"[T]he new guidance [1] clarifies that the safe harbor does not extend to in-person services, medical equipment, or drugs furnished in connection with telehealth or other remote care services.... [2] clarifies how Direct Primary Care Service Arrangements (DPCSAs) interact with HSAs.... [3] provides that beginning January 1, 2026, bronze and catastrophic health plans, including those obtained through a health insurance exchange, will be treated as HSA-compatible, even if they don't meet the traditional high-deductible requirements."  MORE >>

"[CMS] proposed two models aiming to implement international reference pricing approaches for drugs under Medicare ... As proposed, both models would be mandatory for any drug manufacturer wishing to participate in Medicare. Both would assess rebates for certain single-source drugs and biological products 'if the prices exceed those paid in economically comparable countries.' The models share a number of conceptual and design features, but operational differences between Part B and Part D do play out in the models' design."  MORE >>

"[Minnesota's] highly anticipated Paid Family Medical Leave fully launches on Jan. 1, with applications already live for those who welcomed a child in 2025.The program offers up to 12 weeks for both medical and family leave -- with a total limit of 20 weeks a year. Over 5,000 Minnesotans have already submitted applications for leave to bond with children welcomed in 2025 after applications opened in December, according to Gov. Tim Walz's office."  MORE >>

"Although the plaintiff alleged that an accident in 2019 ultimately caused permanent blindness in one eye in 2023, the court held that the policy unambiguously required the physical loss to occur within 365 days of the accident. Because more than four years separated the alleged accident and the loss of vision, the court ruled that the plaintiff could not state a cognizable claim for benefits under ERISA Section 502(a)(1)(B) and granted MetLife's motion to dismiss." [Camardelle v. Metropolitan Life Ins. Co., No. 25-1382 (E.D. La. Dec. 19, 2025)]  MORE >>

"[T]wo air ambulance providers ... have filed a petition for writ of certiorari with the U.S. Supreme Court ... The petition asks the Court to decide a key question that has divided federal courts across the country: whether the NSA permits providers to bring private causes of action to enforce IDR awards in court. Should the Supreme Court grant cert, the outcome of the case could have broad implications for the enforceability of NSA arbitration awards, a key feature of the NSA's regulatory framework." [Guardian Flight, L.L.C. and Med-Trans Corp. v. Health Care Serv. Corp., No. 24-10561 (5th Cir. June 12, 2025; cert. pet. filed Oct. 8, 2025, No. 25-441)]  MORE >>

"For economic growth to meaningfully improve America's long-term fiscal outlook, Medicare spending would need to grow more slowly than GDP. But under the program's current structure, it will continue to grow faster than GDP for the foreseeable future. Every pathway through which growth occurs -- innovation, longer lives, cost disease -- feeds directly into higher Medicare spending. The conclusion is inescapable: we cannot grow our way out of the Medicare-driven debt crisis without reforming Medicare itself."  MORE >>