Effective January 1, 2025, a recently passed Illinois law will impact providers’ ability to provide physical therapy (PT) via telehealth.

On December 21, 2024, the American Relief Act 2025, a year-end government spending bill, was signed into law. While released drafts of the bill included provisions providing relief that would have allowed high-deductible health plans (HDHPs) to provide pre-deductible coverage for non-preventive telehealth services, this relief was not included in the final version of the…

The government recently announced changes regarding rules about preventive services and contraceptive coverage for health plans. A previous alert on this topic is included below for reference. Here’s what you need to know: What Happened? What Does This Mean for Employers? Proposed Tri-Agency Regulations: OTC Contraceptives and Preventive Services (originally sent November 4, 2024) The…

Both houses of Congress have recently passed, and President Biden is expected to sign, legislation that includes significant changes to Affordable Care Act (ACA) reporting requirements. It is important to note that while this legislation will significantly alter federal ACA reporting requirements, it does not impact state-specific reporting obligations. California, New Jersey, Rhode Island, and…

The IRS has announced that the annual PCORI fee, which is imposed on health insurance issuers and self-insured health plan sponsors to fund the work of the Patient-Centered Outcomes Research Institute, will increase from $3.22 per plan enrollee to $3.47 per plan enrollee for plans that end between October 1, 2024 and September 30, 2025. While…

Effective September 20, 2024, the State of Arkansas implemented Emergency Rule 128 requiring pharmacy benefit managers (PBMs) to apply “fair and reasonable rates” to their pharmacy reimbursements. While Arkansas state law requires PBMs to use National Average Drug Acquisition Cost (NADAC) pricing for product reimbursement, the law does not address professional dispensing fees. Failing to…

Employers with employees in Massachusetts are required to electronically submit the Massachusetts Health Insurance Responsibility Disclosure (HIRD) form each year. The form was newly launched in 2018, replacing and significantly streamlining the previous HIRD reporting process.

The Departments of Treasury, Labor, and Health and Human Services (Tri-Agencies) have released proposed regulations that, if adopted in their current form, would address a number of issues regarding preventive services as well as expanding over-the-counter (OTC) contraceptive coverage.

Three states – Alaska, Missouri, and Nebraska – will have paid sick leave (PSL) initiatives on the ballot for the November 5, 2024 election. These PSL initiatives, if passed, would take effect on July 1, May 1, and October 1, 2025, respectively. The ballot measures include the following provisions: Alaska Missouri Nebraska