Insights

On May 29, 2022, HB 970 was enacted. Effective January 1, 2023, the new statute prohibits health insurers from imposing a prior authorization requirement for prescription drugs used as post-exposure prophylaxis for the prevention of HIV, if the drug is prescribed in accordance with CDC guidelines. This prohibition will apply to group health insurance policies issued in the state and which provide coverage for prescription drugs. Employer plan sponsors should verify with their ins

On May 16, 2022, Gov. Hogan signed HB 1397 into law. Effective for policies issued on or after January 1, 2023, the new law prohibits insurers from imposing a copayment or coinsurance greater than $30 for a 30-day supply of insulin drugs or $150 for a 30-day supply of a prescription drug to treat diabetes, HIV or AIDS. The requirements apply to group health insurance policies issued in the state and which provide coverage for prescription drugs. Employer plan sponsors should verify with their i

On June 3, 2022, the IRS, DOL and HHS (the 'departments') released a federal independent dispute resolution (IDR) process checklist of requirements for group health plans and insurers. The checklist was designed to help plans and insurers understand their obligations when processing claims for items and services covered by the No Surprises Act (NSA) balance billing protections. The NSA provisions protect participants from surprise bills for out-of-network (OON) emergency and air ambulance servi

Proposed amendments to the Connecticut FMLA (CT FMLA) are expected to be reviewed and approved soon by the state's Legislative Regulation Review Committee. Additionally, new notice requirements become effective July 1, 2022. In 2019, the state passed two laws that resulted in the Connecticut Paid Family and Medical Leave (CT PFML) program. The first law expanded employee eligibility and other provisions of the existing FMLA program. The second law provided eligible employees with income replace

Through May and June of this year, Gov. Pritzker signed a series of bills into law mandating health insurers in the state provide certain coverage for the following services: SB2969 (signed June 15, 2022): medically necessary continuous glucose monitors for individuals with Type 1 or Type 2 diabetes, effective January 1, 2023Press Release on SB2969 HB5318 (signed June 10, 2022): annual prostate cancer screening and medically necessary follow-up testing without imposing a deductible, coinsur

On June 13, 2022, the Office of Civil Rights (OCR) updated its website with guidance related to audio-only telehealth and HIPAA Privacy and Security Rules. The OCR stated the guidance was in direct response to Executive Order 14058, which was issued in December 2021 and ordered the federal government agencies to design and deliver services in a more equitable and effective manner, especially for those who have been historically underserved. The guidance notes that telehealth that includes video

On June 3, 2022, the IRS announced that they will begin a new pre-examination retirement plan compliance program in June of 2022. Plan sponsors who are selected for the program will receive a letter from the IRS indicating that they have 90 days to review their retirement plan's documentation and operation to determine if they meet the IRS' requirements. The IRS will potentially schedule a full exam for those employers who do not respond. Upon completing the review, employers who find mistakes

On June 9, 2022, the IRS released Announcement 2022-13, in which the agency increased the optional standard mileage rate for computing the deductible costs of operating an automobile for business to 62.5 cents per mile. The optional standard mileage rate for medical and moving expenses is increased to 22 cents per mile. These increases are effective starting on July 1, 2022, and were increased in part due to higher fuel costs. Taxpayers may use the optional standard mileage rates to calculate t

On June 1, 2022, the US Court of Appeals for the Seventh Circuit held in Zicarrelli v. Dart et al. that an employee's FMLA rights may be violated without an actual denial of leave '” simply interfering with an employee's attempt to exercise those rights can violate the law. Plaintiff Salvatore Zicarrelli worked for the Cook County Sheriff's Office for over 27 years. During that time, he periodically took FMLA leave. In September 2016, he called the Sheriff's Office FMLA manager to discuss taki