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Compliance Corner: Podcasts

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September 27, 2022

Ep 128: Fall Bills: Congress Considers Mental Health Services Proposals

In this episode, Suzanne Spradley and Chase Cannon walk through recent activity in the House and Senate relating to several new laws under consideration on coverage of mental health services. Suzanne starts by reviewing some potential changes relating to Medicare coverage of mental health services, such as required behavioral health monitoring for suicide ideations and the need for interventions such as detoxification for substance abuse. Suzanne and Chase walk through proposals from the House on coverage for forensic medical exams relating to sexual assault. Suzanne and Chase close with a discussion of provider network proposals and the Senate’s reauthorization of funding for the Jackie Walorski Maternal and Child Home Visiting Act, which promotes healthy pregnancy practices, language development and early learning at home.
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September 13, 2022

Ep 127: Benefits Aspects of the Inflation Reduction Act

In this episode, Chase Cannon and Suzanne Spradley discuss the benefits provisions of the recently-enacted Inflation Reduction Act. Chase walks through the extension of premium tax credit expansions through 2025, and the impact on employers with respect to the employer mandate penalties. Next, Chase and Suzanne discuss Medicare prescription drug cost reductions and a formalization of prior IRS guidance that allows HDHP coverage of insulin in certain circumstances without impacting HSA eligibility. The two close the podcast by outlining the new law’s increased funding of the IRS and how that might impact compliance enforcement on employer group health plans.
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July 19, 2022

Ep 126: Post-Dobbs Executive Orders, HHS Guidance and State Developments

In this episode, Chase Cannon and Suzanne Spradley recap the past few weeks’ guidance relating to Post-Dobbs considerations on employer coverage and reimbursement of abortion-related services. Chase starts by comparing the approaches of two different states – Texas and New Jersey – with respect to the legality of abortion services. New laws and developments in each of those states highlight the challenge of navigating state law for employers. Suzanne and Chase then discuss the directives from the most recent executive order, aimed at protecting abortion access. Chase dives in on two new pieces of HHS guidance relating to abortion coverage. The two close with a discussion on the importance of time and patience and how court decisions will shape the future environment for employers and group health plans.
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June 07, 2022

Ep 125: FMLA and Mental Health

In this episode, Suzanne Spradley and Patrick Myers discuss recent guidance concerning the interaction between FMLA and mental health conditions. Suzanne provides some context for this guidance and a brief refresher on FMLA itself. Suzanne and Patrick then discuss how mental health conditions can apply in a FMLA context, including when a mental health condition is a “serious health condition” or a disability. Suzanne continues with a discussion about how mental health conditions and FMLA apply to an employee’s family members, FMLA military caregiver leave, and retaliation. Suzanne and Patrick close with a reminder that other state and federal laws may also apply in this context, and employers should review their FMLA and leave policies to make sure that mental health conditions are provided for.
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May 24, 2022

Ep 124: Hospital Prices and Group Health Plan Costs

In this episode, Suzanne Spradley and Chase Cannon discuss hospital prices and their impact on employer group health plans. Suzanne describes this issue as it relates to the new transparency in coverage rules. Suzanne and Chase review a recent study that reviews hospital prices nationwide, including Medicare-certified, short-stay and other facility types. Suzanne discussing the findings of the study, price consistency among the various states, and what it all might mean for employer-sponsored group health plans. Suzanne and Chase close with a discussion of what other means might be available for controlling healthcare costs.
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May 11, 2022

Ep 123: Point Solution Programs and Compliance Issues

In this episode, Chase Cannon and Suzanne Spradley look at the recent rise in so-called “point solution programs.” These add-on programs enhance or expand on a group health plan offering and have benefits such as mental health, musculoskeletal, life coaching and fertility. Chase explains some of the compliance challenges that arise from offering the programs, including ERISA, COBRA, and ACA issues when the programs include components of medical care. Next, Chase and Suzanne discuss the challenges surrounding HSA eligibility and taxation, and the two close with general comments on these types of programs.
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April 26, 2022

Ep 122: Transparency in Coverage Updates

In this episode, Suzanne Spradley and Chase Cannon update us on employer compliance obligations under the Transparency in Coverage (TIC) rules. Suzanne begins with an overview of the TIC rules and how they are meant to address consumerism and rising health care costs. Suzanne and Chase then hone in on the actual requirements, including posting of plan information, with both in-and-out-of-network rates. Next, Suzanne dives in on the different challenges for fully and self-insured plans, and the importance of employers working closely with their carriers and TPAs. The episode closes out with a discussion on provider and TPA contracting.
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March 29, 2022

Ep 121: Looking Ahead: The Impact of the 9th Circuit’s Reversal on Wit v. United Behavioral Health

In this episode, Chase Cannon and Sarah Burns revisit recent mental health claims litigation under the Employee Retirement Income Security Act (ERISA) and the Mental Health Parity and Addiction Equity Act (MHPAEA). Sarah begins with a discussion of the class action lawsuit Wit, et al. v. United Behavioral Health, overturned by the 9th Circuit on March 22, 2022. Next, they address the impact of this decision on future mental health claims litigation and the Department of Labor’s MHPAEA enforcement efforts. The episode closes with MHPAEA compliance reminders for employer plan sponsors.
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March 24, 2022

Ep 120: Mark Rieder Visits Naviant’s “Digital Transformation Talks: Start Your Innovation Journey”

Join NFP’s own Head of Innovation, Mark Rieder, as he discusses what innovation looks like at NFP and how to start your own innovation journey with Naviant’s Ema Roloff on their “Digital Transformation Talks” podcast series. Discussion points include: • How to engage a team in innovation • How to support continual education within an organization • Tips on starting the innovation process Take a listen to hear how innovation gets a strong foundation here at NFP.
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March 15, 2022

EP 119: Mental Health Parity Civil Litigation and Administrative Action

In this episode, Patrick Myers and Suzanne Spradley review recent litigation and administrative action brought under the Mental Health Parity and Addiction Equity Act (MHPAEA). Suzanne begins the discussion by providing background on the requirements imposed on plans by MHPAEA, with a particular focus on non-quantitative treatment limitations (NQTLs). Suzanne then discusses the report submitted to Congress by the DOL, HHS and the IRS that highlighted several deficiencies they found when examining plan sponsors and insurance providers for MHPAEA compliance. She follows up by discussing a large civil case involving a behavioral health provider. And the episode closes with a discussion on two large settlements between the DOL and administrative service providers as part of the agency’s efforts to enforce MHPAEA compliance.
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NFP Corp. and its subsidiaries do not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.

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