No health insurance benefit program, no matter how high profile, is immune to the temptations of insurance fraud. In the past, multiple former NFL players pleaded guilty to defrauding the NFL Player Health Reimbursement...more
In Rev. Proc. 2024-25, the IRS released the inflation adjusted amounts for 2025 relevant to Health Savings Accounts (HSAs) and high deductible health plans (HDHPs). The table below summarizes those adjustments and other...more
On April 2, 2024, the Centers for Medicare & Medicaid Services (CMS) released the 2025 Notice of Benefit and Payment Parameters (NBPP) final rule (Final Rule), finalizing policies applicable to qualified health plans offered...more
In an industry full of buzzwords, “adaptogens” and “nootropics” are current stand outs within the beverage industry. The beverage industry experienced a significant shift in consumer preference following the COVID-19...more
Since Washington launched its Paid Family Medical Leave program ("PFML") in 2020, employers have had very limited access to information from the state regarding employee leaves, including when leaves begin or end. With the...more
In Rev. Proc. 2023-23, the IRS released the inflation-adjusted amounts for 2024 relevant to Health Savings Accounts (HSAs) and high deductible health plans (HDHPs). The table below summarizes those adjustments and other...more
On April 29, 2022, the IRS announced the Health Savings Account limits for 2023. With respect to contribution limits, the limits are slightly higher than the ones for 2022, and the required deductible and out of pocket...more
On December 28, 2021, HHS released a proposed rule governing plans issued in the Patient Protection and Affordable Care Act (ACA) marketplaces beginning with the 2023 plan year (the Proposed Rule). Among other changes to the...more
On August 27, 2021, Governor Pritzker signed the Consumer Coverage Disclosure Act (the Act), which became effective immediately. The Act requires Illinois employers (both private and governmental) to disclose to all new hires...more
Although many states have legalized marijuana for medicinal and/or recreational use, when it comes to using marijuana in a research setting, sources have been very limited. The US Drug Enforcement Administration (DEA) has...more
Last week, the U.S. Food and Drug Administration (“FDA”) announced that it will be conducting research in conjunction with a new rule they plan to roll out. The FDA update is located here. This proposed rule would update the...more
Now that we have had the chance to read and meditate on the historic Medicaid waiver approved on Friday January 8th, giving Tennessee permission from the Federal government to fundamentally alter Medicaid’s traditional...more
California health insurers and health care service plans that provide hospital, medical, or surgical coverage and that are issued, amended, or renewed on or after January 1, 2021 will be required to cover all medically...more
In this week’s episode, Carla DewBerry and Kelsey Jernigan discuss issues in mental health parity in the context of recent California legislation. In particular, the presenters discuss how a new California bill has sparked a...more
On July 17, 2020, a panel majority of the D.C. Circuit Court of Appeals upheld a rule issued by the Department of Treasury, the Department of Labor, and the Department of Health and Human Services (collectively, the...more
In France, Ordinance No 2017-49 of 19 January 2017 significantly modified the rules governing payments from life sciences companies to the healthcare sector. After more than three years, on June 15, 2020, Decree No 2020-730...more
On March 18, 2020, CMS issued Frequently Asked Questions (FAQs) to clarify that the diagnosis and treatment of Coronavirus Disease 2019 (COVID-19) is covered by catastrophic health plans. CMS also confirms that the agency...more
As federal and state governments respond to COVID-19, employers and plan fiduciaries must also address the evolving issues arising under employer-sponsored health plans. The specific considerations covered in this update are...more
On March 12, 2020, the Center for Medicare & Medicaid Services Center for Consumer Information & Insurance Oversight issued an FAQ regarding coverage for diagnosis and treatment of COVID-19 under the Affordable Care Act. CMS...more
As the Coronavirus has continued to spread, there has been guidance from various entities on a myriad of topics pertaining to employee benefits. Summaries and links to such guidance can be found below. This information will...more
High-deductible health plans may now cover testing and treatment for 2019 novel coronavirus (COVID-19) on a first-dollar basis without risking making participants ineligible to participate in health savings accounts (HSAs)....more
Congress recently passed an $8.3 billion emergency spending bill to fund vaccine development, support for state and local governments, and assistance for affected small businesses. Federal lawmakers are likely to consider...more
The Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director (SMD) letter and fact sheet on Jan. 30, 2020, that encouraged states to pursue block grant or per capita cap funding through their Medicaid...more
Manufacturers, distributors, and suppliers of CBD products should embrace and participate in reform to address public health concerns, write Bilzin Sumberg attorneys. Consumer groups like the Arthritis Foundation are stepping...more
The Affordable Care Act (ACA) removed pre-existing condition barriers, defined a broad range of essential health benefits, and improved access to coverage and care for millions of people nationwide. However, the ACA has thus...more