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What Should Be in a Vaccination Policy?

Employers are facing a myriad of decisions as they consider vaccination requirements for their workforces.

Mandatory vaccine policies, for example, should include rationale for why they are required, McDermott partner Carole A. Spink said in this Society for Human Resource Management article. The scope of any policy should be clearly identified and explain which employees it applies to.

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IRS Issues Guidance on Fertility Treatment Deductibility for Same-Sex Couples

On April 9, 2021, the Internal Revenue Service (IRS) released PLR 202114001 (PLR), which provides guidance on the deductibility of medical costs under Section 213 of the Internal Revenue Code relating to fertility expenses for same-sex couples. The PLR disallows most of the costs incurred by a same-sex couple wishing to have a child.

However, according to McDermott partner John T. Lutz, the IRS’ distinction between deductible costs for medical procedures attributable to the taxpayer and non-deductible costs for medical procedures attributable to third parties raises unique concerns about the equitable treatment of different taxpayers.

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California Requires Vaccines or Regular COVID-19 Testing for Certain Healthcare Workers and State Employees

On July 26, 2021, the California Department of Public Health (CDPH) issued a new Order that impacts healthcare and state employers in California. According to McDermott’s Michelle S. Strowhiro, Ellen M. Bronchetti and Ludia Kwon, the CDPH Order requires that almost all healthcare employers verify the vaccination status of all of their workers.

The Order also requires workers who are not fully vaccinated to go through regular COVID-19 testing at specified intervals. These facilities also must have a plan in place for tracking verified worker vaccination statuses.

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Obtaining Payer Coverage for New Tests Continues to Be Difficult

Clinical laboratories continue to face challenges to obtain positive coverage decisions by government and private payers for new tests. According to McDermott+Consulting Senior Director Deborah Godes, payers require reasons to establish new coverage assays.

“[The] key to getting a positive coverage decision from payers is making a solid case through good quality evidence,” Godes notes in a recent Dark Report article. “Clinical laboratories need to demonstrate that a particular assay actually works as it is intended and also that it is used by clinicians to make decisions regarding patient care. ”

Not all payers will be persuaded by the same arguments. Each payer has its own coverage determination process, and clinical laboratories should be prepared to deal with each one individually.

“You need to determine what drives that payer’s denials and then present evidence to address those concerns,” Godes says.

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Can Employers Offer COVID-19 Vaccine Incentives for Employees?

Can employers offer incentives for employees to get a COVID-19 vaccine? In short, yes. Incentives may take many forms, such as a one-time bonus, a gift card or a few extra vacation hours. Employers can get creative.

According to McDermott’s Michelle S. Strowhiro, Judith Wethall and Ludia Kwon, there are two issues to consider when implementing a vaccine incentive program for purposes of complying with employment and benefits laws: the concepts of coercion and reasonable accommodation.

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COVID-19 Laws and Regulations: A Midyear Update

As employers navigate evolving COVID-19 state and federal rules, workplaces will have to stay vigilant about changes throughout the second half of 2021. These include changes to mask mandates, the Occupational Safety and Health Administration’s Emergency Temporary Standard and the New York Health and Essential Rights (HERO) Act.

Recent US Equal Employment Opportunity Commission guidance, for example, confirmed what employment lawyers had already been counseling businesses to do, according to McDermott partner Carole A. Spink in a recent Law360 article.

“The guidance was important because it did clarify that employers can provide incentives for voluntary programs. [There] was a big open question about, ‘Am I going to get into trouble because I’m trying to incentivize people to be vaccinated?'”

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New York State Department of Labor Publishes Standard for Prevention of Airborne Infectious Diseases

On July 6, 2021, the New York State Department of Labor (NYSDOL) published its Airborne Infectious Disease Exposure Prevention Standard (Standard), as required under the New York Health and Essential Rights (HERO) Act. Under the Standard, employers with worksites located in New York are required to either adopt the NYSDOL’s model exposure prevention plan or develop their own alternative prevention plan no later than August 5, 2021, and circulate their plan to employees no later than September 4, 2021.

According to McDermott’s Lindsay DitlowChristina S. Dumitrescu and Abigail M. Kagan, employers must adopt a prevention plan but are not required to implement the plan until the New York State Commissioner of Health (Commissioner) designates an airborne disease as a “highly contagious communicable disease that presents a serious risk of harm to the public health.” As of the date of this alert, the Commissioner has not issued any such designation so employers need not implement their plans just yet.

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Drug Prices Are Prime Target in Biden’s Competition Order

President Biden’s July 9, 2021, Executive Order—which seeks to increase competition throughout the American economy—takes aim at prescription drug prices. In this article, published in Law360, McDermott partner Emily Jane Cook says Biden’s focus on drug prices is unsurprising given the “significant public interest and frustration” with drug costs.

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COVID-19 Vaccine Q&A

Can employers mandate some employees get the vaccine and not others? Is there an obligation to consider requiring a COVID-19 test before coming back to work? What are the potential workers’ compensation claims relating to possible adverse reactions to a vaccine? Should employers mandate vaccinations?

In this article, McDermott partners Carole Spink, Joseph Mulherin, Kathleen Quinn and Troy Van Dongen answer common employer questions about the COVID-19 vaccine.

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Ruling Gives Ammunition in Fights Over Health Insurer Clawbacks

A recent ruling from a New Jersey federal district court gives ammunition to providers fighting to stop insurers from engaging in cross-plan offsetting, a common billing practice where health insurers attempt to claw back overpaid claim money from one patient by withholding payment from another patient in a different health plan.

The ruling—which found that the practice violates the Employee Retirement Income Security Act (ERISA)—could lead to more lawsuits and changes to plan documents. McDermott partner Judith Wethall said in a recent Bloomberg Law article the ruling was more significant than the U.S. Court of Appeals for the Eighth Circuit’s 2019 ruling in Peterson v. UnitedHealth Group, Inc.

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