"To address evolving threats and regulatory challenges, OCR has issued proposed modifications to the Security Rule, introducing stricter security controls, mandatory encryption requirements, and a shift away from 'addressable' implementation specifications. While these changes aim to improve data security, they also introduce new compliance burdens that could be challenging for many regulated entities."  MORE >>

"[T]he court concluded that the participants adequately alleged a breach of fiduciary duty by alleging that the insurer violated the governing plan terms by using the PxDx system to make medical necessity determinations. According to the participants, the governing plan provisions required medical necessity determinations to be made by a medical director -- making it a fiduciary breach for the insurer to use the AI-based PxDx algorithm for these determinations." [Kisting-Leung v. CIGNA Corp., No. 23-1477 (E.D. Cal. Mar. 31, 2025)]  MORE >>

"The law's 'any-willing-provider' requirement -- which limits a plan's ability to exclude pharmacies from its network -- has an 'impermissible connection' with benefit plans governed by [ERISA], [the district court judge] said  ... because it dictates the scope of provider networks eliminates plans' 'discretion to shape benefits as they see fit'[.]" [McKee Foods Corporation v. BFP Inc., No. 21-0279 (E.D. Tenn. Mar. 31, 2025)]  MORE >>

"The court agreed with plaintiffs that the type of individual harm they alleged could, under certain circumstances, constitute injury-in-fact for standing purposes.... The court nevertheless concluded that the actual facts plaintiffs alleged could not satisfy Article III's standing requirements because their alleged harm was speculative and ultimately not redressable.... The court's fundamental point was this: even if plaintiffs prevailed in this case and received all the relief they requested, Wells Fargo could still increase their contribution amounts under the terms of the plan without violating ERISA." [Navarro v. Wells Fargo & Co., No. 24-3043 (D. Minn. Mar. 24, 2025)]  MORE >>

"[A]mong the flurry of executive orders President Donald Trump signed during his first five weeks back in office was a promise to 'Make America Healthy Again' by giving patients accurate health care prices.... Trump's 2025 order is also a symbol of how little progress the country has made since he issued a similar directive nearly six years ago. Consumers find it only partially useful, and the quality of the information is spotty."  MORE >>

April 2 hearing. Video with Opening Statement by Chairman Rick Allen (R-GA) and witness testimony of [1] Ms. Angela Shields, on behalf of the National Association of REALTORS; [2] Ms. Marcie Strouse, on behalf of the National Federation of Independent Business; and [3] Ms. Bethany Lilly, The Leukemia & Lymphoma Society.  MORE >>

"Most employers (79%) turn to their brokers or benefits advisors to help them identify and evaluate the myriad of choices and select the benefits that best suit their employee base.... Employers are now seeking more data-driven insights, justification for recommended approaches, and demanding economic value from their programs. This increased focus on economic value has changed the conversations that brokers are having with their clients, and as a result, change what brokers value from carriers and other partners."  MORE >>