Benefits Compliance Consulting
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Keeping up—and staying compliant—with changing health insurance requirements could be a full-time job, and for Corporate Synergies’ in-house compliance team, it is. Careful research of new and changing rules supports our compliance advisors’ personalized recommendations. Our comprehensive review uncovers risk, provides a remediation plan and keeps your organization protected.
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Latest Compliance Resources Entries
CMS Issues Revised RxDC Reporting Instructions for Reporting Due June 1
A group of employees participating in the Johnson & Johnson (“J&J”) employee and retiree medical plans have filed a class action lawsuit against J&J and its plan fiduciaries alleging ERISA fiduciary breach violations related to the management and administration of prescription drug benefits offered through these plans. The complaint alleges that the plans drastically overpaid for drugs through the plans’ pharmacy benefit manager (PBM). Among other allegations, it is alleged that the company paid $10,000 for a 90-day supply of a generic multiple sclerosis drug that would have cost just $28 if the person went into a pharmacy and paid out of pocket. The complaint argues that these breaches cost J&J’s plans and employees millions of dollars in the form of higher payments for prescription drugs, higher premiums, higher deductibles, higher coinsurance, higher copays and lower wages. While there have been a growing number of ERISA lawsuits challenging the costs and fees paid by health plans, this case is unique in that it is the first to directly take aim at plan fiduciaries for PBM contracting allegedly resulting in increased costs to plan participants and beneficiaries.
* posted on our site on 02.19.24