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Health Insurance

Quarles & Brady LLP

Massachusetts Law Permitting Pharmacies and Pharmaceutical Manufacturers to Offer Drug Discounts to Consumers Extended to January...

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The Massachusetts law permitting pharmacies and pharmaceutical manufacturers to offer drug discounts to consumers, which was set to expire on January 1, 2026, has recently been extended to January 1, 2031....more

McDermott Will & Schulte

CMS to enforce MMSEA 111 reporting compliance beginning October 2025

Beginning October 11, 2025, failure to comply with the statutory obligation that most insurers of medical claims (including self-insured entities) have to report claims under Section 111 of the Medicare, Medicaid and SCHIP...more

Ankura

The Healthcare Crossroads: Navigating the Impact of Trump’s 2025 Tax Bill

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On July 4, 2025, President Donald Trump signed into law his signature tax bill commonly referred to as the “One Big Beautiful Bill Act” (OBBBA). At the heart of the legislation lies a dramatic reconfiguration of federal...more

Ballard Spahr LLP

Court Upholds Arkansas Pharmacy Benefit Management (PBM) Reporting Requirements

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A recent federal district court decision has upheld an Arkansas Insurance Department rule that requires health benefit plans to submit certain pharmacy compensation information to the Department....more

McDermott+

Healthcare Preview for the Week of: September 8, 2025

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There are 22 days until the fiscal year ends, and only 12 of those will be in-session days for Congress. While there is still no consensus on the path forward, we’re hearing more from Congress about the possibility of a...more

Rivkin Radler LLP

NY Insurer Fined $250,000 for Mental Health “Ghost Network”

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The New York Attorney General’s office recently announced an agreement with MVP Health Care under which the insurer will pay $250,000 in penalties, fees, and costs to the state for maintaining an inaccurate mental health...more

Gray Reed

Texas Capitol Report: New Legislation Takes Effect

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The 89th Texas Legislative Session brought forward a series of new laws, including those that took effect on September 1. These changes directly impact how businesses across industries operate, from compliance requirements to...more

Alston & Bird

New Maryland Law Regulates Use of AI in Health Care Utilization Management Reviews

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Our Health Care Group discusses what businesses need to know about a new law in Maryland that creates new requirements for health plans’ use of artificial intelligence in making coverage and treatment decisions....more

Cozen O'Connor

Pennsylvania Perspective for Thursday, September 4, 2025

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Gov. Shapiro Navigates SEPTA Crisis Amid Budget Stalemate - Governor Josh Shapiro (D) is caught between House Democrats and Senate Republicans as he tries to secure long-term funding for SEPTA, which has already cut service...more

McGuireWoods LLP

The Fertility Economy: Where Science Meets Market Demand

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The fertility and reproductive health sectors are experiencing dynamic growth, driven by shifting demographics, evolving societal attitudes and rapid technological advancement. The global fertility market size is expected to...more

Smith Debnam Narron Drake Saintsing & Myers,...

Grey Divorce: Why Are More Couples Over 50 Calling It Quits?

Grey divorce, also known as late‑life or “silver split” divorce, refers to the dissolution of long‑term marriages by couples typically aged 50 and older who are entering a new phase of life. This phenomenon is becoming...more

Greenbaum, Rowe, Smith & Davis LLP

One Big Beautiful Bill Act: An Overview of Key Healthcare Provisions & Impacts

The One Big Beautiful Bill Act (OBBBA) was signed into law on July 4, 2025. A sweeping piece of legislation that reshapes healthcare financing and delivery across Medicaid, Medicare, and the insurance marketplaces, the bill...more

McDermott Will & Schulte

[Webinar] Provider-Sponsored Health Plans: Strategy Playbook for Health Systems - September 18th, 1:00 pm - 2:00 pm EDT

Market pressures, regulatory changes, and capital requirements are driving health systems to reassess the role of provider-sponsored health plans (PSHPs) in their broader enterprise strategies. In many cases, these...more

Vedder Price

Health Plan Tobacco Surcharge Litigation

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Employers are facing a surge in class action lawsuits challenging health plan premium surcharges imposed on smokers and other tobacco users, commonly referred to as “smoker surcharges.” Earlier this year Bass Pro Shops agreed...more

Patrick Malone & Associates P.C. | DC Injury...

Better Health Care Newsletter - September 2025

The U.S. medical system is already the costliest in the world, with much poorer outcomes than achieved in peer nations. It’s getting worse. The Republican Congress, combined with major policies the administration is...more

Stark & Stark

Making the Invisible Visible: How Diffusion Tensor Imaging Sheds Light on Mild Traumatic Brain Injury

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Mild traumatic brain injury (mTBI), often called a concussion, is one of the most misunderstood injuries in medicine and law. Doctors, insurers, and defense experts frequently point to “normal” CT or MRI scans as proof that...more

Haynes Boone

A Plan Document a Day Keeps the Physician Lawsuits Away

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Physicians generally do not have direct standing to bring a claim for benefits under an ERISA group health plan. Rather, a physician’s standing derives from the patient’s status as a plan participant and must be assigned....more

FordHarrison

Illinois Enacts New Neonatal Intensive Care Leave Act

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On August 15, 2025, Illinois Governor J.B. Pritzker signed into law the Neonatal Intensive Care Leave Act (NICLA). NICLA will require employers with 16 or more employees to provide certain amounts of unpaid leave (depending...more

Sheppard Mullin Richter & Hampton LLP

Shifting Landscapes: How Federal and State Policies are Expanding Access to IVF

Earlier this summer, the White House confirmed that President Trump is actively reviewing policy proposals developed in response to his executive order (“EO”) aimed at expanding access to in vitro fertilization (“IVF”)....more

King & Spalding

Court in Northern District of Texas Finds Elevance Health’s Drop in Ratings Proper

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On August 18, 2025, the United States District Court for the Northern District of Texas denied Plaintiff Elevance Health’s (“Elevance”) motion for summary judgment against HHS and CMS. Elevance’s lawsuit alleges that HHS and...more

Cozen O'Connor

NY AG Puts Mental Health Ghost Network to Rest

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New York AG Letitia James has announced an agreement with MVP Health Plan (MVP) following an investigation that found systemic problems with the insurer’s mental health provider network. The investigation revealed that MVP’s...more

Troutman Pepper Locke

Colorado Division of Insurance Expands AI Governance and Framework Regulation to Private Passenger Auto and Health Benefit Plan...

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On August 20, 2025, the Colorado Division of Insurance (Division) amended Regulation 10-1-1 to expand its existing limited applicability to insurers offering individual life insurance to apply to insurers offering private...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - August 2025

The August Monthly Minute brings you the latest guidance on ERISA retirement plan investment in alternative assets and highlights a recent ruling in mental health parity nonquantitative treatment limitation (NQTL) litigation....more

Williams Mullen

[Hybrid Event] 2025 Benefits Forum: Benefit Trends for a Resilient Workforce - September 25th, Richmond, VA

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Join Williams Mullen for our hybrid 2025 Benefits Forum, where our attorneys will examine how emerging trends and recent legislative developments have created new opportunities for employers to design benefits that meet the...more

Holland & Hart - The Benefits Dial

One Too Many … Employer Considerations Following New Lawsuit Challenging Employer Providing Health Plan Options

A recently filed lawsuit against Northwestern University and its health plan fiduciaries raises novel claims that could be problematic for employers that offer multiple medical benefit options, if the suit gains traction. The...more

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