Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 244: The Future of Independent Physician Practices with Ray Waldrup of The Leaders Rheum
Navigating Legal Strategies for Covering GLP-1s in Self-Insured Medical Plans — Employee Benefits and Executive Compensation Podcast
CareYaya: A Revolutionary Approach to Elder Care
Top Healthcare Compliance Priorities for 2025
AGG Talks: Healthcare Insights Podcast - Episode 8: What Healthcare Companies Need to Know When the Government Comes Knocking
AGG Talks: Healthcare Insights Podcast - Episode 7: National MultiPlan Litigation: A Guide for Healthcare Providers
Defending HIMP-1 Claims in New York
Understanding Pharmacy Benefit Managers: The PBM Landscape Explained
DOJ’s New Self-Disclosure Policy and Corporate Whistleblower Awards Pilot Program
AGG Talks: Healthcare Insights Podcast - Episode 4: What to Do When Insurance Companies Deny Behavioral Health Claims
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Updates to Statute 1557 that Healthcare Providers Need to Know
The No Surprises Act: A Cost Saving Opportunity for Employer Plan Sponsors
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
Opting Out of Medicare: When and How to Do It
The Burr Broadcast April 2023 - The Official End of COVID-19 Emergencies
Video: Health Care's Past, Present, and Future - Diagnosing Health Care Podcast
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 117: Chris Severn, Co-Founder & CEO, Turquoise Health
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 115: Dr. Michael Havig, CEO, HealthMe
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 106: Dr. James McElligott, MUSC & Dr. Shawn Stinson, BlueCross BlueShield of SC
AT A GLANCE - There have been a number of important developments in the United States relating to health and welfare over recent months....more
For employers offering benefit plans, fiduciary responsibility is not just a legal designation. Under the Employee Retirement Income Security Act of 1974, as amended, the fiduciary duty is the highest standard of care...more
A plan sponsor’s fiduciary duty to be transparent in Pharmacy Benefit Manager contracts safeguards plan participants’ interests and mitigates the risk of litigation, regulatory penalties, and reputational harm, say Hall...more
With so much happening in the employee benefits world over the last few months, we bring you Benefits Catch-Up, our catch-up contribution to help you keep up with recent developments. Eversheds Sutherland’s US Employee...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
On March 13, 2025, several current and former participants in the JPMorgan Chase Health Care and Insurance Program for Active Employees, as well as its component Medical Plan (collectively referred to as the “Plan”) filed a...more
A recent wave of cases has attempted to apply the theory of liability for retirement plan excessive fee cases to health plans – specifically, arrangements with pharmacy benefit managers. Though the cases thus far have...more
On March 10, 2024, the plaintiffs filed an amended complaint in a much-followed putative class action lawsuit against Johnson & Johnson (“J&J”) alleging that the plan fiduciaries for J&J’s group health plan violated ERISA by...more
The March Monthly Minute brings you three recent case updates addressing 401(k) forfeiture utilization, TPA responsibility for recovering self-insured plan’s fraudulently paid claims, and continued PBM litigation in the wake...more
In the wake of the December 4, 2024 fatal shooting of UnitedHealthcare’s CEO Brian Thompson, questions were raised about insurance claim denial practices. Several news outlets noted that UnitedHealth Group’s profits have been...more
Effective January 1, 2025, Kentucky has new law regulating pharmacy benefit managers (“PBMs”). Earlier this year, the Governor of Kentucky signed SB 188 into law, making Kentucky the latest state to pass legislation...more
Last week, former Wells Fargo employees filed a class action lawsuit against Wells Fargo and its health plan fiduciaries alleging that Wells Fargo’s self-funded health plan violated ERISA by paying its pharmacy benefits...more
While the sweltering roil of temporary regulatory changes related to the COVID-19 pandemic may have cooled and the initial burst of SECURE 2.0 steam begins to dissipate, sponsors of employee benefit plans should keep their...more
The first complaint was filed in what is expected to be a wave of litigation alleging breach of fiduciary duty in selecting and monitoring welfare plan vendors. While the facts of this particular case may make it somewhat...more
In the final days of October, the New York Department of Financial Services (“DFS) published new regulations regarding assessing, licensing, and recordkeeping for pharmacy benefit managers (“PBM”) while revising existing...more
On August 15, 2023, the U.S. Court of Appeals for the Tenth Circuit (the “Tenth Circuit”) issued its decision in Pharmaceutical Care Management Association (PCMA) v. Mulready, one of the first major opinions to further define...more
On August 15, 2023, the U.S. Court of Appeals for the Tenth Circuit issued an opinion in Pharmaceutical Care Management Association v. Glen Mulready, in his official capacity as Insurance Commissioner of Oklahoma, Oklahoma...more
In a win for self-funded (i.e., self-insured) health plans subject to the Employee Retirement Income Security Act of 1974, as amended (ERISA), the Tenth Circuit recently ruled that ERISA preempts provisions of an Oklahoma law...more
ERISA’s notorious preemption clause is no more than a few lines of text. But it has a dramatic effect on the trillions of dollars flowing through ERISA pension and health plans in any given year. The U.S. Supreme Court has...more
Insurance regulators and examiners (“Insurance Regulators”) are increasing their efforts to scrutinize pharmacy benefit managers (“PBMs”), including conducting examinations of their business operations and initiating...more
This legislative session, Florida has joined Arkansas and Oklahoma among the most regulatory-minded states with respect to pharmacy benefit plans and programs as well as pharmacy benefit managers (PBMs). Florida's...more
The Mitchell Williams Insurance Regulatory team of lawyers recently attended the National Association of Insurance Commissioners (NAIC) 2022 Summer National Meeting which was held in Portland, Oregon on August 9-13th. We have...more
On June 24, 2022, the Supreme Court of the United States issued its highly anticipated decision in Dobbs v. Jackson Women’s Health Organization, No. 19-1392. The Dobbs decision expressly overrules the two key precedents that...more
In December, the Supreme Court requested that U.S. Solicitor General Elizabeth Prelogar file a brief in John Doe 1 v. Express Scripts Inc., weighing in on whether the Court should hear a case about prescription drug costs. If...more
What You Need to Know: Members at the Joint Meeting of the Executive (EX) Committee and Plenary voted to move forward forming the Innovation, Cybersecurity and Technology (H) Committee. Additionally, charges for the new...more