Showing What’s Possible: A New Standard for High Performance

Showing What’s Possible: A New Standard for High Performance

Roger Bannister’s breaking of the four-minute mile barrier is a significant moment in the history of athletics. The achievement was not only a testament to his athletic prowess but also a demonstration of human determination and the breaking of mental barriers. His record-breaking run sparked a surge of interest and belief in the potential of human athletic performance. (more…)

What to Do When You Can’t Attest

What to Do When You Can’t Attest

Among other things, the Consolidated Appropriations Act (CAA) requires group health plans to attest that they are in compliance with the CAA’s gag clause prohibition. TPAs and PBMs seem ready to attest (or sub-attest).

But what’s an employer to do if its plan is not in compliance? And what if the TPA or PBM doesn’t contractually restrict the data, but in practice restricts the data? Is it okay for a TPA or PBM to restrict information as long as they don’t contractually do so? This sure seems contrary to the intent of the law! (more…)