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

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

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

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

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

A Major League Baseball Players (MLB) Benefit Plan participant recently filed an ERISA lawsuit against Aetna Health and Life Insurance Co. (Aetna) and the MLB Benefits Plan. The suit challenges the denial of inpatient mental health treatment claims for the participant’s daughter. MLB offers mental health benefits to employees and their beneficiaries, including inpatient and outpatient treatment of mental health Read More

Committees in both houses of Congress recently voted to advance legislation reforming pharmacy benefit managers (PBMs). In recent months, PBMs, which manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, and large employers, have come under fire for allegedly anticompetitive practices and inflated consumer drug prices. The Senate Finance Committee, which handles matters Read More

The Federal Trade Commission (FTC) recently unanimously voted to withdraw its previously issued policy statement that opposed state legislation increasing transparency over pharmacy benefit managers (PBMs). Consistent with heightened scrutiny of PBMs by federal agencies, the FTC issued a statement cautioning against reliance on prior advocacy statements regarding PBMs that no longer may be valid. The FTC stated Read More

Three federal agencies – the Department of Labor (DOL), the Department of Treasury (Treasury), and the Department of Health & Human Services (HHS) – released joint proposed rules designed to amend existing rules under the Mental Health Parity and Addiction Equity Act (MHPAEA). The proposed rules also fulfill the mandate of the Consolidated Appropriations Act, 2021 (CAA, 2021) to implement nonquantitative Read More

A Delaware federal judge heard arguments recently on Elon Musk’s motion to dismiss all claims against him personally in a lawsuit filed by former Twitter employees over severance benefits. The case is Arnold et al. v. X Corp. et al., case number 1:23-cv-00528, the U.S. District Court for the District of Delaware. Musk argued that he did not sign off on the provisions of the 2022 Twitter takeover deal concerning Read More