Aetna and MLB Face ERISA Suit Over Denied Mental Health Claims

A Major League Baseball Players (MLB) Benefit Plan participant recently filed an ERISA lawsuit against Aetna Health and Life Insurance Co. (Aetna) and the MLB Benefits Plan. The suit challenges the denial of inpatient mental health treatment claims for the participant’s daughter. MLB offers mental health benefits to employees and their beneficiaries, including inpatient and outpatient treatment of mental health Read More

U.S. Supreme Court Eases Standard for Employees to Sue Employers Concerning Denied Religious Accommodations in the Workplace

The U.S. Supreme Court recently issued its decision in Groff v. DeJoy, Postmaster General, making it easier for employees to sue employers that fail to offer religious workplace accommodations. In its ruling, the Court revived a Title VII lawsuit that former U.S. Postal Service (USPS) employee and Evangelical Christian Gerald Groff had filed after the USPS would not accommodate his religious practices. When the Read More

PBM Reform Legislation Advances in Senate and House Committees

Committees in both houses of Congress recently voted to advance legislation reforming pharmacy benefit managers (PBMs). In recent months, PBMs, which manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, and large employers, have come under fire for allegedly anticompetitive practices and inflated consumer drug prices. The Senate Finance Committee, which handles matters Read More

FTC Withdraws Prior Health Care Antitrust Policy Statements as It Continues to Investigate PBM Market

The Federal Trade Commission (FTC) recently unanimously voted to withdraw its previously issued policy statement that opposed state legislation increasing transparency over pharmacy benefit managers (PBMs). Consistent with heightened scrutiny of PBMs by federal agencies, the FTC issued a statement cautioning against reliance on prior advocacy statements regarding PBMs that no longer may be valid. The FTC stated Read More

U.S. Supreme Court Eliminates Affirmative Action in Higher Education

On June 29, 2023, the U.S. Supreme Court issued its ruling in Students for Fair Admissions, Inc. v. President and Fellows of Harvard College, in which it struck down affirmative action in higher education. The decision ended 40 years of colleges and universities being able to consider race as a factor in their admissions processes. The case arose from two lawsuits in which Students for Fair Admissions, Inc. Read More

A Look at the Proposed Joint Regulations to Implement MHPAEA and NQTL Requirements

Three federal agencies – the Department of Labor (DOL), the Department of Treasury (Treasury), and the Department of Health & Human Services (HHS) – released joint proposed rules designed to amend existing rules under the Mental Health Parity and Addiction Equity Act (MHPAEA). The proposed rules also fulfill the mandate of the Consolidated Appropriations Act, 2021 (CAA, 2021) to implement nonquantitative Read More

NLRB Ruling Modifies Independent Contractor Test

The National Labor Relations Board (NLRB) recently issued a ruling in Atlanta Opera, Inc., which alters the test employers must use to determine whether workers are independent contractors or employees. In its decision, the NLRB ruled that makeup artists, wig artists, and hairstylists working at the Atlanta Opera were employees, not independent contractors. As a result of the ruling, the workers could file an Read More

Musk Pleads No Personal Liability in Former Employee Severance Claims

A Delaware federal judge heard arguments recently on Elon Musk’s motion to dismiss all claims against him personally in a lawsuit filed by former Twitter employees over severance benefits. The case is Arnold et al. v. X Corp. et al., case number 1:23-cv-00528, the U.S. District Court for the District of Delaware. Musk argued that he did not sign off on the provisions of the 2022 Twitter takeover deal concerning Read More

EEOC Issues Guidance on AI Usage in Employment Practices

The U.S. Equal Employment Opportunity Commission (EEOC) has issued new guidance on using artificial intelligence (AI) in employment practices under Title VII of the Civil Rights Act of 1964. Specifically, the EEOC advises that employers may not rely on representations by vendors that their AI tool complies with Title VII. Instead, they must ensure that the tool has no adverse discriminatory impact. Otherwise, the Read More

Takeaways from Biden Administration’s Proposed Rules on Mental Health Parity

The U.S. Department of Labor (DOL), U.S. Department of the Treasury (Treasury), and the U.S. Department of Health and Human Services (HHS) recently issued 395 pages of proposed rules designed to guide group health plans on compliance with mental health parity laws. These rules clarify that the Biden administration intends to restrict plans’ use of nonquantitative limits on mental health and substance use disorder Read More