Oct. 29, 2025. "What's New ... Employers no longer have to automatically send Form 1095-B to individuals. The requirement for furnishing the statement is met if the entity responsible for issuing the statements provides clear, conspicuous, and accessible notice on its website that an individual may request a copy of their statement and the copy is timely furnished. For this purpose, the statement is timely furnished if issued to the individual no later than 30 days after the date of the request."  MORE >>

"The law bans discriminatory network steering, protects pharmacy ancillary services, and establishes new claims payment integrity rules. PBMs must be licensed by 2027 and owe a fiduciary duty to payers. These changes increase transparency, level the playing field for nonaffiliated pharmacies, and introduce new enforcement mechanisms, with provisions phasing in through 2029."  MORE >>

"The case highlights the consequences of procedural lapses in claim handling and reinforces that remand, not immediate benefits, is typically the appropriate remedy when no administrative record exists." [Chalk v. Life Ins. Co. of N. Am., No. 25-0133 (W.D. Ky. Oct. 27, 2025)]  MORE >>

"Accelerating healthcare costs have less to do with hospital and physician services than with surging drug spending ... [Data suggests] advanced therapies increasingly are taking the place of procedure-based care. For example, whereas GLP-1 use increased by more than 700% during a recent five-year period, bariatric surgery rates were flat to declining. Similarly, SGLT2 inhibitor patients more than tripled, while cardiac catheterization volumes declined slightly."  MORE >>

"Before the Inflation Reduction Act (IRA) passed in 2022, drug manufacturers increased prices an average of 4.2 percent on more than 900 brand-name drugs ... To discourage such price hikes, the IRA requires manufacturers to pay inflation rebates to the Medicare program when they increase certain drug prices faster than inflation.... This year, 2025, will be the first in which drug manufacturers will be invoiced for any rebates they owe the federal government under the new policy."  MORE >>

"This year's enrollment period is especially significant, as a record number of new entrepreneurs are not only expected to navigate the Health Insurance Marketplace for the first time, but many entrepreneurs could face higher health care premiums given the premium tax credits are set to expire this year unless Congress acts to renew them."  MORE >>