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Over the last two years, a compliance tidal wave has loomed over employers and their benefit advisors. The crest of this massive wave has begun to touch down upon fiduciaries of employer groups, so how can benefit advisors stay dry?
The shortfall of generic drugs, which comprise the majority of medications that Americans consume, has been a chronic problem, starting well before the mid-2020s.
"While the nation is crippled with health care debt, while employers are spending more and more every single year, the reality is that revenue turns into profit for insurers," Lester Morales said.
Less than half of employers are confident in the integrity of health care services and fees charged by hospitals, pharmacy benefit managers, third-party administrators and even broker and consultants, says a new report.
A recent hearing at the U.S. House of Representative Health Subcommittee of the Energy and Commerce Committee heard testimony from shareholders and policy experts on costs and price transparency.
In January, the Biden administration pledged to increase public access to Medicare information to conduct research studies that can influence public health reforms, but this week the CMS announced a proposal to diminish access.
For years, Medicare has paid hospitals double the rates it pays other providers for the same services, such as colonoscopies and blood tests, but a new House bill requires Medicare to pay the same rates for such services.
Last year, lawmakers in 29 states considered some 90 bills that would regulate quicker response times from insurers, according to the American Medical Association, with victories in New Jersey and Washington, D.C.
The Federal Trade Commission launched its inquiry of the 6 largest PBMs in June 2022, after Sen. Chuck Grassley (R-Iowa) had pressed the commission for years to review their role in determining prices for prescriptions like insulin.
The DOL's complaint against BCBSM, Inc., as well as the series of lawsuits against other TPAs and insurers, may redefine the landscape of fiduciary responsibilities and the role of TPAs in plan administration.