News & Analysis as of

Health Insurance

Pullman & Comley - Labor, Employment and...

Federal Court Decision Reshapes ACA Enforcement by HHS and IRS

The recent federal district court decision in Faulk Company, Inc. v. Xavier Becerra, et al., No. 24-cv-00609-P (N.D. Tex. 2025) significantly alters the primary mechanism used by the U.S. Department of Health and Human...more

Foley & Lardner LLP

Benefits Basics – When an Employee Becomes Disabled: A Resource Guide for HR & Benefits Professionals

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When an employee becomes disabled, a variety of questions arise regarding that employee’s entitlement to compensation and benefits. As a member of your company’s human resources or employee benefits department, employees and...more

Brownstein Hyatt Farber Schreck

Key Differences in Provisions Between Draft Senate and House-Passed Reconciliation Bill

Over the last week, the Senate Finance Committee and Senate Agriculture Committee released their portions of reconciliation text, which includes most of the Medicaid and food insecurity provisions. The Senate committees will...more

Hall Benefits Law

PBM Contracts Could Expose Plan Sponsors to Fiduciary Liability

Hall Benefits Law on

A plan sponsor’s fiduciary duty to be transparent in Pharmacy Benefit Manager contracts safeguards plan participants’ interests and mitigates the risk of litigation, regulatory penalties, and reputational harm, say Hall...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

Arnall Golden Gregory LLP

Landmark $9.25M AGG Class Action Settlement Against UnitedHealthcare Receives Preliminary Approval, Class Claim Submission Process...

AGG Healthcare Litigation attorneys Rich Collins and Landen Benson represent two of the three named plaintiffs in an ERISA class action against UnitedHealthcare (“United”), involving the insurer’s denial of access to proton...more

Arnall Golden Gregory LLP

Federal Court Permits MultiPlan Antitrust MDL to Proceed: Court Upholds Federal and State Antitrust and Consumer Protection...

On June 3, 2025, Judge Matthew F. Kennelly of the U.S. District Court for the Northern District of Illinois issued a sweeping ruling in In re MultiPlan Health Insurance Provider Litigation, largely denying motions to dismiss...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

Troutman Pepper Locke

Fifth Circuit Clarifies Enforcement of IDR Awards Under the No Surprises Act

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On June 12, the U.S. Court of Appeals for the Fifth Circuit issued a significant opinion in the case involving Guardian Flight, LLC and Med-Trans Corporation, two air ambulance providers, against the defendant insurance...more

Troutman Pepper Locke

California AG Takes Action Against $1.3 Million Insurance Fraud Scheme

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In May, California’s attorney general (AG) charged a local dermatologist with more than 20 counts of fraud after uncovering a scheme that allegedly resulted in the state’s Medicaid program paying out over $1.3 million for...more

Rivkin Radler LLP

Quick Bites: Special Needs Planning

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If you have a loved one with special needs, you know that caring for him or her can, at times, feel totally overwhelming. Presumably, you have retained an attorney to guide you through the special education process in your...more

Alston & Bird

House Reconciliation Bill Expands and Improves Health Savings Accounts and Individual Coverage Health Reimbursement Arrangements

Alston & Bird on

The House-passed reconciliation bill would significantly modify health savings accounts (HSAs) and individual coverage health reimbursement arrangements (ICHRAs). Our Employee Benefits & Executive Compensation Group unpacks...more

Jones Day

Medicare's Innovation Center Charts New Direction: Part 3 – Drugs, Devices, and Data

Jones Day on

The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the third of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding drugs,...more

Miller Nash LLP

Washington Legislature Expands Worker Protections and Clarifies “Stacking” Limits for Paid Family and Medical Leave

Miller Nash LLP on

On May 17, 2025, Washington Governor Bob Ferguson signed House Bill 1213, which both expands worker protections relating to Washington’s Paid Family and Medical Leave Insurance Program (PFML) and allows an employer to limit...more

King & Spalding

Affordable Care Act Preventative Care Mandate At Risk Pending Supreme Court Decision

King & Spalding on

A case pending before the Supreme Court could jeopardize the Affordable Care Act’s (ACA) mandate that certain preventive services be provided on a first dollar coverage basis to plan members. Kennedy v. Braidwood Management...more

Proskauer - Health Care Law Brief

No Surprises Here! Connecticut District Court Confirms IDR Awards Are Enforceable Under the NSA, Deepening Judicial Divide Over...

The U.S. District Court for the District of Connecticut has become the latest court to weigh in on whether Independent Dispute Resolution (“IDR”) awards issued under the No Surprises Act (“NSA”) are enforceable. In a recent...more

Holland & Knight LLP

HHS Secretary Kennedy Dismisses Entire CDC Vaccine Advisory Panel

Holland & Knight LLP on

In a surprising move, the U.S. Department of Health and Human Services (HHS) announced it is reconstituting the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP), removing...more

Fennemore

California’s Bold Experiment with Whole-Person Centered Care: Has it Worked?

Fennemore on

CalAIM is an initiative of the California Department of Health Care Services (the Department) to improve the quality of life and health outcomes of Medi-Cal members by implementing delivery system, program, and payment...more

ArentFox Schiff

Federal Court Sides With Payers on No Surprises Act IDRE Selection Process: What Providers Need to Know Now

ArentFox Schiff on

A recent decision from the US District Court for the Eastern District of New York has significant implications for providers navigating the No Surprises Act (NSA) independent dispute resolution (IDR) process....more

McDermott Will & Emery

Trending in Telehealth: May 2025

McDermott Will & Emery on

Trending in Telehealth highlights monthly state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and...more

Troutman Amin LLP

SCAMMERS OR DUMMIES?: Selling Limited Benefits Plans to Consumers Seeking Health Insurance Lands Four Dudes In Hot Water–BUT Are...

Troutman Amin LLP on

The lead generation industry is fascinating. If there is one over arching mantra it is this– monetize all data available. And sometimes that can get folks into BIG trouble, especially when lead buyers end up pitching...more

King & Spalding

MultiPlan Algorithmic Pricing Antitrust Claims Survive Motion to Dismiss

King & Spalding on

On June 3, 2025, Judge Matthew F. Kennelly of the United States District Court for the Northern District of Illinois denied motions to dismiss antitrust claims in a multidistrict litigation (MDL) against MultiPlan, Inc. and...more

Epstein Becker & Green

What Health Care Lawyers and Professionals Need to Know About Emerging Employee Benefit Issues

“ERISA, you’ll need a lawyer for that.” Our practice group’s tagline is meant to be a shorthand for the alphabet soup of laws that apply to employee benefits, including the Employee Retirement Income Security Act (ERISA)....more

McDermott+

Breaking Down the New No Surprises Act FAQs Post-TMA III (June 2025 Update)

McDermott+ on

UPDATE: On May 30, 2025, the Fifth Circuit granted the TMA III plaintiffs’ petition for rehearing en banc, which was previously filed on December 16, 2024. Of note, the Fifth Circuit’s mandate has not yet been issued, so as a...more

Epstein Becker & Green

Hot Topics in Employee Benefits: A Primer for In-House Lawyers

“ERISA, you’ll need a lawyer for that.” Our practice group’s tagline is meant to be a shorthand for the alphabet soup of laws that apply to employee benefits, including the Employee Retirement Income Security Act (ERISA)....more

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