Federal agencies have finalized resources to promote compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA), including final FAQs and a model disclosure request form. Employers should consider using these resources to review their group health plan’s compliance…

The Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA) requires a health insurance carrier to refund part of the premiums it receives if it does not spend at least 80% (for individuals and small employer groups) or…

In 2018, Massachusetts established the Paid Family and Medical Leave Act, a statewide paid family and medical leave program financed by employer and employee contributions. In 2019, leadership agreed to delay the required contributions for three months, from July 1…

Wednesday, August 14th, Harvard Pilgrim Health Care and Tufts Health Plan announced an agreement to merge, consolidating Massachusetts' 2nd and 3rd largest insurers. The board of directors will comprise equal representation from both directors. “Through the combination of two strong…

While still in it's development stage, HHS and the FDA are releasing the below Safe Importation Action Plan to describe steps that will be taken to allow the importation of certain drugs from Canada, as well as allow manufacturers to…

To prepare for open enrollment, group health plan sponsors should be aware of the legal changes affecting the design and administration of their plans for plan years beginning on or after Jan. 1, 2020. Items to consider include: ACA Affordability…

Enacted on May 28, 2019, Maine’s Earned Employee Leave Law is the first legislation in the United States to allow private employees to earn paid leave that may be used for any reason. Effective Jan. 1, 2021, this law allows…

Workplace investigations are crucial when it comes to establishing a safe and welcoming work environment. However, these investigations are often complex and can involve navigating sensitive topics and disputes. More than ever before, companies face irreversible reputational damage and negative…

As a result of a recent Georgia court order, the New Hampshire Insurance Department is advising consumers that Aliera, a company that markets itself as a health care sharing ministry, may be operating illegally in New Hampshire. In the past,…

Beginning in May of last year, the Trump administration began searching for ways to curb out-of-control prescription drug costs—referring to the initiative as American Patients First. This effort is finally seeing some traction, with the administration publishing its first final…

The Affordable Care Act (ACA) requires health insurance issuers and sponsors of self-insured health plans (including qualified Health Reimbursement Arrangements/HRA) to pay Patient-Centered Outcomes Research Institute fees (PCORI fees). The PCORI fees generally apply to insurance policies providing accident and…

On May 9, 2019, President Donald Trump delivered a speech criticizing the practice of surprise medical billing. The president’s speech aligned with this administration’s American Patients First initiative—a blueprint for lowering consumer health costs. Here are the four main regulatory…