With the recent passing of the June 1 deadline for reporting Consolidated Appropriations Act (CAA) required prescription drug data to government agencies, plan sponsors must ask themselves a crucial question: Has my carrier, claims payer, TPA, or PBM timely submitted the required Rx data on my plan’s behalf, and does this mean I am […]
From Reporting to Benchmarking: Ensuring Complete CAA Compliance Read More »
In the ever-evolving landscape of healthcare, access to comprehensive data is a game-changer, offering unparalleled insights into utilization and cost. One significant development in this realm is the transition from traditional data access to the groundbreaking Consolidated Appropriations Act (CAA), ushering in a new era of transparency and accountability. This is a new frontier. The
The Rise of Data Evolution: How the CAA is Redefining Healthcare Decision-Making Read More »
In an era marked by unprecedented disruption in healthcare, navigating the landscape can be daunting. Traditional pharmacy benefit managers (PBMs) have long dominated the market, often shrouded in opaque pricing structures that leave employers and participants at a loss. However, a paradigm shift is underway, driven by the principles of transparency and fiduciary responsibility. In
In recent discussions surrounding our Health Plan Lawsuit Series, where we talk about data analysis, pharmacy benefit management, and actionable strategies for employers and benefit advisors. We talked about the Employee Retirement Income Security Act (ERISA) compliance and the potential risks associated with fiduciary duties, a myriad of critical points have surfaced. Scott Burt
Navigating the Complexities of ERISA Compliance and Risk Mitigation Read More »
In 2023, the healthcare industry found itself at a critical juncture, marked by the emergence of 17 issued or pending lawsuits centered around non-compliance by payers, providers, and employers. This alarming trend serves as a stark indicator that the challenges posed by regulatory changes are not dissipating but intensifying. At the heart of this legal
In recent years, healthcare has witnessed a surge in legal actions, particularly concerning health plan management and fiduciary duties. The Health Plan Lawsuit Series, spearheaded by HPfid, has been instrumental in dissecting landmark events and shedding light on pivotal issues within the healthcare industry. The healthcare landscape is shaped by a myriad of factors,
The Changing Landscape of Healthcare: Insights from the Health Plan Lawsuit Series Read More »
In recent discussions surrounding health plan fiduciary responsibilities, from our Health Plan Lawsuit Talk Series a notable case involving Johnson & Johnson has sparked considerable attention. Analyzing the implications of this case and delving into broader fiduciary obligations can offer valuable insights for plan sponsors, executives, and employees alike. Being a Great Fiduciary Guide is
Health Plan Lawsuits Unveiled: What You Need to Know to Stay Compliant Read More »
In recent years, the landscape of healthcare litigation has been evolving, with a particular focus on fiduciary responsibilities and transparency within employer-sponsored health plans. One such prominent case is the Lewandowski versus Johnson & Johnson lawsuit, which sheds light on critical issues surrounding prescription drug benefits. In this comprehensive blog post, we’ll delve into the
How much can we learn about HEALTH plan sponsor fiduciary responsibility from a legal case involving an employee class action lawsuit against the employer plan sponsor’s RETIREMENT plan fiduciaries? As it turns out, PLENTY! A U.S. District Court case, Khan v. Bd. of Dir. of Pentegra Defined Contribution Plan, addresses the need for plan
What we can learn about health plan fiduciary obligations from the retirement sector Read More »
Yes… yet another post on the Lewandowski v Johnson & Johnson case, this time diving into the named defendants. Of course, there’s J&J, and the J&J Pension and Benefits Committee, but then there is this: “Peter Fasolo, Warren Luther, Lisa Blair Davis and Does 1-20”… Who are these people? Well, we have an Executive VP
Individual Named Defendants in the J&J Lawsuit Read More »
