final Rule banning non-competes. The initial two cases were filed in Texas federal court, which is widely viewed as a more hospitable forum for attacks on the Rule. The third case was filed in Pennsylvania federal court, possibly for the strategic purpose of creating a circuit split to enhance appellate options.... While other lawsuits against the FTC and its commissioners trickle in, it's likely the U.S. Chamber's lawsuit will take the lead."   MORE >>