The Consolidated Appropriations Act, 2021 (CAA) requires insurance companies and employer-based health plans to file periodic Prescription Drug Data Collection reports (RxDCs) with the Centers for Medicare and Medicaid Service (CMS). The purpose of this data is to allow government agencies to analyze American medical spending. The first RxDC report, which is to contain 2020 and 2021 data, was originally due on Read More

A Florida district court judge has denied Wells Fargo & Company’s motion to dismiss a proposed class action suit over deficient COBRA notices sent to thousands of health plan participants. The case is Blessinger et al. v. Wells Fargo & Company, case number 8:22-cv-01029, U.S. District Court for the Middle District of Florida. Three former Wells Fargo employees sued the company in May 2022 under the Read More

The Internal Revenue Service (IRS) issued Internal Revenue Bulletin 2023-1 on January 3, 2023. Bulletin 2023-1 contains various revisions that supersede some 2022 Revenue Procedures. Administrative Rev. Proc. 2023-1, 2023-2, and 2023-3 all cover administrative issues. These procedures are effective as of January 3, 2023. Rev. Proc. 2023-1 contains revised procedures for letter rulings and information Read More

A California federal judge has denied Calbiotech’s bid to dismiss a former employee’s ERISA suit involving a claim that it failed to match contributions to employees’ 401(k) plans. The judge also kept the former employee’s retaliatory discharge claim alive but tossed his claims related to a separate employer-sponsored pension plan. The case is Raya v. Barka et al., case number 3:19-cv-02295, U.S. District Court for Read More

A group of healthcare providers and individual plaintiffs have filed a class action lawsuit against UnitedHealthcare Inc., OptumHealth Care Solutions, and various other defendants in a Florida federal district court. The providers received an assignment of benefits from the defendants for COVID-19 testing that they have provided and continue to provide to beneficiaries of the defendants’ plans and their family Read More

The Consolidated Appropriations Act, 2023 (CAA, 2023), which Congress passed, and President Biden has now signed into law, contains provisions that impact retirement and group health plan sponsors and advisors. Plan administrators and sponsors must be aware of these provisions and make any adjustments to their plans and policies as needed. Telehealth / High Deductible Health Plans Typically, individuals can Read More

The U.S. Department of Labor has filed a motion asking a Texas federal district court to put a pending court battle on hold while it issues revised guidance on insurance plan coverage under ERISA. Data Marketing Partnership LP offers health insurance to individuals who pay their own premiums in exchange for turning over their personal web tracking data. The case is Data Marketing Partnership LP et al. v. U.S. Read More

Counsel for healthcare workers in a class action lawsuit who alleged overcharges to their employee benefit stock plans in violation of the Employee Retirement Income Security Act (ERISA) has filed a motion requesting almost $3.4 million in attorney's fees and expenses. The case is Gamino v. KPC Healthcare Holdings Inc. et al., Case Number 5:20-cv-01126, U.S. District Court for the Central District of Read More

A split three-judge panel of the U.S. Court of Appeals for the Ninth Circuit affirmed a federal district court’s decision that an embezzler lacked standing under ERISA to direct how her former employer spent restitution that she paid in an accompanying criminal case. The case is Colleen Lehr et al. v. Perri Electric Inc. et al., case number 19-17199, U.S. Court of Appeals for the Ninth Circuit. In its unpublished Read More

While no one can predict the future with 100% accuracy, some healthcare trends and legislative issues are more likely to arise in 2023 than others. Continually rising healthcare costs, increased mental health services, Affordable Care Act tweaks, and the Consolidated Appropriations Act are all likely to play a significant role in the months ahead.  Increased Healthcare Costs Healthcare costs are rising, and Read More