With the US election less than one week away, what are the legal implications of a Harris-Walz administration versus a Trump-Vance administration on reproductive rights? In this Q&A, Sarah Raaii explores how the election’s outcome could impact how plan sponsors and employers address reproductive care, including fertility treatments like in vitro fertilization.
With the US election one week away, what are the legal implications of a Harris-Walz administration versus a Trump-Vance administration regarding gender-affirming care? In this Q&A, Greg Fosheim, Sarah Raaii, and Alden Bianchi discuss how the election’s outcome could affect clients in the employee benefits and healthcare spaces.
Employee Retirement Income Security Act class action lawsuits filed earlier this year against the group health plans of two large US employers underscore the importance of implementing formal welfare benefit plan governance structures that include fiduciary committees comparable to the governance structures employer sponsors of retirement plans routinely adopt.
This recent article, published by the Society for Human Resource Management, offers plan sponsors a list of practical action items to consider to help protect themselves from risks related to the fiduciary governance of their health and welfare plans.
Alden Bianchi, Jake Mattinson, and Sarah Raaii recently authored an article in ALM Benefits Pro commenting on the final Mental Health Parity and Addiction Equity Act (MHPAEA) regulations issued last month by the Biden administration. While some of the more objectionable features of the proposed MHPAEA regulations were not finalized, they argue that their basic structure remains fully intact, including provisions that employers found most burdensome.
On September 9, 2024, the Biden administration issued much-anticipated final regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). The rules implement a host of complicated new compliance requirements for sponsors and issuers of health plans, instituting new obligations to collect and evaluate plan data, conduct comparative analyses, and act to address material differences in access to mental health and substance abuse benefits as compared to medical and surgical benefits.
During a recent webinar, Alden Bianchi, Jake Mattinson, and Sarah Raaii provided a comprehensive overview of the new rules, including compliance deadlines and key takeaways for employers, plan sponsors, and issuers of group health plans. The speakers also addressed how the new rules might impact any ongoing US Department of Labor investigations.
Healthcare providers, payors, and other healthcare organizations should be aware of a recently announced, “first-of-its-kind” settlement between the Texas attorney general and a healthcare generative artificial intelligence (AI) company resolving allegations that the company made a series of false and misleading statements about the accuracy and safety of its AI products. The settlement highlights the potential for enforcement against companies that utilize AI in a healthcare setting under existing laws that are not specific to AI and the importance of exercising caution in developing claims about an AI product’s efficacy or performance.
On September 9, 2024, the US Departments of Health and Human Services , Labor, and the Treasury finalized a rule related to the Mental Health Parity and Addiction Equity Act. This rule introduces significant updates to mental health and substance use disorder benefits, ensuring parity with medical and surgical benefits. Key changes include enhanced protections against restrictive treatment limitations, clarified definitions, and new data evaluation requirements. These updates, effective from January 2025, are crucial for hospitals, health systems, and managed care providers.
The US Departments of the Treasury, Labor, and Health and Human Services recently issued much-anticipated final regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). The newly issued final regulations update the 2013 final regulations principally to reflect the changes to MHPAEA enacted by the Consolidated Appropriations Act, 2021, which requires plans and issuers to formally analyze and compare nonquantitative treatment limitations as they apply to both mental health and substance use disorder benefits and medical/surgical benefits.
The changes in the final regulations largely take effect in 2025, with the effective date for some provisions delayed until 2026. Although the final regulations may face litigation challenges, considering the recent decision in Loper Bright Enterprises v. Raimondo, health plan sponsors should plan to comply by the quickly approaching deadlines.
On August 12, 2024, the Biden administration launched a new “Time Is Money” initiative, seeking to crack down on time-consuming and burdensome business processes.
The initiative includes a requirement for federal employee health plans to provide an online opportunity to submit claims. It also features an accompanying letter to health insurance CEOs from the heads of the US Department of Health and Human Services and US Department of Labor that challenges the CEOS to offer online claim submissions, deny claims only where appropriate, and provide clear steps to appeal decisions.
Read more about the initiative and other McDermott+ healthcare-related regulatory updates here.
In response to evolving market demands, an increasing number of hospitals and health systems are considering creating provider-sponsored health plans (PHSPs), which are health insurance plans owned and operated by healthcare providers. McDermott’s healthcare team recently hosted a webinar exploring how PSHPs may offer hospitals a strategic pathway towards achieving sustainable, patient-centered care delivery by driving improvements in care coordination, health outcomes, and member satisfaction.
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