News & Analysis as of

Regulatory Requirements Health Insurance

Stotler Hayes Group, LLC

Still Stuck in the (Utah) Gap: How the “Miller Trust” Punishes the Most Vulnerable

For those seeking Medicaid coverage to pay for their care in a skilled care setting, like a nursing home, the Medicaid process can be daunting. For institutional Medicaid approval, an applicant must prove that they are...more

Hendershot Cowart P.C.

Qlarant, Novitas Audits Escalate as Medicare Skin Substitutes Spending Hits $1.6 Billion, CMS Seeks Evidence of Clinical...

Hendershot Cowart P.C. on

The wound care industry faces unprecedented scrutiny as Medicare Part B expenditures for skin substitutes exceeded $1.6 billion in the fourth quarter of 2023 alone. The spending surge has triggered a wave of skin substitute...more

Mintz - Health Care Viewpoints

Challenges Facing Managed Care Organizations under the Current Administration

Within the first six months of President Trump’s second term, his Administration and the GOP have already implemented significant policies that are reshaping health care in the United States. Through his Administration’s...more

Proskauer - Employee Benefits & Executive...

Supreme Court Decision Leaves ACA Preventive Services Mandate Intact

On the last day before the U.S. Supreme Court’s summer recess, the Court issued a decision that left in place the Affordable Care Act (“ACA”) mandate that requires non-grandfathered group health plans and issuers to cover,...more

Warner Norcross + Judd

U.S. Supreme Court Preserves Preventive Care Coverage Under the ACA

On June 27, 2025, the U.S. Supreme Court issued its decision in Kennedy v. Braidwood Management, Inc., rejecting a constitutional challenge to the Affordable Care Act’s (ACA) preventive services mandate. The Supreme Court...more

Bass, Berry & Sims PLC

Reminder – Annual Deadline (July 31) to Report and Pay PCORI Fee is Approaching (UPDATED)

The annual filing (and fee payment) for applicable self-insured health plans and specified health insurance policies used to fund the Patient-Centered Outcomes Research Institute (PCORI fee) is due by Thursday, July 31, 2025....more

Holland & Knight LLP

Upcoming Utilization Review Restrictions in Light of Emerging Artificial Intelligence

Holland & Knight LLP on

With the rapid development of artificial intelligence (AI), state legislatures have been attempting to keep up with the technological advancing surge. Most recently, Texas enacted Senate Bill (SB) 815, a law imposing greater...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

Seyfarth Shaw LLP

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

Seyfarth Shaw LLP on

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

Pullman & Comley - Labor, Employment and...

Federal Court Decision Reshapes ACA Enforcement by HHS and IRS

The recent federal district court decision in Faulk Company, Inc. v. Xavier Becerra, et al., No. 24-cv-00609-P (N.D. Tex. 2025) significantly alters the primary mechanism used by the U.S. Department of Health and Human...more

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

Washington State Scales Up Paid Family and Medical Leave Law

On May 20, 2025, Washington Governor Bob Ferguson took the final step toward implementing House Bill (HB) 1213’s expansion of the state’s paid family and medical leave program when he greenlit funding for the program as part...more

Alston & Bird

House Reconciliation Bill Expands and Improves Health Savings Accounts and Individual Coverage Health Reimbursement Arrangements

Alston & Bird on

The House-passed reconciliation bill would significantly modify health savings accounts (HSAs) and individual coverage health reimbursement arrangements (ICHRAs). Our Employee Benefits & Executive Compensation Group unpacks...more

McDermott Will & Emery

Trending in Telehealth: May 2025

McDermott Will & Emery on

Trending in Telehealth highlights monthly state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and...more

Epstein Becker & Green

Hot Topics in Employee Benefits: A Primer for In-House Lawyers

“ERISA, you’ll need a lawyer for that.” Our practice group’s tagline is meant to be a shorthand for the alphabet soup of laws that apply to employee benefits, including the Employee Retirement Income Security Act (ERISA)....more

Foley & Lardner LLP

Risk Bearing Entity Requirements: Massachusetts

Foley & Lardner LLP on

This blog discusses the regulatory requirements that apply to risk-bearing entities in Massachusetts, including recent updates introduced by Chapter 343 of the Massachusetts Acts of 2024 (the Act). This blog is part of Foley...more

Troutman Pepper Locke

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

Troutman Pepper Locke on

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

Freeman Law

The FMLA – A Detailed Review of the Family and Medical Leave Act

Freeman Law on

The FMLA and the employment rights and circumstances it seeks to protect are many times complicated and delicate to address in real-time. Employees and employers alike can find themselves frustrated with understanding the...more

Bond Schoeneck & King PLLC

Administration Grants Welcome Reprieve From Certain NQTL Requirements

Administration Grants Welcome Reprieve From Certain NQTL Requirements - Earlier this month, the Departments of Labor, Health and Human Services and Treasury (the “Departments”) announced that for the foreseeable future...more

Warner Norcross + Judd

Delayed Enforcement of Mental Health Parity NQTL Comparative Analysis Final Regulations

Warner Norcross + Judd on

Under the Mental Health Parity and Addiction Equity Act (MHPAEA), as amended by the Consolidated Appropriations Act (CAA), 2021, group health plans and health insurance issuers must conduct comparative analyses to show that...more

Mintz - Health Care Viewpoints

CMS Announces Sweeping Changes to RADV Audits

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced significant changes in its risk adjustment data validation (RADV) audits. The changes focus on speed, the volume of targeted contracts, and...more

Foley & Lardner LLP

Mental Health Parity Alert - Non-Enforcement of Final Rules

Foley & Lardner LLP on

The Mental Health Parity and Addiction Equity Act (MHPAEA), and its implementing regulations and guidance, prohibits health insurance policies and group health plans that cover mental health and substance use disorder...more

Quarles & Brady LLP

Departments Will Not Enforce 2024 Final Rule under MHPAEA

Quarles & Brady LLP on

The Trump Administration has just announced that it will pause enforcement of the September 2024 final rule (“Final Rule”) under the Mental Health Parity and Addiction Equity Act (“MHPAEA”)....more

Seyfarth Shaw LLP

Parity in Peril? Plan Sponsors Breathe Easier As Trump Administration Hits Pause on Enforcement of Mental Health Parity Final Rule

Seyfarth Shaw LLP on

On May 15, 2025 the Departments of Labor, Health and Human Services, and Treasury (the “Departments”) announced they will temporarily not enforce their new standards published under the mental health parity Final Rule last...more

Morgan Lewis - ML Benefits

Mental Health Parity Non-Enforcement Statement Released

The US Departments of Labor, Health and Human Services, and the Treasury (the Departments) announced their non-enforcement policy on May 15, 2025, indicating they will not enforce any new requirements imposed by the...more

Troutman Pepper Locke

Federal Ruling on CMS Staffing Mandate Offers Relief for Long-Term Care Facilities

Troutman Pepper Locke on

Long-term care facilities, embattled by rising costs and potential Medicaid cuts, are seeing some relief on the horizon following a recent federal court ruling that struck down portions of the Centers for Medicare & Medicaid...more

155 Results
 / 
View per page
Page: of 7

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide