Latest Publications

Share:

ERISA Group Health Plans – The New Target in Fee Cases

Earlier this year, a Johnson & Johnson (“J&J”) employee brought a class action complaint (the “Complaint”) against J&J alleging fiduciary breaches under ERISA related to the prescription drug coverage under J&J’s self-funded...more

ERISA Preemption Reaffirmed: Tenth Circuit Limits State PBM Regulation

On August 15, 2023, the Tenth Circuit issued its much-anticipated decision in PCMA v. Mulready, rejecting Oklahoma’s position that its pharmacy network requirements were not preempted by ERISA. Mulready has been closely...more

States Continue Expansion of PBM Regulation

State legislatures over the past five years have focused heavily on the role of pharmacy benefit managers (“PBMs”) in the context of health care benefits. While initial efforts were focused largely on PBM services offered to...more

IRS Explains FSA Substantiation Rules

On April 28, 2023, the Internal Revenue Service (“IRS”) Office of Chief Counsel issued a Chief Counsel Advice (“CCA”) explaining the requirements for claim substantiation for health and dependent care flexible spending...more

Data Marketing Poses Significant Implications for Health Plans Regulation

Data Marketing Partnership, LLP (“Data Marketing”) offers a health insurance plan to individuals that download an app that tracks phone usage. The company treats such persons as “partners” in their business. The result is...more

A Surprise Turn of Events for the No Surprises Act Dispute Resolution Process

The ongoing implementation of the No Surprises Act’s (“NSA”) prohibition on surprise balance billing, and the related independent dispute resolution (“IDR”) process between payers and providers became much less certain after...more

Illinois Employers: Are You Complying With the Consumer Coverage Disclosure Act?

Illinois recently enacted the Consumer Coverage Disclosure Act (the “CCDA”), which requires that Illinois employers provide a disclosure to employees regarding how the employer’s group health plan compares with the essential...more

OSHA Shot or Test Rule: Keeping It All Straight

Ever since the Occupational Safety and Health Administration (“OSHA”) published its Emergency Temporary Standard (“ETS”) regarding the COVID-19 vaccine or test requirement, there has been a flurry of litigation, culminating...more

HHS Issues Proposed Rules Implementing the Individual Health Insurance Agent & Broker Fee Disclosure Requirements

As we discussed in our earlier summary, the Consolidated Appropriations Act, 2021, Public Law 116-260 (“CAA”), signed into law by the President on December 27, 2020, imposed new compensation disclosure requirements upon...more

Surprise! Tri-Agencies Meet Deadline with First Set of Surprise Billing Rules, With More to Come

On July 1, 2021, the Office of Personnel Management, Department of the Treasury, Department of Health and Human Services (“HHS”), and Department of Labor (“DOL”) (collectively, the “Departments”), released the interim final...more

Trump Administration Issues COVID-19 Vaccine and Transparency Rules

In late October, the Trump Administration, through the Departments of Health and Human Services (“HHS”), the Treasury, and Labor (“Departments”), issued two different rules — one implementing the Coronavirus Aid, Relief, and...more

The Supreme Court Narrows ERISA Preemption in Rutledge v. PCMA

In the recently-decided Rutledge v. Pharmaceutical Care Management Association (“PCMA”), the Supreme Court found 8–0 (Justice Barrett did not take part) that ERISA did not preempt an Arkansas state law that established...more

12 Results
 / 
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide