A federal court has invalidated a 2021 U.S. Department of Health and Human Services (HHS) regulation as arbitrary and capricious. The regulation changed the relationship between direct financial support from drug manufacturers and the Affordable Care Act (ACA) annual limits on cost-sharing. The case is HIV and Hepatitis Policy Inst. v. HHS, 2023 WL 6388932 (D.D.C. 2023). Drug manufacturers often provide direct Read More

A Texas federal judge recently upheld a U.S. Department of Labor (DOL) final rule concerning environmental, social, and governance (ESG) considerations in investment decisions by plan fiduciaries. Judge Matthew J. Kacmaryk found that the DOL’s ESG investing rule did not violate the Employment Retirement Income Security Act (ERISA). The ruling was unanticipated, as Judge Kacmaryk historically has struck down many Read More

A federal court judge in North Carolina dismissed a lawsuit in which a former employee alleged that Old Dominion Freight Line had violated its fiduciary duty under ERISA by mismanaging its workers’ 401(k) plan. Specifically, ex-employee Harvey Davis claimed that Old Dominion failed to substitute cheaper investment funds for more expensive options, thus violating the duty of prudence under ERISA and failing to monitor Read More

In L.D. v. United Healthcare Insurance, 2023 WL 4847421 (D. Utah 2023), a group health plan participant sued the plan and its insurer after receiving a denial of coverage for her child’s residential treatment as not medically necessary. The plan participant claimed that the denial of her claim violated the Mental Health Parity and Addiction Equity Act (MHPAEA) in that the plan applied the "medically necessary" Read More

The U.S. Court of Appeals for the Tenth Circuit recently issued a decision in Pharmaceutical Care Management Association (PCMA) v. Mulready, which many see as a significant win for pharmacy benefit managers (PBMs) and self-funded health plans. In its decision, the Tenth Circuit held that PBMs are subject to ERISA, thus preempting state law restrictions on PBMs. PCMA filed suit to challenge certain provisions of Read More

A D.C. federal court judge dismissed a 401(k) provider’s lawsuit challenging the U.S. Department of Labor’s (DOL) guidance concerning cryptocurrency investments. In his ruling, the judge found that DOL guidance was not subject to judicial review, and the 401(k) provider lacked standing to file suit. However, the judge also found that the relief the 401(k) provider requested, or invalidation of the DOL guidance and an Read More

The Internal Revenue Service (IRS) has issued Notice 2023-62, which gives guidance on Section 603 of the SECURE 2.0 Act concerning catch-up contributions. The Notice delays the requirement in Section 603 for highly compensated individuals to make catch-up contributions on a Roth basis – with no pre-tax option – to qualified retirement plans effective January 1, 2024. Instead, the Notice establishes a two-year Read More

The Internal Revenue Service (IRS) has released 2024 indexing adjustments to the Affordable Care Act (ACA) percentages. These percentages are critical to coverage under the ACA. As a result, large employers should pay close attention to these adjustments because failing to offer affordable coverage as defined under the ACA could result in costly employer-shared responsibility penalties. Under the ACA, the required Read More

As a company conducts due diligence as part of its plans to acquire a U.S. company, it should review the executive compensation of the company being acquired. This review not only allows a better understanding of the compensation structure but may uncover any liabilities or compliance issues that might affect the purchase price in the transaction. Compensation information is necessary to properly draft appropriate Read More

In a unanimous decision, the U.S. Court of Appeals for the Eleventh Circuit upheld a lower court’s decision denying a severance package for Bryan Rhode, a former CSX executive. Like the lower court, the appellate rejected the plan participant’s allegations that a conflict of interest and a flawed investigation by a plan administrator led to the rejection of his claim. The case is Bryan Rhode v. CSX Transportation Read More