Groom Law Group, Chartered

The Trump Administration Implements Aggressive Medicare Advantage Plan Audits

On May 21, 2025, the Centers for Medicare & Medicaid Services (“CMS”) announced its intent “to crush[] fraud, waste, and abuse across all federal healthcare programs” through aggressive audits of Medicare Advantage (“MA”) plans…more

6/12/2025 / Administrative Law, Health, Science, Computers, & Technology

Modernization of DC Plan Investments

There is a growing interest from the retirement industry and policymakers to modernize 401(k) and other defined contribution (“DC”) plan investments by incorporating alternative asset classes and lifetime income features. …more

6/10/2025 / Administrative Law, Labor & Employment Law, Finance & Banking

This Week From the Hill (June 8 – 14, 2025)

Each week while Congress is in session, our Policy team delivers a key update to highlight a topical benefits, health, or retirement news item from the Hill, such as a newly introduced bill, a summary of a committee hearing, or…more

6/10/2025 / Elections & Politics, Health, Taxation

Departments Pause Enforcement of MHPAEA Final Rule and Reconsider MHPAEA Enforcement Program

In a widely anticipated and welcome move, the Departments of Health and Human Services (“HHS”), the Treasury, and Labor (“DOL”) (collectively, the “Departments”), sought an abeyance of a lawsuit challenging the Mental Health…more

5/29/2025 / Administrative Law, Health, Labor & Employment Law

District Court Dismisses Weight Loss Drug Discrimination Suits

The U.S. District Court for the District of Maine recently dismissed two separate suits alleging that health plans’ coverage exclusion for weight loss drugs constitutes unlawful disability discrimination. Both complaints…more

5/14/2025 / Civil Rights, Health, Insurance

CMS Finalizes Annual Medicare Advantage and Part D Rulemaking Updates

In April 2025, the Centers for Medicare and Medicaid Services (“CMS”) issued multiple pieces of guidance related to Medicare Advantage plans and Medicare Part D prescription drug coverage, including the Final CY 2026 Part D…more

5/9/2025 / Administrative Law, Health

The Trump Administration Explores Deregulation of Medicare

On April 11, 2025, the Centers for Medicare & Medicaid Services (“CMS”) published a Request for Information (“RFI”) requesting the public provide feedback on how to streamline regulations and reduce administrative burdens on…more

5/8/2025 / Administrative Law, Health

CMS Finalizes Updates to the Prescription Creditable Coverage Methodology Determination

In April 2025, the Centers for Medicare and Medicaid Services (“CMS”) issued multiple pieces of guidance related to Medicare Part D prescription drug coverage, including the Final CY 2026 Part D Redesign Program Instructions…more

5/8/2025 / Administrative Law, Health

This Week From the Hill (May 4 – 10, 2025)

Each week while Congress is in session, our Policy team delivers a key update to highlight a topical benefits, health, or retirement news item from the Hill, such as a newly introduced bill, a summary of a committee hearing, or…more

5/6/2025 / Health, Labor & Employment Law, Taxation

Cunningham v. Cornell: Supreme Court Lowers Bar for ERISA 406(a) Claims

On April 17, 2025, the Supreme Court ruled in Cunningham v. Cornell University that, to state a claim under ERISA section 406(a), plaintiffs need only allege the elements contained in section 406(a). Prior to the Supreme Court’s…more

4/24/2025 / Civil Procedure, Labor & Employment Law

One Court Permits Tobacco Premium Surcharge Claims to Proceed Beyond the Pleading Stage, While Dispositive Motions Remain Pending in More Than a Dozen Cases

In fall 2024, plaintiffs filed a wave of putative class action lawsuits against employers challenging wellness programs that impose a health coverage premium surcharge on participants if they do use tobacco or do not complete a…more

4/24/2025 / Civil Procedure, Health, Labor & Employment Law

DOL Issues SECURE 2.0 Annual Funding Notice Guidance, Including Updated Model Notices

On April 3, 2025, the Department of Labor (“DOL”) issued Field Assistance Bulletin 2025-02 (the “Bulletin”), which provides guidance related to certain modifications made by the SECURE 2.0 Act of 2022 (“SECURE 2.0”) to the…more

4/8/2025 / Administrative Law, Finance & Banking, Labor & Employment Law

This Week From the Hill (April 6 – 12, 2025)

Each week while Congress is in session, our Policy team delivers a key update to highlight a topical benefits, health, or retirement news item from the Hill, such as a newly introduced bill, a summary of a committee hearing, or…more

4/8/2025 / Elections & Politics, Taxation

This Week From the Hill (March 30 – April 5, 2025)

Each week while Congress is in session, our Policy team delivers a key update to highlight a topical benefits, health, or retirement news item from the Hill, such as a newly introduced bill, a summary of a committee hearing, or…more

4/2/2025 / Elections & Politics, Finance & Banking, Taxation

Plaintiffs Double Down on Challenges to PBM Arrangements in Class Action Lawsuits Involving Johnson & Johnson and JPMorganChase

On March 10, 2024, the plaintiffs filed an amended complaint in a much-followed putative class action lawsuit against Johnson & Johnson (“J&J”) alleging that the plan fiduciaries for J&J’s group health plan violated ERISA by…more

3/25/2025 / Civil Procedure, Health, Labor & Employment Law

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