Compliance

The rule would require prior authorization decisions within 72 hours for expedited, urgent requests and seven calendar days for standard, non-urgent requests – and denials would be required to include a specific reason.

Employers need to ensure that employees are informed about changes to their health benefits, regarding COVID testing and vaccines, and offer coverage to those affected by the suspension of Medicaid dis-enrollments.

In January, the White House announced plans to extend the national emergency, as well as the public health emergency, until May 11. However, the legislation ending the national emergency takes effect immediately.

Many of the severance agreements employers have used for years when terminating an employee will now be deemed illegal by the General Counsel.

Insurers and employers are expected to be reluctant or even unable to immediately begin charging copays or deductibles for the affected preventive care for certain services, such as screening for diabetes, hepatitis and certain cancers.

Pfizer's CEO was the first major pharmaceutical company leader to add his name to the open letter, written after a Texas federal judge banned the use of the FDA-approved abortion pill mifepristone.

The article argues that, given the federal government's endorsement of RBP and its proven efficacy in reducing employer costs and expanding participant options, it is now virtually impossible for a plan fiduciary to lawfully discharge their duties in accordance with ERISA without at least considering the implementation of RBP.

In terms of the illegal act exclusions, it is vital that plan administrators use their discretionary authority to regularly assess the applicability of these exclusions.