"The Consolidated Appropriations Act, 2026 (CAA 2026) ... includes a very significant and long-awaited set of reforms designed primarily to address pharmacy benefit manager (PBM) prescription drug pricing and compensation structures. These new rules that apply in 2029 will require PBM contractual protections for employer data access, extensive PBM reporting standards to employers, new employee notice requirements, disclosure enhancements, and a pass-through compensation mandate."  MORE >>

"The Federal Departments released proposed Transparency in Coverage (TiC) regulations to improve the public disclosure of prices for medical items and services. [This article describes] [1] The issues that make pricing data challenging to download, understand or consume. [2] Four new files to provide additional pricing context: Change Log, Utilization, Taxonomy and Text. [3] Changes to the INN Rate and OON Allowed Amount Files, which are intended to reduce the size of the Files and increase the amount of usable pricing data."  MORE >>

"[T]he proposed regulation is much broader than the corresponding rule for pension and retirement plans, not only in terms of the type of compensation and fees that are subject to disclosure but also regarding [1] the extent of the written disclosure, [2] the timing and frequency of disclosure, [3] the requirement to generally disclose using monetary amounts (versus formulas or percentages), and [4] the provision of specific rights to plan fiduciaries with respect to the disclosures (e.g., audit rights)."  MORE >>

"The required advance, written disclosures would be necessary for parties to contracts or arrangements for PBM services to obtain the benefit of a prohibited transaction exemption under ERISA 408(b)(2).... If a third-party administrator (TPA) contracts with an ERISA self-insured group health plan to provide pharmacy benefit management services, the TPA is a covered service provider under this proposal, even if it intends to rely on another provider to perform those services (e.g., a subcontracted PBM)."  MORE >>

"Plan sponsors should determine if and how the new Part 2 requirements apply to their group health plan and review their NPPs accordingly. Plan sponsors should also review whether and how PHI and SUD records travel through their systems and consult with any vendors that handle SUD records to ensure compliance. This may also require updates to business associate agreements for vendors that handle SUD on behalf of the group health plan."  MORE >>

"In addition to the required NPP changes going into effect on February 16, 2026, OCR's authority to enforce Part 2 will take effect, which will allow the following: [1] Individuals will be able to file complaints with OCR for alleged Part 2 violations; [2] Part 2 providers will be required to report breaches of unsecured Part 2 records; and [3] OCR can begin investigation and enforcement activities, including the imposition of civil monetary penalties for violations."  MORE >>

"It is critical for covered entities to understand what state laws, if any, may impose additional obligations upon them, and that merely complying with HIPAA is not enough. This is made even more important by the raft of state-specific privacy protection laws that states across the country have implemented within the last decade. The examples [in this article] illustrate when and where state law may impose burdens more demanding than HIPAA and the Privacy Rule, but also note where HIPAA preempts other, conflicting state laws."  MORE >>

"Many employers include a brief description of their educational assistance program in their employee handbook and consider the issue addressed. While handbooks are a useful communication tool, they are not sufficient for tax purposes. Under Internal Revenue Code Section 127, educational assistance programs must be established and maintained pursuant to a separate written plan document in order for benefits to be excluded from employees’ taxable income."  MORE >>

"Beginning Feb. 22, 2026, most employers in New York City must provide 32 hours of unpaid sick and safe leave.... [E]mployers must separately track and report paid sick and safe leave, unpaid sick and safe leave, and prenatal leave on pay stubs and maintain related records for at least three years.... Employers that fail to provide required sick and safe leave may be required to restore leave hours and pay $500 per employee per calendar year for each year a noncompliant policy was in effect."  MORE >>

"The emergency declaration triggers the special five-day paid leave requirements and remains in effect until the national emergency has ended.... After the covered employee exhausts accrued sick leave and other available leave, employers must provide up to five additional days of paid sick leave to employees who have influenza or are suspected of having influenza during the emergency."  MORE >>

"One of the most significant and potentially complex changes brought by the amendments is the creation of new job-protection rights for employees who take leave for their own medical condition while receiving Temporary Disability Insurance (TDI) or Family Leave Insurance (FLI) benefits.... Employees now have expanded rights to determine which state benefits to use -- and the order in which to use them -- particularly when they qualify simultaneously for paid sick leave, TDI, or FLI benefits. This increased employee choice complicates employer leave administration."  MORE >>

"The Appellate Division affirmed that a concrete supplier's paid leave policy violated several sections of the ESLL, including notice and recordkeeping requirements and providing paid sick leave, and that the company did not fall within the ESLL's 'construction industry' exemption.... This decision clarifies important questions for employers about the ESLL exemptions, the financial risks of noncompliance, and how groups of workers can assert their rights under the statute without the need for a class action." [Cano and Bonelli v. County Concrete Corp., No. A-0056-24 (Sup. Ct. N.J. App. Div. Jan. 28, 2026)]  MORE >>

"Over 81% of employers said that mental health issues increased absences at their workplaces, 50% reported seeing an increase in mental health claims, and 30% admitted to an increase in claims related to postpartum depression. In turn, as more employees take leave based on mental health issues, they are asking employers to provide them with the care and support they need while on leave.... [E]mployers may wish to review their leave policies to improve their workers' leave experiences."  MORE >>

"[I]ndividuals and businesses in the State of Montana affected by severe storms and flooding that began on Dec. 10, 2025 ... now have until May 1, 2026, to file various federal individual and business tax returns and make tax payments.... [I]ndividuals and households that reside or have a business in the Blackfeet Indian Reservation, Lincoln, and Sanders counties qualify for tax relief."  MORE >>