caa

A person in scrubs is holding a tablet computer that displays a 3D holographic image of a heart. Text on the screen includes medical jargon in Cyrillic and Latin characters. The background appears to be a futuristic medical bay or computer lab.

The Rise of Data Evolution: How the CAA is Redefining Healthcare Decision-Making

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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 […]

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Unveiling Healthcare’s Hidden Costs: The Power of Transparency and Fiduciary Responsibility 

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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

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Navigating the Complexities of ERISA Compliance and Risk Mitigation

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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

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Navigating the Complex Landscape of Healthcare Compliance: A Closer Look at Lawsuits and the CAA 

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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

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The Changing Landscape of Healthcare: Insights from the Health Plan Lawsuit Series

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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,

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The Johnson & Johnson Health Plan Lawsuit: Implications for Employers and Benefit Advisors 

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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

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What you need to know about the Consolidated Appropriations Act (CAA)

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The Consolidated Appropriations Act (CAA) was passed in 2021 and amends ERISA (Employee Retirement Income Security Act). It contains 90 pages of new rules, law, and legislation that affect employers who offer a health plan to their employees. Employers who offer a health plan are mandated to perform specific administrative, data analytics, and benchmarking processes

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