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Executive Order Targets Prescription Drug Pricing: Potential Impact on Group Health Plans

President Donald Trump issued an executive order (EO) on May 12, 2025 to address the high cost of prescription drugs in the United States with the goal of ensuring Americans have access to most-favored-nation (MFN) pricing,...more

Mental Health Parity Non-Enforcement Statement Released

The US Departments of Labor, Health and Human Services, and the Treasury (the Departments) announced their non-enforcement policy on May 15, 2025, indicating they will not enforce any new requirements imposed by the...more

US District Court Grants Freeze on Mental Health Parity Enforcement

The US Departments of Health and Human Services, Labor, and the Treasury (together, the Departments) filed a motion to suspend the litigation proceedings in The ERISA Industry Committee vs. HHS et al. on May 9, 2025 while the...more

US Administration’s Executive Orders and Actions’ Impact on Group Health Plans

Since taking office, President Donald Trump has issued several executive orders (EOs) and actions that may have an impact on group health plans. These EOs provide insight into the US administration’s policies and outline...more

Tobacco Surcharge Lawsuits: Considerations for Plan Sponsors

A growing number of class action lawsuits have been filed against employer-sponsored self-insured group health plans alleging that tobacco cessation wellness programs violate key provisions of the Employee Retirement Income...more

HHS Proposes Security Rule Update: What Group Health Plans Need to Know

The US Department of Health and Human Services (HHS) on January 6, 2025 issued a notice of proposed rulemaking (NPRM) seeking feedback on proposed updates to the Security Standards for the Protection of Electronic Protected...more

Welcome Healthcare Reporting Simplification Enacted

On December 23, 2024, President Biden signed into law two bills that will simplify employer reporting compliance under the Affordable Care Act (ACA). The new laws streamline the rules for employers furnishing ACA reporting...more

Fiduciary Considerations Raised By the Use of AI in Group Health Plans

The use of artificial intelligence (AI) in the administration of group health plans is nothing new: AI has been used for a number of years to analyze data, improve risk assessment, identify fraud, and streamline claims...more

Despite Challenges to Reproductive Healthcare Privacy Final Rule, Plan Sponsors Should Still Comply by December 23

The US Department of Health and Human Services’ (HHS) final rule on reproductive healthcare privacy is already subject to challenge even before its effective date. As described in our previous blog post, the HHS issued final...more

CMS Disclosures Due October 15: Is Your Plan’s Rx Coverage Still Creditable?

The Inflation Reduction Act (IRA) made several changes to Medicare Part D that may impact whether employer-sponsored coverage will be creditable for the 2025 plan year. With open enrollment season about to begin, plan...more

Federal Agencies Release Final MHPAEA Regulations: Navigating the Key Changes

The US Departments of Health and Human Services, Labor, and the Treasury (collectively, the Departments) released their much anticipated final rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and...more

DOL Reiterates Its Focus on Cybersecurity with Updated Guidance

The US Department of Labor (DOL) issued a press release on September 6, 2024 reminding ERISA plan fiduciaries that it considers cybersecurity to be an area of “great concern” and emphasizing that it continues to investigate...more

HHS Issues Final Regulations on Section 1557: Implications for Health Plans

The US Department of Health and Human Services (HHS) recently issued final regulations implementing Section 1557 of the Patient Protection and Affordable Care Act, which will restore and expand the scope of civil rights...more

OCR Releases Final HIPAA Privacy Rule to Support Reproductive Health Care Privacy

The US Department of Health and Human Services, Office for Civil Rights (OCR) published its Final Rule titled HIPAA Privacy Rule to Support Reproductive Health Care Privacy in the Federal Register on April 26, 2024....more

Managing Welfare Plan Risk: The Fiduciary Committee

Fiduciary committees have long been established in connection with retirement plans to manage the investment, legal compliance, and operational risks that can arise under the Employee Retirement Income Security Act of 1974,...more

The Trends—and Traps—that Will Shape 2024

At a time marked by themes of “push” and “pull,” organizations across all sectors and jurisdictions are grappling with the pursuit of innovation within an increasingly complex regulatory framework. Over the next 12 months,...more

First Gag Clause Attestations Due From Group Health Plans by December 31

The Consolidated Appropriations Act, 2021 (CAA), requires group health plans and insurers to annually attest that they are in compliance with the gag clause prohibition under the CAA. The first attestation is due no later...more

Plan Sponsors and Fiduciaries: Some Clarity on Mental Health Parity Compliance

A recently issued White House Fact Sheet, along with a regulatory package from the US Departments of the Treasury, Labor, and Health and Human Services (the Departments), provides some welcome clarity for plan sponsors and...more

Biden Administration Proposes Increased Enforcement of Mental Health Parity Requirements

The US Departments of the Treasury, Labor, and Health and Human Services (the Departments) recently unveiled a proposed rule intended to increase mental health coverage through expanded plan oversight and enforcement...more

Assessing Your Health Plan’s Service Provider Compensation

Based on new ERISA disclosure rules, now is a good time to review the compensation paid to your health plan’s consultant and broker. ERISA Section 408(b)(2)(B) requires brokers and consultants expecting $1,000 or more in...more

COVID-19 Public Health and National Emergencies to End May 11—or Earlier

With the COVID-19 public health emergency and the presidential declaration of national emergency intended to end on May 11 and the US government recently issuing guidance on unwinding these emergency declarations, this...more

DOL Continues Active ERISA Enforcement and Focus on Cybersecurity Including Health and Welfare Plans

The Employee Benefits Security Administration (EBSA) of the US Department of Labor (DOL) has continued to be active in civil and criminal enforcement investigations of ERISA’s fiduciary duties. This blog post details two...more

Plan Sponsors and Administrators: Prepare for the End of the COVID-19 Emergency

The Biden administration intends to end the national emergency and public health emergency declarations (Emergency Declarations) attributable to the COVID-19 pandemic on May 11, 2023. The COVID-19 pandemic brought multiple...more

Evolving Laws and Litigation Post–Dobbs: The State of Reproductive Rights as of January 2023

The US Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization set off a series of changes in reproductive health law across the country. As we transition to a new year and a new Congress, we provide a...more

Evolving Laws and Litigation Post–Dobbs: The State of Reproductive Rights as of November 18

The recent midterm elections produced many important developments in the area of reproductive rights and set the stage for future legislative action at the state level. We also continue to see important decisions from state...more

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