On January 25th, 2022 the Tri-agencies released their 2022 annual report to congress on the [...]
Civil Monetary Penalties for Mental Health Parity Violations on plan sponsors or plan administrators was [...]
The complaint alleges that Aetna imposes a set of overly restrictive criteria to determine which [...]
UnitedHealthcare will pay $15.6 million in penalties and payments to beneficiaries and it will correct [...]
Note: A plan applies different copays to some of its outpatient, in-network medical/surgical benefits. What [...]
One of the biggest questions currently outstanding is will the DOL require plan sponsors to [...]
The Department of Labor DOL has listed enforcement of MHPAEA compliance as a top priority [...]
As a Plan Sponsor or Broker, how would you like to see how much your [...]
As the marketplace is scrambling to complete Drug and Healthcare Cost Reporting for the very [...]
For the TPAs in the Market Place that have had a chance to look at [...]
Compliance delays for the first years of reporting (2020 and 2021) make this first year [...]
This is getting into the weeds a bit but it goes to show that the [...]
PBMs are telling their clients “we have you taken care of” on the data submissions [...]
In total a Plan Sponsor must submit (or have submitted on their behalf) 8 different [...]
Subject: Drug and Healthcare Cost Reporting due 12/27/2022 Hope you are doing well. We are [...]
A reporting entity is someone who submits some or all of the required information to [...]
Drug Cost Reporting (Section 204 of the CAA) requires health plans (plans) and carriers (issuers) [...]
Since this reporting is new to the marketplace starting in 2022, you might be confused [...]
