The U.S. District Court for the District of Maine recently dismissed two separate suits alleging that health plans’ coverage exclusion for weight loss drugs constitutes unlawful disability discrimination. Both complaints...more
5/14/2025
/ Affordable Care Act ,
Americans with Disabilities Act (ADA) ,
Appeals ,
Class Action ,
Disability Discrimination ,
Employer Group Health Plans ,
Health Insurance ,
Insurance Litigation ,
Obesity ,
Prescription Drugs ,
Section 1557
On December 4, 2024, a federal court in the Eastern District of Texas issued a ruling vacating the notice requirement under the final regulations (the “Final Rule”) on hospital and other fixed indemnity insurance (“Fixed...more
On June 28, 2024, in a 6-3 decision, the Supreme Court overturned Chevron v. Natural Resources Defense Council (“Chevron”), the most-cited case in administrative law. Chevron established a framework for how the federal...more
On April 29, 2024, the Department of Labor (“DOL”) released a final regulation (the “Final Rule”) that rescinded the Trump Administration rule that expanded the availability of association health plans (“AHPs”) (“Trump DOL...more
On January 22, the Departments of Labor, Treasury, and Health and Human Services (“Tri-Agencies”) issued a set of Frequently Asked Questions (“ACA FAQs Part 64”) clarifying the contraceptive-related services that plans and...more
In early November, the Centers for Medicare and Medicaid Services (“CMS”) published the contract year 2025 proposed rulemaking (“Proposed Rule”) for Medicare Advantage (“MA”) and Part D sponsors. The Proposed Rule previews...more
On July 7, the Departments of Labor, Treasury, and Health and Human Services (the “Tri-Agencies”) published a long-anticipated proposed rule (“Proposed Rule”) that...more
On Tuesday, December 13, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“New Proposed Rule”) to improve the prior authorization process and advance interoperability for Medicare Advantage...more
12/22/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Comment Period ,
Federally Facilitated Exchanges ,
Health Insurance ,
Healthcare ,
Managed Care Contracts ,
Medicaid ,
Medicare ,
Medicare Advantage Organizations (MAOs) ,
Prior Authorization ,
Proposed Rules ,
Qualified Health Plans
On Tuesday, October 11, Treasury and IRS issued final regulations amending the regulations under the Affordable Care Act (“ACA”) regarding the affordability determination for an employee’s family members of employer-sponsored...more