News & Analysis as of

Health Insurance Portability and Accountability Act (HIPAA) Health Insurance

Bricker Graydon LLP

Can you Charge Smokers More for Your Health Plan?  

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Several new lawsuits have been filed recently alleging that employers violated HIPAA’s non-discrimination rule by charging higher health insurance premiums to employees who use tobacco products. ...more

Husch Blackwell LLP

Employers Continue to Face ERISA Tobacco Surcharge Lawsuits, With Mixed Results

Husch Blackwell LLP on

Recently, companies have seen a spate of class action lawsuits challenging the legality of tobacco cessation wellness programs and related tobacco surcharges imposed by their employer-sponsored health benefit plans....more

Akerman LLP - Health Law Rx

FBI Warning: Criminals Posing as Health Insurers and Fraud Investigators Are Targeting Providers and Patients

The FBI issued a warning on June 27, 2025, that criminals impersonating healthcare insurers and fraud investigators are sending text messages and emails to healthcare providers and patients to trick them into providing...more

Seyfarth Shaw LLP

Time to Revisit Your HIPAA Documents After Reproductive Health Privacy Rule Vacated

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In the wake of a recent federal District Court decision, the reproductive health care HIPAA Privacy rules finalized during the Biden Administration have been vacated and plan sponsors should re-evaluate the language included...more

Troutman Pepper Locke

Navigating Legal Strategies for Covering GLP-1s in Self-Insured Medical Plans — Employee Benefits and Executive Compensation...

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In this episode of Troutman Pepper Locke's Employee Benefits and Executive Compensation podcast, hosts Lydia Parker and Lynne Wakefield explore the complex legal landscape surrounding the coverage of GLP-1s prescribed for...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Regulators Pause Mental Health Parity Rules Enforcement

Federal regulators recently indicated they will not enforce parts of the final regulations issued in September 2024 under the Mental Health Parity and Addiction Equity Act (MHPAEA) and may soon propose new rules altogether....more

Health Care Compliance Association (HCCA)

Top Healthcare Compliance Priorities for 2025

Recently Protiviti released an intriguing report: Top Compliance Priorities for U.S. Healthcare Organizations in 2025. In this podcast their Global Healthcare Compliance Leader, Leyla Erkan, CHC, CHP, CHRC, shares some of the...more

Bricker Graydon LLP

Why You Can’t Kick High Claimants Off Your Health Insurance

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If your health insurance premiums have gone up again, you are not alone.  For that reason, we frequently get questions from clients on whether there is anything they can do to get high claimants off of their plans....more

Amundsen Davis LLC

Refusing to Quit: Class Actions on Tobacco Surcharges in Health Plans Continue

Amundsen Davis LLC on

Over the past year, numerous class actions have been filed against large employers claiming their health plan surcharge for tobacco use is not in compliance with HIPAA nondiscrimination rules. With yet another lawsuit filed...more

Alston & Bird

Health Care Week in Review | Congress Passes Government Funding Package; HHS Nominee Confirmation Process Heats Up

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Morgan Lewis - ML Benefits

Tobacco Surcharge Lawsuits: Considerations for Plan Sponsors

A growing number of class action lawsuits have been filed against employer-sponsored self-insured group health plans alleging that tobacco cessation wellness programs violate key provisions of the Employee Retirement Income...more

Maynard Nexsen

Tri-Agency FAQ Provides Updated Guidance Regarding Compliance with the Gag Clause Prohibition

Maynard Nexsen on

On January 14, 2024, the Departments of Labor, Health and Human Services, and the Office of Personnel Management (the “Departments”) jointly released the FAQs About Consolidated Appropriations Act, 2021 Implementation Part 69...more

Kerr Russell

The Difference Between ‘Non-Covered’ vs. ‘Disallowed’ Services

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Question: I have had several colleagues describe their experience with dental plan audits. All of them have had to pay something back. Sometimes they say this is due to a service being deemed a “noncovered service.” Other...more

Holland & Knight LLP

Holland & Knight Health Dose: January 21, 2025

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Holland & Knight Health Dose Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

Warner Norcross + Judd

Holy Smokes: Is Your Tobacco Surcharge Program Compliant?

Warner Norcross + Judd on

A “tobacco surcharge” is part of many employers’ wellness programs, where the employer charges tobacco users higher health insurance premiums than non-tobacco users. A typical tobacco surcharge program will ask an employee if...more

Proskauer - Health Care Law Brief

This New Year, California Imposes Guardrails on the Use of AI by Payors for Utilization Management Determinations

SB 1120 (the “Bill”), which takes effect on January 1, 2025, amends existing California law to adopt guardrails around the use of artificial intelligence tools for the purpose of utilization management. As discussed in a...more

Fisher Phillips

Rising ERISA Class-Action Lawsuits Over Tobacco Surcharges in Health Plans: What Employers Need to Know + 6 Steps to Stay...

Fisher Phillips on

A wave of ERISA class-action lawsuits is challenging tobacco surcharge programs in employer-sponsored health plans across the U.S. These cases center on potential fiduciary breaches, with plaintiffs arguing that surcharges...more

Quarles & Brady LLP

Uncertainty on Health Care Rules Amid Administration Change

Quarles & Brady LLP on

In recent months, several changes to healthcare rules regulations focusing on reproductive health care have been introduced. These include (1) privacy protections for reproductive health data under HIPAA, (2) expanding access...more

Holland & Knight LLP

Regulation of AI in Healthcare Utilization Management and Prior Authorization Increases

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Over the past two years, federal and state government agencies have moved to regulate the deployment of artificial intelligence (AI) in the healthcare setting, including in the utilization management (UM) and prior...more

Holland & Knight LLP

The Future for AI Usage in California Healthcare Hinges on Governor's Indication of State Limits

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With the surge of artificial intelligence (AI) development in recent years, state legislatures, including California's, have contemplated how to balance patient safety and quality of care with the need for and expectation of...more

Groom Law Group, Chartered

Recent Lawsuits Target Health Plan Premium Surcharges Based on Tobacco Use

There is a new series of putative class action lawsuits in which the plaintiffs allege that employers that sponsor self-funded health plans with health plan premium surcharges related to tobacco use or vaccination status...more

Baker Donelson

Health Plan Compliance Concerns for Year-End 2024

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As employers look toward open enrollment for their group health plans, now is a good time to review action items needed for those plans by year-end, as well as upcoming deadlines in the near future. While fully-insured health...more

Ballard Spahr LLP

Health Plan Compliance Deadlines Draw Near

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Regulations under Section 1557 of the Affordable Care Act and HIPAA will require health plans and health care providers to take action in the coming months to meet new requirements. Health plan sponsors and providers that...more

Bass, Berry & Sims PLC

New Reproductive Health Care Privacy Final Rule: Key Compliance Steps and Dates

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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

Hall Benefits Law

HHS Updates HIPAA Privacy Rule to Protect Reproductive Healthcare Privacy: What Group Health Plans Need to Know

Hall Benefits Law on

The U.S. Department of Health and Human Services (HHS) has issued a final rule that modifies the Standards for Privacy of Individually Identifiable Health Information (“the Privacy Rule”) under the Health Insurance...more

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