GLP-1 medications have quickly become a significant cost driver in employer-sponsored health plans, with annual per-participant costs frequently exceeding $10,000 and utilization rates continuing to rise. The GLP-1 landscape continues to change (for example, in December 2025, the U.S. Food and Drug Administration (FDA) approved a daily pill form of GLP-1). Consequently, plan sponsors are … Continue Reading
As the No Surprises Act (NSA) enters 2026, federal agencies are expected to focus on three key issues: finalizing delayed rulemaking, issuing guidance to address operational challenges in the Independent Dispute Resolution (IDR) process, and managing enforcement discretion amid ongoing litigation. At the same time, several statutory provisions remain unimplemented, creating regulatory uncertainty for health … Continue Reading
2024 might almost be over, but the Senate recently passed two bills that are intended to ease at least some employer burdens under the Patient Protection and Affordable Care Act (ACA). The bills, both of which are pending signature by President Biden, are:… Continue Reading
The three federal agencies tasked with enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) — the Departments of Labor, Health & Human Services (through CMS), and Treasury (the Departments) — issued their Final Rule to implement the MHPAEA on September 9, 2024, to mixed reviews. Groups composed of providers, such as the … Continue Reading
In just a few days’ time, recently promulgated federal final rules addressing sex-based nondiscrimination in the administration of health care benefits have created a flurry of healthcare industry activity. The angst arises from providers, payers, and certain health plans alike. While the spotlight shines brightest on healthcare providers and health insurers, the focus of this … Continue Reading
The Department of Health and Human Services Office for Civil Rights (OCR) issued a proposed rule on April 17, 2023, to amend provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to strengthen privacy protections for individuals’ protected health information (PHI) related to reproductive healthcare (the Proposed Rule). The Proposed Rule would … Continue Reading
