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
7/7/2025
/ Benefit Plan Sponsors ,
Drug Pricing ,
Employer Group Health Plans ,
Insurance Industry ,
New Legislation ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Regulatory Requirements ,
Reporting Requirements ,
Rutledge v Pharmaceutical Care Management Association ,
Self-Funded Health Plans ,
State Legislatures
Just before the holidays, two bills impacting reporting under the Affordable Care Act (“ACA”), H.R. 3801 (EMPLOYER REPORTING IMPROVEMENT ACT) and H.R. 3797 (PAPERWORK BURDEN REDUCTION ACT), passed both houses and were sent to...more
Earlier this year, the Internal Revenue Service (IRS) issued a number of new notices updating and clarifying the preventive services expenses that high deductible health plans (“HDHP”) can cover without affecting a...more
As the temperatures continue to rise, regulations and litigation related to employer-sponsored group health plans have followed suit. As these new rules continue to evolve, we are often asked whether a self-insured group...more
7/17/2024
/ Affordable Care Act ,
Americans with Disabilities Act (ADA) ,
Bostock v Clayton County Georgia ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Employer Liability Issues ,
Equal Protection ,
Gender Identity ,
Health Insurance ,
Self-Funded Health Plans ,
Sexual Orientation ,
Title VII ,
Transgender
For the vast majority of records maintained by public schools, the Health Insurance Portability and Accountability Act (“HIPAA”) is not applicable. This is because most records that contain medical information related to a...more
4/10/2024
/ Business Associates ,
Covered Entities ,
Data Privacy ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
FERPA ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Health Plan Sponsors ,
Medical Records ,
PHI ,
Public Schools ,
School Districts ,
Students