For most of its HIPAA enforcement history, the HHS Office for Civil Rights (OCR) has engaged in a remarkably similar pattern with (allegedly) noncompliant healthcare organizations:...more
Employers nationwide are experiencing a new wave of ERISA litigation targeting so-called “tobacco surcharges” on employees enrolled in employer-sponsored health plans. Because these lawsuits are generally brought as putative...more
On April 7, 2026, the Court of Appeals for the Sixth Circuit affirmed that portions of Tennessee’s pharmacy benefit manager (“PBM”) laws are preempted by the Employee Retirement Income Security Act (“ERISA”) as applied to...more
Why the Compliance Answer You’re Getting May Not Be the Answer You Need- If your company offers health benefits, someone has probably asked about GLP‑1 coverage in the last six months. The drugs work, employees want...more
The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced on April 23, 2026, what may be one of the first – if not the first – Health Insurance Portability and Accountability Act (HIPAA)...more
The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently announced a HIPAA enforcement action against an employer-sponsored group health plan. The action resulted in a payment to HHS of...more
The U.S. Court of Appeals for the Sixth Circuit recently decided McKee Foods Corp. v. BFP, Inc. The Court held that the Employee Retirement Income Security Act (ERISA) preempts key parts of Tennessee’s “any-willing-pharmacy”...more
On January 13, 2025, Conduent Business Services LLC (Conduent) discovered it was the subject of a cybersecurity incident involving unauthorized access to its systems between October 21, 2024, and January 13, 2025....more
The recent rise in state law regulation of pharmacy benefit managers (PBMs) and prescription drug pricing continues to test the limits of preemption under the Employee Retirement Income Security Act of 1974, as amended...more
Less than two months into 2026, several pivotal moments have emerged in the long-running pharmacy benefit manager (“PBM”) reform discussions. This Alert provides an overview of three key developments in the PBM reform...more
Season 2, Episode 2: Reimagining Employer-Sponsored Healthcare with Jack Hill of Nomi Health In this episode of BRight Minds in Healthcare Delivery, host Eric Tower speaks with Jack Hill, Senior Vice President of Enterprise...more
Certain rules governing the contents of a HIPAA Notice of Privacy Practices (“HIPAA Notice”) have been updated and require that the HIPAA Notice be revised no later than February 16, 2026....more
Many people see the start of a new year as a time to refresh and renew themselves. For covered entities under HIPAA, which include group health plans, it’s also time to refresh and renew your HIPAA Notice of Privacy Practices...more
A recent federal district court decision highlights a little known but significant risk faced by employers with welfare benefit plans that rely on medical provider and facility networks supplied by insurance carriers or...more
The U.S. Department of Justice recently issued a press release concerning a Statement of Interest that shields small businesses from being forced to provide medical coverage for gender dysphoria. In Bernier v. Turbocam et...more
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
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
By July 31, employers that sponsor self-funded medical plans must report and pay their PCORI fee. By July 31, employers that sponsor calendar-year employee benefit plans that are subject to ERISA must file a Form 5500 (unless...more
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
There has been a recent rise in Employee Retirement Income Security Act of 1974 (ERISA) litigation against third-party administrators (TPAs) and other service providers challenging their management of self-funded health...more
In recent years, prescription drug prices have been top-of-mind for state legislators, who have responded by passing laws that seek to control that pricing in a variety of ways, including by regulating pharmacy benefit...more
While the Patient-Centered Outcomes Research Initiative (“PCORI”) fee was updated at the turn of the year, the fee is not actually paid until July. For those of you that forgot about the fee, this is your reminder to start...more
The government recently issued final rules on the Mental Health Parity and Addiction Equity Act (MHPAEA). The rules implement requirements for plans to conduct a comparative analysis of their nonquantitative treatment...more
If you are a state or local government that sponsors a “self-funded” employee group health plan instead of using an insurance provider, you had previously been allowed to “opt out” of compliance with the following four...more
In the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization and subsequent state abortion bans, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services issued a...more