The ERISA Industry Committee is backing a pharmacy benefit manager (PBM) bill that would establish a fiduciary duty under the Employee Retirement Income Security Act (ERISA) for PBMs to put the interests of employer plan sponsors and participants ahead of their own. Sen. Roger Marshall (R-Kan.) and three bipartisan sponsors have proposed the PBM Fiduciary, Accountability, Integrity, and Reform Act, or the PBM FAIR Read More

The Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA), and the U.S. Department of Health and Human Services (HHS) have proposed rules on price transparency reporting requirements. The proposed rules would amend existing rules under the Public Health Service Act, the Employee Retirement Income Security Act (ERISA), and the Internal Revenue Code.  The proposed rules would affect Read More

A split three-judge panel of the U.S. Court of Appeals for the Fifth Circuit ruled that a federal district court should decide whether Aramark can proceed with its lawsuit against Aetna or must resolve the dispute through arbitration. According to the court’s ruling, the arbitration clause is sufficiently ambiguous to be subject to court review.  Aetna, a subsidiary of CVS Health, has been Aramark’s third-party Read More

The Commonwealth of Virginia has filed suit against various pharmacy benefit managers (PBMs) and insulin manufacturers for allegedly violating the Virginia Consumer Protection Act. According to the lawsuit, the defendants, including Express Scripts, CVS Caremark, and OptumRx, as well as Sanofi-Aventis U.S. and Novo Nordisk, engaged in an insulin pricing scheme that artificially inflated insulin prices, deceiving Read More

Employers are increasingly facing lawsuits under the Employee Retirement Income Security Act (ERISA) for their voluntary benefit plans, which include products such as accident, critical illness, hospital indemnity, and cancer insurance. Since coverage is voluntary, employees pay most or all of the policy premiums, although employers deduct the premiums from their paychecks. Filed just before Christmas, the suits Read More

Sen. Marsha Blackburn (R-Tenn.), a member of the Senate Finance Committee, sent a letter to David Joyner, CEO of CVS Health, asking for answers on “the company’s lengthy record of fraud and regulatory violations” as well as the “role the company has played in driving up healthcare costs.” Blackburn accused CVS of increasing health insurance premiums, which, in turn, have increased federal government spending on Read More