An Illinois federal judge has ruled that an insurer that acted as a third-party claims administrator (TPA) for self-insured health plans violated Section 557 of the Affordable Care Act (ACA) by excluding coverage for gender-affirming care. In C.P. v. Blue Cross Blue Shield of Ill., 2022 WL 17788148 (W.D. Wash. 2022), a class action lawsuit filed by a transgender individual and his parent, the judge found that the Read More

The U.S. Department of Labor (DOL) has issued its 2023 annual updates to various civil monetary penalties that it imposes for benefit-related violations. The 2023 adjusted penalty amounts are effective for penalties assessed after January 15, 2023, and they apply to violations after November 2, 2015. The following summarizes some updated DOL penalty amounts for failing to comply with various DOL rules and Read More

The Internal Revenue Service (IRS) issued a proposed rule on December 27, 2022, that would permanently allow remote witnessing of spousal consent elections under certain circumstances. The proposed rule would go into effect six months after publication in the Federal Register. Taxpayers can continue to make remote spousal consent elections according to the proposed rule until it formally goes into Read More

The U.S. Securities and Exchange Commission (SEC) highlighted the duty of public companies to protect their shareholders and cure misconduct in an enforcement action concerning McDonald’s Corp. and its former CEO, Stephen J. Easterbrook. In a recent development, McDonald's, Easterbrook, and the SEC reached a deal by which Easterbrook agreed to a $400,000 fine and a five-year ban on serving as officer or director to Read More

The Office of Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS) released a Notice of Proposed Rulemaking entitled “Safeguarding the Rights of Conscience as Protected by Federal Statutes” on December 29, 2022. The proposed rule would partially rescind a Trump-era OCR regulation, which never went into effect because three federal courts previously found the regulation unlawful. The 2019 Read More

The Consolidated Appropriations Act, 2021 (CAA) requires insurance companies and employer-based health plans to file periodic Prescription Drug Data Collection reports (RxDCs) with the Centers for Medicare and Medicaid Service (CMS). The purpose of this data is to allow government agencies to analyze American medical spending. The first RxDC report, which is to contain 2020 and 2021 data, was originally due on Read More

A Florida district court judge has denied Wells Fargo & Company’s motion to dismiss a proposed class action suit over deficient COBRA notices sent to thousands of health plan participants. The case is Blessinger et al. v. Wells Fargo & Company, case number 8:22-cv-01029, U.S. District Court for the Middle District of Florida. Three former Wells Fargo employees sued the company in May 2022 under the Read More

The Internal Revenue Service (IRS) issued Internal Revenue Bulletin 2023-1 on January 3, 2023. Bulletin 2023-1 contains various revisions that supersede some 2022 Revenue Procedures. Administrative Rev. Proc. 2023-1, 2023-2, and 2023-3 all cover administrative issues. These procedures are effective as of January 3, 2023. Rev. Proc. 2023-1 contains revised procedures for letter rulings and information Read More

A California federal judge has denied Calbiotech’s bid to dismiss a former employee’s ERISA suit involving a claim that it failed to match contributions to employees’ 401(k) plans. The judge also kept the former employee’s retaliatory discharge claim alive but tossed his claims related to a separate employer-sponsored pension plan. The case is Raya v. Barka et al., case number 3:19-cv-02295, U.S. District Court for Read More

A group of healthcare providers and individual plaintiffs have filed a class action lawsuit against UnitedHealthcare Inc., OptumHealth Care Solutions, and various other defendants in a Florida federal district court. The providers received an assignment of benefits from the defendants for COVID-19 testing that they have provided and continue to provide to beneficiaries of the defendants’ plans and their family Read More