News & Analysis as of

Health Insurance Regulatory Reform Healthcare Reform

Ballard Spahr LLP

The OBBBA’s Impact on Employee Benefits and Executive Compensation

Ballard Spahr LLP on

H.R.1—the One Big Beautiful Bill Act (OBBBA)—contains several provisions that directly affect employer-provided benefit programs, primarily health and welfare programs....more

Jones Day

CMS Updates Kidney Care Choices Model

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The Center for Medicare and Medicaid Innovation ("CMMI") announced sweeping changes to the Kidney Care Choices Model ("KCC Model"), a key set of value-based programs....more

Saul Ewing LLP

Trump’s Megabill: Expanding Choice With Health Savings Accounts

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On July 4, 2025, President Trump signed the reconciliation bill entitled An Act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (“Act”) into law. The changes proposed in the earlier House version of the...more

McDermott+

Health Plans’ Commitment to Prior Authorization Improvements: What’s New Versus What’s Already Required

McDermott+ on

Health plan members of AHIP and the Blue Cross and Blue Shield Association made news earlier this week when they announced a series of steps that a broad swath of health insurers will take to improve the prior authorization...more

Jones Day

Medicare's Innovation Center Charts New Direction: Part 1 - Providers

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The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the first of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding health care...more

McDermott+

First Steps in Implementing the Trump Administration’s Price Transparency Agenda

McDermott+ on

Recently, the Trump administration took steps toward implementing one of its major priorities: improving price transparency. As discussed in a previous Regs & Eggs blog post, President Trump signed an executive order (EO) on...more

McDermott Will & Schulte

Enforcement of Mental Health Parity Regulations Suspended: Takeaways for Plan Sponsors and Health Insurance Issuers

In January 2025, The ERISA Industry Committee (ERIC) filed a complaint against the US Departments of Labor, Health and Human Services, and the Treasury (the departments) seeking to invalidate the 2024 final regulations under...more

Jones Day

CMS Innovation Center Announces Cost-Saving Restructuring of Value-Based Payment Model Portfolio

Jones Day on

The Center for Medicare and Medicaid Services ("CMS") has announced significant changes to its value-based payment model portfolio projected to save $750 million as part of a shift in the agency's refocused strategy toward...more

Jones Day

Executive Orders and Policy Updates

Jones Day on

Since President Trump's inauguration, the Trump administration has issued a number of executive orders and policy actions with potential impacts for the life sciences industry. Notable actions include rescinding Biden-era...more

Mintz - Health Care Viewpoints

CMS’s ACA Marketplace Integrity and Affordability Proposed Rule – What it may mean for Health Plans

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) released its 2025 Marketplace Integrity and Affordability Proposed Rule (Proposed Rule), proposing a number of enrollment and eligibility policies...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Legislative Day 24 - February 2025

With one week to go until Crossover Day, lawmakers and lobbyists are already feeling the exhaustion and exasperation captured in the face of James Oglethorpe’s bust on the North Steps. As committees convene constantly to...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Legislative Day 22 - February 2025

Lawmakers and lobbyists watching the Georgia State Senate on Monday saw a lot of green and red, but it wasn’t exactly Christmas. While some state agencies and contractors stand to see a few extra greenbacks in the Senate...more

McDermott Will & Schulte

Trump Administration May Expand Access to IVF Services

On February 18, 2025, US President Donald Trump signed an executive order directing his administration to develop policy recommendations within 90 days to increase access to in vitro fertilization (IVF) services and to reduce...more

Akin Gump Strauss Hauer & Feld LLP

Expanding Access to In Vitro Fertilization (Trump EO Tracker)

This order makes it the policy of the Administration to ensure reliable access to IVF treatment, including by easing unnecessary statutory or regulatory burdens to make IVF treatment more affordable. Within 90 days of the...more

Fennemore

Regulatory Landscape of Insurance Claims Denial Practices and Suggestions for a Path Forward to a Sustainable Healthcare Future

Fennemore on

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

McDermott Will & Schulte

Healthcare Regulatory Check-Up Newsletter | December 2024 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for December 2024. We discuss several civil and criminal enforcement actions pertaining to healthcare fraud and abuse authorities,...more

Fenwick & West LLP

The Shifting Regulatory Landscape for Level-Funded Plans: An Alternative for Group Health Insurance

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In the constantly changing health insurance landscape, level-funded health plans are steadily gaining ground as a viable middle approach between fully insured health plan and self-funded health plans—arguably offering...more

Mintz - Employment Viewpoints

Association Health Plan Perspectives (Part 2): The Look-Through Rule and the Limits of State Regulatory Power

In a summary of the recently issued Association Health Plan (AHP) final regulations, the U.S. Department of Labor (DOL) rightly observed that AHPs are a species of multi-employer welfare arrangements, or MEWAs, that are...more

Ballard Spahr LLP

Final Regulations Expand Availability of Individual Insurance Not Meeting ACA Requirements

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The U.S. Departments of the Treasury, Labor, and Health and Human Services have jointly issued final rules modifying the definition of short-term, limited-duration insurance (STLDI). STLDI provides health coverage that is...more

Bricker Graydon LLP

Association Health Plans: Another tool for small employers to manage health care costs and increase employee access to affordable...

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Following last fall’s Executive Order 13813, which directs regulatory agencies to improve access to affordable employer coverage, the Department of Labor (DOL) recently released the final regulations on small business...more

Ballard Spahr LLP

DOL Releases Final Regulation Expanding Association Health Plans

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The U.S. Department of Labor (DOL) on Tuesday released final regulations modifying the Association Health Plan (AHP) rules to expand their availability for small and large employers and to address their affordability by...more

Stinson LLP

DOL Issues Final Association Health Plan Rule

Stinson LLP on

On June 19, 2018, the Department of Labor (DOL) released a final rule that offers new options for associations to sponsor health plans for their members. These new options allow more small businesses to come together to...more

Littler

Association Health Plans: How Do You Solve a Problem Like a MEWA?

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On June 19, 2018, the Department of Labor issued its highly anticipated final rule expanding the availability of association health plans (“AHPs”). ...more

Mintz - Employment Viewpoints

The Department of Labor’s Proposed Association Health Plan Regulation: Who Wins, Who Loses?

In last week’s post we explained the changes made by a newly proposed Department of Labor regulation, the purpose of which is make it easier for small employers to band together to form “association health plans” (“AHPs”). In...more

Seyfarth Shaw LLP

Issue 117: DOL Issues Proposed Rules On Association Health Plans

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This is the one hundred and seventeenth 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...more

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