A recent excellent New York Times article explains how a change in law first effective in 2022 has quickly come to be used by out-of-network providers to obtain significant overpayments for routine medical procedures. Not stated in the article is the impact on self-funded group health plans and the sponsors of those plans. Specifically, the
The Departments of Labor, Health and Human Services, and the Treasury (the “Departments”) recently released their 2025 Report to Congress on enforcement activity under the Mental Health Parity and Addiction Equity Act (“MHPAEA”).
MHPAEA is a federal law that generally requires group health plans and health insurance issuers that provide mental health or substance
The Department of Labor’s Employee Benefits Security Administration (EBSA) does not frequently issue Field Assistance Bulletins (FABs); in fact, in the last decade, there have only been ten FABs issued. Furthermore, EBSA rarely uses them to articulate an overarching enforcement philosophy. The usual offering is guidance on notice requirements and announcements of EBSA’s temporary enforcement
On March 30, the Department of Labor (“DOL”) issued its long-anticipated proposed regulation, “Fiduciary Duties in Selecting Designated Investment Alternatives”, that is intended to address the dual aims of (i) expanding 401(k) designated investment alternatives (“DIAs”) to funds that include alternative assets and (ii) limiting litigation risk. The impetus for the proposed regulation