Republican Senator Accuses CVS CEO of Fraud, Regulatory Violations, and Inflated Health Care Costs

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

Senate Rejects Bills to Extend ACA Subsidies from Both Parties

The U.S. Senate has failed to bring to a vote two bills that would have extended subsidies under the Affordable Care Act (ACA) beyond the end of the year. Meanwhile, a coalition of 22 House Democrats and 15 House Republicans, led by Rep. Jennifer Kiggans, R-Va., has proposed the CommonGround for Affordable Health Care Act bill, which could at least temporarily extend subsidies if passed.  The Democrats introduced Read More

CVS Caremark Settles Claim of Over $5M for Underpaying Oklahoma Pharmacies

CVS Caremark has agreed to pay more than $5 million to settle claims by Oklahoma pharmacies that the pharmacy benefit manager (PBM) giant underpaid them for medications. The settlement is designed to reimburse pharmacies for over 68,000 prescriptions they filled between January 2024 and August 2025.  Oklahoma’s Attorney General filed the suit in January 2025, seeking censure, suspension, or revocation of CVS Read More

Blue Cross Advocates for Less Regulation of AI by States

The Big Data and Artificial Intelligence Working Group of the National Association of Insurance Commissioners (NAIC) is developing an artificial intelligence (AI) evaluation tool for use by state insurance regulators. The NAIC represents 33 independent U.S. insurance organizations. The purpose of the tool is to gauge the extent to which insurance companies rely on AI systems and how well they monitor their use. NAIC Read More

11th Circuit Affirms Dismissal of Fired Flooring Company CEO’s Suit Over Severance Package

A three-judge panel of the U.S. Court of Appeals for the Eleventh Circuit declined to revive a suit filed by Jay Gould, the former CEO of Interface Inc., a flooring manufacturer, seeking a severance package. Interface fired Gould after he went on a drunken rant at a company function and used explicit swear words to describe another employee. The panel decision characterized Gould’s appeal as an impermissible Read More

Court Denies Investment Adviser’s Bid to Dismiss Utility Co. 401(k) Suit

A Missouri federal district court judge refused to dismiss a proposed class action suit by former employees of a Midwest utility company alleging that an investment adviser cost them millions in retirement plan losses after giving them poor advice. The case is Doll et al. v. Evergy Inc. et al., Case Number 4:25-cv-00043, U.S. District Court for the Western District of Missouri. Former employees and participants in Read More

Notable ERISA Rulings from November

C.P. et al. v. Blue Cross Blue Shield of Illinois, Case Number 23-4331, U.S. Court of Appeals for the Ninth Circuit In C.P., the U.S. Court of Appeals for the Ninth Circuit overturned a grant of summary judgment in a class action in favor of transgender employee health plan participants who claimed that the insurance giant’s denials of coverage for gender-affirming care discriminated against them. On appeal, a Read More

Adidas Investors Claim Company Hid Rapper’s Hate Speech

Adidas investors appealed to the U.S. Court of Appeals for the Ninth Circuit to renew their putative securities class action that an Oregon federal district court judge dismissed in August 2024. According to investors, Adidas failed to disclose the risks of relying on Ye (f/k/a Kanye West and a/k/a Yeezy) for a multibillion-dollar partnership due to the rapper’s extreme antisemitism. They claim that although the Read More

4th Circuit Questions Class Status in Genworth Financial 401(k) Suit

A three-judge panel of the U.S. Court of Appeals for the Fourth Circuit seemed to express doubt over the propriety of class status during arguments in an Employee Retirement Income Security Act (ERISA) lawsuit by Genworth Financial employee retirement plan participants. The class, which consists of nearly 4,000 members, claims that their retirement savings plummeted due to underperforming BlackRock target date Read More

Bipartisan Senate Finance Committee Leaders Reintroduce PBM Regulation Bill

A bipartisan coalition of legislators, led by the leaders of the Senate Finance Committee, has reintroduced a major pharmacy benefit manager (PBM) regulation bill in Congress. Sen. Mike Crapo, R-Idaho, Senate Finance Committee chairman, and Sen. Ron Wyden, the highest-ranking Democrat on the committee, have introduced the "PBM Price Transparency and Accountability Act" bill in conjunction with a bevy of Republican Read More