Regulatory Updates

Healthcare costs in the United States remain a major concern for patients and policymakers alike. Many Americans face unexpected bills after hospital visits, often without clear information about prices beforehand. Since January 2025, several bills have recently been introduced in Congress aiming to improve transparency in hospital pricing and billing. This article summarizes five key pieces of legislation designed to make healthcare costs clearer and more predictable for pat

A May 2026 proposed rule titled Excepted Fertility Benefits introduces a new category of limited excepted benefits under the Affordable Care Act (ACA). This rule aims to establish certain fertility benefits as separate from traditional group health plans, potentially improving the ability of employers to provide group health plan participants with access to, and the ability to better manage fertility-related care. What Are Excepted Benefits under the ACA? The ACA imposes cert

The Affordable Care Act's (ACA) nondiscrimination rule, known as Section 1557, has been one of the most important legal frameworks affecting access to healthcare for transgender individuals. Over the last decade, however, the meaning and enforcement of Section 1557 - especially as it relates to gender identity and gender-affirming care - have shifted repeatedly through rule-making, court decisions, and agency guidance. For employers, health plan sponsors, providers, and patie

Retirement plans have traditionally focused on stocks, bonds, and mutual funds. Recently, the Department of Labor (DOL) has introduced new rulemaking that directly impacts how private assets can be included in these plans. This change brings both opportunities and challenges for plan sponsors who want to diversify their offerings. Understanding the DOL’s recent guidance is essential for sponsors to manage risks and meet fiduciary responsibilities. What Are Private Assets in R

Pharmacy Benefit Managers (PBMs) play a crucial role in managing prescription drug benefits for health plans, employers, and government programs. Yet, their complex business practices have often raised concerns about transparency, pricing, and patient access to medications. The 2026 PBM transparency regulations aim to address these issues by requiring PBMs to disclose more detailed information about their operations, pricing, and rebates. This blog post explains what these ne

The Department of Labor (DOL) is setting clear enforcement priorities for 2026 that will impact employers, health plans, and employee benefit programs across the United States. These priorities focus on key areas such as the No Surprises Act, mental health parity rules, cybersecurity, and the timely remittance of ERISA employee contributions. Understanding these priorities helps organizations prepare for compliance and avoid costly penalties. Source: landline.media No Surpris