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Insurance Regulations Health Insurance

Arnall Golden Gregory LLP

Mental Health Parity Enforcement Paused: What Providers and Patients Need to Know

On May 15, 2025, the U.S. Departments of Labor, Health and Human Services, and the Treasury issued a statement related to the enforcement of the Mental Health Parity and Addiction Equity Act (“MHPAEA”)....more

Cozen O'Connor

Illinois Insights: An update from Cozen O'Connor (8/4)

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Aquifer protection, Chicago pension boost among more than 100 new laws- “Gov. JB Pritzker on Friday signed into law 124 of the 436 bills sent to him by lawmakers in the spring legislative session. The measures signed last...more

Foley & Lardner LLP

Virginia Bureau of Insurance Issues Guidance Clarifying Material Change and Required Notifications for Managed Care Health...

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On July 22, the Virginia Bureau of Insurance (BOI) issued Administrative Letter 2025-02 (the Letter) to all licensed insurers writing Managed Care Health Insurance Plans (MCHIPs) in Virginia. The Letter clarifies what...more

Pullman & Comley, LLC

Deadline Reminder: BCBS Settlement Claims Due by July 29, 2025

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Health care providers who have treated or provided services, equipment, or supplies to patients insured by Blue Cross Blue Shield (BCBS) between July 24, 2008 and October 4, 2024 may be entitled to compensation under a $2.67...more

Davis Wright Tremaine LLP

Anthem's New Chargemaster-Based Claim Edits: Which Charges and Providers Will Anthem's New Process Target and How Will It Impact...

Effective August 1, 2025, Anthem will implement a new claims-editing process that adjusts payments for Medicare Advantage (MA) claims based on an undisclosed, customized chargemaster table. The announcement identifies claims...more

Foley & Lardner LLP

Key Texas Insurance Bills From the 89th Regular Legislative Session

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The topic of insurance often causes glazed eyes in some readers not immersed in the industry, but insurance was a hot topic coming into the 89th Regular Session of the Texas Legislature. Interest stemmed not only from ongoing...more

Verrill

Preventive Services vs. Preventive Care

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In the context of medical coverage, the terms “Preventive Services” and “Preventive Care” are often used interchangeably. The two terms, however, have very different meanings. Understanding the difference can have significant...more

Mitchell, Williams, Selig, Gates & Woodyard,...

2025 Arkansas Insurance Legislation Summary: Health

This is the third article in a series of summaries of insurance legislation from the 95th Arkansas General Assembly....more

Mitchell, Williams, Selig, Gates & Woodyard,...

2025 Arkansas Insurance Legislation Summary: General

This is the first article in a series of summaries of insurance legislation from the 95th Arkansas General Assembly. The 95th Arkansas General Assembly convened on January 13, 2025, and recessed on April 16, 2025. The...more

Pullman & Comley - Connecticut Health Law

Considering a Direct Primary Care Practice? Don’t Ignore State Law!

Our recent article in Physicians Practice outlines 10 Dos and Don’ts for physicians and other practitioners to take into account when deciding whether to establish a direct primary care (DPC) practice. ...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Legislative Day 25 - February 2025

Amidst the usual suits and blazers, white dresses and tuxedos have been appearing with increasing frequency around the Georgia State Capitol this spring. Apparently word is out amongst the city’s photographers that the...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Legislative Day 11 - February 2025

Many of the skirmishes fought under the Gold Dome each year are turf wars, sometimes literally. A perennial favorite is the dispute over Georgia’s northern border, which Representative Martin Momtahan (R-Dallas) is seeking to...more

Hinshaw & Culbertson LLP

How the 2024 U.S. Election Results Will Impact Insurers: A First Attempt at Reading the Tea Leaves

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The results of the November 5, 2024, election in the United States will almost certainly have profound consequences within the country and across the globe. The election will surely impact policyholder exposures, insurer...more

McGlinchey Stafford

Podcast: Reflections on Insurance Regulation: A Conversation with McGlinchey’s Newest Member, Former Commissioner Donelon, Part 1...

