Compliance Stuff

The US Departments of Treasury, Labor, and Health and Human Services have issued a sweeping final rule ( CMS -9897-F) implementing significant changes to the Federal Independent Dispute Resolution ( IDR ) process established under the No Surprises Act ( NSA ). This final rule has been long awaited by stakeholders, as changes were proposed by the Departments back in late 2023. It requires health insurers and plans (payers) to provide additional information on initial explanations of benefits (EOBs), reduces administrative fees to $15 per party per dispute, expands batching requirements, and implements substantial procedural reforms to the open negotiation and IDR initiation processes. These changes represent the most comprehensive revisions to the federal IDR process since its inception in 2022. The rule itself will become effective 60 days after it is published in the Federal Register, but some of its provisions will be implemented later. As background, US Congress passed the NSA to ...

Just days before the first compliance deadline (April 24, 2026) for the U.S. Department of Justice’s (DOJ) final regulation on website accessibility for state and local governments, the department has extended that deadline by one year, as well as the companion deadline for smaller governmental entities. 0:00 4:35 Quick Hits The DOJ extended the deadline for compliance with the rules on website accessibility for most state and local governments from April 24, 2026, to April 27, 2027 . HHS has not yet acted to provide an additional extension on its website compliance regulation for “recipients” subject to the Rehabilitation Act, but may yet extend that May 2026 deadline. The additional year also lengthens the implied “grace period” that state and local government websites had to conform to the website accessibility rule. In an  interim final rule  published on April 20, 2026, in the  Federal Register , the DOJ justified this deadline based on the significant burdens associ...

2025 has been a landmark year for False Claims Act (FCA) enforcement, marked by record-breaking settlements, evolving legal theories, and a broadening scope of government priorities. The FCA remains one of the federal government’s most potent tools for combating fraud, with billions recovered annually and an ever-expanding reach into new sectors and compliance areas . This roundup synthesizes the year’s most significant developments—drawing on recent case law and shifting enforcement priorities—and provides actionable insights for businesses navigating the FCA landscape. Case Law Update: Constitutional Challenges and Qui Tam Relators In 2025, the constitutionality of the FCA’s qui tam provisions—which empower private litigants (relators) to prosecute fraud claims on the government’s behalf—continued to emerge as a focal point of judicial debate . Historically, federal courts, including the U.S. Court of Appeals for the Fifth, Sixth, Ninth, and Tenth Circuits, have rejected arguments ch...

Nevada will soon impose new limits on fees health care providers can charge employees for completing paperwork required under the federal Family and Medical Leave Act (FMLA) .  Assembly Bill 305 , which was recently approved by the Governor and set to take effect on January 1, 2026, caps that fee at $30 and ties future increases to inflation. Although this new law will apply directly to providers, HR professionals who routinely guide employees through the FMLA process should be aware of the changes this law will bring about. This Insight explains how the law works, what’s changing, and how the fee cap may affect your FMLA administrative process. What Does AB 305 Actually Do? When an employee requests a potentially FMLA-qualifying leave, employers are permitted to require the employee to submit a medical certification in support of the need for leave. This often involves a licensed health care provider completing the certification with information concerning the condition and the e...

  The federal government may continue to enforce the Affordable Care Act’s preventive-care mandates, thanks to the Supreme Court’s recent decision in   Kennedy v. Braidwood Management . In a 6-3 bipartisan opinion written by Justice Brett Kavanaugh, SCOTUS rejected constitutional challenges brought by a Texas business and others to the structure of a federal health task force that, as SCOTUS put it, issues “preventive-service recommendations of critical importance to patients, doctors, insurers, employers, healthcare organizations, and the American people more broadly.”   But could the Court’s rationale make the coverage rules more susceptible to political influence? Here’s what employers and plan sponsors need to know about the June 27 decision and how it could impact group health plans. The ACA’s Preventive-Care Mandates and the U.S. Preventive Services Task Force ACA Requirements.  The Affordable Care Act (ACA) requires most group health plans to cover certain...