Weekly Benefits & HR Compliance Updates 8.16.24

Hole in the Bottle… Employer Considerations After Another Lawsuit Against an Employer Health Plan

“Consider whether it makes sense to establish a health and welfare fiduciary committee ... Review and negotiate services agreements with health plan third-party administrators and PBMs.... Engage independent consultants ... to understand and monitor the plan's fee and rebate arrangement along with how the plan's prescription drug formulary is structured.... Periodically conduct requests for proposal for medical plan third-party administrators and PBMs.” Full Article

Holland & Hart, LLP

HIPAA Reproductive Health Care Rule: HHS Publishes Model Attestation

“Attestations must be written in plain English, and they must be signed and dated by the person requesting the PHI. Attestations must also include [specific] elements. As noted in the model attestation instructions, attestations may not be combined with other documents (except for documents provided to support the attestation) and may not include statements or content that is not otherwise required under the Reproductive Health Care Rule.” Full Article

Proskauer Rose, LLP

Michigan Supreme Court Voids Current Minimum Wage and Paid Medical Leave Law and Reinstates 2018 Ballot Initiatives

"The Michigan Supreme Court's Opinion voids the current Michigan Paid Medical Leave Act and reinstates the Earned Sick Time Act as it was originally adopted by the Michigan Legislature in September 2018. The Court's Opinion also provides for a 205-day period of transition to allow employers to prepare for and comply with these new laws Michigan businesses will be required to begin complying with the Earned Sick Time Act on February 21, 2025.” Full Article

Miller, Johnson, Snell & Cummiskey, P.L.C.

Why Many Nonprofit (Wink, Wink) Hospitals Are Rolling in Money

“When many U.S. hospitals were founded over the past two centuries they were accorded nonprofit status for doling out free care. But as more Americans gained insurance and medical treatments became more effective -- and more expensive -- there was money to be made. In this century, they also began acquiring parts of the health care systems that had long been for-profit.” Full Article

KFF Health News

New York Employers Must Provide Paid Lactation Breaks: 4 Key Takeaways

“New York State amended its Labor Law to require employers to provide nursing employees with 30-minutes of paid break time to express breast milk at work, enhancing a law that previously permitted reasonable, unpaid break time. This new paid time must be provided each time an employee has a reasonable need to express breast milk and can be extended through existing paid breaks or mealtimes if the employee needs more than 30 minutes to express breast milk.” Full Article

Fisher & Phillips, LLP

Ignoring Request for Documents Can Be Costly for Health Insurer

“The defendant utilized proprietary guidelines to adjudicate claims involving both mental health treatment as well as for medical and surgical treatment. The plaintiffs requested that the plan provide copies of both sets of guidelines, but their request was ignored. Although the court determined that the benefit denial was warranted, the court nonetheless deemed the penalty appropriate for non-compliance with required disclosures.” Full Article

DeBofsky Law, Ltd.

This Weekly Digest is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.