"The Trump Administration has released its Marketplace Integrity and Affordability Final Rule, which revises Marketplace eligibility and enrollment rules and increases obligations for participants to receive premium tax credits.... While the Final Rule largely finalized the proposal with little or no change ... some of these changes will only be effective for a single plan year (plan year 2026), because those provisions are only effective beginning in plan year 2026 and are set to sunset at the end of that year."  MORE >>

"The checklist covers 15 best-practice compliance to-dos, organized into six key categories: [1] HIPAA/HITECH risk assessment; [2] Policies, procedures and business associate agreements; [3] Staff training; [4] Processes to detect and report PHI data breaches; [5] Business associate monitoring; [6] System access control and activity reviews."  MORE >>

"Senate Bill 140 ... addresses pharmacy network adequacy and prohibits PBMs from entering network contracts that would prevent pharmacists from advising patients about lower cost options.... House Bill 1004 imposes added price transparency requirements and price controls on Indiana nonprofit hospitals intended to lower the cost of hospital care."  MORE >>

"The Court rejected Braidwood's arguments that Task Force members are not inferior officers.... [T]he Court interpreted the term 'independent' to mean avoiding undue influence from external affiliations, not complete insulation from the Secretary of HHS. Finally, the Court found that the Secretary's inability to compel specific recommendations does not disqualify Task Force members as inferior officers[.]" [Kennedy v. Braidwood Management, Inc., No. 24-316 (S. Ct. Jun. 27, 2025)]  MORE >>

"Challengers argued that members of the task force are 'principal officers' who should have been appointed by the president and confirmed by the Senate.... A majority of the Court disagreed, finding the members are 'inferior officers' who have been, and continue to be, properly appointed by the Secretary of [HHS]. Accordingly, all of the task force's recommendations since the ACA was enacted in 2010 are enforceable." [Kennedy v. Braidwood Management, Inc., No. 24-316 (S. Ct. Jun. 27, 2025)]  MORE >>

"The ruling ... essentially eliminates the enhanced federal privacy protection for reproductive health care information.... [C]ertain regulated entities are still required to comply with applicable state privacy and consumer laws regarding the disclosure of reproductive health care information." [Purl v. HHS, No. 24-0228 (N.D. Tex. Jun. 18, 2025)]  MORE >>

"Unum relied on the supposed absence of 'clinical findings' to justify termination ... [and] questioned the severity of her symptoms based on [surveillance footage of her] daily activities and a selective reading of her records. The court flatly rejected these rationales emphasizing that while the subjective nature of migraine and vestibular syndromes makes objective validation inherently difficult, it does not undermine their legitimacy as disabling conditions." [Jessica L. v. Unum Life Ins. Co. of Am., No. 24-2046 (N.D. Cal. June 24, 2025)]  MORE >>

"For many employers, the prospect of self-funding can be daunting due to concerns over cash flow and risk exposure. However, alternative strategies -- such as level funding and group captive models -- could offer a reasonable middle ground, enabling cost control and financial flexibility without assuming the full self-insured risk."  MORE >>

"Using unique small group market (SGM) data with detailed claims and enrollment information, [the authors] analyze the welfare gains across households in the SGM from alternative formulations of ACA health insurance exchanges (HIXs).... Shutting down the SGM would reduce equilibrium adverse selection in HIX-type markets ... The majority of households would obtain higher equilibrium welfare from HIXs, stemming from having more choices."  MORE >>

"[Some groups] are lobbying for employers to be able to make tax-free contributions to employees' 529 plans as an additional benefit. [PSCA] asked plan sponsors if this is something their organization would consider doing if it was allowed. While thirty percent said no, an equal percentage said maybe, and a quarter are unsure -- only 15 percent said they would definitely be interested in this."  MORE >>

"While lowering out-of-pocket costs for patients is a commendable objective, adopting price controls similar to those used in other countries could potentially lead to comparable consequences.... While the MFN executive order captured headlines, the most durable changes to U.S. drug pricing are likely to emerge from broader structural shifts already underway."  MORE >>

"Interpretive Bulletin 75-2 ... provided the DOL's views on whether a 'party in interest' has engaged in a prohibited transaction with an employee benefit plan where the party in interest has engaged in a transaction with an entity in which the plan has invested.... Interpretive Bulletin 75-6 related to ERISA section 408(c)(2) and whether a plan could make an advance to a fiduciary to cover expenses to be properly and actually incurred by such person in performing duties with respect to the plan.... Interpretive Bulletin 75-10 ... addressed ambiguity arising from the joint jurisdiction of the Department and IRS with respect to parallel provisions in title I of ERISA and the Code.... [T]he DOL believes the interpretive bulletins are no longer needed, and if left on the books, add potential confusion and unnecessary complexity.... This direct final rule removes these obsolete interpretive bulletins prospectively as of the effective date and has no effect on their legal effectiveness prior to that date."  MORE >>

"[1] Mental health parity enforcement freeze ... [2] Crypto 401(k) warning withdrawn ... [3] ESG investing rule replacement."  MORE >>