Weekly Health Compliance Briefing

February 18, 2026

Note to Subscribers

 

The Weekly Health Compliance Briefing will not be published on February 25, 2026. Look for your next Weekly Health Compliance Briefing on Wednesday, March 4, 2026.

Health Notes

 

HIPAA Part 2 Model Notice Released
As a reminder, HIPAA covered entities creating, receiving, maintaining, or transmitting Part 2 records are required to update their Notice of Privacy Practices (NPP) by February 16, 2026. On February 13, 2026, the Office for Civil Rights updated the webpage Understanding Confidentiality of Substance Use Disorder (SUD) Patient Records or “Part 2” to provide in part the following

1. Updated Model HIPAA NPP for HIPAA covered entities;
2. Model Part 2 Patient Notice for Part 2 programs;
3. Online portal to file a Part 2 complaint if a person believes that an individual or an organization shared SUD patient records in noncompliance with Part 2; and
4. Guidance for Part 2 programs regarding reporting breaches of unsecured Part 2 records (similar to how HIPAA breaches are reported).

DOL Issues Updated Model Employer CHIP Notice
The U.S. Department of Labor (DOL), through the Employee Benefits Security Administration (EBSA), has released a new model Employer Children’s Health Insurance Plan (CHIP) Notice with information current as of January 31, 2026. As a reminder, the CHIP Reauthorization Act of 2009 (CHIPRA) imposes an annual notice requirement on employers that maintain group health plans in states that provide premium assistance subsidies under a Medicaid plan or CHIP. An employer can choose to provide the notice on its own or along with: (i) materials notifying the employee of health plan eligibility; (ii) materials provided to the employee in connection with an open enrollment process conducted under the plan; or (iii) the summary plan description. An employer is subject to this annual notice requirement if its group health plan covers participants who reside in a state that provides a premium assistance subsidy, regardless of the employer’s location. The DOL’s model notice, which employers may use for this disclosure, is updated periodically to reflect changes in the states that offer premium assistance subsidies. The DOL’s model Employer CHIP Notice now includes information current as of January 31, 2026. The EBSA’s CHIPRA webpage includes the latest model notice (English language and Spanish language versions are available), a Fact Sheet, a compliance assistance guide, and other publications for employers.

NMHPA Inapplicable to Newborn Child Absent Timely Plan Enrollment
In the case of Townley v. Aetna Life Ins. Co., 2025 WL 3771448 (S.D. Tex. 2025), after a group health plan participant gave birth by cesarean section, her newborn required immediate medical care and incurred approximately $7,000 in expenses. The plan participant submitted claims for reimbursement, but the insurer denied them, explaining that the newborn had not been enrolled within the plan’s required enrollment window. After exhausting internal appeals, the participant sued the insurer under ERISA and the Newborns’ and Mothers’ Health Protection Act (NMHPA), arguing that her child was entitled to automatic coverage for the first 31 days after birth. The insurer asked the court to dismiss the case, asserting that it had interpreted the plan’s enrollment provisions correctly and that NMHPA was inapplicable because the child was not a covered individual. The court agreed with the insurer that neither the plan documents nor NMHPA supported the participant’s claims. The plan clearly required enrollment of a newborn within 31 days of birth for coverage to be effective retroactively to the date of birth, and the participant provided no evidence of such enrollment. The court further rejected the participant’s argument that NMHPA requires automatic coverage for newborns, explaining that the statute only prohibits plans from limiting the length of hospital stays for mothers and covered newborns below the statutory minimums (e.g., 96 hours following a cesarean section). The statute does not require coverage for individuals who are not otherwise covered under the plan. The court therefore dismissed the case, holding that the insurer’s claim denial was neither arbitrary nor capricious. This case is a reminder of the importance of clear communications regarding dependent eligibility and enrollment procedures, as well as the limits of statutory mandates like NMHPA. Plan sponsors should ensure that plan documents and summary plan descriptions clearly communicate the need for timely dependent enrollment after birth.

Aon Publications

 

Proposed PBM Transparency Regulations Issued
On January 30, 2026, the Department of Labor issued proposed regulations requiring “covered service providers” including pharmacy benefit managers (PBMs) to disclose comprehensive information related to compensation they receive to fiduciaries of self-insured health plans to ensure that the contracts with and compensation to those service providers are reasonable under ERISA. Disclosures are required in advance of the date the contract with the covered service provider is entered into, semi-annually, and upon request of the plan sponsor and are subject to audit rights by plan fiduciaries.

If finalized, the regulations would become effective 60 days after they are issued, with an applicability date for plan years beginning on or after July 1, 2026 (i.e., January 1, 2027, for calendar year plans). Many of the provisions in the proposed regulation are similar to the provisions in the legislation passed by Congress earlier this year (Consolidated Appropriations Act (CAA), 2026) but differ in various respects. The final regulations will likely look to harmonize those varying provisions.

The Aon bulletin is available here.

Congress Expands Compensation Disclosure Requirements for Service Providers of Group Health Plans
CAA, 2026, expands the compensation disclosure requirements under ERISA to require ERISA-covered group health plans to receive compensation disclosures from nearly all of their plan vendors (and beyond only brokers and consultants, as previously required under CAA, 2021). The provision appears to be effective immediately and is likely applicable to contracts entered into or renewed between a plan and a service provider after the date of enactment (i.e., after February 3, 2026).

Employers who are in the process of selecting a new service provider for their group health plan, including renewing, or extending the contract of an existing provider, should review the requirements and request the appropriate compensation disclosures from service providers.

The Aon bulletin is available here.