"Last year, legislatures in Arizona, Maryland, Nebraska, and Texas enacted bills to address AI use in health insurance determinations.... [T]his post summarizes legislation under consideration in the first quarter of 2026 that governs health insurers' use of AI in determinations such as prior authorization and utilization review."  MORE >>

Video of April 22 hearing, with Opening Statement from Subcommittee Chairman Rep. Rick Allen (R-GA), and witness testimony from: [1] Mr. James Gelfand, The ERISA Industry Committee (ERIC); [2] Mrs. Chris Deacon, VerSan Consulting; [3] Professor Mariana Socal, Johns Hopkins Bloomberg School of Public Health; and [4] Ms. Hannah Anderson, America First Policy Institute.  MORE >>

"Employers, lawmakers, patient advocates, price transparency groups and more urged the [DOL] to quickly finalize a rule that would force pharmacy benefit managers ... to share more pricing and compensation information. PBMs did not feel the same, according to industry comments on the proposed regulation."  MORE >>

"Speaking [April 21] at Politico's Health Care Summit, the celebrity entrepreneur and cofounder of Cost Plus Drugs, a direct-purchase marketplace for generic drugs, painted the picture of an industry cowed by major insurers and pharmacy benefit managers."  MORE >>

"Rather than continuing to be squeezed by ever-higher—and often unsubstantiated—costs from traditional health insurance and pharmacy benefit management (PBM) firms, business are instead now putting their contracts up for bids from prospective partners that are willing and able to offer more affordable options."  MORE >>

"[FAB 2026-01] is a positive development for plan sponsors and fiduciaries, as on the whole it suggests a more restrained and targeted enforcement approach: Likely fewer investigations overall, particularly those based on novel or unsettled legal theories or on ESOP valuations. Greater focus on clear-cut violations, especially those involving conflicts of interest or significant participant harm. Increased focus on fiduciary duty of loyalty and reduced emphasis on standalone prudence claims, absent loyalty concerns. More centralized decision-making within EBSA, leading to greater consistency across regions."  MORE >>