The No Surprises Act, enacted as part of the Consolidated Appropriations Act , includes transparency provisions requiring group health plans to report information on prescription drugs and healthcare spending to the departments of Labor, Health and Human Services and the Treasury (“the departments”). This requirement applies to group health plans and health insurance issuers in the individual and group markets but does not apply to account-based plans and excepted benefits. This reporting process is referred to as the prescription drug data collection (or “RxDC report”). The first RxDC report was due Dec. 27, 2022 (covering data for 2020 and 2021); however, the departments provided a submission grace period through Jan. 31, 2023, for this first report. Subsequent RxDC reports are due by June each year covering data for the previous calendar year. According to interim final rules , employers may use issuers, third-party administrators, pharmacy benefit managers or other third parties t

Prescription drug cost drivers Although prescription drug spending has historically been a small proportion of national healthcare costs compared to hospital and physician services, it has grown rapidly in recent years. According to CMS, prescription drug spending increased 7.8% to $378.0 billion in 2021, up 3.7% from the previous year. A recent study found that “In 2022, overall pharmaceutical expenditures in the US grew 9.4% compared to 2021, for a total of $633.5 billion. Utilization (a 5.9% increase), price (a 1.7% increase) and new drugs (a 1.8% increase) drove this increase.” These results illustrate increasing prescription drug spending, especially with new, specialty and cancer drugs. According to the same study, employers will have to watch for a predicted rise of 6% to 8%. A multitude of factors led to this steady rise in prescription drug pricing, including the following. An influx of specialty drugs Specialty medications account for a smaller portion of U.S. prescriptions

Implementing a comprehensive risk management strategy is imperative for C-level executives and senior management at HANYS member hospitals. One critical, but often overlooked component, is the executive disability income protection program. But what exactly is this program and why is it vital for high-income earners?   With increasing interest in executive disability income protection programs from C-suite executives, TruePlan Benefit and Retirement Advisors interviewed Bernard A. Gleeson, Director, Employee Benefit Services on Executive disability income protection programs FAQs.  What is an executive disability income protection program?  An executive disability income protection program (EDIPP) is a specialized form of disability insurance designed to supplement existing group disability plans offered by employers. These individual plans provide additional coverage beyond the typical monthly maximum benefit cap found in traditional employer-based offerings. By overlaying on top of g