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1459183354
March 01, 2023
EP 133: PBM Transparency: Potential State and Federal Activity
In this episode, Suzanne Spradley and Chase Cannon discuss potential activity at the federal and state level relating to PBM transparency. Suzanne begins the discussion by outlining a few proposals from Congress that attempt to hold PBMs accountable for unfair and deceptive practices that may be driving up prescription drug costs. Suzanne then addresses a few state proposals that attempt to regulate PBMs. Suzanne and Chase close by discussing the potential impact on employers and their group health plans.
NFP's Insights from the Experts
1436987146
January 31, 2023
EP 132: Public Health Emergencies, Telehealth Extensions & State Compliance Considerations – 2023
In this episode, Beth Allen and Chase Cannon look at several new developments for plan compliance in 2023. The two start with the recent announcement on the end of the COVID-19 public health emergency, which impacts the outbreak period and extension of timeframes for certain compliance deadlines. Chase then dives in on the CAA 2023 extension of relief for telehealth services in conjunction with HSA eligibility. Chase and Beth close by outlining several state compliance challenges, including state law interaction with telehealth services and the ever-evolving landscape of state paid family and medical leave laws.
NFP's Insights from the Experts
1416565585
January 04, 2023
Ep 131: Healthcare Policy and Compliance Issues for Employers to Consider in 2023
In this episode, Suzanne Spradley and Chase Cannon highlight several areas of healthcare policy and compliance that will be on center stage in 2023. Suzanne starts with a discussion of transparency in healthcare and prescription drug costs, including several compliance requirements that will take effect in 2023. Suzanne and Chase discuss state compliance challenges, including abortion travel coverage, paid family and medical leave, and new legislation aimed at providers (but could indirectly impact employers). Suzanne closes by addressing the extension of telehealth relief with respect to HSA eligibility and what to look for in 2023 on the mental health parity analysis requirement.
NFP's Insights from the Experts
1379071426
November 08, 2022
Ep 130: More COBRA Cases — Class Actions and COBRA Election Notices
In this episode, Suzanne Spradley and Chase Cannon discuss several recent COBRA cases. Suzanne starts by outlining several class action lawsuits filed against employers and plan sponsors relating to deficiencies in an employer health plan’s COBRA election notice. Suzanne and Chase discuss the use of the DOL’s Model Election Notice and how that usage interacts with potential DOL regulatory fines and participant lawsuits, and how employers can get into trouble by not including the appropriate information in the model or other election notices. Suzanne then describes a lawsuit against a single employer relating to a COBRA election notice delivery failure, including the involvement of a TPA.
NFP's Insights from the Experts
1370048719
October 25, 2022
Ep 129: Recent Court Rulings on COBRA and the ACA
In this episode, Chase Cannon and Suzanne Spradley discuss three recent court rulings—all at the district court level. Chase outlines the first case relating to a COBRA election notice failure, including takeaways for employers to enhance their notice distribution procedures. Chase and Suzanne dive into an ACA-related case challenging gender-affirming care guidance published by HHS earlier in 2022. The two close with a review of a third case challenging certain aspects of the ACA’s preventive care mandate.
NFP's Insights from the Experts
1352410255
September 27, 2022
Ep 128: Fall Bills: Congress Considers Mental Health Services Proposals
In this episode, Suzanne Spradley and Chase Cannon walk through recent activity in the House and Senate relating to several new laws under consideration on coverage of mental health services. Suzanne starts by reviewing some potential changes relating to Medicare coverage of mental health services, such as required behavioral health monitoring for suicide ideations and the need for interventions such as detoxification for substance abuse. Suzanne and Chase walk through proposals from the House on coverage for forensic medical exams relating to sexual assault. Suzanne and Chase close with a discussion of provider network proposals and the Senate’s reauthorization of funding for the Jackie Walorski Maternal and Child Home Visiting Act, which promotes healthy pregnancy practices, language development and early learning at home.
NFP's Insights from the Experts
1343326957
September 13, 2022
Ep 127: Benefits Aspects of the Inflation Reduction Act
In this episode, Chase Cannon and Suzanne Spradley discuss the benefits provisions of the recently-enacted Inflation Reduction Act. Chase walks through the extension of premium tax credit expansions through 2025, and the impact on employers with respect to the employer mandate penalties. Next, Chase and Suzanne discuss Medicare prescription drug cost reductions and a formalization of prior IRS guidance that allows HDHP coverage of insulin in certain circumstances without impacting HSA eligibility. The two close the podcast by outlining the new law’s increased funding of the IRS and how that might impact compliance enforcement on employer group health plans.
NFP's Insights from the Experts
1308148120
July 19, 2022
Ep 126: Post-Dobbs Executive Orders, HHS Guidance and State Developments
In this episode, Chase Cannon and Suzanne Spradley recap the past few weeks’ guidance relating to Post-Dobbs considerations on employer coverage and reimbursement of abortion-related services. Chase starts by comparing the approaches of two different states – Texas and New Jersey – with respect to the legality of abortion services. New laws and developments in each of those states highlight the challenge of navigating state law for employers. Suzanne and Chase then discuss the directives from the most recent executive order, aimed at protecting abortion access. Chase dives in on two new pieces of HHS guidance relating to abortion coverage. The two close with a discussion on the importance of time and patience and how court decisions will shape the future environment for employers and group health plans.
NFP's Insights from the Experts
1283066884
June 07, 2022
Ep 125: FMLA and Mental Health
In this episode, Suzanne Spradley and Patrick Myers discuss recent guidance concerning the interaction between FMLA and mental health conditions. Suzanne provides some context for this guidance and a brief refresher on FMLA itself. Suzanne and Patrick then discuss how mental health conditions can apply in a FMLA context, including when a mental health condition is a “serious health condition” or a disability. Suzanne continues with a discussion about how mental health conditions and FMLA apply to an employee’s family members, FMLA military caregiver leave, and retaliation. Suzanne and Patrick close with a reminder that other state and federal laws may also apply in this context, and employers should review their FMLA and leave policies to make sure that mental health conditions are provided for.
NFP's Insights from the Experts
1274573506
May 24, 2022
Ep 124: Hospital Prices and Group Health Plan Costs
In this episode, Suzanne Spradley and Chase Cannon discuss hospital prices and their impact on employer group health plans. Suzanne describes this issue as it relates to the new transparency in coverage rules. Suzanne and Chase review a recent study that reviews hospital prices nationwide, including Medicare-certified, short-stay and other facility types. Suzanne discussing the findings of the study, price consistency among the various states, and what it all might mean for employer-sponsored group health plans. Suzanne and Chase close with a discussion of what other means might be available for controlling healthcare costs.
NFP's Insights from the Experts
NFP Corp. and its subsidiaries do not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.