"Plans must attest that agreements with third party administrators, pharmacy benefit managers, and other service providers do not include prohibited gag clauses, which are provisions that restrict access to provider cost or quality information, de-identified claims data, or related disclosures or sharing that information with a HIPAA business associate."  MORE >>

"To comply with HIPAA Privacy Regulations, by February 16, 2026, all HIPAA covered entities are required to update their Notice of Privacy Practices (NPP) to address the use and disclosure of substance use disorder (SUD) treatment records that covered entities may receive from a SUD treatment program subject to 42 CFR Part 2 (Part 2 Program). The updates to the NPP are required even if the covered entity itself does not provide SUD services and is not itself considered a Part 2 Program."  MORE >>

"As we approach 2026, employers sponsoring cafeteria plans may take advantage of several important developments that permit optional changes to plan design and administration.... [1] Dependent Care FSA limit increase.... [2] Potential introduction of Trump Accounts.... [3] Health FSA and carryover limit adjustments.... [4] Nondiscrimination testing considerations."  MORE >>

"[1] Health legislation in congress ... [2] Transparency regulations ... [3] OBBB act guidance ... [4] NSA guidance ... [5] Mental Health Parity and Addiction Equity Act (MHPAEA) ... [6] Expansion of fertility benefits ... [7] Direct-to-consumer prescription drug programs ... [8] ERISA preemption of state PBM laws ... [9] Fiduciary breach litigation ... 10. HIPAA wellness/tobacco surcharge litigation."  MORE >>

14 pages. "[Annual Wellness Visits (AWVs)] are considerably underused, with 45 percent of Medicare beneficiaries not engaging with their AWVs.... [Fee-for-service] beneficiaries who were more engaged with their AWVs (had at least four AWVs from 2018 to 2023) had a lower annual trend in their total cost of care (TCOC) and considerably lower inpatient and emergency department spending.... [B]eneficiaries who received an AWV were associated with an average of $885 reduction in TCOC per beneficiary per year compared to years without an AWV."  MORE >>

"If passed, HIPRA would extend 'medical-grade' privacy, security, and breach obligations to a wide swath of consumer-focused digital health companies, such as smartwatches, wearables, health and wellness apps, life science companies with patient apps, health plans and hospitals' online tools, retail clinics, data/AI vendors, and employer wellness programs that sit outside traditional (HIPAA) coverage today.... [It] is paramount that digital health companies engage in a more unified, forward-looking privacy and security program now."  MORE >>

"The ERISA Industry Committee (ERIC) and allied organizations filed an amicus brief in the U.S. Court of Appeals for the Eighth Circuit ... The lower court had ruled that certain provisions of a new Iowa state law -- Senate File 383 -- regulating [PBMs] are preempted by [ERISA], but that other provisions of the law were not preempted. In its brief with the Eighth Circuit, ERIC asked the court to affirm the lower court's decision in part and to reverse it in part to provide that all of Senate File 383 is preempted by ERISA." [Iowa Assoc. of Bus. and Ind. v. Ommen, No. 25-0211 (S.D. Iowa Jul. 21, 2025; on appeal to 8th Cir. No. 25-2494)]   MORE >>

"In the latest survey of leading health care policy scholars ... [most] agreed that proposals to convert enhanced subsidies for [ACA] Marketplace plans into contributions for health savings accounts (HSAs) would have an overall effect of worsening health care affordability for enrollees. There was also consensus that requiring small-dollar premiums (instead of permitting fully subsidized plans with no net premium) would measurably reduce Marketplace enrollment; there was further consensus that a scheduled policy change that will effectively end automatic renewals with subsidy will substantially reduce Marketplace enrollment."  MORE >>

28 pages; Dec. 16, 2025. "What's New: [1] Social security and Medicare taxes for 2026.... [2] Moving expense reimbursements.... [3] Employer contributions to Trump accounts."  MORE >>

"Notice 2025-68 addresses several topics of interest to employers, including: [1] Employers can offer employees the option to fund accounts for their dependent children via pretax contributions under an Internal Revenue Code (IRC) Section 125 cafeteria plan. [2] The $2,500 limit on employer contributions that are non-taxable to the employee is an annual limit that applies per employee regardless of how many dependent children the employee has.... [3] Account trustees -- not employers -- are responsible for ensuring that aggregate individual and employer contributions don't exceed the annual $5,000 limit."  MORE >>