Employee Benefits Archives - EMPLOYEE BENEFITS BLOG

Trump Administration Takes Steps to Enhance Healthcare Price Transparency

by Jeffrey Davis and Leigh Feldman | Jun 5, 2025 | Employee Benefits, Health and Welfare Plans

In May, the Trump administration issued guidance and requests for information (RFIs) to enhance healthcare price transparency, focusing on both hospitals and health plans. For hospitals, the guidance reiterates the need to provide actual dollar amounts for payer-specific negotiated charges in machine-readable files (MRFs) rather than percentages, and it seeks input on improving the accuracy and completeness of MRF data. For health plans, the RFI addresses concerns about file size and data integrity, and it explores the implementation of net prices for covered prescription drugs, indicating that the administration plans to issue revised schemas and may pursue further transparency rulemaking.

Read more here.

One Big Beautiful Bill Act Has Compensation & Benefits Impacts for Nonprofit Health Systems

by Travis Jackson, Robert C. Louthian, III and Kristen O'Brien | Jun 3, 2025 | Employee Benefits, Executive Compensation, Health and Welfare Plans

The US House of Representatives passed its One Big Beautiful Bill Act on May 22, 2025 (the Act), but nonprofit health systems may not find much about the Act that’s attractive. If passed by the US Senate and signed into law, the Act would threaten already thin operating margins at nonprofit hospitals and health systems by expanding the executive compensation excise tax, taxing parking, and similar employee benefits.

Read more here.

“Big, Beautiful Bill”: Federal Tax Bill Would Restrict the Employee Retention Credit

by Shawn O’Brien, Samuel Hamer and Michael Scarduzio | May 27, 2025 | Employee Benefits, Fiduciary and Investment Issues

A new federal tax bill under consideration in the US House of Representatives proposes major changes to the Employee Retention Credit (ERC), including disallowing claims made after January 31, 2024 – even if they were filed before the official deadlines in April 2024 and 2025. It would also extend the Internal Revenue Service’s statute of limitations for assessing ERC-related amounts to six years, raising uncertainty for taxpayers with pending or previously approved claims.

Read more here.

Enforcement of Mental Health Parity Regulations Suspended: Takeaways for Plan Sponsors and Health Insurance Issuers

by Alden Bianchi, Jacob Mattinson and Sarah Raaii | May 22, 2025 | Employee Benefits, Mental Health Parity and Addiction Equity Act

Enforcement of the 2024 final regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) has been suspended due to litigation by The ERISA Industry Committee. In response, the US Departments of Labor, Health and Human Services, and Treasury announced that they will not enforce the new rule until the case is resolved, plus an additional 18 months.

The suspension provides temporary relief from several burdensome requirements in the 2024 Final Rule, such as the “relevant data requirements” (which generally required parity in outcomes), the controversial “meaningful benefit” test, and fiduciary certification mandates. However, plan sponsors must still comply with MHPAEA’s core obligations and the requirements of the Consolidated Appropriations Act, 2021, including the written nonquantitative treatment limitation comparative analysis.

Learn more here.

New EO Targets Prescription Drug Costs – and Drug Manufacturers, Hospitals, and Health Centers

by Emily J. Cook, Michael Ryan and Sydney Merritt Martinez | May 15, 2025 | Employee Benefits, Health and Welfare Plans

On April 15, 2025, President Trump signed an executive order (EO) aimed at addressing the cost of prescription drugs. This EO, titled “Lowering Drug Prices by Once Again Putting Americans First,” outlines specific directives designed to reduce drug prices and improve access for US patients. Of particular note for sponsors and providers of employer health plans, the EO tasks the US secretary of labor with proposing regulations to improve employer health plan fiduciary transparency into direct and indirect compensation received by pharmacy benefit managers.

Read more here.

IRS Announces 2026 Limits for Health Savings Accounts, High-Deductible Health Plans, and Excepted Benefit HRAs

by Jacob Mattinson and Sarah Raaii | May 6, 2025 | Employee Benefits, Health and Welfare Plans

The Internal Revenue Service recently announced cost-of-living adjustments to the applicable dollar limits for health savings accounts, high-deductible health plans, and excepted benefit health reimbursement arrangements for 2026. All of the dollar limits currently in effect for 2025 will change for 2026, with the exception of one limit.

Read more here.

The Employee Retention Credit: IRS’s “Risking” Model Faces Legal Challenge

by Shawn O’Brien, Samuel Hamer and Michael Scarduzio | Apr 30, 2025 | Employee Benefits

In April 2025, the US District Court for the District of Arizona rejected a motion for a preliminary injunction filed by two tax preparation companies. These firms aimed to stop the Internal Revenue Service from using an automated “risk assessment model” to evaluate and reject Employee Retention Credit (ERC) claims, seeking to reinstate individualized reviews of ERC claims.

Read more here.

PBMs Score a Win in Federal Court Against State Regulation

by Alden Bianchi and Sarah Raaii | Apr 25, 2025 | Employee Benefits, Health and Welfare Plans

A recent federal court decision in McKee Foods Corp. v. BFP Inc. declared that Tennessee’s “any willing pharmacy” requirement was preempted by the federal Employee Retirement Income Security Act of 1974. This decision impacts self-funded group health plans, potentially allowing them to comply with a single set of rules nationwide rather than navigating conflicting state laws.

Read more here.

Senate Committee Advances Bills to Tackle High Drug Prices, Enhance Market Competition

by Christopher M. Bruno | Apr 18, 2025 | Employee Benefits, Health and Welfare Plans

The US Senate Judiciary Committee has advanced six bills aimed at reducing pharmaceutical prices and improving market competitiveness. These bills address various issues, including limiting the number of patents a biologics license holder can assert in litigation, clarifying the boundaries of permissible settlements in “pay for delay” agreements, and preventing “product hopping” by branded drug manufacturers. Additionally, the bills seek to curb abuses of the US Food and Drug Administration’s citizen petition process, improve interagency coordination on patent information, and mandate the Federal Trade Commission publish a report analyzing pharmaceutical benefit manager pricing practices and the pharmaceutical supply chain.

Read more here.

The Employee Retention Credit: How to Litigate and Resolve Claims

by Shawn O’Brien, Samuel Hamer and Michael Scarduzio | Apr 10, 2025 | Employee Benefits, Employment

The Employee Retention Credit (ERC), introduced under the Coronavirus Aid, Relief, and Economic Security Act in March 2020, was designed to help employers retain employees during the COVID-19 pandemic by offering a refundable tax credit against certain employment taxes. However, the processing and payment of ERC claims have faced significant delays, with many claims remaining unprocessed or disallowed by the Internal Revenue Service (IRS).

In this Bloomberg Tax article, Shawn O’Brien, Samuel Hamer, and Michael Scarduzio summarize each ERC stage and outline a taxpayer’s path to payment by stage.

Access the article.

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