In a closely watched decision, the Supreme Court has upheld the authority of the U.S. Preventive Services Task Force (Task Force), preserving the Affordable Care Act’s (ACA) requirement that health plans cover preventive...more
7/2/2025
/ Affordable Care Act ,
Appointments Clause ,
Constitutional Challenges ,
Corporate Counsel ,
Department of Health and Human Services (HHS) ,
Employer Liability Issues ,
Health Insurance ,
Healthcare ,
HIV ,
Kennedy v Braidwood Management Inc ,
Patient Access ,
Preventive Health Care ,
SCOTUS ,
Statutory Interpretation
As expected, the lawsuits have commenced following the enactment of the Arkansas legislation prohibiting pharmacy benefit managers (PBM’s) from owning or operating actual pharmacies within the state. Michigan has filed its...more
6/6/2025
/ Antitrust Litigation ,
Antitrust Violations ,
Business Ownership ,
Commerce Clause ,
Constitutional Challenges ,
Drug Pricing ,
Health Insurance ,
Healthcare ,
New Legislation ,
Patient Access ,
Pharmaceutical Industry ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Preemption ,
Prescription Drugs ,
Privileges and Immunities ,
Proposed Legislation ,
Regulatory Agenda ,
State and Local Government ,
State Attorneys General ,
TRICARE
Arkansas has become the first state in the nation to enact legislation, effective starting in 2026, prohibiting pharmacy benefit managers (PBM’s) from owning or operating actual pharmacies within the state. We take a look at...more
4/25/2025
/ Arkansas ,
Compensation & Benefits ,
Drug Pricing ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
New Legislation ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
State and Local Government
In a move with potentially significant implications for entities subject to the Affordable Care Act, the Department of Health and Human Services (HHS) has reversed course and now contends that Section 1557 of the Affordable...more
3/13/2025
/ Affordable Care Act ,
Bostock v Clayton County Georgia ,
Civil Rights Act ,
Department of Health and Human Services (HHS) ,
Disability Discrimination ,
Employee Benefits ,
Executive Orders ,
Gender Discrimination ,
Gender Dysphoria ,
Gender Expression ,
Gender Identity ,
Health Insurance ,
Healthcare ,
LGBTQ ,
New Guidance ,
Patient Access ,
Rehabilitation Act ,
Section 1557 ,
Statutory Interpretation ,
Transgender ,
Trump Administration
Following through on a campaign theme focused on transgender issues and access to gender-affirming health care, on Friday, January 28, President Trump signed an Executive Order, titled “Protecting Children from Chemical and...more
2/12/2025
/ Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Employee Retirement Income Security Act (ERISA) ,
Equal Access ,
Executive Orders ,
Gender Expression ,
Gender Identity ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Insurance Reform ,
LGBTQ ,
Medicaid ,
Medicare ,
Patient Access ,
Section 1557 ,
Transgender
Access to reproductive health care has been a part of the national debate for years, and even more so since 2022 when the US Supreme Court issued its ruling in Dobbs overturning decades of precedent established under Roe v....more
10/28/2024
/ Abortion ,
Compensation & Benefits ,
Employee Benefits ,
Employees ,
EMTALA ,
Equal Protection ,
Health Insurance ,
Healthcare ,
Human Rights ,
Life Sciences ,
Patient Access ,
Pregnancy ,
Regulatory Agenda ,
Reproductive Healthcare Issues ,
Roe v Wade ,
Women's Rights
On Monday, September 9, 2024, the Departments of Health and Human Services, Labor and Treasury (the “Departments”) issued their final rule regarding the nonquantitative treatment limitation (NQTL) comparative analysis...more
9/11/2024
/ Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employer Group Health Plans ,
Final Rules ,
Health Insurance ,
Healthcare ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Proposed Rules ,
U.S. Treasury
Seyfarth Synopsis: Following years of back and forth, new final rules were published by the Department of Health and Human Services (HHS) on May 6, 2024 reinstituting the Department’s interpretation that the prohibition on...more
5/21/2024
/ Affordable Care Act ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Final Rules ,
Gender Identity ,
Health Insurance ,
LGBTQ ,
OCR ,
Section 1557 ,
Sex Discrimination ,
Transgender
The agencies have finalized a portion of their proposed rules impacting so-called “junk insurance” regarding short-term limited-duration insurance, but deferred finalizing the more significant changes that would have impacted...more
Seyfarth Synopsis: Last week, the Alabama Supreme Court ruled that cryogenically frozen embryos are children and are protected from destruction under state law. This is the latest in a series of post-Dobbs judicial rulings...more
2/28/2024
/ Abortion ,
AL Supreme Court ,
Dobbs v. Jackson Women’s Health Organization ,
Employee Benefits ,
Employer Liability Issues ,
Family Planning Clinics ,
Fertility Treatments ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Human Embryos ,
Internal Revenue Code (IRC) ,
Patient Access ,
Reproductive Healthcare Issues ,
Wrongful Death
