Industry News

On February 3, 2026, Congress passed, and the President signed the Consolidated Appropriations Act, 2026 (CAA 26), which requires compensation transparency from not only Pharmacy Benefit Managers (PBMs) but from all service providers to group health plans, including third-party administrators (TPAs). These service providers must disclose all direct and indirect compensation they receive in connection with the plan — and it appears that this requirement is effective immediatel

On February 13, 2026, the Department of Health and Human Services (HHS) released a new model Notice of Privacy Practices (NPP) that incorporates new requirements for protecting substance use disorder (SUD) records. The new model notice is available for download from HHS’ website. Covered entities, including health plans that may receive SUD treatment information, were required to update NPPs by February 16 to comply with the requirement.

The Department of Labor (DOL) proposed regulations which would require mandatory fee disclosure by Pharmacy Benefit Managers (PBMs) and their affiliated brokers/consultants to fiduciaries of self-insured ERISA group health plans. A summary of the proposed rule and potential changes can be viewed at the link below.

The Centers for Medicare & Medicaid Services (CMS) issued final guidance on April 7, 2025 with an implementation date of January 1, 2026 on the creditable coverage determination method.

The Mental Health Parity and Addition Equity Act (MHPAEA) rules released on September 9, 2024, by the Departments of Health and Human...

The Consolidated Appropriations Act of 2021 (CAA) prohibits gag clauses in healthcare contracts and requires group health plans and...

The proposed rule makes clear that the use of any interest rate between PBGC rates and funding rates (including a “blended rate”) is a valid

On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (ARPA) into law. The key provisions for multiemployer pensio