Family building benefits continue to be top of mind as employers and plan sponsors implement new benefit programs to support family building journeys for their employees. At the same time, there have been a few recent lawsuits challenging health plan eligibility criteria for infertility treatment coverage. This post summarizes the recent litigation and challenges for
Health Plan
More on Braidwood: ACA Preventive Services Mandate Remains Mostly in Place (For the Time Being)
At the end of June, the U.S. Court of Appeals for the Fifth Circuit affirmed a district court order invalidating the Affordable Care Act preventive services mandate for “A” or “B” items and services recommended by the United States Preventive Services Task Force (USPSTF) on or after March 23, 2010, on the basis that the…
Supreme Court Rejects Challenge to FDA Approval of Mifepristone: Impact on Health Plans
Today, the U.S. Supreme Court rejected a challenge to the U.S. Food and Drug Administration (FDA) approval of the drug mifepristone, which is used as part of a two-drug protocol to induce abortion. The Court ruled that the providers seeking to overturn the FDA approval did not have standing, because the providers were not directly…
Fifth Circuit Supports Restrictions on Medication Abortion, But No Immediate Impact on Health Plans (For Now)
Last week, the U.S. Court of Appeals for the Fifth Circuit affirmed in part and vacated in part a Texas federal district court order revoking the U.S. Food and Drug Administration (FDA) approval of the drug mifepristone, which is used as part of a two-drug regimen to induce abortion. The Fifth Circuit vacated the district…
Fifth Circuit Stay Means Preventive Services Mandate Remains in Effect
On Tuesday, the U.S. Court of Appeals for the Fifth Circuit approved the parties’ stipulated agreement to stay enforcement of the district court decision in Braidwood Management Inc. v. Becerra until the appeal is resolved (with a limited exception for the named plaintiffs). As readers will recall from our prior blog, in Braidwood, a district court had enjoined enforcement of the preventive services mandate for “A” or “B” items and services recommended by the United States Preventive Services Task Force (“USPSTF”) on or after March 23, 2010. If the district court decision stands, non-grandfathered health plans would not have to cover those particular preventive services without cost-sharing.
Fifth Circuit Stay Reinstates Preventive Services Mandate—For Now
On Monday, the U.S. Court of Appeals for the Fifth Circuit issued an administrative stay of enforcement of the district court decision in Braidwood Management Inc. v. Becerra. Readers of our earlier blog (found here) will remember that in Braidwood, the district court enjoined enforcement of the preventive services mandate for “A” or “B” items and services recommended by the United States Preventive Services Task Force (“USPSTF”) on or after March 23, 2010. If the district court decision stands, this means that non-grandfathered plans would not have to cover these services without cost-sharing. However, as a result of the Fifth Circuit stay issued on May 15, non-grandfathered health plans will continue to be subject to the mandate for these services for the time being. All other preventive care requirements for health plans remain in place.
Preventive Care in a Post-Braidwood World: Agencies Release Guidance on Preventive Services Coverage Requirements
The Departments of Labor, Treasury, and Health and Human Services (the “Departments”) recently released guidance for group health plans on required preventive services coverage. The guidance was issued in response to a federal district court decision in a case called Braidwood Management, Inc. v. Becerra that enjoined enforcement of the preventive services mandate for items and services with an “A” or “B” rating from the United States Preventive Services Task Force (“USPSTF”) on or after March 23, 2010. The Departments issued this guidance to clarify the current scope of the preventive services mandate in light of the court’s decision.
[Podcast]: Cyber-theft of 401(k) Accounts
In this episode of the Proskauer Benefits Brief, partner Robert Projansky and special guest Garrett Fenton, senior attorney at Microsoft Corporation, discuss cyber theft of 401(k) plan accounts. Tune in as we discuss why 401(k) plans are vulnerable to cyber security breaches, what kinds of cyber security frauds we are seeing in 401(k) plans, evolving litigation on these issues and steps plan sponsors can take to mitigate risk.
EBSA FY 2019 MHPAEA Enforcement
The Employee Benefits Security Administration (EBSA) is charged with ensuring that plans comply with ERISA, including the Mental Health Parity and Addiction Equity Act (MHPAEA). EBSA recently released its MHPAEA report for Fiscal Year (FY) 2019. We provide below highlights from EBSA’s report and also note some comparisons to FY 2018.
In FY 2019, EBSA…