"HHS expects each manufacturer to commit to aligning U.S. pricing for all brand products across all markets that do not currently have generic or biosimilar competition with the lowest price of a set of economic peer countries. The MFN target price is the lowest price in an OECD country with a GDP per capita of at least 60 percent of the U.S. GDP per capita. These targets will drastically bring down U.S. drug prices[.]"  MORE >>

"The Order applies to branded products without generic or biosimilar competition (presumably meaning marketed equivalent products).... The countries whose prices will be used to determine the MFN price are those in the Organization for Economic Cooperation and Development (OECD) having GDP per capita of at least 60 percent of U.S. GDP per capita ... The target prices that manufacturers will be asked to offer reflect current lowest prices in these countries, rather than prices somewhere between U.S. prices and those lowest prices in the other countries."  MORE >>

"This Draft Guidance introduces several developments affecting manufacturers of drugs covered under both Medicare Part B and Part D, as 2028 is the first negotiation cycle that will include Medicare Part B drugs.... CMS provided new commentary that may alter its treatment of fixed combination products as well as initial guidance on implementation of the renegotiation provisions of the Inflation Reduction Act."  MORE >>

"Effective October 1, 2025, Maryland employers covered by the federal Family and Medical Leave Act ('FMLA') will no longer be subject to the state's unpaid parental leave requirements. Senate Bill 785 ... amends Maryland's Parental Leave Act (PLA) to reduce overlap with federal law and ease compliance burdens for certain employers."  MORE >>

"House Bill 102 ('the Amendment'), which again pushes back the start date for Maryland's Family and Medical Leave Insurance Program (FAMLI).... Although the Amendment does not alter FAMLI's funding model, the required payroll deductions, previously scheduled to start on July 1, 2025, will now begin on January 1, 2027...., [The Amendment] directs the Secretary of Labor to announce when the benefits will be available, provided the announcement is not later than January 3, 2028. Previously, benefits were supposed to begin January 1, 2026."  MORE >>

"The court’s decision creates a significant enforcement gap. Since HHS and the exchange currently lack a system for issuing the required certifications to employers, the IRS cannot assess or impose penalties for ACA violations." [Faulk Company, Inc. v. HHS, No. 24-0609 (N.D. Tex. Apr. 10, 2025)]   MORE >>

"On May 18, the House Budget Committee advanced a budget reconciliation bill that includes significant changes to the Medicaid program and the [ACA], as well as additional provisions related to Medicare and Health Savings Accounts. [A table provides] a summary of the health provisions included in the House Rules Committee Print released on May 19 compared to current law"  MORE >>

"[A Health Payment Account (HPA)] is a low-cost, flexible payment tool that gives employees immediate access to an employer-defined revolving line of credit ... to cover out-of-pocket healthcare expenses, interest free.... A recent study ... found that 34% of employees with access to an HPA would consider switching to a plan with lower premiums.... [In] one case study ... 40% of employees opted into an HSA-qualified health plan when an HPA was offered alongside it."  MORE >>

"The surging demand -- and high cost -- of GLP-1 drugs ... presents a complex balancing act for insurers to control near-term drug costs and manage long-term health outcomes.... On the one hand, insurers recognize the potential for GLP-1 drugs to reduce costly chronic conditions, but on the other, are wary of the sheer scale and cost of widespread adoption. Their current strategy is to contain near-term expenses while waiting for clearer long-term data and possible price competition (including generics or biosimilars)."  MORE >>

20 pages. "Employers negotiate with health care providers to secure favorable rates, which directly impact premium costs, out-of-pocket expenses, and the affordability of health care for employees. However, provider rate negotiations occur in a complex health care environment ... While conventional wisdom suggests that hospitals compensate for lower Medicare and Medicaid reimbursements by increasing prices for private insurers, economic theory and recent research challenge this assumption."  MORE >>

"Recognizing the benefits of deferential review, Firestone set off a veritable land grab by insurers and plan administrators to claim that either existing language in their plans or quickly adopted plan amendments granted discretion to interpret plan provisions and render eligibility determinations.... [1] The import of discretionary clauses ... [2] Discretionary language ... [3] Efforts to rein in discretionary clauses ... [4] The impact of discretionary clauses ... [5] Conflict of interest ... [6] Forfeiture of discretion ... [7] The meaning of substantial evidence."  MORE >>