Where we’re going

With annual open enrollment approaching, employers and employees alike are at heightened levels of stress over the potential for significant increases in benefit costs. End-of-year health plan renewals may see significant increases in the cost of coverage, potentially resulting in higher employer and employee contributions and/or higher point of purchase cost sharing (deductibles, copayments, etc.). … Continued

The federal government prevailed at summary judgment in a case brought by the Association of Air Medical Services (the “Association”) against the U.S. Department of Health and Human Services et al. (“HHS”), marking it the government’s first major victory in the string of court challenges to the No Surprises Act (the “NSA”). No Surprises Act … Continued

While the No Surprises Act (NSA) intends to end surprise medical billing, also known as balance billing, and protect patients from receiving high out-of-network charges in certain situations, there remain challenges with enforcement over rulings made through the Independent Dispute Resolution (IDR) process. A new survey conducted by the Americans for Fair Health Care (AFHC) … Continued

Compliance with the No Surprises Act (NSA) remains a priority for employer-sponsored health plans The NSA ends surprise medical billing, also known as balance billing, in certain situations – such as emergency care or services from out-of-network providers at in-network facilities. Physicians and other payers continue to challenge agency regulations implementing NSA, specifically provisions that … Continued

Advance Transparency in Coverage (TiC) rules require employers to provide employees with easy access to an online shopping tool featuring 500 shoppable services and highlighting personalized out-of-pocket cost information for covered healthcare items and services. These pivotal transparency mandates are intended to spearhead a massive shift in the role of the patient as a healthcare … Continued

The Departments of Health and Human Services (HHS) issued the first annual report on the impact of the No Surprises Act (NSA). The report “focuses largely on establishing a baseline and a framework for further evaluation” and “details key trends in factors that will be important to evaluate NSA effects including: the implementation and impacts … Continued

The TITAN Women In Business Awards annually celebrates the achievements of women who are making a significant contribution in various industries and professions, from accomplished executives to rising entrepreneurs, who demonstrate exceptional innovation, excellence, and leadership in their respective fields. Through its partnership with the International Awards Associate (IAA), this esteemed competition has captured the … Continued

Prescription drug costs are a major concern among employer groups of all sizes. Increased use of prescription drugs increased nationwide spending tenfold – from $30 billion in 1980 to $335 billion in 2018 (adjusted for inflation in 2018 dollars). Driving much of that increase over the past ten years is specialty pharmacy whose costs have … Continued

As our nation continues to experience a surge in post-pandemic demand for behavioral health counseling and therapy over residual stress, anxiety and depression, Americans are finding it difficult to access and afford mental and behavioral health services. In fact, President Biden declared a National Behavioral Health Crisis during his 2022 State of the Union address, … Continued

Many are questioning how the U.S. healthcare inflation rate compares to the rest of our nation’s economy. The simple answer: it’s significantly lower, which is unusual given that healthcare inflation historically outpaces general inflation. According to McKinsey, inflation is at record highs. Consumer prices have rarely risen faster than healthcare inflation, but that’s the situation … Continued