Opioid Litigation: Insurance and Risk Management Considerations

The United States is confronting an opioid epidemic that is taking thousands of lives annually and causing billions of dollars in economic losses. While many are working to address the health effects of the crisis, plaintiff attorneys are litigating the matter, seeking monetary damages against various parties.City, state, and county governments across the US have filed lawsuits against organizations associated with the manufacturing, distribution, and/or sale of opioids. Litigation targets — including pharmaceutical manufacturers, distributors, pharmacies, prescribing physicians, and pharmacy benefit managers — must develop a comprehensive approach and practice to address and defend against opioid-related claims, as well as maximize any potential insurance coverage.

Read the full briefing now…

Emerging Blockchain Applications in the Pharmaceutical Industry

The pharmaceutical industry regularly participates in the development of new drugs, filing patents and funding clinical trials. Blockchain offers new methods for documenting proof of work, user validation and smart contracts. Health care facilities are rethinking the ways in which they manage, record and store data; blockchain has the potential to completely transform the industry, offering transparency and security to everyone involved in pharmaceutical transactions. Here are four interesting blockchain applications that are emerging in the pharmacy industry today.

  1. Improving the Speed and Trustworthiness of Clinical Trials

Getting a new drug tested and approved by the FDA requires a long, complicated and expensive process. Some drugs take years and billions of dollars for approval. Clinical trials generate a lot of data that must be shared. The more people that are working on the trials, the more complex and expensive the process. Establishing that a new drug is safe is a scientific challenge but also a data challenge as well. Blockchain could have a major impact on the integrity of the data from start to finish throughout the process. Blockchain technology ensures the trustworthiness of the data through cryptographic validation of each and every transaction, and, because every transaction is connected, the history of every data process is easy to follow due to transaction linkages and timestamps.

Continue reading “Emerging Blockchain Applications in the Pharmaceutical Industry”

DOL Releases Final Rule Expanding Association Health Plans

The U.S. Department of Labor (DOL) has issued a final rule expanding the opportunity of unrelated employers of all sizes (but particularly small employers) to offer employment-based health insurance through Association Health Plans (AHPs). Significantly, the final rule applies “large group” coverage rules under the Affordable Care Act (ACA) to qualifying AHPs.

The final rule confirms that AHPs may be formed by employers in the same trade, industry, line or businesses, or profession. They may also be formed based on a geographic test such as a common state, city, county or same metropolitan area (even if the metropolitan area includes more than one State).

Read the full compliance update…

Be Wise with Your Eyes: Treating Common Eye Conditions

If you’ve ever experienced any type of eye problem or irritation, you know how extremely uncomfortable it can be. Fortunately, many common eye maladies usually go away on their own or can be managed with self-care. Over-the-counter treatments like artificial tears, ointments and ocular decongestants can help with dryness, itchiness or excessive watering of the eye. However, if you or anyone in your family is showing signs of an eye infection, you should seek medical help right away.

Read More…

How to Make Healthy Habits Stick

Healthy choices can have a dramatic effect on your life.  Indeed, healthy habits like eating fruits and vegetables and getting regular exercise not only makes you feel better, but they can also reduce your risk for the most common and preventable health problems—such as heart disease, stroke, cancer, type 2 diabetes, and obesity.

Maybe you’ve already tried to eat better, get more exercise or sleep, quit smoking, or reduce stress. It’s not always easy. However, research shows that change is possible, and there are proven strategies you can use to set yourself up for success.

Read More…

Prescription Opioid Risks to the Workplace Explored at RIMS 2018

When the White House declared opioid use a national Public Health Emergency under federal law in 2017, businesses began reviewing their policies and making efforts to curb their employees’ abuse of the drug in its prescribed form. This escalating risk to organizations is why the business impact of prescription opioid use was such a hot topic at RIMS 2018, where a session on April 17 focused on the practical and bottom-line costs of workforce use of prescription opioids. In a session the next day, attendees learned how liability policies are responding to government-led lawsuits against opioid manufacturers, and how to prepare for similar suits brought against other industries. Continue reading “Prescription Opioid Risks to the Workplace Explored at RIMS 2018”

IRS Issues Affordability Percentage Adjustment for 2019

In Rev. Proc. 2018-34, the IRS released the inflation adjusted amounts for 2019 relevant to determining whether employer-sponsored coverage is “affordable” for purposes of the Affordable Care Act’s (“ACA’s”) employer shared responsibility provisions and premium tax credit program.  For plan years beginning in 2019, the affordability percentage is 9.86% of an employee’s household income or applicable safe harbor.

Read the full compliance update…

A New Stance on Dietary Cholesterol: What you need to know

In the past, you may have read or even heard from your doctor to limit your dietary cholesterol. That advice is now changing. In the U.S. government’s 2015-2020 “New Dietary Guidelines for Americans” the limit on cholesterol has been removed. Previously, American adults were advised to limit cholesterol in their diet to 300 milligrams a day, which is the equivalent of two eggs.

WHY HAS THE LIMIT BEEN REMOVED?

A good amount of scientific research suggests that there isn’t a strong connection between dietary cholesterol and blood cholesterol. In fact, the cholesterol in your diet is only responsible for a small fraction of your total blood cholesterol. Your body naturally produces most
cholesterol on its own. Other factors that contribute to blood cholesterol levels include smoking, obesity, physical activity, age, family history and even certain medications.  So, all of these elements must be taken into account when it comes to maintaining healthy blood cholesterol.

Read More…

IRS Releases 2019 HSA Contribution Limits & HDHP Deductible & Out-of-Pocket Limits

In Rev. Proc. 2018-30, the IRS released the inflation adjusted amounts for 2019 relevant to HSAs and high deductible health plans (HDHPs).

Read the full compliance update…

 

Agencies Issue Guidance on Mental Health Parity Issues & Signals Enhanced Enforcement

On April 23, 2018, the Departments of Labor, Treasury, and Health and Human Services released several pieces of guidance on issues arising under the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), including 2017 enforcement actions, guidance on mental health parity implementation, and an action plan for enhanced enforcement in 2018.

The guidance includes:

  • Proposed FAQs (Part 39) regarding non-quantitative treatment limitations (e.g., non-numerical limits on benefits, such as preauthorization requirements) and plan disclosure issues;
  • An updated draft model disclosure form participants may use to request information from employer-sponsored health plans;
  • A self-compliance tool for group health plans, plan sponsors, insurance carriers, State regulators and other parties to evaluate MHPAEA compliance by a group health plan or insurance carrier; and
  • A 2018 DOL report to Congress titled Pathway to Full Parity.

Read the full compliance update…