DOL’s New Retirement Security Rule Remains on Hold as Agency Pauses Appeals

The U.S. Department of Labor (DOL) has filed a motion with the U.S. Court of Appeals for the Fifth Circuit to pause its appeals of two federal court cases challenging its new Retirement Security Rule. This move follows two July 2024 federal court orders staying the implementation of the rule, which was supposed to go into effect in September 2024. The new Retirement Security Rule extends fiduciary responsibilities Read More

HHS Settles HIPAA Security Breach Stemming from Phishing Cyberattack for $3 Million

The Office for Civil Rights (OCR), a division of the U.S. Department of Health and Human Services (HHS), has announced a $3 million settlement with Solara Medical Supplies, LLC, a covered entity under the Health Insurance Portability and Accountability Act (HIPAA). The unauthorized disclosures stemmed from a cyberattack that resulted in violations of the HIPAA security and breach notification rules. OCR began its Read More

HHS Delays Effective Date of Final Rule Modifying HIPAA Retail Pharmacy Standards

The U.S. Department of Health and Human Services (HHS) has extended the effective date of its final rule updating electronic transaction standards for retail pharmacy transactions under the Health Insurance Portability and Accountability Act (HIPAA). The final rule also modifies the Medicaid pharmacy subrogation standard. These final rules were scheduled to go into effect on February 11, 2025. The new effective date Read More

UnitedHealth TPA Settles DOL Suit Based on Improper ER Claim Review Processes for $20.25M

UMR, which is UnitedHealth-owned third party administrator (TPA), agreed to pay $20.25 million in a U.S. Department of Labor (DOL) suit over their process for review of emergency room (ER) claims. Vincent Micone III, acting DOL secretary, has asked the U.S. District Court for the Western District of Wisconsin to approve a consent order and judgment to resolve the pending court case. In July 2023, the DOL filed a Read More

State Republican Finance Officials Urge SEC and DOL to Adopt Regulations Prohibiting Use of ESG or DEI Factors

Republican state finance officials from 18 states have urged the acting heads of the U.S. Securities and Exchange Commission (SEC) and U.S. Department of Labor (DOL) to adopt regulations for asset managers and retirement plan sponsors banning the use of environmental, social and governance (ESG) or diversity, equity and inclusion (DEI) factors. The officials pointed to a recent legal loss by American Airlines as Read More

Agencies Report on Mental Health Parity Compliance; Highlight Enforcement Activity

The U.S. Department of Labor (DOL), U.S. Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS) recently released their 2024 Mental Health Parity and Addiction Equity Act (MHPAEA) Report to Congress. DOL also released its FY 2023 MHPAEA Enforcement Fact Sheet. The Consolidated Appropriations Act, 2021, provides for an annual report specific to nonquantitative treatment limitation (NQTL) Read More

Federal Court Dismisses Breach of Fiduciary Duty Claim Stemming from High Drug Costs Against Johnson & Johnson for Lack of Standing

A New Jersey federal district court has dismissed the plaintiff’s breach of fiduciary claims in Lewandowski v. Johnson & Johnson, et al. No 3:24-cv-00671 (D.N.J. January 24, 2025) without prejudice and with leave to amend the complaint, based on standing. In her lawsuit against Johnson & Johnson and its Pension & Benefits Committee, Ann Lewandowski alleged that the defendants collectively breached their Read More

Seventh Circuit Cites Noncompete Provision in Stock Agreement in Reopening Lawsuit Seeking Clawback from Company’s Former Manager

The Seventh Circuit has reinstated a lawsuit by an auto parts corporation seeking a clawback of the proceeds a former plant manager received from selling his stock shares. The Court reversed the lower court’s grant of summary judgment in favor of the former manager, stating that it should not have considered the reasonableness of the noncompete clause in the stock agreement. The case is LKQ Corporation v. Robert Read More

Federal Agencies Issue FAQs, Again Extending Enforcement Relief for Surprise Billing QPA Calculations

The U.S. Department of Labor (DOL), U.S. Department of Health and Human Services (HHS), and the Internal Revenue Service (IRS) have issued FAQs About Consolidated Appropriations Act, 2021 Implementation Part 69. The FAQs provide guidance on the calculation of the qualifying payment amount (QPA) used in the independent dispute resolution (IDR) process under the No Surprises Act. The FAQs also extended enforcement Read More

Employers Struggle to Provide Quality Healthcare Amid Increased Costs and Fiduciary Concerns

Employers are facing multiple challenges this year in providing competitive and quality health care benefits for employees. Skyrocketing costs, increased fiduciary risk, and a constantly evolving legal and political landscape all are impacting the ability of employers to effectively provide healthcare benefits. Nonetheless, employers appear dedicated to continuing to provide these benefits, with an estimated 43% Read More