"The Proposed Rule attempts to provide ... transparency by: [1] Requiring PBMs to provide written disclosures of the PBM's direct and indirect compensation ... reasonably in advance of entering into or renewing a service arrangement ... [2] Establishing audit provisions designed to ensure that plan fiduciaries can verify the accuracy of the disclosures; and [2] Providing relief for plan fiduciaries if the PBM fails to meet its disclosure obligations.... [T]he Proposed Rule would require PBMs to disclose compensation as a monetary amount (even if estimated), rather than providing formulas, which are notoriously difficult for fiduciaries to assess when evaluating reasonableness."  MORE >>

"The new schedule reduces the number of vaccines universally recommended for children and adolescents from birth to 18 years old.... Importantly, all vaccines remain available and covered under federal requirements, meaning families should not face out-of-pocket costs for preventive immunizations."  MORE >>

"The minimum penalty for each violation of a particular HIPAA requirement or prohibition increases to $145 (up from $141) for a covered entity or business associate that did not know -- and could not have known by exercising reasonable diligence -- about the violation. For violations due to reasonable cause and not willful neglect, the minimum penalty increases to $1,461 (up from $1,424).... The calendar-year penalty cap increases to $2,190,294 (up from $2,134,831) for all violations of an identical HIPAA provision."  MORE >>

"The IRS now gives employers 90 days to respond to Letter 226J. Prior to 2025, the IRS only gave 30 days which may likely resulted in employers scrambling to investigate the tax assessments or asking for extensions. The deadline is 90 days from the date on the Letter 226J, not from when you received it."  MORE >>

"The penalty for failing to file a Form M-1 is almost as severe as the penalty for failing to file a Form 5500, at a rate of $1,992 per day in penalty fees.... MEWAs and Entities Claiming Exception required to file Form M-1 are now eligible to correct late filings under [DFVCP].... For self-insured plans, many states also have filing and approval requirements as well as requirements to keep a reserve with the state's Department of Insurance."  MORE >>

"Peter Nelson, who leads the branch of [CMS] that oversees private health insurance and Marketplaces, has pitched an ambitious vision for how compacts could be used. CMS recently requested and received input from the National Association of Insurance Commissioners (NAIC) as a prelude to rulemaking.... [ACA Section 1333] it permits the sale of health insurance that departs from many of a state's insurance rules, But Sec. 1333 generally provides no authority to depart from federal law or provide federal funding. And it is doubtful that compact plans could share a risk pool across states."  MORE >>

"While Minnesota’s Paid Leave statute covers certain personal safety events (e.g., domestic violence and stalking), it does not include language explicitly providing leave for fear of general civil unrest or public safety threats tied to protests or law enforcement operations."  MORE >>

"Maine's paid family and medical leave (PFML) program will begin paying benefits on May 1, 2026. Employers with at least one employee in Maine began making contributions to the PFML fund in January 2025 through employee payroll deductions and employer contributions. On January 20, 2026, the Maine Paid Family and Medical Leave Benefits Authority announced that the fund was sufficiently solvent to make benefits available to 'most Mainers,' effective May 1, 2026."  MORE >>

"44.9% of all health care payments across all lines of business were tied to APMs that hold providers accountable for quality and cost of care (HCPLAN Categories 3-4) in calendar year (CY) 2024 compared to 45.2% in CY 2023. 28.7% of health care payments across all lines of business were tied to APMs with downside risk (HCPLAN Categories 3B-4) in CY 2024 compared to 28.5% in CY 2023."  MORE >>

"One in three insured adults in the U.S. say they find prior authorizations a 'major burden' to getting health care. An additional four in ten (37%) say the process is a 'minor burden,' bringing the total share of insured adults who find the process burdensome to about seven in ten (69%). This is larger than the share who say other aspects are burdensome such as understanding bills or what is owed (60%), getting needed appointments (60%), or finding providers who accept their insurance (53%)."  MORE >>

"While ChatGPT can tell you that you need an MRI for your knee pain, it can't tell you that the imaging center five miles north charges $150 while the one downtown wants $1,800 for the exact same scan. ... ChatGPT Health can coach employees on diet, track workouts and explain medical terms. That's genuinely valuable for healthfulness and engagement. But when employees still don't understand their benefits coverage or how to find affordable, in-network care, we're only solving part of the equation."  MORE >>

"The Committee for a Responsible Federal Budget just dropped a detailed analysis on implementing RBP for the Federal Employee Health Benefits program. Buried in there is a roadmap for what ANY employer can expect when they stop letting hospitals yank them around with astronomical chargemaster pricing and just as phony carrier 'discounts.' The government's proposed pricing target amount of 200% of Medicare will deliver about 12% total savings. Go to 150% of Medicare? You're looking at 22% savings. Even at 250%, you still get 5-6% back."  MORE >>

"In FY 2025, EBSA closed 878 civil investigations. Of those, 556 investigations (63 percent) produced monetary results for plans or other corrective action, for a total of $714.4 million recovered.... In FY 2025, [EBSA] obtained 297 non-monetary civil corrections, including: [1] removing 15 fiduciaries, [2] barring 24 individuals from serving as fiduciaries, [3] appointing 18 fiduciaries, [4] improving missing participant procedures for 49 plans, and [5] implementing 61 global corrections across multiple ERISA-covered health plans."  MORE >>