"Plan sponsors who previously made updates to the plan’s NPP, or other HIPAA compliance materials, to reflect the now vacated rules related to reproductive health information will also need to update those materials to remove those changes, if they have not already done so."  MORE >>

"The updated HRSA guidelines add the following to the list of health services that must be covered without cost-sharing for plan years beginning on or after December 29, 2026: [1] Self-collected cervical cancer screening for women aged 30 to 65 years with average risk. [2] Additional testing if necessary to complete the screening process for malignancies."  MORE >>

"If finalized, the proposed rule would: [1] require health plans to exclude from the in-network rate files certain data for services providers would be unlikely to perform; [2] require health plans to organize in-network rate files by provider network, rather than by plan; [3] require change-log and utilization files ... [4] reduce in-network rate and allowed amount files from monthly to quarterly; and [5] reorganize the allowed amount files by health insurance market type, reduce the claims threshold to eleven or more claims, and increase the reporting period[.]"  MORE >>

"By eliminating unnecessary software and services, patching vulnerabilities, and implementing secure configurations, organizations can reduce their 'attack surface,' thereby reducing the weaknesses and vulnerabilities that an attacker can exploit. OCR emphasizes that hardening is not a single action but an ongoing discipline requiring regular review, documentation, and updates as threats evolve. The newsletter outlines how HIPAA covered entities, business associates, and their workforce can strengthen their defenses through system hardening."  MORE >>

"President Donald J. Trump's Great Healthcare Plan is a broad healthcare initiative that will slash prescription drug prices, reduce insurance premiums, hold big insurance companies accountable, and maximize price transparency in the American healthcare system." [Also available: White House Fact Sheet]  MORE >>

"The Great Healthcare Plan [1] calls for codifying the Trump Administration's Most-Favored-Nation deals to get Americans the same low prices for prescription drugs that people in other countries pay.... [2] funds a cost-sharing reduction program for healthcare plans which would save taxpayers at least $36 billion ... [3] will end the kickbacks paid by pharmacy benefit managers (PBMs) to the large brokerage middlemen ... [4] [creates] the 'Plain English' insurance standard and [requires] insurance companies to prominently post the profits they take out of premiums as well as information on the frequency with which they deny care ... [5] requires any healthcare provider or insurer who accepts Medicare or Medicaid to prominently post their pricing and fees in their place of business[.]"  MORE >>

"The high court denied a petition by two air ambulance companies to review a circuit court's 2025 decision that IDR awards are not enforceable in federal court. That opinion by the U.S. Court of Appeals for the Fifth Circuit removes litigation as a tool for ensuring health plans pay IDR awards." [Guardian Flight, L.L.C. and Med-Trans Corp. v. Health Care Serv. Corp., No. 24-10561 (5th Cir. June 12, 2025; cert. pet. denied Jan. 12, 2026, No. 25-441)]  MORE >>

"Determining what employer actions constitute an endorsement of the voluntary program, and thus cause the program to be subject to ERISA, is highly fact-specific but may include actions such as using an employer logo or its letterhead on communications about the program. Employers should contact their legal counsel to determine if a voluntary benefit program is subject to ERISA."  MORE >>

"51% of brokers said voluntary products generate more than half of their sales revenue. Plaintiffs' law firms are connecting the dots between incentives, misuse of plan access and conflicted advice.... Voluntary benefits themselves are not the problem -- the incentives are.... [E]mployers should treat any recommendation, product access or employee interaction as an area requiring thoughtful, documented fiduciary oversight -- especially when employees are making decisions influenced by those recommendations."  MORE >>

"Health care spending in the US reached $5.3 trillion and increased 7.2 percent in 2024, similar to growth of 7.4 percent in 2023 ... As in 2023, the use and intensity of health care goods and services continued to grow rapidly in 2024, particularly for hospital care, physician and clinical services, and retail prescription drugs.... Health care spending growth continued to outpace overall economic growth in 2024, and as a result, the health care share of the economy increased from 17.7 percent in 2023 to 18.0 percent in 2024."  MORE >>

"Beginning Jan. 1, 2026, a California law, SB 41, went into effect, imposing fiduciary responsibilities on [PBMs]. At the same time, CalPERS ... began the year with a new pharmacy benefit manager ... that includes performance guarantees that hold the PBM accountable for meeting cost and quality targets. Taken together, these two efforts could signal a change in the relationship of PBMs, health plans and payers."  MORE >>

"The changes to the national enforcement projects ... highlight where EBSA will focus its enforcement resources to increase broad-based employee benefit plan compliance, address abusive practices and bad actors, and deliver results that increase security for participants and beneficiaries.... investigators will prioritize cases related to: [1] Cybersecurity; [2] Barriers to mental health and substance use disorder benefits; [3] Protecting benefit distributions; [4] Retirement asset management; [5] Surprise billing; [6] Criminal abuse of contributory benefit plans. EBSA will continue its long-standing commitment to identifying abusive Multiple Employer Welfare Arrangements [MEWAs] ... EBSA removed [ESOPs] from the national enforcement project list and will reduce its focus on missing participants following the establishment of the Retirement Savings Lost and Found Database."  MORE >>

"Trump Accounts present a meaningful new benefits opportunity for employers through tax-free employer contributions under Section 128 and pre-tax employee contributions through Section 125 cafeteria plans. Although Trump Accounts cannot receive contributions before July 4, 2026, employers interested in the benefit can begin evaluating budget considerations, program design, trustee coordination and nondiscrimination rules."  MORE >>

"What we saw in 2025: [1] Supreme Court: lowering the pleading bar for prohibited transaction claims ... [2] Defined benefit plans: evolving pension risk transfer and actuarial equivalence litigation ... [3] Defined contribution plans: expanding fiduciary breach theories ... [4] Health plan litigation: mounting cases even as health plan fiduciaries score wins ... [6] The Trump administration focuses on ERISA ... What [to watch] in 2026: [1] ERISA in the Supreme Court: the meaningful benchmark divide ... [2] ERISA jury trials in the Second Circuit: the saga continues."  MORE >>