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In this installment of the More with McGlinchey Podcast, Insurance Regulatory Member Lauren Ybarra interviews Member and Former Louisiana Insurance Commissioner Jim Donelon. They reflect on Jim’s tenure as Louisiana’s...more

Carlton Fields

NAIC Groups Carve Up the Mountain at the Winter Meeting

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After strapping on their skis and riding up the lifts, the NAIC groups reported to their events. The results of the events of note for life insurers are as follows...more

Polsinelli

Louisiana Insurance Department Fines Express Scripts and Medimpact for Delayed Pharmacy Payments

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The Louisiana Insurance Department (“Department”) recently fined Express Scripts Administrators, LLC (“ESA”) $275,000 and MedImpact Healthcare Systems, Inc. (“MedImpact”) $250,000 for allegedly failing to pay electronically...more

Polsinelli

Florida Proposes New Pharmacy Benefit Manager Rules

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On September 18, 2023, the Florida Office of Insurance Regulation (“OIR”) published proposed rules to implement provisions of the Prescription Drug Reform Act (Florida Senate Bill 1550) governing Pharmacy Benefit Managers...more

Akerman LLP - Health Law Rx

ACTION REQUIRED TO AVOID FINES! DEADLINE APPROACHING: Florida Pharmacy Benefit Managers Must Be Licensed as a Third-Party...

Pharmacy Benefit Managers (PBMs) take note! Under Florida’s new Prescription Drug Reform Act, PBMs must be licensed as an insurance administrator (also known as a third-party administrator, or TPA). Under this new law, any...more

Pullman & Comley - Labor, Employment and...

Group Health Plans and Medicare Secondary Payer Rules: Do the Mandatory Reporting Obligations Apply to You?

The Medicare Secondary Payer provisions (MSP) apply to group health plans sponsored by employers with 20 or more employees, in both the private and public sectors. MSP’s mandatory reporting requirements are designed to...more

Carlton Fields

Expect Focus - Volume III, September 2023

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Regulators Hit Jackpot: Off-Channel Communications - Several years before announcing the first “off-channel” communications enforcement action, the SEC and FINRA cautioned broker-dealers and investment advisers about...more

Polsinelli

Third Party Administrator & Pharmacy Benefit Manager 2023 Newsletter: TPA & PBM Licensing And Compliance Developments

Polsinelli on

Florida OIR Issues Informational Memorandum OIR-23-04M to PBMs - On July 19, 2023, the Florida Office of Insurance Regulation (“OIR”) issued Informational Memorandum OIR-23-04M (“Memorandum”) to Pharmacy Benefit Managers...more

Polsinelli

Louisiana Insurance Department Issues Cease and Desist Orders to a TPA and the Louisiana Office of Group Benefits for Failure to...

Polsinelli on

The Louisiana Insurance Department (“Department”) recently issued separate Cease and Desist Orders to both a TPA operating as a Pharmacy Benefit Manager (“PBM”) and the Office of Group Benefits, a Louisiana state agency that...more

Herbert Smith Freehills Kramer

NAIC Group Updates Financial Analysis Tools

A National Association of Insurance Commissioners (NAIC) working group adopted changes to the NAIC’s Financial Analysis Handbook (Handbook) capturing a number of current topics affecting insurers. Insurers should consider the...more

Polsinelli

Pharmacy Benefit Managers Licensing and Compliance Developments

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In response to calls for greater transparency in the prescription drug industry, 2021 continued a nationwide trend of increased state licensing and regulation of Pharmacy Benefit Managers (“PBMs”). In the last year, laws...more

Carlton Fields

FOIR Releases Guidance on New Disclosure Requirements for Health Insurers, MCOs

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The Florida Office of Insurance Regulation released an informational memorandum on Friday to all health insurers and managed care organizations authorized to do business in Florida to provide guidance regarding new disclosure...more

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