The U.S. Court of Appeals for the Tenth Circuit recently overturned portions of Oklahoma’s Patient’s Right to Pharmacy Choice Act, a state law regulating pharmacy benefit managers (PBMs), who serve as intermediaries between pharmacies, insurance companies, and drug companies. A three-judge panel reversed a federal district court judge’s April 2022 ruling in finding that the Act’s restrictions on network access and Read More
DOL Seeks Comment on SECURE 2.0 Reporting, Disclosure Changes
The U.S. Department of Labor (DOL) is seeking public comment on various provisions of SECURE Act 2.0. The Employee Benefit Security Administration (EBSA) published the 60-day request for public comment in the Federal Register on August 11, 2023. Comments are due by October 10, 2023, and can be submitted via the federal rulemaking portal at www.regulations.gov or by mail to the DOL. President Joe Biden signed Read More
Former Employee Challenges Employer’s Diversity Program on Religious Discrimination Grounds
Courtney Rogers, a former recruiter for Compass Group USA, recently filed a lawsuit against the company in the U.S. District Court for the Southern District of California. Rogers argues that Compass violated Title VII of the Civil Rights Act of 1964 after it terminated her for requesting a religious accommodation to avoid working on a corporate diversity, equity, and inclusion (DE&I) program that excluded white Read More
Federal Court Temporarily Halts Additional Provisions of No Surprises Act IDR Process
A federal district court has temporarily halted additional provisions of the No Surprises Act independent dispute resolution (IDR) process, which the legislation mandates some out-of-network providers, group health plans, and insurers use to resolve billing disputes. The case is Texas Med. Ass’n v. HHS, 2023 WL 4977746 (E.D. Tex. 2023). On two previous occasions, the court has set aside portions of U.S. Department Read More
California Supreme Court Revives Aetna Retaliation Suit
The California Supreme Court has revived a long-standing lawsuit between the California Medical Association (CMA) and Aetna over the insurance company’s alleged retaliation against physicians who referred their patients to out-of-network providers. The trial court judge and a state appellate court both dismissed the suit, which CMA originally filed in 2012, finding that CMA had no standing to bring the Read More
District Court Allows Mental Health Parity Claim Based on As-Applied Disparity to Proceed
A self-insured health plan participant sued the plan and plan administrator after receiving denials of his claims for his child’s residential mental health treatment. The participant claimed that Anthem Blue Cross and Blue Shield violated the Mental Health Parity and Addiction Equity Act (MHPAEA) for imposing a treatment limitation on mental health/substance use disorder (MH/SUD) benefits that it did not impose on Read More
U.S. Supreme Court to Consider Whether Mandatory Job Transfer Constitutes Discriminatory Employment Action
The U.S. Supreme Court has agreed to hear an appeal from the Eighth Circuit entitled Muldrow v. City of St. Louis. The issue in Muldrow involves whether Title VII of the Civil Rights Act of 1964 prohibits discrimination in job transfer decisions, absent evidence that the transfer caused the plaintiff a material disadvantage. As a result, the high Court will consider whether Title VII applies to all terms, conditions, Read More
DC Circuit Upholds $1.1M ACA Penalty as Tax
The U.S. Court of Appeals for the D.C. Circuit recently ruled that $1.1 million in penalties that the Internal Revenue Service (IRS) assessed against a wireless phone company for failing to provide health insurance coverage for its employees in violation of the Affordable Care Act (ACA) is a tax. Therefore, the company could not challenge the penalty due to the Anti-Injunction Act, which prohibits lawsuits Read More
Scorching Temperatures Spurn Feds to Call for Increased Worker Protections
Late July and early August brought about record-breaking heat waves nationwide, and many saw temperatures hit triple digits. In response, President Biden called for the U.S. Department of Labor (DOL) to issue its first-ever heat-related Hazard Alert. DOL’s Occupational and Safety Health Administration (OSHA) issued the Hazard Alert on July 27, 2023, affirming protections for workers from excessive heat under federal Read More
Mental Health Parity: Agencies Report to Congress on Continued Compliance Issues and Highlight Enforcement Activity
The U.S. Department of Labor (DOL), the U.S. Department of Health and Human Services (HHS), and the U.S. Department of Treasury have issued their second MHPAEA Comparative Analysis Report to Congress. This report is a requirement of the Consolidated Appropriations Act, 2021 (CAA, 2021) and the Mental Health Parity and Addiction Equity Act (MHPAEA). Under the CAA, 2021, health plans and insurers imposing Read More
