News & Analysis as of

Employer Group Health Plans

Warner Norcross + Judd

Group Health Plan PCORI Fees Due by July 31 - UPDATED JULY 2025

As a reminder, the deadline for submitting Patient-Centered Outcomes Research Institute (PCORI) fees is July 31. Employers who sponsor self-insured group health plans should report and pay PCORI fees using the most recently...more

Foley & Lardner LLP

The HDHP Telehealth Safe Harbor Returns – For Good This Time

Foley & Lardner LLP on

President Trump signed into law the One Big Beautiful Bill Act (OBBB) on July 4, 2025. The telehealth safe harbor, which allowed first dollar coverage of telehealth services without impacting Health Savings Account (HSA)...more

Warner Norcross + Judd

U.S. Supreme Court Preserves Preventive Care Coverage Under the ACA

On June 27, 2025, the U.S. Supreme Court issued its decision in Kennedy v. Braidwood Management, Inc., rejecting a constitutional challenge to the Affordable Care Act’s (ACA) preventive services mandate. The Supreme Court...more

Bricker Graydon LLP

Is My Group Health Plan Covered by State PBM Reporting Laws?

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State laws seeking to regulate pharmacy benefit managers (PBMs) have increased significantly over the past few years. As it stands, all 50 states have laws that regulate PBMs in some way, but all are unique. However, most of...more

Husch Blackwell LLP

MHPAEA July 2025 Update: What Employers and Plans Need to Know about Federal Non-Enforcement

Husch Blackwell LLP on

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was enacted to ensure that group health plans and health insurance issuers offering mental health and substance use disorder (MH/SUD) benefits do not impose...more

Fisher Phillips

Reproductive Healthcare Privacy Rule Struck Down Nationwide by Texas Judge: What Providers and Employer-Sponsored Health Plans...

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A federal judge in Texas just tossed out Biden-era reproductive healthcare privacy protections, halting a 2024 final rule with nationwide effect. The rule, which largely took effect in December and created new HIPAA privacy...more

McAfee & Taft

Employer health plan surcharges pose litigation risks

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Many employers implement wellness programs into their employee health plan offering. Wellness programs have varying designs but commonly offer premium discounts to participants who are tobacco-free or achieve certain...more

BCLP

Closing the Gap: Health and Welfare Compliance

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Even the most well-managed employee benefit plans may have certain compliance blind spots. From outdated documentation to missed filing deadlines, we have highlighted a few areas below where we often see gaps....more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Washington State Scales Up Paid Family and Medical Leave Law

On May 20, 2025, Washington Governor Bob Ferguson took the final step toward implementing House Bill (HB) 1213’s expansion of the state’s paid family and medical leave program when he greenlit funding for the program as part...more

Seyfarth Shaw LLP

Supreme Court Upholds Tennessee Transgender Care Ban

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In a widely awaited for decision, the Supreme Court in a 6-3 opinion authored by Justice Roberts held that a Tennessee law which prohibits certain medical treatments (puberty blockers and hormones) for transgender minors,...more

King & Spalding

Appeals Court Revives Company’s Suit against Blue Cross for Breach of ERISA Fiduciary Duty

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On May 21, 2025, the Sixth Circuit revived a company’s lawsuit against Blue Cross Blue Shield of Michigan (BCBSM) for breaching its fiduciary duties under ERISA as a third-party administrator (TPA). The plaintiff company,...more

Woodruff Sawyer

REMINDER: PCORI Fees Due By July 31, 2025

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Employers that sponsor self-insured group health plans, including health reimbursement arrangements (HRAs) should keep in mind the upcoming July 31, 2025 deadline for paying fees that fund the Patient-Centered Outcomes...more

Davis Wright Tremaine LLP

What Relief Does the Mental Health Parity and Addiction Equity Act Nonenforcement Policy Actually Provide to Employers?

Employers navigating the complexities of the Mental Health Parity and Addiction Equity Act ("MHPAEA") may find themselves questioning the true impact of the federal government's recently issued nonenforcement policy. This...more

Littler

The Parity Paradox: MHPAEA Compliance for Employers and Insurers During the 2024 Enforcement Pause

Littler on

The U.S. Departments of Labor, Health and Human Services, and Treasury have announced that they will pause enforcement of the 2024 Mental Health Parity and Addiction Equity Act (MHPAEA) Final Rule (the “2024 Final Rule”) for...more

Morgan Lewis - ML Benefits

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

Lathrop GPM

Administration Issues Cross-Agency Guidance Targeting Health Care Pricing and Focusing on Hospitals and Health Plans

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On May 22, 2025, the U.S. Department of Health and Human Services, Department of Treasury and Department of Labor (the “Agencies”) announced new steps intended to “strengthen healthcare price transparency.” ...more

Venable LLP

Government Issues Nonenforcement Statement on Mental Health Parity Rules

Venable LLP on

The government recently stated that it will delay enforcement of the 2024 final rules on the Mental Health Parity and Addiction Equity Act (MHPAEA). (Our previous alert regarding the 2024 final rules can be found here.) This...more

Ropes & Gray LLP

Tri-Agencies Stay Enforcement of the 2024 MHPAEA Final Rules

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On May 15, 2025, the Departments of Labor, Health and Human Services (“HHS”) and the Treasury (“the Departments”) issued a nonenforcement policy of the final rules under the Mental Health Parity and Addiction Equity Act of...more

Quarles & Brady LLP

Departments Will Not Enforce 2024 Final Rule under MHPAEA

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The Trump Administration has just announced that it will pause enforcement of the September 2024 final rule (“Final Rule”) under the Mental Health Parity and Addiction Equity Act (“MHPAEA”)....more

Jackson Lewis P.C.

UPDATE – Departments issue nonenforcement policy statement!

Jackson Lewis P.C. on

On May 15, 2025, the Departments of Labor, Treasury, and Health and Human Services issued their anticipated nonenforcement policy regarding the 2024 Mental Health Parity regulations. As expected, nonenforcement is applicable...more

Proskauer - Employee Benefits & Executive...

Departments Press Pause on Final Mental Health Parity Regulations

Yesterday, the Departments of Labor, Treasury, and Health and Human Services announced a non-enforcement policy with respect to final regulations issued under the Mental Health Parity and Addiction Equity Act of 2008...more

Ballard Spahr LLP

Mental Health Brake: 2024 MHPAEA Regulations Put on Hold

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A recent court filing offers a reprieve to health plan sponsors in their efforts to comply with final regulations issued last year under the Mental Health Parity and Addiction Equity Act (MHPAEA)....more

Groom Law Group, Chartered

District Court Dismisses Weight Loss Drug Discrimination Suits

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

Epstein Becker & Green

Federal Regulators Announce Non-Enforcement of the 2024 Rule for Mental Health Parity

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On May 9, 2025, the Departments of Labor, Health and Human Services, and Treasury (collectively, “the Departments”) asked the D.C. federal court to suspend litigation while they consider whether to rescind or modify the 2024...more

Venable LLP

June 1, 2025 Prescription Drug Reporting Deadline for Group Health Plans

Venable LLP on

Employer group health plans must make an annual disclosure of the plan's prescription drug and healthcare spending to the Centers for Medicare & Medicaid Services (CMS). The disclosure, called the Prescription Drug Data...more

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