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June 19, 2026Health & Welfare

The Daily Brief for Benefits Professionals

BenefitsWire

Health & Welfare Plans

June 19, 2026

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18 items · ~4 min read

In this issue

Expert Analysis (12)  ·  Regulatory Action and Guidance (5)  ·  ERISA Litigation (1)

Expert Analysis

12 items
Episode 39: Let’s Talk Compliance: Not All wRVU’s are Created Equal (Part 2)

“In this episode, Jana Kolarik, a partner in Foley’s Health Care Practice Group, and Angie Caldwell, principal and CFO of PYA, continue their discussion on the importance of work relative value units (wRVUs) and fair market value (FMV) under the Stark Law and what this can mean for how health care organizations pay their physicians.” MORE >>

Source: Foley & Lardner

What Plan Sponsors Need to Know About the Federal Independent Dispute Resolution (IDR) Operations Final Rules – Five Takeaways

“By Allison B. Bans On May 28, 2026, the federal government issued Final Rules and a Fact Sheet that change how payment disputes between health plans and out-of-network providers are handled under the No Surprises Act’s (“NSA”) binding arbitration system.” MORE >>

Source: swlaw.com

Developing NSA IDR Overhaul: What Stakeholders Need To Know

“On May 28, 2026, the US Departments of Health and Human Services, Labor, and the Treasury, along with the Office of Personnel Management (collectively, the Departments), released a final rule addressing operational aspects of the federal No Surprises Act (NSA) independent dispute resolution (IDR) process.” MORE >>

Source: mondaq.com

Mental Health Parity Enforcement 2026: State Regulations & Fines

“Regulation Substance Use Disorder Treatment and Behavioral Health Integration Have a New Regulatory Architecture in 2026. The Open Question Is Whether the Financing Will Survive Long Enough to Use It.” MORE >>

Source: acuity.news

Does Your Population Need a Large Behavioral Health Network? | Segal

“Articles | June 18, 2026 By Sarah Gunderson Access to affordable and reliable mental healthcare remains a critical challenge. Nearly 40 percent of Americans live in areas without enough mental health professionals to meet demand for care.” MORE >>

Source: Segal

Texas Judge Suggests Non-Lawyer AI ‘Chats’ May Be Protected Attorney Work Product

“Quick Hits On June 3, 2026, Judge Grant Dorfman for the Texas Business Court Eleventh Division issued a minute entry in Tate Group Automotive, LLC v.” MORE >>

Source: Ogletree Deakins

New PBM Disclosure Rules—DOL Proposal Meets CAA 2026

“Alert / ERISA June 11, 2026 Two federal actions—the DOL’s proposed pharmacy benefit management rule and the Consolidated Appropriations Act 2026—would expand PBM pricing and compensation transparency, and strengthen audit rights.” MORE >>

Source: nixonpeabody.com

Rounding May Face More Scrutiny as Technology Improves

“In the News Robert Pritchard says a U.S. Department of Labor (DOL) wage and hour opinion letter emphasizes that “timekeeping practices that used to be commonplace — such as rounding — will face increasing scrutiny as technology enables increasingly precise time tracking.” MORE >>

Source: Littler

Michaela Taylor Sheppard

“Michaela has a vast background in health services, health care, and health law.” MORE >>

Source: Bricker Graydon

Proxy Voting Under ERISA: DOL Guidance Signals Greater Oversight—and Risk

“The US Department of Labor’s Employee Benefits Security Administration (EBSA) has issued a technical release providing targeted guidance on when proxy advisory firms could be viewed as acting as Employee Retirement Income Security Act of 1974 (ERISA) fiduciaries and how ERISA preemption is viewed by the Department in relation to certain state disclosure laws that pertain to proxy voting.” MORE >>

Source: morganlewis.com

Out-of-Pocket Costs for Long-Acting Reversible Contraception Among Individuals Enrolled in Employer Sponsored Insurance Plans

“Despite the Affordable Care Act (ACA) requiring contraceptives to be covered without cost-sharing, many privately insured long-acting reversible contraceptives (LARC) users still face out-of-pocket expenses.” MORE >>

Source: KFF

Developing Groom’s Excellence Recognized in Chambers USA 2026

“In the 2026 Chambers & Partners USA Guide, Groom Law Group (“Groom”) is again recognized as a national leader, with rankings in Employee Benefits & Executive Compensation, ERISA Litigation, and Healthcare.” MORE >>

Source: Groom Law Group

Regulatory Action and Guidance

5 items
Group Health Plans Face Added Duties, Tighter Requirements Under Newly Finalized Federal No Surprises Act IDR Operations Rule

“Group health plans, their employer or union plan sponsors, and fiduciaries update their processes for handling out-of-network provider charge disputes in response to the CMS, Federal Independent Dispute Resolution Operations; Final Rules (CMS-9897-F, full text PDF) released on May 28, 2026 to implement the No Surprises Act (“NSA”).” MORE >>

Source: slphrbenefitsupdate.com

Medicare Program; Strengthening Oversight of Accrediting Organizations (AOs) and Preventing AO Conflicts of Interest, and Related Provisions

“This site displays a prototype of a “Web 2.0” version of the daily Federal Register. It is not an official legal edition of the Federal Register, and does not replace the official print version or the official electronic version on GPO’s govinfo.” MORE >>

Source: Federal Register

DOL Signals Continued MHPAEA Enforcement Amid Rulemaking Reset

“The DOL has issued new guidance outlining the EBSA’s enforcement priorities, alongside the 2025 MHPAEA report to Congress, which was jointly filed by DOL, the Department of Health and Human Services, and the Department of the Treasury (collectively, the “Departments”).” MORE >>

Source: agg.com

Time to Assess “Foreign Private Issuer” Status – 2026

“Articles + Publications June 17, 2026 Thomas M. Rose Nicole A. Edmonds Shona Smith Alexander T. Yarbrough Taylor M. Williams Jason L. Langford It is time to assess “foreign private issuer” status.” MORE >>

Source: Troutman Pepper Locke

Federal Regulators Start to Gather Detailed PBM Pay Information

“Congress put two sets of PBM rules in the Consolidated Appropriations Act, 2026 package. One affects self-insured employer plans. CMS is starting by implementing the other set of PBM rules, which affects Medicare drug plans.” MORE >>

Source: benefitspro.com

ERISA Litigation

1 item
PCMA sues to exempt PBMs from Illinois drug law

“Illinois’ law, called the Prescription Drug Affordability Act, clashes with ERISA, the PBM lobby argued in a complaint filed Tuesday.” MORE >>

Source: Healthcare Dive

Also of Note

BenefitsWire · A digest for ERISA attorneys, third-party administrators, actuaries, recordkeepers, and benefits consultants.
An informational digest, not legal advice.
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