Seyfarth Synopsis: The Consolidated Appropriations Act, 2021 (“CAA”) contains a requirement that that group health plans may not have agreements with service providers that would restrict certain information that the plan may...more
Seyfarth Synopsis: Following over a decade of protracted litigation over the Affordable Care Act, and several failed attempts by Congress to get rid of the ACA entirely, a Texas federal district court ruled on March 30, 2023...more
Seyfarth Synopsis: The No Surprises Act (the “Act”) was part of the Consolidated Appropriations Act of 2021 signed into law last December 2020. The Act was aimed at protecting insured individuals from getting a bill from a...more
Synopsis: For years, employers have struggled to understand what level of incentives in wellness programs might be considered “voluntary” under the Americans with Disabilities Act (ADA). ...more
Seyfarth Synopsis: One of many COVID-19 benefits-related concerns focused on the ability of individuals covered under High Deductible Health Plans to have services to diagnose or treat the coronavirus covered before their...more
3/13/2020
/ Clinical Laboratory Testing ,
Coronavirus/COVID-19 ,
Cost-Sharing ,
Crisis Management ,
Deductible Expenses ,
Emergency Response ,
Employee Benefits ,
HDHP ,
Health and Safety ,
Health Insurance ,
HSA ,
Infectious Diseases ,
IRS ,
New Guidance ,
Public Health ,
Relief Measures
Seyfarth Synopsis: Because everything has a coronavirus angle now….this blog post covers various issues and considerations plan sponsors and administrators should keep in mind as the coronavirus outbreak continues to...more
3/6/2020
/ Americans with Disabilities Act (ADA) ,
Benefit Plan Sponsors ,
China ,
Coronavirus/COVID-19 ,
Crisis Management ,
Disclosure Requirements ,
Electronic Protected Health Information (ePHI) ,
Employee Benefits ,
Employee Privacy Rights ,
Employee Retirement Income Security Act (ERISA) ,
Employment Policies ,
Government Agencies ,
Health and Safety ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Infectious Diseases ,
OSHA ,
Personal Protective Equipment ,
PHI ,
Plan Administrators ,
Public Health ,
Workplace Safety
Seyfarth Synopsis: Recent changes to the federal rules governing confidentiality of substance use disorder (SUD) patient records may require updates to agreements between group health plans and their third-party vendors....more
1/31/2020
/ Confidential Information ,
Deadlines ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
Employer Group Health Plans ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicaid ,
Medical Records ,
Medicare ,
PHI ,
SAMHSA ,
Service Agreements ,
Substance Abuse ,
Third-Party Relationships
Last year, the IRS published the calendar year 2018 health savings account (HSA) contribution limits for individual and family coverage. Rev. Proc. 2017-37, I.R.B. 2017-21 (5/4/2017). ...more
On Tuesday, August 22, the US District Court for the District of Columbia ordered the EEOC to revisit its controversial rules placing certain limits on employer-sponsored wellness programs under the Americans with...more
8/30/2017
/ AARP ,
Affordable Care Act ,
Americans with Disabilities Act (ADA) ,
Discrimination ,
Employee Benefits ,
Employer Group Health Plans ,
Equal Employment Opportunity Commission (EEOC) ,
Genetic Discrimination ,
GINA ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Non-Discrimination Rules ,
Wellness Programs
Seyfarth Synopsis: The Republican’s efforts to repeal and replace the Affordable Care Act may be dead on arrival. The defection of a total of four Senators from support of BCRA 2.0 means that bill has no chance of passage. ...more
Seyfarth Synopsis: The epicenter of the health care repeal and replace effort has moved from the House of Representatives to the Senate. After several weeks of drafting behind closed doors, the Senate introduced the Better...more
This is the one hundred and ninth issue in our series of alerts for employers on selected topics on health care reform. This series of Health Care Reform Management Alerts is designed to provide an in-depth analysis of...more
5/9/2017
/ Affordable Care Act ,
American Health Care Act (AHCA) ,
Cadillac Tax ,
CBO Report ,
Employer Mandates ,
Essential Health Benefits ,
Flexible Spending Accounts ,
Health Insurance ,
Health Insurance Exchanges ,
Health Savings Accounts ,
Medicaid ,
Medicare ,
Premium Subsidies ,
Proposed Legislation ,
Repeal ,
Trump Administration
This is the one hundred and eighth issue in our series of alerts for employers on selected topics on health care reform. This series of Health Care Reform Management Alerts is designed to provide an in-depth analysis of...more
This is the one hundred and sixth issue in our series of alerts for employers on selected topics on health care reform. This series of Health Care Reform Management Alerts is designed to provide an in-depth analysis of...more
3/8/2017
/ Abortion ,
Affordable Care Act ,
Employer Mandates ,
Excise Tax ,
Form 1094 ,
Form 1095 ,
Health Insurance ,
Healthcare Reform ,
Prescription Drugs ,
Proposed Legislation ,
Reporting Requirements ,
Tanning Salons ,
Trump Administration