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No More Surprise Medical Bills: Fifth Circuit Affirms Vacatur of Arbitration Provisions of Surprise Billing Rules (TMA II)

On August 2, health care providers scored yet another significant victory when the US Court of Appeals for the Fifth Circuit affirmed the vacatur of various federal regulations regarding the arbitration procedures used to...more

Court Holds NC State Health Plan Constitutes “Health Program or Activity,” Granting Summary Judgment for Transgender Plaintiffs...

On December 5, 2022, the US District Court for the Middle District of North Carolina held that the North Carolina State Health Plan (NCSHP) constitutes a “Health Program or Activity” under the Affordable Care Act (ACA). In so...more

Supreme Court Holds Benefit Plan Limiting Dialysis Reimbursement Does Not Run Afoul of Medicare Secondary Payer Act

On June 21, 2022, the Supreme Court concluded, in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., No. 20-1641, 2022 WL 2203328 (U.S. June 21, 2022), that the terms of a benefit plan limiting...more

As It Mulls Whether To Grant Cert in ERISA Case on PBM Fiduciary Liability, Supreme Court Seeks Government's Input

In December, the Supreme Court requested that U.S. Solicitor General Elizabeth Prelogar file a brief in John Doe 1 v. Express Scripts Inc., weighing in on whether the Court should hear a case about prescription drug costs. If...more

Supreme Court Unanimously Vacates Seventh Circuit ERISA Investment Fees Case

With nearly 150 similar class action lawsuits pending nationwide, the ruling is a win for the ERISA plaintiff's bar, potentially supporting their expansive view of plan fiduciaries' duty to monitor investments. As...more

Supreme Court Set To Rule This Spring on ERISA Investment Fees, Affecting Over 150 Cases Around the Country

The U.S. Supreme Court heard oral argument to decide a circuit split and determine what ERISA requires of ERISA-governed pension plan fiduciaries with respect to investment fees and recordkeeping. A decision is expected in...more

Supreme Court Holds Arkansas Statute Regulating PBMs Not Preempted By ERISA

States seeking to regulate pharmacy benefit managers (PBMs) and prescription drug pricing received a win from the Supreme Court, which reversed an Eighth Circuit decision that had invalidated an Arkansas law governing...more

Eighth Circuit: A State Statute that Implicitly Regulates ERISA Plans Is Preempted by ERISA

Last month, in Pharmaceutical Care Management Association v. Tufte et al. No. 18-2926 (8th Cir. August 7, 2020), the United States Court of Appeals for the Eighth Circuit invalidated legislation in North Dakota on the grounds...more

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